Kelly L. R. v. O'Malley

Background

Kelly L. R. sought judicial review of the Commissioner of the Social Security Administration’s final decision denying her application for disability insurance benefits. She alleged disability based on several physical and mental conditions, including posttraumatic stress disorder, intellectual and learning disabilities, depression, anxiety, arthritis, and diabetes. An administrative law judge found that she was not disabled and determined that she could perform other work, including work as a sorter, merchandise marker, or office helper.

One of Kelly L. R.’s providers, therapist Courtney Mike, completed a Mental Functioning Questionnaire. Ms. Mike identified several mild, moderate, moderate-to-marked, and marked mental limitations. She also estimated that Kelly L. R. would be off task for 20 percent of the workday, would need 20-minute breaks every few hours, and would be absent or tardy more than four times per month because she needed mental-health days up to twice a week.

Issues Presented

Kelly L. R. raised three issues: whether the administrative law judge properly considered the supportability and consistency of Ms. Mike’s opinion; whether the judge should have included an absenteeism limitation in the residual functional capacity assessment; and whether the administrative law judge and Appeals Council members were properly appointed. The parties filed cross-motions for summary judgment, which ask the court to decide whether the administrative decision should stand based on the record and applicable law.

Supportability of Ms. Mike’s Opinion

Social Security regulations require an administrative law judge to evaluate how persuasive a medical opinion is. The two most important factors are supportability and consistency. Supportability concerns how well the medical source’s own evidence and explanations support the opinion. Consistency concerns how well the opinion fits with evidence from other medical and nonmedical sources.

The court held that the administrative law judge did not adequately address supportability. The judge called Ms. Mike’s opinion “not persuasive” and cited normal mental-status findings and two progress reports, but did not explain how those materials related to the supporting explanations Ms. Mike gave for the limitations in her questionnaire. The court also determined that several cited pages were not evidence from Ms. Mike, and that the pages from Ms. Mike’s notes did not provide a sufficient supportability analysis. One cited notation described an irritable mood, which could support rather than undermine Ms. Mike’s opinion.

The court rejected the Commissioner’s attempt to supply additional reasons after the administrative decision was issued. The court explained that judicial review is limited to the reasons the administrative law judge actually gave. Because the judge failed to explain the supportability analysis, the court found legal error requiring remand.

Consistency of the Opinion

The court reached a different conclusion about consistency. The administrative law judge cited normal mental-status findings—including cooperation, normal mood, appropriate affect, logical thought content, intact remote memory, and focused attention and concentration—and explained that these findings were inconsistent with Ms. Mike’s opinions about being off task, absenteeism, and responding to supervisory criticism. The court held that this was a sufficient explanation of the consistency factor and declined to reweigh the evidence.

Absenteeism Limitation

The administrative law judge’s residual functional capacity assessment did not include an absenteeism limitation. The court stated that the judge would necessarily have to reconsider the absenteeism limitation described by Ms. Mike when reconsidering her opinion. The court therefore did not address the issue further at that time.

The court rejected Kelly L. R.’s other arguments concerning absenteeism. It found that the judge adequately considered her testimony about taking mental-health days and that the judge’s evaluation of the claimed severity and effects of her symptoms was supported by substantial evidence. The court also upheld the judge’s treatment of a state disability-benefits review team’s finding that Kelly L. R. could not maintain pace and persistence for a 40-hour workweek. Finally, the court found that paystubs showing “unpaid time off” did not establish that the absences resulted from medical impairments or would continue in the future.

Appointment Challenge

The court rejected Kelly L. R.’s argument that the administrative law judge and Appeals Council members were improperly appointed. The court stated that this argument was foreclosed by Dahle v. Kijakazi, 62 F.4th 424 (8th Cir. 2023), and therefore did not grant remand on that basis.

Disposition

Judge John F. Docherty granted Kelly L. R.’s motion for summary judgment, denied the Commissioner’s motion for summary judgment, reversed the Commissioner’s decision, and remanded the matter to the Social Security Administration for further consideration of Ms. Mike’s opinion and an explanation of how the administrative law judge considered the supportability factor under 20 C.F.R. § 404.1520c.