Devi K. v. O'Malley

Background

Devi K. applied for supplemental security income under the Social Security Act, asserting that she was disabled. The administrative record included diagnoses of fibromyalgia, chronic pain syndrome, plantar fasciitis, and lumbar degenerative disc disease. It also included notes that she sometimes appeared to use a cane.

The administrative law judge denied the application after finding that Devi K. had the residual functional capacity to perform light work. The administrative law judge noted that the record did not document the medical necessity of the cane. Devi K. sought judicial review. United States Magistrate Judge Leo I. Brisbois recommended denying her appeal, and Devi K. objected.

Court’s Analysis

The court conducted an independent review of the record and objections under 28 U.S.C. § 636(b)(1) and Local Rule 72.2(b). Under 42 U.S.C. § 405(g), the court could reject the Commissioner’s decision only if it was not supported by substantial evidence—relevant evidence that a reasonable person would accept as adequate to support the conclusion.

The court rejected Devi K.’s challenge to the medical-necessity standard for cane use. It followed decisions requiring medical documentation showing that the cane is necessary for walking or standing and describing the circumstances in which it is needed. The court stated that, although a prescription was not required, the record needed at least an unambiguous opinion from a physician supporting medical necessity.

The court also rejected Devi K.’s argument that the administrative law judge had not made a finding about medical necessity. It concluded that the administrative law judge had considered both her cane and her reported use of a walker and had found that the record lacked evidence that her assistive devices were medically necessary.

The court further concluded that the record contained repeated observations of cane use but no finding by a physician or other provider that the cane was medically necessary rather than a personal preference. Because medical necessity was not established, the administrative law judge was not required to consider how cane use would affect Devi K.’s ability to perform light work or to ask a vocational expert about that issue.

Finally, the court rejected Devi K.’s objection to the assessment of the intensity, persistence, and limiting effects of her chronic-pain symptoms. It concluded that the administrative law judge had considered evidence that she successfully managed those symptoms and that substantial evidence supported the finding.

Disposition

The court overruled Devi K.’s objections to the January 4, 2024 Report and Recommendation, adopted the Report and Recommendation, and ordered that the matter be dismissed. The order directed that judgment be entered accordingly.