Chapman v. Colvin

Filing 14

ORDER granting 9 Motion for Judgment on the Pleadings; denying 11 Motion for Judgment on the Pleadings. This matter is remanded to the Commissioner for further proceedings in accordance with this decision. Signed by Hon. Frank P. Geraci, Jr. on 1/27/2017. SO ORDERED. (SC) -CLERK TO FOLLOW UP-

UNITED STATES DISTRICT COURT
WESTERN DISTRICT OF NEW YORK
ANGELA CHAPMAN,
Plaintiff,
Case # 15-CV-6523-FPG
v.
DECISION AND ORDER
CAROLYN W. COLVIN, ACTING COMMISSIONER
OF SOCIAL SECURITY,
Defendant.

Plaintiff Angela Chapman (“Chapman”) brought this action under Title XVI of the Social
Security Act (“the Act”). 1

ECF No. 1.

Chapman has asked this Court to review the

Commissioner of Social Security’s (“the Commissioner”) decision denying her application for
Supplemental Security Income (“SSI”). This Court has jurisdiction 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. 9, 11.

For the reasons that follow, the

Commissioner’s motion is DENIED and Plaintiff’s motion is GRANTED.
BACKGROUND
On September 13, 2012, Chapman protectively applied for SSI with the Social Security
Administration (“the SSA”). Tr. 2 158-164, 173. In her application, Chapman alleged that she
became disabled on October 1, 2010. Tr. 158, 199. She alleged that her disability resulted from
fibromyalgia, thrombotic thrombocytopenic purpura, and depression.
administrative level, the SSA denied Chapman’s application.

1

Tr. 199. At the initial

Tr. 84-92.

Following that

On January 18, 2017, the Social Security Administration published a final rule announcing revisions to the
Act that affect the provisions which govern the Court’s decision in this case. 20 C.F.R. §§ 404, 416 (2017).
However, those revisions do not affect decisions on applications filed before March 27, 2017. Id.
2
References to “Tr.” are to the administrative record in this matter.

1

decision, Administrative Law Judge John P. Ramos (“the ALJ”) considered Chapman’s
application de novo. Tr. 37-51. On April 2, 2014, the ALJ held a hearing (Tr. 56-83), and on
June 20, 2014, he found that Chapman was not disabled within the meaning of the Act. Tr. 4051. That finding became the Commissioner’s final decision when the Appeals Council denied
Chapman’s request for review. Tr. 1-4. On September 2, 2015, Chapman initiated this action.
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). A decision by the Commissioner is “conclusive”
under the Act 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).
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 20 C.F.R. § 416.920. First, the ALJ must determine
whether the claimant is engaged in substantial gainful work activity.

See 20 C.F.R. §

416.920(a)(4)(i). If so, the claimant is not disabled. Id. If not, the ALJ proceeds to the second

2

step 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. § 416.920(a)(4)(ii). If the
claimant does not have a severe impairment or combination of impairments, the analysis
concludes with a finding of “not disabled.” Id. If the claimant does, the ALJ continues to the
third step.
At step three, the ALJ examines whether a claimant’s impairment meets or medically
equals the criteria of a listed impairment in 20 C.F.R. Part 404, Subpart P, Appendix 1 of the
regulations (“the Listings”). If the impairment meets or medically equals the criteria of a Listing
and meets the durational requirement (20 C.F.R. § 416.909), 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. § 416.945(a)(1). The ALJ then proceeds to the fourth
step 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. § 416.920(a)(4)(iv). If the claimant can perform such
requirements, then he or she is not disabled. Id.
If the claimant cannot perform the requirements of his or her past work, the ALJ proceeds
to the fifth and final step. There the burden shifts to the Commissioner to show that the claimant
is not disabled. Bush v. Shalala, 94 F.3d 40, 44-45 (2d Cir. 1996). To do so, the Commissioner
must present evidence to demonstrate that the claimant “retains a residual functional capacity to
perform alternative substantial gainful work” in light of his or her age, education, and work
experience. See Rosa v. Callahan, 168 F.3d 72, 77 (2d Cir. 1999) (internal quotation marks
omitted); see also 20 C.F.R. § 416.960(c)(1). To find that the claimant is not disabled, the ALJ

3

must be satisfied that a significant number of jobs which the claimant can perform exist in the
national economy. 20 C.F.R. § 416.960(c)(2).
DISCUSSION
I.

