Kaylan F. v. Kijakazi

Background

Kaylan F. sought review under 42 U.S.C. § 405(g) of the Commissioner of Social Security’s final decision denying her application for Supplemental Security Income. She alleged disability beginning October 4, 2019. After the Social Security Administration denied the application initially and on reconsideration, an administrative law judge held a hearing at which Kaylan F., her mother, a medical expert, and a vocational expert testified. Kaylan F. was represented by counsel.

The administrative law judge found that Kaylan F. had severe obsessive-compulsive disorder, generalized anxiety disorder, and autism spectrum disorder, and non-severe gastroesophageal reflux disease. The judge found mild, moderate, and marked limitations in different areas of mental functioning, but determined that no impairment or combination of impairments met the Social Security regulations’ listed impairments. The judge then found that Kaylan F. had the residual functional capacity—the most she could still do despite her impairments—to perform work at all exertional levels with specified safety, workplace-change, interaction, decision-making, and pace restrictions. Relying on vocational-expert testimony, the judge identified hand packager, stores laborer, and machine packager as representative jobs and found Kaylan F. not disabled.

Issues and analysis

Kaylan F. challenged four parts of the administrative law judge’s decision: the finding of only a moderate limitation in concentration, persistence, and maintaining pace; the finding of only a moderate limitation in adapting and managing herself; the finding that the medical expert’s testimony was partially persuasive; and the conclusion that her conditions were treatable despite her argument that her mental disorders created barriers to treatment.

The court found that the record was not sufficiently developed regarding concentration, persistence, and pace. The administrative law judge relied on medical evaluations and Kaylan F.’s reported activities, but the court identified conflicting evidence, including statements that her obsessive-compulsive checklist and behaviors could interfere with gainful activity. More importantly, the medical expert acknowledged that he did not have a good understanding of the severity, duration, and effects of behaviors such as showering and handwashing. The court held that substantial evidence did not support treating that testimony as partially persuasive because the expert’s opinion was based on an inadequately developed record.

The court held that substantial evidence supported the administrative law judge’s finding of no more than moderate limitations in adapting and managing herself. The court nevertheless directed the Commissioner, after developing the record about the characteristics and effects of Kaylan F.’s hygiene-related compulsions, to reconsider that finding as well as the findings about concentration, persistence, and pace.

The court also found legal error in the treatment analysis. Listing 12.00 of the Social Security regulations requires consideration of whether inconsistent treatment or failure to follow treatment results from the claimant’s mental disorder. If it does, the regulation says that the inconsistency cannot be used as evidence that the claimant lacked ongoing medical treatment. The court held that the administrative law judge did not make this required determination before relying, at least in part, on Kaylan F.’s failure to pursue treatment. The court therefore remanded for a determination of whether treatment inconsistency and noncompliance were features of her mental disorders.

Disposition

The court granted in part and denied in part Kaylan F.’s motion for summary judgment. It also granted in part and denied in part the Commissioner’s motion for summary judgment. The court remanded the matter to the Commissioner under sentence four of 42 U.S.C. § 405(g) for proceedings consistent with the order. The opinion did not award benefits; it required further administrative proceedings.