Rivera v. Berryhill
Filing
20
Ruling denying [Doc. No. 17] Motion to Reverse the Decision of the Commissioner; granting [Doc. No. 19] Motion to Affirm the Decision of the Commissioner. Signed by Judge Robert M. Spector on 12/12/2018. (Stokely, Justyn)
UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF CONNECTICUT
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:
ANGELITA RIVERA
:
:
V.
:
:
NANCY A. BERRYHILL,
:
ACTING COMMISSIONER OF
:
SOCIAL SECURITY1
:
:
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3:17-CV-01726 (RMS)
DATE: DECEMBER 12, 2018
RULING ON PLAINTIFF’S MOTION TO REVERSE THE DECISION OF THE
COMMISSIONER AND ON DEFENDANT’S MOTION TO AFFIRM THE DECISION OF
THE COMMISSIONER
This action, filed under § 205(g) of the Social Security Act, 42 U.S.C. § 405(g), seeks
review of a final decision by the Commissioner of Social Security [“SSA” or “the Commissioner”]
denying the plaintiff’s application for Supplemental Security Income [“SSI”] and Social Security
Disability Insurance [“SSDI”] benefits.
I.
ADMINISTRATIVE PROCEEDINGS
On or about March 27, 2014, the plaintiff filed applications for SSI and SSDI benefits,
claiming that she has been disabled since February 1, 2009, due to depression, anxiety, extreme
fatigue, hepatitis C, and human immunodeficiency virus [“HIV”].
(Certified Transcript of
Administrative Proceedings, dated January 9, 2018 [“Tr.”] 283; see Tr. 103–104, 147, 151, and
160). The plaintiff’s applications were denied initially and upon reconsideration. (Tr. 23, 90–102,
103–15, 118–31, 132–45). On January 7, 2015, the plaintiff requested a hearing before an
1
On January 21, 2017, Nancy A. Berryhill became the Acting Commissioner of Social Security. The Federal
Vacancies Reform Act limits the time a position can be filled by an acting official, 5 U.S.C. § 3349(b); accordingly,
as of November 17, 2017, Nancy Berryhill is serving as the Deputy Commissioner for Operations, performing the
duties and functions not reserved to the Commissioner of Social Security.
Administrative Law Judge [“ALJ”] (Tr. 23, 165; see also 20 C.F.R. §§ 404.929, et seq. and
416.1929, et seq.), and on February 27, 2016, a hearing was held before ALJ Louis Bonsangue, at
which the plaintiff and a vocational expert, Renee Jubrey,2 testified. (Tr. 20–35; see Tr. 50–87).
On June 2, 2016, the ALJ issued an unfavorable decision denying the plaintiff’s claim for benefits.
(Tr. 20–35). On June 20, 2016, the plaintiff requested review of the hearing decision (Tr. 242–
43), and on August 10, 2017, the Appeals Council denied the plaintiff’s request for review, thereby
rendering the ALJ’s decision the final decision of the Commissioner. (Tr. 1–3).
On October 12, 2017, the plaintiff filed her complaint in this pending action (Doc. No. 1),
and on February 20, 2018, the defendant filed her answer and certified administrative transcript,
dated January 9, 2018. (Doc. No. 13). On February 27, 2018, this case was transferred to United
States Magistrate Judge Joan G. Margolis, following the parties’ consent to a Magistrate Judge.
(Doc. No. 16). On April 19, 2018, the plaintiff filed the pending Motion to Reverse the Decision
of the Commissioner, with brief in support (Doc. Nos. 17, 17-1 [“Pl.’s Mem.”]), along with a Joint
Statement of Material Facts. (Doc. No. 17-2). On May 1, 2018, the case was transferred to this
Magistrate Judge (Doc. No. 18), and on June 18, 2018, the defendant filed her Motion to Affirm
the Decision of the Commissioner, with brief in support. (Doc. Nos. 19, 19-1 [“Def.’s Mem.”]).
For the reasons stated below, the plaintiff's Motion to Reverse the Decision of the
Commissioner (Doc. No. 17) is DENIED, and the defendant’s Motion to Affirm (Doc. No. 19) is
GRANTED.
2
The hearing took place in Hartford, Connecticut, where the ALJ and the plaintiff appeared in person. The vocational
expert, Ms. Jubrey, appeared via telephone. (See Tr. 50). The plaintiff had no objection to Ms. Jubrey’s qualifications
to testify as a vocational expert.
2
II.
FACTUAL BACKGROUND
As of her alleged onset date of disability, February 1, 2009, the plaintiff was forty-four
years old. (See Tr. 90). The plaintiff lives alone in an apartment and has lived alone for
approximately seven years. (Tr. 62). The plaintiff has two adult children, a son and a daughter,
as well as one grandson. (Tr. 62, 75). The plaintiff has a ninth grade education and does not have
a driver’s license; she took a driver’s test, but failed. (Tr. 63). She does not “have patience” for
public transportation because she “feel[s] awkward being around a lot of people.” (Tr. 63–64).
The plaintiff’s friend typically drives the plaintiff wherever she has to go. (See Tr. 63, 76).
The plaintiff has a history of heavy drug use; however, she testified at the hearing that she
has not used drugs since 1997. (Tr. 71–72). The plaintiff was incarcerated for a period of time
during the 1980s at the York Correctional Institution in Niantic, Connecticut. (See Tr. 66, 67; see
also Tr. 84). While she was incarcerated, the plaintiff took classes and obtained a certification in
business. (Tr. 66). The plaintiff attempted to get her GED, but her “anger took the best side of
[her],” and she was unable to complete the program. (Tr. 66). She sees her therapist weekly for
her anxiety and depression, which she testified developed after she was molested at age seven or
eight. (Tr. 72). According to the plaintiff, her depression has gotten worse since she has been
sober. (Tr. 72).
A.
ACTIVITIES OF DAILY LIVING
The plaintiff watches television every day, including one-hour shows, and is able to tell
others about what occurred on the show that she just watched. (Tr. 76, 82). When watching an
hour-long television show, however, the plaintiff gets up several times to “drink water” or “use
the bathroom.” (Tr. 76). The plaintiff uses the bathroom frequently throughout the day, as her
hepatitis C medication causes diarrhea. (Tr. 68–69, 292). The plaintiff also enjoys reading, but at
3
times has trouble understanding big words. (Tr. 82). One of the plaintiff’s hobbies is cleaning her
apartment. (Tr. 82–83). The plaintiff cleans her apartment at least once a week and whenever she
thinks it needs to be cleaned. (Tr. 83–84, 294). There are some days, though, when the plaintiff’s
aches and pains make it difficult to do chores. (Tr. 83–84, 294). When this happens, the plaintiff
“suck[s] it up” and cleans. (Tr. 83–84). On days when the plaintiff is “no good,” her friend will
help her with household chores. (Tr. 79). The plaintiff manages her own finances (Tr. 293),
showers, and brushes her teeth most days (Tr. 290); however, on occasion, she has a “bad day”
and does not get out of bed or shower. (Tr. 79).
Although the plaintiff does not like to cook, she cooks for herself multiple times per week
and often prepares home-cooked meals such as soup, rice and beans, and pork shoulder. (Tr. 82;
see Tr. 291). The plaintiff has trouble following recipes, however, because she “tend[s] to forget
them.” (Tr. 82). There are also days when the plaintiff’s friend will cook for her (see Tr. 79) and,
on particularly bad days when she cannot get out of bed, her friend will feed her. (Tr. 80).
Moreover, the plaintiff’s friend does most of her grocery and clothes shopping because the plaintiff
has trouble being around people. (Tr. 64). The plaintiff testified that there are times when she
“just can’t be around people” and that she feels as though others are “out to get her,” so she does
not have the “patience” to go to the store. (Tr. 64). When she does go to the store, which is about
once per month, she “want[s] to hurry up and get it done,” and expects the employees to “hurry up
and take care of [her] so [she] can go.” (Tr. 65).
The plaintiff often cares for her five year old grandson, whom she sees nearly every day.
(Tr. 75). When the plaintiff is with her grandson, she plays with, and reads to, him. (Tr. 75). The
plaintiff testified that her grandson is her “pride and joy” and the only person who makes her
happy. (Tr. 77). There are many times when the plaintiff will keep her grandson at her apartment
4
for an entire day and, when her grandson has a three-day weekend from school, she will keep him
for the entire weekend. (Tr. 78). The plaintiff explained that it is hard for her to care for her
grandson and that, when her pain flares up, she calls her daughter to get him. (Tr. 78). The
plaintiff’s friend also assists the plaintiff when her grandson spends the night at the plaintiff’s
apartment and when he needs to be picked up from school. (See Tr. 75, 78).
The plaintiff experiences pain in her daily activities; the pain begins after she has been
sitting or standing for approximately two to three hours. (Tr. 81). When the plaintiff stands for
an extended period of time, her feet become swollen. (Tr. 297). The plaintiff can walk about two
blocks before she needs to stop and rest (Tr. 295); she has to rest for about thirty minutes before
she can continue walking again. (Tr. 295). Even when she experiences pain, the plaintiff “forces
[her]self” to walk; however, there are days when the plaintiff is unable to make it up and down
stairs. (Tr. 81). She can leave the house on her own, but does not go outside often because she
does not “feel too good physically.” (Tr. 294). The plaintiff can pay attention until she “feel[s]
bored,” but does not always finish what she starts. (Tr. 295). She has trouble getting along with
family members, friends, and neighbors because she does not like socializing (Tr. 296), and she
struggles with authority figures because she feels as though they are “talking about [her].” (Tr.
295).
