HARPER v. COMMISSIONER OF SOCIAL SECURITY
Filing
16
ORDER granting in part and denying in part 10 Plaintiff's Motion for Summary Judgment and denying 13 Defendant's Motion for Summary Judgment. Case is remanded to the Commissioner of Social Security for further evaluation under sentence four of 42 U.S.C. § 405(g) in light of this Order. Signed by Chief Judge Mark R. Hornak on 11/22/2024. (dpo)
IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF PENNSYLVANIA
ASHLEY LYNN HARPER,
)
)
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)
)
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)
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Plaintiff,
v.
COMMISSIONER OF SOCIAL SECURITY,
Defendant.
Civil Action No. 23-360-E
ORDER
AND NOW, this 22nd day of November, 2024, upon consideration of Defendant’s
Motion for Summary Judgment (Doc. No. 13) filed in the above-captioned matter on May 10,
2024,
IT IS HEREBY ORDERED that said Motion is DENIED.
AND, further, upon consideration of Plaintiff’s Motion for Summary Judgment (Doc. No.
10) filed in the above-captioned matter on April 25, 2024,
IT IS HEREBY ORDERED that said Motion is GRANTED IN PART and DENIED IN
PART. Specifically, Plaintiff’s Motion is granted to the extent that it seeks a remand to the
Commissioner of Social Security (“Commissioner”) for further evaluation as set forth below and
denied in all other respects. Accordingly, this matter is hereby remanded to the Commissioner
for further evaluation under sentence four of 42 U.S.C. § 405(g) in light of this Order.
I.
Background
Plaintiff Ashley Lynn Harper protectively filed a claim for disability insurance benefits
under Subchapter II of the Social Security Act, 42 U.S.C. §§ 401 et seq., and a claim for
supplemental security income benefits under Subchapter XVI of the Act, 42 U.S.C. §§ 1381 et
1
seq., claiming that she became disabled on August 1, 2018 due to a variety of impairments,
including narcolepsy, depression, anxiety, attention deficit hyperactivity disorder, and posttraumatic stress disorder. (R. 17, 232-33, 255). After being denied initially on January 18, 2022,
and upon reconsideration on July 11, 2022, Plaintiff sought a hearing before an Administrative
Law Judge (“ALJ”). (R. 139-48, 156-63). After a hearing was held on December 8, 2022, ALJ
Douglas Cohen denied Plaintiff’s request for benefits in an unfavorable decision dated January
10, 2023. (R. 14-27). On October 26, 2023, the Appeals Council declined to review the ALJ’s
decision. (R. 1-6). Plaintiff filed a timely appeal with this Court, and the parties have filed
cross-motions for summary judgment. (Doc. Nos. 10, 13).
II.
Standard of Review
Judicial review of the Commissioner’s final decisions on disability claims is based upon
the pleadings and the transcript of the record, and the scope of that review is limited to
determining whether the Commissioner applied the correct legal standards and whether the
record, as a whole, contains substantial evidence to support the Commissioner’s findings of fact.
See 42 U.S.C. § 405(g); Matthews v. Apfel, 239 F.3d 589, 592 (3d Cir. 2001) (noting that “‘[t]he
findings of the Commissioner of Social Security as to any fact, if supported by substantial
evidence, shall be conclusive’”) (quoting § 405(g)) (emphasis in original); Schaudeck v. Comm’r
of Soc. Sec. Admin., 181 F.3d 429, 431 (3d Cir. 1999) (stating that the court has plenary review
of all legal issues, and reviews the ALJ’s findings of fact to determine whether they are
supported by substantial evidence). The Court may not undertake a de novo review of the
Commissioner’s decision or re-weigh the evidence. Monsour Medical Center v. Heckler, 806
F.2d 1185, 1190-91 (3d Cir. 1986). If the district court finds the Commissioner’s findings of fact
are supported by substantial evidence then it must uphold the Commissioner’s final decision.
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See Rutherford v. Barnhart, 399 F.3d 546, 552 (3d Cir. 2005). The Court may not set aside a
decision that is supported by substantial evidence “even if [it] would have decided the factual
inquiry differently.” Hartranft v. Apfel, 181 F.3d 358, 360 (3d Cir. 1999) (citing § 405(g));
Monsour, 806 F.2d at 1190-91.
“Substantial evidence” is defined as “more than a mere scintilla.” Plummer v. Apfel, 186
F.3d 422, 427 (3d Cir. 1999) (quoting Ventura v. Shalala, 55 F.3d 900, 901 (3d Cir. 1995)). It
means “such relevant evidence as a reasonable mind might accept as adequate to support a
conclusion.” Id.; Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019). However, a “single piece of
evidence will not satisfy the substantiality test if the [Commissioner] ignores, or fails to resolve,
a conflict created by countervailing evidence.” Morales v. Apfel, 225 F.3d 310, 317 (3d Cir.