The ALJ’s Decision
The ALJ’s decision analyzed Chapman’s application for benefits under the process

described above. Tr. 40-51. At step one, the ALJ found that Chapman had not engaged in
substantially gainful activity since September 13, 2012. Tr. 42. At step two, the ALJ found that
Chapman suffers from four severe impairments: fibromyalgia, degenerative disc disease of the
lumbar spine, depressive disorder, and anxiety disorder. Tr. 42-44.
At step three, the ALJ found that none of Chapman’s impairments, alone or combined,
meet or medically equal any impairment in the Listings. Tr. 44-46. For that reason, the ALJ
proceeded to determine Chapman’s RFC. Tr. 46. In doing so, the ALJ considered Chapman’s
testimony about her impairments, the objective medical evidence, and the opinions of five
doctors. Tr. 46-49. Before crediting the doctors’ opinions, the ALJ assessed what weight to give
them. Tr. 48-49. He gave the opinions of Justine Magurno, M.D., a consulting physician, and
Sara Long, Ph.D., a consulting psychologist, who each examined Chapman once, “significant
weight.” Tr. 48. Likewise, he gave the opinions of V. Reddy, Ph.D., a state agency psychologist
who examined Chapman’s medical records, “significant weight.” Tr. 48. Conversely, he gave
the opinions of Nadanaguru Akila, M.D., Chapman’s treating physician, and Satyavathy

4

Sarakanti, M.D., Chapman’s treating psychiatrist, “minimal weight.” 3 Tr. 49.

With that in

mind, the ALJ concluded that Chapman has the RFC to perform sedentary work. 4 Tr. 46.
At step four, the ALJ found that Chapman has no past relevant work experience. Tr. 49.
For that reason, he moved directly to the final step. Tr. 49. At step five, the ALJ considered
Chapman’s age, education, work experience, and RFC and concluded that jobs Chapman can
perform exist in significant numbers in the national economy. Tr. 50-51. On that basis, the ALJ
concluded that Chapman is not disabled under the Act. Tr. 51.
II.

Analysis
Chapman argues that the ALJ erred by failing to give proper weight to the opinion of her

treating psychiatrist. 5 ECF No. 9, at 12-24. Specifically, Chapman claims that the ALJ violated
the treating physician rule when he assigned “minimal weight” to Dr. Sarakanti’s opinion in
determining her RFC. Id. at 13. The Commissioner responds that the ALJ did not violate the
treating physician rule because, though he did give minimal weight to Dr. Sarakanti’s opinion, he
gave “good reasons” for doing so. ECF No. 11, at 12-14.
The treating physician rule is “a series of regulations set forth by the Commissioner . . .
detailing the weight to be accorded a treating physician’s opinion.” De Roman v. Barnhart, No.
03-CV-0075, 2003 WL 21511160, at *9 (S.D.N.Y. July 2, 2003). Under the treating physician
rule, the ALJ must give controlling weight to a treating physician’s opinion regarding the “nature

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The ALJ did stray from these general weight assignments at times. For instance, he gave Dr. Magurno’s
opinion that Chapman should wholly avoid environmental irritants like dust and fumes “reduced weight.” Tr. 48.
He also gave Dr. Akila’s opinions regarding Chapman’s postural and environmental limitations “reduced weight”
instead of “minimal weight.” Tr. 49.
4
“Sedentary work involves lifting no more than 10 pounds at a time and occasionally lifting or carrying
articles like docket files, ledgers, and small tools. Although a sedentary job is defined as one which involves sitting,
a certain amount of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking
and standing are required occasionally and other sedentary criteria are met.” 20 C.F.R. § 416.967(a).
5
Chapman challenges the ALJ’s decision on other grounds, but this Court declines to reach those claims.
Chapman’s argument that the ALJ failed to give proper weight to the opinion of her treating physician is sufficient
to dispose of this matter.