The vocational expert testified that the plaintiff’s past relevant work as a “package sealer,
machine” and “houseworker, general” were medium exertional jobs with an SVP3 of two and three
respectively. (Tr. 56). The ALJ posed a hypothetical to the vocational expert about an individual
The Dictionary of Occupational Titles “lists a specific vocational preparation (SVP) time for each described
occupation.” Social Security Ruling 00-4p, 2000 WL 1898704, at *3 (S.S.A. Dec. 4, 2000). “Using the skill level
definitions in 20 C.F.R. [§§] 404.1568 and 416.968, unskilled work corresponds to an SVP of 1-2; semi-skilled work
corresponds to an SVP of 3-4; and skilled work corresponds to an SVP of 5-9 in the [Dictionary of Occupational
Titles].” Id.
3
5
who was limited to medium exertional work; simple, routine, repetitive tasks with no productionrate pace; little or no contact with co-workers and no requirement for collaborative efforts; no
public contact; and few changes in the work routine from day-to-day. (Tr. 57). The vocational
expert testified that this hypothetical person would be unable to perform the plaintiff’s past
relevant work, but that jobs existed in significant numbers in the national economy that this person
would be able to perform. (Tr. 57–58). The ALJ then added the limitation that this hypothetical
person would “occasionally not respond appropriately to any criticism from supervisors,” and the
vocational expert opined that “there would be no job for that [individual].” (Tr. 58–59).
The ALJ then asked the vocational expert to opine whether jobs existed for a hypothetical
individual with the same limitations; however, limited to light exertional work. (Tr. 59). The
vocational expert testified that this individual would be able to perform the jobs of a “mail clerk,”
a “marker,” and a “rooming clerk” (Tr. 59–60), and that these jobs existed in significant numbers
in the national economy. Again, however, when the ALJ added the limitation that the individual
would “occasionally not respond appropriately to any criticism from supervisors,” the vocational
expert opined that there would be no jobs for the individual. (Tr. 60).
B.
MEDICAL RECORDS4
1.
DR. ZIFE KROSI
The record reflects the plaintiff’s extensive treatment history at Staywell Health Care, Inc.
[“SHC”]. Dr. Zife Krosi evaluated the plaintiff initially on June 3, 2009, when the plaintiff
complained of back pain and right knee pain. (Tr. 466–68). A physical examination of the
plaintiff’s musculoskeletal system revealed that she had “[f]ull range of motion of the knees[,] [n]o
4
The following recitation is largely drawn from the parties thorough Joint Statement of Facts. (See Doc. No. 17-2).
Commonly used medical terms do not appear in quotation marks, but are taken directly from the plaintiff’s medical
records.
6
crepitus, full ROM, ligaments intact, [and] no tendonitis.” (Tr. 468). Dr. Krosi recommended that
the plaintiff treat her knee pain with “ice, rest, and Ibuprofen.” (Tr. 468). A psychological review
revealed that the plaintiff was depressed because she had “no family around”; however, she denied
the need for prescription antidepressants and declined a referral to a mental health provider. (Tr.
466).
On December 17, 2009, the plaintiff complained of pain in her left hip. (Tr. 453). A
physical examination of the plaintiff’s hips showed “full range of motion” and “normal mobility,”
but tight muscles in her left hip. (Tr. 454). Also on this date, Dr. Krosi noted that the plaintiff was
resuming interferon treatment for her hepatitis C.5 (Tr. 453). On March 18, 2010, however, the
plaintiff reported to Dr. Krosi that she was “very disappointed because her treatment for hepatitis
C failed to suppress the virus” (Tr. 449) and that she “sometimes” experienced pain in her knees.
(Tr. 449). On July 26, 2010, the plaintiff complained of left hip pain that was “on and off,” which
she believed was related to an incident that occurred when she was younger and under the influence
of drugs. (Tr. 435). The plaintiff complained also of pain in the right side of her lower back. (Tr.
436). A physical examination of the plaintiff showed that she had full range of motion in her
lumbosacral spine (Tr. 437); a neurological examination was unremarkable. (Tr. 437). An MRI
on August 19, 2010, revealed “[m]oderate spondylotic changes [at] L2-L3 level with a moderate
dextroscoliosis at L2.” (Tr. 352).
On December 2, 2010, Dr. Krosi evaluated the plaintiff and noted that she reported in her
“usual state of good health.” (Tr. 432). The plaintiff complained of menopause symptoms, but
The plaintiff received treatment for hepatitis C at Yale New Haven Hospital [“YNHH”]. (See Tr. 506–35; see also
Tr. 794–97). Records from YNHH reveal that, as of May 2012, the plaintiff had stage two liver fibrosis. (See Tr.
527). After December 2012, the plaintiff did not return to YNHH for hepatitis C treatment until July 2014, at which
time the plaintiff reported that she felt “well overall” and had no “new liver-specific complaints.” (Tr. 507). The
records indicate also that, between December 2012 and July 2014, the plaintiff either “no showed” or cancelled her
scheduled appointments. (Tr. 507).
5
7
also reported that her quality of life has “greatly improved” since she stopped her hepatitis C
treatment. (Tr. 432). The plaintiff did not report any musculoskeletal symptoms, and Dr. Krosi
noted that her gait and stance were normal. (Tr. 433–34). On April 13, 2010, the plaintiff reported
“achy and stiff joints” in the mornings, as well as sometimes “feeling poorly (malaise),” which Dr.
Krosi concluded was most likely related to her hepatitis C. (Tr. 428). The plaintiff rated her pain
as a five out of ten. (Tr. 429). On February 22, 2012, the plaintiff explained to Dr. Krosi that she
had “pain in her bones,” but felt “well overall except for insomnia [that] she attributes to feeling
anxious about her 26 year old daughter and the way she is caring for her baby.” (Tr. 424).
Additionally, the plaintiff agreed to meet with a mental health provider “to sort through her feelings
and anger which stresses her.” (Tr. 424). A physical examination revealed that the plaintiff’s gait
and stance were normal. (Tr. 426).
On August 9, 2012, the plaintiff stated to Dr. Krosi that “she can’t work because of many
health issues: arthralgias, fatigue, body aches” (Tr. 417); Dr. Krosi noted “musculoskeletal
symptoms” under the section titled “history of present illness.” (Tr. 417). A physical examination
of the plaintiff’s musculoskeletal system showed that the plaintiff had “[f]ull range of motion of
the knees bilaterally, no swelling, [and] no effusion” (Tr. 419); a neurological examination
revealed that the plaintiff’s gait and stance were normal. (Tr. 419). On October 18, 2012, the
plaintiff reported to Dr. Krosi that, over the preceding two weeks, she had experienced three
instances of “loss of pleasure,” no instances of “loss of interest in activities,” and six instances of
“feeling down or hopeless.” (Tr. 405). An examination of the plaintiff was unremarkable. (Tr.
405–408).
On January 31, 2013, a review of the plaintiff’s musculoskeletal system showed that the
plaintiff had muscle and joint aches. (Tr. 398). A psychological review revealed “[a]nxiety mild,
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depression mild, and sleep disturbances . . . .” (Tr. 398). On October 2, 2013, Dr. Krosi noted that
the plaintiff did not have any pain. (Tr. 383). On February 20, 2014, the plaintiff complained to
Dr. Krosi of “achy bones” (Tr. 371, 780) and stated that it was “difficult for her to stand too long
or sit for too long.” (Tr. 371, 780). The plaintiff stated also that her joints ached and that she was
“too tired to work.” (Tr. 371, 780). A review of the plaintiff’s musculoskeletal system revealed
joint pain in the legs and back, and muscle aches. (Tr. 372, 781). Dr. Krosi concluded that the
joint pain could be related to the plaintiff’s hepatitis C (Tr. 373, 782); she also referred the plaintiff
for mental health counseling. (Tr. 373). On May 5, 2014, Dr. Krosi evaluated the plaintiff, who
complained again of “body aches” (Tr. 365, 773), but noted that she was “otherwise good.”6 (Tr.
365, 773). The plaintiff stated also that she was “doing much better” after seeing a therapist and
a psychiatrist. (Tr. 365, 773, 775). Dr. Krosi did not make any objective findings related to the
plaintiff’s musculoskeletal system or “body aches”; however, she noted that the plaintiff’s gait and
stance were normal. (Tr. 367, 775).
On August 6, 2014, the plaintiff complained to Dr. Krosi that she had “body aches, joint
pains and fatigue when [she] exerts herself” (Tr. 761), and as a result, she has been unable to hold
a job. (Tr. 763). Following a physical examination of the plaintiff, Dr. Krosi noted that the
plaintiff’s pain was “possibly related to hepatitis C,” and/or “fibromyalgia.”7 (Tr. 763). An
examination of the plaintiff on November 10, 2014, revealed that there was “[n]o localized joint
6
Shortly before this date, on April 27, 2014, the plaintiff presented to the emergency department at Waterbury
Hospital, complaining of lumbar pain that was “onset 2 days ago and chronic.” (Tr. 847). The plaintiff described the
pain as moderate, sharp pain, which was exacerbated by “movement, standing, walking, sitting and changing position.”
(Tr. 847). A physical examination of the plaintiff’s musculoskeletal system revealed “normal inspection, full [range
of motion]”; the plaintiff was diagnosed with sciatica and chronic back pain. (Tr. 849).
Dr. Krosi also completed a form entitled “Medical Report on Adult with Allegation of Human Immunodeficiency
Virus (HIV) Infection.” (Tr. 536–40). On this form, she noted that the plaintiff suffered from depression as a result
of her HIV and that she exhibited “marked limitation in maintaining social functioning” and “marked limitation in
completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace.” (Tr. 538).
7
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pain,” and “[n]o anxiety, no depression, and no sleep disturbances.” (Tr. 745). On July 20, 2015,
the plaintiff complained of lower back pain, specifically, “[r]adicular pain, posterior aspect of
lower extremities.” (Tr. 717). Dr. Krosi did not note any objective findings regarding the
plaintiff’s musculoskeletal system or her complaints of radicular pain; however, she noted that the
plaintiff’s gait and stance were normal. (Tr. 719–20). On September 16, 2015, Dr. Krosi referred
the plaintiff for an x-ray of her left knee, which showed “mild degenerative arthritis.” (Tr. 591).
