FIGUEROA v. COMMISSIONER OF SOCIAL SECURITY
OPINION. Signed by Judge Kevin McNulty on 2/1/16. (DD, )
UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF NEW JERSEY
Civ. No. 14—7734 (KM)
COMMISSIONER OF SOCIAL SECURITY,
KEVIN MCNULTY, U.S.D.J.:
Jessica Figueroa brings this action pursuant to 42 U.S.C.
§ 405(g) to
review a final decision of the Commissioner of Social Security (“Commissioner”)
denying her claims for Title II Disability Insurance Benefits (“DIB”) and Title
XVI Supplemental Security Income (“SSI”). Ms. Figueroa has been diagnosed
with a Lisfranc fracture to her left foot, for which she has undergone multiple
surgeries, and with possible early reflex sympathetic dystrophy. (See, e.g., R.
26, 206’ (ECF. No. 5)). Ms. Figueroa alleges that she suffers from constant
extreme pain and swelling in the foot, as well as drowsiness from pain
medication, which leaves her unable to work. (See, e.g., R. 29—3 1).
For the reasons set forth below, the Administrative Law Judge’s (“AU”)
decision is AFFIRMED.
refers to the pages of the administrative record filed by the
Commissioner as part of her answer. (ECF No. 5)
Ms. Figueroa seeks to reverse an AU’s finding that she was not disabled
from June 2010, the alleged onset date, through December 31, 2012, her date
last insured. (R. 10—18)
Ms. Figueroa most recently worked as a dispatcher until she was laid off
in 2008. (R. 34—35) Before then she worked as a receptionist until 2007 and as
a machine operator in a factory. (R. 36)
In June 2010, Ms. Figueroa twisted her foot and fell, sustaining
dislocations and a fracture to the tarsal and metatarsal bones of her left foot.
(E.g., R. 204) After surgery at the Raritan Bay Medical Center, she experienced
severe pain. (Id.) She underwent a second operation in June 2011, which
initially appeared successful. (R. 225, 275, 289) By November 2011, however,
she again complained of pain during her monthly visits to her podiatrist, Dr.
Fausto J. Ramos. (R. 276-8 1) Ms. Figueroa adds that she underwent a third
surgery in February 2013, ten days before the AU issued his decision. (P1. Br.
23 & n.2 (ECF No. 9); see also R. 291 (pre-op testing orders))
Ms. Figueroa initially applied for DIB and SSI benefits on December 10,
2010. (E.g., R. 48, 57) Those claims were first denied on February 3, 2011 (R.
56, 65), and denied again on reconsideration on October 5, 2011 (R. 76, 87).
On October 13, 2011, Ms. Figueroa filed a request for a hearing. (R. 104—06)
On July 24, 2012, the ALT held a hearing, at which Ms. Figueroa testified and
was represented by counsel. (R. 2 1—47) On February 22, 2013, AU Joel H.
Friedman denied Ms. Figueroa’s application for DIB and SSI benefits. (R. 1018) On October 9, 2014, the Appeals Council denied Ms. Figueroa’s request for
review, making the AU’s decision the final decision of the Commissioner. (R. 1—
4) Ms. Figueroa now appeals that decision.
Ms. Figueroa’s applications listed her onset date as December 8, 2010 (R. 137,
141), but her attorney amended that date at the hearing (R. 10, 24).
To qualify for Title II DIB benefits, a claimant must meet the insured
status requirements of 42 U.S.C.
§ 423(c). To be eligible for SSI benefits, a
claimant must meet the income and resource limitations of 42 U.S.C. § 1382.
To qualify under either statute, a claimant must show that she is unable to
engage in substantial gainful activity by reason of any medically determinable
physical or mental impairment that can be expected to result in death or that
has lasted (or can be expected to last) for a continuous period of not less than
twelve months. 42 U.S.C.
§ 423(d)(1)(A), 1382c(a)(3)(A); see, e.g., Diaz v.
Comm’r of Soc. Sec., 577 F.3d 500, 503 (3d Cir. 2009).
A. Five-Step Process and this Court’s Standard of Review
Under the authority of the Social Security Act, the Social Security
Administration has established a five-step evaluation process for determining
whether a claimant is entitled to benefits. 20 C.F.R.
