UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA
CHANEL PYATT,
Plaintiff, v. No. 17-cv-2809 (EGS) KILOLO KIJAKAZI, Acting Commissioner of Social Security,
Defendant.
MEMORANDUM OPINION AND ORDER
I. Introduction
Plaintiff Chanel Pyatt (“Ms. Pyatt”) seeks reversal of the
final decision by Defendant Kilolo Kijakazi 1 in her official
capacity as Commissioner of Social Security (the “Commissioner”
or “Defendant”) denying her claim for supplemental security
income payments. 2 Compl., ECF No. 1 at 8. Specifically, Ms. Pyatt
is seeking a remand order that is for an award of benefits, or,
in the alternative, for a rehearing. Id. Pending before the
Court are Ms. Pyatt’s Motion for Judgement of Reversal (“Pl.’s
Mot.”), see ECF No. 13; and the Commissioner’s Motion for
1 Kilolo Kijakazi became the Commissioner of Social Security on July 9, 2021. Pursuant to Rule 25(d) of the Federal Rules of Civil Procedure, Kilolo Kijakazi has been substituted for former Acting Commissioner Nancy A. Berryhill as the Defendant in this action. 2 When citing electronic filings throughout this Opinion, the
Court cites to the ECF page number, not the page number of the filed document. Judgment of Affirmance (“Def.’s Mot.”), see ECF No. 14. Upon
careful consideration of the motions, oppositions, and Ms.
Pyatt’s reply and notice of supplemental authority, the
administrative record, and the relevant case law, the Court
GRANTS Ms. Pyatt’s motion to reverse the Commissioner’s final
decision, see ECF No. 13; and DENIES the Commissioner’s motion
to affirm her final decision, see ECF No. 14. The Court DENIES
Ms. Pyatt’s request for an award of benefits and REMANDS to the
Commissioner for reconsideration.
II. Background
Ms. Pyatt is a resident of the District of Columbia. See
Compl., ECF No. 1 ¶ 1. She has been diagnosed with various
mental-health disorders, including bipolar one disorder, cocaine
dependence, alcohol dependence, bipolar disorder with psychotic
features, and depressive disorder. Administrative Record
(“A.R.”), ECF No. 11-2 at 15. On March 7, 2012, Ms. Pyatt filed
an application for supplemental security income (“SSI”) payments
under Title XVI of the Social Security Act. A.R., ECF No. 11-2 at
12. This application was denied, and Ms. Pyatt now seeks reversal
of the decision. See Compl., ECF No. 1 at 8. Before discussing
the factual background in this case, the Court will set forth
2 the relevant legal framework.
A. Legal Framework
1. Defining Disability and Qualifying for Benefits
To qualify for Social Security under Title XVI of the
Social Security Act, Ms. Pyatt must first establish that she is
“disabled.” See 42 U.S.C. § 423(a)(1)(E). Disability is the
“inability to engage in any substantial gainful activity by
reason of any medically determinable or mental impairment . . .
which has lasted or can be expected to last for a continuous
period of not less than 12 months.” Id. § 423(d)(1)(A); see id.
§ 1382c(a)(3)(A). Ms. Pyatt is disabled “only if [her] physical
or mental impairment or impairments are of such severity that
[she] is not only unable to do [her] previous work but cannot,
considering [her] age, education, and work experience, engage in
any other kind of substantial gainful work which exists in the
national economy.” Id. §§ 423(d)(2)(A), 1382c(a)(3)(B).
2. Sequential Evaluation Process
The Administrative Law Judge (“ALJ”) must conduct a five-
step sequential evaluation to assess a claimant’s alleged
disability. See 20 C.F.R. §§ 404.1520, 416.920 (2012). The
claimant bears the burden of proof at the first four steps, and
the burden shifts to the Commissioner at step five. See Butler
v. Barnhart, 353 F.3d 992, 997 (D.C. Cir. 2004).
First, the ALJ must find that the claimant is not presently
3 engaged in “substantial gainful” work. 20 C.F.R. §§ 404.1520(b),
416.920(b). Second, they must find that the claimant has a
“severe impairment” that “significantly limits” her ability to
do basic work activities. Id. §§ 404.1520(c), 416.920(c). Third,
if the ALJ finds that the claimant suffers from an impairment
that meets one of those listed in 20 C.F.R. § 404, Subpart P,
Appendix 1, she is deemed disabled, and the inquiry ends. Id. §§
404.1520(d), 416.920(d). If the claimant’s impairment does not
meet one of those listed in the Appendix, the ALJ determines her
Residual Functional Capacity (“RFC”) based upon all the evidence
of record. Id. §§ 404.1520(e), 416.920€. Once a determination of
the claimant’s RFC has been made, the ALJ moves to step four to
determine whether her RFC allows her to do work that she used to
do, which is called “past relevant work.” Id. §§ 404.1520(f),
416.920(f). If the claimant’s RFC does not allow her to do past
relevant work, the ALJ moves on to step five, where they
determine whether the claimant’s RFC allows her to adjust to any
other work, given her age, education, and work experience. Id.
