Rice v. Commissioner of Social Security
Filing
17
DECISION AND ORDER - IT IS THEREFORE ORDERED THAT: 1. Plaintiff's Statement of Errors (Doc. [11) is GRANTED; 2. The Court REVERSES the Commissioner's non-disability determination; 3. No finding is made as to whether Plaintiff was under a di sability within the meaning of the Social Security Act; 4. This matter is REMANDED to the Social Security Administration under Sentence Four of 42 U.S.C. § 405(g) for further consideration consistent with this Decision and Order; and 5. This case is terminated on the Court's docket. Signed by Magistrate Judge Caroline H. Gentry on 9/2/2022. (srb)
Case: 3:20-cv-00192-CHG Doc #: 17 Filed: 08/02/22 Page: 1 of 11 PAGEID #: 2183
IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF OHIO
WESTERN DIVISION AT DAYTON
NICOLE R., 1
Plaintiff,
vs.
COMMISSIONER OF THE SOCIAL
SECURITY ADMINISTRATION,
Defendant.
: Case No. 3:20-cv-00192
:
: Magistrate Judge Caroline H. Gentry
: (by full consent of the parties)
:
:
:
:
:
DECISION AND ORDER
I.
INTRODUCTION
Plaintiff filed an application for Disability Insurance Benefits in April 2017.
Plaintiff’s claim was denied initially and upon reconsideration. After a hearing at
Plaintiff’s request, the Administrative Law Judge (ALJ) concluded that Plaintiff was not
eligible for benefits because she was not under a “disability” as defined in the Social
Security Act. The Appeals Council denied Plaintiff’s request for review. Plaintiff
subsequently filed this action.
Plaintiff seeks an order remanding this matter to the Commissioner for the award
of benefits or, in the alternative, for further proceedings. The Commissioner asks the
Court to affirm the non-disability decision. This matter is before the Court on Plaintiff’s
See S.D. Ohio General Order 22-01 (“The Committee on Court Administration and Case Management
of the Judicial Conference of the United States has recommended that due to significant privacy concerns
in social security cases federal courts should refer to claimants only by their first names and last
initials.”).
1
Case: 3:20-cv-00192-CHG Doc #: 17 Filed: 08/02/22 Page: 2 of 11 PAGEID #: 2184
Statement of Errors (Doc. 11), the Commissioner’s Memorandum in Opposition (Doc.
14), Plaintiff’s Reply (Doc. 15), and the administrative record (Doc. 8).
II.
BACKGROUND
Plaintiff asserts that she has been under a disability since February 19, 2016. She
met the insured status requirements for Title II disability benefits purposes through June
30, 2016. She was thirty-one years old on the alleged disability onset date and as of the
date last insured. Accordingly, Plaintiff was considered a “younger person” under Social
Security Regulations. See 20 C.F.R. § 404.1563(c). Plaintiff has a “high school education
and above.” See 20 C.F.R. § 404.1564(b)(4).
The evidence in the administrative record is summarized in the ALJ’s decision
(Doc. 8-2, PageID 41-59), Plaintiff’s Statement of Errors (Doc. 11), the Commissioner’s
Memorandum in Opposition (Doc. 14), and Plaintiff’s Reply (Doc. 15). Rather than
repeat these summaries, the Court will discuss the pertinent evidence in its analysis
below.
III.
STANDARD OF REVIEW
The Social Security Administration provides Disability Insurance Benefits to
individuals who are under a “disability,” among other eligibility requirements. Bowen v.
City of New York, 476 U.S. 467, 470 (1986); see 42 U.S.C. §§ 402, 423(a)(1), 1382(a).
The term “disability” means “the inability to do any substantial gainful activity by reason
of any medically determinable physical or mental impairment which . . . has lasted or can
be expected to last for a continuous period of not less than 12 months.” 20 C.F.R.
§ 404.1505(a).