§ 404.1520, 4 16.920.
Review necessarily incorporates a determination of whether the AU
followed the five-step process prescribed by regulation. The steps may be briefly
summarized as follows:
Step 1: Determine whether the claimant has engaged in substantial
gainful activity since the onset date of the alleged disability. 20 C.F.R.
404.1520(b), 416.920(b). If not, move to step two.
Step 2: Determine if the claimant’s alleged impairment, or combination
of impairments, is “severe.” Id.
§ 404.1520(c), 4 16.920(c). If the claimant has a
severe impairment, move to step three.
Step 3: Determine whether the impairment meets or equals the criteria
of any impairment found in the Listing of Impairments. 20 C.F.R. Pt. 404,
Subpt. P, App. 1, Pt. A. (Those Part A criteria are purposely set at a high level,
to identify clear cases of disability without further analysis.) If so, the claimant
is automatically eligible to receive benefits; if not, move to step four. Id.
404.1520(d), 4 16.920(d).
Step 4: Determine whether, despite any severe impairment, the claimant
retains the Residual Functional Capacity (“RFC”) to perform past relevant work.
§ 404.1520(e)—(f), 416.920(e)—(f). If not, move to step five.
Step 5: At this point, the burden shifts to the SSA to demonstrate that
the claimant, considering her age, education, work experience, and RFC, is
capable of performing jobs that exist in significant numbers in the national
economy. 20 C.F.R.
§ 404.1520(g), 4 16.920(g); see Poulos v. Comm’r of Soc.
Sec., 474 F.3d 88, 91—92 (3d Cir. 2007). If so, benefits will be denied; if not,
they will be awarded.
As to all legal issues, this Court conducts a plenary review. Schaudeck v.
Comm’rof Soc. Sec., 181 F.3d 429, 431 (3d Cir. 1999). As to factual findings,
this Court adheres to the AU’s findings, as long as they are supported by
substantial evidence. Jones v. Bamhart, 364 F.3d 501, 503 (3d Cir. 2004)
(citing 42 U.S.C.
§ 405(g)). Where facts are disputed, this Court will “determine
whether the administrative record contains substantial evidence supporting the
findings.” Sykes v. Apfel, 228 F.3d 259, 262 (3d Cir. 2000). “Substantial
evidence is such relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.” Zimsak v. Colvin, 777 F.3d 607, 610 (3d
Cir. 2014) (internal quotation marks and citation omitted). Substantial
evidence “is more than a mere scintilla but may be somewhat less than a
preponderance of the evidence.” Id. (internal quotation marks and citation
[I]n evaluating whether substantial evidence supports the AU’s
leniency should be shown in establishing the claimant’s
the Secretary’s responsibility to rebut it should
be strictly construed. Due regard for the beneficent purposes of the
legislation requires that a more tolerant standard be used in this
administrative proceeding than is applicable in a typical suit in a
court of record where the adversary system prevails.
Reefer v. Bamhart, 326 F.3d 376, 379 (3d Cir. 2003) (internal citations and
quotations omitted). When there is substantial evidence to support the AU’s
factual findings, however, this Court must abide by them. See Jones, 364 F.3d
at 503 (citing 42 U.S.C.
405(g)); Zirnsak, 777 F.3d at 610—11 (“[W]e are
mindful that we must not substitute our own judgment for that of the fact
This Court may, under 42 U.S.C.
405(g), affirm, modify, or reverse the
Secretary’s decision, or it may remand the matter to the Secretary for a
rehearing. Podedworriy v. Harris, 745 F.2d 210, 221 (3d Cir. 1984); Bordes v.
Comm’r of Soc. Sec., 235 F. App’x 853, 865—66 (3d Cir. 2007) (not precedential).
Outright reversal with an award of benefits is appropriate only when a
fully developed administrative record contains substantial evidence that the
claimant is disabled and entitled to benefits. Podedworny, 745 F.2d at 221—
222; Morales v. Apfel, 225 F.3d 310, 320 (3d Cir. 2000).