§§ 404.1520(g), 416.920(g). If the ALJ finds that the claimant
can either perform past relevant work (at step four) or that she
can adjust to any other work (at step five), they will find that
the claimant is not disabled. Id.
4 3. Drug Addiction or Alcoholism as a “Contributing Factor Material” to the Individual’s Disability
An individual with a disability is ineligible for SSI
benefits if drug addiction or alcoholism (DAA) 3 is a
“contributing factor material” to the individual’s disability.
42 U.S.C. § 423(d)(2)(C). DAA is “material” “if the claimant
would not meet the definition of disability if they were not
using drugs or alcohol.” SSR 13-2p, 78 Fed. Reg. at 11,941. The
ALJ must evaluate the extent to which the claimant’s mental and
physical limitations would remain absent substance use; if the
remaining limitations would not be disabling, the substance use
disorder is a contributing factor material to the determination
of disability such that the claimant is not considered disabled.
20 C.F.R § 416.935.
B. Factual Background
Ms. Pyatt has been diagnosed with various mental-health
disorders, including bipolar one disorder, cocaine dependence,
alcohol dependence, bipolar disorder with psychotic features, and
depressive disorder. A.R., ECF No. 11-2 at 15. She has suffered
sexual abuse, rape, and domestic violence, including as a child.
Pl.’s Mot., ECF No. 13 at 5–6. She has struggled to find an
3 SSA indicates that “drug addiction” and “alcoholism” are medically outdated terms, but it uses the words because they appear in the statute. SSR 13-2p, 78 Fed. Reg. 11,939 (Feb. 20, 2013).
5 appropriate psychiatric care regime and has used drugs and
alcohol for more than three decades, with periods of sobriety.
Id. at 7–8. Ms. Pyatt has been hospitalized at least fifteen
times. Id. at 8. Her efforts to work, including through
attempting her GED, pursuing vocational rehabilitation, and
holding temporary positions, have been largely unsuccessful. Id.
at 10–11.
Dr. Joel Cohen is a psychiatrist who treated Ms. Pyatt,
first at Psychiatric Center Chartered in 2003 or 2004 and then at
Community Connections from 2010 through 2014. Id. at 8. Dr.
Cohen’s notes from his treatment of Ms. Pyatt (which Ms. Pyatt
relies on as Dr. Cohen’s medical opinion) expand on Ms. Pyatt’s
difficulties. See, e.g., A.R., ECF No. 11-12 at 136 (Dr. Cohen
recorded on June 9, 2010 that Ms. Pyatt came to him “with acute
depressive symptoms and self destructive thoughts”); id. at 54
(on February 29, 2012, Dr. Cohen noted that “[s]he has been
experiencing abuse and has had difficulty dealing with the
trauma, turn (sic) to alcohol and on February 22nd had a FD-12
at CPEP overnight”); id. at 24 (in his treatment notes on August
31, 2012, Dr. Cohen recorded: “She is struggling with no income,
though has been trying to do some part-time work, which has been
difficult given her many symptoms.” He added: “She is reporting
that she is clean and sober, does take her medication
appropriately, but is presenting with increased depressive
6 symptoms including a good deal of irritability, low frustration
tolerance, difficulties with concentration and focus and
intensified trama [sic] symptoms.”). Ms. Pyatt’s medications
have changed several times, which she alleges makes it hard for
her to keep track of her medications. A.R., ECF No. 11-2 at 51,
56. Some medications have made her feel worse, and have had side
effects such as making her break out in hives, giving her
nightmares, and making her confused, sleepy and moody. Id. at
52, 56-57, 77. Ms. Pyatt also takes medicine for gout, heart
palpitations, and high blood pressure. Id. at 61.
As to the link between substance abuse and Ms. Pyatt’s
mental disorders, the record establishes the following: Following
her sexual abuse, Ms. Pyatt began experiencing depressive
symptoms at the age of thirteen before she ever started abusing
drugs and alcohol. Id. at 47. She had an eighteen-month period
of abstinence during the 1990s in which she continued to
experience bipolar and anxiety symptoms. A.R., ECF No. 11-2 at
57-59. She also had a psychiatric hospitalization in March 2012
after she had been sober for over one month. Id. at 47. Her
symptoms improved when she was off drugs and alcohol and taking
her medication, as periods in February 2012 and May 2013
demonstrate. Id. at 16, 26–27; see also id. at 84. Her symptoms
worsened when she used substances and did not take her
medication. Id. at 16, 27–28. Sometimes Ms. Pyatt drinks because
7 she is feeling bad, and the alcohol makes her feel better. Id.
at 63.
