This article discusses an actual Social Security disability claim for anxiety, depression, and obsessive-compulsive disorder that was denied and appealed to federal court. I'll explain the background of the case and the judge's decision from 2016.
The claimant, Laura Julin, filed an application for Social Security disability benefits (SSDI) and Supplemental Security Income (SSI) in December 2009, alleging that she was unable to work because of poor concentration, low energy, and difficulties interacting socially and maintaining a regular work schedule. The claimant had a sporadic work history, with only one year of work that counted as substantial gainful activity (SGA) to Social Security since 1983.
The claimant's physician Dr. Welsh, who treated the claimant every four to eight weeks beginning in December 2009, diagnosed the claimant with major depressive disorder and dysthymic disorder, a chronic form of depression. Dr. Welsh submitted a number of medical opinions to Social Security indicating that the claimant would be unable to work due to poor social interaction and concentration.
At Julin's hearing, the administrative law judge (ALJ) found that Julin's residual functional capacity (RFC) was for unskilled work involving "no more than simple work-related decisions with few work place changes; no more than occasional, brief, and superficial interaction with the public, co-workers, and supervisors; and no work at production rate pace." The ALJ found that there were jobs that the claimant could do with this RFC and denied the claim.
Julin again appealed and at the Appeals Council, the claimant's claim was sent back to the ALJ for further consideration of Dr. Welsh's medical opinions. Nevertheless, the ALJ again denied Julin's claim, and this time the Appeals Council agreed with the denial of benefits. The claimant then appealed her case to the Eighth Circuit Court of Appeals.
The Eighth Circuit judge looked at three major issues on appeal:
RFC assessment. As to the first issue, the Eighth Circuit judge held that there was substantial evidence to support the claimant's RFC. The ALJ had used some of Dr. Welsh's opinions to lower the skill level, social interaction, and pace of work in the RFC, and the ALJ had also used the opinions of Social Security's medical consultant.
Treating doctor's opinion. In discussing the second issue, the court held that the ALJ was correct to discount (ignore) Dr. Welsh's opinion that the claimant "was unable to work full time," as this statement is a legal conclusion that only Social Security can come up with, not a medical opinion. As a result, Dr. Welsh was essentially speaking beyond the bounds of his expertise.
The ALJ also failed to give much weight to Dr. Welsh's other opinions explaining why the claimant would be unable to work. According to the Eighth Circuit, Dr. Welsh stated that the claimant "struggles to interact with people she knows," "would have trouble managing appointments more frequent than her treatment sessions...and completing tasks," and would "feel overwhelmed, tearful, anxious, and irritable" if she had to interact with others. The ALJ found that these opinions weren't entitled to controlling weight mostly because they were based on the subjective reports of the claimant, who (as discussed below) the ALJ found not to be credible. The Eighth Circuit found that, although treating physicians' opinions are generally entitled to controlling weight, the ALJ had provided solid reasons for discounting Dr. Welsh's opinions in this case.
Claimant's credibility. As to the third issue, the ALJ found the claimant lacked credibility for a number of reasons. The fact that the claimant had done a substantial amount of work for only a single year since 1983, the ALJ wrote, suggested that the claimant may lack the motivation to work. The claimant also apparently failed to follow prescribed treatment, refusing to change medications and turning down her physician's offer to arrange for therapy in late 2009.
Finally, the ALJ wrote that the claimant's daily activities suggested she might be more capable than she alleged. For example, the claimant was able to prepare two-course meals, read, and play games on the Internet. She left her apartment multiple times per week to shop, clean houses, and attend treatment sessions with Dr. Welsh. The ALJ found—and the Eighth Circuit agreed—that the claimant's daily activities showed that she was not as limited as she claimed.
As a result, the Eighth Circuit affirmed the denial of benefits.
This decision from the Eighth Circuit contains many of the usual hallmarks of a federal court decision rejecting a disability appeal. As in many cases, the court sides with Social Security's medical consultant, who examined the claimant once (or in some cases, not at all) over the clear opinions of the claimant's treating physician.
Also, as in many cases, the court defers to the ALJ's determination that the claimant's allegations are not credible. It is worth pointing out, however, that in this case, the court somewhat incredibly uses the fact that the claimant regularly attends medical appointments as evidence against her. The judge wrote:
One wonders what inferences the ALJ would have drawn if the claimant had not been meeting with her doctor on a regular basis!
The bottom line is that most federal courts tend to simply defer to the ALJ's credibility determination, and trying to reverse a finding of lack of credibility is rarely a successful argument on appeal.
Read the full text of this case, Julin v. Colvin, 826 F.3d 1082 (8th Cir. 2016).