Freeman v. Commissioner of Social Security
Filing
18
DECISION AND ORDER: re: 13 MOTION for Judgment on the Pleadings filed by Commissioner of Social Security. For the foregoing reasons, the Commissioner's Motion for Judgment on the Pleadings (Docket No. 13) is DENIED; Plaintiff's reques t for remand is GRANTED (Docket No. 17); and this case is REMANDED for further proceedings consistent with this Decision and Order. The Clerk is directed to enter a final judgment consistent with the decision and order. (Signed by Magistrate Judge Gary R Jones on 9/19/2022) (ama) Transmission to Orders and Judgments Clerk for processing.
Case 1:21-cv-03617-GRJ Document 18 Filed 09/19/22 Page 1 of 14
UNITED STATES DISTRICT COURT
SOUTHERN DISTRICT OF NEW YORK
----------------------------------------------------MAYA I.D.F.,
Plaintiff,
DECISION AND ORDER
1:21-CV-03617-GRJ
v.
COMMISSIONER OF SOCIAL SECURITY,
Defendant.
----------------------------------------------------GARY R. JONES, United States Magistrate Judge:
In September of 2018, Plaintiff Maya I.D.F. 1 applied for Disability
Insurance Benefits and Supplemental Security Income benefits under the
Social Security Act. The Commissioner of Social Security denied the
applications. Plaintiff, pro se, commenced this action seeking judicial
review of the Commissioner’s denial of benefits under 42 U.S.C. §§ 405 (g)
and 1383 (c)(3). The parties consented to the jurisdiction of a United
States Magistrate Judge. (Docket No. 9).
This case was referred to the undersigned on March 24, 2022.
Presently pending is the Commissioner’s Motion for Judgment on the
Pleadings under Rule 12 (c) of the Federal Rules of Civil Procedure.
Plaintiff’s name has been partially redacted in compliance with Federal Rule of Civil
Procedure 5.2 (c)(2)(B) and the recommendation of the Committee on Court
Administration and Case Management of the Judicial Conference of the United States.
1
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(Docket No. 13). For the following reasons, the Commissioner’s motion is
due to be denied and this case is remanded for further proceedings.
I. BACKGROUND
A.
Administrative Proceedings
Plaintiff applied for benefits on September 11, 2018, and September
27, 2018, respectively, alleging disability beginning July 24, 2018. (T at
193-99, 200-208).2 Plaintiff’s applications were denied initially and on
reconsideration. She requested a hearing before an Administrative Law
Judge (“ALJ”). A hearing was held on July 8, 2020, before ALJ Angela
Banks. (T at 25). Plaintiff appeared with an attorney and testified. (T at 3040). The ALJ also received testimony from Dale Pasculli, a vocational
expert. (T at 41-43).
B.
ALJ’s Decision
On August 25, 2020, the ALJ issued a decision denying the
applications for benefits. (T at 84-101). The ALJ found that Plaintiff had not
engaged in substantial gainful activity since July 24, 2018 (the alleged
onset date) and met the insured status requirements of the Social Security
Act through September 30, 2020 (the date last insured). (T at 89). The ALJ
concluded that Plaintiff’s degenerative disc disease of the lumbar spine and
2
Citations to “T” refer to the administrative record transcript at Docket No. 12.
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degenerative joint disease of her bilateral knees were severe impairments
as defined under the Act. (T at 90).
However, the ALJ found that Plaintiff did not have an impairment or
combination of impairments that met or medically equaled one of the listed
impairments in 20 CFR Part 403, Subpart P, Appendix 1. (T at 90).
At step four of the sequential analysis the ALJ determined that
Plaintiff retained the residual functional capacity (“RFC”) to perform
sedentary work, as defined in 20 CFR 404.1567 (a), with the following
limitations: she can occasionally balance, stoop, crouch, kneel, and crawl;
occasionally climb ramps and stairs, but she can never climb ladders,
ropes or scaffolds; sit for no more than about 30 minutes without
interruption, followed by an opportunity to stand and stretch briefly (1 to 2
minutes) without leaving the work station; stand and/or walk without
interruption for a combined total of no more than about 30 minutes,
followed by an opportunity to sit for up to 5 minutes. (T at 91).
The ALJ concluded that Plaintiff could not perform her past relevant
work as a physical instructor. (T at 93).
However, considering Plaintiff’s age (46 on the alleged onset date),
education (at least high school), work experience, and RFC, the ALJ
determined that there were jobs that exist in significant numbers in the
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national economy that Plaintiff can perform. (T at 93-94). As such, the ALJ
found that Plaintiff had not been under a disability, as defined under the
Social Security Act, and was not entitled to benefits for the period between
July 24, 2018 (the alleged onset date) and August 25, 2020 (the date of the
ALJ’s decision). (T at 21-22). On March 5, 2021, the Appeals Council
denied Plaintiff’s request for review, making the ALJ’s decision the
Commissioner’s final decision. (T at 1-7).