On September 17, 2015, the plaintiff stated to Dr. Krosi that she had been experiencing left knee
pain for two to three weeks and that, following physical therapy, her lower back pain was
beginning to improve. (Tr. 710). Dr. Krosi diagnosed the plaintiff with “arthralgia of the [left]
knee/patella/tibia/fibula,” and referred her to physical therapy. (Tr. 712).
2.
DR. JOHN BATTISTA AND SUSAN MURRAY
The plaintiff underwent extensive treatment with Dr. John Battista and counselor Susan
Murray, M.A., LPC, LADC, at SHC beginning in April 2014. (See Tr. 502). On June 18, 2014,
Dr. Battista and Ms. Murray completed a report for SSA regarding the plaintiff’s mental health
condition. (See Tr. 502–505). They indicated that the plaintiff suffered from major depressive
disorder, posttraumatic stress disorder, opioid dependence, and cocaine dependence. (Tr. 502).
They noted also that the plaintiff’s condition was “improved” and that she was able to manage her
activities of daily living. (Tr. 502). Under the section titled “General appearance,” they indicated
that the plaintiff was “isolative, self critical, [and] irritable” (Tr. 502); under “Cognitive status,”
they found that the plaintiff had “intrusive memories, difficulty with attention and concentration,
[and] obsessive checking.” (Tr. 502). They stated in the report that the plaintiff had “No Problem”
with the following: “taking care of her personal hygiene”; “caring for her physical needs (i.e.
dressing and eating)”; “using good judgment regarding safety and dangerous circumstances”;
10
“carrying out single-step instructions”; “carrying out multi-step instructions”; or “changing from
one simple task to another.” (Tr. 503–504). They noted that the plaintiff had “A Slight Problem”
with the following: “focusing long enough to finish assigned simple activities or tasks”; and
“performing basic work activities at a reasonable pace/finishing on time.” (Tr. 504). They
indicated, however, that the plaintiff had “An Obvious Problem” with: “[u]sing appropriate coping
skills to meet ordinary demands of a work environment”; “interacting appropriately with others in
a work environment”; “asking questions or requesting assistance”; and “performing work activity
in a sustained basis (i.e., 8 hrs per day, 5 days a week).” (Tr. 503). Lastly, they noted that the
plaintiff
had
“A
Serious
Problem”
with:
“[h]andling
frustration
appropriately”;
“respecting/responding appropriately to others in authority”; and “getting along with others
without distracting them or exhibiting behavioral extremes.”
(Tr. 503–504).
The report
commented that the plaintiff had “anger and rage with frustration,” “anger and rage/inability to
communicate effectively,” and “concentration issues.” (Tr. 503–504).
Dr. Battista completed a “progress note” on October 8, 2014, in which he explained that
the plaintiff “[d]escribe[d] multiple episodes of depression on and off for years” (Tr. 754), and
that, at the time, the plaintiff had felt depressed for at least some portion of each day for two years.
(Tr. 754). The plaintiff also explained that she was “[f]earful that people don’t want to be around
her,” “[m]ore socially withdrawn,” “[l]acks interest,” and had “[n]o sexual interest.” (Tr. 754).
Dr. Battista noted that the plaintiff had been gaining weight even though her appetite was poor,
which he believed was due to a lack of exercise. (Tr. 754). In addition, the plaintiff told Dr.
Battista that she had trouble falling asleep because she “can’t turn her mind off at night.” (Tr.
754).
The plaintiff indicated also that she cried “without reason,” her “[c]ognition [was]
impaired,” and that she “[s]ometimes heard people calling her name.” (Tr. 754). Dr. Battista also
11
included in the progress note that the plaintiff had “[s]elf critical thoughts” and that she got “angry
easily,” which was “an exacerbation of a life-long history of irritability.” (Tr. 754). Dr. Battista
added that the plaintiff “associate[d] her anger with being sexually molested” when she was seven
years old, and that the plaintiff ha[d] intrusive memories about this still.” (Tr. 754). He opined
that the plaintiff “[m]eets criteria for PTSD,” that her “symptoms are currently more active than
in the past,” and that she meets the criteria for “Major Depression, recurrent with psychotic
features.” (Tr. 754). Dr. Battista explained that the plaintiff “[h]as some checking that does
interfere with getting out of [the] house,” but that he would not “diagnose [her] with OCD at this
point.” (Tr. 754). On October 8, 2014, Dr. Battista noted that the plaintiff was “[i]mproving week
over week.” (Tr. 755).
On October 15, 2014 and November 7, 2014, Dr. Battista noted that certain medication that
the plaintiff was taking made the plaintiff feel more irritable. (Tr. 750, 753). On October 29,
2014, Ms. Murray noted that the plaintiff had made “No Progress” over a ninety-day period and
that the plaintiff had been “non-compliant with [the] attendance policy and is [at] risk for discharge
from Behavioral Health.” (Tr. 765 (emphasis omitted)). On November 7, 2014, Dr. Battista
indicated that the plaintiff’s depression was “generally well controlled” (Tr. 750), but that the
plaintiff was “still socially inhibited.” (Tr. 750).
On April 2, 2015, the plaintiff underwent a ninety-day treatment plan review, which
detailed the problems that treatment sought to address. Dr. Battista and Ms. Murray indicated that
the plaintiff experienced “[d]epression, crying, anger, agitation and irritability daily,” and that she
continued “to have issues when it comes to her adult daughter,” but was “much better with her
partner.” (Tr. 819). They indicated that the plaintiff experienced “[i]ntrusive thoughts, memories
and dreams of past trauma,” although “her medications seem to have alleviated most symptoms.”
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(Tr. 819). The plaintiff’s self-esteem was “poor but improved.” (Tr. 819). Dr. Battista and Ms.
Murray noted additionally that the plaintiff had a “[h]istory of chronic severe illness requiring
close medical monitoring,” and that her “compliance issues” were “addressed and improved
slightly.” (Tr. 819). They noted “[g]ood clinical improvement,” and explained that the plaintiff
would continue to see Ms. Murray “weekly for 52 weeks or less, with progress evaluated every 90
days.” (Tr. 819).
On July 8, 2015, Dr. Battista completed a “progress note,” which summarized the
plaintiff’s progress over five months. Dr. Battista indicated that the plaintiff’s depression “comes
and goes,” and that, at times, she is irritable, moody, and short-tempered. (Tr. 723). Dr. Battista
noted that, as of June 3, 2015, the plaintiff was taking sertraline, which was making her less
anxious and less irritable;8 he noted also that the plaintiff’s depression was “under better control.”
(Tr. 723).
On July 29, 2015, Dr. Battista and Ms. Murray completed a document titled “Medical
Report.” (Tr. 541–50). On the report, Dr. Battista and Ms. Murray indicated that the plaintiff
suffered from posttraumatic stress disorder and major depressive disorder, and that the
combination of conditions prevented the plaintiff from working for twelve months or more. (Tr.
543). They detailed the following impacts on the plaintiff’s ability to work: “depression, anxiety,
irritability, agoraphobic, difficulty interacting without anger, difficulty interpersonally with men,”
and that “physical illness limits psychiatric medication intervention, concentration and social
interactions on the job would be poor [and] problematic.” (Tr. 543). Dr. Battista and Ms. Murray
noted also that the plaintiff’s mental health and/or substance abuse issues impacted her ability to
work because of “intrusive memories related to childhood sexual abuse,” as well as “anger,
8
On July 8, 2015, however, the plaintiff stated that her HIV medication was making her “more irritable.” (Tr. 723).
13
irritability, difficulty with attention and concentration, isolative/social anxiety.” (Tr. 546). They
indicated that the plaintiff was “Not Significantly Limited” in the following: remembering
locations and work-like procedures; understanding and remembering very short, simple
instructions; carrying out very short, simple instructions; making simple work-related decisions;
asking simple questions or requesting assistance; being aware of normal hazards and taking
appropriate precautions; and setting realistic goals or making plans independently of others. (Tr.
547–48).
They noted that the plaintiff was “Moderately Limited” in understanding and
remembering detailed instructions; carrying out detailed instructions; working in coordination with
or proximity to others without being distracted by them; interacting appropriately with the general
public; maintaining socially appropriate behavior and adhering to basic standards of neatness and
cleanliness; responding appropriately to changes in the work setting; and traveling in unfamiliar
places or using public transportation. (Tr. 547–48). Lastly, they stated that the plaintiff was
“Markedly Limited” in maintaining attention and concentration for extended periods; performing
activities within a schedule, maintaining regular attendance, and being punctual within customary
tolerances; sustaining an ordinary routine without special supervision; accepting instructions and
responding appropriately to criticism from supervisors; and getting along with co-workers or peers
without distracting them or exhibiting behavioral extremes. (Tr. 547–48). The report indicated
that the plaintiff’s condition had “improved with medication and therapy,” but that she was “still
minimally functional.” (Tr. 549).
