Knox v. Social Security Administration

Filing 26

ORDER granting in part and denying in part the plaintiff's motion for judgment on the pleadings, Docket Item 16 , and denying the Commissioner's cross-motion for judgment on the pleadings, Docket Item 23 . The decision of the Commissioner is VACATED, and the matter is REMANDED for further administrative proceedings consistent with this decision. SO ORDERED. Signed by Hon. Lawrence J. Vilardo on 12/9/19. (CEH)-CLERK TO FOLLOW UP-

UNITED STATES DISTRICT COURT
WESTERN DISTRICT OF NEW YORK

ROSE M. KNOX,
Plaintiff,
v.

18-CV-541
DECISION & ORDER

COMMISIONER OF SOCIAL SECURITY,
Defendant.

On May 13, 2019, the plaintiff, Rose M. Knox, brought this action under the
Social Security Act (“the Act”). She seeks review of the determination by the
Commissioner of Social Security (“Commissioner”) that she was not disabled. Docket
Item 1. On May 31, 2019, Knox moved for judgment on the pleadings, Docket Item 16;
on September 24, 2019, the Commissioner responded and cross-moved for judgment
on the pleadings, Docket Item 23; and on October 15, 2019, Knox replied, Docket Item
25.
For the reasons that follow, this Court grants Knox’s motion in part and denies
the Commissioner’s cross-motion.
BACKGROUND
I.

PROCEDURAL HISTORY
On July 29, 2014, Knox applied for Supplemental Security Income. Docket Item

8 at 229-34. She claimed that she had been disabled since October 1, 2009, due to
depression, dysthymia, posttraumatic stress disorder (“PTSD”), anxiety, asthma,

pituitary adenoma, chronic back and leg pain, social anxiety, and panic attacks. Id. at
225, 245.
On December 11, 2014, the Commissioner denied Knox’s application because
she was not disabled under the Act. Id. at 165-70. Knox requested a hearing before an
administrative law judge (“ALJ”), id. at 171-73, which was held on February 16, 2017, id.
at 111-45. The ALJ then issued a decision on March 22, 2017, confirming the finding
that Knox was not disabled. Id. at 14-24. Knox appealed the ALJ’s decision, but her
appeal was denied, and the decision then became final. Id. at 5-7.
II.

RELEVANT MEDICAL EVIDENCE
The following summarizes the medical evidence most relevant to Knox’s claim.

Knox was examined by several different providers, but the opinions of Arvind Samant,
M.D.; Cynthia McPhaden, L.M.H.C.; John Schwab, D.O.; Gregory Fabiano, Ph.D.; and
C. Butensky are of most significance to the claim of disability here.
A.

Niagara County Mental Health: Arvind Samant, M.D., and Cynthia
McPhaden, L.M.H.C.

In 2006, Knox spent five days in Niagara Falls Memorial Hospital with
“depression and suicidal thoughts.” Id. at 412, 416. Over the next decade, she
continued to receive treatment from mental health professionals at the Niagara County
Department of Mental Health, including Dr. Samant, a psychiatrist, and Ms. McPhaden,
a licensed therapist. Id. at 416.
As of at least April 10, 2014, and through at least December 29, 2016, Knox
received psychiatric care from Dr. Samant once every three months. Dr. Samant
diagnosed dysthymia and PTSD and prescribed various antidepressants throughout the

2

course of treatment. Id. at 335, 366, 458-59, 495-96, 513, 543, 561-62, 585-86, 608,
631. On ten separate occasions, Dr. Samant reported that Knox denied delusions,
hallucinations, mood swings, racing thoughts or suicidal ideations; was alert and
oriented; had intact cognitive functioning and memory; and had fair insight and
judgment. Id. at 335, 365, 458, 542, 561, 585, 607, 630; but see id. at 513 (Knox
admitting to “racing thoughts and mind wandering” in February and May 2016 but
reporting no other symptoms).
In February 2014, Knox began care with Ms. McPhaden. See id. at 300-10.
Knox reported suicidal ideation in the prior month. Id. at 307-08. Ms. McPhaden
provided psychotherapy weekly from March 2014 through September 2014, and then
every other week from October 2014 through January 2017. See id. at 300-82, 452-88,
489-646. The primary goal of the psychotherapy was to address Knox’s “self isolat[ion]”
and “difficulties engaging in relationships.” See, e.g., id. at 326, 464; see also id. at
312, 480, and 490 (Ms. McPhaden opining that Knox was severely impaired in the
areas of “initiating relationships,” “assertiveness,” and forming friendships). Ms.
McPhaden did not identify any suicide risk during these psychotherapy sessions, see id.
at 328, 331, 334, 339, 343, 346, 351, 357, 361, 364, 369, 372, 375, 379, 382, 500, 539,
553, 574, 591, 611, 640, 644, but she did identify a moderate risk of self-harm in
January and March 2015, and again between September 2016 and January 2017, see
id. at 454, 465, 468, 471, 474, 477, 605, 625.
B.

