Ratynski v Colvin

Filing 35

MEMORANDUM AND ORDER granting 30 Motion for Judgment on the Pleadings; denying 23 Motion for Judgment on the Pleadings. For the reasons discussed above, the plaintiff's motion for judgment on the pleadings (Docket no. 23) is denied and the defendant's cross-motion (Docket no. 30) is granted. The Clerk of Court is respectfully directed to enter judgment accordingly and close this case. (As further set forth in this Memorandum and Order.) (Signed by Magistrate Judge James C. Francis on 4/6/2017) Copies Sent by Chambers. (mro)

disability as of December 30, 2008.

(R. at 172-79).2

After her

claims were denied on initial review (R. at 112-14, 121-27), the
plaintiff requested a hearing before an administrative law judge
(“ALJ”) (R. at 130-31).

A hearing was initially held on December

17, 2013, before ALJ Katherine Edgell, but was adjourned at Ms.
Ratynski’s request to allow her to obtain legal representation and
supplement the medical record.

(R. at 104, 106-08).

The hearing

resumed by videoconference on March 7, 2014, at which time the
plaintiff was represented by counsel. (R. at 39-100). On July 23,
2014, the ALJ issued a determination finding that Ms. Ratynski was
not disabled under the Act.

(R. at 18-38).

The Appeals Council

denied review on November 25, 2015, thus rendering the ALJ’s
decision the final determination of the Commissioner.
12).

(R. at 8-

This action followed.
B. Personal History
Ms. Ratynski was born in 1970 and holds a college degree in

computer science.

(R. at 44-46, 174).

At the time of her hearing

in March 2014, she lived with her husband in a house.

(R. at 43).

The

a

plaintiff

last

worked

full-time

programmer and systems developer.

in

2002

(R. at 55).

as

computer

She did not work at

all from 2003 to 2008 (R. at 54-55), and from 2008 through 2010,

2

“R.” refers to the administrative record, filed as part of
the Commissioner’s answer.
2

she worked a few weeks each year as a bar manager, assisting the
bartender and ordering supplies (R. at 46-51, 186).
C. Medical Evidence
1. The Plaintiff’s Claimed Disabilities
Ms.

Ratynski

alleges

a

variety

of

disabling

conditions,

including herniated discs, reflex sympathetic dystrophy (“RSD”),3
migraine headaches, a knee impairment, and an affective disorder.
(R. at 59-60, 69-72, 92-94).

At her hearing before the ALJ, she

testified that she was in an automobile accident in 1998, resulting
in over a dozen surgeries, including a “tibia transplant.”
59, 71).

(R. at

The plaintiff stated that she has radiating pain in both

legs as a result of her back condition (R. at 59-60, 94), for which
she takes oxycodone four times each day (R. at 61).

She said she

has had headaches daily for fifteen years and a migraine headache
about once a week, for which she takes Fioricet.
92-93).

(R. at 61, 71-72,

According to Ms. Ratynski, her RSD causes pain and

sensitivity, changes in temperature, and discoloration in her right
knee and leg, all on a daily basis.

(R. at 59, 69-70).

She also

testified that she received treatment for a respiratory condition.

3

RSD is characterized by diffuse, persistent pain, often in
an extremity, and it is associated with vasomotor disturbances,
trophic changes, and limitation or immobility of joints. Stedman’s
Medical Dictionary 558 (27th ed. 2000) (“Stedman’s”). Frequently,
RSD follows a local injury. Id.
3

(R. at 62-63).

The plaintiff asserted that she had bilateral

hearing loss but did not wear hearing aids because they were
uncomfortable.

(R. at 73-74).

Ms. Ratynski testified that she does no household tasks, does
not cook, and does not visit friends.

(R. at 63, 66).

Since 2008,

she allegedly spends her days propped up in a chair reading or
watching television.

(R. at 63-64).

that she only drives once a month.

She owns a car but reported

(R. at 45, 95).

The plaintiff

maintained that she could sit for twenty minutes to one half hour
at a time, could walk for five to ten minutes, and could stand for
about fifteen minutes.

(R. at 68, 93, 96).

2. Medical Evidence Prior to the December 30, 2008
Disability Onset Date
From 2003 through December 12, 2008, Ms. Ratynski visited Dr.
Rodolfo Nazario on approximately a monthly basis, complaining of a
variety of symptoms, including weight gain, sensitivity in her
right leg, headaches, nausea, and neck and back pain.
34).

(R. at 503-

Dr. Nazario’s notes do not indicate any objective findings

with respect to the plaintiff’s extremities, though once in 2006
and twice in 2008, he recorded a positive Lasegue sign.4
501,

504,

512).

In

addition,

4

in

July

2008,

the

(R. at

plaintiff

The Lasegue test relies on the patient’s subjective reports
of pain upon flexion of the leg to assess lumbar root or sciatic
nerve irritation. Stedman’s at 1638 (27th ed. 2000).
4

complained of increased sensitivity over the back of her right leg.
(R. at 504).
Ms. Ratynski was seen by Dr. Harsha Sharma in January 2004.
Dr. Sharma noted that an examination in 2000 had revealed a
“painful right knee from localized tissue injury and indication of
neuropathic symptoms in the right lower extremity, possibly complex
regional pain syndrome.”

(R. at 412-23).

The plaintiff reported

that she was taking Neurontin and OxyContin and that symptoms of
hyperalgesia and allodynia had improved.5

(R. at 412).

Dr. Sharma

did not report any new examination findings but stated that the
plaintiff had lumbar nerve block injections in the past and could
repeat this treatment annually.

(R. at 412-13, 445-72).

In May 2005, Ms. Ratynski underwent a CT scan of her lumbar
spine.

This revealed a central disc bulge at L4-L5 without

stenosis of the spinal canal; mild neural foramina compromise at
L5-S1 due to a diffuse bulging disc; and mild neural foramina
compromise on the right at L2-L3 and L3-L4.

