GUZMAN v. COMMISSIONER OF SOCIAL SECURITY

Filing 13

OPINION. Signed by Judge Esther Salas on 12/19/2016. (JB, )

NOT FOR PUBLICATION

UNITED STATES DISTRICT COURT
DISTRICT OF NEW JERSEY

DWAYNE GUZMAN,
Plaintiff,

Civil Action No. 15-6859 (ES)

v.

OPINION

COMMISSIONER OF SOCIAL SECURITY,
Defendant.

SALAS, DISTRICT JUDGE
Before the Court is an appeal filed by Dwayne Guzman (“Plaintiff”) seeking review of
Administrative Law Judge Nicholas Cerulli’s (“ALJ” or “ALJ Cerulli”) decision denying
Plaintiff’s application for Disability Insurance Benefits (“DIB”) and Supplemental Security
Income (“SSI”) under Titles II and XVI of the Social Security Act (the “Act”), respectively. The
Court decides this 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) and 1383(c)(3).
For the reasons set forth below, the Court vacates ALJ Cerulli’s decision and remands the case
for further proceedings consistent with this Opinion.
I.

BACKGROUND
On July 22, 2013, Plaintiff protectively filed an application for SSI, alleging disability

beginning July 18, 2013. (D.E. No. 6, Administrative Record (“Tr.”) at 19). The claim was
initially denied on October 23, 2013 and denied again upon reconsideration on February 6, 2014.
(Id.). Plaintiff subsequently filed a request for a hearing in front of an Administrative Law Judge
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on February 19, 2014. (Id.). Plaintiff’s request was granted, and Plaintiff appeared and testified
at a hearing held on January 23, 2015 in Pennsauken, NJ. (Id.).
At the hearing, Plaintiff reiterated his claims of a disability due to frequent shortness of
breath, chest pains, dizziness, and vision problems resulting from adult onset diabetes and a heart
attack. (Id. at 45). Plaintiff also complained of (among other difficulties) an inability to sit,
stand, or walk for extended periods of time, numbness and tingling in his extremities, and
difficulty climbing stairs. (Id. at 45-47). Plaintiff’s treating physician suggested that Plaintiff’s
ambulatory complications could be corrected with the use of a cane. (Id. at 472). But Plaintiff
was not prescribed a cane, nor did he bring one with him to the hearing on January 23, 2015. (Id.
at 27).
On February 10, 2015, ALJ Cerulli denied Plaintiff’s application, finding Plaintiff’s
“statements concerning the intensity, persistence and limiting effects of these symptoms . . . not
entirely credible.” (Id. at 24). ALJ Cerulli assigned little weight to both the State agency
medical consultant’s opinion (which found Plaintiff’s impairments to be non-severe) and to
Plaintiff’s primary care physician’s opinion (which “largely consist[ed] of checking off boxes on
a form with no supporting medical or objective evidence to support his findings”). (Id. at 26-27).
On April 16, 2015, Plaintiff requested an Appeals Council review (id. at 10), which was denied
on July 16, 2015 (id. at 1).
On September 15, 2015, Plaintiff appealed the Commissioner’s decision by filing a
Complaint with this Court. (D.E. No. 1). The Court received the administrative record on
December 10, 2015. (D.E. No. 6). The parties briefed the issues raised by Plaintiff’s appeal.
(See D.E. No. 11, Brief in Support of Dwayne Guzman filed on June 23, 2016 (“Pl. Mov. Br.”);

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D.E. No. 12, Defendant’s Brief Pursuant to Local Civil Rule 9.1 filed on August 8, 2016 (“Def.
Opp. Br.”)). The matter is now ripe for resolution.
II.

LEGAL STANDARD
A. Standard for Awarding Benefits
To be eligible for DIB under Titles II and XVI of the Act, a claimant must establish that

he or she is disabled as defined by the Act. See 42 U.S.C. §§ 423 (Title II), 1382 (Title XVI). A
claimant seeking DIB must also satisfy the insured status requirements set forth in § 423(c).
Disability is defined as the 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
twelve months.” 42 U.S.C. § 423(d)(1)(A). The individual’s physical or mental impairment(s)
must be “of such severity that he is not only unable to do his previous work but cannot,
considering his 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), 1382c(a)(3)(B).
The Act has established a five-step sequential evaluation process to determine whether a
plaintiff is disabled.