John Schwab, D.O.

On November 11, 2014, Dr. Schwab, an internist, completed a consultative
internal medicine examination of Knox. See id. at 412-15. Dr. Schwab noted Knox’s
3

history of dysthymia and diagnosed low back pain, asthma, hypothyroidism, pituitary
adenoma, PTSD, anxiety, panic attacks, carpal tunnel syndrome of the right hand, and
tobacco and substance abuse. Id. at 415. He opined that Knox was “mild[ly] restrict[ed]
in bending, lifting, and carrying [objects].” Id. at 415.
C.

Gregory Fabiano, Ph.D.

On November 11, 2014, Dr. Fabiano, a psychologist, completed a consultative
psychological examination of Knox. Id. at 416-20. Dr. Fabiano diagnosed major
depressive disorder (recurrent episodes), panic disorder, and possible PTSD, and he
recommended that Knox continue with her ongoing psychological and psychiatric
treatment. Id. at 420. He opined that Knox had no limitations in the areas of following
and understanding simple directions and instructions, performing both simple and
complex tasks independently, maintaining a regular schedule, learning new tasks, and
making appropriate decisions; but he found that she had “mild to moderate” limitations
in maintaining attention and concentration, relating adequately with others, and
appropriately dealing with stress. Id. at 419. Although these limitations “appear[ed]
consistent with psychiatric problems,” Dr. Fabiano found that those problems were not
“significant enough to interfere with [Knox’s] ability to function on a daily basis.” Id.
D.

C. Butensky

On December 10, 2014, C. Butensky, a state medical examiner whose
qualifications are not included in the record, reviewed Knox’s records and completed a
disability determination for the Social Security Administration. See id. at 152-64. C.
Butensky opined that Knox was not limited in the areas of understanding and memory;

4

but was moderately limited in sustaining attention and concentration, interacting with
others, and adapting or managing herself. Id. at 160-61.
III.

THE ALJ’S DECISION
In denying Knox’s application, the ALJ evaluated Knox’s claim under the Social

Security Administration’s five-step evaluation process for disability determinations. See
20 C.F.R § 416.920(a)(2). At the first step, the ALJ determines whether the claimant is
currently engaged in substantial gainful employment. § 416.920(a)(4)(i). If so, the
claimant is not disabled. Id. If not, the ALJ proceeds to step two. § 416.920(a)(4).
At step two, the ALJ decides whether the claimant is suffering from any severe
impairments. § 416.920(a)(4)(i). If there are no severe impairments, the claimant is not
disabled. Id. If there are any severe impairments, the ALJ proceeds to step three.
§ 416.920(a)(4).
At step three, the ALJ determines whether any severe impairment or combination
of impairments meets or equals an impairment listed in the regulations.
§ 416.920(a)(4)(iii). If the claimant’s severe impairment or combination of impairments
meets or equals one listed in the regulations, the claimant is disabled. Id. But if the ALJ
finds that no severe impairment or combination of impairments meets or equals any in
the regulations, the ALJ proceeds to step four. § 416.920(a)(4).
As part of step four, the ALJ first determines the claimant’s residual functional
capacity (“RFC”). See §§ 416.920(a)(4)(iv); 416.920(d)-(e). The RFC is a holistic
assessment of the claimant—addressing both severe and non-severe medical
impairments—that evaluates whether the claimant can perform past relevant work or
other work in the national economy. See § 416.945
5