C. Procedural History
On March 7, 2012, Ms. Pyatt filed an application for SSI
payments under Title XVI of the Social Security Act. A.R., ECF
No. 11-2 at 12. Ms. Pyatt alleges disability beginning July 1,
2007. Id. On her disability report, Ms. Pyatt alleged that
bipolar disorder and depression limited her ability to work. See
Compl., ECF No. 1 ¶ 31. Her application was denied both
initially and upon reconsideration. A.R., ECF No. 11-2 at 9. An
ALJ then denied the claim in a decision dated October 2, 2014.
Id. Following a remand from the Appeals Council, which asked for
an analysis of whether drug addiction and alcoholism are
contributing factors material to the determination of
disability, an ALJ, F.H. Ayer (“ALJ Ayer”) again reviewed the
case. Id. On September 8, 2016, ALJ Ayer held a hearing at which
Ms. Pyatt, Ms. Candace Loeffler, and a Vocational Expert (“VE”),
Mr. Mark Heckman, testified. Id. ALJ Ayer issued a decision
denying benefits on January 11, 2017. Id. at 35.
Although ALJ Ayer found that Ms. Pyatt had a disability, he
determined that drug addiction and alcoholism were a “material
factor contributing” to the finding of disability. Id. at 19, 34.
Specifically, ALJ Ayer determined that in the absence of drugs
and alcohol, Ms. Pyatt could “perform work that does not require 8 performing more than simple 1-4 step, routine, repetitive tasks
in a work environment with only occasional contact with
coworkers and supervisors and no general public contact.” Id. at
20. ALJ Ayer did not assign any weight to Dr. Cohen’s statements
in either opinion. See Pl.’s Mot., ECF No. 13 at 13. The Appeals
Council denied review on October 13, 2017, rendering ALJ Ayer’s
decision the final decision of the Commissioner. Id. at 2.
On June 18, 2018, Ms. Pyatt filed a Motion for Judgment of
Reversal. See ECF No. 13. Ms. Pyatt’s action raises two issues:
(1) whether ALJ Ayer properly evaluated the medical opinion
evidence; and (2) whether ALJ Ayer properly determined that Ms.
Ayer would not be disabled if she stopped her substance abuse. On
August 2, 2018, Defendant filed a Motion for Judgment of
Affirmance, see ECF No. 14; and a Memorandum in Opposition
(“Def.’s Opp’n), ECF No. 15. Ms. Pyatt replied on August 24,
2018, Ms. Pyatt. See Pl.’s Reply, ECF No. 16. The motions are
fully briefed and ready for adjudication.
III. Standard of Review
Judicial review in this Court is statutorily limited to
whether the Commissioner, acting through the ALJ, correctly
applied the relevant law, and whether there is substantial
evidence to support the Commissioner’s final decision that Ms.
Pyatt was not disabled. See 42 U.S.C. § 405(g); Butler, 353 F.
3d at 999. “Substantial evidence” is “such relevant evidence as
9 a reasonable mind might accept as adequate to support a
conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971). It
“requires more than a scintilla, but can be satisfied by
something less than a preponderance of the evidence.” Butler,
353 F.3d at 999 (quoting Florida Mun. Power Agency v. F.E.R.C.,
315 F.3d 362, 366 (D.C. Cir. 2003) (internal quotation omitted).
A court’s review of administrative decisions for substantial
evidence requires “careful scrutiny of the entire record.” Brown
v. Bowen, 794 F.2d 703, 705 (D.C. Cir. 1986). But a court “may
not reweigh the evidence presented to it . . . [or] replace the
[Commissioner’s] judgment concerning the weight and validity of
the evidence with its own. Davis v. Heckler, 566 F. Supp. 1193,
1195 (D.D.C. 1983).
IV. Discussion
Ms. Pyatt argues that legal errors tainted ALJ Ayer’s
conclusion that DAA was material to her disability. First, Ms.
Pyatt argues that ALJ Ayer did not properly consider the view of
Dr. Cohen, her treating physician, under 20 C.F.R. § 416.927(c).
Pl.’s Mot., ECF No. 13, at 14. Second, Ms. Pyatt argues that ALJ
Ayer did not properly disentangle her drug and alcohol use and
her disabling limitations concerning periods of sobriety and
hospitalization. Id. at 18 (citing SSR 13-2p, 78 Fed. Reg.
11,939). The Court considers each of these arguments in turn.
10 A. ALJ Ayer Did Not Properly Consider Dr. Cohen’s Opinion
Ms. Pyatt argues ALJ Ayer erred in not considering what she
presents as Dr. Cohen’s opinion that she would have a disability
even if she stopped her drug and alcohol use. Pl.’s Mot., ECF
No. 13 at 18. She contends that ALJ Ayer should have given Dr.
Cohen’s opinion controlling weight, or at least should have
stated his reasons for giving less or no weight to the opinion.