5

and severity” of the claimant’s impairments when that opinion is “well-supported by medically
acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other
substantial evidence in [the] record.” 20 C.F.R. § 416.927(c)(2). The rule affords deference to
treating physicians because they are “most able to provide a detailed, longitudinal picture of [the
claimant’s] medical impairment(s)” and bring “a unique perspective to the medical evidence that
cannot be obtained from the objective medical findings alone or from reports of individual
examinations.” Id.
Consistent with that principle, “[t]he regulations provide progressively more rigorous
tests for weighing opinions as the ties between the source of the opinion and the individual
become weaker.”

SSR 96-6P, 1996 WL 374180 (July 2, 1996), cited with approval in

Richardson v. Astrue, No. 09-CV-1941, 2009 WL 4793994, *7 (S.D.N.Y. Dec. 14, 2009). To
that end, “[t]he opinions of physicians or psychologists who do not have a treatment relationship
with the [claimant] are weighed by stricter standards, based to a greater degree on medical
evidence, qualifications, and explanations for the opinions, than are required of treating sources.”
Id. That principle applies with even greater force where, as here, the claimant suffers from
mental impairments: “[b]ecause mental disabilities are difficult to diagnose without subjective,
in-person examination, the treating physician rule is particularly important in the context of
mental health.” See Canales v. Comm’r of Soc. Sec., 698 F. Supp. 2d 335, 342 (E.D.N.Y. 2010).
That is not to say an ALJ may never discount the opinion of a treating physician. See
20 C.F.R. § 416.927(c) (“Regardless of its source, we will evaluate every medical opinion we
receive.”). As noted above, a treating physician’s opinion is only entitled to controlling weight if
it is (1) “well-supported by medically acceptable clinical and laboratory diagnostic techniques”
and (2) “not inconsistent with the other substantial evidence in [the] record.” 20 C.F.R. §

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416.927(c)(2). But even if an ALJ finds a treating physician’s opinion does not satisfy both
deference-triggering requirements, he or she may not summarily dismiss it. See id. The Act
identifies factors that the ALJ must consider in determining how much weight to give such an
opinion. Id. Those factors include the length, nature and extent of the treatment relationship, the
frequency of examination, the evidence in support of the treating physician's opinion, the
consistency of the opinion with the record as a whole, and whether the opinion is from a
specialist. 20 C.F.R. §§ 416.927(c)(2)(i)-(ii), (c)(3)-(6). Further, in addressing those factors, the
ALJ must “comprehensively set forth [his or her] reasons for the weight assigned.” Halloran v.
Barnhart, 362 F.3d 28, 33 (2d Cir. 2004); see also 20 C.F.R. § 416.927(c)(2) (“We will always
give good reasons in our notice of determination or decision for the weight we give [the
claimant's] treating source's opinion.”). Regardless of the weight assigned to the physicians’
opinions, the ALJ must not substitute his or her “own assessment of the relative merits of the
objective evidence and subjective complaints for that of a treating physician.”

Garcia v.

Barnhart, No. 07-CV-534, 2003 WL 68040, at *7 (S.D.N.Y. Jan. 7, 2003).
Here, the ALJ gave “minimal weight” to Dr. Sarakanti’s opinions regarding Chapman’s
mental impairments.

Tr. 49.

Dr. Sarakanti has treated Chapman for mental health and

psychiatric impairments at least twice per month since May 2013, and in the course of those
treatments she diagnosed Chapman with panic disorder with agoraphobia and depressive
disorder. Tr. 299-300. On December 13, 2013, Dr. Sarakanti completed a Mental Residual
Functional Capacity Questionnaire. Tr. 298-303. There, Dr. Sarakanti noted that Chapman
“demonstrates severe anxiety symptoms and panic attacks in public,” “also demonstrates
obsessive compulsive behaviors which impact her daily functioning and cause interruptions and
delays in her completing and following through with tasks,” and “would likely demonstrate

7

severe decompensation if she [had] to be in a public setting for any length of time.” Tr. 303. Dr.
Sarakanti also indicated that Chapman has little or no ability to maintain regular attendance,
complete a normal workday or week without interruptions from psychologically based
symptoms, or work appropriately with others.

