Mount v. Colvin
Filing
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DECISION AND ORDER. Plaintiff's Motion for Judgment on the Pleadings 7 is GRANTED, the Commissioner's Motion for Judgment on the Pleadings 8 is DENIED, and this matter is REMANDED to the Commissioner for further administrative proceedings. SO ORDERED. Signed by Hon. Frank P. Geraci, Jr. on 09/28/2016. (AFM)
UNITED STATES DISTRICT COURT
WESTERN DISTRICT OF NEW YORK
BERNARD E. MOUNT,
Plaintiff,
Case # 15-CV-367-FPG
v.
DECISION AND ORDER
CAROLYN W. COLVIN,
ACTING COMMISSIONER OF SOCIAL SECURITY,
Defendant.
Bernard E. Mount (“Mount” or “Plaintiff”) brings this action pursuant to the Social
Security Act (“the Act”) seeking review of the final decision of the Acting Commissioner of
Social Security (“the Commissioner”) that denied his application for Supplemental Security
Income (“SSI”) under Title XVI of the Act. ECF No. 1. This Court has jurisdiction over this
action under 42 U.S.C. §§ 405(g), 1383(c)(3).
Both parties have moved for judgment on the pleadings pursuant to Rule 12(c) of the
Federal Rules of Civil Procedure. ECF Nos. 7, 8. For the reasons that follow, this Court finds
that the Commissioner’s decision is not in accordance with the applicable legal standards.
Accordingly, Plaintiff’s motion is GRANTED, the Commissioner’s motion is DENIED, and this
matter is REMANDED to the Commissioner for further administrative proceedings.
BACKGROUND
On October 6, 2011, Mount protectively filed an application for SSI with the Social
Security Administration (“the SSA”). Tr.1 97-102. He alleged that he had been disabled since
October 1, 2011, due to poor eyesight, glaucoma, and cataracts in both eyes, retina detachment in
the left eye, right arm nerve damage, left arm rotator cuff injury, left wrist injury, possible
1
References to “Tr.” are to the administrative record in this matter.
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chronic obstructive pulmonary disease (“COPD”), and emphysema.
Tr. 118.
After his
application was denied at the initial administrative level, a hearing was held via videoconference
before Administrative Law Judge Harvey Feldmeier (“the ALJ”) on March 28, 2013 in which the
ALJ considered Mount’s application de novo. Tr. 22-60. Mount appeared at the hearing with his
attorney and testified. Id. On April 12, 2013, the ALJ issued a decision finding that Mount was
not disabled within the meaning of the Act.
Tr. 11-17.
That decision became the
Commissioner’s final decision when the Appeals Council denied Mount’s request for review on
February 27, 2015. Tr. 1-5. Thereafter, Mount commenced this action seeking review of the
Commissioner’s final decision. ECF No. 1.
LEGAL STANDARD
I.
District Court Review
“In reviewing a final decision of the SSA, this Court is limited to determining whether
the SSA’s conclusions were supported by substantial evidence in the record and were based on a
correct legal standard.” Talavera v. Astrue, 697 F.3d 145, 151 (2d Cir. 2012) (internal quotation
marks omitted); see also 42 U.S.C. § 405(g). The Act holds that a decision by the Commissioner
is “conclusive” if it is supported by substantial evidence. 42 U.S.C. § 405(g). “Substantial
evidence means more than a mere scintilla. It means such relevant evidence as a reasonable
mind might accept as adequate to support a conclusion.” Moran v. Astrue, 569 F.3d 108, 112 (2d
Cir. 2009) (internal quotation marks omitted). It is not this Court’s function to “determine de
novo whether [the claimant] is disabled.” Schaal v. Apfel, 134 F.3d 496, 501 (2d Cir. 1998)
(internal quotation marks omitted); see also Wagner v. Sec’y of Health & Human Servs., 906
F.2d 856, 860 (2d Cir. 1990) (holding that review of the Secretary’s decision is not de novo and
that the Secretary’s findings are conclusive if supported by substantial evidence).
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II.
