M.M. v. O'Malley

Background

M.M. sued the Commissioner of the Social Security Administration under 42 U.S.C. § 405(g), seeking review of the denial of his application for Social Security Disability Insurance benefits. M.M. had worked as a UPS driver for nearly 30 years. He suffered a heart attack in August 2020 and applied for benefits the following month, reporting that the heart attack and a back injury limited his ability to work.

The agency denied the claim initially and on reconsideration. After a March 2022 hearing, an administrative law judge found that M.M. had several severe medically determinable impairments, including lumbar degenerative disc disease after a fusion, coronary artery disease, and obesity. The judge also identified depression and alcohol use disorder as impairments that were not severe. The judge concluded that M.M. was not disabled beginning August 3, 2020 because he retained the capacity to perform light work, including work as a bus driver. The Appeals Council denied review in June 2023.

Record-development issue

M.M. argued that the administrative law judge should have further developed the record by considering workers’ compensation records. Before the hearing, M.M. submitted about 2,000 pages of records, including workers’ compensation records from 2013 through 2018. The judge declined to admit the submission because it contained duplicates and material that was not medical evidence, but offered M.M. the opportunity to resubmit it after removing duplicates. M.M.’s counsel said that would not be necessary and that testimony would suffice.

The court held that the judge did not fail to develop the record. M.M. did not identify ambiguous evidence, and the medical records already considered addressed his history and treatment for back pain. The court also noted that both the judge and M.M.’s counsel treated the workers’ compensation records as general background that added nothing more to the claim. The additional workers’ compensation records M.M. later submitted as an offer of proof did not establish an error because the duty to develop the record depends on whether the evidence already before the judge was ambiguous or inadequate.

Symptom testimony and work capacity

The court explained that when a claimant presents objective medical evidence of an impairment that could reasonably produce the alleged symptoms, and there is no evidence of intentional exaggeration, an administrative law judge may reject testimony about the severity of those symptoms only by giving specific, clear, and convincing reasons. The judge found that M.M.’s impairments could reasonably cause at least some of his symptoms and did not find evidence of intentional exaggeration.

M.M. testified about insomnia, worsening symptoms, medication-related fogginess and fatigue, swollen knees, burning feet, difficulty sitting and standing, pain in his back, hips, and knees, difficulty concentrating, irritability, and the need to sit or lie down for part of the day. He said he could stand for only 10 to 15 minutes and walk his dog less than a quarter mile.

The court found that the administrative law judge did not give the required specific, clear, and convincing reasons for rejecting this testimony. The decision said only that the medical evidence could not be fully reconciled with, and did not support, the alleged level of limitation. It summarized the medical evidence but did not identify specific conflicts between M.M.’s testimony and medical findings, identify which symptoms or limitations were being rejected, or explain why.

The court also found the reasoning inadequate because the judge concluded that M.M. could perform light work, which includes frequent lifting or carrying of objects weighing up to 10 pounds and a good deal of walking or standing, without adequately explaining why that conclusion was consistent with M.M.’s claimed inability to stand for more than 10 to 15 minutes and his limited walking. The court stated that the residual functional capacity assessment must be based on the claimant’s limitations; it cannot be used to define which symptoms the claimant supposedly has.

Insomnia

M.M. separately argued that the administrative law judge failed to properly consider his insomnia at the second step of the disability analysis and when determining his residual functional capacity. The court held that any error at step two, which screens out weak claims, could not by itself support a remand because the judge found other severe impairments and continued through the remaining steps.

The court nevertheless found it unclear whether the judge fully accepted M.M.’s testimony about insomnia and other symptoms when determining his residual functional capacity. The judge mentioned M.M.’s insomnia and restricted climbing and work at unprotected heights because of fatigue, but did not clearly identify which symptoms or limitations were discounted in finding that M.M. could perform light work. On remand, the agency must address the insomnia and clearly explain which testimony it accepts and which it discounts, giving clear and convincing reasons for any testimony it rejects.

Disposition

The court reversed the Commissioner’s decision and remanded M.M.’s application to the agency for reconsideration of his residual functional capacity in accordance with the order, including proper consideration of M.M.’s subjective symptom testimony.