Id. The Commissioner makes two principal counterarguments.
First, the Commissioner argues that Ms. Pyatt does not cite to a
medical opinion. Def.’s Opp’n, ECF No. 15 at 7. Second, the
Commissioner argues that this Court should not remand even if
Ms. Pyatt cites to a medical opinion, because Dr. Cohen’s
medical opinion only addressed whether Ms. Pyatt would have
symptoms, not whether Ms. Pyatt would have a disability, and
because substantial evidence of materiality outweighed Dr.
Cohen’s medical opinion to the contrary. Id. at 8. At most, the
Commissioner contends, “Ms. Pyatt cites to treatment notes that,
according to Ms. Pyatt, indicate that some of her symptoms
persisted during periods of abstinence.” Id. The Commissioner
does not contest that Dr. Cohen was Ms. Pyatt’s “longstanding”
treating physician. Pl.’s Mot., ECF No. 13, at 16. Ms. Pyatt
replies that the Commissioner’s argument that Dr. Cohen’s
statements do not qualify as medical opinions focuses overly on
their classification as treatment notes rather than the relevant 11 definition. Pl.’s Reply, ECF No. 16 at 8. The Court agrees with
Ms. Pyatt and concludes that she properly cites to a medical
opinion that ALJ Ayer should have considered.
Ms. Pyatt’s argument rests on Dr. Cohen’s “assessment in
2012 that – even when Ms. Pyatt was sober and complying with her
treatment regimen – her symptoms persisted.” Pl.’s Mot., ECF No.
13 at 17. Dr. Cohen’s full statement in the Record is as
follows: “She is reporting that she is clean and sober, does
take her medication appropriately, but is presenting with
increased depressive symptoms including a good deal of
irritability, low frustration tolerance, difficulties with
concentration and focus and intensified trama (sic) symptoms.”
A.R., ECF No. 11-12 at 24. Ms. Pyatt further asserts that Dr.
Cohen “found that Ms. Pyatt’s trauma symptoms were causing her
to abuse substances, not the other way around.” Pl.’s Mot., ECF
No. 13 at 17. Dr. Cohen’s statement in the Record provides: “She
has been experiencing abuse and has had difficulty dealing with
the trauma, turn (sic) to alcohol and on February 22nd had a FD-
12 at CPEP overnight.” A.R., ECF No. 11-12 at 54. Further,
“[s]he does use her substances as medication.” Id. at 136. 4
Lastly, Ms. Pyatt asserts that Dr. Cohen “observed that Ms.
4 Ms. Pyatt also cites to A.R., ECF No. 11-16 at 61, but this page does not contain a statement of Dr. Cohen’s and does not assert that Ms. Pyatt’s trauma symptoms caused her to abuse substances. 12 Pyatt did not have the capacity to better manage her trauma
symptoms.” Pl.’s Mot., ECF No. 13 at 17. Dr. Cohen’s statement
in the Record is as follows: “She obviously does have poor
coping skills.” A.R., ECF No. 16 at 67. Ms. Pyatt adds that Dr.
Cohen’s medical opinion is “well-supported and not contradicted
by substantial evidence.” Pl.’s Mot., ECF No. 13 at 17.
Federal regulations instruct the Social Security
Administration (“SSA”) to “evaluate every medical opinion” in
considering a claim for SSI benefits. 20 C.F.R. § 416.927(c). 5
Medical opinions are statements that reflect “judgments about
the nature and severity of [the claimant’s] impairment(s),
including [the claimant’s] symptoms, diagnosis and prognosis.”
Id. § 416.927(a)(1).
Facially, the Commissioner’s argument has intuitive appeal:
Dr. Cohen’s statements are presented in his treatment notes,
rather than an explicit diagnosis directly conveyed to the
patient. However, the Commissioner provides no case law that
suggests treatment notes cannot be considered as medical
judgments, nor does the Commissioner engage substantively with
the contents of the notes, and whether they amount to “judgments
about the nature and severity of [Ms. Pyatt’s] impairment(s),
5 This regulation only covers claims, like this one, filed before March 27, 2017. A superseding regulation governs claims filed after that date. 20 C.F.R. § 416.920(c). 13 including [Ms. Pyatt’s] symptoms, diagnosis and prognosis.” Id.
§ 416.927(a)(1). The Court concludes that they do. First, Dr.
Cohen’s statements address Ms. Pyatt’s “increased depressive”
symptoms, including “a good deal of irritability, low
frustration tolerance, difficulties with concentration and focus
and intensified trama (sic) symptoms.” A.R., ECF No. 11-12 at
24. Second, Dr. Cohen’s statements that Ms. Pyatt “turn[ed]” to
alcohol in dealing with her trauma resemble a diagnosis, even if
not explicitly conveyed to Ms. Pyatt in the moment. Id. at 136.