(R. at 414-15).

The

exiting nerve roots for the disc levels involved were unremarkable.
(R. at 414).

5

Allodynia is pain from a stimulus that would not normally
trigger pain. Stedman’s at 48 (27th ed. 2000).
5

3. Medical Evidence After the December 30, 2008
Disability Onset Date
From

December

2008

through

October

2010,

Ms.

Ratynski

continued to treat with Dr. Nazario approximately once a month.
(R. at 493-503). In June 2009, she complained of tenderness in the
right lower back, and Dr. Nazario noted a positive Lasegue sign on
the right.

(R. at 501).

Dr. Nazario reported possible Lyme

disease in August 2010, but subsequent blood tests were negative.
(R. at 495, 546).
Ms. Ratynski underwent magnetic resonance imaging (“MRI”)
studies of her lumbar spine, thoracic spine, and right knee on
October 13, 2010.
lumbosacral

spine

(R. at 416-17, 419-20).
revealed

a

shallow

right

The MRI of the
paracentral

disc

protrusion with mild right anterior thecal sac impingement but no
significant neural foraminal stenosis at L5-S1.

(R. at 416).

At

L4-L5, there was a right paracentral disc protrusion with annular
tear

and

discogenic

endplate

changes

with

mild

thecal

impingement but no disc herniation or foraminal stenosis.
416).

sac

(R. at

The MRI of the thoracic spine showed a small paracentral

disc protrusion with minimal right anterior cord impingement at T6T7 and some disc bulges at T7-T8 and T8-T9.
of

the

plaintiff’s

right

knee

showed

including surgical hardware in the tibia.

6

(R. at 417).

The MRI

post-surgical

changes

(R. at 419).

There was

some evidence of a meniscal tear, but the cruciate and collateral
ligaments were intact.

(R. at 419-20).

In October and November 2010, Ms. Ratynski saw Dr. Nazario for
routine examinations. (R. at 493, 692-97). She complained of neck
and back pain, but an examination showed normal strength in all
muscle groups, normal range of motion in all joints, and no joint
swelling.

(R. at 693, 697).

Her motor strength was 5/5 and equal

in all extremities, and her deep tendon reflexes were 2/4 and equal
bilaterally.

(R. at 693, 697).

focal neurological deficits.

Dr. Nazario did not observe any
(R. at 693, 697).

He diagnosed

thoracic spinal cord impingement, lumbar disc displacement, a torn
lateral meniscus in the right knee, hypertension, and migraines,
and

he

noted

the

plaintiff

was

taking

Zolpidem,

Percocet, Fioricet, butalbital, and OxyContin.

ibuprofen,

(R. at 690-95).

In November 2010, Ms. Ratynski was examined by Dr. Jin Li at
Westchester Medical Center.

(R. at 484-85).

She complained of

right knee and low back pain and appeared to lean to the left while
walking.

(R. at 484-85).

Her strength was 5/5 in all extremities

except for her right leg, where it was reduced due to pain.
485).

(R. at

Her sensation was intact except on the back of her right

leg, where it was decreased.

(R. at 485).

Dr. Li diagnosed the

plaintiff with low back and right knee pain and referred her for
physical therapy, pain management, and electromyography (“EMG”)
7

testing.

(R. at 485).

The plaintiff continued to see Dr. Nazario monthly from
December 2010 through August 2011.

(R. at 491-92, 668-91).

In

March 2011, he noted lumbar muscle spasm and a positive Lasegue
sign.

(R. at 668, 677, 679, 683, 689, 691).

On a full examination

in April 2011, Dr. Nazario noted normal motor strength, normal
range of motion, normal reflexes and other neurological signs,
normal respiration, and grossly normal psychiatric findings.
at 685).

(R.

In June 2011, Dr. Nazario noted RSD and referred Ms.

Ratynski to a Dr. Weinstein, but there is no indication that she
ever followed up.

(R. at 677).

Ms. Ratynski was examined by Dr. Michael Cho in June 2011, and
he reported that her gait, sensation, and motor strength were all
normal, and that her reflexes were 2+ and symmetric.

(R. at 421).

He assessed the plaintiff as having degeneration of a lumbar disc.
(R. at 421).
In July and September 2011, the plaintiff was examined for a
salivary gland mass, which was determined not to be malignant.
at 322-24, 432, 616-19).

(R.

Dr. Jagadish Navare, an ear, nose, and

throat (“ENT”) specialist, examined Ms. Ratynski in July 2011 and,
among other things, found that her hearing was grossly intact
bilaterally.

(R. at 617-18).

Dr. Lawrence Gordon, another ENT

specialist, saw the plaintiff in October and November 2011 for
8

complaints of throat pain and fatigue.
examinations,

the

plaintiff

denied

(R. at 598-603).
any

ear

At both

complaints,

and

examinations showed that her hearing was grossly intact bilaterally.
(R. at 598-99, 601-02).

Dr. Gordon diagnosed a chronic infection

of the lymph nodes and prescribed acyclovir.

(R. at 599, 606-15).

In October 2011, Ms. Ratynski was seen at the Orange Regional
Medical Center, where she complained of shortness of breath.
at 326-28).

(R.

A pulmonary examination revealed normal breath sounds

and no respiratory distress.

(R. at 326-27).

Medical staff

conducted blood tests and took x-rays and CT scans of the chest and
found no evidence of active pulmonary disease.

(R. at 328-38).

A

musculoskeletal examination found a normal range of motion, no
swelling, and no tenderness.
From

September

2011

(R. at 327).

through

January

continued to see Dr. Nazario regularly.

2012,

Ms.

Ratynski

(R. at 650-67).

