JOHNSON v. COMMISSIONER OF SOCIAL SECURITY
Filing
9
OPINION. Signed by Judge Esther Salas on 12/20/12. (jd, )
NOT FOR PUBLICATION
UNITED STATES DISTRICT COURT
DISTRICT OF NEW JERSEY
PHYLLIS JOHNSON,
Plaintiff,
Civil Action No.: 11-6737 (ES)
v.
OPINION
MICHAEL J. ASTRUE,
COMMISSIONER OF
SOCIAL SECURITY,
Defendant.
SALAS, District Judge
Before the Court is an appeal filed by Phyllis Johnson (“Claimant” or “Ms. Johnson”)
seeking review of an Administrative Law Judge’s (“ALJ”) decision denying her application for
disability insurance benefits under Title II of the Social Security Act. (D.E. No. 1). The Court
decides the matter without oral argument pursuant to Federal Rule of Civil Procedure 78(b). The
Court has subject matter jurisdiction pursuant to 42 U.S.C. § 405(g). For the reasons set forth
below, the Court vacates the Commissioner’s decision and remands for further administrative
proceedings consistent with this Opinion.
I.
Background
Ms. Johnson slipped and fell in January 1984. (R. at 23, 377).1 During the relevant time
period detailed below, she suffered from pain and weakness with her wrists purportedly as a
result of her fall. (R. at 22, 23). Ms. Johnson claims that this caused her gripping difficulties.
(Id.). Her wrist problem was characterized as “Madelung’s deformity of both of wrists.” (R. at
1
The Court uses the initial “R.” to refer to the Administrative Record.
1
22). Ms. Johnson was also determined to suffer from “degenerative disc disease of the lumbar
spine.” (Id.). This allegedly caused Ms. Johnson to experience, inter alia, back pain. (R. at 23).
On August 31, 1984, Ms. Johnson filed an application for disability insurance benefits.
(R. at 322-25). Ms. Johnson’s application was initially denied on November 19, 1984, (R. at
320-21), and upon reconsideration on March 4, 1985, (R. at 316-18).2 Thereafter, Ms. Johnson
requested a hearing before an ALJ. (R. at 294). On June 26, 1985, following a hearing earlier
that month, ALJ Irving Fliegler issued a decision finding that Ms. Johnson was not entitled to a
period of disability or disability insurance benefits. (R. at 245-50).
On November 26, 1985, Ms. Johnson filed a second application for disability insurance
benefits. (R. at 240-43). Ms. Johnson’s second application was initially denied on February 20,
1986, (R. at 239), and again upon reconsideration on September 9, 1986, (R. at 236). On
February 1, 1994, Ms. Johnson then filed a third application for disability insurance benefits. (R.
at 206-08). On February 18, 1994, this third application was denied. (R. at 203-205).
On July 13, 1994, Ms. Johnson filed a fourth application for disability insurance benefits.
(R. at 181-84). Ms. Johnson’s fourth application was initially denied on January 28, 1995, (R. at
175-79), and again upon reconsideration on April 27, 1995, (R. at 172). On May 30, 1995, Ms.
Johnson subsequently requested a hearing before an ALJ. (R. at 171). After a hearing in March
1996, on April 13, 1996, ALJ De Steno issued a decision finding that Ms. Johnson was not
entitled to a period of disability or to disability insurance benefits. (R. at 130-139).
Notably, in his decision, ALJ De Steno determined that the February 18, 1994 denial
“was not appealed and thus constitutes a ‘final determination’ of the agency.” (R. at 135). ALJ
2
Although the index to the Administrative Record provides that Ms. Johnson’s application was denied upon
reconsideration on March 4, 1985, (R. at 5), the actual document is difficult to read and may reference a February
20, 1985 date, (R. at 316-317). Nevertheless, the parties do not address these differences, and the Court’s
disposition does not depend on any such discrepancy.
2
De Steno then concluded that he could find “no valid reason for re-opening the [February 1,
1994] claim” and therefore that “the portion of the instant claim alleging disability on or before
February 18, 1994, is dismissed.”
(Id.).
ALJ De Steno accordingly determined that Ms.
Johnson’s July 13, 1994 application must be denied for administrative res judicata. (See R. at
118 (Appeals Council interpreting ALJ De Steno’s denial of July 13, 1994 application based on
res judicata)).