Third, Dr. Cohen’s statement that Ms. Pyatt has limited coping
skills resembles a prognosis. See A.R., ECF No. 11-15 at 67. Dr.
Cohen’s statements plainly appear to fit the definition of a
“medical opinion” as stated in the relevant regulation, which
defines medical opinion “functionally.” 20 C.F.R. § 416.927(c).
As Ms. Pyatt notes, “there is no ‘treatment note’ exception to
the definition of ‘medical opinion.’” Pl.’s Reply, ECF No. 16 at
9. In fact, persuasive authority cuts the opposite way. In
Furister, the court rejected an argument that the ALJ did not
have to consider a medical opinion that occurred in a treatment
note. Furister v. Comm’r of Soc. Sec., No. 16-10454, 2017 U.S.
Dist. LEXIS 17447, at *29 (E.D. Mich. Feb. 8, 2017).
The Commissioner argues that “[t]o the extent that Dr.
Cohen’s notes could be construed as an opinion supporting
disability, ALJ Ayer cited to substantial evidence undermining
14 the opinion.” Def.’s Mot., ECF No. 2 at 11. However, viewed
differently, Dr. Cohen’s notes could themselves undermine ALJ
Ayer’s opinion. Moreover, this argument mistakes the relevant
standard, which requires that ALJs must “evaluate every medical
opinion” in considering a claim for SSI benefits. 20 C.F.R. §
416.927(c) (emphasis added). While the evidence cited by ALJ
Ayer may in comparison undercut the contents of the treatment
notes, there is no evidence to suggest that Dr. Cohen’s opinion
was considered at all. It is also irrelevant whether ALJ Ayer
“agreed that Plaintiff would still experience symptoms if she
stopped abusing substances.” Def.’s Mot., ECF No. 2 at 11.
First, Ms. Pyatt’s argument is that Dr. Cohen’s notes state she
would have a disability, not just experience symptoms, if she
stopped abusing substances. Second, the relevant legal standard
requires that ALJ Ayer have considered every medical opinion,
particularly that of a treating physician like Dr. Cohen, whose
medical opinion “[g]enerally” receives “more weight” and may
even receive “controlling weight.” Id. § 416.927(c)(2). If, even
without considering Dr. Cohen’s opinion, ALJ Ayer agreed that
Ms. Pyatt would experience symptoms without abusing substances,
it is possible that Dr. Cohen’s opinion could persuade ALJ Ayer
that Ms. Pyatt would continue to have a disability if she
stopped abusing substances.
15 The Court concludes that Dr. Cohen’s treatment notes are
“medical opinions” that must be considered, and remands to the
Commissioner to reconsider Ms. Pyatt’s disability anew. On
remand, ALJ Ayer should explain what weight he attaches to Dr.
Cohen’s conclusions, or if he attaches none, his reasons
therefor. See Simms v. Sullivan, 877 F.2d 1047, 1053 (D.C. Cir.
1989).
B. ALJ Ayer Erred in Not Considering Periods of Abstinence
Ms. Pyatt argues that ALJ Ayer “violated the SSA’s rules
regarding how to analyze the impact of the substance use
disorder on her mental health impairments,” by “speculat[ing]
that the cessation of such use would allow Ms. Pyatt to work,
contrary to an abundance of evidence in the Record . . ..” Pl.’s
Mot., ECF No. 13 at 18. Ms. Pyatt points to four specific
instances. First, she asserts that ALJ Ayer “incorrectly framed
the question as whether drug abuse or alcoholism contributed to
Ms. Pyatt’s limitations and speculated as to whether substance
use fostered noncompliance with Ms. Pyatt’s medication regimen.”
Id. at 19. Next, she argues that ALJ Ayer did not properly
analyze her periods of sobriety. Id. at 21. Third, she contends
that “the ALJ further erred by failing to properly consider the
sheer volume of [her] [] hospitalizations.” Id. at 22. Finally,
she reiterates that ALJ Ayer failed to consider Dr. Cohen’s
opinion. The Court considers each of these arguments in turn, 16 except for the last one as to Dr. Cohen, which has already been
discussed supra.
First, Ms. Pyatt argues that ALJ Ayer violated SSR 13-2 by
finding that her drug addiction “contributed to” her disability,
instead of asking whether substance abuse “was the only barrier
between her current disability and her ability to work.” Pl.’s
Mot., ECF No 13 at 18-19. The Commissioner responds that this
argument is semantical, and that ALJ Ayer properly followed the
sequential evaluation necessary to find that if Ms. Pyatt
stopped her substance abuse, her impairments would not meet the
requirements for presumptive disability. Def.’s Mot., ECF No. 14
at 14. The Court agrees with the Commissioner.
SSR 13-2p requires evidence that a claimant, already found
to have a disability, would not have a disability in the absence
of DAA. “To support a finding that DAA is material, we must have
evidence in the case record that establishes that a claimant
with a co-occurring mental disorder(s) would not be disabled in
the absence of DAA.” SSR 13-2p, 78 Fed. Reg. at 11,943.
