Martinez v. Colvin
Filing
22
DECISION AND ORDER: Plaintiff's Motion for Judgment on the Pleadings, ECF No. 15 , is GRANTED, the Commissioner's Motion for Judgment on the Pleadings, ECF No. 17 , is DENIED, and this matter is REMANDED to the Commissioner for further ad ministrative 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). Because Plaintiff filed his application over five years ago, the Court directs the Commissioner to expedite its review of this matter. The Clerk of Court will enter judgment and close this case. SO ORDERED. Signed by Hon. Frank P. Geraci, Jr. on 9/28/18. (JO)-CLERK TO FOLLOW UP-
UNITED STATES DISTRICT COURT
WESTERN DISTRICT OF NEW YORK
MIGUEL A. MARTINEZ,
Plaintiff,
Case # 17-CV-6036-FPG
v.
DECISION AND ORDER
COMMISSIONER OF SOCIAL SECURITY,
Defendant.
Miguel A. Martinez brings this action pursuant to the Social Security Act seeking review
of the final decision of the Acting Commissioner of Social Security that denied his application for
Disability Insurance Benefits (“DIB”) under Title II of the Act. ECF No. 1. The Court has
jurisdiction over this action under 42 U.S.C. § 405(g).
Both parties moved for judgment on the pleadings pursuant to Federal Rule of Civil
Procedure 12(c). ECF Nos. 15, 17. For the reasons that follow, 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 August 12, 2013, Martinez protectively applied for DIB with the Social Security
Administration (“SSA”). Tr. 1 162-65. He alleged disability since October 31, 2009, due to a back
injury, an inability to concentrate, and depression. Tr. 27. On June 8, 2015, Martinez and a
vocational expert (“VE) appeared and testified via videoconference at a hearing before
Administrative Law Judge Roxanne Fuller (“the ALJ”). Tr. 45-75. On September 25, 2015, the
ALJ issued a decision finding that Martinez was disabled within the meaning of the Act from
1
“Tr.” refers to the administrative record in this matter.
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December 29, 2009 through May 12, 2014, but that his disability ended on May 13, 2014. Tr. 1644. On November 16, 2016, the Appeals Council denied Martinez’s request for review. Tr. 1-7.
Thereafter, Martinez 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) (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)
(quotation marks omitted). It is not the Court’s function to “determine de novo whether [the
claimant] is disabled.” Schaal v. Apfel, 134 F.3d 496, 501 (2d Cir. 1998) (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).
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 Parker 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
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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. Id. 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. 20 C.F.R. § 404.1520(g). To do so, the
Commissioner must present evidence to demonstrate 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).
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DISCUSSION
I.
The ALJ’s Decision
The ALJ’s decision analyzed Martinez’s claim for benefits under the process described
above. At step one, the ALJ found that Martinez had not engaged in substantial gainful activity
since December 29, 2009. Tr. 24. At step two, the ALJ found that from December 29, 2009,
through May 12, 2014, Martinez had degenerative disc disease, which constituted a severe
impairment. Tr. 24-26. At step three, the ALJ found that this impairment did not meet or medically
equal a Listings impairment. Tr. 26.
Next, the ALJ determined that from December 29, 2009 through May 12, 2014, Martinez
retained the RFC to perform sedentary work 2 with additional limitations. Tr. 26-37. Specifically,
the ALJ found that Martinez could occasionally climb ramps and stairs but could not climb ladders,
ropes, or scaffolds; could occasionally balance, stoop, crouch, kneel, and crawl; could frequently
reach with his left non-dominant arm; could frequently handle and finger objects with both hands;
could sit for one hour with one to five minutes of standing or walking between periods of sitting;
and would be off-task 20% of the workday. Tr. 26.
At steps four and five, the ALJ determined that from December 29, 2009 through May 12,
2014, Martinez could not perform his past relevant work or adjust to other work that existed in
significant numbers in the national economy given his RFC, age, education, and work experience.
Tr. 33-34. Accordingly, the ALJ concluded that Martinez was disabled under the Act from
December 29, 2009 through May 12, 2014. Tr. 34.
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“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. § 404.1567(a).
