Feliz v. Commissioner of Social Security

Background

Indhira A. Feliz sought judicial review under 42 U.S.C. § 405(g) of the Acting Commissioner of the Social Security Administration’s final decision denying her applications for disability insurance benefits and supplemental security income. Feliz alleged that she became unable to work because of herniated discs, anxiety, and attention deficit hyperactivity disorder. She had previously worked as a hair stylist.

After a hearing, Administrative Law Judge Hilton R. Miller found that Feliz had several severe impairments, including sciatica, right shoulder rotator cuff tears with arthritis, knee problems, lumbar degenerative disc disease, osteoarthritis of the thoracic spine, obesity, and anxiety disorder. The administrative law judge found that she could not perform her past relevant work but retained the residual functional capacity—the most she could still do despite her impairments—to perform a limited range of light work. Relying on vocational-expert testimony, he found that she could perform jobs such as inspector, collator operator, and photocopy-machine operator. He therefore found her not disabled.

The parties filed competing motions for judgment on the pleadings, asking the court to decide the case based on the pleadings and administrative record.

Issues and analysis

The court held that the administrative law judge’s residual-functional-capacity finding was not supported by substantial evidence, meaning relevant evidence that a reasonable person could accept as adequate to support the conclusion. The court focused on the requirement that the administrative law judge evaluate medical opinions based especially on their supportability and consistency with the record.

Evaluation of Dr. Islam and Dr. Figueroa

The administrative law judge found the opinions of primary-care physician Dr. Ali Islam and consultative examiner Dr. Rita Figueroa less persuasive partly because Feliz had received conservative treatment. Dr. Islam had opined that Feliz could sit, stand, or walk for only limited periods, could lift and carry up to five pounds occasionally, could not balance or stoop, needed a cane, and would miss work more than three times per month. Dr. Figueroa had found moderate limitations in prolonged walking, sitting, and standing and marked limitations in repetitive bending, lifting, and carrying.

The court explained that conservative treatment may be considered as one factor, but it is not, by itself, compelling evidence sufficient to overcome an otherwise valid medical opinion. The record included a steroid injection, physical therapy, orthopedic referral, pain-management treatment, multiple prescription medications, and use of a back brace. The administrative law judge did not adequately explain whether this evidence supported or was consistent with Dr. Islam’s opinion. The court also found that the administrative law judge did not adequately analyze Dr. Figueroa’s opinion because Dr. Figueroa had not prescribed treatment and the judge offered no sufficient explanation beyond referring to conservative treatment records.

Evaluation of Dr. Ostrow and other opinions

The administrative law judge largely adopted the residual-functional-capacity assessment of Dr. Arnold Ostrow, a medical expert who had not examined Feliz. Dr. Ostrow testified that Feliz could stand and walk for six hours and sit for six hours in an eight-hour workday. The court found that the administrative law judge did not identify the specific medical records supporting Dr. Ostrow’s opinion or explain how that opinion was consistent with the other evidence. The court also noted that the administrative law judge did not adequately account for the fact that Dr. Ostrow and state-agency consultant Dr. M. Periakaruppan had not examined Feliz.

The court further found that the administrative law judge inadequately evaluated the opinions of treating psychiatrist Dr. Raquel Choua and consultative psychiatric examiner Dr. Toula Georgiou. Dr. Choua had identified extreme limitations in several areas of mental functioning and predicted that Feliz would miss more than three days of work per month. Although the administrative law judge reasonably observed that Dr. Choua’s extreme limitations were not supported by the treatment records, he improperly relied on Feliz’s ability to take walks, clean her house, and help her children with homework as a basis to discount the opinion. The court explained that basic daily activities do not necessarily show an ability to work in a restrictive workplace, especially where Feliz had reported that her children performed many household tasks.

Dr. Georgiou had opined that Feliz might have difficulty regulating her emotions and that psychiatric and cognitive problems might significantly interfere with her daily functioning. The administrative law judge did not explain why he gave this opinion no weight. The court held that this omission was an additional failure to properly evaluate the medical evidence.

Why the errors mattered

The court concluded that the errors were not harmless. The vocational expert testified that a person unable to bend, lift, or carry for one-third of the workday, unable to sit, stand, or walk for two hours of an eight-hour day, required to change positions every 15 minutes, unable to stoop or balance, or off task more than 10 percent of the time could not perform full-time competitive employment. The vocational expert also testified that two absences per month would not be tolerated. Because Dr. Islam and Dr. Choua had identified limitations and absences that could meet or exceed those thresholds, proper evaluation of their opinions could change the disability determination.

Disposition

The court granted Feliz’s motion for judgment on the pleadings, denied the Commissioner’s cross-motion, and remanded the case for further proceedings under sentence four of 42 U.S.C. § 405(g). The court did not determine that Feliz was disabled and did not reach her other arguments because the medical-opinion issues independently required remand.