2000) (quoting Kent v. Schweiker, 710 F.2d 110, 114 (3d Cir. 1983)).
“Nor is evidence
substantial if it is overwhelmed by other evidence – particularly certain types of evidence (e.g.,
that offered by treating physicians) – or if it really constitutes not evidence but mere conclusion.”
Id. (internal quotations omitted). To facilitate the district court’s review, an ALJ’s findings must
“be accompanied by a clear and satisfactory explication of the basis on which [they] rest[].”
Cotter v. Harris, 642 F.2d 700, 704 (3d Cir. 1981). Decisions that are conclusory in their
findings or indicate the ALJ’s failure to consider all the evidence are not supported by substantial
evidence. See id. at 705-06. Moreover, the Court must ensure the ALJ did not “reject evidence
for no reason or for the wrong reason[.]” Id. at 706 (citing King v. Califano, 615 F.2d 1018 (4th
Cir. 1980)).
A disability is established when the claimant can demonstrate some medically
determinable basis for an impairment that prevents him or her from engaging in any substantial
gainful activity for a statutory twelve-month period. See Fargnoli v. Massanari, 247 F.3d 34,
38-39 (3d Cir. 2001). “A claimant is considered unable to engage in any substantial gainful
3
activity ‘only if his physical or mental impairment or impairments are of such severity that he is
not only unable to do his previous work but cannot, considering his age, education, and work
experience, engage in any other kind of substantial gainful work which exists in the national
economy . . . .’” Id. at 39 (quoting 42 U.S.C. § 423(d)(2)(A)).
The Social Security Administration has promulgated regulations incorporating a five-step
sequential evaluation process in guiding ALJs in determining whether a claimant is under a
disability as defined by the Act. See 20 C.F.R. §§ 404.1520, 416.920. At Step One, the ALJ
must determine whether the claimant is currently engaging in substantial gainful activity. See id.
at §§ 404.1520(a)(4)(i), 416.920(a)(4)(i). If so, the disability claim will be denied. See Bowen v.
Yuckert, 482 U.S. 137, 140 (1987). If not, the second step of the process is to determine whether
the
claimant
is
suffering
from
a
severe
impairment.
See
20
C.F.R.
§§
404.1520(a)(4)(ii), 416.920(a)(4)(ii). “An impairment or combination of impairments is not
severe if it does not significantly limit [the claimant’s] physical or mental ability to do basic
work activities.” Id. at §§ 404.1522, 416.922. If the claimant fails to show that his or her
impairments are “severe," he or she is ineligible for disability benefits. If the claimant does have
a severe impairment, however, the ALJ must proceed to Step Three and determine whether the
claimant’s impairment meets or equals the criteria for a listed impairment.
See id. at §§
404.1520(a)(4)(iii), 416.920(a)(4)(iii). If a claimant meets a listing, a finding of disability is
automatically directed. If the claimant does not meet a listing, the analysis proceeds to Steps
Four and Five.
In considering these steps, the ALJ must formulate the claimant’s residual functional
capacity (“RFC”). A claimant’s RFC is defined as the most that an individual is still able to do
despite the limitations caused by his or her impairments. See Fargnoli, 247 F.3d at 40; 20 C.F.R.
§§ 404.1545(a), 416.945(a). In crafting the RFC, the ALJ must consider all the evidence in the
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record. Burnett v. Comm’r of Soc. Sec., 220 F.3d 112, 121 (3d Cir. 2000). At Step Four, it is the
claimant’s burden of demonstrating an inability to perform his or her past relevant work. See
Adorno v. Shalala, 40 F.3d 43, 46 (3d Cir. 1994). If the ALJ determines that the claimant lacks
the RFC to resume his or her former occupation, the evaluation then moves to the fifth and final
step. See 20 C.F.R. §§ 404.1520(a)(4)(iv), 416.920(a)(4)(iv).
At this stage, the burden of production shifts to the Commissioner, who must demonstrate
that the claimant is capable of performing other available work in the national economy in order
to deny a claim of disability. See id. at §§ 404.1520(a)(4)(v), 416.920(a)(4)(v). In making this
determination, the ALJ must consider the claimant’s RFC, age, education, and past work
experience. See id. The ALJ must further analyze the cumulative effect of all the claimant’s
impairments in determining whether he or she is capable of performing work and is not disabled.
See id. at §§ 404.1523, 416.923.
III.
The ALJ's Decision
In his January 10, 2023 decision, the ALJ found that Plaintiff had not been engaged in
substantial gainful activity since the amended onset date of April 30, 2021. (R. 20). The ALJ
proceeded to the second requirement of the process and found that Plaintiff had several severe
impairments: narcolepsy, irritable bowel syndrome, migraine cephalgia, Chiari malformation,
major depressive disorder, generalized anxiety disorder, posttraumatic stress disorder, and
attention deficit hyperactivity disorder.