On May 9, 1996, Ms. Johnson then requested that the Appeals Council review ALJ De
Steno’s decision, (R. at 127-29), but, on January 2, 1998, the Appeals Council found “no basis . .
. for granting [her] request for review,” (R. at 122-123). On March 6, 1998, Ms. Johnson then
filed a complaint in the U.S. District Court for the District of New Jersey against the
Commissioner of Social Security,3 and, on January 13, 1999, the District Court remanded Ms.
Johnson’s claim pursuant to a consent order by the parties. (R. at 120-21).
On May 21, 1999, the Appeals Council accordingly issued an order vacating the
Commissioner’s final decision and remanded the matter back to the ALJ. (R. at 118). Notably,
the Appeals Council also determined that the February 18, 1994 denial of Ms. Johnson’s
February 1, 1994 application was “not a medical denial.” (Id.). The Appeals Council therefore
concluded that “res judicata does not apply” and it ordered the ALJ to “consider the merits of the
application filed on July 13, 1994,” which ALJ De Steno’s April 13, 1996 decision had failed to
do. (Id.).
On September 23, 1999, ALJ Richard Still4 conducted a post-remand hearing pursuant to
the Appeal Council’s May 21, 1999 order. (R. at 76, 326-65). On March 31, 2000, ALJ De
3
(See Civil Action 98-1005, D.E. No. 1).
The transcript provides that ALJ Still conducted the post-remand hearing, but ALJ De Steno later asserts that he
conducted the post-remand hearing. (R. at 76). The Commissioner of Social Security likewise alleges that ALJ De
4
3
Steno then issued a decision finding that Ms. Johnson was not entitled to a period of disability or
disability insurance benefits. (R. at 73-83). In this decision, ALJ De Steno explained that—
before the February 18, 1994 denial which was ultimately determined to be a non-medical denial
by the Appeals Council—the most recent “final determination of the agency on the basis of
disability was a reconsideration determination made on September 9, 1986, based on a claim
filed on November 26, 1985.” (R. at 77). Since Ms. Johnson’s next application was not filed
until February 1, 1994, more than four years after this September 9, 1986 determination, ALJ De
Steno determined that Ms. Johnson’s November 26, 1985 application “cannot be reopened.”
(Id.). Accordingly, ALJ De Steno determined that the “period on and prior to the reconsideration
determination of September 9, 1986, is barred from consideration based on the doctrine of res
judicata” and therefore that “the period in issue for establishing disability is from September 10,
1986 through the date last insured, June 30, 1989.” (Id.). ALJ De Steno concluded that Ms.
Johnson “was not under a disability . . . for the period in issue” and therefore “not entitled to a
period of disability and disability insurance benefits based on her July 13, 1994 Title II
application.” (Id.).
On April 28, 2000, Ms. Johnson again requested that the Appeals Council review ALJ De
Steno’s decision. (R. at 70-72). Nearly ten years later, on January 22, 2010, the Appeals
Council remanded Ms. Johnson’s application to an ALJ. (R. at 62-66). The Appeals Council
explained that “the record upon which the [ALJ] based the decision could not be located” and
that it was “unable to locate or redevelop all of the evidence in this case.” (R. at 64). The
Appeals Council accordingly determined that Ms. Johnson “should have the opportunity for a
new hearing and decision on the issues raised by her application filed on July 13, 1994.” (Id.).
Steno conducted the post-remand hearing. (D.E. No. 4, Answer, ¶ 4). The parties do not address this discrepancy
and it is not relevant to the Court’s disposition.
4
The Appeals Council remanded the case to a different ALJ than ALJ De Steno and “regret[ted]
the delay involved.” (Id.).
On January 28, 2011, ALJ Michelle Cavadi subsequently held a hearing concerning the
issues raised by Ms. Johnson’s July 13, 1994 application. (R. at 19, 366-401). On May 20,
2011, ALJ Cavadi issued a decision finding that Ms. Johnson was not disabled from September
10, 1986 through June 30, 1989 and not entitled to disability insurance benefits. (R. at 16-26).
ALJ Cavadi determined that “the unadjudicated period begins on September 10, 1986, the day
after the reconsideration determination” through “June 30, 1989 . . . the date last insured.” (R. at
19, 20, 22). ALJ Cavadi then concluded that Ms. Johnson “was not under a disability, as defined
in the Social Security Act, at any time from September 10, 1986, the alleged onset date, through
June 30, 1989, the date last insured.” (R. at 26).