After determining the claimant’s RFC, the ALJ completes step four.
§ 416.920(e). If the claimant can perform past relevant work, he or she is not disabled
and the analysis ends. § 416.920(f). But if the claimant cannot, the ALJ proceeds to
step five. §§ 416.920(a)(4)(iv); 416.920(f).
In the fifth and final step, the Commissioner must present evidence showing that
the claimant is not disabled because the claimant is physically and mentally capable of
adjusting to an alternative job. See Bowen v. Yuckert, 482 U.S. 137, 146 n.5 (1987);
20 C.F.R. § 416.920(a)(4)(v), (g). More specifically, the Commissioner bears the
burden of proving that the claimant “retains a residual functional capacity to perform
alternative substantial gainful work which exists in the national economy.” Rosa v.
Callahan, 168 F.3d 72, 77 (2d Cir. 1999).
In this case, the ALJ found at step one that Knox had not engaged in substantial
gainful activity since the date she filed her application for disability benefits. Docket
Item 8 at 16. At step two, the ALJ found that Knox had “the following severe
impairments: PTSD, dysthymia, and sciatica.” Id. The ALJ found that Knox’s anxiety
was not a medically determinable impairment and that her pituitary adenoma and
asthma, though sufficiently limiting to qualify as medical impairments, were nonetheless
“non-severe.” Id.
At step three, the ALJ determined that Knox did “not have an impairment or
combination of impairments that meets or medically equals the severity of one of the
listed impairments in 20 CFR Part 404, Subpart P, Appendix 1.” Id. at 17. More
specifically, the ALJ found that Knox’s sciatica did not meet Listing 1.04 (disorders of
the spine). The ALJ also found that Knox’s mental impairments did not meet Listing

6

12.04 (depressive, bipolar, and related disorders) or Listing 12.15 (trauma- and
stressor-related disorders) because Knox did not have at least two marked limitations or
one extreme limitation in the areas of understanding, remembering, or applying
information; interacting with others; concentrating, persisting, or maintaining pace; or
adapting or managing herself. Id. at 17-18.
The ALJ then found that Knox had the following RFC:
[Knox can] perform light work 1 . . . except she can only occasionally interact
with supervisors, rarely (meaning less than occasionally but not never) with
coworkers, and never with the public and is limited to unskilled (simple,
routine tasks not at a production rate pace) and simple work-related
decisions when dealing with change in the work setting.
Id. at 18. The ALJ explained that although “[Knox]’s medically determinable
impairments could reasonably be expected to cause [her] alleged symptoms[,] . . .
[Knox]’s statements concerning the intensity, persistence and limiting effects of [those]
symptoms [were] not entirely consistent with the medical evidence and other evidence
in the record.” Id. at 19. In reaching this determination, the ALJ accorded “great
weight” to the opinion of the consulting physician, Dr. Schwab; “partial weight” to the
opinion of the consulting psychologist, Dr. Fabiano; and “some weight” to the opinion of
the non-examining consultant, C. Butensky. Id. at 21-22.
At step four, the ALJ found that Knox had no past relevant work. Id. at 22. And
at step five, the ALJ found that “[c]onsidering [Knox’s] age, education, work experience,
and [RFC], there [were] jobs that exist[ed] in significant numbers in the national

1

“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.” 20 C.F.R. § 416.967(b).
7

economy that [Knox] could perform.” Id. at 23. Specifically, the ALJ credited the
testimony of a vocational expert that Knox could find work as a garment folder,
garnisher, or warehouse support worker. Id.
STANDARD OF REVIEW
“The scope of review of a disability determination . . . involves two levels of
inquiry.” Johnson v. Bowen, 817 F.2d 983, 985 (2d Cir. 1987). The court “must first
decide whether [the Commissioner] applied the correct legal principles in making the
determination.” Id. This includes ensuring “that the claimant has had a full hearing
under the . . . regulations and in accordance with the beneficent purposes of the Social
Security Act.” Moran v. Astrue, 569 F.3d 108, 112 (2d Cir. 2009) (quoting Cruz v.
Sullivan, 912 F.2d 8, 11 (2d Cir. 1990)). Then, the court “decide[s] whether the
determination is supported by ‘substantial evidence.’” Johnson, 817 F.2d at 985
(quoting 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.” Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting
Consol. Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)). “Where there is a reasonable
basis for doubt whether the ALJ applied correct legal principles, application of the
substantial evidence standard to uphold a finding of no disability creates an
unacceptable risk that a claimant will be deprived of the right to have her disability
determination made according to correct legal principles.” Johnson, 817 F.2d at 986.

8

DISCUSSION
I.

ALLEGATIONS
Knox argues that the ALJ erred in three ways in determining her mental RFC.