On January 14, 2016, Ms. Murray completed another “Medical Opinion Questionnaire,” in
which she noted that the plaintiff had “Unlimited or Very Good” ability to “[a]dhere to basic
standards of neatness and cleanliness.” (Tr. 790). She noted that the plaintiff had a “Good” ability
to do the following: “[t]ravel in unfamiliar place”; “[r]emember work-like procedures”;
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“[u]nderstand and remember very short and simple instructions”; “[c]arry out very short and
simple instructions”; “[m]aintain attention for two hour segment”; “[m]ake simple work-related
decisions”; “[a]sk simple questions or request assistance”; and “[b]e aware of normal hazards and
take appropriate precautions.” (Tr. 790–91). Ms. Murray indicated that the plaintiff had a “Fair”
ability to do the following: “[i]nteract appropriately with the general public”; “[m]aintain socially
appropriate behavior”; “[u]se public transportation”; “[m]aintain regular attendance and be
punctual within customary, usually strict tolerances”; “[w]ork in coordination with or proximity
to others without being unduly distracting”; “[p]erform at a consistent pace without an
unreasonable number and length of rest periods”; “[r]espond appropriately to changes in a routine
work setting”; “[u]nderstand and remember detailed instructions”; and “[s]et realistic goals or
make plans independently of others.” (Tr. 790–91). Ms. Murray noted that the plaintiff had “Poor”
or no ability to do as follows: “[i]nteract appropriately with the general public”; “[m]aintain
socially appropriate behavior”; “[m]aintain regular attendance and be punctual within customary,
usually strict tolerances”; “[s]ustain an ordinary routine without special supervision”; “[c]omplete
a normal workday and workweek without interruptions from psychologically based symptoms”;
“[a]ccept instructions and respond appropriately to criticism from supervisors”; “[g]et along with
co-workers or peers without unduly distracting them or exhibiting behavioral extremes”; “[d]eal
with normal work stress”; “[c]arry out detailed instructions”; and “[d]eal with stress of semiskilled
and skilled work.” (Tr. 790–91). Ms. Murray commented also that the plaintiff had “difficulty
interacting without angry outbursts” and that she had “poor concentration, inability to interact with
men, [and] poor social interactions.” (Tr. 792). Ms. Murray opined that the plaintiff’s impairments
or treatment would cause her to be absent from work “[m]ore than twice a month.” (Tr. 792).
15
3.
DR. NEHA NANDA
The plaintiff received treatment for her HIV diagnosis primarily from Dr. Neha Nanda.
Dr. Nanda is a board certified infectious disease specialist. (See Pl.’s Mem. at 25 n.2). On August
27, 2015, Dr. Nanda completed a document titled “Medical Opinion RE: Ability to do Physical
Activities,” on which she noted that the plaintiff’s diagnosis was HIV and that her prognosis was
“good.” (Tr. 639). Dr. Nanda indicated that, as a result of her impairment, the plaintiff could walk
about one-half to one city block before she needed to stop and rest, and that the plaintiff could sit
and stand continuously for forty-five minutes at one time. (Tr. 639). Dr. Nanda noted also that,
in an eight-hour work day, the plaintiff could sit for a total of one hour and “stand/walk” for “about
2 hours.” (Tr. 639). Dr. Nanda indicated, however, that the plaintiff did not need a job “which
permits shifting positions at will from sitting, standing or walking.” (Tr. 639) (emphasis omitted).
In this document, Dr. Nanda opined that if the plaintiff were sitting for a prolonged period
of time, her legs should be elevated, and that, during the course of an eight-hour workday, her legs
should be elevated ninety percent of the time. (Tr. 640). Moreover, Dr. Nanda noted that the
plaintiff should use a “cane or other assistive device” when “engaging in occasional
standing/walking,” and that the plaintiff can never lift and carry any amount of weight safely
during an eight hour workday. (Tr. 640). Dr. Nanda indicated also that the plaintiff had
“significant limitations doing repetitive reaching, handling or fingering,” but that the plaintiff
could “frequently” climb stairs and ladders. (Tr. 641). Dr. Nanda opined that the plaintiff should
avoid exposure to extreme cold, extreme heat, high humidity, fumes, odors, dusts, gases, perfumes,
cigarette smoke, soldering fluxes, solvents/cleaners, and chemicals. (Tr. 641). Lastly, Dr. Nanda
noted that the plaintiff’s impairments were “likely to produce ‘good days’ and ‘bad days,’” and
16
that, as a result, she would be absent from work “[m]ore than twice a month” on average. (Tr.
641).
4.
ACCESS REHAB CENTERS
The plaintiff received physical therapy treatment from Access Rehab Centers [“Access”]
from July 27, 2015 through August 24, 2015. (See Tr. 622–38). The Access records reflect that
the plaintiff complained primarily of lower back pain, explaining that activities such as exercising
and cleaning her house increased the pain, but that a “hot shower” would sometimes decrease the
pain. (Tr. 623). The plaintiff described the pain as “pinching, grabbing,” and rated the pain at a
five out of ten at its best, and a nine out of ten at its worst. (Tr. 623). A physical examination
revealed that the plaintiff’s lumbar range of motion was reduced by twenty-five percent in all
directions and that she experienced “lumbar tenderness.” (Tr. 624). The examination revealed
also that the plaintiff was able to walk on her heels and toes, that her gait pattern was unremarkable,
that her mobility was within normal limits, and that a straight leg raising test was negative. (Tr.
624). The Access records show also that the plaintiff had scoliosis with “lumbar S curve” and
right “lumbar hump on flexion” (Tr. 623), and that the plaintiff had functional deficits in bending
and cleaning. (Tr. 624). In a treatment note from August 24, 2015, the plaintiff’s physical therapist
noted that the plaintiff reported no back pain, but complained that her left knee was “very bad.”
(Tr. 630).
5.
STATE AGENCY PHYSICIANS
State agency physicians, Dr. Katrin Carlson, Psy.D., Dr. Luis Zuniga, Dr. Khurshid Khan,
and Dr. Janine Swanson, Psy.D., reviewed the plaintiff’s medical records and opined about
whether the plaintiff was disabled. (See generally Tr. 90–102, 118–31). Dr. Carlson reviewed the
plaintiff’s records and completed her report on July 29, 2014. (See Tr. 90–102). In her report, Dr.
17
Carlson concluded that the plaintiff’s affective disorders, anxiety-related disorders, and substance
abuse disorders were “severe.” (Tr. 95).
Dr. Carlson opined that the plaintiff experienced a “mild” restriction of her activities of
daily living, and moderate difficulties in “maintaining social functioning” and “maintaining
concentration, persistence or pace,” but that she did not experience any “[r]epeated episodes of
decompensation.” (Tr. 95). She opined further that the plaintiff was “[n]ot significantly limited”
in the following areas: “[t]he ability to carry our very short and simple instructions”; “[t]he ability
to perform activities within a schedule, maintain regular attendance, and be punctual within
customary tolerances”; “[t]he ability to sustain an ordinary routine without special supervision”;
“[t]he ability to work in coordination with or in proximity to others without being distracted by
them”; “[t]he ability to make simple work-related decisions”; “[t]he ability to ask simple questions
or request assistance”; “[t]he ability to maintain socially appropriate behavior and adhere to basic
standards of neatness and cleanliness”; “[t]he ability to travel in unfamiliar places or use public
transportation”; and “[t]he ability to set realistic goals or make plans independently of others.”
(Tr. 98–100).
Dr. Carlson concluded that the plaintiff was “moderately limited” in the following areas:
“[t]he ability to carry out detailed instructions”; “[t]he ability to maintain attention and
concentration for extended periods”; “[t]he ability to complete a normal workday and workweek
without interruption from psychologically based symptoms and to perform at a consistent pace
without an unreasonable number and length of rest periods”; “[t]he ability to accept instructions
and respond appropriately to criticism from supervisors”; “[t]he ability to get along with coworkers
or peers without distracting them or exhibiting behavioral extremes”; and “[t]he ability to respond
appropriately to changes in the work setting.” (Tr. 98–99).
18
Lastly, Dr. Carlson indicated that the plaintiff was “markedly limited” in the “ability to
interact appropriately with the general public.” (Tr. 99). Dr. Carlson assessed the plaintiff as
having “occasional problems with prolonged [concentration, persistence, or pace] due to anxiety
and depression.” But she found the plaintiff to be “generally capable of simple [routine, repetitive
tasks] for 2 hour periods in [an] 8 hour day.” (Tr. 99). Dr. Carlson explained also that the plaintiff
“has low frustration tolerance and difficulty communicating effectively due to anger/rage” and,
therefore, was “best suited to non-public work settings with lower social demands.” (Tr. 99).
Additionally, Dr. Carlson opined that the plaintiff had “low frustration tolerance and limits on
adaptive capabilities. She [was] able to respond to simple but not detailed changes. [She was]
[a]ble to note hazards, set work goals and travel.” (Tr. 100).
On July 31, 2014, Dr. Zuniga opined that the plaintiff could “occasionally” lift and/or carry
fifty pounds, “frequently” lift and/or carry twenty-five pounds, stand and/or walk for about six
hours in an eight hour workday, and sit for about six hours in an eight hour workday. (Tr. 97).
Dr. Zuniga expressed that the plaintiff did not have any limitations pushing and/or pulling, and
that the plaintiff had no postural, manipulative, visual, communicative, or environmental
limitations. (Tr. 97–98).
On November 10, 2014, Dr. Swanson reviewed the plaintiff’s records and submitted her
report. (See Tr. 118–31). She concluded that the plaintiff suffered from affective disorders,
anxiety-related disorders, and substance addiction disorders; she found that these disorders were
“severe.” (Tr. 123). She found that the plaintiff experienced a “moderate” restriction of her
activities of daily living, and “moderate” difficulties maintaining social functioning and
maintaining concentration, persistence or pace, but that she did not experience any “[r]epeated
episodes of decompensation.” (Tr. 124).
19
Dr. Swanson determined that the plaintiff was “not significantly limited” in the following
areas: “[t]he ability to carry out very short and simple instructions”; “[t]he ability to perform
activities within a schedule, maintain regular attendance, and be punctual within customary
tolerances”; “[t]he ability to sustain an ordinary routine without special supervision”; “[t]he ability
to work in coordination with or in proximity to others without being distracted by them”; “[t]he
ability to make simple work-related decisions”; “[t]he ability to interact appropriately with the
general public”; “[t]he ability to ask simple questions or request assistance”; “[t]he ability to accept
instructions and respond appropriately to criticism from supervisors”; “[t]he ability to maintain
socially appropriate behavior and adhere to basic standards of neatness and cleanliness”; “[t]he
ability to be aware of normal hazards and take appropriate precautions”; and “[t]he ability to travel
in unfamiliar places and use public transportation.” (Tr. 127–28).