2
Case: 3:20-cv-00192-CHG Doc #: 17 Filed: 08/02/22 Page: 3 of 11 PAGEID #: 2185
This Court’s review of an ALJ’s unfavorable decision is limited to two inquiries:
“whether the ALJ applied the correct legal standards and whether the findings of the ALJ
are supported by substantial evidence.” Blakley v. Comm’r of Soc. Sec., 581 F.3d 399,
406 (6th Cir. 2009); see 42 U.S.C. § 405(g) (“The findings of the Commissioner of Social
Security as to any fact, if supported by substantial evidence, shall be conclusive.”).
“Unless the ALJ has failed to apply the correct legal standards or has made findings of
fact unsupported by substantial evidence,” this Court must affirm the ALJ’s decision.
Emard v. Comm’r of Soc. Sec., 953 F.3d 844, 849 (6th Cir. 2020). Thus, the Court “may
not try the case de novo, nor resolve conflicts in evidence, nor decide questions of
credibility.” Id.
“Under the substantial-evidence standard, a court looks to an existing
administrative record and asks whether it contains ‘sufficien[t] evidence’ to support the
agency’s factual determinations.” Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019)
(citation omitted). This limited standard of review does not permit the Court to weigh the
evidence and decide whether the preponderance of the evidence supports a different
conclusion. Instead, the Court is confined to determining whether the ALJ’s decision is
supported by substantial evidence, which “means—and means only—‘such relevant
evidence as a reasonable mind might accept as adequate to support a conclusion.’” Id.
(citation omitted).
The other line of judicial inquiry—reviewing the correctness of the ALJ’s legal
criteria—may result in reversal even when the record contains substantial evidence
supporting the ALJ’s factual findings. Rabbers v. Comm’r of Soc. Sec., 582 F.3d 647, 651
3
Case: 3:20-cv-00192-CHG Doc #: 17 Filed: 08/02/22 Page: 4 of 11 PAGEID #: 2186
(6th Cir. 2009). “[E]ven if supported by substantial evidence, ‘a decision of the
Commissioner will not be upheld where the SSA fails to follow its own regulations and
where that error prejudices a claimant on the merits or deprives the claimant of a
substantial right.’” Id. (citations omitted). Such an error of law will require reversal even
if “the outcome on remand is unlikely to be different.” Cardew v. Comm’r of Soc. Sec.,
896 F.3d 742, 746 (6th Cir. 2018) (internal quotations and citations omitted).
IV.
THE ALJ’S DECISION
The ALJ was tasked with evaluating the evidence related to Plaintiff’s application
for benefits. In doing so, the ALJ considered each of the five sequential steps set forth in
the Social Security Regulations. See 20 C.F.R. § 404.1520. The ALJ made the following
findings of fact:
Step 1:
Plaintiff did not engage in substantial gainful activity from the
alleged onset date of February 19, 2016, to the date last insured of
June 30, 2016.
Step 2:
Through the date last insured, she had the severe impairments of
obesity, spinal disorder (degenerative disc disease), depressive
disorder, and anxiety disorder with elements of post-traumatic stress
disorder.
Step 3:
She did not have an impairment or combination of impairments that
met or equaled the severity of one in the Commissioner’s Listing of
Impairments, 20 C.F.R. Part 404, Subpart P, Appendix 1.
Step 4:
Her residual functional capacity (RFC), or the most she could do
despite her impairments, see Howard v. Comm’r of Soc. Sec., 276
F.3d 235, 239 (6th Cir. 2002), consisted of light work as defined in
20 C.F.R. § 404.1567(b), subject to the following limitations: “(1)
no more than occasional crouching, crawling, stooping, or kneeling;
(2) no more than occasional balancing; (3) no more than occasional
climbing of ramps or stairs; (4) no climbing of ladders, ropes, or
scaffolds; (5) no work around hazards such as unprotected heights or
4
Case: 3:20-cv-00192-CHG Doc #: 17 Filed: 08/02/22 Page: 5 of 11 PAGEID #: 2187
dangerous machinery; (6) limited to performing unskilled, simple,
repetitive tasks; (7) no more than occasional superficial contact with
co-workers and supervisors (with 'superficial' contact defined as
retaining the ability to receive simple instructions, ask simple
questions, and receive performance appraisals but lacking the ability
to engage in more complex social interactions such as persuading
other people or resolving interpersonal conflicts); (8) no public
contact; (9) no fast-paced production work or jobs involving strict
production quotas; (10) limited to performing jobs that involve very
little, if any, change in duties or work routine from one day to the
next.”
