Scott v. Commissioner of Social Security

Background

Precious Scott sought Supplemental Security Income under the Social Security Act. Her mother filed the application on April 30, 2015, when Scott was 16. Scott alleged that she became disabled at age 15 because of a learning disorder and behavioral problems. During the administrative process, she turned 18.

The administrative law judge found that Scott had a learning disorder, attention-deficit/hyperactivity disorder, and oppositional defiant disorder. Applying the rules for children, the judge found that Scott had a marked limitation in interacting and relating with others but less-than-marked limitations in acquiring and using information, attending and completing tasks, and caring for herself. The judge therefore found that she was not disabled before age 18. Applying the adult disability rules, the judge found that Scott could perform a full range of work at all exertional levels, subject to limits for simple, routine tasks, occasional changes, and occasional interaction with others. The judge also found that jobs existed in the national economy that she could perform and found her not disabled after age 18.

Scott received treatment at Montefiore Behavioral Health Center from January 2016 through September 2017. Therapist Paula Singer completed a Medical Source Statement assessing marked limitations in several areas, including understanding detailed instructions, maintaining regular attendance, completing a normal workday or workweek without interruptions, performing at a consistent pace, responding appropriately to criticism, and maintaining socially appropriate behavior. The statement also assessed an extreme limitation in setting realistic goals or making plans independently. Treating psychiatrist Dr. Myreille Polycarpe reviewed and co-signed the statement and added a handwritten clarification.

Issues and the Parties’ Positions

Scott moved for judgment on the pleadings, asking the court to reverse the Commissioner’s decision. She argued that the administrative law judge failed to consider evidence supporting marked limitations during her childhood and failed to account for limitations involving attendance, concentration, pace, and absences after she became an adult. The Commissioner cross-moved for judgment on the pleadings affirming the decision.

The Commissioner argued that the administrative law judge properly weighed conflicting evidence, including a consultative examination by Dr. Lucy Kim and Scott’s school records. The Commissioner acknowledged that the administrative law judge did not expressly discuss Dr. Polycarpe’s signature on the Medical Source Statement but argued that the form represented Singer’s opinion and that the administrative law judge had given adequate reasons for assigning it only some weight.

Court’s Analysis

The court held that the Medical Source Statement represented Dr. Polycarpe’s opinion as well as Singer’s. A report signed by a treating physician is presumed to express that physician’s opinion unless evidence shows otherwise. Here, Dr. Polycarpe had treated Scott regularly, reviewed the statement, co-signed it, and wrote a clarification on the form. The court found that Dr. Polycarpe had an ongoing treatment relationship with Scott and therefore was her treating physician.

Under the treating-physician rule applicable to Scott’s application, an opinion from a treating source is entitled to controlling weight when it is well supported and not inconsistent with substantial evidence. If an administrative law judge declines to give the opinion controlling weight, the judge must provide good reasons and consider the required regulatory factors. The court ruled that the administrative law judge failed to do either. The judge referred to the statement as Singer’s opinion, gave it only some weight, and stated generally that it did not completely align with the evidence. The court found that this vague explanation was not a good reason for discounting Dr. Polycarpe’s opinion.

The court also held that the error could have affected both periods under review. Dr. Polycarpe’s assessments concerned the child-functioning domains of acquiring and using information, attending and completing tasks, and caring for oneself. They also concerned Scott’s ability as an adult to maintain regular attendance, work at a consistent pace, and complete a normal workday or workweek without interruptions. The vocational experts testified that missing two or three days of work per month or being off task 25 percent of the time would prevent work for a person with the other stated limitations.

Separate from the failure to apply the treating-physician rule, the court found that the administrative law judge’s analysis of Scott’s childhood functioning relied on insufficient evidence. For example, the judge relied on isolated school anecdotes about Scott’s ability to understand certain class content and participate in a dance activity, while failing to address evidence that she had very serious problems focusing, finishing tasks, and working at a reasonable pace. The judge also did not cite Dr. Kim’s opinion when analyzing the three disputed childhood domains.

Disposition

The court granted Scott’s motion for judgment on the pleadings and denied the Commissioner’s cross-motion. It remanded the case for further administrative proceedings under sentence four of 42 U.S.C. § 405(g).

On remand, the administrative law judge must treat the Medical Source Statement as representing Dr. Polycarpe’s opinion, treat Dr. Polycarpe as Scott’s treating physician, give that opinion controlling weight or explain good reasons for not doing so, and reconsider Scott’s functional capacity as both a child and an adult. The judge must also revise the childhood analysis by considering all relevant medical and educational evidence. The court did not decide whether Scott was actually disabled or whether Dr. Polycarpe’s opinion, if given greater weight, would necessarily require a finding of disability.