C.
Procedural History
Plaintiff commenced this action, pro se, by filing a Complaint on April
22, 2021. (Docket No. 1). On November 28, 2021, the Commissioner filed
a motion for judgment on the pleadings, supported by a memorandum of
law. (Docket No. 13, 14). Plaintiff filed two (2) letters in support of her
challenge and in opposition to the Commissioner’s motion. (Docket No. 16,
17).
II. APPLICABLE LAW
A.
Standard of Review
“It is not the function of a reviewing court to decide de novo whether a
claimant was disabled.” Melville v. Apfel, 198 F.3d 45, 52 (2d Cir. 1999).
The court’s review is limited to “determin[ing] whether there is substantial
evidence supporting the Commissioner's decision and whether the
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Commissioner applied the correct legal standard.” Poupore v. Astrue, 566
F.3d 303, 305 (2d Cir. 2009) (per curiam).
The reviewing court defers to the Commissioner's factual findings,
which are considered conclusive if supported by substantial evidence. See
42 U.S.C. § 405(g). “Substantial evidence” is “more than a mere scintilla”
and “means such relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.” Lamay v. Commissioner of Soc. Sec.,
562 F.3d 503, 507 (2d Cir. 2009) (internal quotations omitted) (quoting
Richardson v. Perales, 402 U.S. 389, 401 (1971)).
“In determining whether the agency's findings are supported by
substantial evidence, the reviewing court is required to examine the entire
record, including contradictory evidence and evidence from which
conflicting inferences can be drawn.” Talavera v. Astrue, 697 F.3d 145,
151 (2d Cir. 2012) (internal quotations omitted).
“When there are gaps in the administrative record or the ALJ has
applied an improper legal standard,” or when the ALJ’s rationale is unclear,
remand “for further development of the evidence” or for an explanation of
the ALJ’s reasoning is warranted. Pratts v. Chater, 94 F.3d 34, 39 (2d Cir.
1996).
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B.
Five-Step Sequential Evaluation Process
Under the Social Security Act, a claimant is disabled if he or she
lacks the ability “to engage in any substantial gainful activity by reason of
any medically determinable physical or mental impairment which can be
expected to result in death or which has lasted or can be expected to last
for a continuous period of not less than 12 months ....” 42 U.S.C. §
423(d)(1)(A).
A claimant’s eligibility for disability benefits is evaluated pursuant to a
five-step sequential analysis:
1. The Commissioner considers whether the claimant is
currently engaged in substantial gainful activity.
2. If not, the Commissioner considers whether the claimant has
a “severe impairment” which limits his or her mental or physical
ability to do basic work activities.
3. If the claimant has a “severe impairment,” the Commissioner
must ask whether, based solely on medical evidence, claimant
has an impairment listed in Appendix 1 of the regulations. If the
claimant has one of these enumerated impairments, the
Commissioner will automatically consider him disabled, without
considering vocational factors such as age, education, and
work experience.
4. If the impairment is not “listed” in the regulations, the
Commissioner then asks whether, despite the claimant's severe
impairment, he or she has residual functional capacity to
perform his or her past work.
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5. If the claimant is unable to perform his or her past work, the
Commissioner then determines whether there is other work
which the claimant could perform.
See Rolon v. Commissioner of Soc. Sec., 994 F. Supp. 2d 496, 503
(S.D.N.Y. 2014); see also 20 C.F.R. §§ 404.1520(a)(4)(i)–(v),
416.920(a)(4)(i)–(v).
The claimant bears the burden of proof as to the first four steps; the
burden shifts to the Commissioner at step five. See Green-Younger v.
Barnhart, 335 F.3d 99, 106 (2d Cir. 2003). At step five, the Commissioner
determines whether claimant can perform work that exists in significant
numbers in the national economy. See Butts v. Barnhart, 416 F.3d 101,
103 (2d Cir. 2005); 20 C.F.R. § 404.1560(c)(2).
C.
Pro Se Status
In the Second Circuit, “[w]e liberally construe pleadings and briefs
submitted by pro se litigants, reading such submissions to raise the
strongest arguments they suggest.” McLeod v. Jewish Guild for the Blind,
864 F.3d 154, 156 (2d Cir. 2017)(quoting Bertin v. United States, 478 F.3d
489, 491 (2d Cir. 2007) (alterations in original). This applies to requests for
review of the denial of Social Security benefits. See Tipadis v. Comm'r of
Soc. Sec., 284 F. Supp. 3d 517, 523 (S.D.N.Y. 2018).
