Adam v. Commissioner of Social Security

Filing 17

OPINION: Commissioner's decision is VACATED and this matter remanded for further factual findings pursuant to sentence four of 42 U.S.C. § 405(g); signed by Magistrate Judge Ellen S. Carmody (Magistrate Judge Ellen S. Carmody, jal)

UNITED STATES DISTRICT COURT
WESTERN DISTRICT OF MICHIGAN
SOUTHERN DIVISION

ERIC ADAM,
Plaintiff,

Hon. Ellen S. Carmody

v.

Case No. 1:15-cv-501

COMMISSIONER OF SOCIAL
SECURITY,
Defendant.
______________________________________/
OPINION
This is an action pursuant to Section 205(g) of the Social Security Act, 42 U.S.C.
§ 405(g), to review a final decision of the Commissioner of Social Security denying Plaintiff’s claim
for Supplemental Security Income (SSI) under Title XVI of the Social Security Act. On July 28,
2015, the parties agreed to proceed in this Court for all further proceedings, including an order of
final judgment. (Dkt. #13). Section 405(g) limits the Court to a review of the administrative record
and provides that if the Commissioner’s decision is supported by substantial evidence it shall be
conclusive. The Commissioner has found that Plaintiff is not disabled within the meaning of the
Act. For the reasons articulated herein, the Commissioner’s decision is vacated and this matter
remanded for further factual findings pursuant to sentence four of 42 U.S.C. § 405(g).

STANDARD OF REVIEW
The Court’s jurisdiction is confined to a review of the Commissioner’s decision and
of the record made in the administrative hearing process. See Willbanks v. Sec’y of Health and
Human Services, 847 F.2d 301, 303 (6th Cir. 1988). The scope of judicial review in a social security
case is limited to determining whether the Commissioner applied the proper legal standards in
making her decision and whether there exists in the record substantial evidence supporting that
decision. See Brainard v. Sec’y of Health and Human Services, 889 F.2d 679, 681 (6th Cir. 1989).
The Court may not conduct a de novo review of the case, resolve evidentiary
conflicts, or decide questions of credibility. See Garner v. Heckler, 745 F.2d 383, 387 (6th Cir.
1984). It is the Commissioner who is charged with finding the facts relevant to an application for
disability benefits, and her findings are conclusive provided they are supported by substantial
evidence. See 42 U.S.C. § 405(g). Substantial evidence is more than a scintilla, but less than a
preponderance. See Cohen v. Sec’y of Dep’t of Health and Human Services, 964 F.2d 524, 528 (6th
Cir. 1992) (citations omitted). It is such relevant evidence as a reasonable mind might accept as
adequate to support a conclusion. See Richardson v. Perales, 402 U.S. 389, 401 (1971); Bogle v.
Sullivan, 998 F.2d 342, 347 (6th Cir. 1993). In determining the substantiality of the evidence, the
Court must consider the evidence on the record as a whole and take into account whatever in the
record fairly detracts from its weight. See Richardson v. Sec’y of Health and Human Services, 735
F.2d 962, 963 (6th Cir. 1984).
As has been widely recognized, the substantial evidence standard presupposes the
existence of a zone within which the decision maker can properly rule either way, without judicial
interference. See Mullen v. Bowen, 800 F.2d 535, 545 (6th Cir. 1986) (citation omitted). This

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standard affords to the administrative decision maker considerable latitude, and indicates that a
decision supported by substantial evidence will not be reversed simply because the evidence would
have supported a contrary decision. See Bogle, 998 F.2d at 347; Mullen, 800 F.2d at 545.

PROCEDURAL POSTURE
Plaintiff was 38 years of age on his alleged disability onset date. (PageID.157). He
successfully completed high school and worked previously as a driver. (PageID.51). Plaintiff
applied for benefits on June 4, 2012, alleging that he had been disabled since March 1, 2012, due
to COPD, breathing problems, pinched nerves in his back, and degenerative joint disease.
(PageID.157-60, 173). Plaintiff’s application was denied, after which time he requested a hearing
before an Administrative Law Judge (ALJ). (PageID.99-154).
On September 20, 2013, Plaintiff appeared before ALJ Thomas Walters with
testimony being offered by Plaintiff, an acquaintance of Plaintiff, and a vocational expert.
(PageID.57-91). In a written decision dated October 22, 2013, the ALJ determined that Plaintiff was
not disabled. (PageID.45-53). The Appeals Council declined to review the ALJ’s determination,
rendering it the Commissioner’s final decision in the matter. (PageID.25-27). Plaintiff subsequently
initiated this action pursuant to 42 U.S.C. § 405(g), seeking judicial review of the ALJ’s decision.

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ANALYSIS OF THE ALJ’S DECISION
The social security regulations articulate a five-step sequential process for evaluating
disability. See 20 C.F.R. §§ 404.1520(a-f), 416.920(a-f).1 If the Commissioner can make a
dispositive finding at any point in the review, no further finding is required. See 20 C.F.R. §§
404.1520(a), 416.920(a).