He

reported her muscle strength and range of motion for all joints to
be normal.
shoulder

(R. at 651, 653, 655).
and

knee

pain

during

The plaintiff reported right
the

November

and

December

examinations, and a positive Lasegue sign was sometimes noted.
at 657, 659, 661, 663-64).
opioid

dependence

in

(R.

In January 2012, Dr. Nazario diagnosed

connection

with

OxyContin, and he prescribed Suboxone.

the

plaintiff’s

use

of

(R. at 651, 653).

Dr. Marc Rosenblatt, an osteopath, examined Ms. Ratynski on
9

February 7, 2012.

(R. at 423-24).

The plaintiff stated that

OxyContin was the only medication that relieved her pain but that
her insurance company had told her that she must discontinue using
it and use methadone or morphine instead.

(R. at 423).

On

examination, the plaintiff’s sensation was intact, but she had
bilateral back spasm with multiple trigger points and a limited
range of motion.

(R. at 424).

Dr. Rosenblatt diagnosed the

plaintiff with lumbar L4-L5 disc pathology and serious, chronic low
back pain syndrome that might be appropriate for surgery.
424).

(R. at

He suggested that Ms. Ratynski continue taking OxyContin and

consult with a surgeon.

(R. at 424).

On February 9, 2012, the plaintiff underwent MRIs in connection
with a fall she had the prior November.

(R. at 340-43).

An MRI of

the right knee showed extensive swelling of the bone marrow in the
medial femoral condyl consistent with microtrabecular fractures,
extensive degenerative change and tear of the anterior horn of the
lateral meniscus, and a magnetic artifact consistent with surgical
hardware.

(R. at 340-43).

day revealed

An MRI of the right shoulder the next

a small amount of fluid in the subcoracoid recess and

mild degenerative changes in the acromioclavicular joint without
impingement.

(R. at 344-45).

From February 2012 through October 2012, Dr. Nazario continued
to see Ms. Ratynski periodically.
10

(R. at 640-49, 760-96).

On

February 7, 2012, he noted that the plaintiff’s opioid dependence
was in remission, but he subsequently diagnosed drug dependence and
prescribed Suboxone.

(R. at 649).

Dr. Nazario continued to report

normal muscle strength, normal range of motion, no swelling, normal
respiration, and occasional positive Lasegue signs.

(R. at 641,

643, 645, 647, 649, 761, 764, 766, 768, 772, 776, 778, 780, 782,
784, 788, 790, 792, 794, 796).
In

October

2012,

Ms.

Ratynski

returned

to

Dr.

Gordon,

complaining of headaches, ear and neck discomfort, and a fever. (R.
at 595-97).

Dr. Gordon found that the plaintiff’s hearing was

grossly intact bilaterally and that her pain was most likely related
to right temporomandibular joint dysfunction.
referred the plaintiff to “Dr. Phul.”

(R. at 596-97).

He

(R. at 597).

From November 2012 through August 2013, the plaintiff continued
to see Dr. Nazario, whose observations were consistent with his
prior examinations: Ms. Ratynski continued to complain of back and
knee pain, but, with the exception of positive Lasegue signs, the
findings

were

generally

unremarkable;

Dr.

Nazario

noted

Ms.

Ratinski’s continued lumbar disc degeneration and meniscus tear.
(R. at 724, 727, 732, 735, 737, 740, 743, 746, 749, 752, 755, 758).
On April 18, 2013, Dr. Nazario provided Ms. Ratynski with an
assessment that stated that she could lift ten pounds occasionally
but could not carry objects of any weight; could sit, stand, or walk
11

for fifteen minutes at a time for a total of two hours each in an
eight-hour work day; and could continuously reach, handle, push, or
pull objects but could never stoop, kneel, or crouch.

(R. at 405-

08). He stated that the plaintiff was able to hear, understand, and
communicate simple information and use the telephone.

(R. at 408).

He further asserted that she was unable to shop, walk one block at
a reasonable pace on a rough surface, or climb a few steps at a
reasonable pace due to post traumatic radiculopathy of the left leg
and herniated discs.

(R. at 410).

He did note that the plaintiff

could use public transportation, cook simple meals, and care for her
personal hygiene.

(R. at 410).

Ratynski “doesn’t hear.”

Dr. Nazario also stated that Ms.

(R. at 410).

Dr. Nazario continued to see the plaintiff on a monthly basis
from September 2013 through January 2014, during which time the
plaintiff’s

complaints

and

Dr.

Nazario’s

observations

were

consistent with prior examinations, and he noted the following
continued problems: hypertension, thoracic spinal cord impingement,
lumbar disc displacement, meniscus tear, hearing loss, migraines,
insomnia,

disc

degeneration,

tendon

repture,

ovarian

cysts,

endometriosis, abdominal pain, pelvic pain, opioid dependence, RSD,
and cellulitis.

(R. at 699-72).

On December 12, 2013, he wrote a letter including his opinion
that,

because

of

various

conditions,
12

Ms.

Ratynski

was

“100%

disabled.” (R. at 487-88). Further, he stated that the plaintiff’s
pain was relieved only by high doses of narcotics that left her
“drugged” and “mentally disabled.”

(R. at 488).

On January 28, 2014, Dr. David Ramos administered a treadmill
test to the plaintiff.

He found evidence of mild pulmonary

hypertension, and while he referred the plaintiff for further
pulmonary evaluation, he did not recommend additional cardiovascular
testing.

(R. at 856).

On February 27, 2014, Dr. Nazario provided Ms. Ratynski’s
attorney with a letter stating that the plaintiff was unable to work
because of physical disability.

(R. at 858).

4. Consultative Examinations
In connection with her application for benefits, Ms. Ratynski
was examined by two consultants on September 4, 2012. The first was
Dr. Leslie Helprin, a psychologist.