20 C.F.R. § 404.1520(a)(4).

If at any point in the sequence the

Commissioner finds that the individual is or is not disabled, the appropriate determination is
made and the inquiry ends. Id. The burden rests on the claimant to prove steps one through four.
See Bowen v. Yuckert, 482 U.S. 137, 146 n.5 (1987).1 At step five, the burden shifts to the
Commissioner. Id.
Step One. At step one, the claimant must demonstrate that she is not engaging in any
substantial gainful activity. 20 C.F.R. § 404.1520(a)(4)(i). Substantial gainful activity is defined
as significant physical or mental activities that are usually done for pay or profit. Id. §§

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Unless otherwise indicated, all internal citations and quotation marks are omitted, and all emphasis is added.

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416.972(a), (b). If an individual engages in substantial gainful activity, she is not disabled under
the regulation, regardless of the severity of her impairment or other factors such as age,
education, and work experience. Id. § 404.1520(b). If the claimant demonstrates she is not
engaging in substantial gainful activity, the analysis proceeds to the second step.
Step Two. At step two, the claimant must demonstrate that her medically determinable
impairment or the combination of impairments is “severe.” Id. § 404.1520(a)(4)(ii). A “severe”
impairment significantly limits a plaintiff’s physical or mental ability to perform basic work
activities. 20 C.F.R. § 404.1520(c). Slight abnormalities or minimal effects on an individual’s
ability to work do not satisfy this threshold. See Leonardo v. Comm’r of Soc. Sec., No. 10-1498,
2010 WL 4747173, at *4 (D.N.J. Nov. 16, 2010).
Step Three. At step three, the ALJ must assess the medical evidence and determine
whether the claimant’s impairment or combination of impairments meet or medically equal an
impairment listed in the Social Security Regulations’ “Listings of Impairments” in 20 C.F.R. Part
404, Subpart P, Appendix 1. See 20 C.F.R. § 404.1520(a)(4)(iii). Upon a finding that the
claimant meets or medically equals a listing, the claimant is presumed to be disabled and is
automatically entitled to benefits. Id. § 416.920(d).
When evaluating medical evidence in step three, an ALJ must give controlling weight to,
and adopt the medical opinion of, a treating physician if it “is well-supported . . . and is not
inconsistent with the other substantial evidence in [the] case record.” Id. §§ 404.1527(c)(2),
416.927(c)(2). Not inconsistent does not mean that the opinion must “be supported directly by
all of the other evidence [i.e., it does not have to be consistent with all the other evidence] as
long as there is no other substantial evidence that contradicts or conflicts with the opinion.”
Williams v. Barnhart, 211 F. App’x 101, 103 (3d Cir. 2006).

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Even where the treating

physician’s opinion is not required to be given controlling weight, the opinion is not necessarily
rejected and may still be entitled to deference “depending upon the extent to which supporting
explanations are provided.” Plummer v. Apfel, 186 F.3d 422, 429 (3d Cir. 1999). If there is
conflicting medical evidence, “the ALJ may choose whom to credit but cannot reject evidence
for no reason or for the wrong reason.” Morales v. Apfel, 225 F.3d 310, 317 (3d Cir. 2000). “In
choosing to reject the treating physician’s assessment, an ALJ may not make speculative
inferences from medical reports and may reject a treating physician’s opinion outright only on
the basis of contradictory medical evidence and not due to his or her own credibility judgments,
speculation or lay opinion.” Id.
Step Four. If a claimant is not found to be disabled at step three, the analysis continues
to step four, in which the ALJ determines whether the claimant has the residual functional
capacity (“RFC”) to perform her past relevant work. 20 C.F.R. § 416.920(a)(4)(iv). If the
claimant lacks the RFC to perform any work she has done in the past, the analysis proceeds.
Step Five. In the final step, the burden shifts to the Commissioner to show that there is a
significant amount of other work in the national economy that the claimant can perform based on
her RFC and vocational factors. Id. § 404.1520(a)(4)(v).
B. Standard of Review
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). “Substantial evidence does not mean a large or considerable amount
of evidence, but rather such relevant evidence as a reasonable mind might accept as adequate to
support a conclusion.” Hartranft v. Apfel, 181 F.3d 358, 360 (3d Cir. 1999) (quoting Pierce v.
Underwood, 487 U.S. 552, 565 (1988)). Although substantial evidence requires “more than a

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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). While failure to meet the substantial evidence standard
normally warrants remand, such error is harmless where it “would have had no effect on the
ALJ’s decision.” Perkins v. Barnhart, 79 F. App’x 512, 515 (3d Cir. 2003).
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, 181 F.3d at 360.
Thus, this Court is limited in its review because 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).
Regarding the ALJ’s assessment of the record, the Third Circuit has stated, “[a]lthough
the ALJ 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.” Burnett v. Comm’r of Soc.
Sec., 220 F.3d 112, 121 (3d Cir. 2000). The Third Circuit noted, however, that “Burnett does not
require the ALJ to use particular language or adhere to a particular format in conducting his
analysis. Rather, the function of Burnett is to ensure that there is sufficient development of the
record and explanation of findings to permit meaningful review.” Jones v. Barnhart, 364 F.3d
501, 505 (3d Cir. 2004).
III.