The regulations also provide that if a claimant suffers from a

nonexertional impairment as well as an exertional impairment, both are considered in determining
his residual functional capacity. See 20 C.F.R. §§ 404.1545, 416.945.
The burden of establishing the right to benefits rests squarely on Plaintiff’s shoulders,
and he can satisfy his burden by demonstrating that his impairments are so severe that he is unable
to perform his previous work, and cannot, considering his age, education, and work experience,
perform any other substantial gainful employment existing in significant numbers in the national
economy. See 42 U.S.C. § 423(d)(2)(A); Cohen, 964 F.2d at 528. While the burden of proof shifts
to the Commissioner at step five of the sequential evaluation process, Plaintiff bears the burden of
proof through step four of the procedure, the point at which his residual functioning capacity (RFC)
is determined. See Bowen v. Yuckert, 482 U.S. 137, 146 n.5 (1987); Walters v. Comm’r of Soc. Sec.,

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1. An individual who is working and engaging in substantial gainful activity will not be found to be “disabled”
regardless of medical findings (20 C.F.R. §§ 404.1520(b), 416.920(b));
2. An individual who does not have a “severe impairment” will not be found “disabled” (20 C.F.R. §§ 404.1520(c),
416.920(c));
3. If an individual is not working and is suffering from a severe impairment which meets the duration requirement and
which “meets or equals” a listed impairment in Appendix 1 of Subpart P of Regulations No. 4, a finding of “disabled”
will be made without consideration of vocational factors. (20 C.F.R. §§ 404.1520(d), 416.920(d));
4. If an individual is capable of performing her past relevant work, a finding of “not disabled” must be made (20 C.F.R.
§§ 404.1520(e), 416.920(e));
5. If an individual’s impairment is so severe as to preclude the performance of past work, other factors including age,
education, past work experience, and residual functional capacity must be considered to determine if other work can
be performed (20 C.F.R. §§ 404.1520(f), 416.920(f)).

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127 F.3d 525, 528 (6th Cir. 1997) (ALJ determines RFC at step four, at which point claimant bears
the burden of proof).
The ALJ determined that Plaintiff suffers from (1) COPD, (2) degenerative disc
disease, (3) degenerative joint disease of the bilateral knees, and (4) obesity, severe impairments that
whether considered alone or in combination with other impairments, failed to satisfy the
requirements of any impairment identified in the Listing of Impairments detailed in 20 C.F.R., Part
404, Subpart P, Appendix 1. (PageID.47-48). With respect to Plaintiff’s residual functional
capacity, the ALJ found that Plaintiff retained the ability to perform a limited range of sedentary
work. (PageID.48).
The ALJ found that Plaintiff cannot perform his past relevant work at which point
the burden of proof shifted to the Commissioner to establish by substantial evidence that a
significant number of jobs exist in the national economy which Plaintiff could perform, his
limitations notwithstanding. See Richardson, 735 F.2d at 964. While the ALJ is not required to
question a vocational expert on this issue, “a finding supported by substantial evidence that a
claimant has the vocational qualifications to perform specific jobs” is needed to meet the burden.
O’Banner v. Sec’y of Health and Human Services, 587 F.2d 321, 323 (6th Cir. 1978) (emphasis
added). This standard requires more than mere intuition or conjecture by the ALJ that the claimant
can perform specific jobs in the national economy. See Richardson, 735 F.2d at 964. Accordingly,
ALJs routinely question vocational experts in an attempt to determine whether there exist a
significant number of jobs which a particular claimant can perform, his limitations notwithstanding.
Such was the case here, as the ALJ questioned a vocational expert.

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The vocational expert testified that there existed approximately 1,200 jobs in the state
of Michigan, and approximately 43,000 jobs nationwide, which an individual with Plaintiff’s RFC
could perform, such limitations notwithstanding. (PageID.84-86). Based on this testimony, the ALJ
concluded that there existed a significant number of jobs which Plaintiff could still perform.
(PageID.52). The ALJ concluded, therefore, that Plaintiff was not entitled to disability benefits.

I.

The Treating Physician Doctrine
On October 15, 2012, Dr. Laurie Gulick completed a report concerning Plaintiff’s

“ability to do work-related activities (physical).” (PageID.330-31). The doctor reported that
Plaintiff’s ability to perform work-related activities was much more limited than the ALJ concluded.
The ALJ, however, afforded only “limited weight” to Dr. Gulick’s opinions. (PageID.51). Plaintiff
asserts that he is entitled to relief because the ALJ failed to articulate good reasons for his decision
to afford less than controlling weight to his treating doctor’s opinions.
The treating physician doctrine recognizes that medical professionals who have a
long history of caring for a claimant and her maladies generally possess significant insight into her
medical condition. See Barker v. Shalala, 40 F.3d 789, 794 (6th Cir. 1994). An ALJ must,
therefore, give controlling weight to the opinion of a treating source if: (1) the opinion is “wellsupported by medically acceptable clinical and laboratory diagnostic techniques” and (2) the opinion
“is not inconsistent with the other substantial evidence in the case record.”

Gayheart v.

Commissioner of Social Security, 710 F.3d 365, 375-76 (6th Cir. 2013) (quoting 20 C.F.R. §
404.1527).