Disability Determination
An ALJ must follow a five-step sequential evaluation to determine whether a claimant is
disabled within the meaning of the Act. See Bowen v. City of New York, 476 U.S. 467, 470-71
(1986). At step one, the ALJ must determine whether the claimant is engaged in substantial
gainful work activity. See 20 C.F.R. § 404.1520(b). If so, the claimant is not disabled. If not,
the ALJ proceeds to step two and determines whether the claimant has an impairment, or
combination of impairments, that is “severe” within the meaning of the Act, meaning that it
imposes significant restrictions on the claimant’s ability to perform basic work activities. 20
C.F.R. § 404.1520(c). If the claimant does not have a severe impairment or combination of
impairments, the analysis concludes with a finding of “not disabled.” If the claimant does, the
ALJ continues to step three.
At step three, the ALJ examines whether a claimant’s impairment meets or medically
equals the criteria of a listed impairment in Appendix 1 of Subpart P of Regulation No. 4 (the
“Listings”). 20 C.F.R. § 404.1520(d). If the impairment meets or medically equals the criteria
of a Listing and meets the durational requirement (20 C.F.R. § 404.1509), the claimant is
disabled. If not, the ALJ determines the claimant’s residual functional capacity (“RFC”), which
is the ability to perform physical or mental work activities on a sustained basis, notwithstanding
limitations for the collective impairments. See 20 C.F.R. § 404.1520(e)-(f). The ALJ then
proceeds to step four and determines whether the claimant’s RFC permits him or her to perform
the requirements of his or her past relevant work. 20 C.F.R. § 404.1520(f). If the claimant can
perform such requirements, then he or she is not disabled. If he or she cannot, the analysis
proceeds to the fifth and final step, wherein the burden shifts to the Commissioner to show that
the claimant is not disabled. To do so, the Commissioner must present evidence to demonstrate
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that the claimant “retains a residual functional capacity to perform alternative substantial gainful
work which exists in the national economy” in light of his or her age, education, and work
experience. See Rosa v. Callahan, 168 F.3d 72, 77 (2d Cir. 1999) (quotation marks omitted); see
also 20 C.F.R. § 404.1560(c).
DISCUSSION
I.
The ALJ’s Decision
The ALJ’s decision analyzed Mount’s claim for benefits under the process described
above. At step one, the ALJ found that Mount had not engaged in substantial gainful activity
since the application date. Tr. 13. At step two, the ALJ found that Mount has the following
severe impairments: reduced vision, history of left shoulder surgery, and disc herniation. Tr. 13.
At step three, the ALJ found that such impairments, alone or in combination, do not meet or
medically equal an impairment in the Listings. Tr. 13.
Next, the ALJ determined that Mount retained the RFC to perform light work2 that
includes occasional overhead reaching with his left shoulder and occasional postural motions.
Tr. 13-16. The ALJ also determined that Mount must avoid jobs that require fine visual acuity,
including operating motor vehicles. Id. At step four, the ALJ found that Mount can perform his
past relevant work as a cook because that job does not require work-related activities that are
inconsistent with the RFC assessment. Tr. 16. Accordingly, the ALJ concluded that Mount was
not “disabled” under the Act. Id.
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“Light work involves lifting no more than 20 pounds at a time with frequent lifting or carrying of objects
weighing up to 10 pounds. Even though the weight lifted may be very little, a job is in this category when it requires
a good deal of walking or standing, or when it involves sitting most of the time with some pushing and pulling of
arm or leg controls. To be considered capable of performing a full or wide range of light work, [the claimant] must
have the ability to do substantially all of these activities. If someone can do light work, [the SSA] determine[s] that
he or she can also do sedentary work, unless there are additional limiting factors such as loss of fine dexterity or
inability to sit for long periods of time.” 20 C.F.R. § 416.967(b).
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II.
Analysis
Mount argues that remand is warranted because the ALJ improperly assessed his visual
restrictions, which resulted in a RFC that is not supported by substantial evidence.3 ECF No. 71, at 13-14. Specifically, Mount argues that the ALJ relied on raw medical data and his own lay
opinion to determine that he “must avoid jobs that require fine visual acuity.”
Id.
The
Commissioner maintains that the ALJ did not err and that the RFC assessment is supported by
substantial evidence. ECF No. 8-1, at 9-10.
“[A]n ALJ is not qualified to assess a claimant’s RFC on the basis of bare medical
findings, and as a result an ALJ’s determination of RFC without a medical advisor’s assessment
is not supported by substantial evidence.” Wilson v. Colvin, No. 13-CV-6286P, 2015 WL
1003933, at *21 (W.D.N.Y. Mar. 6, 2015) (citation omitted).
