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Ortiz v. Colvin

United States District Court, D. Connecticut

July 26, 2016

MARIA ELENA ORTIZ
v.
CAROLYN W. COLVIN, ACTING COMMISSIONER, SOCIAL SECURITY ADMINISTRATION

          ORDER

          HON. SARAH A. L. MERRIAM UNITED STATES MAGISTRATE JUDGE.

         Plaintiff Maria Elena Ortiz (“plaintiff”), brings this appeal under §205(g) of the Social Security Act (the “Act”), as amended, 42 U.S.C. §405(g), seeking review of a final decision by the Commissioner of the Social Security Administration (the “Commissioner”) denying her application for Disability Insurance Benefits (“DIB”) and Supplemental Security Income (“SSI”) under the Act. Plaintiff has moved for judgment on the administrative record and pleadings pursuant to Rule 12(c) of the Federal Rules of Civil Procedure. [Doc. #16].

         For the reasons set forth below, plaintiff's Motion for Judgment on the Administrative Record and Pleadings Pursuant to Fed.R.Civ.P. 12(c) [Doc. #16] is GRANTED, to the extent it seeks remand for a new hearing. Defendant's Motion for an Order Affirming the Commissioner's Decision [Doc. #21] is DENIED.

         I. PROCEDURAL HISTORY

         Plaintiff filed concurrent applications for DIB and SSI on February 14, 2012, alleging disability beginning February 28, 2011. (Certified Transcript of the Administrative Record, compiled on August 2, 2015, (hereinafter “Tr.”) 197-209). Plaintiff's applications were denied initially on May 9, 2012, (Tr. 61-84), and upon reconsideration on October 12, 2012. (Tr. 87-112).

         On February 18, 2014, the plaintiff, accompanied and represented by attorney Danielle Choi, appeared and testified at a hearing before Administrative Law Judge (“ALJ”) James E. Thomas. (Tr. 35-60). Vocational Expert (“VE”) Richard B. Hall also testified at the hearing. (Tr. 56-59). On March 19, 2014, the ALJ issued an unfavorable decision. (Tr. 18-34). On April 17, 2015, the Appeals Council denied plaintiff's request for review, thereby making the ALJ's March 19, 2014, decision the final decision of the Commissioner. (Tr. 1-6). The case is now ripe for review under 42 U.S.C. §405(g).

         Plaintiff, represented by attorney Howard D. Olinksy, timely filed this action for review and now moves to reverse the Commissioner's decision. [Doc. #16]. On appeal, plaintiff asserts the following:

1. The ALJ erred in his application of the treating physician rule;
2. The ALJ erred in determining that plaintiff did not have any severe physical impairments;
3. The ALJ's credibility assessment is not supported by substantial evidence; and
4. The ALJ's step four determination is not supported by substantial evidence.

         As set forth below, the Court finds that ALJ Thomas erred in his application of the treating physician rule, and that the ALJ's credibility determination is not supported by substantial evidence. The Court does not reach the merits of plaintiff's remaining contentions as they concern her alleged physical impairments, in light of the above determinations.

         II. STANDARD OF REVIEW

         The review of a social security disability determination involves two levels of inquiry. First, the Court must decide whether the Commissioner applied the correct legal principles in making the determination. Second, the Court must decide whether the determination is supported by substantial evidence. See Balsamo v. Chater, 142 F.3d 75, 79 (2d Cir. 1998). Substantial evidence is evidence that a reasonable mind would accept as adequate to support a conclusion; it is more than a “mere scintilla.” Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)). The reviewing court's responsibility is to ensure that a claim has been fairly evaluated by the ALJ. Grey v. Heckler, 721 F.2d 41, 46 (2d Cir. 1983) (citation omitted).

         The Court does not reach the second stage of review - evaluating whether substantial evidence supports the ALJ's conclusion - if the Court determines that the ALJ failed to apply the law correctly. See Norman v. Astrue, 912 F.Supp.2d 33, 70 (S.D.N.Y. 2012) (“The Court first reviews the Commissioner's decision for compliance with the correct legal standards; only then does it determine whether the Commissioner's conclusions were supported by substantial evidence.”). “Where there is a reasonable basis for doubt whether the ALJ applied correct legal principles, application of the substantial evidence standard to uphold a finding of no disability creates an unacceptable risk that a claimant will be deprived of the right to have her disability determination made according to the correct legal principles.” Johnson v. Bowen, 817 F.2d 983, 986 (2d Cir. 1987).

         “[T]he crucial factors in any determination must be set forth with sufficient specificity to enable [a reviewing court] to decide whether the determination is supported by substantial evidence.” Ferraris v. Heckler, 728 F.2d 582, 587 (2d Cir. 1984) (alteration added). The ALJ is free to accept or reject the testimony of any witness, but a “finding that the witness is not credible must nevertheless be set forth with sufficient specificity to permit intelligible plenary review of the record.” Williams ex rel. Williams v. Bowen, 859 F.2d 255, 260-61 (2d Cir. 1988). “Moreover, when a finding is potentially dispositive on the issue of disability, there must be enough discussion to enable a reviewing court to determine whether substantial evidence exists to support that finding.” Johnston v. Colvin, No. 3:13CV00073(JCH), 2014 WL 1304715, at *6 (D. Conn. Mar. 31, 2014).

         It is important to note that in reviewing the ALJ's decision, this Court's role is not to start from scratch. “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.” Lamay v. Comm'r of Soc. Sec., 562 F.3d 503, 507 (2d Cir. 2009); 42 U.S.C. §405(g).

         III. SSA LEGAL STANDARD

         Under the Social Security Act, every individual who is under a disability is entitled to disability insurance benefits. 42 U.S.C. §423(a)(1).

         To be considered disabled under the Act and therefore entitled to benefits, Ms. Ortiz must demonstrate that she is unable to work after a date specified “by reason of any 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 not less than 12 months.” 42 U.S.C. §423(d)(1)(A). Such impairment or impairments must be “of such severity that [s]he is not only unable to do [her] previous work but cannot, considering [her] age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy.” 42 U.S.C. §423(d)(2)(A)(alterations added); 20 C.F.R. §§404.1520(c), 416.920(c) (alterations added)(requiring that the impairment “significantly limit[] ... physical or mental ability to do basic work activities” to be considered “severe”).

         There is a familiar five-step analysis used to determine if a person is disabled. See 20 C.F.R. §§404.1520, 416.920. In the Second Circuit, the test is described as follows:

First, the Secretary considers whether the claimant is currently engaged in substantial gainful activity. If he is not, the Secretary next considers whether the claimant has a “severe impairment” which significantly limits his physical or mental ability to do basic work activities. If the claimant suffers such an impairment, the third inquiry is whether, based solely on medical evidence, the claimant has an impairment which is listed in Appendix 1 of the regulations. If the claimant has such an impairment, the Secretary will consider him disabled without considering vocational factors such as age, education, and work experience; the Secretary presumes that a claimant who is afflicted with a “listed” impairment is unable to perform substantial gainful activity.

Berry v. Schweiker, 675 F.2d 464, 467 (2d Cir. 1982) (per curiam). If and only if the claimant does not have a listed impairment, the Commissioner engages in the ...


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