Docket Item 16-1 at 12-21. First, Knox argues that the ALJ did not fulfill her affirmative
obligation to fill a gap in the administrative record. Id. at 21. Second, she argues that
the ALJ’s mental RFC determination is internally inconsistent. Id. at 12-16. Finally, she
argues that the ALJ improperly substituted her own lay judgment for that of medical
professionals. Id. at 16-21. Knox argues that in light of these errors, the ALJ’s finding is
not supported by substantial evidence and thus warrants remand for proper
consideration of her mental RFC. Id. at 12-21. The Court agrees with the first
argument and accordingly remands the matter to the Commissioner for further record
development and reconsideration of Knox’s mental RFC in light of the expanded record.
II.

ANALYSIS
A.

Duty to Develop the Record

Knox argues that the ALJ erred procedurally in determining her mental RFC
without first filling material gaps in the record. Docket Item 16-1 at 21. This Court
agrees.
“Because a hearing on disability benefits is a non-adversarial proceeding, the
ALJ generally has an affirmative obligation to develop the administrative record.” Perez
v. Chater, 77 F.3d 41, 47 (2d Cir. 1996) (citing Echevarria v. Sec’y of Health & Human
Servs., 686 F.2d 751, 755 (2d Cir. 1982)); see also Pratts v. Chater, 94 F.3d 34, 37 (2d
Cir. 1996) (same); 42 U.S.C. § 423(d)(5)(B) (requiring that the Commissioner, before
rendering any eligibility determination, “make every reasonable effort to obtain from the
9

individual’s treating physician (or other treating health care provider) all medical
evidence, including diagnostic tests, necessary in order to properly make such
determination”). Thus, “where there are deficiencies in the record, an ALJ is under an
affirmative obligation to develop a claimant’s medical history ‘even when the claimant is
represented by counsel or . . . by a paralegal.’” Rosa v. Callahan, 168 F.3d 72, 79 (2d
Cir. 1999) (quoting Perez, 77 F.3d at 47)). On the other hand, “where there are no
obvious gaps in the administrative record, and where the ALJ already possesses a
‘complete medical history,’ the ALJ is under no obligation to seek additional information
in advance of rejecting a benefits claim.” Rosa, 168 F.3d at 79 n.5 (quoting Perez, 77
F.3d at 48)). The Social Security Administration’s own regulations reflect this duty,
stating that “[b]efore [the Commissioner] make[s] a determination that [a claimant is] not
disabled, [the Commissioner] will develop [the claimant’s] complete medical history . . .
[and] will make every reasonable effort to help [the claimant] get medical reports from
[her] own medical sources when [she] give[s] [the Commissioner] permission to request
the reports.” 20 C.F.R. § 404.1512(d)(1).
The regulations further explain that when a claimant is receiving or has received
ongoing treatment from a qualified medical professional, the Commissioner “will request
a medical source statement [from the claimant’s treating physician] about what [the
claimant] can still do despite [her] impairment(s).” Tankisi v. Comm’r of Soc. Sec., 521
Fed. App’x 29, 33 (2d Cir. 2013) (summary order) (quoting former 20 C.F.R.
§ 416.913(b)(6) 2) (additional citation omitted). That is so because the opinions of

2

This section was amended, effective on March 27, 2017. Revisions to the
Rules Regarding the Evaluation of Medical Evidence, 82 Fed. Reg. 5844-01, 5844,
5875 (Jan. 18, 2017). Because Knox applied for disability benefits on July 29, 2014—
10

treating sources—physicians, psychologists, optometrists, podiatrists, and qualified
speech-language pathologists who have “ongoing treatment relationship[s]” with
claimants and therefore are most able to “provide . . . detailed, longitudinal picture[s] of
[claimants’] medical impairments”—are entitled to controlling weight so long as they are
“well-supported [sic] by medically acceptable clinical and laboratory diagnostic
techniques and [are] not inconsistent with the other substantial evidence in [the
claimant’s] case record.” 3 See 20 C.F.R. §§ 416.913(a) (2015), 416.927(c)(2) (2015);
see also Genier v. Astrue, 298 Fed. App’x 105, 108 (2d Cir. 2008) (summary order).
The Second Circuit has observed that the “plain text” of section 416.913(b)(6)
“does not appear to be conditional or hortatory: it states that the Commissioner ‘will
request a medical source statement’ containing an opinion regarding the claimant’s
residual capacity. The regulation thus seems to impose on the ALJ a duty to solicit
such medical opinions.” Tankisi, 521 Fed. App’x at 33 (emphasis in original) (quoting
former 20 C.F.R. § 416.913(b)(6)) (additional citation omitted). Although “remand is not
always required when an ALJ fails in his duty to request [medical source] opinions [from
treating sources], particularly where . . . the record contains sufficient evidence from
which an ALJ can assess the [claimant’s] residual functional capacity,” remand is

that is, before the date the changes became effective—her claim is governed by the
prior regulation. See id. at 5844-46.
3

