Carter v. Commissioner of Social Security

Background

Oswin Anthony Carter challenged the Commissioner of Social Security’s final decision under 42 U.S.C. § 405(g). The decision found Carter disabled beginning November 22, 2017, when he turned 55, but not disabled before that date. The administrative law judge found that Carter could perform light work involving simple, routine, repetitive tasks and only occasional contact with supervisors, coworkers, and the public. The judge identified jobs that Carter could perform before November 22, 2017, including cleaner, photocopying machine operator, and advertising material distributor.

Carter had previously appealed an unfavorable decision. In the earlier round of this case, the district court remanded after finding that the administrative law judge had improperly discounted a treating physician’s view and had failed to consider the combined effect of Carter’s mental and physical impairments. On remand, the administrative law judge awarded benefits only from November 22, 2017. Carter then challenged the denial of benefits for the earlier period.

Issues and Analysis

Carter raised two arguments: that the administrative law judge improperly weighed the medical-opinion evidence and that the judge improperly evaluated Carter’s own reports about his symptoms. The court decided the medical-opinion issue and did not reach the second argument.

The court focused on an October 2014 questionnaire completed by Dr. Elizabeth Fitelson, one of Carter’s treating psychiatrists. Dr. Fitelson described persistent low mood, loss of pleasure, poor concentration, low energy and motivation, anxiety, hopelessness, and suicidal thoughts. She also identified other symptoms and concluded that Carter would be unlikely to function in a work setting for many months, possibly more than a year. She further opined that his mental impairments would cause him to miss more than four workdays each month, which would have prevented him from performing the jobs identified by the administrative law judge.

The court applied the treating-physician rule. Under that rule, a treating physician’s opinion generally receives controlling weight when it is well supported by acceptable medical techniques and is not inconsistent with the other substantial evidence in the record. If an administrative law judge does not give the opinion controlling weight, the judge must provide good reasons and consider factors such as the treatment relationship, supporting evidence, consistency with the record, and whether the doctor is a specialist.

The court found that the administrative law judge did not expressly consider several required factors, including the nature of the treatment relationship, the evidence supporting Dr. Fitelson’s opinion, and whether she was a specialist. The court then examined whether the judge nevertheless gave adequate reasons for discounting the opinion.

The administrative law judge had identified two reasons. First, the judge stated that Dr. Fitelson’s questionnaire conflicted with her September 2014 treatment notes. The court disagreed, explaining that Carter’s lack of intent to act on suicidal or violent thoughts did not contradict the existence of those thoughts, and that Carter’s reported belief that others wished to harm him was consistent with paranoid thinking or suspiciousness. The court also noted that reports of seeing shadows or vague shapes could support Dr. Fitelson’s description of Carter’s symptoms.

Second, the administrative law judge stated that Dr. Fitelson had overstated Carter’s limitations because his mental health had improved with medication and counseling. The court found that this was an incomplete and misleading view of the record. Carter’s symptoms improved at times but worsened at others, including reports of dark thoughts, passive homicidal thoughts, desperation, renewed negative thoughts, increased hopelessness, and thoughts about leaving his physical body. The court explained that uneven progress was important in evaluating mental-health conditions and that improvement with treatment alone did not show an ability to work.

Ruling

The court held that the administrative law judge failed to provide good reasons for discounting Dr. Fitelson’s opinion and therefore violated the treating-physician rule. The court concluded that remand was proper. It did not decide whether Carter was disabled during the period before November 22, 2017, did not reverse the Commissioner’s decision, and did not order an expedited hearing or decision.

Disposition

The court granted Carter’s motion for judgment on the pleadings, denied the Commissioner’s motion for judgment on the pleadings, and remanded the case to the Commissioner. The court directed the Clerk of Court to close the motions and the case.