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III. DISCUSSION
Plaintiff submitted two (2) pro se letters providing this Court with
background concerning her life circumstances, progress in recovery from
an accident in June of 2018, and future aspirations. (Docket Nos. 16 &
17).3 This Court will deem Plaintiff’s letters to be a request for remand and
consider whether the ALJ’s decision was consistent with applicable law,
accompanied by an adequate explanation, and supported by substantial
evidence.
A.
RFC
A claimant’s “residual functional capacity” (“RFC”) is his or her
“maximum remaining ability to do sustained work activities in an ordinary
work setting on a continuing basis.” Melville, 198 F.3d at 52 (quoting SSR
96-8p). When assessing a claimant’s RFC, an ALJ must consider medical
opinions regarding the claimant’s functioning and make a determination
based on an assessment of the record as a whole. See 20 C.F.R. §§
404.1527(d)(2), 416.9527(d)(2) (“Although we consider opinions from
medical sources on issues such as ...your residual functional capacity...the
Plaintiff also discusses new injuries arising from a motor vehicle accident that occurred
in February of 2022. Because this was after the date of the ALJ’s decision, any
additional alleged impairment arising from this incident would need to be the subject of
a new application for benefits and is outside the scope of this Court’s review.
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final responsibility for deciding these issues is reserved to the
Commissioner.”).
As mentioned above, the ALJ determined that Plaintiff retained the
RFC to perform sedentary work, as defined in 20 CFR 404.1567 (a), with
the following limitations: she can occasionally balance, stoop, crouch,
kneel, and crawl; occasionally climb ramps and stairs, but never climb
ladders, ropes or scaffolds; sit for no more than about 30 minutes without
interruption, followed by an opportunity to stand and stretch briefly (1 to 2
minutes) without leaving the work station; stand and/or walk without
interruption for a combined total of no more than about 30 minutes,
followed by an opportunity to sit for up to 5 minutes. (T at 91).
It is well-settled that the ALJ must provide an adequate "roadmap" for
her reasoning. The failure to do so deprives the Court of the ability to
determine accurately whether the ALJ’s opinion is supported by substantial
evidence. Ferraris v. Heckler, 728 F.2d 582, 587 (2d Cir. 1984) (noting that
“the crucial factors in any determination must be set forth with sufficient
specificity to enable us to decide whether the determination is supported by
substantial evidence”).
In other words, it is the ALJ’s responsibility to “build an accurate and
logical bridge from the evidence to [her] conclusion to enable meaningful
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review.” Horton v. Saul, 19-CV-8944, 2021 WL 1199874, at *12 (S.D.N.Y.
March 30, 2021) (quoting Hamedallah ex rel. E.B. v. Astrue, 876 F.
Supp.2d 133, 142 (N.D.N.Y. 2012)); see also Diaz v. Comm'r of Soc. Sec.,
No. 18-CV-8643 (SN), 2020 WL 1699996, at *11 (S.D.N.Y. Apr. 8,
2020)(“The ALJ’s consideration of these factors must be evident from the
ALJ’s decision, as the claimant is entitled to an explanation as to why the
ALJ did not credit the findings of a treating physician.”).
Here, the Court finds that the ALJ failed to provide an adequate
roadmap of her reasoning.
Dr. Howard Baum, a treating orthopedist, provided an assessment in
June of 2020, in which he described Plaintiff as experiencing abnormal gait,
limited range of motion in the lumbar spine, and limited range of motion in
the right knee. (T at 445). He opined that Plaintiff would need to lie down
for 30-60 minutes during the day. (T at 445-46). Dr. Baum reported that
Plaintiff could sit for 30 minutes at a time and for a total of 2 hours in an 8hour workday; stand for 20 minutes at a time and for a total of 2 hours in an
8-hour workday; and walk for 20 minutes at a time and for a total of 2 hours
in an 8-hour workday. (T at 447). He also opined that Plaintiff could
occasionally lift up to 5 pounds, but never more than that. (T at 447). Dr.
Baum also assessed limitations as to gross and fine manipulation and
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opined that Plaintiff could never push or pull with her arms or use her feet
for repetitive movements. (T at 448-49).
Dr. Shouhei Yamagami, another treating physician, also completed
an assessment in June of 2020. Dr. Yamagami reported essentially the
same limitations that Dr. Baum did, including (in particular) limitations on
Plaintiff’s ability to sit for prolonged periods and lift more than 5 pounds. (T
at 542-48).
