Espinosa v. Astrue
953 F. Supp. 2d 25
| D.D.C. | 2013Background
- Plaintiff Kevin Espinosa (born c. 1981) applied for SSDI/SSI claiming disability from depression, OCD, anxiety and related conditions beginning June 2009; applications were denied and an ALJ denied benefits after a July 2011 hearing; Appeals Council denied review.
- Treating psychologist Dr. Don Miller treated Espinosa frequently from 2009–2011 and consistently opined plaintiff was totally disabled; in July 2011 he reported marked limitations and predicted frequent absenteeism and lateness.
- Multiple non‑treating clinicians (consultative and hospital psychiatrists) documented depression, OCD, panic symptoms and variable improvement on medication; most recommended continued medication and therapy.
- At the ALJ hearing Espinosa testified to punctuality problems and care limitations; a vocational expert testified that employers typically will not tolerate more than a 12–15% productivity decline and that the jobs identified required punctual attendance.
- The ALJ gave an RFC for sedentary, unskilled work with limited public contact and found jobs available at step five, rejecting controlling weight for Dr. Miller; the district court reviewed for substantial evidence.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the ALJ properly discounted the treating physician's opinion | Dr. Miller’s opinion is consistent with the record and entitled to controlling or at least greater weight | ALJ permissibly discounted Dr. Miller because his opinion conflicts with other evidence | Court: ALJ erred; failed to explain rejection of treating opinion and record supports Dr. Miller’s conclusions |
| Whether Espinosa met Listings 12.04/12.06 | If Dr. Miller’s opinion is credited, Espinosa meets the A and B criteria for affective and anxiety listings | Listings not met given other clinicians’ reports and plaintiff’s activities | Court: Substantial evidence supports that Espinosa meets listings when Dr. Miller’s opinion is properly weighed |
| Reliance on vocational expert testimony at step five | VE testimony based on treating physician’s limitations shows no jobs would tolerate Espinosa’s absenteeism/productivity | ALJ may rely on VE and discounted treating opinion so VE scenario was inapplicable | Court: Because treating opinion should have been credited, VE testimony supports finding of disability; ALJ’s step‑five conclusion not supported |
| Remedy on remand — further proceedings vs. award of benefits | Immediate award appropriate because record is fully developed and clearly indicates disability | Remand for additional proceedings appropriate to resolve conflicts | Court: Remand for award of benefits — further fact finding would only delay inevitable award |
Key Cases Cited
- Butler v. Barnhart, 353 F.3d 992 (D.C. Cir. 2004) (defining substantial‑evidence review and treating‑physician rule principles)
- Poulin v. Bowen, 817 F.2d 865 (D.C. Cir. 1987) (treating physician deference explained)
- Richardson v. Perales, 402 U.S. 389 (U.S. 1971) (definition of substantial evidence)
- Simms v. Sullivan, 877 F.2d 1047 (D.C. Cir. 1989) (ALJ must explain crediting of consulting physicians over treating physician)
- Smith v. Astrue, 534 F. Supp. 2d 121 (D.D.C. 2008) (treating physician framework and weight of opinions)
- Turner v. Astrue, 710 F. Supp. 2d 95 (D.D.C. 2010) (ALJ’s burden in explaining rejection of treating opinions)
- Lockard v. Apfel, 175 F. Supp. 2d 28 (D.D.C. 2001) (hypothetical to VE must faithfully reflect treating physician unless good reason to disregard)
- Blackmon v. Astrue, 719 F. Supp. 2d 80 (D.D.C. 2010) (ALJ’s step‑five burden to show other work exists)