Jami G. v. O'Malley

Background

Jami G. applied for disability insurance benefits on December 17, 2020. She alleged that she became disabled in July 2020 because of borderline personality disorder, post-traumatic stress disorder, anxiety, depression, attention-deficit hyperactivity disorder, and asthma. Her application was denied initially and on reconsideration.

An administrative law judge (ALJ) held a hearing at which Jami G. testified with an attorney representing her. The ALJ found severe impairments including depressive disorder, substance-use disorder, anxiety disorder, post-traumatic stress disorder, and paranoid disorder. The ALJ found that these impairments did not meet or medically equal a listed impairment. The ALJ determined that Jami G. could perform a full range of work with non-exertional limits, including only occasional interaction with coworkers and the public and the ability to understand, remember, and carry out only simple instructions.

The ALJ found that Jami G. would miss more than two days of work per month because of her substance-use disorder while using drugs or alcohol. As a result, the ALJ found that no jobs were available to her during periods of substance use. Because drug addiction or alcoholism alone cannot establish disability under the Social Security Act, the ALJ also evaluated whether Jami G. would be disabled if she stopped using drugs or alcohol. The ALJ found that she would not miss more than two days of work per month while sober and that jobs existed that she could perform. The ALJ therefore found that she was not disabled. The Appeals Council denied review.

Issues and analysis

Jami G. raised several challenges. She argued that the ALJ insufficiently analyzed paragraph C of the mental-health listings, that the evidence did not support the conclusion that she could work while sober because the record lacked substantial periods of sobriety, and that the ALJ improperly evaluated a Rule 25 assessment. She also asked the court to consider evidence from treatment occurring after the ALJ’s decision.

The court considered the later evidence, which showed that Jami G. entered residential treatment in October 2022 and relapsed on December 19, 2022. The court concluded that the relapse occurred after the period covered by the ALJ’s decision and that the evidence did not create a reasonable probability of a different outcome. The court held that a remand for further agency consideration of that evidence was not required.

The court rejected the paragraph C argument. Those requirements concern serious and persistent mental disorders and include a documented history lasting at least two years, ongoing treatment or a highly structured setting that reduces symptoms, and minimal ability to adapt to changes or demands outside a person’s daily life. The court found that the ALJ had thoroughly discussed the medical records and that substantial evidence supported the ALJ’s determination that Jami G.’s frequent hospital stays, inpatient programs, and jail stays were caused by drug addiction and alcoholism rather than her mental-health conditions.

The court also upheld the ALJ’s evaluation of Jami G.’s residual functional capacity (RFC), meaning her ability to perform work-related activities. The record showed that she maintained sobriety for several months in summer 2020. During that period, providers described her as calm, controlled, and cooperative, with normal speech, attention, and concentration, a neutral mood, and no abnormal perception. The record also showed no hospitalizations or inpatient mental-health treatment during that period. The court further noted that providers often recorded cooperative behavior, normal mood and attention, and intact insight, judgment, and memory even when she was using substances. The court concluded that substantial evidence supported the ALJ’s finding that substance use was material to the disability determination and that Jami G. would not be disabled without substance abuse.

Finally, the court rejected Jami G.’s challenge to the Rule 25 assessment, which Minnesota law requires for people seeking drug- or alcohol-abuse treatment. The ALJ had stated that the assessment was based on self-reporting without objective findings, but also noted that it generally found Jami G. fully functional. The court concluded that the ALJ had not rejected the assessment outright and that the assessment did not support disability without substance abuse.

Disposition

The court ruled that substantial evidence supported the ALJ’s conclusion that Jami G. was not disabled. It ordered that Jami G.’s motion for judgment be DENIED, the Commissioner’s motion for judgment be GRANTED, and the matter be DISMISSED with prejudice. Judgment was ordered to be entered accordingly.