Court finds evidence developed over eight years sufficient to make entitlement to benefits clear
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Thursday, April 2, 2020

Court finds evidence developed over eight years sufficient to make entitlement to benefits clear

By Payroll and Entitlements Editorial Staff

A 67-year-old claimant who suffered from back pain and psychiatric conditions had her application for disability benefits evaluated by two ALJs. The first ALJ determined that the claimant’s severe impairments left her capable of performing a limited range of sedentary jobs. Yet, on remand for a more thorough consideration of the claimant’s mental health problems, a second ALJ found that the claimant had no physical limitations whatsoever and declined to award benefits. The second ALJ determined that the claimant’s back pain was not severe and did not affect her ability to work. At no point in the analysis did the second ALJ discuss the first ALJ’s findings that the claimant suffered from severe physical limitations. On appeal, the claimant argued that the second ALJ’s conclusion was not supported by substantial evidence.

The court agreed, concluding that the second ALJ’s determination that the claimant could perform physical work at all exertional levels found no substantial support in the record. The only medical opinion given more than little weight by the second ALJ was one provided by an agency physician who had never examined the claimant or reviewed her previous case file. In addition, the second ALJ credited only particular findings made by an examining physician in what the court highlighted as impermissible cherry-picking, ignoring evidence that would support a finding of disability. Indeed, many of the examining physician’s observations aligned with the first ALJ’s findings regarding the claimant’s physical limitations. Although the law did not require a comparative analysis, the court noted that it would have expected the second ALJ to explain the basis for reaching such a different jobs she could perform. Moreover, the court reasoned that the agency’s own guidance directed remanding with instructions to grant benefits. Given the claimant’s advanced age, physical conditions limiting her to light or sedentary work, and previous semi-skilled work experience, the agency’s regulatory guidelines directed a finding of disability. The court concluded that the evidence developed in eight years of proceedings as well as the agency’s own guidelines combined to make the claimant’s entitlement to benefits clear (Gail A. Martin v. Saul, CA-7, No. 19-1957, 2/7/2020).

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