Lisa F. v. Commissioner of Social Security

Background

Lisa F. applied for Supplemental Security Income benefits in October 2018, alleging disability beginning October 1, 2018. The Social Security Administration denied the application initially and on reconsideration. After a hearing, Administrative Law Judge Sandra M. McKenna denied the application on February 5, 2020. The Appeals Council declined review, making the administrative law judge’s decision the Commissioner’s final decision.

The administrative law judge found that Lisa F. had severe osteoarthritis of the lumbar spine, obesity, a seizure disorder, hypertension, and bipolar disorder. The judge determined that Lisa F. retained the capacity for sedentary work, with physical and mental restrictions, and that jobs existed in significant numbers in the national economy that she could perform.

Lisa F., represented by counsel, filed this action seeking judicial review. Both sides filed motions for judgment on the pleadings, which ask the court to decide the case based on the pleadings and administrative record.

Legal standard

The court reviewed whether the Commissioner applied the correct legal standards and whether the decision was supported by substantial evidence. Substantial evidence means relevant evidence that a reasonable person could accept as adequate to support a conclusion. The court was required to consider the entire record, including evidence pointing in both directions.

Because Lisa F.’s application was filed after March 27, 2017, regulations requiring administrative law judges to evaluate the persuasiveness of medical opinions applied. Those regulations require specific discussion of an opinion’s supportability and consistency with the other evidence, along with other relevant factors.

Court’s analysis

The administrative law judge found the opinions of treating psychiatrist Dr. Arcangelo Lubrano and treating family nurse practitioner Debra Rivera-Oquendo not persuasive. Dr. Lubrano had treated Lisa F. monthly for two and a half years and assessed serious limitations, including extreme problems maintaining concentration, regular attendance, and a normal workday and workweek. He also expected her to miss work more than three times per month. Rivera-Oquendo assessed essentially the same marked and extreme psychiatric limitations.

The court found that the administrative law judge relied too heavily on treatment notes describing Lisa F. as stable or showing an appropriate affect during relatively brief appointments. The record also showed continuing moderate symptoms, difficulty focusing during psychotherapy, occasional suicidal thoughts, and daily functioning that Lisa F. consistently found very difficult. The court noted that Lisa F. was living in a homeless shelter and relying on her husband for nearly all support with daily activities.

The court also found that the administrative law judge did not adequately explain why the treating providers’ opinions were supposedly inconsistent with the opinion of consultative examiner Dr. Joanne Rolan. Dr. Rolan assessed moderate limitations in several areas, described Lisa F. as depressed, hopeless, anxious, and tense, observed impaired memory and attention and poor insight and judgment, and gave a guarded prognosis. The court concluded that the opinions were consistent as to the existence of significant work-related impairments, differing mainly in the degree of limitation.

The court further held that the administrative law judge did not adequately account for the fact that Dr. Lubrano and Rivera-Oquendo independently reached similar conclusions after long-term treatment. The opinions of state-agency reviewers provided some support for the Commissioner’s position, but the court found them insufficient by themselves to satisfy the substantial-evidence requirement. The administrative law judge could resolve conflicts among medical opinions, but could not favor the less severe opinions without adequate support and explanation.

Disposition

The court found that the administrative law judge’s evaluation of the medical opinions was unsupported by substantial evidence and inconsistent with applicable law. It determined that the record was complete and contained persuasive proof of disabling mental-health impairments. Because the Commissioner identified no purpose for additional administrative proceedings, the court concluded that remand for calculation of benefits, rather than further proceedings, was warranted.

The court granted Lisa F.’s motion for judgment on the pleadings, denied the Commissioner’s motion for judgment on the pleadings, and remanded the case for calculation of benefits. The Clerk was directed to enter final judgment and close the file.