NOBLES v. COLVIN
Filing
12
OPINION and ORDER granting 8 Motion for Summary Judgment; denying 10 Motion for Summary Judgment. It is further ordered that the decision of the Commissioner of Social Security is hereby vacated and the case is remanded for further administrative proceedings consistent with the foregoing opinion. Signed by Judge Donetta W. Ambrose on 6/1/15. (slh) Modified on 6/1/2015. (slh)
IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF PENNSYLVANIA
SAMUEL RAYMOND NOBLES,
Plaintiff,
-vsCAROLYN W. COLVIN,
COMMISSIONER OF SOCIAL SECURITY,
Defendant.
)
)
)
)
)
)
)
)
)
)
Civil Action No. 14-149E
AMBROSE, Senior District Judge
OPINION
Pending before the Court are Cross-Motions for Summary Judgment. (ECF Nos. 8 and
10). Both parties have filed Briefs in Support of their Motions. (ECF Nos. 9 and 10). After
careful consideration of the submissions of the parties, and based on my Opinion set forth
below, I am granting Plaintiff’s Motion for Summary Judgment (ECF No. 8) and denying
Defendant’s Motion for Summary Judgment. (ECF No. 10).
I.
BACKGROUND
Plaintiff brought this action for review of the final decision of the Commissioner of Social
Security (ACommissioner@) denying his applications for supplemental security income (“SSI”)
and disability insurance benefits (“DIB”) pursuant to the Social Security Act (AAct@). Plaintiff filed
his applications alleging he had been disabled since October 15, 2008.1 (ECF No. 6-6, pp. 2,
11). Administrative Law Judge (“ALJ”), James J. Pileggi, held a hearing on November 7, 2012
and on July 26, 2012. (ECF No. 6-2, pp. 25-60). On November 26, 2012, the ALJ found that
Plaintiff was not disabled under the Act. (ECF No. 6-2, pp. 14-21).
After exhausting all administrative remedies, Plaintiff filed the instant action with this
court. The parties have filed Cross-Motions for Summary Judgment. (Docket Nos. 8 and 10).
The issues are now ripe for review.
1
At the hearing, Plaintiff amended his alleged onset date to August 28, 2010, due to the filing of a prior
application which was dismissed on August 27, 2010. (ECF No. 6-2, pp. 29-30).
II.
LEGAL ANALYSIS
A.
Standard of Review
The standard of review in social security cases is whether substantial evidence exists in
the record to support the Commissioner=s decision. Allen v. Bowen, 881 F.2d 37, 39 (3d Cir.
1989). Substantial evidence has been defined as Amore than a mere scintilla. It means such
relevant evidence as a reasonable mind might accept as adequate.@ Ventura v. Shalala, 55
F.3d 900, 901 (3d Cir. 1995), quoting Richardson v. Perales, 402 U.S. 389, 401 (1971).
Additionally, the Commissioner=s findings of fact, if supported by substantial evidence, are
conclusive. 42 U.S.C. '405(g); Dobrowolsky v. Califano, 606 F.2d 403, 406 (3d Cir. 1979). A
district court cannot conduct a de novo review of the Commissioner=s decision or re-weigh the
evidence of record. Palmer v. Apfel, 995 F.Supp. 549, 552 (E.D. Pa. 1998). Where the ALJ's
findings of fact are supported by substantial evidence, a court is bound by those findings, even if
the court would have decided the factual inquiry differently. Hartranft v. Apfel, 181 F.3d 358, 360
(3d Cir. 1999). To determine whether a finding is supported by substantial evidence, however,
the district court must review the record as a whole. See, 5 U.S.C. '706.