ALJ CERULLI’S DECISION
At step one of the analysis, ALJ Cerulli determined that Plaintiff had not engaged in

substantial gainful employment (“SGA”) since July 22, 2013, the date of Plaintiff’s application.
(Tr. at 21). Although Plaintiff had worked briefly after the application date, his earnings records
for the remainder of 2013 showed an income slightly over $1,000. (Id.). Plaintiff also worked
for approximately one month in the summer of 2014, but he stopped work after having a heart

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attack. (Id.). ALJ Cerulli found that “[s]uch earnings do not rise to the level of SGA given the
short duration of the work activity.” (Id.).
At step two, the ALJ determined that Plaintiff suffered from multiple severe impairments:
diabetes mellitus, high myopia, coronary artery disease, and degenerative joint disease. (Id.).
These impairments were found to “cause more than a minimal limitation in claimant’s ability to
perform basic work activities.”

(Id.).

The ALJ determined, however, that Plaintiff’s

impairments of GERD, asthma, hypertension, degenerative disc disease, and obesity were not
severe. (Id.).
At step three, ALJ Cerulli found that Plaintiff did not have an “impairment or
combination of impairments that m[et] or medically equal[ed] the severity of one of the listed
impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1.” (Id. at 22). The ALJ pointed out
that there were no findings by any treating or examining physician “equivalent in severity to any
listed impairment, nor [were] such findings indicated or suggested by the medical evidence of
record.” (Id.). Specifically, ALJ Cerulli considered Listing 1.02 and found that there were no
major dysfunctions of any joints “[c]haracterized by gross anatomical deformity and chronic
joint pain and stiffness with signs of limitation of motion or other abnormal motion of the
affected joint(s).” (Id.). The ALJ also considered Listing 11.14, but did not find “peripheral
neuropathies with significant and persistent disorganization of motor function in two extremities,
resulting in sustained disturbance of gross and dexterous movements, or gait and station, in spite
of prescribed treatment.” (Id.). Finally, the ALJ considered the listings in sections 2.00 (Special
Senses and Speech), 4.00 (Cardiovascular System), and 9.00 (Endocrine System), but determined
that Plaintiff’s impairments did not satisfy the requirements of any of those listings. (Id.).

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At step four, the ALJ determined that Plaintiff had the RFC to perform light work as
defined in 20 C.F.R. 416.967(b). (Id.). Plaintiff was deemed capable of performing work
requiring near and far acuity and field of vision (with the caveat that he must avoid concentrated
exposure to extreme heat and hazards) and was limited to unskilled work involving routine and
repetitive tasks with occasional changes in the work setting. (Id.).
At step five, the ALJ concluded that, based on Plaintiff’s RFC and the testimony of the
vocational expert, there were jobs that existed in significant numbers in the national economy
that Plaintiff could perform, including bagger, bottle packer, and garment sorter. (Id. at 58).
Accordingly, ALJ Cerulli found that Plaintiff was not disabled, as defined in the Act, and
Plaintiff was therefore ineligible for disability benefits. (Id. at 28).
IV.

DISCUSSION
On appeal, “Plaintiff argues that the substantial evidence in the administrative record

establishes entitlement and eligibility for and to” disability benefits.

(Pl. Mov. Br. at 9).

Plaintiff appeals ALJ Cerulli’s determinations on steps three, four, and five. (Id. at 15-25).
Specifically, Plaintiff contends (among other things) that (i) the ALJ failed to consider Plaintiff’s
impairments in combination as required by step three (id. at 15-20); and (ii) the ALJ’s RFC
determination was not supported by substantial evidence (id. at 20-25). Plaintiff asks the Court
to reverse the Commissioner’s final administrative decision and order the payment of benefits.
(Id. at 9). Alternatively, Plaintiff asks the Court to remand this case to the Commissioner for a
new hearing and a new decision. (Id.).
A. The ALJ Failed to Consider Plaintiff’s Impairments in Combination
Plaintiff argues that in step three of his evaluation, ALJ Cerulli failed to “combine and
compare” the totality of Plaintiff’s impairments to determine if, when combined, they are