Remand is proper if the record is incomplete, or if there is a lack of
substantial evidence to support a definitive finding on one or more steps of the
five step inquiry. See Podeciworny, 745 F.2d at 22 1—22. Remand is also proper
if the AU’s decision lacks adequate reasoning or support for its conclusions, or
if it contains illogical or contradictory findings. See Burnett v. Comm’r of Soc.
Sec., 220 F.3d 112, 119—20 (3d Cir. 2000); Leech v. Barnhart, 111 F. App’x 652,
658 (3d Cir. 2004) (“We will not accept the AU’s conclusion that Leech was not
disabled during the relevant period, where his decision contains significant
contradictions and is therefore unreliable.”) (not precedential). It is also proper
to remand where the AU’s findings are not the product of a complete review
which “explicitly weigh[sj all relevant, probative and available evidence” in the
record. Adorno v. Shalala, 40 F.3d 43, 48 (3d Cir. 1994) (internal quotation
B. The AU’s decision
AU Friedman determined that Ms. Figueroa’s date last insured (see
https: / /secure.ssa.gov/poms.nsf/lnx/042550 1320) was December 31, 2012,
and that the alleged disability onset date was in June 2010. (R 12) The AU
ultimately concluded, however, that from June 2010 through December 31,
2012, Ms. Figueroa was not “under a disability, as defined in the Social
Security Act.” (R. 16) The AU’s determinations may be summarized as follows.
At step one, the AU determined that Ms. Figueroa had “not engaged in
substantial gainful activity since June 2010.” (R. 12)
At step two, the AU
found that Ms. Figueroa had the following severe
impairment: “status post fractured foot.” (R. 12) He added that the medical
record supports the finding that Ms. Figueroa’s impairments significantly limit
her ability to do at least one basic work activity, and that her impairments have
been continuously severe for more than twelve months. (R. 12—13)
At step three, the AU
determined that Ms. Figueroa’s impairment or
combinations of impairments did not meet or medically equal the severity of
one of the listed impairments, 20 C.F.R. Pt. 404, Subpt. P, App. 1, Pt. A
§ 1.00 musculoskeletal system impairments). (R. 13)
Step 4- RFC
The AU then determined Ms. Figueroa’s RFC, finding her capable of
performing the following:
the full range of sedentary work as defined in 20 CFR 404.1567(a)
and 4 16.967(a) except that she can never climb ladders, ropes and
scaffolds, never kneel, crouch, or crawl, but can occasionally climb
ramps and stairs, balance and stoop. She needs to avoid
concentrated exposure to temperature extremes, wetness and
hazards and all exposure to humidity and vibration.
The ALl supported his RFC determination by finding that Ms. Figueroa’s
allegations concerning the intensity of her symptoms and the extent to which
they are limiting were “not entirely credible.” (Id.; accord R. 16) The AUJ listed
the details of her medical record, including Ms. Figueroa’s injury, the ensuing
operation, examinations from doctors and podiatrists, second surgery,
treatments and tests, treating physician reports, and state agency physician
reports. (R. 14—15) Among other things, he described her injury, surgery, and
resultant pain. (R. 14 (citing R. 204)) He also included observations of two
treating podiatrists: The first, Dr. Ujjwal K. Datta, opined in January 2011 that
Ms. Figueroa’s ability to do work related activities was limited to sitting for less
than six hours per day. (Id. (citing R. 207)) The second, Dr. Ramos, stated in
May 2011 that Ms. Figueroa had walking and standing, as well as lifting and
carrying, limitations, but was not limited in her ability to sit. (Id. (citing R. 217))
also noted that Dr. Ramos’s medical records indicate that the second
surgery was successful, but that Ms. Figueroa did not attend prescribed
physical therapy. (R. 15 (citing R. 275-76)) Additionally, the ALT explained that
Dr. Ramos’s records further show that Ms. Figueroa “took a small jump and
heard a click on the left big toe” after which she could not walk on that toe, and
that subsequent injections did not alleviate the pain. (Id. (citing 278—80))
The ALT recounted Ms. Figueroa’s testimony at her hearing. He observed
that Ms. Figueroa presented with a slight limp and had no difficulty rising for
her oath. (R. 15) He recited that she explained her pain, discomfort, and
swelling when sitting down. (Id.; see R.30) She also explained that her pain
medication, Naprosyn, makes her drowsy. (Id.; see R.31) The ALT recalled that
he asked Ms. Figueroa why she does not take more potent pain medication,
and she answered “that the doctor tells her that Naprosyn is for muscle
inflammation and that is why he is giving it to her.” (Id.; see R. 31) The ALT
further noted that Dr. Ramos opined in the RFC form submitted after the
hearing that Ms. Figueroa’s ability to sit was not affected by her impairment.