To be eligible for social security benefits, the plaintiff must demonstrate that he cannot
engage in substantial gainful activity because of a medically determinable physical or mental
impairment which can be expected to result in death or which has lasted or can be expected to
last for a continuous period of at least 12 months. 42 U.S.C. '423(d)(1)(A); Brewster v. Heckler,
786 F.2d 581, 583 (3d Cir. 1986).
The Commissioner has provided the ALJ with a five-step sequential analysis to use
when evaluating the disabled status of each claimant. 20 C.F.R. '404.1520(a). The ALJ must
determine: (1) whether the claimant is currently engaged in substantial gainful activity; (2) if not,
whether the claimant has a severe impairment; (3) if the claimant has a severe impairment,
whether it meets or equals the criteria listed in 20 C.F.R., pt. 404, subpt. P., appx. 1; (4) if the
2
impairment does not satisfy one of the impairment listings, whether the claimant=s impairments
prevent him from performing his past relevant work; and (5) if the claimant is incapable of
performing his past relevant work, whether he can perform any other work which exists in the
national economy, in light of his age, education, work experience and residual functional
capacity. 20 C.F.R. '404.1520. The claimant carries the initial burden of demonstrating by
medical evidence that he is unable to return to his previous employment (steps 1-4).
Dobrowolsky, 606 F.2d at 406. Once the claimant meets this burden, the burden of proof shifts
to the Commissioner to show that the claimant can engage in alternative substantial gainful
activity (step 5). Id.
A district court, after reviewing the entire record may affirm, modify, or reverse the
decision with or without remand to the Commissioner for rehearing. Podedworny v. Harris, 745
F.2d 210, 221 (3d Cir. 1984).
B.
Residual Functional Capacity (“RFC”)2
Plaintiff argues that the ALJ’s determination of Plaintiff’s RFC3 is not supported by
substantial evidence. (ECF No. 9, pp. 9-13). Specifically, Plaintiff argues the ALJ erred in
determining the weight to be given to the medical opinion evidence. Id. Therefore, Plaintiff
submits that remand is necessary. After a review of the evidence, I agree.
The amount of weight accorded to medical opinions is well-established. Generally, the
ALJ will give more weight to the opinion of a source who has examined the claimant than to a
non-examining source. 20 C.F.R. §§ 416.927(c)(1); 404.1527(c)(1). In addition, the ALJ
generally will give more weight to opinions from a treating physician, “since these sources are
likely to be the medical professionals most able to provide a detailed, longitudinal picture of [a
2
RFC refers to the most a claimant can still do despite his limitations. 20 C.F.R. §§ 404.1545(a),
416.945(a). The assessment must be based upon all of the relevant evidence, including the medical
records, medical source opinions, and the individual’s subjective allegations and description of his own
limitations. 20 C.F.R. § 416.945(a).
3
The ALJ found that Plaintiff has the RFC to perform sedentary work with certain limitations. (ECF No. 62, p. 17).
3
claimant’s] medical impairment(s) and may bring a unique perspective to the medical evidence
that cannot be obtained from the objective medical findings alone or from reports of individual
examinations, such as consultative examinations or brief hospitalizations.” Id. §§ 404.157(c)(2),
416.957(c)(2). If the ALJ finds that “a treating source’s opinion on the issue(s) of the nature and
severity of [a claimant’s] impairment(s) is well-supported by medically acceptable clinical and
laboratory diagnostic techniques and is not inconsistent with the other substantial evidence [of]
record,” he must give that opinion controlling weight. Id. Also, “the more consistent an opinion is
with the record as a whole, the more weight [the ALJ generally] will give to that opinion.” Id. §§
416.927(c)(4), 404.1527(c)(4).
In the event of conflicting medical evidence, the Court of Appeals for the Third Circuit
has explained:
“A cardinal principle guiding disability determinations is that the ALJ accord
treating physicians’ reports great weight, especially ‘when their opinions reflect
expert judgment based on continuing observation of the patient’s condition over a
prolonged period of time.’” Morales v. Apfel, 225 F.3d 310, 317 (3d Cir. 2000)
(quoting Plummer v. Apfel, 186 F.3d 422, 429 (3d Cir. 1999)). However, “where .
. . the opinion of a treating physician conflicts with that of a non-treating, nonexamining physician, the ALJ may choose whom to credit” and may reject the
treating physician’s assessment if such rejection is based on contradictory
medical evidence. Id. Similarly, under 20 C.F.R. § 416.927(d)(2), the opinion of a
treating physician is to be given controlling weight only when it is well-supported
by medical evidence and is consistent with other evidence in the record.