Indeed, an ALJ may not give a treating source’s opinion anything less than
controlling weight unless she first “explicitly consider[s], inter alia: (1) the frequency,
length, nature, and extent of treatment; (2) the amount of medical evidence supporting
the opinion; (3) the consistency of the opinion with the remaining medical evidence;
and[ ] (4) whether the physician is a specialist.” Greek v. Colvin, 802 F.3d 370, 375 (2d
Cir. 2015) (quotations and alterations omitted). “An ALJ’s failure to ‘explicitly’ apply
[these] factors [before] assigning [less-than-controlling] weight” to a treating source
opinion “is a procedural error.” Estrella v. Berryhill, 925 F.3d 90, 96 (2d Cir. 2019)
(quoting Selian v. Astrue, 708 F.3d 409, 418 (2d Cir. 2013) (per curiam)).
11

appropriate where the records are not otherwise complete. See Tankisi, 521 Fed. App’x
at 34. That is the case here.
In determining that Knox had the mental RFC to “occasionally interact with
supervisors, rarely (meaning less than occasionally but not never) with coworkers, and
never with the public,” Docket Item 8 at 18, the ALJ accorded “partial weight” to the
opinion of the consulting psychologist, Dr. Fabiano, that Knox had mild to moderate
limitations in maintaining attention and concentration, relating adequately with others,
and appropriately dealing with stress. Id. at 419. But the ALJ did not rely upon the
opinion of Dr. Samant, Knox’s treating psychiatrist. See id. at 17-22 (citing specific
clinical data points reported by Dr. Samant but never citing any opinion evidence). She
only once cites an opinion offered by Ms. McPhaden, Knox’s treating psychotherapist,
and then only to give “some weight” to Ms. McPhaden’s rating of Knox on the Global
Assessment of Functioning scale. See id. at 22 (citing id. at 374, 451, 552). In that
regard, the ALJ asserted that although Ms. McPhaden’s rating “indicat[ed] that [Knox’s]
mental conditions cause[d] moderate symptoms and impairment in functioning,” it
“lacked longitudinal probative value” because it was only “a snapshot of functioning at
the time of the examination.” Id. at 22.
The ALJ’s mental RFC determination was erroneous in a number of respects.
First, the ALJ’s analysis violated the Commissioner’s own regulations, which “impose on
the ALJ a duty to solicit” a medical source statement from a claimant’s treating
physician. See Tankisi, 521 Fed. App'x at 33 (citing former 20 C.F.R. § 416.913(b)(6)).
The ALJ thus should have requested a medical source statement from Dr. Samant and,

12

possibly, Ms. McPhaden 4. And because the ALJ’s determination that Knox could
“occasionally interact with supervisors, rarely (meaning less than occasionally but not
never) with coworkers, and never with the public,” Docket Item 8 at 18, likely constituted
an implicit rejection of Ms. McPhaden’s opinion that Knox was severely limited in the
areas of “initiating relationships,” “assertiveness,” and forming friendships, see, e.g., id.
at 312, this Court finds no assurance that the ALJ’s error was harmless.
What is more, it was illogical for the ALJ to discount Ms. McPhaden’s opinion as
a “snapshot” while also finding the opinions of Dr. Fabiano, who examined Knox only
once, and C. Butensky, who never examined her, at least somewhat probative of Knox’s
mental functioning. That is particularly so here given that Ms. McPhaden’s “snapshot”
was consistent over the course of three years 5 and corroborated by Dr. Samant 6.
Indeed, the Second Circuit has “cautioned that ALJs should not rely heavily on the
findings of consultative physicians after a single examination,” a “concern [that] is even

4

Although therapists are “other source[s],” see 20 C.F.R. § 416.913(d)(1) (2015),
whose opinions cannot not “establish the existence of a medically determinable
impairment,” an opinion from such a source “may outweigh the opinion of an
‘acceptable medical source[ ]’ . . . [if, f]or example, . . . [the source] has seen the
individual more often . . . and has provided better supporting evidence and a better
explanation for his or her opinion,” see Titles II and XVI: Considering Opinions and
Other Evidence from Sources Who Are Not “Acceptable Medical Sources” in Disability
Claims, 71 Fed. Reg. 45,593, 45,596 (Aug. 9, 2006). Because Ms. McPhaden treated
Knox weekly-to-biweekly for nearly two years, an ALJ could reasonably find that her
opinion deserves significant weight.
5

