Treating Psychiatrist’s Opinion in a Supplemental Security Income Case

Legal News GavelIn a district court decision that may give those seeking supplemental security income in California some sense of the process, a plaintiff sought judicial review of an administrative law judge’s decision denying his request for supplemental security income under Title XVI. The plaintiff had filed his first application for benefits in 2013, and he was denied in 2014, and then denied reconsideration.

He had therapy four times with a particular licensed clinical social worker. He next had weekly therapy at a counseling center. In 2015, he started to take psychiatric medication and began to see a psychiatrist. He had an exam with a state agency psychologist in 2014, and also had a psychological evaluation.

By law, someone claiming social security disability benefits need to prove he is unable to do any substantial gainful activity because of any medically determinable physical or mental impairment that has lasted or is expected to last for 12 or more months. The administrative law judge is supposed to evaluate a claimant in five steps performed in sequence to decide whether the claimant is disabled such that he should receive benefits.

In the first step, the claimant needs to show he hasn’t been involved in substantial gainful activity since the date he became disabled. If he’s been able to work and that work is considered substantial gainful activity, the claimant will be determined to be not disabled. The administrative law judge in this case found that the plaintiff hadn’t been involved in substantial gainful activity since the date on which he became disabled.

In the second step, a claimant must show he is severely impaired by a medical condition or a combination of impairments. Impairments aren’t severe when they are just slight abnormalities that have only a minor effect on the capacity to do basic work. In this case, the administrative law judge determined that the plaintiff suffered from major depressive disorder with psychotic features, antisocial personality traits, obsessive compulsive disorder, antisocial personality traits, borderline intellectual functioning and bipolar disorder.

In the third step, the administrative law judge needs to compare the claimant’s impairments to those listed. The claimant must be able to show that his condition equals an impairment that’s listed. If he can make this showing, it is presumed he is disabled and benefits will then be awarded. If he cannot make this showing, the administrative law judge determines the claimant’s residual functional capacity and goes onto the next step. In this case, the administrative law judge determined he didn’t have an impairment or combination of them that were equivalent to what was listed.

The administrative law judge also found that the plaintiff retained the residual functional capacity to perform all kinds of work at all levels of exertion, with several environmental and physical restrictions. The administrative law judge found the plaintiff would be restricted to routine, repetitive and simple tasks, and that his environment needed to be stable.

In the fourth step, the administrative law judge decided the plaintiff did not have past relevant work. In the fifth step he concluded that, based on testimony, the plaintiff could successfully adjust to jobs that were sufficiently present in the national economy and he wasn’t disabled.

In asking the district court to review, the plaintiff argued that the administrative law judge hadn’t addressed his treating psychiatrist’s opinion. The court explained that only licensed doctors and other qualified specialists can be considered for their medical opinions. A social workers isn’t an acceptable medical source. The psychiatrist was the plaintiff’s sole treating doctor. The court determined it couldn’t resolve the plaintiff’s additional issues unless the administrative law judge addressed the sole treating doctor’s analysis in his 5-step process. The defendant’s motion for summary judgment was denied, and the case was sent back down.

It can be challenging to meet the requirements necessary to start receiving benefits from the federal government. Often, an experienced Social Security lawyer can make a difference to the outcome of your case. If you believe you may need to apply for Supplemental Security Income in Fresno, please call Peña & Bromberg, PLC at 559-439-9700 or via our online form.

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