Becker v. Comm’r of Social Sec. Admin., No. 10-2517, 2010 WL 5078238, at *5 (3d Cir. Dec.
14, 2010). Although the ALJ may choose whom to credit when faced with a conflict, he “cannot
reject evidence for no reason or for the wrong reason.” Diaz v. Comm’r of Soc. Security, 577
F.3d 500, 505 (3d Cir. 2009). Additionally, I note that state agency opinions merit significant
consideration. See SSR 96–6p (“Because State agency medical and psychological consultants
... are experts in the Social Security disability programs, ... 20 C.F.R. §§ 404.1527(f) and
416.927(f) require [ALJs] ... to consider their findings of fact about the nature and severity of an
individual's impairment(s)....”).
In this case, the ALJ evaluated all of the medical opinion evidence in a single paragraph.
4
(ECF No. 6-2, p. 19).
As for the opinion evidence, I give great weight to the opinions of the State
agency medical consultant because I find it to be well-supported and consistent
with other substantial evidence of record as herein set forth. (Exhibits B1A,
B2A). During a consultative examination in April 2011, the claimant exhibited a
modestly decreased range of motion in the neck in every direction. (Exhibit
B4F/3). The claimant did not exhibit much tenderness over the sacroiliac joints
and he demonstrated good reflexes and adequate strength in his legs. (Exhibit
B4F/3). Accordingly, I give great weight to the findings of the consultative
examiner (Exhibit B4F/6-7, 8-9), but I impose greater limitations on the claimant
in order to partially credit his subjective complaints. I have considered the
opinion of Dr. Mohan, a treating source, that the claimant is disabled, but I
ultimately give it little weight because Dr. Mohan fails to indicate any symptoms
or associated limitations beyond the claimant’s diagnosis. (Exhibit B3F, B4F/5).
(ECF No. 6-2, p. 19). I find this evaluation to be quite confusing.
The first opinion mentioned by the ALJ is the state agency medical consultant, V. Rama
Kumar, M.D. (ECF No. 6-2, p. 19). The ALJ gave Dr. Kumar great weight. Id. However, the
ALJ does not state any reasons why he gave Dr. Kumar’s opinion great weight other than to
say that he finds it to be “well-supported and consistent with other substantial evidence of
record.” (ECF No. 6-2, p. 19). This statement is nothing more than conclusory. An ALJ must
provide sufficient explanation of his or her final determination to provide a reviewing court with
the benefit of the factual basis underlying the ultimate disability finding. Cotter v. Harris, 642
F.2d 700, 705 (3d Cir. 1981). An ALJ must provide “an expression of the evidence s/he
considered which supports the result…In the absence of such an indication, the reviewing
court cannot tell if significant probative evidence was not credited or simply ignored.”
Carter v. Apfel, 220 F.Supp.2d 3 9 3 , 396 (M.D. Pa. 2000), citing, Cotter v. Harris, 642 F.2d
700, 705 (3d Cir. 1981), rehearing denied, 650 F.2d 481 (3d Cir. 1981).
Based on the
conclusory statement by the ALJ, I am unable to conduct a meaningful and proper review.
Furthermore, in his report, Dr. Kumar noted that “The medical source opinion of the
nontreating source, John Nesbitt, M.D., in the report received 04/15/11, indicates that the
claimant is disabled.” (ECF No. 6-3, pp. 7, 15). This is an incorrect statement. In fact, Dr.
Nesbitt indicated that he was provided a form from Dr. Mohan, Plaitniff’s treating physician and
5
that form, which is in Dr. Nesbitt’s file, indicated that Plaintiff was permanently disabled. (ECF
No. 6-8, pp. 41-41). The ALJ fails to mention this incorrect statement. As such, I am unable to
determine if the ALJ was aware of this incorrect statement.
Additionally, Dr. Kumar found that Dr. Nesbitt’s opinion is “without substantial support
from the other evidence of record, which renders it less persuasive;” but, then Dr. Kumar gives
great weight and adopts the assessment of Dr. Nesbitt. (ECF No. 6-3, pp. 7, 15). This is
nonsensical and, yet, the ALJ does not mention or discuss this obvious inconsistency.