(Id. (citing R. 294))
Based on this evidence, the ALT found that Ms. Figueroa was not fully
credible. (R. 16) Against Ms. Figueroa’s claims of a minimal ability to sit or
stand, the ALT cited Dr. Ramos’s opinion that Ms. Figueroa had no sitting
limitations (see, e.g., R. 294); her minimal medication regimen and failure to
seek stronger medication; and her admission that she could stand for 20—25
minutes at a time (see R. 40), which the AU found consistent with sedentary
work. (R. 16) The AU also found it relevant that Ms. Figueroa does not use
assistive devices (see R. 39—40), does household chores, shops with the
assistance of a neighbor, and is able to care for her children. (R. 16)
The AU also gave limited weight to the opinions of two of Ms. Figueroa’s
physicians. (R. 16) The AU noted that Dr. Datta, who opined that Ms. Figueroa
was disabled, was doing so with an eye towards state welfare, not social
security, standards. (Id.) In fact, in the same report, Dr. Datta suggested that
Ms. Figueroa might be able to perform a desk job. (Id.; see R. 2 12—13) The AU
similarly gave “little weight” to Dr. Ramos’s opinion of Ms. Figueroa’s physical
limitations. (R. 16) Dr. Ramos opined that Ms. Figueroa was limited to lifting
and carrying five pounds, but the AU
found that there was “no impairment
documented that would impose such a draconian limitation.” (Id.; see R. 293)
Dr. Ramos also stated that Ms. Figueroa could never climb, stoop, crouch,
kneel or crawl. (Id.; see R. 294) The AU
found that those opinions were
unsupported by the record and inconsistent with Ms. Figueroa’s current daily
activities, which consist of household chores and child care. (Id.) The ALT also
found that Dr. Ramos gave little supporting explanation for his opinions. (Id.
(citing 20 C.F.R.
§ 404.1527 (d)(3), 416.927(d)(3)))
Based on that analysis of the evidence, the ALT gave far more weight to
the state agency physicians’ assessment that Ms. Figueroa could perform
sedentary work with limitations. (R. 17; see, e.g., R. 52—56)
Thus, the ALT found that, based on her RFC, Ms. Figueroa was unable to
perform any past relevant work. (R. 17)3 The ALT further determined that, since
Ms. Figueroa was born on February 2, 1982, and was 28 years old, she was
The ALT explained that she may not have performed her past sedentary jobs
at the substantial gainful activity level. (Id.)
categorized as a “younger individual age 18-49, on the alleged disability onset
date.” (Id.) The AU also noted that Ms. Figueroa had a limited education and
was able to communicate in English. (Id.) The AU added that “[t]ransferability
of job skills is not material to the determination of disability because using the
Medical-Vocational Rules as a framework supports a finding that the claimant
is ‘not disabled,’ whether or not the claimant has transferable job skills.” (Id.
(citing SSR 82—41 and 20 C.F.R. Pt. 404, Subpt. P, App. 2))
At step five, the AU considered Ms. Figueroa’s “age, education, work
experience, and residual functional capacity,” and found that “there are jobs
that exist in significant numbers in the national economy that [Ms. Figueroa]
can performed.” (R. 17) The AU
explained that “[i]f the claimant had the
residual functional capacity to perform the full range of sedentary work, a
finding of ‘not disabled’ would be directed by Medical-Vocational Rule 201.24.”
