Angelica P. v. Commissioner of Social Security

Background

Angelica P. applied for Supplemental Security Income on May 20, 2019, alleging disability beginning May 1, 1996. The Commissioner of Social Security denied the application initially and on reconsideration. After a hearing, Administrative Law Judge Flor Suarz denied the application on May 28, 2021. The Appeals Council declined review, making the administrative law judge’s decision the Commissioner’s final decision.

The administrative law judge found that Angelica P.’s schizophrenia, anxiety, and type one diabetes were severe impairments, but that they did not meet or equal a listed impairment. The administrative law judge found that she could perform medium work with physical, environmental, and mental limitations, including low-stress work, limited interaction with other people, and permission to be off task for 5% of the workday in addition to regular breaks. Although she could not return to her past work as a day care worker, the administrative law judge found that other jobs existed in significant numbers that she could perform.

Angelica P. appeared without a lawyer at the administrative hearing. She was represented by counsel in the federal court case. She argued that the administrative law judge failed to develop the record and properly assess the evidence, and that the administrative law judge improperly discounted her credibility.

Court’s Analysis

The court explained that an administrative law judge must investigate the facts and develop the arguments both supporting and opposing an application for benefits. That duty is heightened when a claimant appears without a lawyer and alleges mental impairments.

The court found that the administrative law judge recognized the significant nature of Angelica P.’s schizophrenia and anxiety but failed to obtain medical opinions from any treating providers. The administrative law judge obtained treatment notes, but the court stated that treatment records alone were not enough; the administrative law judge also had to try to obtain opinions addressing how the impairments affected Angelica P.’s ability to function and work.

The court also found that the medical evidence was conflicting. A consulting psychiatrist assessed mostly mild limitations. Two non-examining State Agency physicians assessed some moderate limitations, while reaching different conclusions about Angelica P.’s ability to perform unskilled work. The administrative law judge found none of these opinions fully persuasive, concluding that some underestimated and others overestimated particular limitations. Because the evidence conflicted and no treating-provider opinions were obtained, the court held that the record needed further development.

Ruling and Disposition

The court held that remand was required before it could determine whether the Commissioner’s decision was supported by substantial evidence. It directed the administrative law judge to obtain functional assessments from Angelica P.’s treating providers and then reassess her residual functional capacity in light of any additional findings.

The court granted Angelica P. judgment on the pleadings and remanded the case for further proceedings consistent with the decision and order. The Clerk was directed to enter final judgment and close the file.