Finally, Dr. Kumar states that Plaintiff has “aggressively pursued treatment for his
Ankylosing Spodylitis Si Joints, DJD L-spine and C-Spine.…He has been prescribed, and taken,
appropriate medications for the alleged impairments.”
(ECF No. 6-3, pp. 7, 15)(emphasis
added). I am unable to determine what evidence these statements are based upon. The
records from Plaintiff’s treating physician, Dr. Mohan, of November 4, 2009, states that Plaintiff
never took the medications prescribed (MTX and Enbrel). (ECF No. 6-8, p. 21). Then, on
September 22, 2010, the next record indicates that Plaintiff still had never taken MTX and
intermittently only took Enbrel 5 times. It further indicates that Plaintiff had no good reason for
not taking the medications. (ECF No. 6-8, pp. 14). As a result, Dr. Mohan noted that if Plaintiff
“does not follow through on our recommendations [regarding medications] this time, I will plan on
discharging him from the clinic.” (ECF No. 6-8, p. 16). Additionally, Dr. Mohan noted that
Plaintiff missed several appointments. (ECF No. 6-8, p. 14). In fact, the record indicates that
Plaintiff only saw Dr. Mohan on November 4, 2009, and then not again until September 22,
2010. (ECF No. 6-8, pp. 14-27). Thus, I do not find the evidence to support the statements of Dr.
Kumar that Plaintiff “aggressively pursued treatment” or that Plaintiff had taken the medications
prescribed. Yet, the ALJ fails to mention or discuss the lack of supporting evidence for Dr.
Kumar’s opinion.
To the contrary, the ALJ only states that Dr. Kumar’s opinion is “well-
supported and consistent with other substantial evidence of record” without more. (ECF No. 62, p. 19).
6
Based on the above, I cannot say that the ALJ’s opinion, with regard to the opinions of
Dr. Kumar and Dr. Nesbitt, is based on substantial evidence.
I am unable to conduct a
meaningful and proper review. Consequently, I find remand is necessary as to the opinions of
Dr. Kumar4 and Dr. Nesbitt.
Finally, Plaintiff argues that ALJ erred in giving little weight to the opinion of his treating
physician, Dr. Mohan. (ECF No. 9, pp. 12-13). The ALJ gave Dr. Mohan’s opinion little weight
because Dr. Mohan “fails to indicate any symptoms or associated limitations beyond the
claimant’s diagnosis.” (ECF No. 6-2, p. 19). Upon review, however, I find these reasons are not
borne out by the record. Dr. Mohan clearly states her impressions of his symptoms which were
based upon her examinations of Plaintiff and the objective medical evidence. (ECF No. 6-8, pp.
14-27). Consequently, remand is warranted with regard to Dr. Mohan as well.
Therefore, I am remanding for full and proper analysis of the medical opinion evidence.
An appropriate order shall follow.
4
Plaintiff also suggests that the opinion of Dr. Kumar is outdated. (ECF No. 9, pp. 10-11). An ALJ is
entitled to rely upon the findings of the state agency evaluator even if there is a lapse of time between the
report and the hearing. Chandler v. Comm'r of Soc. Sec., 667 F.3d 356, 361 (3d Cir. 2012). Thus, I find
no error in relying on Dr. Kumar’s opinion based on age of the opinion.
7
IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF PENNSYLVANIA
SAMUEL RAYMOND NOBLES,
)
)
)
)
)
)
)
)
)
)
Plaintiff,
-vsCAROLYN W. COLVIN,
COMMISSIONER OF SOCIAL SECURITY,
Defendant.
Civil Action No. 14-149E
AMBROSE, Senior District Judge
ORDER OF COURT
THEREFORE, this 1st day of June, 2015, it is ordered that Plaintiff=s Motion for Summary
Judgment (Docket No. 8) is granted and Defendant=s Motion for Summary Judgment (Docket
No. 10) is denied.
It is further ordered that the decision of the Commissioner of Social Security is hereby
vacated and the case is remanded for further administrative proceedings consistent with the
foregoing opinion.
BY THE COURT:
s/ Donetta W. Ambrose
Donetta W. Ambrose
United States Senior District Judge
8
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?