(R. 17) He added that Ms. Figueroa’s postural and environmental limitations
“do not significantly erode the sedentary occupational base, as noted in SSR
96-9p.” (Id.) Thus the AU determined that Ms. Figueroa was not “under a
disability” during the relevant period, and Ms. Figueroa was denied disability
benefits and supplemental security income. (R. 18)
C. Ms. Figueroa’s appeal
Ms. Figueroa challenges the AU’s determinations at steps three, four,
and five. At step three, Ms. Figueroa argues that the AU’s “one-sentence
statement which doesn’t even identify which listing was consulted for a
comparison” was insufficient, and thus cannot be properly reviewed by this
Court. (P1. Br. 16; accord P1. Br. 11—18) At step four, Ms. Figueroa argues that
does not properly support his decision with evidence from the record,
and that the AU
improperly rejects treating opinions in favor of state agency
physician review. (P1. Br. 18—25, 32—34) At step five, Ms. Figueroa argues that
improperly substituted his own judgment for that of a vocational
expert. (P1. Br. 25—32)
The claimant bears the burden of proving that her impairments, whether
individually or collectively, equal or meet those listed in Appendix 1. Burnett,
220 F.3d at 120 n.2. However, “if a claimant’s impairment does not match one
listed in Appendix 1, the AU
is required to perform a comparison between the
claimant’s impairment(s) and those listed in Appendix 1.” Tori-es v. Comm’r of
Soc. Sec., 279 F. App’x 149, 151 (3d Cir. 2008) (not precedential) (citing 20
§ 404.1526(b)). The Third Circuit has stated that step three requires the
AU to perform “an analysis of whether and why [the claimant’s individual
impairments], or those impairments combined, are or are not equivalent in
severity to one of the listed impairments.” Burnett, 220 F.3d at 120.
“Conclusory statements that a condition does not constitute the medical
equivalent of a listed impairment are insufficient.” Diaz, 577 F.3d at 504. The
AU is “not require[d
to use particular language or adhere to a particular
format in conducting his analysis. Rather
sufficient development of the
record and explanation of findings to permit meaningful review” is necessary.
Jones, 364 F.3d at 505.
In Ms. Figueroa’s case, the AU’s explicit step three analysis is limited to
4. The claimant does not have an impairment or
combination of impairments that meets or medically equals
the severity of one of the listed impairments in 20 CFR Part
404, Subpart P, Appendix 1 (20 CFR 404.1520(d), 404.1525,
404.1526, 416.920(d), 416.925 and 416.926).
Although the claimant has impairments that are considered
to be “severe,” they are not attended, singly or in combination, with
the specific clinical signs and diagnostic findings required to meet
or equal the requirements set forth in the Listing of Impairments
under 1.00 (Musculoskeletal System).
That analysis is skimpy. I do find, however, that it permits meaningful
review, for two reasons: (1) Even now, Ms. Figueroa does not point to any
evidence even suggesting that her impairment might meet or equal one of those
listed in Appendix 1. (2) The AU
identified “1.00 (Musculoskeletal System)” as
the relevant category of impairments, and the evidence as a whole well
supports his finding that the impairments, singly or in combination, do not
match or meet criteria within
§ 1.00. Cf Sentz v. Bamhart, 83 F. App’x 410 (3d
Cir. 2003) (“despite the inadequate explanation by the AU, meaningful judicial
review of the AU’s analysis at step three is possible because of the nature of
[petitionerj’s back impairment, the singular listing at issue and the type of
medical evidence necessary to establish this presumptively disabling
condition”) (not precedential). It is important to remember that the Appendix A
listings set a purposefully high bar, because meeting all of the requirements
results in an automatic finding of disability. Meeting only some of the
requirements is insufficient. See Sullivan v. Zebley, 493 U.S. 521, 530—32, 110
S. Ct. 885, 89 1—92 (1990).
Ms. Figueroa briefly mentions
§ 1.03 and 1.06, suggesting that her
impairments meet or are equivalent to them. (P1. Br. 16) Both, however, require
“an inability to ambulate effectively, as defined in 1.00.B2b.” 20 C.F.R.
404, Subpt. P, App. 1. Ms. Figueroa’s evidence fails to meet that definition.
1.03 Reconstructive surgery or surgical arthrodesis of a major weightbearing joint, with inability to ambulate effectively, as defined in
1 .OOB2b, and return to effective ambulation did not occur, or is not
expected to occur, within 12 months of onset.