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The ALJ then conducted the analysis required to determine whether Martinez’s impairment
improved medically. Tr. 34-35; see also 20 C.F.R. § 404.1594(b). The ALJ found that medical
improvement occurred as of May 13, 2014, which is related to Martinez’s ability to work because
it increased his RFC. Tr. 35. The ALJ then went through the disability analysis again and found
that as of May 13, 2014, Martinez had degenerative disc disease and carpal tunnel syndrome, which
constitute severe impairments.
Id.
The ALJ found that these impairments, alone or in
combination, do not meet or medically equal a Listings impairment. Id.
Specifically, as of May 13, 2014, the ALJ determined that Martinez can perform sedentary
work with additional limitations. Tr. 35-38. The ALJ found that Martinez can occasionally climb
ramps and stairs but cannot climb ladders, ropes, or scaffolds; can occasionally balance, stoop,
crouch, kneel, and crawl; can frequently reach with his left non-dominant arm; can frequently
handle and finger objects with both hands; and can sit for one hour with one to five minutes of
standing or walking between periods of sitting. Tr. 35.
At step four, the ALJ again found that Martinez cannot perform his past relevant work. Tr.
38. At step five, however, the ALJ found that Martinez can adjust to other work that exists in
significant numbers in the national economy given his RFC, age, education, and work experience.
Tr. 39-40. Specifically, the VE testified that Martinez could work as a surveillance system
monitor, food and beverage order clerk, and lens inserter. Tr. 39. Accordingly, the ALJ concluded
that Martinez’s disability ended on May 13, 2014. Tr. 40.
II.
Analysis
Martinez argues that remand is required because the ALJ improperly concluded that there
was a medical improvement in his impairment. 3 ECF No. 15-1 at 16-22. The Court agrees.
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Martinez makes another argument in support of his motion. See ECF No. 15-1 at 16-22. The Court does not consider
that argument because the ALJ committed a legal error that requires remand.
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Once the Commissioner determines that a claimant’s impairment renders him disabled, the
“claimant is entitled to a presumption that the classification will not change unless the condition,
governing statutes, or regulations change.” Nascimento v. Colvin, 90 F. Supp. 3d 47, 53 (E.D.N.Y.
2015) (quoting Carbone v. Astrue, No. 08-CV-2376, 2010 WL 3398960, at *12 (E.D.N.Y. Aug.
26, 2010)). Consequently, if the Commissioner concludes that a claimant is disabled for a closed
period, that conclusion “must be demonstrated by substantial evidence of medical improvement in
the claimant’s impairment or combination of impairments such that the claimant is now able to
engage in substantial gainful activity.” Id. (citing Veino v. Barnhart, 312 F.3d 578, 586 (2d Cir.
2002)); see also 20 C.F.R. § 404.1594(a) (“We must determine if there has been any medical
improvement in your impairment(s) and, if so, whether this medical improvement is related to your
ability to work.”).
A “medical improvement” is “any decrease in the medical severity of [the claimant’s]
impairment(s) which was present at the time of the most recent favorable medical decision that
[the claimant was] disabled or continued to be disabled.” 20 C.F.R. § 404.1594(b)(1). An ALJ’s
conclusion that that there has been a medical improvement, or a decrease in the medical severity
of an impairment, “must be based on improvement in the symptoms, signs, and/or laboratory
findings associated with [the claimant’s] impairment(s).” Id. In other words, the ALJ must
compare the current medical severity of a claimant’s impairment to the medical severity of that
same impairment at the time of the most recent favorable medical decision. Veino, 312 F.3d at
586-87 (citing 20 C.F.R. § 404.1594(b)(7)). The “most recent favorable medical decision” is the
“latest[, final] decision involving a consideration of the medical evidence and the issue of whether
[the claimant was] disabled or continued to be disabled[.]” 20 C.F.R. § 404.1594(b)(7).