Id.

Regarding Chapman’s prognosis, Dr.

Sarakanti stated that Chapman “has medical issues which interfere with her ability to take certain
psychotropic medications that would prove to be most beneficial for symptom management.”
Tr. 300. For that reason, Dr. Sarakanti characterized that Chapman’s prognosis as “poor to fair.”
Id.
Despite Dr. Sarakanti’s history with Chapman, the ALJ gave her opinion regarding
Chapman’s mental health impairments “minimal weight.” That decision compels remand for
two reasons. First, the ALJ’s decision fails to provide “good reasons” for giving Dr. Sarakanti’s
opinion less than controlling weight. Second, even if Dr. Sarakanti’s opinion was entitled to
something less than controlling weight, the ALJ’s decision fails to address several of the factors
that the Act requires an ALJ to address to determine what weight to give a treating physician’s
opinion.
1. The ALJ Did Not Provide “Good Reasons” for Giving Dr. Sarakanti’s Opinion
Less than Controlling Weight.
The ALJ gave Dr. Sarakanti’s opinion less than controlling weight because he found that
substantial evidence in the record contracted Dr. Sarakanti’s opinion. Tr. 49. In particular, the
ALJ found that the opinions of Drs. Akila and Long, Chapman’s Global Assessment of
Functioning (“GAF”) score, and a number of other details pulled from the record undermined Dr.
Sarakanti’s opinion. Tr. 49. The Court disagrees.

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a. Dr. Akila’s Opinion
Dr. Akila’s opinion is not a “good reason” to discredit Dr. Sarakanti’s opinion. As an
initial matter, the ALJ found that Dr. Akila’s opinion was entitled to only “minimal weight.” Tr.
49.

Specifically, the ALJ afforded Dr. Akila’s opinion regarding Chapman’s mental

impairments—the portion of his opinion corresponding to Dr. Sarakanti’s opinion—minimal
weight. Tr. 49. (“The undersigned gives minimal weight to primary care physician Dr. Akila’s
opinions regarding [Chapman’s] mental work-related functional limitations, because they are not
consistent with the overall evidence . . . .”). Without distinguishing the minimal weight assigned
to Dr. Akila’s opinion from the minimal weight assigned to Dr. Sarakanti’s, the ALJ then used
Dr. Akila’s opinion as a reason to discount Dr. Sarakanti’s opinion. Tr. 49.

That inconsistency

gives the Court pause. Cf. Salisbury v. Colvin, No. 13-CV-2805, 2015 WL 5458816, at *36
(S.D.N.Y. Sept. 21, 2015) (noting “a subtly insidious incongruit[y]” where an ALJ dismissed one
physician’s work-related assessment because that physician was not a vocational expert but
heavily relied on the work-related assessment of another physician who was also not a vocational
expert).
Even setting that aside, the ALJ’s premise—that Dr. Akila’s opinion is inconsistent with
Dr. Sarakanti’s—is incorrect.

Dr. Akila’s opinion is consistent with Dr. Sarakanti’s.

To

illustrate, Dr. Sarakanti found that Chapman’s mental impairments leave her with poor to no
ability to use public transportation. Tr. 299, 714. Similarly, Dr. Akila found that she unable to
use public transportation. Tr. 490. Dr. Sarakanti found that Chapman’s ability to interact
appropriately with the general public is “fair.”

Tr. 299.

Similarly, Dr. Akila found that

Chapman’s inability to interact appropriately with the public is “marked.”

Tr. 493.

Dr.

Sarakanti found that Chapman’s ability to understand and remember simple instructions is

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“good.” Tr. 301.

Similarly, Dr. Akila found that Chapman’s inability to understand and

remember simple instructions is “moderate.” Tr. 492.
To be sure, the two doctors completed different forms, which asked them different
questions, and relied on different scales.

Compare Tr. 492-94 (asking Dr. Akila to label

Chapman’s inability to perform a certain function as “none,” “mild,” “moderate,” “marked,” or
“extreme”), with Tr. 299-303 (asking Dr. Sarakanti to label Chapman’s ability to perform a
certain function as “unlimited or very good,” “good,” “fair,” or “poor to none”), and Tr. 714-17
(same). Necessarily, their responses are not identical. But that does not mean that they are
inconsistent.