On July 22, 2011, Ms. Johnson requested that the Appeals Council review ALJ Cavadi’s
decision, (R. at 12), but, on September 29, 2011, the Council determined that it had “no reason
under [its] rules to assume jurisdiction” and that ALJ Cavadi’s decision constituted a “final
decision of the Commissioner of Social Security,” (R. at 7-8). On November 15, 2011, Ms.
Johnson subsequently filed a complaint with this Court, appealing the final decision of the
Commissioner of Social Security (“Defendant” or “Commissioner”). (D.E. No. 1). The Court
received the administrative record on February 23, 2012, (D.E. dated February 23, 2012), and the
parties subsequently briefed the issues raised by Ms. Johnson’s appeal, (D.E. No 7, Brief in
Support of Claimant (“Cl. Br.”); D.E. No. 8, Brief in Support of Defendant (“Def. Br.”)).
5
II.
Legal Standard
A.
Benefits
To qualify for disability insurance benefits under Title II of the Social Security Act, the
claimant must establish that she meets certain requirements under 42 U.S.C. § 423. Namely, for
purposes of such benefits, the term “disability” means an “inability to engage in any substantial
gainful activity by reason of any medically determinable physical or mental impairment which
can be expected to result in death or which has lasted or can be expected to last for a continuous
period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A).
Moreover, a claimant is disabled in this respect only if her “physical or mental
impairments are of such severity that [s]he is not only unable to do [her] previous work but
cannot, considering [her] age, education, and work experience, engage in any other kind of
substantial gainful work which exists in the national economy . . . .” Id. § 423(d)(2)(A).
The Social Security Administration has established the following five-step, sequential
evaluation process to determine whether an individual is disabled:
(i) At the first step, we consider your work activity, if any. If you
are doing substantial gainful activity, we will find that you are not
disabled. . . .
(ii) At the second step, we consider the medical severity of your
impairment(s). If you do not have a severe medically determinable
physical or mental impairment that meets the duration requirement
in § 404.1509, or a combination of impairments that is severe and
meets the duration requirement, we will find that you are not
disabled. . . .
(iii) At the third step, we also consider the medical severity of your
impairment(s). If you have an impairment(s) that meets or equals
one of our listings in appendix 1 of this subpart and meets the
duration requirement, we will find that you are disabled. . . .
6
(iv) At the fourth step, we consider our assessment of your residual
functional capacity and your past relevant work. If you can still do
your past relevant work, we will find that you are not disabled. . . .
(v) At the fifth and last step, we consider our assessment of your
residual functional capacity and your age, education, and work
experience to see if you can make an adjustment to other work. If
you can make an adjustment to other work, we will find that you
are not disabled. If you cannot make an adjustment to other work,
we will find that you are disabled. . . .
20 C.F.R. § 404.1520(a)(4). Finally, disability insurance benefits may not be paid unless the
claimant meets the statutory insured status requirements. 42 U.S.C. § 423(a)(1)(A); see also id.
§ 423(c)(1) (setting the statutory requirements for determining whether a claimant is insured for
disability insurance benefits).
B.
Burden of Proof
The five-step sequential evaluation process involves a shifting burden of proof. See
Wallace v. Sec’y of Health & Human Servs., 722 F.2d 1150, 1153 (3d Cir. 1983). At step one,
the claimant has the burden of establishing that she has not engaged in “substantial gainful
activity” since the onset of the alleged disability, and at step two that she suffers from a “severe
impairment” or “combination of impairments.” 20 C.F.R. § 404.1520(a)-(c). If the claimant is
able to demonstrate both that she has not engaged in substantial gainful activity and that she
suffers from a severe impairment, then the claimant must then demonstrate—at step three—that
her impairments are equal to or exceed one of the impairments listed in Appendix 1 of the
regulations. 20 C.F.R. § 404.1520(d). If she is able to make this showing then she is presumed
disabled. If she cannot show that she meets or exceeds a listed impairment, then at step four she
must show that her residual functional capacity does not permit her to return to her previous
work. 20 C.F.R. § 404.1520(e). If the claimant meets this burden, then at step five, the burden
shifts to the Commissioner to demonstrate that the claimant can perform other substantial gainful
7
work. 20 C.F.R. § 404.1520(g). If the Commissioner cannot meet this burden then the claimant
shall receive disability benefits.