Conversely: “We will find that DAA is not material to the
determination of disability and allow the claim if the record is
fully developed and the evidence does not establish that the
claimant’s co-occurring mental disorder(s) would improve to the
point of non-disability in the absence of DAA.” Id. at 11,944.
17 The problem with Ms. Pyatt’s argument is that she cherry-
picks a few sentences from ALJ Ayer’s detailed analysis, see
A.R., ECF No. 11-2 at 19-21; but overlooks his reasoned
conclusion that “[i]f the claimant stopped the substance abuse,
the remaining limitations would not meet or medically equal the
criteria of listings,” id. at 19. As the Commissioner points
out, ALJ Ayer “provided numerous well-supported reasons for his
conclusion that if Ms. Pyatt stopped abusing drugs and alcohol,
she would not be disabled.” Def.’s Opp’n, ECF No. 15, at 11. For
instance, ALJ Ayer finds that “once Ms. Pyatt ceased her
substance abuse and began taking medications, her symptoms were
no longer disabling.” Id. ALJ Ayer highlights evidence from
February 2012 and May 2013 showing that Ms. Pyatt’s condition
improved when not using drugs or alcohol and when taking her
medications. See A.R., ECF No. 11-2 at 26-27. In contrast, her
disability manifested when she was using drugs or alcohol and
not taking her medications. See id. at 25-26. Ms. Pyatt does not
show that SSR 13-2p prohibited ALJ Ayer from considering
evidence of improvement after hospitalization and medication,
even if the regulation cautions against it.
This evidence, along with other evidence in the decision,
is substantial because it offers “such relevant evidence as a
reasonable mind might accept as adequate to support a
conclusion” that Ms. Pyatt would not have a disability if she
18 stopped using drugs or alcohol. 20 C.F.R. § 404.901. Substantial
evidence “entails a degree of deference to the Commissioner’s
decision,” and the Court “may not reweigh the evidence and
‘replace the [Commissioner]’s judgment regarding the weight and
validity of the evidence with its own.’” Jackson v. Barnhart,
271 F. Supp. 2d 30, 33-34 (D.D.C. 2002) (citing Davis v.
Heckler, 566 F. Supp. 1193, 1195 (D.D.C. 1983)).
Ms. Pyatt’s argument from case law that substantial
evidence does not support ALJ Ayer’s conclusion relies heavily
on Murray v. Colvin, No: 1:16-CV-00181, 2017 WL 1289588
(W.D.N.Y. April 6, 2017). In Murray, an ALJ determined that the
claimant had a disability, but denied him benefits because DAA
was a contributing factor material to the disability. 2017 WL
1289588, at *1–2. The court determined that SSR 13-2p “is quite
restrictive and requires that the record conclusively establish
that, in the absence of DAA, plaintiff’s condition would improve
to the point of nondisability.” Id. at *3. The court then
conducted a “careful review of the record” and found “no
evidence” supporting the ALJ’s conclusion. Id. at *4.
Additionally, a treating physician whose medical opinion
received “significant” weight stated on the record that the
claimant’s limitations in the absence of DAA were “unknown.” Id.
at *2, *4. Here, ALJ Ayer considered evidence from a multitude
of sources, including function reports from nonmedical sources,
19 medical opinions (but incorrectly omitting Dr. Cohen’s), medical
and personal history, hospitalization records and hearing
testimony, before concluding that Ms. Pyatt would not have a
disability absent substance abuse. See A.R., ECF No. 11-2 at 22-
33. Consequently, Murray does not demonstrate that ALJ Ayer’s
decision in this case lacked substantial evidence.
Ms. Pyatt also argues that ALJ Ayer “failed to acknowledge
(as required by SSR 13-2p) that she has had periods of
abstinence during which she exhibited psychiatric symptoms.”
Pl.’s Mot., ECF No. 13 at 21. Ms. Pyatt points to an eighteen-
month period of sobriety in the 1990s in which she experienced
bipolar and anxiety symptoms. Id. The Commissioner responds that
“the question is not whether Ms. Pyatt experienced symptoms, but
whether she had disabling limitations.” Def.’s Opp’n, ECF No.
15, at 12. The Court agrees with Ms. Pyatt that ALJ Ayer
improperly failed to consider her behavior during periods of
abstinence.
SSR 13-2p indicates how SSA evaluates periods of
abstinence, hospitalization, and treatment. However, SSA is
“unable to provide exact guidance on the length and number of
periods of abstinence to demonstrate whether DAA is material in
every case.” SSR 13-2p, 78 Fed. Reg. at 11,945. A “single,
continuous period of abstinence” may be enough to enable ALJs to
make a judgement about materiality. Id. “If, however, a claimant
20 is abstinent and remains disabled throughout a continuous period
of at least 12 months, DAA is not material even if the
claimant’s impairment(s) is gradually improving.” Id. at n.26.