She was unable to perform any of her past relevant work.
Step 5:
Considering Plaintiff’s age, education, work experience, and residual
functional capacity, there were jobs that existed in significant
numbers in the national economy that she could perform.
(Doc. 8-2, PageID 45-59.) These findings led the ALJ to conclude that Plaintiff did not
meet the definition of disability prior to the date last insured and so was not entitled to
benefits. (Id. at PageID 59.)
V.
ANALYSIS
Plaintiff alleges that the ALJ reversibly erred “in evaluating the treating therapist
opinions and the medical record.” (Doc. 11, PageID 2141.) Specifically, Plaintiff
challenges the ALJ’s analysis of the opinions of therapist Paul Quatman, M.S., L.P.C and
chiropractor Gregory Booher, D.C. (Id. at PageID 2141-43.) Plaintiff also contends that
the ALJ failed to discuss two lumbar spine MRI reports. (Id. at PageID 2143-44.) Finding
error in the ALJ’s analysis of Dr. Booher’s opinion, the Court does not address Plaintiff’s
other alleged error and, instead, instructs the ALJ to address all of them on remand.
5
Case: 3:20-cv-00192-CHG Doc #: 17 Filed: 08/02/22 Page: 6 of 11 PAGEID #: 2188
A.
Applicable Law
Social Security regulations require ALJs to adhere to certain standards when
evaluating medical opinions. Because Plaintiff filed her claim in February 2019, the
Social Security Administration’s new regulations for evaluating medical opinion
evidence applied. These regulations define a “medical opinion” as a “statement from a
medical source about what [an individual] can still do despite [his or her] impairment(s)”
and whether the individual has one or more impairment-related limitations or restrictions.
20 C.F.R. § 404.1513(a)(2). Under these regulations, the ALJ “will not defer or give any
specific evidentiary weight, including controlling weight, to any medical opinion(s) or
prior administrative medical finding(s) . . . .” 20 C.F.R. § 404.1520c(a). Instead, the ALJ
must evaluate the persuasiveness of each medical opinion and prior administrative
medical finding by considering the following factors: (1) supportability; (2) consistency;
(3) relationship with the plaintiff; (4) specialization; and (5) any other factor “that tend[s]
to support or contradict a medical opinion or prior administrative medical finding.” 20
C.F.R. § 404.1520c(c).
Because the first two factors – supportability and consistency – are the “most
important” ones, the ALJ “will explain” how he or she considered them. 20 C.F.R.
§ 404.1520c(b)(2) (emphasis added). 2 As to the first factor (supportability), “[t]he more
relevant the objective medical evidence and supporting explanations presented by a
medical source are to support his or her medical opinion(s) . . . the more persuasive the
By contrast, the ALJ “may, but [is] not required to,” explain the consideration given to the remaining factors. 20
C.F.R. § 404.1520c(b)(2).
2
6
Case: 3:20-cv-00192-CHG Doc #: 17 Filed: 08/02/22 Page: 7 of 11 PAGEID #: 2189
medical opinions . . . will be.” 20 C.F.R. § 404.1520c(c)(1). As to the second factor
(consistency), “[t]he more consistent a medical opinion(s) . . . is with the evidence from
other medical sources and nonmedical sources in the claim, the more persuasive the
medical opinion(s) . . . will be.” 20 C.F.R. § 404.1520c(c)(2).
B.
Gregory Booher, D.C.
Dr. Booher completed a Medical Update Form in July 2009. (Doc. 8-7, PageID
310.) Dr. Booher opined that Plaintiff could “not do her current job as it is.” (Id.) He
explained that Plaintiff could not bend or rotate “without increased [low back pain].” (Id.)