C.
Standard of Review
This Court has jurisdiction to review the Commissioner’s decision under 42
U.S.C. § 405(g). The Court must affirm the Commissioner’s decision if it is “supported by
substantial evidence.” 42 U.S.C. §§ 405(g) & 1383(c)(3); Stunkard v. Sec’y of Health & Human
Servs., 841 F.2d 57, 59 (3d Cir. 1988); Doak v. Heckler, 790 F.2d 26, 28 (3d Cir. 1986).
Substantial evidence is more than a “mere scintilla” of evidence and “means such
relevant evidence as a reasonable mind might accept as adequate to support a conclusion.”
Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting Consol. Edison Co. v. NLRB, 305 U.S.
197, 229 (1938)). Although substantial evidence requires more than a mere scintilla, “it need not
rise to the level of a preponderance.” McCrea v. Comm’r of Soc. Sec., 370 F.3d 357, 360 (3d
Cir. 2004).
In reviewing an ALJ’s decision, the Court must look to the ALJ’s “expression of the
evidence s/he considered which supports the result,” as well as the reasoning behind the rejection
of certain evidence to determine if substantial evidence supports the findings. See Cotter v.
Harris, 642 F.2d 700, 705 (3d Cir. 1981).
An ALJ’s reasoning for weighing or rejecting
evidence is particularly important when there is “conflicting probative evidence in the record.”
Id. at 706. The Court is bound by the ALJ’s findings that are supported by substantial evidence
“even if [it] would have decided the factual inquiry differently.” Hartranft v. Apfel, 181 F.3d
358, 360 (3d Cir. 1999). Thus, this Court is limited in its review in that it cannot “weigh the
evidence or substitute its conclusions for those of the fact-finder.” Williams v. Sullivan, 970 F.2d
1178, 1182 (3d Cir. 1992).
8
III.
ALJ Cavadi’s Decision
As a preliminary matter, ALJ Cavadi determined that “the unadjudicated period begins
on September 10, 1986, the day after the reconsideration determination” and that the Claimant
“last met the insured status requirements of the Social Security Act on June 30, 1989.” (R. at 19,
22). Accordingly, ALJ Cavadi ruled that the Claimant must establish disability “on or before”
June 30, 1989 “in order to be entitled to a period of disability and disability insurance benefits.”
(Id. at 20).
At step one, ALJ Cavadi determined that the Claimant “did not engage in substantial
gainful activity during the period from September 10, 1986 through her date last insured of June
30, 1989.” (R. at 22).
At step two, ALJ Cavadi determined that “the [C]laimant had the following severe
impairments: Madelung’s deformity of both wrists and degenerative disc disease of the lumbar
spine.” (Id.). ALJ Cavadi explained that these impairments “are severe because they result in
greater than minimal limitations in the [C]laimant’s ability to perform basic work activities.”
(Id.).
At step three, ALJ Cavadi determined that “the [C]laimant did not have an impairment or
combination of impairments that met or medically equaled one of the listed impairments in 20
CFR Part 404, Subpart P, Appendix 1.”
(Id.).
ALJ Cavadi noted that the Claimant’s
impairments do not equal in severity the impairments provided in “Listings 1.02 and 1.04.” (Id.).
ALJ Cavadi explained that the Claimant’s “degenerative disc disease had not been characterized
by evidence of nerve root compression; spinal arachnoiditis; or lumbar spinal stenosis, as
required by Section 1.04 of the Listings.” (Id.).
9
At step four, ALJ Cavadi determined that the “[C]laimant had the residual functional
capacity to perform light work as defined in 20 CFR 404.1567(b) with postural and manipulative
limitations.” (Id.). She determined that “the [C]laimant was capable of performing past relevant
work as a customer service clerk, loan processor, and medical charts analyst” and that this “work
did not require the performance of work-related activities precluded by the [C]laimant’s residual
functional capacity.” (R. at 26). Accordingly, ALJ Cavadi ruled that the “[C]laimant was not
under a disability . . . at any time from September 10, 1986 . . . through June 30, 1989, the date
last insured.” (Id.).
IV.
Discussion
A.
Ms. Johnson’s Arguments on Appeal
On appeal, Ms. Johnson argues that substantial evidence exists in the administrative
record to support a finding that she is entitled to disability insurance benefits. (Cl. Br. at 12).
