Stacy Lewis v. Nancy Berryhill
2017 U.S. App. LEXIS 9789
| 4th Cir. | 2017Background
- Stacy L. Lewis applied for DIB and SSI alleging disability from March 9, 2009, due to obesity, degenerative disc/joint disease, thoracic outlet syndrome, diabetes, lupus, and depression/anxiety; ALJ denied benefits after hearing and VE testimony; district court affirmed; Lewis appealed.
- Medical record: long-term treating physicians (Drs. Mahmood and Jacob) documented chronic, severe pain in left upper extremity, functional limits on sitting/standing/lifting/handling, frequent flares from lupus, multiple surgeries (including left first rib resection) and powerful analgesics (fentanyl, oxycodone).
- State agency consultants limited Lewis to light work; treating physicians offered more restrictive functional opinions (e.g., limited sitting to ~2 hours, standing/walking 1–3 hours, lifting very limited, need for absences >3/month, constant pain affecting concentration).
- At hearing the VE testified Lewis could not perform past work but some jobs existed for the RFC the ALJ adopted; VE also said inability to tolerate >10% off-task or need to rest 10 minutes every 2 hours would preclude employment.
- ALJ found impairments severe at step two, did not meet listings at step three, assessed an RFC for limited light work (with periodic position changes, limited left-arm use, allowance for 5% off-task and 10-minute breaks every 2 hours, up to eight absences/year), discounted claimant’s subjective symptom intensity and gave treating opinions "partial" weight.
- Fourth Circuit vacated and remanded, holding the ALJ applied improper legal standards when discounting symptom evidence and treating opinions and failed to adequately explain the denial, preventing meaningful appellate review.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ improperly required objective proof of pain intensity before crediting subjective pain evidence | Lewis: ALJ erred by discounting pain testimony for lack of objective corroboration and by requiring more than regulations allow | Commissioner: ALJ permissibly relied on medical records showing limited objective abnormalities and normal exam findings | Court: ALJ applied an improper legal standard by effectively demanding objective evidence of pain intensity and failed to explain credibility findings sufficiently |
| Whether ALJ failed to give controlling weight to treating physicians' opinions | Lewis: Drs. Mahmood and Jacob provided longitudinal, well-supported opinions that were improperly discounted | Commissioner: ALJ permissibly gave limited/partial weight because treating opinions conflicted with examination findings and longitudinal record | Court: ALJ’s rejection of treating opinions was perfunctory, failed to build a logical bridge, and did not apply controlling-weight analysis properly |
| Whether ALJ erred by characterizing course of treatment as "conservative" | Lewis: Treatment was extensive (multiple surgeries, nerve blocks, strong opioids) so "conservative" is incorrect and impermissible lay medical judgment | Commissioner: ALJ relied on portions of record showing some normal findings and conservative elements | Court: ALJ’s characterization was inconsistent with the record and amounted to impermissible "playing doctor," undermining the rationale |
| Whether ALJ’s RFC/findings at step five are supported by substantial evidence | Lewis: RFC omits or downplays treating opinions and symptom limitations; VE testimony shows certain limits would preclude work | Commissioner: RFC supported by some objective findings and VE testimony that jobs exist | Court: Because credibility and treating-opinion errors undermine the RFC assessment, meaningful review of step five is impossible; remand required |
Key Cases Cited
- Mascio v. Colvin, 780 F.3d 632 (4th Cir. 2015) (RFC must include function-by-function analysis and discuss how evidence supports conclusions)
- Monroe v. Colvin, 826 F.3d 176 (4th Cir. 2016) (burden allocation and need for ALJ to build logical bridge from evidence to conclusions)
- Radford v. Colvin, 734 F.3d 288 (4th Cir. 2013) (ALJ must explain which evidence is credited and why to permit meaningful review)
- Bird v. Comm'r of Soc. Sec. Admin., 699 F.3d 337 (4th Cir. 2012) (review limited to whether ALJ applied correct legal standards and supported findings with substantial evidence)
- Hines v. Barnhart, 453 F.3d 559 (4th Cir. 2006) (after objective evidence establishes a condition reasonably likely to cause pain, claimant may rely on subjective evidence to prove severity and work-preclusive effects)
- Gross v. Heckler, 785 F.2d 1163 (4th Cir. 1986) (subjective pain evidence does not override absence of any objective basis for the claimed pain)