Unreported / Non-Citable
Background
James Ramsey, a 25-year-old who reported hearing voices since childhood and struggling with bipolar/schizoaffective disorder, methamphetamine use, incarceration, and homelessness, applied for Supplemental Security Income (SSI) benefits in November 2020. An Administrative Law Judge (ALJ) held a hearing in January 2024 and found Ramsey not disabled, concluding his physical impairments were non-severe and his mental impairments caused no more than moderate limitations.
A central feature of the record was repeated clinical notes suspecting “malingering” — treatment providers documented instances where Ramsey appeared to exaggerate or fabricate psychiatric symptoms (such as suicidal statements) in order to obtain food, housing vouchers, or a cell transfer, rather than because of genuine psychiatric crisis. The ALJ relied heavily on these notes, along with evidence of “calm, polite demeanor” and intact impulse control, to find Ramsey retained the residual functional capacity (RFC) to perform full-time work at all exertional levels with some limitations, and therefore was not disabled.
Ramsey sought judicial review under 42 U.S.C. § 405(g), asking the district court to reverse and order an immediate award of benefits, or alternatively remand for further proceedings. He argued the ALJ improperly rejected his testimony without sufficiently “clear and convincing” reasons, cherry-picked the medical record, and miscalculated his RFC.
The Court’s Holding
The court affirmed the ALJ’s decision in full. Under the Social Security Act, a reviewing court must uphold the Commissioner’s decision unless it rests on legal error or lacks “substantial evidence” — evidence a reasonable mind could accept as adequate, which is more than a scintilla but less than a preponderance. Normally, when an ALJ rejects a claimant’s testimony about the severity of symptoms, the ALJ must give “specific, clear and convincing” reasons for doing so. But the court explained that this heightened standard does not apply whenever there is affirmative evidence of malingering in the record — in that circumstance, the ALJ need only meet the ordinary substantial-evidence standard.
Applying that rule, the court found the ALJ had cited specific treatment notes — from Dr. Kory Combs, Dr. Amy Yang, and Dr. Maria Langi, among others — documenting that Ramsey had admitted exaggerating or fabricating symptoms to obtain resources (for example, admitting he hit his head over being denied extra food, despite testifying the voices alone caused it). This qualified as affirmative evidence of malingering, relieving the ALJ of the clear-and-convincing burden, and the same evidence independently satisfied the lower substantial-evidence bar.
The court also rejected Ramsey’s argument that his malingering was itself merely a symptom of his underlying mental illness, distinguishing the two cases he relied on: in one, the claimant’s limitations stemmed from a separate, undisputed mental disorder the ALJ had ignored; in the other, the issue concerned a doctor’s acceptance of self-reported symptoms, not the claimant’s own testimony, and involved pre-2017 rules no longer in effect. Finally, the court found the ALJ had not cherry-picked the record — he cited both supporting and undermining exhibits — and had adequately addressed Ramsey’s absenteeism arguments by crediting malingering findings over claimed work-limiting symptoms.
Key Takeaways
- Affirmative evidence of malingering in the medical record eliminates the ALJ’s usual obligation to give “specific, clear and convincing” reasons for discounting a claimant’s testimony about symptom severity — only the lower “substantial evidence” standard applies instead.
- Treatment notes documenting a claimant’s own admissions that symptoms were exaggerated or fabricated to obtain resources (housing, food, cell transfers) can constitute sufficient affirmative evidence of malingering, even without a formal malingering diagnosis.
- A claimant’s argument that his malingering is itself a symptom of an underlying mental illness will fail unless he can show, as in Carr v. Astrue, a separate and distinct disabling condition that the ALJ ignored — not simply that the same impairment produced both the alleged symptoms and the malingering behavior.
- Courts will not find an ALJ “cherry-picked” the record where the decision cites both supporting and contrary exhibits across a voluminous medical file; citing fewer pages than a claimant would like is not, by itself, cherry-picking.
- An RFC determination that discusses a claimant’s alleged limitations (e.g., absenteeism) but discounts them based on credited malingering findings is not legally deficient merely because it does not adopt every limitation the claimant proposes.
Why It Matters
This decision is a useful illustration, for practitioners handling Social Security disability appeals in the Ninth Circuit, of how the “malingering exception” to the clear-and-convincing testimony standard operates in practice. It shows that courts will look to the specific content of treatment records — not just a formal malingering diagnosis — to determine whether an ALJ was excused from the heightened reason-giving requirement, and it clarifies the narrow circumstances (a separate, undiscussed disabling condition) under which a claimant can argue that malingering is itself a disability symptom rather than a basis to discount testimony.
For claimant’s counsel, the case underscores the importance of addressing malingering notes head-on in briefing rather than treating the clear-and-convincing standard as automatically applicable, and of building a record that ties any malingering behavior to a documented, distinct psychiatric condition if that argument is to succeed. For defense and agency counsel, it offers a template for defending RFC determinations that weigh credited malingering evidence against claimed functional limitations.