Thus, even though the
Commissioner is empowered to make the RFC determination, “[w]here the medical findings in
the record merely diagnose [the] claimant’s exertional impairments and do not relate those
diagnoses to specific residual functional capabilities,” the general rule is that the Commissioner
“may not make the connection himself.” Id. (citation omitted); Hilsdorf v. Comm’r of Soc. Sec.,
724 F. Supp. 2d 330, 347 (E.D.N.Y. 2010) (“Because an RFC determination is a medical
determination, an ALJ who makes an RFC determination in the absence of supporting expert
medical opinion has improperly substituted his own opinion for that of a physician, and has
committed legal error.”) (citations omitted).
Here, it is apparent that the ALJ relied solely on raw medical data when he assessed
Mount’s visual impairments. The ALJ summarized treatment notes from Community Eye Care
Specialists and cited Mount’s visual acuity scores at various appointments. Tr. 14-15 (citing Tr.
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Mount advances other arguments that he believes warrant reversal of the Commissioner’s decision. ECF
No. 7-1, at 9-13, 14-16. However, because this Court disposes of this matter based on the improper RFC
determination, those arguments need not be reached.
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202-06, 216-24, 242-47, 297-306). None of these records, however, contain any medical opinion
as to how Mount’s visual impairments affect his ability to engage in work at any exertional level
on a regular and continuous basis in an ordinary work setting. Yet the ALJ, who is not a medical
professional, somehow determined that Mount could perform light work as long as he “avoid[ed]
jobs that require fine visual acuity, including operation of motor vehicles.” Tr. 13-16; see also
Schmidt v. Sullivan, 914 F.2d 117, 118 (7th Cir. 1990) (“[J]udges, including administrative law
judges of the Social Security Administration, must be careful not to succumb to the temptation to
play doctor.”) (citations omitted). This was improper.
The Commissioner asserts that the opinion of consultative examiner Samuel Balderman,
M.D. (“Dr. Balderman”), which the ALJ afforded “substantial weight” (Tr. 15-16), sufficiently
addressed the functional limitations that resulted from Mount’s visual impairments. ECF No. 81, at 9. In his examination notes, Dr. Balderman noted that Mount’s “[m]ain medical problem”
was “poor eyesight,” and that Mount had undergone bilateral cataract operations, surgery for
detached retina on the left eye, and was being treated for glaucoma. Tr. 207. In his medical
source statement, however, Dr. Balderman merely observed that Mount “has reduced vision
mainly in the left eye.” Tr. 209. Dr. Balderman does not explain in his examination notes or
medical source statement how Mount’s visual impairments affect (or will not affect) his ability to
engage in work-related activities. Tr. 207-10. This is problematic because “[a]n ALJ commits
legal error when he makes a [RFC] determination based on medical reports that do not
specifically explain the scope of [the] claimant’s work-related capabilities.” Woodford v. Apfel,
93 F. Supp. 2d 521, 529 (S.D.N.Y. 2000) (citations omitted) (emphasis added). Dr. Balderman’s
remark that Mount “has reduced vision mainly in the left eye” (Tr. 209) and the raw medical
evidence in the record from Community Eye Care Specialists (Tr. 202-06, 216-24, 225-26, 242-
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47, 297-306) do not provide substantial evidence for the ALJ’s determination that Mount could
perform light work as long as he “avoid[ed] jobs that require fine visual acuity, including
operation of motor vehicles” (Tr. 13-16). Accordingly, remand is required.
CONCLUSION
For the reasons stated, Plaintiff’s Motion for Judgment on the Pleadings (ECF No. 7) is
GRANTED, the Commissioner’s Motion for Judgment on the Pleadings (ECF No. 8) is
DENIED, and this matter is REMANDED to the Commissioner for further administrative
proceedings consistent with this opinion, pursuant to sentence four of 42 U.S.C. § 405(g). See
Curry v. Apfel, 209 F.3d 117, 124 (2d Cir. 2000); 42 U.S.C. § 1383(c)(3). The Clerk of Court is
directed to enter judgment and close this case.
IT IS SO ORDERED.
Dated: September 28, 2016
Rochester, New York
______________________________________
HON. FRANK P. GERACI, JR.
Chief Judge
United States District Court
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