The record shows that Ms. Pyatt continued to experience
psychiatric symptoms even during periods of abstinence,
including an 18-month long period of abstinence. A.R., ECF No.
11-2 at 58-59; ECF No. 11-9 at 77. Admittedly, this period was
decades prior in the late 1990s, and it is possible Ms. Pyatt’s
symptoms did not rise to the level of a disability, but ALJ Ayer
did not consider that period at all. The Commissioner argues
that “the question is not whether Plaintiff experienced
symptoms, but whether she had disabling limitations,” Def.’s
Mot., ECF No. 14 at 14; but the Court cannot fathom how it is
possible to properly determine the latter (Plaintiff’s
limitations without substance abuse) without even considering
the former (Plaintiff’s symptoms in the absence of substance
abuse). The Commissioner is incorrect that the “burden is on
Plaintiff to demonstrate limitations beyond those found by the
ALJ.” Id. Rather, Ms. Pyatt “has the burden of proving
disability throughout the sequential evaluation process.” SSR 13-
2p, 78 Fed. Reg. at 11,941. At this stage, post an ALJ’s
decision, “the party seeking reversal normally must explain why
the erroneous ruling caused harm,” Nelson, 131 F.3d at 1236;
which Ms. Pyatt adequately does here by arguing that in
21 erroneously overlooking evidence as to abstinent periods, ALJ
Ayer deprived her of benefits.
Ms. Pyatt further argues that ALJ Ayer’s analysis
“conflicts with the SSA’s instructions that ALJs be cautious
when evaluating evidence demonstrating that the claimant’s co-
occurring mental disorder(s) improved when he or she received
treatment in a highly structured setting.” Pl.’s Mot., ECF No.
13 at 21. However, as Defendant observes, “SSR 13-2p does not
prohibit an ALJ from considering improvement post-
hospitalization.” Def.’s Opp’n, ECF No. 15, at 12. SSR 13-2p
states that SSA “may find that a claimant’s co-occurring mental
disorder(s) is still disabling even if increased support or a
highly structured setting reduce the overt symptoms and signs of
the disorder.” SSR 13-2p, 78 Fed. Reg. at 11,939 (emphasis
added). However, SSR 13-2p did not require ALJ Ayer to find that
the mental disorder was still disabling. While ALJ Ayer could
have been more cautious in his analysis to avoid focusing on the
“brief moments” where Ms. Pyatt’s symptoms “may [have]
appear[ed] to improve because of the structure and support
provided in a highly structured treatment setting,” id. at
11,945; the Court cannot “replace the [Commissioner’s] judgment
concerning the weight and validity of the evidence with its
own." Heckler, 566 F. Supp. at 1195.
22 Ms. Pyatt also argues that ALJ Ayer “erred by failing to
properly consider the sheer volume of Ms. Pyatt
hospitalizations.” Pl.’s Mot., ECF No. 13, at 22. SSR 13-2p
indicates that “a record of multiple hospitalizations, emergency
department visits, or other treatment for the co-occurring
mental disorder—with or without treatment for DAA—is an
indication that DAA may not be material even if the claimant is
discharged in improved condition after each intervention.” SSR
13-2p, 78 Fed. Reg. at 11,939. However, as above, SSR 13-2p does
not mandate that a record of multiple hospitalizations is an
indication that DAA is not material.
The Court concludes that Ms. Pyatt fails to show that ALJ
Ayer went beyond his authority in evaluating Ms. Pyatt’s
hospitalizations or treatment, except in ignoring periods of
C. Remand Rather Than an Award of Benefits is the Appropriate Remedy
In her request for relief, Ms. Pyatt asks this Court to
award her benefits rather than to remand for further
proceedings. Pl.’s Mot., ECF No. 13 at 23. In support, Ms. Pyatt
maintains that the record in her case has been thoroughly
developed and a “hearing would merely “function to delay the
[inevitable] award of benefits.” Id. The Court disagrees.
23 Courts award benefits when the ALJ could not reasonably
decide against the claimant on remand. See Ademakinwa v. Astrue,
696 F. Supp. 2d 107, 112 (D.D.C. 2010); Lockard v. Apfel, 175 F.
Supp. 2d 28, 33–34 (D.D.C. 2001). In Ademakinwa, the defendant
conceded that substantial evidence did not support the ALJ’s
decision, nor did the defendant “controvert” the plaintiff’s
evidence. 696 F. Supp. 2d at 112. The court awarded benefits
because the defendant “suggested no basis” for it to prevail on
remand. Id. In Lockard, the ALJ “irrationally” disregarded a
treating physician’s diagnosis. 175 F. Supp. 2d at 33. The
district court awarded benefits because it would have been
“virtually impossible” for the ALJ to find against the plaintiff
if the ALJ properly accepted the treating physician’s testimony.
