Horton v. Saul

Background

Keisha L. Horton sought judicial review of the Commissioner of Social Security’s decision that she was not disabled and was not entitled to disability insurance benefits. Horton alleged that injuries from an October 14, 2015 car accident caused continuing neck and back pain, difficulty walking and standing, and other limitations. After an administrative law judge (ALJ) denied her application, the Appeals Council declined review, making the ALJ’s decision the final agency decision.

The parties filed cross-motions for judgment on the pleadings, asking the court to decide the case based on the administrative record. Horton argued that the ALJ failed to consider her need for a cane, her efforts to obtain pain relief, and the opinions of her treating physicians, and that the decision was not supported by substantial evidence. The Commissioner argued that the ALJ committed no legal error and that substantial evidence supported the denial.

ALJ’s Decision

The ALJ found that Horton had severe degenerative disc disease of the lumbar spine, but concluded that it did not meet or equal Listing 1.04, a Social Security listing for certain spinal disorders. The ALJ found that Horton had the residual functional capacity (RFC)—her remaining ability to work despite her impairments—to perform sedentary work with limitations. Those limitations included sitting and standing at will, sitting for no more than 15 minutes at a time, standing and walking for 30 minutes at a time, carrying less than 10 pounds, using a cane for ambulation, and performing limited and relatively simple tasks.

The ALJ found that Horton could not perform her past work but could perform other jobs identified by a vocational expert. The ALJ therefore concluded that Horton was not disabled.

Court’s Analysis

Listing 1.04A. Judge Sarah Netburn concluded that the ALJ’s discussion of Listing 1.04A was inadequate. The listing required evidence of a spinal disorder with nerve-root compression, limited spinal movement, motor loss accompanied by sensory or reflex loss, and, for lower-back involvement, positive straight-leg-raising tests in both sitting and lying positions.

The court found substantial evidence supporting each of those criteria, including Horton’s reports of radiating pain and numbness, diagnoses of radiculopathy, disc herniations and bulges shown by imaging, limited spinal movement, muscle weakness, sensory and reflex loss, and positive straight-leg-raising tests. The ALJ nevertheless stated that there was no evidence of nerve-root compression without adequately addressing the conflicting medical evidence. The court held that the ALJ needed to explain why the evidence did not establish that Horton met or equaled the listing. The court did not itself award benefits; it directed the ALJ to reassess the listing and provide a clearer explanation if the ALJ reached the same conclusion.

Cane and assistive-device evidence. The court rejected Horton’s argument that the ALJ failed to consider her cane. The ALJ expressly included a cane for ambulation in the RFC and relied on vocational-expert testimony about the jobs Horton could perform with that limitation. The court also found substantial evidence supporting the ALJ’s conclusion that Horton needed the cane for walking, but not for balance.

Dr. Schwartz’s opinions. The court found that the ALJ did not properly apply the treating-physician rule. Because Horton filed her application before March 2017, the ALJ was required either to give a treating physician’s well-supported opinion controlling weight or to provide good reasons for discounting it. Dr. Schwartz treated Horton over an extended period and gave opinions about her physical limitations, including the need for an assistive device and limits on standing, walking, lifting, and postural activities.

The court concluded that the ALJ did not adequately address the regulatory factors relevant to Dr. Schwartz’s opinions and improperly assessed the opinions by comparing them to the ALJ’s own RFC conclusion. The court explained that the medical opinions should be evaluated against the medical evidence, rather than judged by whether they matched an RFC already selected by the ALJ.

Evaluation of Horton’s symptoms. The court also found that the ALJ did not adequately explain the evaluation of Horton’s statements about the intensity and effects of her pain. The ALJ emphasized that Horton drove, used transportation, cared for her daughter, and performed daily activities, but did not adequately address Horton’s testimony that she could drive only briefly, needed help, took hours to perform some tasks, and sometimes abandoned them.

The court further found that the ALJ selectively discussed the medical evidence and did not adequately reconcile conflicting examinations, imaging, treatment records, and the history of repeated injections and other pain-treatment procedures. The court also stated that the ALJ could not rely on Horton’s decision not to undergo spinal surgery without considering her stated concern about the risk of losing the ability to walk.

Because these errors required remand, the court did not reach Horton’s remaining argument that the RFC was not supported by substantial evidence.

Disposition

Judge Sarah Netburn granted Horton’s motion for judgment on the pleadings and denied the Commissioner’s motion. The matter was remanded for further proceedings consistent with the opinion. The remand required further consideration of Listing 1.04A, Dr. Schwartz’s opinions, and Horton’s statements about her symptoms. The order also directed Horton’s counsel to file any request for attorney’s fees and costs under the Equal Access to Justice Act within 30 days after entry of the order.