First, Ms. Johnson argues that ALJ Cavadi’s step three analysis is improper because (1) ALJ
Cavadi failed to set forth the reasons why Ms. Johnson’s wrist impairment does not meet Listing
1.02 in 20 C.F.R. Part 404, Subpart P, Appendix 1, (Cl. Br. at 22); and (2) ALJ Cavadi failed to
provide an analysis of whether a combination of Ms. Johnson’s impairments medically equals
any Listing from Appendix 1, (id. at 23-24). Thus, in sum, Ms. Johnson asserts that ALJ Cavadi
“refused to compare [her] severe wrist impairments to any of the Commissioner’s listings at step
three [and] refused to combine these wrist impairments with [her] severe lumbar disc disease to
determine medical equivalence at step three . . . .” (Id. at 18).5 Ms. Johnson therefore asserts
that this matter “must be remanded for a proper step three analysis.” (Id. at 24).
5
Ms. Johnson briefly references ALJ Cavadi’s determination that Ms. Johnson’s “degenerative disc disease of the
lumbar spine” does not match Listing 1.04. (Cl. Br. at 22). She observes that ALJ Cavadi had noted the symptoms
that Ms. Johnson lacks—i.e., “nerve root depression [sic], spinal arach[n]oiditis and spinal stenosis.” (Id.). Ms.
Johnson then only reiterates the symptoms she does have relating to her spine; she does not actually argue that, in
10
Second, Ms. Johnson argues that, at step four, ALJ Cavadi failed to articulate a nexus
between Ms. Johnson’s condition and the residual functional capacity assessment. (Cl. Br. at
28). Said differently, Ms. Johnson argues that ALJ Cavadi determined a residual functional
capacity without explaining “how the evidence compels or even suggests th[at] finding[].” (Id.).
Ms. Johnson also argues that ALJ Cavadi improperly posed a hypothetical question to a
vocational expert. (Id. at 30). Finally, Ms. Johnson asserts that, in view of her “bilateral
deformities in both hands and wrists,” ALJ Cavadi’s finding that Ms. Johnson “could go back to
work typing and filing all day” is illogical. (Id. at 31).6
Therefore, Ms. Johnson asks this Court to reverse the Commissioner’s final decision and
order that Ms. Johnson be paid disability insurance benefits. (Id. at 12). Alternatively, Ms.
Johnson asks the Court to remand the ALJ’s decision and order a new hearing. (Id.). Notably,
Ms. Johnson does not, however, challenge ALJ Cavadi’s determination that the “unadjudicated
period begins on September 10, 1986” and continues until Ms. Johnson “last met the insured
status requirements of the Social Security Act on June 30, 1989.” (R. at 19, 22; see generally Cl.
Br.).
As detailed below, the Court finds that ALJ Cavadi erred in her step three analysis and
this matter will therefore be remanded for further administrative proceedings.
Since ALJ
Cavadi’s step three analysis could obviate the need to evaluate Ms. Johnson’s impairments in
step four, the Court will not consider issues concerning step four at this time. See Jones v.
Astrue, No. 11-4379, 2012 WL 5451528, at *6 (D.N.J. Nov. 5, 2012) (“Because the ALJ’s
view of these other symptoms, Listing 1.04 is satisfied. (See id.). Accordingly, the Court finds that Ms. Johnson
does not actually assert an argument on appeal concerning ALJ Cavadi’s step three determination relating to her
degenerative disc disease.
6
Ms. Johnson also seems to challenge ALJ Cavadi’s determination that, notwithstanding her Madelung’s deformity
of both wrists, Ms. Johnson is “limited to frequent handling and fingering.” (Cl. Br. at 28-29). Referring to ALJ
Cavadi’s finding that Ms. Johnson had the residual functional capacity to perform light work with “manipulative
limitations,” Ms. Johnson then declares: “Where in the world are the manipulative limitations?” The Court is unable
to decipher Ms. Johnson’s objection with ALJ Cavadi’s determination in this respect.
11
reassessment at Step Three could affect and/or obviate the need to evaluate Plaintiff’s
impairments at Steps Four and Five, the Court declines to address issues concerning Steps Four
and Five at this time.”); Butler v. Astrue, No. 09-3252, 2010 WL 3908627, at *4 (D.N.J. Sept.