See id. at 302, 325, 328, 341, 359, 361, 367, 374, 377, 380, 452-508, 518, 522,
526, 531, 536, 548, 552, 555, 566, 571, 575, 580, 589, 593, 599, 604, 608, 609, 614,
617, 620, 623, 627, 634, 638, 642, (Ms. McPhaden rating Knox’s GAF at 57 after every
psychotherapy session from February 2014 to January 2016 but providing no GAF
beginning in April 2016).
6

See id. at 336, 366, 452-508, 513, 543, 562, 586, 631 (Dr. Samant rating
Knox’s GAF at 57 after every evaluation from April 2014 through February 2016 but
providing no GAF beginning in April 2016).
13

more pronounced in the context of mental illness where . . . a one-time snapshot of a
claimant’s status may not be indicative of her longitudinal mental health.” Estrella v.
Berryhill, 925 F.3d 90, 98 (2d Cir. 2019) (first quoting Selian v. Astrue, 708 F.3d 409,
419 (2d Cir. 2013) (per curiam)); see also id. at 97 (explaining that because “[c]ycles of
improvement and debilitating symptoms [of mental illness] are a common occurrence,
. . . it is error for an ALJ to pick out a few isolated instances of improvement over a
period of months or years and to treat them as a basis for concluding a claimant is [not
disabled]” (second alteration in original) (quoting Garrison v. Colvin, 759 F.3d 995, 1017
(9th Cir. 2014)).
In short, because there was an “obvious gap[ ] in the administrative record” as it
related to Knox’s mental functioning, the ALJ was obligated make a reasonable effort to
fill that gap before rejecting Knox’s application for disability benefits—specifically, by
requesting a medical source statement from Knox’s treating psychiatrist. See Rosa,
168 F.3d at 79 n.5 (quoting Perez, 77 F.3d at 48)). Because she did not do so, the
Court remands the matter so that the ALJ may develop the record and then re-evaluate
Knox’s application in light of the expanded record.
In light of this result, the Court will not reach the remaining arguments raised by
Knox. See Watkins v. Barnhart, 350 F.3d 1297, 1299 (10th Cir. 2003) (“We will not
reach the remaining issues raised by [the claimant] because they may be affected by
the ALJ’s treatment of this case on remand.”); see also Bonet ex rel. T.B. v. Colvin, No.
1:13-CV-924, 2015 WL 729707, at *7 (N.D.N.Y. Feb. 18, 2015) (“Given the need to
apply the proper legal standard, the Court will decline at this time to consider whether
substantial evidence exists to support the findings the ALJ made.”). But on remand, the

14

ALJ should consider both Knox’s limitations in the specific functional domains as well as
the impact of Knox’s response to stress on her ability to work. See Stadler v. Barnhart,
464 F.Supp.2d 183, 189 (W.D.N.Y. 2006) (citing SSR 85-15, 1985 WL 56857 (Jan. 1,
1985); Welch v. Chater, 923 F. Supp. 17, 21 (W.D.N.Y. 1996)) (“Because stress is
‘highly individualized,’” the ALJ must “make specific findings about the nature of [the
claimant’s] stress, the circumstances that trigger it, and how those factors affect [her]
ability to work.”). She also should ensure that any specific RFC limitations, such as the
amount of time that Knox can interact with supervisors, coworkers, and the public, are
based on specific medical evidence in the record, not her “own surmise.” See Cosnyka
v. Colvin, 576 Fed. App’x 43, 46 (2d Cir. 2014) (summary order).

15

CONCLUSION
For the reasons stated above, the Commissioner's motion for judgment on the
pleadings, Docket Item 23, is DENIED, and Knox’s motion for judgment on the
pleadings, Docket Item 16, is GRANTED in part and DENIED in part. The decision of
the Commissioner is VACATED, and the matter is REMANDED for further
administrative proceedings consistent with this decision.

SO ORDERED.
Dated:

December 9, 2019
Buffalo, New York

/s/ Lawrence J. Vilardo
LAWRENCE J. VILARDO
UNITED STATES DISTRICT JUDGE

16