Dr. Booher also opined that Plaintiff could do a “sitting job.” (Id.)
The ALJ concluded that Dr. Booher’s opinion was “not persuasive.” (Doc. 8-2,
PageID 53.) The ALJ explained:
Chiropractors are not included among the acceptable sources of medical
evidence defined in the regulations (20 CFR 404.1502 and 416.902).
Secondly, the statement has no relevance to the period of time at issue - it
was made more than five years prior to the alleged disability onset date of
February 19, 2016. Thirdly, the statement is not compelling because of its
non-specificity; it fails to indicate why the claimant cannot perform her
current job (or even what that job entailed) nor does it indicate the duration
of any limitations or even what limitations the claimant had, at that time, that
would have limited her to doing a "sitting" job (whatever the medical source
meant be [sic] that designation).
(Id.)
i.
Failure to Comply with Applicable Regulations
The ALJ’s assessment of Dr. Booher’s opinion does not comply with the
applicable regulations. The ALJ was required to explain his analysis of the supportability
and consistency factors when considering the persuasiveness of all of the medical
7
Case: 3:20-cv-00192-CHG Doc #: 17 Filed: 08/02/22 Page: 8 of 11 PAGEID #: 2190
opinions and prior administrative medical findings. 20 C.F.R. § 404.1520c(b)(2), (c)(1),
and (c)(2) (emphasis added). The ALJ did not consider Dr. Booher’s opinion in the
context of other evidence in the record, as is required to evaluate its consistency. Instead,
the ALJ rejected Dr. Booher’s opinion because he is not an “acceptable medical source,”
because of the temporal remoteness of the opinion, and because it is “non-specific[].”
(Doc. 8-2, PageID 53.) None of these reasons go to the issue of whether Dr. Booher’s
opinion is consistent with other evidence in the record. The ALJ’s failure to analyze the
consistency of Dr. Booher’s opinion, as required by the applicable regulations, constitutes
an error of law that warrants reversal.
The ALJ also erred by basing his decision to deny benefits upon the fact that Dr.
Booher, a chiropractor, is not an “acceptable sourc[e] of medical evidence.” (Doc. 8-2,
PageID 53.) Although chiropractors are excluded from the list of medical sources who
meet the definition of an “acceptable medical source,” Dr. Booher is a “medical source”
under 20 C.F.R. § 404.1502(a), (d). The new regulations for evaluating medical opinion
evidence require the ALJ to analyze the persuasiveness of “all of the medical opinions”
in the record, not just opinions from acceptable medical sources. 20 C.F.R. § 404.1520c
(emphasis added). Dr. Booher’s status as a “medical source,” rather than an “acceptable
medical source,” does not provide a basis for finding his opinion unpersuasive.
Defendant relies on Noto v. Comm’r of Soc. Sec., 632 F. App’x 243, 248-49 (6th
Cir. 2015) to argue that the ALJ was permitted to reject Dr. Booher’s opinion because he
is not an acceptable medical source. (Doc. 14, PageID 2167.) But the Sixth Circuit issued
Noto under the old regulations for the consideration of medical opinion evidence. 632 F.
8
Case: 3:20-cv-00192-CHG Doc #: 17 Filed: 08/02/22 Page: 9 of 11 PAGEID #: 2191
App’x at 248. The new regulations that apply here do not give any particular weight or
deference to any particular medical source. 20 C.F.R. S. 404.1520c. Instead, as discussed
above, the ALJ must evaluate the persuasiveness of all medical opinions and address the
supportability and consistency of each one. Id. For this reason, too, the ALJ erred as a
matter of law and his decision should be reversed.
ii.
Lack of Substantial Evidence
The ALJ rejected Dr. Booher’s opinion as “non-specific” because Dr. Booher
failed to “indicate the duration of any limitations or even what limitations [Plaintiff] had .