The ALJ considered the opinions of Dr. Baum and Dr. Yamagami,
deemed them “somewhat supported by their examination findings,” but
determined that the physicians’ push/pull, environmental, and manipulation
limitations were too restrictive given the clinical findings documented in the
treatment notes. (T at 92-93).
The ALJ erred, however, by characterizing the treating physicians’
opinions as consistent with the ability to perform a limited range of
sedentary work. (T at 92). Notably, both physicians stated that Plaintiff
could not sit for more than 2 hours in an 8-hour workday (T at 447, 545),
which would erode, and perhaps preclude, the performance of sedentary
work. See Rosa v. Callahan, 168 F.3d 72, 78 n.3 (2d Cir. 1999); Maurer v.
Comm'r of Soc. Sec., No. 21CIV6518KMKJCM, 2022 WL 2657146, at *19
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(S.D.N.Y. June 17, 2022), report and recommendation adopted, No. 21CV-6518 (KMK), 2022 WL 2657190 (S.D.N.Y. July 8, 2022).
The ALJ failed to acknowledge, let alone address, this conflict
between her RFC determination and the assessments of the two treating
physicians on an issue material to the ultimate disposition. A remand is
required for reconsideration of the treating physicians’ opinions. See Greek
v. Colvin, 802 F.3d 370, 375 (2d Cir. 2015) (holding that “failure to provide
good reasons for not crediting the opinion of a claimant's treating physician
is a ground for remand”); see also Halloran v. Barnhart, 362 F.3d 28, 33
(2d Cir. 2004); Diaz, 2020 WL 1699996, at *11 (“[R]emand is appropriate
when the ALJ fails to ‘comprehensively set forth his reasons for the weight
assigned to a treating physician's opinion.’”)(quoting Burgess, 537 F.3d at
129-30)).
This Court recognizes that Drs. Li and Lee, non-examining State
Agency review physicians, opined that Plaintiff could sit for about 6 hours in
an 8-hour workday. (T at 51, 71). The ALJ found these opinions
persuasive and relied upon them in formulating the RFC determination. (T
at 92).
Notably, however, the State Agency physicians reviewed the record
in January and September of 2019, respectively. Consequently, neither
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had the benefit of considering the assessments of the treating physicians,
which were not provided until June of 2020.
Moreover, non-examining physician opinions, without more, cannot
constitute substantial evidence sufficient to support a denial of benefits,
particularly where (as here) the ALJ failed to recognize or reconcile a
conflict between those opinions and the assessment of the claimant’s
treating doctors regarding on issue material to the disability determination.
A remand is required. See e.g., Jimenez on behalf of D.S.J. v. Comm'r of
Soc. Sec., No. 21CIV2030KMKAEK, 2022 WL 4085953, at *12 (S.D.N.Y.
Aug. 18, 2022), report and recommendation adopted sub nom. Jimenez v.
Comm'r of Soc. Sec., No. 21-CV-2030 (KMK), 2022 WL 4087958 (S.D.N.Y.
Sept. 6, 2022); Vargas v. Sullivan, 898 F.2d 293, 295 (2d Cir. 1990);
Rodriguez v. Apfel, No. 97 CIV. 9030 (MGC), 1999 WL 511867, at *5
(S.D.N.Y. July 19, 1999).
B.
Remand
“Sentence four of Section 405 (g) provides district courts with the
authority to affirm, reverse, or modify a decision of the Commissioner ‘with
or without remanding the case for a rehearing.’” Butts v. Barnhart, 388 F.3d
377, 385 (2d Cir. 2002) (quoting 42 U.S.C. § 405 (g)). Remand for further
administrative proceedings is the appropriate remedy “[w]here there are
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gaps in the administrative record or the ALJ has applied an improper legal
standard.” Rosa v. Callahan, 168 F.3d 72, 82-83 (2d Cir. 1999); see also
Rhone v. Colvin, No. 13-CV-5766 (CM)(RLE), 2014 U.S. Dist. LEXIS
180514, at *28 (S.D.N.Y. Nov. 6, 2014).
A remand is warranted here for reconsideration of the treating
physicians’ opinions in light of the errors outlined above.
IV. CONCLUSION
For the foregoing reasons, the Commissioner’s Motion for Judgment
on the Pleadings (Docket No. 13) is DENIED; Plaintiff’s request for remand
is GRANTED (Docket No. 17); and this case is REMANDED for further
proceedings consistent with this Decision and Order. The Clerk is directed
to enter a final judgment consistent with the decision and order.
s/Gary R. Jones
Dated: September 19, 2022
GARY R. JONES
United States Magistrate Judge
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