Claimant with fibromyalgia awarded benefit after court finds ALJ cherry-picked facts
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Monday, January 25, 2021

Claimant with fibromyalgia awarded benefit after court finds ALJ cherry-picked facts

By Payroll and Entitlements Editorial Staff

A claimant who suffered from various conditions, including fibromyalgia, and was denied benefits argued that the ALJ erred by discrediting her subjective complaints of pain and fatigue and in according little weight to the opinion of her treating physician. Her treating physician diagnosed the claimant with fibromyalgia and based his findings on "exquisitely tender trigger points" in accordance with the diagnostic criteria. The physician opined that the claimant could not sustain full-time work. The ALJ reviewed the claimant’s pain testimony and the medical evidence in the record and concluded that the claimant was capable of performing her past relevant work as a dining room manager. On appeal, the court joined its sister circuits in holding that ALJs may not rely on objective medical evidence, or the lack thereof, to discount a claimant’s subjective complaints regarding symptoms of fibromyalgia or some other disease that does not produce such evidence. The court found that the ALJ cherry-picked certain facts and misstated other material facts. In addition, the court concluded that the ALJ erred by concluding that the claimant’s subjective complaints of pain were inconsistent with her daily activities. Such a conclusion failed to account for the waxing and waning nature of fibromyalgia and the symptoms as a whole. The court also exercised discretionary review of the ALJ’s decision to give little weight to the treating physician’s opinion. In finding that the ALJ erred by discounting the treating physician’s opinion, the court reasoned that the opinion was entitled to controlling weight under the correct legal standard. Moreover, controlling weight should not have been given to the agency consultants’ opinions. The ALJ did not provide any discussion of supporting evidence, just a conclusory explanation. The ALJ’s failure was particularly improper given the unique nature of fibromyalgia. Finally, the court concluded that the record established the claimant’s disability and entitlement to benefits. The judgment of the district court was reversed and the case was remanded to the agency for a calculation of benefits (Esin E. Arakas v. Commr., CA-4, No. 19-1540, December 14, 2020).

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