. . that would have limited her to doing a ‘sitting’ job.” (Doc. 8-2, PageID 53.) This
finding is not supported by substantial evidence in the record. In fact, Dr. Booher stated
that Plaintiff experienced “constant [low back pain],” especially on the right from L3 to
the sacroiliac joint. (Doc. 8-7, PageID 310.) Further, although Dr. Booher acknowledged
that Plaintiff experienced “no lower extremity neuro[logical] [symptoms],” he stated that
Plaintiff was “ok[ay]” only if she did not perform any rotation or extension. (Id.) Dr.
Booher also noted that Plaintiff experienced pain upon straight leg raising and with
extension and flexion of the spine. (Id.) These statements “indicate . . . what limitations
[Plaintiff] had . . . that would have limited her to doing a ‘sitting’ job,” contrary to the
ALJ’s final reason for rejecting Dr. Booher’s opinion. (Doc. 8-2, PageID 53).
VI. REMAND
A remand is appropriate when the ALJ’s decision is unsupported by substantial
evidence or when the ALJ failed to follow the Administration’s own regulations and that
shortcoming prejudiced the plaintiff on the merits or deprived the plaintiff of a substantial
9
Case: 3:20-cv-00192-CHG Doc #: 17 Filed: 08/02/22 Page: 10 of 11 PAGEID #: 2192
right. Bowen, 478 F.3d at 746. Remand may be warranted when the ALJ failed to provide
“good reasons” for rejecting a treating medical source’s opinions, see Wilson, 378 F.3d at
545-47; failed to consider certain evidence, such as a treating source’s opinions, see
Bowen, 478 F.3d at 747-50; failed to consider the combined effect of the plaintiff’s
impairments, see Gentry, 741 F.3d at 725-26; or failed to provide specific reasons
supported by substantial evidence for finding that the plaintiff lacks credibility, see
Rogers, 486 F.3d at 249.
Under Sentence Four of 42 U.S.C. § 405(g), the Court has authority to affirm,
modify, or reverse the Commissioner’s decision “with or without remanding the cause for
rehearing.” Melkonyan v. Sullivan, 501 U.S. 89, 99 (1991). Consequently, a remand
under Sentence Four may result in the need for further proceedings or an immediate
award of benefits. E.g., Blakley, 581 F.3d at 410; Felisky v. Bowen, 35 F.3d 1027, 1041
(6th Cir. 1994). The latter is warranted where the evidence of disability is overwhelming
or where the evidence of disability is strong while contrary evidence is lacking. Faucher
v. Sec’y of Health & Human Servs., 17 F.3d 171, 176 (6th Cir. 1994).
A judicial award of benefits is unwarranted in this case because the evidence of
disability is neither overwhelming nor strong while contrary evidence is lacking.
Faucher, 17 F.3d at 176. Instead, Plaintiff is entitled to an Order remanding this case to
the Social Security Administration pursuant to Sentence Four of Section 405(g) for the
reasons stated above. On remand, the ALJ should evaluate the evidence of record under
the applicable legal criteria mandated by the Commissioner’s regulations and rulings and
governing case law. The ALJ should evaluate Plaintiff’s disability claim under the
10
Case: 3:20-cv-00192-CHG Doc #: 17 Filed: 08/02/22 Page: 11 of 11 PAGEID #: 2193
required five-step sequential analysis to determine whether she was under a disability and
whether her application for Disability Insurance Benefits should be granted.
IT IS THEREFORE ORDERED THAT:
1.
Plaintiff’s Statement of Errors (Doc. 11) is GRANTED;
2.
The Court REVERSES the Commissioner’s non-disability determination;
3.
No finding is made as to whether Plaintiff was under a “disability” within
the meaning of the Social Security Act;
4.
This matter is REMANDED to the Social Security Administration under
Sentence Four of 42 U.S.C. § 405(g) for further consideration consistent
with this Decision and Order; and
5.
This case is terminated on the Court’s docket.
/s/ Caroline H. Gentry
Caroline H. Gentry
United States Magistrate Judge
11
Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.
Why Is My Information Online?