There's only one published opinion from the Ninth Circuit and California appellate courts thus far today. And when I first saw it, I thought it wouldn't likely be something worth writing about. It's a Social Security disability case. You see those published from time to time. They're almost always fact-specific to the particular plaintiff involved and his or her specific complaints. Not doctrinally complicated, at least usually.
Which is indeed true for today's opinion. It's basically just about whether Travis Coleman is in fact a person who's disabled from working.
But what makes the case interesting -- at least for me -- is that I suspect that Mr. Coleman's problem is one shared by a nontrivial number of people in America these days.
Mr. Coleman says he suffers an immense amount of pain. Pain that's so severe to be debilitating, and that prevents him from doing his usual IT job. (Because, in essence, "all he can think about is the pain he's in," not his actual occupation.) Of course, pain is inherently subjective; you can often see its objective cause, but sometimes you can't. And, obviously, sometimes people can say they're in pain (perhaps in an attempt to get disability benefits) when they're actually not. So it's necessarily hard to figure out whether someone's actually in pain. The issue relies a lot on credibility calls.
Mr. Coleman's various doctors and nurses are split on whether they can find an objective cause for his subjective complaints of pain. Some say there's nothing there -- or at least nothing they can find. But others say that, yep, there's a spinal problem that may well explain why he says he's in severe pain.
But the ALJ thinks there's an alternative explanation for what's going on here. One that isn't as simple as just "he's lying about pain just to get money."
The ALJ concludes that Mr. Coleman says he's in pain not particularly to get money, but rather to get drugs. Painkillers. Opioids. What's the evidence for that? Well, there's the fact that he went to his first doctor for multiple years, but then stopped going to that doctor "after the doctor declined to prescribe additional pain medication." Then there are the facts about just how many pain pills Mr. Coleman has received:
"Between the end of May and early June 2015, the record shows that Coleman visited the emergency room on three separate occasions with reports of severe neck pain. When he arrived at the ER on June 5, the ER doctor declined his request for pain medication, noting that an Emergency Department Information Exchange alert showed multiple prescriptions for pain medication being filled by multiple providers, with approximately 380 pills in the last 30 days and 800 pills in the last five months. When Coleman returned the next day with reports of even more severe pain, he was again denied pain medication."
Multiple providers and lots of pills. 380 pills in 30 days is approximately a dozen pain pills a day. That is a fair amount, no?
So the ALJ says that this is indicative of classic drug-seeking behavior. Though you see what the underlying problem is, right? Sure, he's (probably) got a drug problem. But is the drug problem a result of constantly being in pain (in which case, yeah, he's likely disabled), or is it instead a drug problem masquerading as a pain issue? Or, perhaps, something in between; he's got an opioid problem, and since he takes too many drugs, his synapses and the like are now all messed up, and he's now in constant pain as a result?
It's a toughie to be sure. And I'm quite confident that Mr. Coleman -- whatever the truth -- is not alone in his status.
The Ninth Circuit ultimately affirms the lower tribunals. There was a credibility call made that Mr. Coleman was engaged in drug-seeking behavior and that his stories weren't credible. The Ninth Circuit defers to that determination. So no disability benefits for him.
Which is why it makes sense to publish this opinion. Because I'm sure this is neither the first nor the last case about alleged drug-seeking patients and subjective complaints of pain.
Far from it.