Dr. Swanson found that the plaintiff was “moderately limited” in the following areas: “[t]he
ability to carry out detailed instructions”; “[t]he ability to maintain attention and concentration for
extended periods”; “[t]he ability to complete a normal workday and workweek without
interruptions from psychologically based symptoms and to perform at a consistent pace without
an unreasonable number and length of rest periods”; “[t]he ability to get along with coworkers or
peers without distracting them or exhibiting behavioral extremes”; “[t]he ability to respond
appropriately to changes in the work setting”; and “[t]he ability to set realistic goals or make plans
independently of others.” (Tr. 127–28). Dr. Swanson did not find that the plaintiff was “markedly
limited” in any way. (See Tr. 127–28). She noted that the plaintiff was “able to attend to simple
tasks for at least two hours at a time, but secondary to anxiety and depressive symptoms would not
be able to sustain concentration on complex tasks for more than a very brief period.” (Tr. 127–
28). Dr. Swanson continued that the plaintiff was “also likely to demonstrate some cognitive
20
slowing indicative of depression, which would make it difficult for [her] to perform adequately in
a fast paced, competitive environment. Thus, secondary to reduced concentration and pace, [the
plaintiff would] . . . be able to perform simple, routine, repetitive tasks in a setting that does not
require strict adherence to time or production quotas.” (Tr. 128). Dr. Swanson stated that that the
plaintiff would “do best in a non-public work [environment], where contact with others is
superficial and infrequent and the need for collaboration is not required,” and that she “would
likely have difficulty adapting to [a] rapidly changing work environment, and would have
difficulty establishing realistic goals for herself. Thus, she would benefit from working in an
environment that changes minimally from day to day, and from having daily concrete goals set for
her.” (Tr. 128).
On November 4, 2014, Dr. Khan reviewed the plaintiff’s records and determined that the
plaintiff could “occasionally” lift and/or carry fifty pounds, and that she could “frequently” lift
and/or carry twenty-five pounds. (Tr. 126). Dr. Khan added that the plaintiff could stand and/or
walk for about six hours in an eight-hour workday, and that she could sit for about six hours in an
eight-hour workday. (Tr. 126). Finally, Dr. Khan concluded that the plaintiff had no limitations
pushing and/or pulling, and that the plaintiff had no postural, manipulative, visual, communicative,
or environmental limitations. (Tr. 126).
21
III.
THE ALJ’S DECISION
Following the five-step evaluation process,9 the ALJ found that the plaintiff’s date last
insured for purposes of SSDI was December 31, 201310 (Tr. 24, 25), and that she has not engaged
in substantial gainful activity since February 1, 2009, her alleged onset date of disability. (Tr. 26,
citing 20 C.F.R. §§ 404.1571, et seq. and 416.971, et seq.). At step two, the ALJ concluded that
the plaintiff has the following severe impairments: depression, anxiety, Hepatitis C and chronic
liver disease, HIV, degenerative disc disease of the lumbar spine, degenerative arthritis in the left
knee, and substance abuse. (Tr. 26, citing 20 C.F.R. §§ 404.1520(c) and 416.920(c)). At step
three, the ALJ found that the plaintiff does not have an impairment or a combination of
impairments that meets or medically equals one of the listed impairments in 20 C.F.R. Part 404,
Subpart P, Appendix 1. (Tr. 26–27, citing 20 C.F.R. §§ 404.1520(d), 404.1525, 416.920(d),
416.925, and 404.926). The ALJ concluded that the plaintiff has the residual functional capacity
9
An ALJ determines disability using a five-step analysis. See 20 C.F.R. § 404.1520. First, the ALJ must determine
whether the claimant is currently working. See 20 C.F.R. §§ 404.1520(a)(4)(i) and 416.920(a). If the claimant is
currently employed, the claim is denied. Id. If the claimant is not working, as a second step, the ALJ must make a
finding as to the existence of a severe mental or physical impairment; if none exists, the claim is also denied. See 20
C.F.R. §§ 404.1520(a)(4)(ii) and 416.920(a)(4)(ii). If the claimant is found to have a severe impairment, the third step
is to compare the claimant's impairment with those in Appendix 1 of the Regulations [the “Listings”]. See 20 C.F.R.
§§ 404.1520(a)(4)(iii) and 416.920(a)(4)(iii); Bowen v. Yuckert, 482 U.S. 137, 141 (1987); Balsamo v. Chater, 142
F.3d 75, 79–80 (2d Cir. 1998). If the claimant's impairment meets or equals one of the impairments in the Listings,
the claimant is automatically considered disabled. See 20 C.F.R. §§ 404.1520(a)(4)(iii) and 416.920(a)(4)(iii); see
also Balsamo, 142 F.3d at 80. If the claimant’s impairment does not meet or equal one of the listed impairments, as
a fourth step, she will have to show that she cannot perform her former work. See 20 C.F.R. §§ 404.1520(a)(4)(iv)
and 416.1520(a)(4)(iv). If the claimant shows she cannot perform her former work, the burden shifts to the
Commissioner to show that the claimant can perform other gainful work. See Balsamo, 142 F.3d at 80 (citations
omitted). Accordingly, a claimant is entitled to receive disability benefits only if she shows she cannot perform her
former employment, and the Commissioner fails to show that the claimant can perform alternate gainful employment.
See 20 C.F.R. §§ 404.1520(a)(4)(v) and 416.920(a)(4)(v); see also Balsamo, 142 F.3d at 80 (citations omitted).
A claimant’s date last insured applies only to claims for SSDI, not SSI. See McLellan v. Astrue, No. 3:12-CV-1657
(DFM), 2016 WL 4126414, at *1 n.1 (D. Conn. Aug. 3, 2016); Severino v. Astrue, No. 3:07-CV-1347 (WIG), 2008
WL 3891956, at *1 (D. Conn. June 20, 2008), Magistrate Judge’s Recommended Ruling approved and adopted, No.
3:07-CV-1347 (MRK) (D. Conn. July 11, 2008). Accordingly, reference to the plaintiff’s date last insured of
December 31, 2013 is applicable only to her claim for SSDI. The relevant time period for the plaintiff’s claims for
SSI is the date on which she filed her application for SSI through the date of the ALJ’s decision. See Stergue v. Astrue,
No. 3:13-CV-25 (DFM), 2014 WL 12825146, at *2 (D. Conn. May 30, 2014) (citing Pratt v. Astrue, No. 3:10-CV413 (CFD), 2011 WL 322823, at *3 (D. Conn. Jan. 28, 2011)).
10
22
[“RFC”] to perform light work as defined in 20 C.F.R. §§ 404.1567(b) and 416.967(b), except that
the plaintiff is limited to simple, routine, and repetitive tasks not at any production-rate pace; little
or no contact with coworkers, and no requirement for any collaborative efforts; no public contact;
and few changes in the workday from day-to-day. (Tr. 28). At step four, the ALJ determined that
the plaintiff is unable to perform her past relevant work. (Tr. 33, citing 20 C.F.R. §§ 404.1565 and
416.965). Finally, after considering the plaintiff’s RFC, age, education, and work experience, the
ALJ concluded that there are jobs that exist in significant numbers in the national economy that
the plaintiff could perform. (Tr. 33, citing 20 C.F.R. §§ 404.1569(a), 404.969, and 404.969(a)).
Specifically, the ALJ determined that the plaintiff would be able to perform the jobs of a mail
clerk, a marker, and a routing clerk. (Tr. 34). Accordingly, the ALJ concluded that the plaintiff
was not “under a disability, as defined in the Social Security Act, from February 1, 2009, through
the date of this decision.” (Tr. 34, citing 20 C.F.R. §§ 404.1520(g) and 416.920(g)).
IV.
STANDARD OF REVIEW
The scope of review of a Social Security disability determination involves two levels of
inquiry. First, the court must decide whether the Commissioner applied the correct legal principles
in making the determination. See Balsamo v. Chater, 142 F.3d 75, 79 (2d Cir. 1998) (citation
omitted). Second, the court must decide whether substantial evidence supports the determination.
Id. The court may “set aside the Commissioner’s determination that a claimant is not disabled
only if the factual findings are not supported by substantial evidence or if the decision is based on
legal error.” Burgess v. Astrue, 537 F.3d 117, 127 (2d Cir. 2008) (internal quotation marks &
citation omitted); see also 42 U.S.C. § 405(g). Substantial evidence is evidence that a reasonable
mind would accept as adequate to support a conclusion; it is more than a “mere scintilla.”
Richardson v. Perales, 402 U.S. 389, 401 (1971) (citation omitted); see Yancey v. Apfel, 145 F.3d
23
106, 111 (2d Cir. 1998) (citation omitted). The substantial evidence rule also applies to inferences
and conclusions that are drawn from findings of fact. See Gonzalez v. Apfel, 23 F. Supp. 2d 179,
189 (D. Conn. 1998) (citation omitted); Rodriguez v. Califano, 431 F. Supp. 421, 423 (S.D.N.Y.
1977) (citations omitted). However, the court may not decide facts, reweigh evidence, or substitute
its judgment for that of the Commissioner. See Dotson v. Shalala, 1 F.3d 571, 577 (7th Cir. 1993)
(citation omitted).
Instead, the court must scrutinize the entire record to determine the
reasonableness of the ALJ’s factual findings. See id. Furthermore, the Commissioner’s findings
are conclusive if supported by substantial evidence and should be upheld even in those cases where
the reviewing court might have found otherwise. See 42 U.S.C. § 405(g); see also Beauvoir v.
Chater, 104 F.3d 1432, 1433 (2d Cir. 1997) (citation omitted); Eastman v. Barnhart, 241 F. Supp.
2d 160, 168 (D. Conn. 2003).
V.
DISCUSSION
Here, the plaintiff contends that the ALJ afforded improper weight to the plaintiff’s treating
physicians and other medical sources. (Pl.’s Mem. at 18–30). Specifically, the plaintiff argues
that the ALJ afforded improper weight to the opinions of Dr. Battista and Ms. Murray (Pl.’s Mem.
at 19–24), Dr. Nanda (Pl.’s Mem. at 24–25), Dr. Krosi (Pl.’s Mem. at 25–27), and DDS experts
Dr. Carlson and Dr. Swanson. (Pl.’s Mem. at 27–30). Additionally, the plaintiff maintains that
substantial evidence does not support the ALJ’s RFC determination.