If anything, the occasional difference between Dr. Sarakanti’s opinion of

Chapman’s mental impairments and Dr. Akila’s is one of minor degree and not substance.
Compare Tr. 493 (finding Chapman has a “moderate” inability to interact appropriately with coworkers), with Tr. 301 (finding Chapman has a “poor” ability to interact with co-workers). At
any rate, Dr. Akila himself did not consider his conclusions to be inconsistent with Dr.
Sarakanti’s: when asked to identify factors that support his assessment of Chapman’s mental
impairments, Dr. Akila cited Dr. Sarakanti’s opinion. Tr. 493.

Accordingly, Dr. Akila’s

opinion does not amount to substantial, inconsistent evidence.
b. Details from the Record
The few details that the ALJ pulled from the record to discredit Dr. Sarakanti’s opinion
do not amount to “good reasons.” For evidence contradicting Dr. Sarakanti’s opinion, the ALJ
pointed to Chapman’s “one friend and good family relationships,” her appropriate interactions
“with medical personnel during examinations,” that she once “attended her daughters’ church
play,” that she “keeps herself busy by caring for her three children at home” and tends “to do for
everyone at the expense of herself,” and that “she has been devoting more time to working on

10

crafts.” Tr. 49. The Commissioner characterizes this list as “a litany of factors that contradicted
Dr. Sarakanti’s pessimistic assessment of [Chapman’s] functional capabilities.” ECF No. 11, at
14. That “litany of factors” does not survive inspection.
The ALJ’s list of contradicting evidence is problematic because it highlights isolated
instances of Chapman’s ability to function in society while ignoring evidence that tends to
demonstrate Chapman’s impairments.

Trumpower v. Colvin, No. 13-CV-6661, 2015 WL

162991, at *17 (W.D.N.Y. Jan. 13, 2015) (“[An ALJ] cannot pick and choose evidence that
supports a particular conclusion.”). It is again problematic because in putting this list together,
the ALJ pulled facts from Dr. Sarakanti’s notes and simply came to his own contradictory
conclusion about them. Calzada v. Astrue, 753 F. Supp. 2d 250, 277 (S.D.N.Y. 2010) (“An ALJ
must not substitute his own assessment of the relative merits of the objective evidence . . . for
that of a treating physician.”). But even setting those issues aside, the ALJ’s list of contradicting
evidence is problematic because the details that the ALJ highlights do not actually contradict Dr.
Sarakanti’s opinion.
To begin, maintaining a single friendship and good family relationships does not
necessarily undercut Dr. Sarakanti’s opinion that Chapman has social limitations. See Rodriguez
v. Astrue, No. 07-CV-534, 2009 WL 637154, at *22 (S.D.N.Y. Mar. 9, 2009) (“[T]he ability to
get along with family and friends does not necessarily mean a person is not limited in social
functioning generally.”).

The same is true of Chapman’s ability to act appropriately with

medical personnel in medical settings: that Chapman can respond appropriately to doctors in
controlled, medical settings does not necessarily contradict Dr. Sarakanti’s conclusion that
Chapman’s ability to interact appropriately with the general public is between “fair,” Tr. 299,
and “poor.” Tr. 714. But cf. Lovell v. Colvin, 137 F. Supp. 3d 347, 352 (W.D.N.Y. 2015)

11

(finding the claimant’s ability to interact appropriately with medical personnel, among other
things, indicated that the claimant had “no more than moderate difficulties in social
functioning”).
Regarding Chapman’s attendance at her daughters’ church play, the fact that the ALJ
could find in the medical records only one instance of Chapman going out in public is more
telling than that single instance itself. In fact, the medical records frequently mention her
inability to leave her house. See, e.g., Tr. 634 (“[Chapman] struggles to get out of the house.”);
Tr. 639 (“She typically spends most of her time in the house, with the doors locked, and the
shades drawn . . . .”); Tr. 647 (“She is now sitting at home in the dark most days, secluding
herself to her room . . . .”); Tr. 645 (“She continues to isolate herself in the house.”). Finally,
that Chapman “keeps herself busy by caring for her three children at home” and that “she has
been devoting more time to working on crafts” has no logical connection to her social
functioning. For those reasons, the ALJ’s “litany of factors” does not amount to substantial
inconsistent evidence.
c. Chapman’s GAF Score
The ALJ identified Chapman’s GAF score as a point of conflict, but that too is
insufficient.