(R. at 348-52).

stated that she had worked until 2007.
a

history

embolism,

of

a

tibia

Epstein-Barr

transplant,
syndrome,

The plaintiff

(R. at 348).

heart

hearing

surgery,
loss,

She reported
a

pulmonary

ovarian

hypertension, RSD, heart disease, and lymphoma tests.

cysts,

(R. at 348-

52). She also stated she had difficulty sleeping, occasional crying
spells, and difficulty concentrating, but she denied suicidal
thoughts or thought disorders. (R. at 349). The plaintiff reported
that she could maintain her personal hygiene but was unable to cook
13

or clean, and her socializing was limited because of her pain; her
time was spent mostly reading and watching television. (R. at 350).
Dr. Helprin found that Ms. Ratynski’s thought process was coherent
and goal-directed; her affect was restricted; her mood was neutral
except

for

one

brief

episode

of

crying;

her

attention,

concentration, and memory were very mildly impaired; her cognitive
functioning was below average; and her insight and judgment were
good.

(R. at 349-50).

Dr. Helprin diagnosed the plaintiff as

having a mild and episodic adjustment disorder with depressed mood.
(R.

at

351).

She

concluded

that

the

plaintiff

was

able

to

understand and follow simple directions and instructions; perform
simple rote tasks and at least some complex tasks independently;
maintain sufficient attention and concentration; maintain a regular
schedule; make appropriate decisions; relate adequately with others;
and generally deal appropriately with stressors.

(R. at 350).

Ms. Ratynski was also examined by Dr. Ralph Alvarez.
354-58).

(R. at

She reported that she had left her job in 2007 due to leg

pain. (R. at 354). She stated that she suffered migraines a couple
of times each month but that they were somewhat controlled with
medication.
(R. at 355).

(R. at 354).

She also said she had hearing problems.

The plaintiff stated she could drive and manage her

personal hygiene but could not do much cooking, cleaning, or
shopping; she sometimes required assistance with toileting.
14

(R. at

355-56).

She reported that her activities consisted of reading,

watching television, and going to appointments.

(R. at 356).

Dr.

Alvarez observed that Ms. Ratynski’s gait was normal; she could
stand on her heels and toes without difficulty; she could squat
halfway; she could rise from a seated position; and she got on and
off the examination table without difficulty.

(R. at 356).

The

plaintiff did need assistance getting up from a supine position.
(R. at 356).
clear.

The plaintiff’s skin was normal and her chest was

(R. at 356).

She had full range of motion of the cervical

spine; with respect to the lumbar spine, she had forward flexion of
sixty degrees, lateral flexion of twenty degrees, and rotation of
twenty degrees.

(R. at 357).

Ms. Ratynski displayed full range of

motion of all extremities, including her knees.

(R. at 357).

Her

strength was 5/5 for all extremities, with no sensory deficits. (R.
at 357).

Joints were stable, with no redness, tenderness, or

swelling.

(R. at 357).

Dr. Alvarez diagnosed chronic back pain,

chronic right leg pain, migraine headaches, depression, insomnia,
history of edema, hypertension, a history of aortic valve repair,
and “hard of hearing.”

(R. at 357-58).

It was his opinion that,

because of her back pain, the plaintiff had mild to moderate
restrictions for bending, lifting, carrying, squatting, and rising
from a supine position.

(R. at 358).

15

Analytical Framework
A. Determination of Disability
A claimant is disabled under the Social Security Act and
therefore entitled to disability benefits if she can demonstrate,
through medical evidence, that she is unable 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), 1382c(a)(3)(A); see also Arzu v. Colvin, No. 14 Civ.
2260, 2015 WL 1475136, at *7 (S.D.N.Y. April 1, 2015).

The

disability must be of “such severity that [the claimant] 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.”

42

U.S.C. §§ 423(d)(2)(A), 1382c(a)(3)(B).
To determine whether a claimant is entitled to disability
benefits, the Commissioner employs a five-step sequential analysis.
20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4).

First, the claimant

must demonstrate that she is not currently engaging in substantial
gainful

activity.

20

C.F.R.

§§

404.1520(a)(4)(i),

(b),

416.920(a)(4)(i), (b). Second, the claimant must prove that she has
a severe impairment that significantly limits her physical or mental
16

ability

to

perform

basic

work

activities.

404.1520(a)(4)(ii), (c), 416.920(a)(4)(ii), (c).

20

C.F.R.

§§

Third, if the

impairment is listed in what are known as “the Listings,” see 20
C.F.R. Part 404, Subpt. P, App. 1, or is the substantial equivalent
of a listed impairment, the claimant is automatically considered
20

disabled.

C.F.R.

416.920(a)(4)(iii), (d).

§§

404.1520(a)(4)(iii),

(d),

Fourth, if the claimant is unable to make

the requisite showing under step three, she must prove that she does
not have the residual functional capacity to perform her past work.
20

C.F.R.

§§

404.1520(a)(4)(iv),

(e),

416.920(a)(4)(iv),

(e).

Fifth, if the claimant satisfies her burden of proof on the first
four steps, the burden shifts to the Commissioner to demonstrate
that there is alternative substantial gainful employment in the
national economy that the claimant can perform.

20 C.F.R. §§

404.1520(a)(4)(v), (g), 416.920(a)(4)(v), (g), 416.960(c); Longbardi
v. Astrue, No. 07 Civ. 5952, 2009 WL 50140, at *23 (S.D.N.Y. Jan.
7, 2009) (citing Rosa v. Callahan, 168 F.3d 72, 77 (2d Cir. 1999),
and Bapp v. Bowen, 802 F.2d 601, 604 (2d Cir. 1986)).

In order to

determine whether the claimant can perform other substantial gainful
employment, the Commissioner must consider objective medical facts,
diagnoses or medical opinions based on these facts, subjective
evidence of pain or disability, and the claimant’s educational

17

background, age, and work experience.