(Pl.’s Mem. 30–36).
Specifically, the plaintiff argues that the ALJ’s RFC determination does not address adequately
findings of the plaintiff’s off-task behavior and absenteeism (Pl.’s Mem. at 31–33), the need for
limited interaction with supervisors (Pl.’s Mem. at 33–34), and additional limitations that would
preclude the plaintiff from performing light exertion work. (Pl.’s Mem. 34–36). The defendant
24
responds that substantial evidence supports the ALJ’s evaluation of the medical evidence and the
RFC determination. (Def.’s Mem. at 4–16). The Court agrees with the defendant.
A.
THE ALJ PROPERLY APPLIED THE TREATING PHYSICIAN RULE
The plaintiff claims that the ALJ erred by failing to give the opinions of her treating
physicians and the State agency consultants “significant or controlling weight.” (See Pl.’s Mem.
at 19; see generally Pl.’s Mem. at 18–30). Specifically, the plaintiff argues that “[t]he ‘treating
physician rule’ requires that in all cases, the treating physician’s opinion must be given substantial
deference.” (Pl.’s Mem. at 19, citing Arnone v. Bowen, 882 F.2d 34, 41 (2d Cir. 1989); Mongeur
v. Heckler, 722 F.2d 1033, 1039 n.2 (2d Cir. 1983); Rosa v. Callahan, 168 F.3d 72, 78–79 (2d Cir.
1999); Ruiz v. Apfel, 98 F. Supp. 2d 200 (D. Conn. 1999)). The defendant responds that “[t]he
ALJ identified valid reasons under the [defendant’s] regulations to discount the various opinions”
of the plaintiff’s treating physicians and the State agency consultants. (Def.’s Mem. at 7; see
generally, Def.’s Mem. at 7–15).
The treating physician rule requires that “the opinion of a claimant’s treating physician as
to the nature and severity of the impairment is given ‘controlling weight’ so long as it ‘is wellsupported by medically acceptable clinical and laboratory diagnostic techniques and is not
inconsistent with the other substantial evidence in [the] case record.’” Burgess, 537 F.3d at 128,
(quoting 20 C.F.R. § 404.1527(d)(2) [now (c)(2)]); see 20 C.F.R. § 416.927(c)(2). When the ALJ
“do[es] not give the treating source’s opinion controlling weight,” he must “apply the factors
listed” in 20 C.F.R. §§ 404.1527(c)(2) and 416.927(c)(2), including “(1) the frequency, length,
nature, and extent of treatment; (2) the amount of medical evidence supporting the opinion; (3) the
consistency of the opinion with the remaining medical evidence; and (4) whether the physician is
a specialist.” Selian v. Astrue, 708 F.3d 409, 417 (2d Cir. 2013) (per curiam). Once the ALJ has
25
considered these factors, the ALJ must “comprehensively set forth [his] reasons for the weight
assigned to a treating physician’s opinion.” Halloran v. Barnhart, 362 F.3d 28, 33 (2d Cir. 2004);
see 20 C.F.R. §§ 404.1527(c)(2) and 416.927(c)(2) (“We will always give good reasons in our
notice of determination or decision for the weight we give [the claimant’s] treating source’s
medical opinion.”).
1.
OPINIONS OF DR. BATTISTA AND MS. MURRAY
The ALJ explained that he afforded “little weight” to Dr. Battista’s opinions because “Dr.
Battista did not explain or justify his opinions by providing objective medical evidence of the
limitations asserted. Rather, Dr. Battista simply checked boxes on a piece of paper.” (Tr. 31).
The ALJ added that Dr. Battista’s opinions “are also given little weight because they are
inconsistent with the record . . . .” (Tr. 31). Similarly, the ALJ afforded “little weight” to Ms.
Murray’s opinions because “Ms. Murray did not provide any objective medical evidence
supporting her opinions; she simply checked boxes on a piece of paper,” and because her opinions
were “inconsistent with the record.” (Tr. 32). The plaintiff argues that, regardless of form, Dr.
Battista’s and Ms. Murray’s opinions are “entitled to weight” (Pl.’s Mem. at 22), and that “[i]t is
disingenuous for the ALJ to reject treating physician opinions because they were completed on a
check-list style form, that was created and supplied by the [SSA].”11 (Pl.’s Mem. at 23). The Court
disagrees.
The Court notes that “[f]orm reports in which a physician’s obligation is only to check a box or fill in a blank are
weak evidence at best.” Mason v. Shalala, 994 F.2d 1058, 1065 (3d Cir. 1993). “[W]here these so-called ‘reports are
unaccompanied by thorough written reports, their reliability is suspect . . . .’” Id. The Second Circuit has shared in
the skepticism of check-box or fill in the blank forms that are unaccompanied by written reports or other objective
medical evidence. See, e.g., Halloran, 362 F.3d at 31 n.2 (characterizing as “only marginally useful” a multiple choice
form from the New York State Office of Temporary and Disability Assistance); but see Camille v. Colvin, 625 F.
App’x 25, 28 (2d Cir. 2016) (summary order) (concluding that the ALJ did not err in weighing the opinions of a state
agency consulting psychologist because, inter alia, “his check-box opinions were supplemented by narrative
explanation” (citing 20 C.F.R. § 404-1527(c)(3)-(6)).
11
26
The minimal objective medical evidence in the record does not support the ratings that Dr.
Battista and Ms. Murray provided. In June 2014, Dr. Battista and Ms. Murray opined that the
plaintiff was able to manage her activities of daily living (Tr. 503), and, in a “progress note” from
June 3, 2015, Dr. Battista indicated that the plaintiff was “less anxious, less irritable,” and that her
“depression [was] under better control.” (Tr. 723). On July 20, 2015, Ms. Murray noted that the
plaintiff was “hoping to return to school,” and that she had made “[g]ood [p]rogress.” (Tr. 725).
Additionally, on May 7, 2014, Dr. Battista noted that the plaintiff’s “[d]epression and insomnia
[were] well controlled,” and that “PTSD symptoms [were] also well controlled.” (Tr. 754). On
October 8, 2014, Dr. Battista noted that the plaintiff developed “[p]roblems with attention,
concentration, and learning after she was molested,” and that the plaintiff’s hyperactivity as a child
was “suggestive of a possible underlying attention deficit disorder” (Tr. 754, 755); however, Dr.
Battista did not indicate whether or how the plaintiff’s difficulties with attention and concentration
impacted her currently. The objective evidence in the record indicates that the plaintiff was making
good progress overall and that she experienced, at most, moderate depression symptoms.
Dr. Battista’s and Ms. Murray’s ratings are also inconsistent with the other medical
evidence in the record. For instance, in October 2012, the plaintiff underwent a standardized
depression screening, which revealed that the plaintiff had “no significant symptoms.” (Tr. 408).
Additionally, in a May 2014 visit note, Dr. Krosi indicated that the plaintiff was seeing Dr. Battista
and “doing much better” (Tr. 367); and in a February 20, 2014 visit note, Dr. Krosi included that
a standardized depression screening revealed “mild to moderate symptoms.” (Tr. 375). The record
does not indicate that the plaintiff suffered from the numerous marked limitations that Dr. Battista
and Ms. Murray checked on the multiple choice/check-box forms.
27
It bears note that most of the records on which Dr. Battista and Ms. Murray recorded their
assessments of the plaintiff are, in fact, multiple choice or check-box forms. (See Tr. 502–505,
541–50, 790–93). For example, on one form, Dr. Battista and Ms. Murray rated on a one through
five scale how much of a problem the plaintiff had with activities of daily living, social
interactions, and task performance. (Tr. 503–04). Another form required Dr. Battista and Ms.
Murray to choose whether the plaintiff showed “No Evidence of Limitation,” or was “Not
Significantly Limited,” “Moderately Limited,” or “Markedly Limited” in a number of categories.
Although these forms provide an indication of where Dr. Battista and Ms. Murray rated the
plaintiff’s limitations and abilities, there is no objective medical evidence in the record to
supplement or support the ratings that Dr. Battista and Ms. Murray reached.
Furthermore, Dr. Battista’s and Ms. Murray’s opinions are inconsistent with the plaintiff’s
own testimony and indications about her activities of daily living. The plaintiff testified that she
cleaned her apartment as a hobby, and that she took at least one day each week to clean and do
chores. (Tr. 83, 290, 294). The plaintiff added that she cooked for herself multiple times each
week, often preparing home-cooked meals that took approximately one half-hour to make. (Tr.
82, 291). The plaintiff watched hour-long television shows and was able to explain to others what
occurred on the show. (Tr. 76, 82, 293). Importantly, the plaintiff testified that she cared for her
grandson, who came to her house every day and would often spend the night or the entire weekend.
(Tr. 75, 77–78). She added that she read to her grandson and played with him. (Tr. 75, 76). Such
testimony is inconsistent with the answers that Dr. Battista and Ms. Murray provided on the
multiple choice/check-box forms. Accordingly, the ALJ properly afforded “little weight” to the
opinions of Dr. Battista and Ms. Murray.
28
2.
OPINION OF DR. KROSI
The plaintiff argues similarly that the ALJ afforded improper weight to Dr. Krosi. The
ALJ afforded “little weight” to Dr. Krosi’s opinion that the plaintiff “has a marked limitation in
maintaining social functions, and that the [plaintiff] has a marked limitation[] with concentration,
persistence, or pace.” (Tr. 32). The ALJ reasoned that “Dr. Krosi did not explain why the
[plaintiff] has these limitations or provide objective examples of the limitations asserted. Dr. Krosi
simply checked boxes on a piece of paper.” (Tr. 32). The ALJ added that “this [opinion] is given
little weight because it is grossly inconsistent with the record. As already explained, the [plaintiff]
is in a committed relationship, cares for her grandson, earned a certificate in business, and regularly
watches the news.” (Tr. 32). The plaintiff reasserts her argument that the opinions of a treating
physician are “entitled to more weight than the opinion of any other examining or non-examining
physician, and [are] entitled to ‘controlling weight’ ‘if it is well supported by medical findings and
not inconsistent with other substantial record evidence.’” (Pl.’s Mem. 26). The defendant
responds that the ALJ’s rationale for affording little weight to Dr. Krosi’s opinion “largely tracks
the ALJ’s rationale with respect to Dr. Battista’s opinions, and is equally valid under the
Commissioner’s regulations and the record in this case.” (Def.’s Mem. at 14). The Court agrees
with the defendant.