“A GAF score between fifty-one and sixty indicates moderate symptoms or

moderate difficulty in social, occupational or school functioning.” Laracuente v. Colvin, No. 15CV-9583, 2016 WL 4004680, at *11 n.2 (S.D.N.Y. July 26, 2016) (citing AM. PSYCHIATRIC
ASS’N, DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS 34 (4th ed. rev. 2000)).
Chapman’s GAF score is 56. Tr. 637. In contrast, Dr. Sarakanti describes significant social and
occupational impairments. See, e.g., Tr. 302 (“Angela demonstrates severe anxiety symptoms

12

and panic attacks in public.”).

Though Dr. Sarakanti’s opinion seems inconsistent with

Chapman’s GAF score, that inconsistency is not as important as it might seem.
In the context of SSI, GAF scores are of limited value. “[A]s a global reference intended
to aid in treatment, a GAF score does not . . . necessarily reveal a particular type of limitation
and is not an assessment of a claimant's ability to work.” Beck v. Colvin, No. 13–CV–6014,
2014 WL 1837611, at *10 (W.D.N.Y. May 8, 2014) (internal quotation marks omitted) (noting
that, “[t]o the extent the ALJ rejected [a treating physician’s opinion] as incompatible with [a]
GAF score,” the ALJ “failed to explain why a single GAF score, which is a generalized
assessment, superseded [the treating physician’s] more precise opinion”).

Moreover, the

literature regarding the GAF scale indicates a general lack of reliability. See I.H. Monrad Aas,
Global Assesment of Functioning (GAF): Properties and Frontier of Current Knowledge,
ANNALS

OF

GENERAL

PSYCHIATRY,

May

7,

2010,

http://annals-general-

psychiatry.biomedcentral.com/articles/10.1186/1744-859X-9-20 (reviewing relevant literature
and concluding that it indicated insufficient reliability in clinical settings as well as a lack of
precision). Indeed, the Psychiatric Association removed the GAF scale from the Fifth Edition of
the Diagnostic and Statistical Manual of Mental Disorders.

See AM. PSYCHIATRIC ASS’N,

DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS 16 (5th ed. rev. 2013). But even
if Chapman’s GAF score was a reliable assessment of her ability to work, “[t]he ALJ . . . is not
permitted to ‘rely on any test score alone.’ ” Walterich v. Astrue, 578 F. Supp. 2d 482, 513
(W.D.N.Y. 2008) (quoting 20 C.F.R. § 416.926a(e)(4)(i)). On that basis, Chapman’s GAF score
does not amount to substantial evidence inconsistent with Dr. Sarakanti’s opinion.

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d. Dr. Long’s Opinion
Finally, Dr. Long’s opinion alone cannot discredit Dr. Sarakanti’s. In contrast to his view
of Dr. Sarakanti’s opinion, the ALJ gave Dr. Long’s opinion—rendered in 2012, prior to the
commencement of Chapman’s mental health treatment—significant weight. Tr. 48. He did so
because of Dr. Long’s “programmatic expertise and the relative consistency of [her] opinions
with the medical evidence.” Tr. 48. He then gave Dr. Sarakanti’s opinion minimal weight, at
least in part, because it conflicts with Dr. Long’s. Tr. 49. That distribution of authority “turns
the treating-physician rule on its head.” Rodriguez, 2009 WL 637154, at *25.
The treating physician rule, at its most fundamental level, tips the scales in favor of a
treating physician’s opinion. See id. (“The regulations and case law rest on the premise that a
doctor who personally treats a claimant, and in particular a doctor who has a long-term treating
relationship with the claimant, is likely to have a better understanding of her condition than a
doctor who only examines her on one occasion.”). Though the treating physician rule can be
overcome, “[n]ot all expert opinions rise to the level of evidence that is sufficiently substantial to
undermine the opinion of the treating physician.” Burgess v. Astrue, 537 F.3d 117, 128 (2d Cir.
2008). Particularly in the context of mental health, the opinion of a treating physician deserves
more respect than that of a consulting physician. See Rodriguez, 2009 WL 637154, at *26 (“The
mandate of the treating-physician rule to give greater weight to the opinions of doctors who have
a relationship with a plaintiff is particularly important in the mental-health context.”); see also
Westphal v. Eastman Kodak Co., No. 05-CV-1720380, 2006 WL 1720380, at *4–5 (W.D.N.Y.
June 21, 2006) (“Because of the inherent subjectivity of a psychiatric diagnosis, and because a
proper diagnosis requires a personal evaluation of the patient's credibility and affect, it is the

