Tiffany E. v. Kijakazi

Background

Tiffany E. sought judicial review under 42 U.S.C. § 405(g) of the Commissioner of Social Security’s final decision denying her application for disability insurance benefits. She had also applied for Supplemental Security Income, but the opinion states that she was not pursuing that claim in this case. Tiffany E. originally alleged an earlier disability-onset date and amended it at the administrative hearing to October 11, 2017. She identified depression, post-traumatic stress disorder, borderline personality disorder, fibromyalgia, back pain, sleep apnea, and external ear problems as the bases for her claim.

An administrative law judge held a hearing at which an attorney represented Tiffany E. and a vocational expert testified. The administrative law judge found severe impairments including obesity, bilateral kneecap cartilage problems, major depressive disorder, bipolar disorder, generalized anxiety disorder, borderline personality disorder, and post-traumatic stress disorder. The judge found that these impairments did not meet or equal a listed impairment.

The administrative law judge determined that Tiffany E. retained the residual functional capacity—the ability to work despite her limitations—to perform medium work with restrictions. Those restrictions included lifting or carrying up to 25 pounds frequently and 50 pounds occasionally; performing short, simple instructions; occasional interaction with coworkers and the public; maintaining attention for routine work in two-hour segments; and responding appropriately to ordinary work pressures and routine changes. The judge found that Tiffany E. could not perform her past relevant work but could perform other jobs, including hand packager, electronic worker, and folder. The judge therefore found her not disabled, and the Appeals Council denied review.

Arguments and Analysis

Tiffany E. raised three challenges. First, she argued that the administrative law judge failed to account for the possibility that her mental-health symptoms varied between better and worse days and failed to consider whether treatment noncompliance was itself a symptom of her mental-health conditions. The court distinguished a prior related proceeding involving more severe documented mental-health problems and evidence connecting noncompliance to mental illness. The court concluded that Tiffany E. had not identified record evidence establishing that her impairments caused the noncompliance and that noncompliance was only one factor supporting the decision. The court also relied on the opinions of state-agency psychologists and other evidence of functioning and treatment.

Second, Tiffany E. argued that the administrative law judge should have given more weight to the opinion of Scott Ressler, Psy.D., who examined her once. The court explained that the governing regulations require consideration of factors such as supportability, consistency, treatment relationship, and specialization, with supportability and consistency being the most important. The court concluded that the administrative law judge considered those factors, including the one-time examination, inconsistencies between Ressler’s conclusions and his examination findings, inconsistencies with other medical observations, and Tiffany E.’s conservative treatment history.

Third, Tiffany E. argued that the administrative law judge failed to apply the factors used to assess a claimant’s reports of pain and fatigue. The court concluded that the decision considered her daily activities and work history, diagnoses, the severity of her conditions, treatment effectiveness, and functional restrictions. The court also found substantial evidence supporting the assessment of her physical limitations, including conservative treatment, inconsistent physical therapy participation, lack of pain-management referral, intact strength and range of motion, and her reported activities.

Ruling

The court held that the Commissioner’s decision was supported by substantial evidence and should be affirmed. It denied Tiffany E.’s motion for summary judgment, granted the Commissioner’s motion for summary judgment, and affirmed the Commissioner’s decision. Judge Dulce J. Foster also ordered that Tiffany E.’s complaint be dismissed with prejudice and that judgment be entered accordingly.