This United States District Court opinion and order responds to the claimant’s appeal of the denial of his application for Social Security benefits based on his HIV and other conditions. The claimant, DeHaven, applied for disability benefits and supplemental security income, based on asymptomatic HIV infection, osteoarthritis and allied disorders, and anti-social personality disorder. His application was denied by an administrative law judge (ALJ), who found him capable of performing medium work, with a few exceptions and specifications. DeHaven appealed, stating that the ALJ’s decision was not based on substantial evidence. Despite a deferential standard of review, the district court reversed the finding of no disability. The court found that the ALJ failed to provide evidence that the treating source’s (DeHaven’s physician) opinion was not supported by medically acceptable clinical and laboratory techniques nor was inconsistent with other evidence in the record. Thus, by failing to give that source adequate weight, the court found that the ALJ violated DeHaven’s procedural rights.
DeHaven’s complaint focuses on the ALJ’s opinion concerning strength limitations, mental limitations, and limitations on his residual functional capacity. Regarding DeHaven’s strength limitations, the consulting examing physician stated DeHaven was fit for sedentary work; the state agency reviewing physician found him capable of light work, an opinion affirmed by a third physician. The court held the ALJ’s discussion of range of motion test results and DeHaven’s subjective complaints were sufficient evidence to discount the consulting examining physician’s opinion. However the “cursory conclusion that they were not supported by objective medical evidence,” was insufficient to discount the other two medical opinions.
Similarly, the court held that the ALJ failed to articulate good reasons for discounting the two medical opinions regarding DeHaven’s mental limitations. The court was uncertain as to whether the ALJ even acknowledged DeHaven’s psychotherapist of 10 months as a treating source. The court found that the ALJ’s reason for rejecting the second medical opinion, simply stating it was “not substantiated,” was insufficient, as well. The ALJ weighted the medical opinions of two reviewing consulting sources more heavily than the opinions of the treating sources, despite the fact that the opinions from the treating sources were completed after the consulting opinions, so they could not have been considered by the reviewing sources. In light of the ALJ’s errors regarding exertional and mental limitations, the court also held that the ALJ should reconsider any limitations on DeHaven’s residual functional capacity, which may be affected by the exertional and mental limitations.
This decision is significant because it reinforces the procedural rights of people living with HIV when applying for disability benefits and supplemental security income. Since discrimination against people with HIV is not necessarily overt, unenforced procedural rights may provide an opportunity for such discrimination. This ruling acknowledges the essential nature of access to public benefits for people with HIV.