Brown v. Apfel, 174 F.3d 59,

62 (2d Cir. 1999).
B. Judicial Review
Under Rule 12(c) of the Federal Rules of Civil Procedure, a
party is entitled to judgment on the pleadings if she establishes
that no material facts are in dispute and that she is entitled to
judgment as a matter of law.

See Burnette v. Carothers, 192 F.3d

52, 56 (2d Cir. 1999); Morcelo v. Barnhart, No. 01 Civ. 743, 2003
WL 470541, at *4 (S.D.N.Y. Jan. 21, 2003).
The Social Security Act provides that the Commissioner’s
findings “as to any fact, if supported by substantial evidence,
shall be conclusive.”
Commissioner’s

42 U.S.C. § 405(g).

decision

“may

set

aside

A court reviewing the
a

decision

of

the

Commissioner if it is based on legal error or if it is not supported
by substantial evidence.”

Geertgens v. Colvin, No. 13 Civ. 5133,

2014 WL 4809944, at *1 (S.D.N.Y. Sept. 24, 2014) (quoting Hahn v.
Astrue, No. 08 Civ. 4261, 2009 WL 1490775, at *6 (S.D.N.Y. May 27,
2009)); see also Longbardi, 2009 WL 50140, at *21.
Judicial review, therefore, involves two levels of inquiry.
First, the court must decide whether the Commissioner applied the
correct legal standard. Tejada v. Apfel, 167 F.3d 770, 773 (2d Cir.
1999); Calvello v. Barnhart, No. 05 Civ. 4254, 2008 WL 4452359, at
*8 (S.D.N.Y. April 29, 2008). Second, the court must decide whether
18

the ALJ’s decision was supported by substantial evidence.
167 F.3d at 773; Calvello, 2008 WL 4452359, at *8.

Tejada,

“In determining

whether substantial evidence exists, a reviewing court must consider
the whole record, examining the evidence from both sides, because
an analysis of the substantiality of the evidence must also include
that which detracts from its weight.”

Longbardi, 2009 WL 50140, at

*21 (citing Brown, 174 F.3d at 62, and Williams v. Bowen, 859 F.2d
255, 258 (2d Cir. 1988)).

Substantial evidence in this context is

“more than a mere scintilla.

It means such relevant evidence as a

reasonable mind might accept as adequate to support a conclusion.”
Hahn, 2009 WL 1490775, at *6 (quoting Richardson v. Perales, 402
U.S. 389, 401 (1971)).
Analysis
A. The ALJ’s Decision
ALJ Edgell analyzed the plaintiff’s claim pursuant to the fivestep sequential evaluation process and concluded that she was not
disabled on or after the date she filed for benefits.
32).

(R. at 20,

She first determined that Ms. Ratynski had not engaged in

substantial gainful activity since the date of the alleged onset of
disability.

(R. at 21).

Next, at step two, she found that the plaintiff had severe
impairments -- a tibia transplant, RSD in the right lower extremity,
disc bulges and degenerative disc disease in the lumbar spine, disc
19

herniation in the thoracic spine, post-surgical changes of the right
knee with a meniscal tear and degenerative changes, a history of
migraine headaches, infections of the lymph nodes, and obesity -that more than minimally affected her ability to perform basic work
activities. (R. at 22). On the other hand, the ALJ determined that
Ms.

Ratynski’s

history

of

aortic

valve

repair,

history

of

hypertension, hearing problems, and shoulder complaints did not
constitute severe impairments.

(R. at 22-23).

ALJ Edgell further

determined that the plaintiff’s affective disorder was not a severe
mental impairment because it caused no more than mild limitations
in the functional areas of daily living; social functioning; and
concentration, persistence, and pace, and because the plaintiff had
suffered no episodes of decompensation.

(R. at 23-24).

At step three, the ALJ found that none of the plaintiff’s
impairments, either individually or in combination, met or was the
equivalent in severity of one of the impairments listed in the
regulations.

(R. at 24-25).

Next, at the fourth step, ALJ Edgell determined that Ms.
Ratynski had the residual functional capacity to perform sedentary
work, except that she was limited to squatting and stooping for no
more than four hours in an eight-hour workday.

(R. at 25-30).

In

addition, the ALJ found that, because of her pain and the effects
of her medication, the plaintiff would be further limited to
20

performing unskilled work involving one to two-step tasks.

(R. at

25-30).
Finally, the ALJ concluded that although Ms. Ratynski was
unable to perform her past relevant work, there nevertheless existed
significant numbers of jobs in the national economy that she was
capable of performing.

(R. at 31-32).

This was based on the

Medical-Vocational Guidelines contained in the regulations (the
“Grids”), see 20 C.F.R. Part 404, Subpt. P, App. 2, against which
the ALJ compared her findings that the plaintiff, who was thirtyeight years old on the alleged disability onset date, qualified as
a “younger individual,” had at least a high school diploma, was able
to communicate in English, and had the residual functional capacity
to perform sedentary work.

(R. at 30-31).

found Ms. Ratynski not to be disabled.

As a result, ALJ Edgell

(R. at 32).

Discussion
The plaintiff advances five grounds for overturning the denial
of her claim for benefits.

First, she asserts that the ALJ

improperly reopened proceedings with respect to the DIB claim and
then

refused

to

develop

evidence

from

that

adjudication.

(Plaintiff’s Memorandum of Law in Support of Motion for Judgment on
the Pleadings Under Rule 12(c) Fed. R. Civ. P. (“Pl. Memo.”) at 1315).

Next, she argues that the ALJ failed to give proper weight to

the opinions of her treating physicians.
21

(Pl. Memo. at 15-19).

Third, Ms. Ratynski maintains that the ALJ misapplied the law in
evaluating her credibility.

(Pl. Memo. at 19-20).