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Here, the ALJ determined that Martinez’s impairment—degenerative disc disease—
medically improved such that his disability ended as of May 13, 2014. Tr. 35. The Court finds it
instructive to show the ALJ’s reasoning in support of this decision in its entirety:
The claimant’s record indicates that he started consistent[ly] doing aqua therapy for
his back pain symptoms in March of 2014. A record from Rochester Brain and
Spine, dated May 13, 2014, shows that aqua therapy had decreased his pain,
increased his range of motion, relieved his tightness, and improved his strength. He
still had occasional pain in his lower back that radiated to his lower extremities, but
his treatments were providing him with relief. The claimant reported that he
occasionally used his TENS unit[ 4] and applied heat for temporary relief. However,
he only used his back brace [] as needed, which suggests that his back pain had
become more intermittent and less severe. [Tr. 384-87]. Thus, I find that medical
improvement occurred as of this date.
Tr. 35.
There are two issues with the ALJ’s conclusion. First, as the regulations above state, the
ALJ must “compare the current medical severity of a claimant’s impairment to the medical
severity of that same impairment at the time of the most recent favorable medical decision.” 20
C.F.R. § 404.1594(b)(7). In the ALJ’s decision, she states only that Martinez’s pain “decreased”
and became “more intermittent” and “less severe,” his range of motion “increased,” tightness in
his back was “relieved,” and that his strength “improved.” Tr. 35. However, she fails to compare
the medical severity in May of 2014—the current medical severity—to the medical severity of
Martinez’s impairment at the time of his most recent favorable decision. In fact, the ALJ compares
the May 2014 record to nothing at all. Consequently, the Court cannot conduct a meaningful
review of her conclusion.
Second, even if the ALJ had done the required comparison, her decision is not supported
by substantial evidence. She bases her conclusion on one four-page record of an examination
4
“TENS, or transcutaneous electrical nerve stimulation, is a back pain treatment that uses low voltage electric current to
relieve pain.” Tyler Wheeler, MD, TENS for Back Pain, WebMD (Oct. 24, 2017), https://www.webmd.com/backpain/guide/tens-for-back-pain (last visited Sept. 28, 2018).
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conducted on one date. Granted, the record contains evidence of purported improvements in
symptoms, but there are no supporting signs or laboratory findings to bolster her conclusion. The
Court does not suggest that an ALJ is required to show improvement in all three categories; indeed,
§ 404.1594(b)(1) contains a disjunctive conjunction—“or”—in addition to “and,” suggesting that
the ALJ may conclude that there was a medical improvement based on one of three categories:
symptoms, signs, or laboratory findings. However, the Court is cannot conclude that improved
symptoms on one date constitutes substantial evidence.
The Court’s conclusion is further supported by the fact that the May 2014 record contains
findings that contradict the ALJ’s conclusion. Clifford J. Ameduri, M.D., who treated Martinez
since at least September 2012, see Tr. 29, also noted in the May 2014 record that Martinez had
“popping in the lower back;” that he complained of “stabbing, throbbing, and tingling pain” in the
lumbar region with “shooting pain as well as numbness and tingling pain radiating” into his toes;
Martinez’s pain was eight on a scale of one to ten; and he appeared to be “in moderate-severe
distress” and was “uncomfortable sitting.” Tr. 384-85.
The latter two findings are particularly significant. Later in her decision, the ALJ noted
that Martinez did not appear in distress at exams in January and March 2015, which “contrast[s]
greatly with earlier records, which show that he appeared to be in moderate[-]to[-]severe distress
during his medical appointments.” Tr. 36; see also Tr. 30 (Martinez appeared to be in “moderatesevere distress” in November 2013, when he was disabled); Tr. 31 (identical finding in December
2013). Martinez also appeared uncomfortable while sitting during the period in which the ALJ
found him disabled. Tr. 29 (September 2012); Tr. 30 (November 2013).
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In sum, the ALJ failed to follow the regulations in determining that Martinez’s impairment
had medically improved and, even if she had, her conclusion that Martinez’s impairment improved
medically is not supported by substantial evidence.
CONCLUSION
Plaintiff’s Motion for Judgment on the Pleadings, ECF No. 15, is GRANTED, the
Commissioner’s Motion for Judgment on the Pleadings, ECF No. 17, 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). Because Plaintiff filed his application over five years ago,
the Court directs the Commissioner to expedite its review of this matter. The Clerk of Court will
enter judgment and close this case.
IT IS SO ORDERED.
Dated: September 28, 2018
Rochester, New York
______________________________________
HON. FRANK P. GERACI, JR.
Chief Judge
United States District Court
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