1.06 Fracture of the femur, tibia, pelvis, or one or more of the tarsal
A. Solid union not evident on appropriate medically acceptable imaging
and not clinically solid;
An inability to ambulate effectively “is defined generally as having
insufficient lower extremity functioning
to permit independent ambulation
without the use of a hand-held assistive device(s) that limits the functioning of
both upper extremities.” Id. at § 1.OO.B.2.b. Further:
To ambulate effectively, individuals must be capable of sustaining
a reasonable walking pace over a sufficient distance to be able to
carry out activities of daily living. They must have the ability to
travel without companion assistance to and from a place of
employment or school. Therefore, examples of ineffective
ambulation include, but are not limited to, the inability to walk
without the use of a walker, two crutches or two canes, the
inability to walk a block at a reasonable pace on rough or uneven
surfaces, the inability to use standard public transportation, the
inability to carry out routine ambulatory activities, such as
shopping and banking, and the inability to climb a few steps at a
reasonable pace with the use of a single hand rail. The ability to
walk independently about one’s home without the use of assistive
devices does not, in and of itself, constitute effective ambulation.
To be sure, the AU performed his most detailed analysis of the evidence
in connection with the RFC. That evidence, however, sheds light on Ms.
Figueroa’s Step 3 claims. The AU noted that Ms. Figueroa testified that “[sjhe
does not use any assistive devices.” (R. 16; see R. 39) She claimed that she can
stand for 20—2 5 minutes at a time but stated that she spends her day doing
chores such as laundry and cleaning. (R. 16; see R. 37, 40) The AU
medical evidence that the second surgery appeared to correct Ms. Figueroa’s
injuries (R. 14—15 (citing R. 270—71, 275)); that Ms. Figueroa did not attend
physical therapy or follow up with her doctor, but instead went away (R. 15,
(citing R. 276)); and that Dr. Ramos reported that Ms. Figueroa could stand
B. Inability to ambulate effectively, as defined in 1 .OOB2b, and return to
effective ambulation did not occur or is not expected to occur within 12
months of onset.
20 C.F.R. § Pt. 404, Subpt. P, App. 1.
and walk for a total of two hours a day (Id. (citing R. 294)). The AU
a slight limp when Ms. Figueroa appeared for the hearing. (R. 15; see R. 40)5
These findings by the AU well exceed the threshold of substantial
evidence to support the conclusion that Ms. Figueroa’s impairment did not
meet or equal any of the relevant impairments listed in
admittedly does not use any assistive device. See
§ 1.00. Ms. Figueroa
§ 1.00.B.2.b. Both she and
her treating physician think she can walk for some amount of time unaided,
and medical evidence supports that. Id. She can do chores and clean her
house, activities which do not alone establish effective ambulation,
§ 1.00.B.2.b., but which combined with the other evidence demonstrate that
Ms. Figueroa can ambulate effectively as defined by § 1 .00.B.2.b., and therefore
does not have an impairment that meets or equals the criteria of § 1.03 or
Ms. Figueroa argues that the AU did not properly explain his RFC
decision. (P1. Br. 18—25) She cites Burnett for the proposition that “[ijn making
a residual functional capacity determination, the AU
evidence before him. Although the AU
must consider all
may weigh the credibility of the
evidence, he must give some indication of the evidence which he rejects and his
reason(s) for discounting such evidence.” 220 F.3d at 121 (internal citations
RFC is an assessment of the most a claimant can do despite her
impairments. See 20 C.F.R.
§ 404.1545. The AU found that Ms. Figueroa had
the RFC to perform “the full range of sedentary work as defined in 20 CFR
the hearing the AU noted that Ms. Figueroa “didn’t have much of a limp,”
and asked her whether it gets worse when she walks more. Ms. Figueroa answered
“yes.” (R. 40)
404.1567(a) and 4 16.967(a)” with some exceptions and environmental
limitations. (R. 13; see section II.B.4., supra) I find that the AU
analyzed the evidence in the record and explained his RFC findings, which are
supported by substantial evidence.
The AU explicitly considered medical records from hospital admissions
and four physicians, the RFC form submitted by Dr. Ramos, the state agency
physicians’ review of Ms. Figueroa’s medical records, and her testimony. (R.