Fourth, the

plaintiff contends that the ALJ did not properly consider the
combined impact of her exertional and non-exertional impairments in
determining her residual functional capacity. (Pl. Memo. at 20-22).
Finally, she asserts that by relying on the Grids to determine
whether there were jobs that she could perform, ALJ Edgell failed
to account for the full extent of her impairments.
22-23).

(Pl. Memo. at

I will address each argument in turn.

A. Reopening
The plaintiff’s argument with respect to “reopening” her DIB
claim is a bit mystifying.

There was no prior adjudication of that

claim, and ALJ Edgell’s determination addresses Ms. Ratynski’s
claims for both SSI and DIB.

(R. at 19).

Furthermore, the ALJ

accepted evidence from at least five years prior to the date alleged
for the onset of disability.

There is simply no substance to the

plaintiff’s claim that she was prejudiced by the manner in which the
DIB claim was handled.
B. Medical Opinion Evidence
Regulations promulgated pursuant to the Act establish that “the
opinion of a claimant’s treating physician as to the nature and
severity of the impairment is given ‘controlling weight’ so long as
it

‘is

well-supported

by

medically
22

acceptable

clinical

and

laboratory diagnostic techniques and is not inconsistent with the
other substantial evidence in [the] case record.’”

Burgess v.

Astrue, 537 F.3d 117, 128 (2d Cir. 2008) (alteration in original)
(quoting 20 C.F.R. § 404.1527(c)(2)); accord Greek v. Colvin, 802
F.3d 370, 375 (2d Cir. 2015); Correale-Englehart v. Astrue, 687 F.
Supp. 2d 396, 426 (S.D.N.Y. 2010).

“This preference is generally

justified because treating sources are likely to be ‘the medical
professionals most able to provide a detailed, longitudinal picture’
of a plaintiff’s medical impairments and offer a unique perspective
that the medical tests and SSA consultants are unable to obtain or
communicate.”

Correale-Engelhart, 687 F. Supp. 2d at 426 (quoting

20 C.F.R. § 416.927(c)(2)); see also Petrie v. Astrue, 412 F. App’x
401, 405 (2d Cir. 2011) (summary order) (“The opinion of a treating
physician

is

accorded

extra

treatment

he

provides

and

weight
the

because

the

doctor/patient

continuity

of

relationship

he

develops place him in a unique position to make a complete and
accurate diagnosis of his patient.” (quoting Mongeur v. Heckler, 722
F.2d 1033, 1039 n.2 (2d Cir. 1983))).
In considering a treating source’s opinion, “the ALJ cannot
arbitrarily substitute his own judgment for competent medical
opinion.”

Rosa, 168 F.3d at 79 (quoting McBrayer v. Secretary of

Health and Human Services, 712 F.2d 795, 799 (2d Cir. 1983)); see
also Wagner v. Secretary of Health and Human Services, 906 F.2d 856,
23

862 (2d Cir. 1990) (noting that “a circumstantial critique by
non-physicians . . . must be overwhelmingly compelling in order to
overcome

a

medical

opinion”).

However,

determination

of

“dispositive” issues, such as whether the plaintiff “meet[s] the
statutory definition of disability” and cannot work, are reserved
for the Commissioner.

20 C.F.R. §§ 404.1527(d)(1), 416.927(d)(1);

see Greek, 802 F.3d at 376; Snell v. Apfel, 177 F.3d 128, 133 (2d
Cir. 1999).
If the ALJ determines that a treating physician’s opinion is
not controlling, she is nevertheless required to consider the
following factors in determining the weight to be given to that
opinion: (1) the length of the treatment relationship and the
frequency of examination; (2) the nature and extent of the treatment
relationship; (3) the evidence and explanation provided to support
the treating physician’s opinion; (4) the consistency of the opinion
with the record as a whole; (5) whether the opinion is from a
specialist; and (6) other factors brought to the Commissioner’s
attention that tend to support or contradict the opinion. 20 C.F.R.
§§ 404.1527(c), 416.927(c); Greek, 802 F.3d at 375; Halloran v.
Barnhart, 362 F.3d 28, 32 (2d Cir. 2004). Although the ALJ need not
explicitly

discuss

the

factors,

the

decision

must

clearly

demonstrate that she properly applied the required analysis.

24

Khan

v. Astrue, No. 11 CV 5118, 2013 WL 3938242, at *15 (E.D.N.Y. July
30, 2013) (citing Petrie, 412 F. App’x at 406).
“A corollary to the treating physician rule is the so-called
‘good reasons rule,’ which is based on the regulations specifying
that ‘the Commissioner “will always give good reasons”’ for the
weight given to a treating source opinion.”

Silva v. Colvin, No.

6:14-cv-6329, 2015 WL 5306005, at *5 (W.D.N.Y. Sept. 10, 2015)
(quoting Halloran, 362 F.3d at 32); see also Burgess, 537 F.3d at
129-30 (noting that ALJ must provide “good reasons” for discounting
treating physician’s opinion). Failure to identify good reasons for
discounting a treating physician’s opinion “denotes a lack of
substantial evidence, even where the conclusion of the ALJ may be
justified based upon the record.”

Silva, 2015 WL 5306005, at *5

(emphasis omitted) (quoting Blakely v. Commissioner of Social
Security, 581 F.3d 399, 407 (6th Cir. 2009)).
Ms. Ratynski’s treating physician, Dr. Nazario, stated that the
plaintiff was “100% disabled” and “unable to work.”
858).

(R. at 488,

The ultimate finding of disability is a matter reserved to

the Commissioner, however, and a treating physician’s opinion on
this issue is therefore entitled to no special weight.

See Greek,

802 F.3d at 374; Snell, 177 F.3d at 133; Maldonado v. Berryhill, No.
16 Civ. 165, 2017 WL 946329, at *14 (S.D.N.Y. March 10, 2017).

25

Dr. Nazario’s specific findings as to Ms. Ratynski’s functional
abilities are entitled to consideration.