Id. at 34.
On the other hand, courts identifying errors in an ALJ’s
assessment of a treating physician’s medical opinion have
remanded for the ALJ to consider the opinion. See Simms, 877
F.2d at 1052–53. In Simms, the claimant argued that the ALJ had
not considered a treating physician’s opinion that the claimant
experienced pain. 877 F.2d at 1052. This opinion “could have
affected” the ALJ’s decision to discount the claimant’s own
testimony concerning his pain. Id. at 1053. The United States
Court of Appeals for the District of Columbia Circuit (“D.C.
Circuit”) instructed the ALJ to explain the weight he attaches
24 to the treating physician’s opinion or his reasons for not
attaching any weight. Id. In Jackson, the ALJ did not cite to
the records of a treating physician. 271 F. Supp. 2d at 36. The
oversight was “troubling” because the treating physician’s
records indicated that the plaintiff had an impairment listed as
“presumptively disabling.” Id. The court did not award benefits
or even instruct the ALJ to grant controlling weight to this
physician on remand. Id. Instead, the court instructed the ALJ
to “reweigh the evidence” and, if not giving controlling weight
to the medical opinion, to “explain the reasons for this
decision.” Id.
In this case, ALJ Ayer could reasonably find against Ms.
Pyatt on remand. The Commissioner has not conceded that ALJ
Ayer’s decision lacked substantial evidence in support, and in
fact contests the evidence in Ms. Pyatt’s favor, unlike in
Ademakinwa, 696 F. Supp. 2d at 112. Lockard provides more
support for Ms. Pyatt because that case involved an ALJ’s
disregard for a treating physician’s testimony. See 175 F. Supp.
2d at 33–34. However, the court considered it “virtually
impossible” for the ALJ to find against the plaintiff after
considering the treating physician’s testimony. Id. Here,
however, Ms. Pyatt has not shown that Dr. Cohen’s opinion would
make it “virtually impossible” for ALJ Ayer to rule against her.
Instead, this case is most similar to Simms, in which the
25 treating physician’s opinion “could have affected” ALJ Ayer’s
decision. 877 F.2d at 1053. Even in Jackson, in which the ALJ’s
oversight of a treating physician’s opinion was “troubling,” the
court did not award benefits but instructed the ALJ to reweigh
the evidence. See 271 F. Supp. 2d at 36. Because ALJ Ayer on
remand could properly consider Dr. Cohen’s medical opinion and
decide whether to give it controlling weight, the Court deems it
appropriate to remand rather than to award benefits. Cf.
Heckler, 566 F. Supp. at 1195 (the court may not replace the
[Commissioner’s] judgment concerning the weight and validity of
the evidence with its own).
The supplemental authority that Ms. Pyatt submitted to this
Court on April 6, 2021 does not change the Court’s conclusion.
See Pl.’s Notice Suppl. Authority, ECF No. 17, at 1–2 (citing
Dowling v. Comm’r of Soc. Sec. Admin., 986 F.3d 377, 386 (4th
Cir. 2021)). In Dowling, the plaintiff sought Social Security
Disability Insurance, not Supplemental Security Income.
Nevertheless, the underlying regulations concerning a treating
physician’s medical opinion are identical. 6 Compare 20 C.F.R. §
404.1527 (SSDI) with 20 C.F.R. § 416.927 (SSI). In Dowling, the
United States Court of Appeals for the Fourth Circuit (“Fourth
6 As with the regulations governing this case, superseding regulations govern claims filed on or after March 27, 2017. 20 C.F.R. § 404.1520c. 26 Circuit”) agreed with the ALJ that the treating physician’s
medical opinion did not merit controlling weight. 986 F.3d at
386. However, the court faulted the ALJ for not considering each
of the factors for assigning weight to a medical opinion. Id.;
see also 20 C.F.R. § 404.1527(c). The court remanded because
greater weight for the opinion reasonably could have altered the
ALJ’s conclusion. 986 F.3d at 386. Without the ALJ’s adequate
explanation for the weight he assigned to the treating
physician’s medical opinion, the district court could not review
the SSA’s determination. Id. A similar rationale as to Dr.
Cohen’s opinion, and the periods of abstinence, applies here.
For these reasons, the Court concludes that the case should be
remanded to the Commissioner.
27 V. Conclusion and Order
For the reasons set forth above, it is hereby
ORDERED that Ms. Pyatt’s Motion for Judgment of Reversal,
see ECF No. 13, is GRANTED; and it is further
ORDERED that the Commissioner’s Motion for Judgment of
Affirmance, see ECF No. 14, is DENIED. This case is HEREBY
REMANDED to the Commissioner for a decision consistent with this
Memorandum Opinion and Order.
SO ORDERED.
Signed: Emmet G. Sullivan United States District Judge July 6, 2022