14—16) Based on that record he found Ms. Figueroa “not fully credible,”
especially her claim of a “very minimal ability to sit or stand” (R. 16) The AU
then supported that finding with substantial evidence, including that even she
admitted to the ability to stand for 20—25 minutes (see R. 40), her treating
physician, Dr. Ramos, indicated no limitations in sitting (see R. 217), and she
has not sought anything stronger than the weak medication that she currently
takes (see R. 3 1—32). (Id.) He also discounted certain findings of Ms. Figueroa’s
various treating physicians because they were made right after surgery or they
were made with no explanation or documentation. (Id.; see Section II.D.3.,
Much of the record supports Ms. Figueroa’s ability to do sedentary work,
and the little evidence that suggests otherwise is poorly supported. In sum, the
record as a whole supports the AU’s conclusion as to Ms. Figueroa’s RFC and
adequately explains how the AU
made his determination. The RFC finding is
thus supported by substantial evidence.
Evaluating the Opinion of the Treating Physician
Ms. Figueroa challenges the AU’s alleged rejection of the opinions of the
treating physicians in favor of the opinions of the state agency physicians who
reviewed her file. (P1. Br. 32—34)
In general, the opinion of a medical professional who has treated the
claimant is entitled to deference. 20 CFR
§ 404. 1527(c)(2)(”Generally, we give
more weight to opinions from your treating sources, since these sources are
likely to be the medical professionals most able to provide a detailed,
longitudinal picture of your medical impairment(s)...”); see also Plummer v.
Apfel, 186 F.3d 422, 429 (3d Cir. 1999) (“Treating physicians’ reports should be
accorded great weight, especially when their opinions reflect expert judgment
based on a continuing observation of the patient’s condition over a prolonged
period of time.” (internal quotation marks omitted)). The Third Circuit has held
that unless there is contradictory medical evidence in the record, an AU may
not reject a treating physician’s opinion. See Brownawell v. Comm’r of Soc. Sec,
554 F.3d 352, 355 (3d Cir. 2008). Further, an AU’s unsupported judgment,
speculation, or lay opinion is not sufficient to outweigh a treating physician’s
opinion. See Morales v. Apfel, 225 F.3d 310, 317 (3d Cir. 2000); see also
Plummer 186 F.3d at 429 (“an AU may not make speculative inferences from
But the opinion of a treating source must be given “controlling weight”
only when that opinion is “well-supported by medically acceptable clinical and
laboratory diagnostic techniques and is not inconsistent with the other
substantial evidence in [the claimant’s] case record.” 20 CFR
§ 404.1527(c) (2).
Although “contradictory medical evidence is required for an AU
to reject a
treating physician’s opinion outright, such an opinion may be afforded more or
less weight depending on the extent to which supporting explanations are
provided.” Plummer 186 F.3d at 429 (internal citation omitted). Further, “[t]he
law is clear
that the opinion of a treating physician does not bind the AU
the issue of functional capacity.” Brown v. Astrue, 649 F.3d 193, 197 (3d Cir.
2011). Rather, “[SI tate agent opinions merit significant consideration as well.”
Chandler v. Comm’r of Soc. Sec., 667 F.3d 356, 361 (3d Cir. 2011).
The AU’s decision to give “little weight” to certain findings of the treating
physicians was supported by substantial evidence. (R. 16) The AUJ discounted
the opinion of Dr. Datta because it was tied to welfare eligibility, and because
Datta’s report suggested that Ms. Figueroa might be able to perform a desk job.
(Id.; see R. 213) The AU discounted some of Dr. Ramos’s RFC opinions
because they had no supporting explanations or documentation and were not
supported by other medical records. (Id.; see R. 293—96) The AU
the limitations described by Dr. Ramos to be inconsistent with Ms. Figueroa’s
own descriptions of her daily activities, which include taking care of her
children, doing chores, cleaning, and laundry. (Id.; see R. 37—39) Finally, the
AU concluded that the state agency physicians’ assessment of her file was
consistent with the credible medical evidence, and thus entitled to great
weight. (R. 17)
Ms. Figueroa argues that the AU failed to support his step five
determination with evidence from a vocational expert. (P1. Br. 25—32) More
specifically, she argues that the AU purposefully found non-exertional
limitations that would allow him to rely on SSR 96—9p in order to avoid the use
of a vocational expert. (P1. Br. 31) To a great extent, this argument rests on Ms.