He found that she could

only occasionally lift up to ten pounds; could never carry that
amount of weight; could only sit, stand, or walk for 15 minutes
without interruption and for a total of no more than two hours each
in an eight-hour workday; could never stoop, kneel, crouch, or
crawl; could not shop, travel by herself, walk one block on an
uneven surface, or climb a few steps at a reasonable pace using a
handrail.

(R. at 405-10).

He further opined that the plaintiff

“doesn’t hear” (R. at 410), and that her use of painkillers left her
“drugged” and “mentally disabled.”

(R. at 488).

ALJ Edgell gave Dr. Nazario’s opinions limited weight on the
basis that they were inconsistent with his own treatment records
(Tr. at 30), and with other evidence in the record, and this
determination is well founded.
occasionally

complained

of

For example, although Ms. Ratynski

pain,

she

consistently

had

normal

strength in all muscle groups, normal range of motion in all
joints, equal reflexes, and no focal neurological deficits. (R. at
701, 704, 710, 713, 718, 724, 727, 732, 735, 737, 740, 743, 749).
Furthermore, Dr. Alvarez, a consulting physician, found that Ms.
Ratynski could stand on her heels and toes without difficulty,
squat halfway, rise from a seated position, and get on and off the
examination table without difficulty. (R. at 356). Similarly, Dr.
26

Nazario’s opinion that the plaintiff’s medications rendered her
psychologically unable to work is also contradicted by his own
treatment notes, since he consistently found her to be alert and
oriented, with grossly normal psychiatric findings.

(R. at 701,

704, 710, 713, 718, 724, 727, 732, 735, 737, 740, 743, 749).
Nazario’s

opinion

of

the

plaintiff’s

mental

status

is

Dr.
also

inconsistent with that of Dr. Helprin, the consulting psychologist,
whose findings were unremarkable.

(R. at 349-51).6

Ms. Ratynski also complains that the ALJ failed to address
evidence of Epstein-Barr syndrome and pulmonary hypertension. This
argument is meritless. The record contains evidence only that test
results indicated that the plaintiff had Epstein-Barr sometime in
the past, not that she currently suffered from it.
608-09).

(R. at 351,

And, contrary to the plaintiff’s representation, ALJ

Edgell did address the evidence of mild pulmonary hypertension,
noting that there had been no follow-up appointments with a
pulmonologist,

no

complications,

and

no

condition would last twelve months or more.

6

indication

that

the

(R. at 22).

The plaintiff contends that the ALJ erred by failing to seek
clarification with respect to the inconsistencies in the record.
(Pl. Memo. at 19). But the obligation to develop the record arises
when there are gaps in the evidence, not when the evidence is less
than uniform. See Rosa, 168 F.3d at 79 n.5.
27

In sum, the ALJ committed no error in her analysis of the
medical opinion evidence.
C. Credibility
In determining residual functional capacity, the ALJ must take
“the claimant’s reports of pain and other limitations into account,
but is not required to accept the claimant’s subjective complaints
without question; [she] may exercise discretion in weighing the
credibility of the claimant’s testimony in light of the other
evidence in the record.”

Genier v. Astrue, 606 F.3d 46, 49 (2d

Cir. 2010) (per curiam) (internal citations omitted).
The regulations prescribe a two-step process for weighing a
claimant’s allegations of pain and other limitations.
also 20 C.F.R. § 416.929.
“whether

the

impairment

claimant

that

could

symptoms alleged.”

Id.; see

At step one, the ALJ must determine

suffers

from

reasonably

be

a

medically

expected

Genier, 606 F.3d at 49.

to

determinable
produce

the

Step two requires the

ALJ to consider “the extent to which [the claimant’s] symptoms can
reasonably be accepted as consistent with the objective medical
evidence

and

other

evidence.”

20

C.F.R.

§§

404.1529(a),

416.929(a). Because “symptoms sometimes suggest a greater severity
of impairment than can be shown by objective medical evidence
alone,” where the claimant’s testimony concerning the intensity,
persistence,

or

functional

limitations
28

associated

with

her

impairments is not fully supported by clinical evidence, the
regulations require the ALJ to consider additional factors to
assess the claimant’s credibility.
(3), 416.929(c)(2)-(3).

20 C.F.R. §§ 404.1529(c)(2)-

The regulations do not allow the ALJ to

reject a claimant’s statements about her symptoms solely because
they are not substantiated by objective medical evidence, but the
ALJ may consider any conflicts between the claimant’s testimony and
the rest of the evidence.

20 C.F.R. §§ 404.1529(c)(2), (4),

416.929(c)(2), (4); Puente v. Commissioner of Social Security, 130
F. Supp. 3d 881, 894 (S.D.N.Y. 2015).
If an ALJ “finds that a claimant is not credible[,] [she] must
do so ‘explicitly and with sufficient specificity to enable the
Court to decide whether there are legitimate reasons for the ALJ’s
disbelief

and

whether

[her]

substantial evidence.’”

determination

is

supported

by

Henningsen v. Commissioner of Social

Security Administration, 111 F. Supp. 3d 250, 268 (E.D.N.Y. 2015)
(quoting Rivera v. Astrue, No. 10 CV 4324, 2012 WL 3614323, at *14
(E.D.N.Y. Aug. 21, 2012)); see also SSR 96-7p, 61 Fed. Reg.
34483-01, 34485-86 (July 2, 1996) (“The determination . . . must be
sufficiently specific to make clear to the individual and to any
subsequent

reviewers

the

weight

the

adjudicator

gave

to

the

individual’s statements and the reasons for that weight.”).

In

determining the claimant’s credibility, the ALJ is not required to
29

“discuss all the factors [] ‘as long as the decision includes
precise reasoning, is supported by evidence in the case record, and
clearly indicates the weight the ALJ gave to the claimant’s
statements and the reasoning for that weight.’”