28, 2010) (“Because the Step Three analysis is sequential, and a reconsideration of Step Three
may obviate or otherwise affect the final two steps, the Court will not consider Plaintiff’s other
arguments.”).
B.
Analysis
At step three, the ALJ must consider the medical severity of the claimant’s impairment(s)
and whether the impairment(s) “meets or equals one of [the] listings in Appendix 1” of 20 C.F.R.
Part 404, Subpart P.
20 C.F.R. § 404.1520(a)(4)(iii) (emphasis added).
This listing of
impairments in Appendix 1 “describes[,] for each of the major body systems[,] impairments that
[are] severe enough to prevent an individual from doing any gainful activity, regardless of his or
her age, education, or work experience.” Id. § 404.1525(a).
The ALJ can find medical equivalence in three ways:
(1)(i) If you have an impairment that is described in appendix 1,
but-(A) You do not exhibit one or more of the findings
specified in the particular listing, or
(B) You exhibit all of the findings, but one or more of the
findings is not as severe as specified in the particular
listing,
(ii) We will find that your impairment is medically equivalent to
that listing if you have other findings related to your impairment
that are at least of equal medical significance to the required
criteria.
(2) If you have an impairment(s) that is not described in appendix
1, we will compare your findings with those for closely analogous
listed impairments. If the findings related to your impairment(s)
12
are at least of equal medical significance to those of a listed
impairment, we will find that your impairment(s) is medically
equivalent to the analogous listing.
(3) If you have a combination of impairments, no one of which
meets a listing (see § 404.1525(c)(3)), we will compare your
findings with those for closely analogous listed impairments. If the
findings related to your impairments are at least of equal medical
significance to those of a listed impairment, we will find that your
combination of impairments is medically equivalent to that listing.
20 C.F.R. § 404.1526(b).
The ALJ must “fully develop the record and explain his findings at step three.” Burnett
v. Comm’r of Soc. Sec. Admin., 220 F.3d 112, 126 (3d Cir. 2000). Moreover, “it is the ALJ’s
duty to investigate the facts and develop the arguments both for and against granting benefits.”
Id. at 120 n.2 (internal quotations omitted). Accordingly, the ALJ must “set forth the reasons for
his decision.” Id. at 119.
Indeed, “an explanation from the ALJ [indicating] the reason why probative evidence has
been rejected is required so that a reviewing court can determine whether the reasons for
rejection were improper.” Cotter, 642 F.2d at 706-07; see also Torres v. Comm’r of Soc. Sec.,
279 F. App’x 149, 152 (3d Cir. 2008) (“There is no way to review the ALJ’s decision . . .
[where] no reasons were given for [the ALJ’s] conclusion that [the claimant’s] impairments in
combination did not meet or equal an Appendix 1 listing.”).
Here, in step two, ALJ Cavadi determined that Ms. Johnson suffered from two “severe
impairments”: “Madelung’s deformity of both wrists” and “degenerative disc disease of the
lumbar spine.” (R. at 22). Thereafter, ALJ Cavadi made the following determination for step
three:
Through the date last insured, the [C]laimant did not have an
impairment or combination of impairments that met or medically
equaled one of the listed impairments in 20 CFR Part 404, Subpart
13
P, Appendix 1 (20 CFR 404.1520(d), 404.1525 and 404.1526). A
review of the medical evidence indicates that none of the
[C]laimant’s impairments meet or are equal in severity to any of
the impairments listed in appendix 1 to Subpart P of 20 CFR 404,
in particular Listings 1.02 and 1.04. The [C]laimant’s degenerative
disc disease has not been characterized by evidence of nerve root
compression; spinal arachnoiditis; or lumbar spinal stenosis, as
required by Section 1.04 of the Listings.
The Court finds two flaws in ALJ Cavadi’s determination. First, ALJ Cavadi fails to
explain how Ms. Johnson’s “severe impairment[]” involving both of Ms. Johnson’s wrists did
not literally or equivalently meet Listing 1.02. See 20 C.F.R. § 404.1526(b). Listing 1.02
provides as follows:
1.02 Major dysfunction of a joint(s) (due to any cause):
Characterized by gross anatomical deformity (e.g., subluxation,
contracture, bony or fibrous ankylosis, instability) and chronic
joint pain and stiffness with signs of limitation of motion or other
abnormal motion of the affected joint(s), and findings on
appropriate medically acceptable imaging of joint space narrowing,
bony destruction, or ankylosis of the affected joint(s). With:
A. Involvement of one major peripheral weight-bearing joint (i.e.,
hip, knee, or ankle), resulting in inability to ambulate effectively,
as defined in 1.00B2b;
or
B. Involvement of one major peripheral joint in each upper
extremity (i.e., shoulder, elbow, or wrist-hand), resulting in
inability to perform fine and gross movements effectively, as
defined in 1.00B2c.