There is no written report or other objective medical evidence supporting the check-box
form on which Dr. Krosi indicated that the plaintiff suffered from “marked limitation in
maintaining social functioning” and “marked limitation in completing tasks in a timely manner
due to deficiencies in concentration, persistence, or pace.” (See Tr. 538). Moreover, the medical
evidence in the record does not support Dr. Krosi’s findings in this regard. For example, on May
5, 2014, Dr. Krosi noted that the plaintiff “sees Dr. Battista and therapist once a week,” and “states
29
that she is doing much better.” (Tr. 367). Additionally, on March 20, 2014, Dr. Krosi noted that
the plaintiff was “[n]ot feeling poorly (malaise)” (Tr. 368), and in February 2014, reported that a
standardized depression screening revealed “mild to moderate symptoms” (Tr. 375). There are
instances in Dr. Krosi’s records where she notes generally the plaintiff’s depression. (See Tr. 365,
367, 371, 373, 375, 377, 383, 402, 405). The only objective medical evidence in Dr. Krosi’s
records regarding the plaintiff’s depression, however, is the following: two standardized
depression screenings, one from February 20, 2014 that notes “mild to moderate symptoms” (Tr.
375), and one from October 18, 2012 that notes “no significant symptoms” (Tr. 408); and one
record from January 31, 2013 that notes “[d]epression mild.” (Tr. 399).12 Dr. Krosi’s treatment
notes, therefore, do not support her answers on the check-box form that she completed.13
Moreover, Dr. Krosi’s opinion is also inconsistent with the plaintiff’s own testimony. As
detailed above, the plaintiff testified that one of her hobbies was cleaning her apartment, and that
she did chores for at least one full day each week. (Tr. 83, 290, 294). The plaintiff indicated that
she prepared home-cooked meals for herself approximately twice each week, which took about
thirty minutes to make. (Tr. 82, 291). Also, the plaintiff watched television shows that lasted for
one hour and was able to explain to others what occurred on the show. (Tr. 76, 82, 293). The
plaintiff testified that she cared for her grandson, and that he came to her house every day and
often spent the night or the entire weekend. (Tr. 75, 77–78). Additionally, she read to her grandson
and played with him when he was with her. (Tr. 75, 76). The medical evidence in the record and
the plaintiff’s own testimony do not indicate that the plaintiff experienced the “marked limitations”
Notably, on several occasions Dr. Krosi pointed out that the plaintiff was “[n]ot taking medication for depression.”
(See Tr. 371, 377, 383, 397, 402, 405). The record reveals, however, that the plaintiff’s condition had “improved with
medication and therapy.” (Tr. 549).
12
Dr. Krosi’s answers on the check-box form are also inconsistent with other medical evidence in the record, such as
the opinion of the State agency consultants that the plaintiff has the ability to “maintain socially appropriate behavior.”
(Tr. 98–100, 127–28).
13
30
from which Dr. Krosi opined the plaintiff suffered. Accordingly, the ALJ weighed properly the
opinion of Dr. Krosi.
3.
OPINION OF DR. NANDA
The plaintiff claims that it was improper for the ALJ to afford “little weight” to Dr. Nanda’s
opinion that the plaintiff “is severely restricted in performing work-related activities such as lifting,
sitting, standing, and fingering.” (Tr. 31). The ALJ explained that he afforded “little weight” to
this opinion because Dr. Nanda “did not explain or justify the opinions expressed by providing
objective medical evidence of the limitations asserted. Rather, Dr. Nanda simply checked boxes
on a piece of paper.” (Tr. 31). The ALJ added that “[f]urthermore, this opinion is given little
weight because Dr. Nanda was discussing physical limitations caused by the [plaintiff’s] HIV
status. However, the record shows that the plaintiff is asymptomatic with regard to HIV” (Tr. 31),
and that “this opinion is also given little weight because it is inconsistent with the evidence in the
record.” (Tr. 31). The plaintiff argues that “Dr. Nanda is a Board Certified Infectious Disease
specialist,” that “[c]ertainly, Dr. Nanda has the expertise to understand, and opine about [the
plaintiff’s] HIV status and how it affects her ability to function,” and that “Dr. Nanda’s opinion is
entitled to significant, if not controlling weight.” (Pl.’s Mem. at 25). The defendant responds that
the ALJ’s rationale for affording little weight to Dr. Nanda’s opinion “largely tracks the ALJ’s
rationale with respect to Dr. Battista’s opinions, and is equally valid under the Commissioner’s
regulations and the record in this case.” (Def.’s Mem. at 14). The Court agrees with the defendant.
The objective medical evidence in the record does not support Dr. Nanda’s opinion. For
example, the plaintiff’s May 5, 2014 visit note from Dr. Krosi indicates that the plaintiff
complained of only “[b]ody aches” (Tr. 365), and on February 20, 2014, the plaintiff complained
that “she has body aches, and is too tired to work, it is difficult for her to stand too long or sit for
31
too long. States her joints ache” (Tr. 371). A physical examination of the plaintiff on February
20, 2014, revealed “[c]ompression arthralgia of multiple sites: possibly related to hep C.” (Tr.
373). Additionally, following a physical examination on October 2, 2013, Dr. Krosi noted “HIV
infection: stable. No treatment.” (Tr. 385). A review of the plaintiff’s musculoskeletal system on
October 1, 2012 revealed that the plaintiff had “No muscle aches.” (Tr. 412). Moreover, there is
nothing in the record to support the opinion that the plaintiff’s legs should be elevated ninety
percent of the day (Tr. 640), or that the plaintiff could not use her hands, fingers, or arms for any
percentage of an eight-hour workday. (Tr. 640).
Additionally, as it does for the other treatment providers, the plaintiff’s testimony conflicts
with Dr. Nanda’s opinion. The plaintiff testified that she could sit for about two to three hours
before she started experiencing pain (Tr. 81), and that she could stand for about two to three hours
before she needed to sit back down because of pain and swelling in her feet (Tr. 81). This
testimony is inconsistent with Dr. Nanda’s indication that the plaintiff could sit and/or stand
continuously for only forty-five minutes. (Tr. 639). The plaintiff testified also that she could lift
a full gallon of milk with two hands (Tr. 81), which is inconsistent with Dr. Nanda’s opinion that
the plaintiff could never safely lift and/or carry even less than ten pounds during an eight-hour day
(Tr. 640). The plaintiff indicated that she could walk approximately two blocks before she had to
stop and rest (Tr. 295), which is inconsistent with Dr. Nanda’s conclusion that the plaintiff could
walk only one-half to one city block without rest. (Tr. 639). Accordingly, the ALJ properly
afforded “little weight” to Dr. Nanda’s opinion.
32
4.
OPINIONS OF THE STATE AGENCY CONSULTANTS
The plaintiff argues that the ALJ afforded improper weight to the opinions of the State
agency consulting psychologists.14 The ALJ afforded “partial weight” to the opinions of Dr.
Carlson and Dr. Swanson, reasoning:
Dr. Carlson opined that the [plaintiff] had mild restrictions with activities of daily
living, moderate difficulties in maintaining social functioning, and moderate
difficulties in maintaining concentration, persistence or pace. . . . This is consistent
with the record, which shows that the [plaintiff] regularly cleans, has a committed
long-term relationship as well as cares for her family, and completed a business
certificate program. This opinion was also largely shared by Dr. Swanson. . . .
However, Dr. [Swanson15] also opined that the [plaintiff] has moderate restrictions
on activities of daily living . . . . This opinion is inconsistent with the record. The
[plaintiff] testified that she sees her grandson every day when she does not feel
physical pain. The [plaintiff] is also able to prepare food, bathe and groom herself,
and care for at least one pet.
(Tr. 31) (citations omitted & footnote added).
The plaintiff argues that the ALJ afforded
insufficient weight to the opinions of Dr. Carlson and Dr. Swanson because “[t]he state agency
physicians here did describe large numbers of at least moderate limitations, which when taken
together would significantly erode [the plaintiff’s] occupational base.”16 (Pl.’s Mem. at 29). The
defendant responds that “[n]o such ‘moderate limitations’ exist in these doctors’ opinions; Plaintiff
confuses a series of ‘questions [which] help determine the individual’s ability to perform sustained
work activities’ with the doctors’ actual opinions, which they are not.” (Def.’s Mem. at 9).
14
The plaintiff does not challenge the weight afforded to the opinions of Dr. Zuniga or Dr. Khan.
15
In his decision, the ALJ indicated incorrectly that it was Dr. Carlson who opined that the plaintiff experienced
“moderate” restrictions in her activities of daily living. (See Tr. 31). However, the ALJ cited to the report submitted
by Dr. Swanson to support that assertion. (See Tr. 31). After carefully reviewing the record and the ALJ’s decision,
it is apparent that the ALJ’s reference should have been to Dr. Swanson, not Dr. Carlson.
The plaintiff argues also that “[i]t is unclear whether the ALJ intended to write ‘this is inconsistent with the record’
instead of ‘[t]his is consistent with the record’ when discussing Dr. Carlson’s opinion that the plaintiff has mild
difficulties with her activities of daily living, and moderate difficulties with maintaining social functioning and
maintaining concentration, persistence, or pace.” (Pl.’s Mem. at 29). When the phrase is put into context, it is apparent
that the ALJ intended the phrase to be as written.