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Such deference is appropriate, however, only where the particular opinion “is based
upon sufficient medical data.” Miller v. Sec’y of Health and Human Services, 1991 WL 229979 at
*2 (6th Cir., Nov. 7, 1991) (citing Shavers v. Sec’y of Health and Human Services, 839 F.2d 232,
235 n.1 (6th Cir. 1987)). The ALJ may reject the opinion of a treating physician where such is
unsupported by the medical record, merely states a conclusion, or is contradicted by substantial
medical evidence. See Cohen, 964 F.2d at 528; Miller v. Sec’y of Health and Human Services, 1991
WL 229979 at *2 (6th Cir., Nov. 7, 1991) (citing Shavers v. Sec’y of Health and Human Services,
839 F.2d 232, 235 n.1 (6th Cir. 1987)); Cutlip v. Sec’y of Health and Human Services, 25 F.3d 284,
286-87 (6th Cir. 1994).
If an ALJ accords less than controlling weight to a treating source’s opinion, the ALJ
must “give good reasons” for doing so. Gayheart, 710 F.3d at 376. Such reasons must be
“supported by the evidence in the case record, and must be sufficiently specific to make clear to any
subsequent reviewers the weight the adjudicator gave to the treating source’s medical opinion and
the reasons for that weight.” This requirement “ensures that the ALJ applies the treating physician
rule and permits meaningful review of the ALJ’s application of the rule.” Id. (quoting Wilson v.
Commissioner of Social Security, 378 F.3d 541, 544 (6th Cir. 2004)). Simply stating that the
physician’s opinions “are not well-supported by any objective findings and are inconsistent with
other credible evidence” is, without more, too “ambiguous” to permit meaningful review of the
ALJ’s assessment. Gayheart, 710 F.3d at 376-77.
In support of his decision to discount Dr. Gulick’s opinions, the ALJ stated as
follows:
The claimant’s treating physician, Dr. Gulick, has opined the
claimant’s lifting, handling, and feeling are limited and that he can
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lift/carry less than ten pounds; stand/walk less than two hours; and
sit/stand every 15 minutes at will. Furthermore, he must be able to
lie down at unpredictable intervals twice a day, due to limitations
involving his neck. In addition, he can never twist, climb stairs, or
ladders and can only occasionally bend and crouch due to his low
back pain/herniated discs. Dr. Gulick also finds the claimant must
avoid all environmental pollutants, extreme cold, and high humidity.
Furthermore, she opines the claimant would miss more than four days
of work per month due to his impairments. (6F) Dr. Gulick is a
treating provider and as such, her opinion is entitled to great
consideration if not controlling weight in this determination.
However, the undersigned finds that while her opinion suggests
disability, it is only partially completed. Furthermore, it overstates
the claimant’s limitations and is not supported by the record as a
whole. Thus, it is assigned limited weight except insofar as it is
consistent with the residual functional capacity contained herein.
(PageID.51).
The ALJ’s vague assertion that Dr. Gulick’s opinions are “not supported by the
record as a whole” is the type of meaningless statement that is simply too ambiguous to permit
meaningful review. While Defendant may be able to identify portions of the record that support the
ALJ’s assessment, the Court cannot find that the ALJ’s conclusion is legally sufficient based upon
such after-the-fact rationalizations. Instead, as Wilson and Gayheart make clear, the task of
articulating the rationale for discounting a treating physician’s opinion rests with the ALJ. In sum,
the ALJ failed to articulate sufficient reasons for discounting Dr. Gulick’s opinions. In light of the
fact that the doctor’s opinions are inconsistent with the ALJ’s RFC determination, the ALJ’s failure
is not harmless. The ALJ’s failure clearly violates the applicable legal standard and renders his
decision legally deficient.

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II.

Remand is Appropriate
While the Court finds that the ALJ’s decision fails to comply with the relevant legal

standards, Plaintiff can be awarded benefits only if “all essential factual issues have been resolved”
and “the record adequately establishes [his] entitlement to benefits.” Faucher v. Secretary of Health
and Human Serv’s, 17 F.3d 171, 176 (6th Cir. 1994); see also, Brooks v. Commissioner of Social
Security, 531 Fed. Appx. 636, 644 (6th Cir., Aug. 6, 2013). This latter requirement is satisfied
“where the proof of disability is overwhelming or where proof of disability is strong and evidence
to the contrary is lacking.” Faucher, 17 F.3d at 176; see also, Brooks, 531 Fed. Appx. at 644.
Evaluation of Plaintiff’s claim requires the resolution of certain factual disputes which this Court
is neither competent nor authorized to undertake in the first instance. Moreover, there does not exist
compelling evidence that Plaintiff is disabled. Accordingly, this matter must be remanded for
further administrative action.

CONCLUSION
For the reasons articulated herein, the Court concludes that the ALJ’s decision is not
supported by substantial evidence. Accordingly, the Commissioner’s decision is vacated and the
matter remanded for further factual findings pursuant to sentence four of 42 U.S.C. § 405(g).
A judgment consistent with this opinion will enter.

Date: April 15, 2016

/s/ Ellen S. Carmody
ELLEN S. CARMODY
United States Magistrate Judge

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