A woman twice denied disability benefits despite evidence of serious mental disabilities causing limitations on her ability to work will get a third chance to make her case for benefits.
In the case of Hortansia D. Lothridge v. Andrew M. Saul, 20-1269, plaintiff Hortansia Lothridge applied for disability insurance benefits and supplemental security income in May 2013, claiming various disabilities including fibromyalgia, chronic obstructive pulmonary disorder, asthma, high blood pressure and multiple mental health conditions. Lothridge had previously held jobs and had earned a certified nursing assistant license, but hip and back pain led her to stop working in December 2009.
Before she stopped working, Lothridge had seen a psychiatrist who diagnosed her with mood disorders, attention deficit disorder and bipolar I disorder. Her treatment and prescriptions lapsed, however, because she was not consistently in the state.
Lothridge eventually settled in Indiana and began seeking mental health counseling in August 2013. Her application for disability benefits was pending at the same time, and an agency psychologist diagnosed her with mood disorder and post-traumatic stress disorder, finding that she had “moderate difficulties with social and occupational functioning.”
Meanwhile, Lothridge saw a family doctor and a rheumatologist, the latter of whom determined in April 2015 that she would be unable to work for at least the next year because her physical and mental ailments were worsening. Over the next year, Lothridge stopped complying with treatment, believing at one point that her medication would kill her.
Also in 2015, Lothridge testified before an administrative law judge that her medications dulled her pain but did not take it away, that her children did most of the housework and that she had to take frequent breaks whenever she supervised them. The ALJ determined in September 2015 that she was not disabled, but an Indiana Northern District Court judge remanded.
By 2016, Lothridge was struggling to get out of bed, complete personal hygiene tasks and clean her home. In 2017, a clinician assessed her as having “a moderate degree of self-care impairment, difficulty with decision-making, impaired social function, and challenges with concentration.” Also, Lothridge had a tendency to self-isolate and was struggling to care for her children.
At a second hearing before the same ALJ in September 2018, Lothridge testified about her lapses in treatment, saying she had trusted her in-home therapist but struggled to find another therapist when her original therapist left the clinic. She also testified that she struggled to attend in-person appointments because she forgot the times and could not find transportation. She was afraid to drive, she said, and she was in pain throughout the hearing.
The ALJ then directed a vocational expert to base his testimony on the assumption that a person with Lothridge’s age, education and work experience could “understand, remember, and carry-out simple instructions and tasks.” Based on those factors, the expert said Lothridge could work as a garment sorter, mail clerk or photocopy machine operator, though he added that someone who needed help leaving for breaks or who would tend to arrive late or leave early could not hold such jobs. That worker, the expert said, would need to be on task for 90% of a workday.
Following that hearing and despite finding that Lothridge had several severe mental impairments, the ALJ again determined in 2018 that she was not disabled. Though the ALJ found that Lothridge had “moderate limitations in understanding and applying information, interaction with others, and maintaining concentration, persistence and pace,” she also determined there were “plentiful positions” that Lothridge could perform.
A second Indiana Northern District Judge upheld the ALJ’s second ruling, but the 7th Circuit Court of Appeals reversed on Tuesday.
The ALJ’s assessment of Lothridge’s residual functioning capacity under 20 C.F.R. § 404.1520 was inconsistent with the finding of “moderate” limitations in concentration, persistence and pace, Judge David Hamilton wrote. He gave the example of the ALJ’s finding that Lothridge only “sometimes” finished a task and could get frustrated easily.
“It is not a court’s role to displace an ALJ’s judgment by making our own findings about the facts, but we cannot uphold an administrative determination that failed to explain the outcome adequately,” Hamilton wrote. “… To put it another way, an internally inconsistent opinion by an ALJ is likely to fail to build a logical bridge between the evidence and the result. … The ALJ’s findings about the jobs Lothridge could perform needed to account in a meaningful way for the earlier findings that recognized her difficulties with concentration, completing tasks, and managing stress.”
The ALJ also cherry-picked and overstated evidence to support her residual functional capacity finding, Hamilton continued, adding that the judge failed to address evidence of Lothridge’s worsening symptoms.
“An ALJ need not address every piece of evidence,” he wrote, “but she may not ignore entire swaths of it that point toward a finding of disability.”
Thus, the district court’s order upholding the denial of benefits was vacated, and Lothridge’s case was again remanded for further proceedings before the commissioner of social security.