16
33
The Second Circuit has recognized that “[t]he opinions of non-examining medical
personnel cannot, in themselves and in most situations, constitute substantial evidence to override
the opinion of a treating source.” Schiesler v. Sullivan, 3 F.3d 563, 570 (2d Cir. 1993). The
opinions of non-examining sources, however, may “override treating sources’ opinions, provided
they are supported by evidence in the record.”
Id. (citing 20 C.F.R. §§ 404.1527(f) and
416.927(f)).
Here, the ALJ properly rejected Dr. Swanson’s opinion that the plaintiff experienced
“moderate restrictions on activities of daily living.” (Tr. 31). Although the plaintiff experienced
some restrictions due to her depression and post-traumatic stress disorder, the evidence in the
record does not support the conclusion that these were “moderate” restrictions. For example, in
June 2014, Dr. Battista and Ms. Murray opined that the plaintiff was able to manage her activities
of daily living (Tr. 503), and the plaintiff indicated to Ms. Murray on July 20, 2015 that she was
hoping to go back to school. (Tr. 725). Additionally, the plaintiff testified that, while she was in
prison, she obtained a business certification, which required her to take classes. (Tr. 66). The
plaintiff indicated that she watches hour-long television shows, and that she can explain to others
what occurred on the show. (Tr. 82, 295). Moreover, the plaintiff testified that she cared for her
grandson, often keeping him overnight or for the entire weekend. (Tr. 75–78). The plaintiff
explained that she talks to her children frequently, even though she does not always get along with
them. (Tr. 296). The record reveals that the plaintiff has had the same partner for several years
(Tr. 397, 402, 405, 409, 411, 417, 420, 424, 432, 435, 440; see also Tr. 365, 372, 377, 383, 388);
Dr. Battista and Ms. Murray indicated on April 2, 2014 that the plaintiff’s relationship with her
partner was improved. (Tr. 819). Lastly, the record shows that the plaintiff never experienced
repeated episodes of decompensation. (Tr. 95, 124). Accordingly, the ALJ properly discredited
34
Dr. Swanson’s opinion that the plaintiff experienced a “moderate” restriction in her activities of
daily living and afforded “partial weight” to the opinions of Dr. Carlson and Dr. Swanson.
B.
SUBSTANTIAL EVIDENCE SUPPORTS THE ALJ’S RFC
DETERMINATION
The plaintiff argues that the ALJ’s RFC determination “lack impairments as described by
plaintiff and treating sources and agency physicians.” (Pl.’s Mem. at 30). The ALJ concluded:
the [plaintiff] has the residual functional capacity to perform light work . . . except
that the [plaintiff] is limited to simple, routine, and repetitive tasks—not at any
production rate pace; little or no contact with coworkers, and no requirement for
any collaborative efforts; no public contact; few changes in the workday from dayto-day.
(Tr. 28). The plaintiff argues that her “medical doctors described limitations that would preclude
light exertion work” and, therefore, “[t]he ALJ should have included these limitations in his RFC
determination.” (Pl.’s Mem. at 35). The defendant responds that “the ALJ set forth a clear basis
for his mental RFC finding, which, in addition to the medical opinions cited above, is also
supported by Plaintiff’s testimony, treatment history, and daily activities as outlined in the ALJ’s
decision.” (Def.’s Mem. at 10).
Residual functional capacity is defined as “the most [a claimant] can do despite [the
claimant’s] limitations.” 20 C.F.R. § 404.1545(a)(1); see also Barry v. Colvin, 606 F. App’x 621,
622 n.1 (2d Cir. 2015) (summary order). The Commissioner assesses a claimant’s residual
functional capacity “based on all the relevant medical and other evidence” in the record, which
includes the plaintiff’s subjective complaints. 20 C.F.R. § 404.1545(a)(1); see also Barry, 606 F.
App’x 622 n.1. The ALJ’s RFC determination need not “perfectly correspond with any of the
opinions of medical sources cited in his decision[;] [an ALJ is] entitled to weigh all of the evidence
available to make an RFC finding that [is] consistent with the record as a whole.” Matta v. Astrue,
508 F. App’x 53, 56 (2d Cir. 2013) (summary order) (citing Richardson v. Perales, 402 U.S. 389,
35
399 (1971); see Pinsky v. Berryhill, No. 17-CV-524 (MPS), 2018 WL 3054672, at *10 (D. Conn.
June 20, 2018).
“Light work involves lifting no more than 20 pounds at a time with frequent lifting or
carrying of objects weighing up to 10 pounds.” 20 C.F.R. § 404.1567(b). “Even though the weight
lifted may be very little, a job is in this category when it requires a good deal of walking or
standing, or when it involves sitting most of the time with some pushing or pulling of arm or leg
controls.” Id. “This court must affirm an ALJ’s RFC determination when it is supported by
substantial evidence in the record.” Barry, 606 F. App’x 622 n.1, citing 42 U.S.C. § 405(g); Perez
v. Chater, 77 F.3d 41, 46 (2d Cir. 1996).
Here, substantial evidence supports the ALJ’s RFC determination. Dr. Krosi indicated that
the plaintiff had full range of motion in her knees in June 2009 (Tr. 468), and that she had full
range of motion and normal mobility in her hips in December 2009. (Tr. 454). An August 2010
MRI revealed that the plaintiff had “moderate spondylotic changes” and “moderate
dextroscoliosis” (Tr. 352); however in December 2010, the plaintiff reported no musculoskeletal
symptoms. (Tr. 433). Additionally, the record indicates that in November 2014, an examination
of the plaintiff revealed “no localized joint pain” (Tr. 745), and that, in July 2015, an x-ray showed
the plaintiff to have mild degenerative arthritis in her left knee. (Tr. 591). The plaintiff’s records
from Access indicate that, although the plaintiff’s range of motion was decreased by twenty-five
percent in all directions, she was able to walk on her heels and toes, her mobility was within normal
limits, her gait pattern was unremarkable, and a straight leg raising test was negative. (Tr. 624).
Moreover, the record reflects that, in June 2009, the plaintiff declined a prescription for an
antidepressant and a referral for mental health treatment despite her complaints of depression. (Tr.
466). In October 2012, the plaintiff reported loss of pleasure, loss of interest in activities, and
36
instances of feeling down (Tr. 405); however, the record reflects that the plaintiff was doing “much
better” after starting mental health treatment. (Tr. 365, 773, 775). The record reflects also that, in
November 2014, the plaintiff had “no depression, no anxiety, [and] no sleep disturbances.” (Tr.
745). Dr. Battista’s notes indicate that the plaintiff’s depression had been “on and off for years”
(Tr. 723, 754), but that the plaintiff was making “good clinical improvement” as of April 2015.
(Tr. 819). The record shows also that, with medication and therapy, the plaintiff’s condition
improved (Tr. 549), and that the plaintiff had no repeated episodes of decompensation. (Tr. 95).
The records from the state agency psychological consultants, to whom the ALJ afforded
partial credit, reveal that the plaintiff experiences “low frustration tolerance,” and that the plaintiff
is best suited for “non-public” work in an environment with “lower social demands.” (Tr. 99).
The State consultants’ records indicate also that the plaintiff experienced a “mild” restriction of
her activities of daily living, and moderate difficulties in “maintaining social functioning” and
“maintaining concentration, persistence or pace.” (Tr. 95). The State psychological consultants’
records reflect that the plaintiff should work in an environment that does not require, inter alia,
collaboration with coworkers, strict adherence to time or production quotas, or substantial change
from day to day. (See Tr. 99–100, 128; see also section II.B.5. supra). The consultant records
reveal that the plaintiff did not experience any “[r]epeated episodes of decompensation” (Tr. 95),
and that she could typically focus for periods of two hours. (Tr. 127–28).
Furthermore, the plaintiff testified that she could sit for approximately two to three hours
before she began to experience pain (Tr. 81), and that she could stand for two to three hours before
her feet would swell and she began to experience pain. (Tr. 81). She testified also that she cleaned
her apartment often, and that if she experienced pain while cleaning, she would “suck it up.” (Tr.
83–84). The plaintiff explained that she saw and cared for her grandson almost every day, during
37
which time she read to him and played with him. (Tr. 75–76). The plaintiff noted that she forced
herself to walk every day and could walk about two blocks before she needed to stop and rest. (Tr.
81, 295). She also testified that she could relay to someone what occurred on a television show
such as Criminal Minds, which lasted for one hour, and follow written instructions. (Tr. 82, 295).
The ALJ’s RFC determination accounts for the restrictions and limitations about which the
medical sources and the plaintiff opined, and also aligns with the hypothetical individual posed to
the vocational expert, whom the vocational expert opined would be capable of performing three
jobs that exist in significant numbers in the national economy. Even though the ALJ’s RFC
determination does not “perfectly correspond” with the opinions of the medical sources in the
record, it is clear that it accounts for all of the evidence in, and is consistent with, the record as a
whole.17 See Matta v. Astrue, 508 F. App’x at 56. Accordingly, substantial evidence supports the
ALJ’s RFC determination.
VI.
CONCLUSION
Accordingly, for the reasons stated above, the plaintiff’s Motion to Reverse the Decision
of the Commissioner (Doc. No. 16) is DENIED, and the defendant’s Motion to Affirm (Doc. No.
17) is GRANTED.
Dated this 12th day of December, 2018 at New Haven, Connecticut.
/s/ Robert M. Spector, USMJ_________
Robert M. Spector
United States Magistrate Judge
17
The plaintiff argues that the ALJ selectively relied upon evidence in the record to support his conclusion that the
plaintiff is not disabled. (See Pl.’s Mem. at 29–30). It is well established, however, that an ALJ “need not recite every
piece of evidence that contributed to the decision, so long as the record permits [the court] to glean the rationale of an
ALJ’s decision.” Cichocki v. Astrue, 729 F.3d 172, 178 n.3 (2d Cir. 2013) (per curiam).
38
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