Teresa B. v. Commissioner of Social Security

Background

Teresa B. applied for disability insurance benefits on March 28, 2020. The Social Security Administration initially denied the application and denied it again on reconsideration. On June 17, 2021, Administrative Law Judge Lori Romeo denied Teresa B.’s claim, and the Appeals Council denied review on December 7, 2021.

The administrative law judge found severe impairments involving obesity, degenerative joint disease of the ankle, and degenerative disc disease of the lumbar spine. The judge found that these impairments did not meet or equal the requirements of the listed impairments considered automatically disabling. The judge determined that Teresa B. had the residual functional capacity—the ability to work despite her impairments—to perform sedentary work with limits on lifting, standing, and walking. The judge concluded that Teresa B. could not return to her past work as a ticket agent but could perform jobs such as document clerk, bench assembler, or electronics inspector.

The parties submitted a joint stipulation instead of separate motions for judgment on the pleadings. The court reviewed whether the administrative law judge applied the correct legal standards and whether the decision was supported by substantial evidence, meaning relevant evidence that a reasonable person could accept as adequate.

Teresa B.’s Arguments

Teresa B. argued that the administrative law judge failed to explain how persuasive the medical opinions were, particularly the opinions of treating providers Drs. Drakos, Herrera, and Ghaw. Those providers described significant limitations involving sitting, standing, absenteeism, and time off task because of moderately severe pain. Teresa B. also argued that the administrative law judge failed to properly evaluate her testimony about her limitations.

Medical-Opinion Analysis

For claims filed under the newer regulations, an administrative law judge must evaluate medical opinions based on factors including supportability and consistency. Supportability concerns the objective medical evidence and explanations provided by the medical source. Consistency concerns how the opinion compares with evidence from other medical and nonmedical sources. The regulations require the judge to explain consideration of supportability and consistency.

The administrative law judge relied on a consultative examination by Dr. Aguilar and state-agency opinions by Dr. Krist and another medical expert in determining that Teresa B. could perform sedentary work. The court found that the judge made only cursory statements about consistency and did not address supportability.

The judge found the opinions of Drs. Drakos, Herrera, and Ghaw unpersuasive because they were allegedly inconsistent with or unsupported by the medical record. The court found that explanation inadequate. The three treating providers had reached similar conclusions in 2021 about Teresa B.’s pain and work-related limitations, but the administrative law judge did not explain how the earlier opinions from 2020 remained consistent with the later medical evidence. The court also noted that the state-agency reviewers could not have considered the 2021 opinions when they reviewed the record in 2020.

The court further found that the administrative law judge did not explain why the treating providers’ opinions were inconsistent with the medical records or their own treatment notes. According to the court, the judge relied on Teresa B.’s ability to walk four or five blocks without a cane, lift up to twenty pounds, squat, and move from sitting to standing to reject the providers’ descriptions of her pain. The court concluded that the judge improperly substituted personal judgment for the medical providers’ judgments, and that the Commissioner could not later supply explanations missing from the administrative decision.

Testimony Analysis

The administrative law judge accurately summarized Teresa B.’s testimony but stated, without further explanation, that her statements were not entirely consistent with the evidence. Teresa B. testified that she could sit for only up to 40 minutes before needing to stand and walk around, could walk four or five blocks without a cane, and had not benefited from physical therapy and injections.

The court found that the administrative law judge used Teresa B.’s ability to walk several blocks to discount her reports and her treating providers’ reports about the effects of her pain. At the same time, the judge did not explain why Teresa B.’s testimony that she could sit for only 40 minutes received no weight in the finding that she could sit for up to six hours per workday and would not be absent or off task.

Disposition

The court granted Teresa B.’s motion for judgment on the pleadings and denied the Commissioner’s motion for judgment on the pleadings. The case was remanded for further proceedings consistent with the opinion and order. The court directed the Clerk to enter final judgment and close the file.