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medically equivalent to a listed impairment. (Id. at 15-20). Plaintiff further argues that “no
combination of impairments is attempted [even though] many different findings recorded in the
evidence and recited in the decision mirror those required in the appropriate listing.” (Id. at 1920). Although ALJ Cerulli promises a further discussion on the combination of Plaintiff’s
impairments by stating “[a]s more fully discussed in this decision” (Tr. at 22), Plaintiff points out
that the ALJ “never again revisits the listings, acknowledges the findings that meet listing
requirements or combines those findings for a discussion of medical equivalence” (Pl. Mov. Br.
at 20).
Defendant responds that “the ALJ specifically discussed Plaintiff’s impairments in the
step-three analysis, and explained that they did not meet any of the listings for musculoskeletal
impairments.” (Def. Opp. Br. at 9). Defendant further argues—sans citations—that “the ALJ
sufficiently analyzed and evaluated the relevant medical evidence as it relates to the Listings
requirements of 4.04A2 and 4.04C (pertaining to ischemic heart disease), and 9.08A, B and C
(pertaining to endocrine disorders in adults).” (Id. at 10). Defendant also notes that “[i]t is
Plaintiff’s burden to prove that her impairments met, or equaled, all of the criteria of the
listings.” (Id. at 11).
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. See 20 C.F.R. § 404.1520(a)(4)(iii). Although the claimant bears the
burden of proving that his impairments meet those listed in Appendix 1, if a claimant’s
impairments do not meet the requirements of any listing, the ALJ is required to determine
whether the combination of impairments is medically equal to any listed impairment. Torres v.
Comm’r of Soc. Sec., 279 F. App’x 149, 151-52 (3d Cir. 2008) (citing Burnett, 220 F.3d at 120

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n.2; 20 C.F.R. § 404.1526(b)). Further, the ALJ must set forth the reasons for his decision.
Burnett, 220 F.3d at 119. Conclusory statements have been found to be “beyond meaningful
judicial review.” Id.
Here, the ALJ states—without discussion or analysis—that the “claimant does not have
an impairment or combination of impairments that meets or medically equals the severity of one
of the listed impairments.” (Tr. at 22). The analysis is conclusory and inadequate. The ALJ
must set forth the reasons for his decision. Burnett, 220 F.3d at 119. As Plaintiff points out, the
“ALJ must combine all severe impairments and compare the joint effects of all impairments
against one of the Commissioner’s Listings to determine medical equivalence.” (Pl. Mov. Br. at
19). Conclusory statements, like the one in this case, are “beyond meaningful judicial review.”
Burnett, 220 F.3d at 119 (stating that an ALJ’s “conclusory” one-sentence step three analysis
was “beyond meaningful judicial review”).

Although the ALJ explains why Plaintiff’s

impairments do not meet the Appendix 1 listings individually, he does not provide any analysis
or explanation as to why Plaintiff’s impairments—in combination—do not meet or equal an
Appendix 1 listing. As in Torres, the ALJ here failed at step three by not considering Plaintiff’s
impairments in combination.
Defendant argues that “[i]t is Plaintiff’s burden to prove that [his] impairments met, or
equaled, all of the criteria of the listings.” (Def. Opp. Br. at 11). Defendant is correct in that a
bare argument that the ALJ did not adequately compare Plaintiff’s limitations to a listing
(without support or analysis) is not enough. See Milano v. Comm’r of Soc. Sec., 152 F. App’x
166, 169 (3d Cir. 2005) (“Milano has not attempted to show that her impairments meet or equal
any specific Listing, and merely concludes that she has ‘severe medical conditions’ that ‘might’
do so. That is simply not enough.”). But Plaintiff here met his burden. (See Pl. Mov. Br. at 16-

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17). He explains, for example, that (i) “Plaintiff’s coronary artery disease, as listed in 4.04C,
was demonstrated by angiogram following [P]laintiff’s heart attack in July 14, 2014 and required
angioplasty and stentin to reopen his narrowed arteries”; and (ii) “[t]he constriction of
[Plainitff’s] visual fields and the large floaters caused by diabetes[,] causing blurry vision
approximate those described in listing paragraph 2.03C and thus listing paragraph 9.08C.” (Id. at
16-17).
Accordingly, the Court remands this case so that the ALJ can complete his step-three
analysis. In doing so, the ALJ should address the combined effects of Plaintiff’s individual
impairments and detail whether the combination of all of Plaintiff’s impairments is equivalent in
severity to a listed impairment. Pending the outcome of the combination analysis at step three,
the ALJ should reconsider his determinations at steps four and five.
V.

CONCLUSION
For the foregoing reasons, the Court hereby vacates ALJ Cerulli’s decision and remands

the case for further proceedings consistent with this Opinion. An appropriate Order accompanies
this Opinion.

s/ Esther Salas
Esther Salas, U.S.D.J.

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