20 C.F.R. Part 404, Subpart P, Appendix 1. Having cited Listing 1.02, ALJ Cavadi simply
concludes that Ms. Johnson’s impairment does not qualify without any supporting explanation as
to how or why her impairment doesn’t qualify. This is insufficient. See Burnett, 220 F.3d at 119
(requiring the ALJ to “set forth the reasons for his decision” relating to step three); Cf. Cadillac
v. Barnhart, 84 F. App’x 163, 167 (3d Cir. 2003) (affirming, in relevant part, the ALJ’s step
14
three determination where the ALJ “explained why she rejected a match between [the
claimant’s] medical evidence and the individual relevant listings”).
Second, ALJ Cavadi fails to explain why the combination of Ms. Johnson’s severe
impairments is not medically equivalent to any of the Listings in Index 1. See 20 C.F.R. §
404.1526(b). Having determined that Ms. Johnson has two severe impairments, ALJ Cavadi was
required to determine whether the “cumulative effect” of these impairments medically equaled
any Listing in Appendix 1. See Cadillac, 84 F. App’x at 167.
Here, ALJ Cavadi concludes that “the [C]laimant did not have an impairment or
combination of impairments that met or medically equaled one of the listed impairments in 20
CFR Part 404, Subpart P, Appendix 1.” (R. at 22). But ALJ Cavadi failed to explain how or
why the combination of Ms. Johnson’s impairments is not equivalent to one of the Listings in
Appendix 1. This too is insufficient. See Burnett, 220 F.3d at 119; see also Jones, 2012 WL
5451528, at *6 (finding improper a conclusory statement that a combination of the claimant’s
impairments did not medically equal any Listing).
The Commissioner, however, argues that, Ms. Johnson “does not identify any particular
Listing these combined impairments would equal.” (Def. Br. at 9). The Commissioner also
asserts that “no medical source in the record opined that the combination of [Claimant’s]
impairments met a Listing, or that those impairments in combination caused any additional
limitations.” (Id.). The Commissioner concludes that Ms. Johnson “has therefore failed to
establish that her combined impairments equaled a Listing.” (Id.).
But the Court cannot accept the Commissioner’s arguments, made on appeal, in lieu of
ALJ Cavadi providing an explanation or analysis as to why a combination of Ms. Johnson’s two
severe impairments does not medically equal any Listing. Rather, it is this Court’s task to review
15
ALJ Cavadi’s decision on appeal. See Burnett, 220 F.3d at 119-120. And the Court cannot
perform its task where no reasons are given for the ALJ’s conclusion that “the [C]laimant did not
have an impairment or combination of impairments that met or medically equaled one of the
listed impairments in 20 CFR Part 404, Subpart P, Appendix 1.” See Torres, 279 F. App’x at
152.
Accordingly, the Court must vacate ALJ Cavadi’s order and remand to the ALJ for an
explanation and analysis as to (1) whether Ms. Johnson’s “Madelung’s deformity of both wrists”
meets or equals Listing 1.02; and (2) whether Ms. Johnson’s severe impairments, in
combination, medically equal any Listing in Appendix 1. See 20 C.F.R. § 404.1526(b).
Finally, the Court disappointingly observes that Ms. Johnson has been seeking disability
insurance benefits for over two decades. And, quite regrettably, the Court is still unable to reach
a final resolution and must agree with Ms. Johnson that “the matter must be remanded for a
proper step three analysis.” (Cl. Br. at 24). Given the duration of this process, the Court
strongly urges the Commissioner to promptly reach a determination in accordance with this
Opinion.
V.
Conclusion
For the foregoing reasons, ALJ Cavadi’s decision is hereby vacated and this case is
remanded for further proceedings consistent with this Opinion. An appropriate order shall
accompany this Opinion.
s/Esther Salas
Esther Salas, U.S.D.J.
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