(Id.).
The ALJ concluded that none of Plaintiff’s
impairments met any of the listings that would satisfy Step Three. (Id.).
At Step Four of the process, the ALJ found that Plaintiff retained the RFC to perform
light work with the following limitations:
•
No more than occasional balancing, crawling, crouching, kneeling, stooping, and
climbing of ramps and stairs only;
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•
•
•
•
•
•
Avoid concentrated exposure to temperature extremes;
Avoid all exposure to unprotected heights, dangerous moving machinery, commercial
driving, and other workplace hazards;
No exposure to noise intensity level 4;
May not perform tasks requiring communication by telephone;
Limited to jobs involving only simple tasks, decisions, and instructions that are not
performed in a production-rate environment and where “simple” is defined as that term is
used in the Dictionary of Occupational Titles describing specific vocational profiles
(SVP) of 1 or 2;
Limited to no more than occasional interaction with supervisors, coworkers, and
members of the general public.
(R. 22). In determining this, the ALJ evaluated several medical opinions and found them to be
“somewhat persuasive,” stating that the RFC was “consistent with” the state agency medical and
psychological consultants and that the ALJ “fails to find any diagnosis of arthropathies . . . [and]
consider[ed] the claimant’s Chiari malformation and narcolepsy to be severe and included an
additional limitation on the claimant’s communication due to her hearing testimony.” (R. 25).
Further, the ALJ found the opinion of the psychological consultative examiner “only somewhat
persuasive because it appear[ed] to rely upon the claimant’s subjective complaints which are not
repeated to her treating provider.” (Id.). The ALJ included no other analysis of these medical
opinions. After finding that Plaintiff had no past relevant work, the ALJ proceeded to determine,
at Step Five, that there were jobs in the national economy that Plaintiff could perform. (R. 2627). Ultimately, the ALJ found that Plaintiff was not disabled. (R. 27).
IV.
Legal Analysis
Plaintiff raises one argument: the ALJ erred by failing to incorporate all of the limitations
opined by the state agency review consultants after finding these opinions persuasive. More
specifically, Plaintiff argues that the opined limitation to one-and-two-step tasks and short and
simple instructions should have been included in Plaintiff’s RFC. (Doc. No. 11). Although the
Court disagrees with Plaintiff’s argument that the ALJ per se erred by failing to incorporate the
6
specific limitations opined by these consultants, the Court agrees with Plaintiff to the extent that
the ALJ inadequately explained the rationale behind his analysis of the state agency reviewing
consultants’ opinions for the reasons explained herein. Accordingly, the Court cannot find the
ALJ’s decision to be supported by substantial evidence and finds that remand is necessary for
further consideration and discussion of the medical opinions.
Plaintiff asserts the ALJ erred by not incorporating all limitations opined by the state
agency review consultants, Drs. Emanuel Schnepp, Ph.D., and Susan Alexis Turner, Psy.D., after
finding these opinions persuasive. (Doc. No. 11 at 3-9). Plaintiff specifically contends that the
ALJ’s determination that these opinions were persuasive necessitates that all their opined
limitations be incorporated into Plaintiff’s RFC finding. (Id.).
While not precisely stated by
Plaintiff,1 related to this issue is whether the ALJ sufficiently evaluated the consultants’ medical
opinions. (See id.).
Perhaps not surprisingly, Defendant disagrees. Defendant counters that the ALJ found
the state agency review consultants’ opinions to be only “somewhat persuasive” and thereby
determined Plaintiff’s RFC consistent with that finding. (Doc. No. 14 at 11-15).
Further, the
ALJ’s failure to include the opined limitation to one-and-two-step tasks and short and simple
instructions is bolstered by the fact that Plaintiff’s mental status exams were generally
unremarkable. (Id. at 2, 13). In sum, Defendant argues that the ALJ considered all of the
relevant evidence and reached a logical RFC finding.
While any arguments not raised in Plaintiff’s initial brief are generally waived, Santiago-Rivera
v. Barnhart, 2006 WL 2794189, at *2 n.5 (E.D. Pa. Sept. 26, 2006) (citing Warren G. v.
Cumberland Cnty Sch. Dist., 190 F.3d 80, 84 (3d Cir. 1999)), this issue will arise on remand and,
therefore, will be addressed in this order. See Freeman v. Berryhill, No. 16-2610, 2017 WL
1351425, at *5 n.5 (E.D. Pa. Mar. 23, 2017), report and recommendation adopted by 2017 WL
1375185 (E.D. Pa. Apr. 10, 2017) (stating “‘[s]ocial security proceedings are inquisitorial rather
than adversarial’. . . and given that the same issue will arise on remand, [the court] will address it
here.”) (internal citations omitted).