Figueroa’s attack on the RFC finding, a contention I have already denied. I hold
that, since the AU’s RFC findings were supported by substantial evidence, his
reliance on SSR 96—9p as additional evidence was permissible as well.
At step five, the Commissioner bears the burden of showing that the
claimant can perform work which exists in the national economy, in light of her
age, education, work experience, and RFC. 20 C.F.R. § 404.1520(a)(4)(v). That
analysis may depend on whether the claimant has only exertional limitations,
or has non-exertional limitations. Exertional limitations are impairment-caused
limitations that affect a claimant’s ability to meet the strength demands of a
job: sitting, standing, walking, lifting, carrying, pushing, and pulling. See 20
C.F.R. § 404. 1569a(b); SSR 96—9p. Non-exertional limitations are impairment
caused limitations that affect a claimant’s ability to meet the other demands of
a job, including mental capabilities; vision and hearing; postural functions
such as climbing, balancing, stooping, kneeling, crouching, crawling, reaching,
handling, fingering, and feeling; and environmental restrictions. See 20 C.F.R.
§ 404.1 569a(c)(1)(i—vi); SSR 96—9p.
Where a claimant has only exertional limitations, the Commissioner may
use the Medical-Vocational Rules to determine whether such work exists. The
Medical-Vocational Rules set forth tables, or grids, with various combinations
of age, education, work experience and RFC, and direct a finding of disabled or
not disabled for each combination. See 20 C.F.R. Part 404, Subpt. P, App. 2.
An AUJ “may rely on these grids to establish that jobs exist in the national
economy that a person with the claimant’s exertional limitations could
perform.” Sykes, 228 F.3d at 263 (3d Cir. 2000). However, this applies only to
exertional limitations; where the claimant has non-exertional limitations, the
grids provide only a framework, and the AU must consider additional evidence
to determine whether there are jobs in the national economy that someone with
the claimant’s combination of impairments could perform. Id. at 270; see also
Allen v. Bamhart, 417 F.3d 396, 404 (3d Cir. 2005).
Where a claimant has non-exertional impairments, an AU
to rely on Social Security Rulings (“SSR”) as the additional evidence required
under Sykes v. Apfel; such SSRs may be a permissible substitute for the
testimony of a vocational expert. See Allen, 417 F.3d at 406 (“While, surely, the
Agency can use its rules as a substitute for individualized determination,
nonetheless, there must be a “fit” between the facts of a given case, namely, the
specific non-exertional impairments, and the way in which the Rule dictates
that such non-exertional limitations impact the base.”). But “it must be crystalclear that the SSR is probative as to the way in which the nonexertional
limitations impact the ability to work,” and the AU must discuss this. Id., at
Here the AU cited to SSR 96—9p as additional evidence supporting the
grid recommendation. (R. 17) SSR 96—9p specifically says that “[p]ostural
limitations or restrictions related to such activities as climbing ladders, ropes,
or scaffolds, balancing, kneeling, crouching, or crawling would not usually
erode the occupational base for a full range of unskilled sedentary work
significantly.” SSR 96—Yp. It also says that an ability to stoop and balance
occasionally is required for most unskilled sedentary occupations. Id. For
environmental restrictions ‘few occupations in the unskilled sedentary
occupational base require work in environments with extreme cold, extreme
heat, wetness, humidity, vibration, or unusual hazards.” SSR 96
--The AU specifically found that Dr. Ramos’s assertion that Ms. Figueroa
could not stoop was not credible, and was inconsistent with her own
description of her daily activities. (R. 16) Even Dr. Ramos felt that Ms. Figueroa
occasionally can balance, and the AU also accepted his finding as to
temperature extremes. (R. 15) Thus the AU properly relied on SSR 96-9p as
additional evidence for using the grid as a framework in conducting step five
for a claimant with exertional and non-exertional limitations under Allen.
For the foregoing reasons, the AU’s decision is AFFIRMED.
Dated: February 1, 2016
United States District Judg
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