14

preferred practice that a psychiatric diagnosis be made based upon a personal interview with the
patient.”).
Chapman has seen Dr. Sarakanti twice a month since May 2013. Tr. 300. Dr. Long
examined Chapman once. Tr. 278-81. The treating physician rule mandates that Dr. Sarakanti’s
relationship with Chapman takes precedence over Dr. Long’s “programmatic expertise.” See
Rodriguez, 2009 WL 637154, at *26 (finding that the spirit of the treating physician rule requires
an ALJ to give more weight to an examining physician’s opinion than to the opinion of a nonexamining physician, even where the non-examining physician has programmatic expertise).
With that in mind, Dr. Long’s opinion, without more, cannot establish sufficient evidence to
overcome the treating physician rule.
2. The ALJ Failed to Adequately Address the Factors for Determining What
Weight to Give a Treating Physician’s Opinion.
Even if the ALJ provided “good reasons” for giving Dr. Sarakanti’s opinion less than
controlling weight, remand is still required because he failed to address all of the factors that the
Act requires an ALJ to consider when deciding what weight to give a treating physician’s
opinion. When an ALJ finds a treating physician’s opinion is not entitled to controlling weight,
the Act requires the ALJ to consider several factors. See 20 C.F.R. § 416.927(c)(2); see also
Richardson, 2009 WL 4793994, at *9.

Those factors include the length of time that the

physician has been treating the claimant, the nature and extent of the physician’s relationship
with the claimant, the amount of evidence the physician presents in support of his or her opinion,
whether the physician is a specialist, and the consistency of the physician’s opinion with other
medical evidence in the record. 20 C.F.R. §§ 416.927(c)(2)(i)-(ii), (c)(3)-(6). An ALJ must not
only consider those factors in the course of his or her decision-making process, the ALJ must
also demonstrate that consideration in his or her written decision by “comprehensively set[ting]
15

forth [his or her] reasons for the weight assigned.” Halloran, 362 F.3d at 33. Failure to address
all of the factors compels remand. Schaal, 134 F.3d at 504.
Here, the ALJ addressed only two of the five factors. As discussed above, the ALJ
considered the consistency of Dr. Sarakanti’s opinion with the other medical evidence and
opinions in the record. Tr. 49. The ALJ also noted that Chapman did not receive “specialized
mental health treatment until May 2013.” Tr. 49. But the ALJ did not address the nature and
extent of Chapman’s relationship with Dr. Sarakanti.

He also failed to mention that Dr.

Sarakanti is a specialist in psychiatry. Lastly, he did not discuss any of the evidence that Dr.
Sarakanti presented to support her opinion. For these reasons, remand is required. Schaal, 134
F.3d at 504.
CONCLUSION
The Commissioner’s Motion for Judgment on the Pleadings (ECF No. 11) is DENIED
and Plaintiff’s Motion for Judgment on the Pleadings (ECF No. 9) is GRANTED. This matter is
REMANDED to the Commissioner for further proceedings in accordance with this decision.

IT IS SO ORDERED.
Dated: January 27, 2017
Rochester, New York
______________________________________
HON. FRANK P. GERACI, JR.
Chief Judge
United States District Court

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