Ninth Circuit Upholds ALJ in Disability Case

The Ninth Circuit Court of Appeals issued an important decision in Higgins v. Kijakazi (Nov. 2, 2023), reinforcing the standards that govern how Administrative Law Judges (ALJs) assess subjective symptom testimony. The case centered on Marcie Higgins, a claimant who applied for disability benefits based on multiple impairments, including fibromyalgia, degenerative disc disease, arthritis, hip pain, and chronic shoulder issues. When her application was denied, she appealed, asserting that the ALJ improperly excluded her symptom testimony without sufficient justification.

Under long-standing Ninth Circuit precedent, an ALJ may not reject a claimant’s subjective symptom testimony arbitrarily. The legal standard requires the ALJ to offer “specific, clear, and convincing reasons” for discrediting such statements. Merely summarizing medical records or selectively highlighting evidence is not enough. In Higgins’ case, she argued that the ALJ had simply cherry-picked parts of her medical history while ignoring the full context of her symptoms and limitations.

However, the Ninth Circuit disagreed with the claimant’s position and affirmed the ALJ’s decision. The Court emphasized that inconsistencies between a claimant’s reported symptoms and their medical treatment history can justify the rejection of subjective testimony. Specifically, the Court pointed out that Higgins claimed to suffer from debilitating right shoulder pain, yet the record revealed minimal follow-through with recommended treatment. Despite a 17-year history of shoulder issues, Higgins had not pursued treatment beyond physical therapy and, notably, declined several scheduled appointments that were intended to manage her condition.

The Court further explained that when a claimant’s symptom reports are contradicted by objective medical evidence—or when the treatment history does not match the alleged severity of symptoms—the ALJ is not required to accept those reports as credible. In Higgins’ case, the ALJ cited multiple parts of the record where her reported limitations did not align with clinical findings. That detailed comparison between subjective claims and medical records was sufficient under the Ninth Circuit’s standard to uphold the decision.

Ultimately, the Ninth Circuit affirmed the district court’s judgment, concluding that the ALJ did not commit reversible error. The ruling serves as a critical reminder for Social Security disability claimants: to be successful, symptom testimony must be consistent with medical records and supported by adequate treatment efforts. When there is a gap between what a claimant says and what the records show—or if treatment is not pursued as recommended—it can severely undermine the case.

For individuals navigating the complex world of Social Security disability law, Higgins v. Kijakazi is a key example of how courts evaluate credibility, medical evidence, and procedural fairness. It underscores the importance of thorough documentation, consistent treatment history, and legal guidance in building a successful claim.

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