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As noted, the RFC finding is defined as “that which an individual is able to do despite the
limitations caused by his or her impairment(s).” Fargnoli, 247 F.3d at 40 (quoting Burnett, 220
F.3d at 121). An ALJ must consider all relevant evidence in determining an individual’s RFC,
and the RFC finding “must ‘be accompanied by a clear and satisfactory explication of the basis
on which it rests.’” Fargnoli, 247 F.3d at 41 (quoting Cotter, 642 F.2d at 704). This relevant
evidence includes medical opinions of record. See 20 C.F.R. § 404.1520c, 416.920c.
In
evaluating these opinions, the ALJ assesses the persuasiveness by evaluating “the two most
important factors[,]” which are “consistency and supportability.” 82 Fed. Reg. at 5853. See also
20 C.F.R. §§ 404.1520c(b) and (c), 416.920c(b) and (c). After considering these factors, the ALJ
makes a persuasiveness determination, which aides in the ultimate RFC finding. See 20 C.F.R.
§§ 404.1520c(b)(2), 416.920c(b)(2); Chandler v. Comm’r of Soc. Sec., 667 F.3d 356, 361 (3d
Cir. 2011). While it is not per se error for the ALJ to find a medical opinion persuasive and then
not incorporate every limitation opined by that medical professional into the RFC, the ALJ must
provide an adequate explanation of how he came to the specific RFC determination.
See
Wilkinson v. Comm’r of Soc. Sec., 558 Fed. Appx. 254, 256 (3d Cir. 2014). Part of this
explanation is an evaluation of these opinions, which includes analysis of the consistency and
supportability factors. See 20 C.F.R. §§ 404.1520c(b) and (c), 416.920c(b) and (c).
Here, the ALJ acknowledged the state agency review consultants’ opinions but failed to
adequately analyze the consistency and supportability factors in relation to these opinions and,
therefore, the ALJ’s RFC finding is in error. To this point, the ALJ wrote only the following
when analyzing all medical opinions of record, including the two opinions of the state agency
psychologists:
The undersigned has fully considered the medical opinions and prior
administrative medical findings as follows: the opinions of the state agency
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medical and psychological consultants are somewhat persuasive and the assigned
residual functional capacity is consistent with the same. (Exhibits B5A/6-9,
B9A/6-10).
The undersigned, however, fails to find any diagnosis of
arthropathies. Nevertheless, the undersigned does consider the claimant’s Chiari
malformation and narcolepsy to be severe and included an additional limitation on
the claimant’s communication due to her hearing testimony. (Exhibits B5A/6-9,
B9A/6-10). The opinion of the psychological consultative examiner is only
somewhat persuasive because it appears to rely upon the claimant’s subjective
complaints which are not repeated to her treating provider. (Exhibit B17F/7-9,
B20F/19-22).
(R. 25). While the ALJ mentioned that Plaintiff’s RFC was “consistent” with the opinions of the
state agency medical and psychological consultants, this did not constitute a sufficient
consistency analysis. An adequate consistency and supportability analysis includes evaluation of
the consistency between the medical source’s opinion in relation to other evidence within the
record and an analysis of the medical source’s opinion in the context of the expert’s articulated
support for such opinion. See Cook v. Comm’r of Soc. Sec., No. 6:20-CV-1197, 2021 WL
1565832, at *3 (M.D. Fla. Apr. 6, 2021) (stating “supportability relates to the extent to which a
medical source has articulated support for the medical source’s own opinion, while consistency
relates to the relationship between a medical source’s opinion and other evidence within the
record.”). In accordance with the applicable regulations, the ALJ will need to reconsider these
opinions and articulate this analysis for each opinion on remand.
This all means that, at this point, the Court will leave it to the Commissioner to clarify the
record as to the medical opinion analysis and the ultimate RFC determination, rather than
attempt to divine the ALJ’s intention itself.2 It will therefore remand the case for further
explanation as to the medical opinions.
2
It is not the role of a reviewing court to look at the evidence and determine whether it
would lead to the conclusions to which the ALJ came. See Fargnoli, 247 F.3d at 44 n.7 (“The
grounds upon which an administrative order must be judged are those upon which the record
discloses that its action was based.”) (quoting SEC v. Chenery Corporation, 318 U.S. 80, 87
(1943))
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V.
Conclusion
In sum, the record does not permit the Court to determine whether the findings of the
ALJ regarding Plaintiff’s RFC are supported by substantial evidence, and, accordingly, the Court
finds that substantial evidence does not support the ALJ’s decision in this case. The Court
hereby remands the case to the Commissioner for reconsideration consistent with this Order.
s/Mark R. Hornak, J.
United States District Judge
ecf:
Counsel of record
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