Kimberly B. v. Berryhill

Background

Kimberly B. sought judicial review under 42 U.S.C. § 405(g) of the Acting Commissioner of Social Security’s final decision denying her applications for disability insurance benefits and supplemental security income. She alleged that osteoarthritis, mood-related disorders, and related impairments prevented her from working. After an earlier administrative law judge decision was remanded by the Appeals Council, the same administrative law judge held a second hearing and again found that Kimberly B. was not disabled.

The administrative law judge found severe impairments including bilateral carpal tunnel syndrome, lower-back osteoarthritis, fibromyalgia, major depression, mild sleep apnea, obesity, peripheral neuropathy, posttraumatic stress disorder, and substance use in remission. The judge found that Kimberly B. had the residual functional capacity—the most she could do despite her impairments—to perform light work with numerous restrictions. Those restrictions included limits on bending, kneeling, crouching, crawling, gripping, stairs, exposure to hazards and extreme vibration, walking on uneven surfaces, and social contact. The judge also required a sit-stand option and allowed use of a cane or walker when walking more than 50 feet. The judge concluded that Kimberly B. could perform her past work as a medical assembler.

Kimberly B. challenged the decision on two principal grounds: that the administrative law judge improperly evaluated the intensity, persistence, and limiting effects of her symptoms, and that the judge improperly weighed the medical opinion evidence. She also later argued that the administrative law judge who handled her hearing had not been properly appointed under the Constitution’s Appointments Clause.

Evaluation of Symptoms

The court held that the administrative law judge gave adequate reasons for finding that Kimberly B.’s statements about the severity of her symptoms were not fully consistent with the record. The judge considered medical findings, imaging, treatment, reports of improvement, compliance with recommended treatment, daily activities, medication effectiveness and side effects, work history, and statements made to different providers.

The administrative law judge cited infrequent documentation of trigger points and tender points, generally mild or minimal examination findings, and unremarkable imaging. The judge also considered treatment such as exercise, therapy, braces, medication, injections, and weight loss relatively conservative, and noted reports that treatment improved Kimberly B.’s symptoms. The record also showed activities including caring for grandchildren, preparing quick meals, running errands, shopping, using a computer, paying bills, traveling, and attending appointments through transportation services.

The court rejected Kimberly B.’s arguments that the administrative law judge relied only on objective medical evidence or made a conclusory assessment of her daily activities. The court explained that objective evidence could be considered along with other factors and found that the administrative law judge had described the daily activities in detail. The court also found substantial evidence supporting the findings that Kimberly B.’s statements about walking limitations, injection effectiveness, and the medical necessity of a cane or walker were inconsistent with other evidence.

Medical Opinion Evidence

The court upheld the administrative law judge’s decision to give little weight to the opinions of Dr. Robert Molony, Dr. Nels Langsten, and Dr. Donald Wiger, and to give greater weight to testimony from Dr. Steiner and opinions from non-examining state agency psychological consultants.

Dr. Molony, a rheumatologist, opined that Kimberly B. had major limits on lifting, sitting, standing, walking, reaching, hand and wrist use, resting, and attendance. The court found that the medical record contained some tender-point evidence but did not support the degree of limitation in Dr. Molony’s opinion. The court also noted that the opinion was given on a check-box form with little explanation and little evidentiary value.

Dr. Langsten, a psychiatrist, opined that Kimberly B. was totally disabled and would miss work more than three times each month. The court found that his brief treatment notes, limited clinical findings, other mental-status examinations, Global Assessment of Functioning scores, daily activities, and his own examination of Kimberly B. did not support those limitations. The court agreed that the administrative law judge gave good reasons for assigning little weight to Dr. Langsten’s opinion, including its reliance on subjective complaints and its check-box format.

The court also upheld the limited weight given to Dr. Wiger’s consultative psychological opinion because the examination identified concerns about cooperation and effort and was inconsistent with other evidence. The court found that the administrative law judge could rely on Dr. Steiner’s testimony and the state agency psychologists’ opinions because they were supported by the record and the more restrictive opinions were not adequately supported.

Appointments Clause Argument

Kimberly B. argued that the administrative law judge was not properly appointed under the Constitution’s Appointments Clause and requested a new hearing. She acknowledged that she had not raised this argument before the Social Security Administration. The court held that the argument was waived because it was not timely presented to the agency.

Disposition

Judge Hildy Bowbeer denied Kimberly B.’s motion for summary judgment and granted Commissioner Nancy A. Berryhill’s motion for summary judgment. The order directed that judgment be entered accordingly.