Simmons v.

Commissioner of Social Security, 103 F. Supp. 3d 547, 569 (S.D.N.Y.
2015) (quoting Felix v. Astrue, No. 11 CV 3697, 2012 WL 3043203, at
*8 (E.D.N.Y. July 24, 2012)).
ALJ Edgell set out the specific reasons why she found Ms.
Ratynski’s testimony not to be credible, and her credibility
determination is accordingly entitled to deference.
Astrue, 708 F.3d 409, 420 (2d Cir. 2013).

Selian v.

Since the Commissioner

has the authority “to resolve evidentiary conflicts and to appraise
the credibility of witnesses, including the claimant,” the only
issue is whether the ALJ’s finding that the plaintiff’s “assertions
concerning her physical limitations were ‘not [entirely] credible’
is supported by substantial evidence in the record.”

Simmons, 103

F. Supp. 3d at 570 (quoting Carroll v. Secretary of Health & Human
Services, 705 F.2d 638, 642 (2d Cir. 1983)).
Specifically, the ALJ found that the plaintiff’s subjective
complaints were out of proportion to the objective evidence.
at 26-27).

(R.

Further, she noted that Ms. Ratynski’s treatment had

always been “entirely conservative.”

(R. at 27).

Next, the ALJ

observed that even after the alleged onset of disability, the
30

plaintiff had engaged in some work activity that had required
“standing, walking, and [] mental acuity.”

(R. at 27).

And,

although the plaintiff alleged complete inactivity, there was no
evidence of muscle atrophy.

(R. at 27).

Finally, Ms. Ratynski

admitted managing her own money, driving, reading every day, and
visiting her doctors, activities inconsistent with the level of
disability she alleged.

(R. at 27).

D. Residual Functional Capacity
Next, Ms. Ratynski contends that the ALJ failed to consider
the aggregate effect of her disabilities in arriving at the
conclusion that she could perform sedentary work.
20-22).

This

specifically

is

took

a

misreading

into

account

of
the

the

(Pl. Memo. at

record.

plaintiff’s

exertional as well as exertional limitations.

ALJ

Edgell

claimed

non-

When a claimant

suffers from a mental impairment, the regulations require the ALJ
to employ a specialized assessment at each step of the sequential
analysis.
2003).

Rosado v. Barnhart, 290 F. Supp. 2d 431, 437 (S.D.N.Y.

At step four, the ALJ must assess the claimant’s mental

residual functional capacity by engaging in a detailed assessment
of the claimant’s ability to perform a variety of work-related
functions.

Pabon

v.

Barnhart,

273

F.

Supp.

2d

506,

515-16

(S.D.N.Y. 2003); see also SSR 96-8p, 1996 WL 374184, at *4, 6 (July
2, 1996).

Furthermore, the ALJ’s residual functional capacity
31

findings “must include a narrative discussion describing how the
evidence supports each conclusion, citing specific medical facts .
. . and nonmedical evidence.”

SSR 96-8p, 1996 WL 374184, at *7;

see also Cichocki v. Astrue, 729 F.3d 172, 177 (2d Cir. 2013)
(“Remand may be appropriate [] where . . . inadequacies in the
ALJ’s residual functional capacity analysis frustrate meaningful
review.”); Glessing v. Commissioner of Social Security, No. 13 CV
1254, 2014 WL 1599944, at *8-9 (E.D.N.Y. April 21, 2014) (“The
problem . . . is that, although the ALJ certainly made findings as
to [the] claimant’s limitations, the ALJ provided no analysis
explaining upon what evidence those findings were based.”); Jones
v. Commissioner of Social Security, No. 12 Civ. 4815, 2013 WL
3486994, at *12 (S.D.N.Y. July 11, 2013).
ALJ Edgell did here.

That is precisely what

She assessed Ms. Ratynski’s claim of an

affective disorder by analyzing each of the relevant functional
areas and determining that the plaintiff had no more than a mild
impairment in any area, with no episodes of decompensation. (R. at
23-24).

In

doing

so,

she

properly

relied

on

Dr.

Helprin’s

evaluation of the plaintiff’s psychological functioning.

(R. at

29).
Similarly,
headaches,
medication.

the

finding

ALJ
that

considered
they

were

(R. at 28).
32

the

evidence

largely

of

migraine

controlled

with

Ms. Ratynski further complains that the ALJ failed to account
for

certain

functional

impairments

such

as

the

inability

to

complete an eight-hour workday. (Pl. Memo. at 21). But ALJ Edgell
did consider this evidence; she discounted it as inconsistent with
other more persuasive evidence in the record.
E. Reliance on the “Grids”
Finally, the plaintiff argues that “[e]xclusive reliance on
the [G]rids is inappropriate where the guidelines fail to describe
the full extent of a claimant’s physical limitations.”
at 22).

This contention is correct as far as it goes.

(Pl. Memo.
The Grids

“take[] into account the claimant’s residual functional capacity in
conjunction

with

the

claimant’s

age,

education,

and

work

experience” and direct a conclusion as to whether the claimant is
disabled or not disabled and able to work in the national economy.
Rosa, 168 F.3d at 78 (alteration in original); see also Pratts v.
Chater, 94 F.3d 34, 38-39 (2d Cir. 1996).

If a claimant suffers

only from exertional impairments, then the ALJ can demonstrate that
there is other work that the claimant can perform by resorting
exclusively to the Grids.

See Zabala v. Astrue, 595 F.3d 402, 410

(2d Cir. 2010); Rosa, 168 F.3d at 78; Pratts, 94 F.3d at 38-39;
Bapp, 802 F.2d at 604.

However, where a claimant has both

exertional and non-exertional impairments, the Grids may be used
only

as

a

framework

for

decision-making.
33

20

C.F.R.

§§