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Bendler-Reza v. Colvin

United States District Court, D. Connecticut

September 22, 2016




         Plaintiff Victoria Bendler-Reza claims that she is disabled and cannot work as a result of spinal and knee injuries, as well as several psychiatric conditions. She brought this action pursuant to 42 U.S.C. § 405(g), seeking review of a final decision of the defendant Commissioner of Social Security, who denied her claim for disability insurance benefits (DIB) and supplemental security income (SSI). The Commissioner concluded that although plaintiff suffered from severe impairments and could not work in her previous job, she could still work in another type of job. For the reasons that follow, I will grant in part plaintiff's motion to reverse or remand the decision of the Commissioner (Doc. #14), deny defendant's motion to affirm the decision of the Commissioner (Doc. #15), and remand the case for prompt reconsideration by the ALJ.


         The Court refers to the transcripts provided by the Commissioner. Docs. #12-1 through #12-10. Plaintiff is a 43-year-old, morbidly obese woman who lives in Seymour, Connecticut. Her last job prior to becoming disabled was working as a certified nurse's aide and home health aide in facilities and in people's homes. Although she had a severe knee injury, she would change sheets, cook meals, clean houses, and help her clients take care of their physical needs. In January 2010, when she was 37 years old, plaintiff fell at work and severely injured her back. Plaintiff has not worked since January 31, 2010, the date of alleged onset of her disability, and has fallen several times since then.[1] Her date last insured (DLI) is September 30, 2013.

         Plaintiff applied for SSI on July 16, 2012. Her application for DIB and SSI was initially denied in February 2013 and upon reconsideration in May 2013. Plaintiff was represented by an attorney at a hearing in March 2014 before Administrative Law Judge (ALJ) Deirdre R. Horton. On April 11, 2014, the ALJ held that plaintiff was not disabled as defined by the Social Security Administration (SSA). Plaintiff requested Appeals Council review of the ALJ's decision in May 2014, which was denied in September 2014. She then filed this federal action asking the Court to reverse the Commissioner's decision or to remand the case for rehearing (Doc. #14). In response, the Commissioner has moved to affirm the SSA's final decision (Doc. #15). Among other claims, plaintiff contends that the ALJ improperly formulated plaintiff's residual functional capacity and failed to obtain testimony from a vocational expert. Although I disagree with plaintiff's other objections, I agree that the ALJ erred in formulating plaintiff's residual functional capacity and that the ALJ should have addressed whether plaintiff's non-exertional limitations were more than negligible such that vocational expert testimony should have been considered.


         The Court may “set aside the Commissioner's determination that a claimant is not disabled only if the factual findings are not supported by substantial evidence or if the decision is based on legal error.” Burgess v. Astrue, 537 F.3d 117, 127 (2d Cir. 2008) (internal quotation marks and citation omitted); see also 42 U.S.C. § 405(g). Substantial evidence is “more than a mere scintilla” and “means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Lesterhuis v. Colvin, 805 F.3d 83, 87 (2d Cir. 2015) (per curiam). Absent a legal error, this Court must uphold the Commissioner's decision if it is supported by substantial evidence and even if this Court might have ruled differently had it considered the matter in the first instance. See Eastman v. Barnhart, 241 F.Supp.2d 160, 168 (D. Conn. 2003).

         To qualify for disability insurance benefits, a claimant must show that she is unable “to engage in 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, ” and “the impairment must be ‘of such severity that [the claimant] is not only unable to do h[er] previous work but cannot, considering h[er] age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy.'” Robinson v. Concentra Health Servs., Inc., 781 F.3d 42, 45 (2d Cir. 2015) (quoting 42 U.S.C. §§ 423(d)(1)(A), 423(d)(2)(A)). “[W]ork exists in the national economy when it exists in significant numbers either in the region where [a claimant] live[s] or in several other regions of the country, ” and “when there is a significant number of jobs (in one or more occupations) having requirements which [a claimant] [is] able to meet with [her] physical or mental abilities and vocational qualifications.” 20 C.F.R. § 404.1566(a)-(b); see also Kennedy v. Astrue, 343 F. App'x 719, 722 (2d Cir. 2009) (summary order).

         To evaluate a claimant's disability, and to determine whether he or she qualifies for benefits, the agency engages in the following five-step process:

First, the Commissioner considers whether the claimant is currently engaged in substantial gainful activity. Where the claimant is not, the Commissioner next considers whether the claimant has a “severe impairment” that significantly limits her 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 that is listed [in the so-called “Listings”] ¶ 20 C.F.R. pt. 404, subpt. P, app. 1. If the claimant has a listed impairment, the Commissioner will consider the claimant disabled without considering vocational factors such as age, education, and work experience; the Commissioner presumes that a claimant who is afflicted with a listed impairment is unable to perform substantial gainful activity. Assuming the claimant does not have a listed impairment, the fourth inquiry is whether, despite the claimant's severe impairment, she has the residual functional capacity to perform her past work. Finally, if the claimant is unable to perform her past work, the burden then shifts to the Commissioner to determine whether there is other work which the claimant could perform.

Cage v. Comm'r of Soc. Sec., 692 F.3d 118, 122-23 (2d Cir. 2012) (alteration in original) (citation omitted); see also 20 C.F.R. § 404.1520(a)(4)(i)-(v). In applying this framework, if a claimant can be found disabled or not disabled at a particular step, a decision will be made without proceeding to the next step. See 20 C.F.R. § 404.1520(a)(4). The claimant bears the burden of proving her case at steps one through four; at step five, the burden shifts to the Commissioner to demonstrate that there is other work that the claimant can perform. See McIntyre v. Colvin, 758 F.3d 146, 150 (2d Cir. 2014).

         Here, the ALJ found at step one that plaintiff did not engage in substantial gainful activity during the relevant time period. At step two, the ALJ found that plaintiff suffered from the following “severe impairments” during the relevant time period: lumbar spondylosis with radiculopathy, cervical radiculopathy, degenerative joint disease of the left knee, morbid obesity, mood disorder, generalized anxiety disorder, borderline personality disorder, and alcohol dependence. Doc. #12-3 at 17. The ALJ determined that a number of plaintiff's other conditions did not constitute severe impairments, including PTSD, hyperlipidemia, hypertension, and COPD.

         At step three, the ALJ declined to conclude that plaintiff was per se disabled, because plaintiff did not have an impairment or combination of impairments that met or medically equaled the severity of one of the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1. Doc. #12-3 at 17. The ALJ considered listings 1.02 (major joint dysfunction), 1.04 (spine disorder), 12.04 (affective disorder), 12.06 (anxiety disorder), 12.08 (personality disorder), 12.09 (substance addiction disorder), focusing in particular on 12.04 and 12.09. Those two listings require-with certain limited exceptions referred to as “paragraph C” criteria-at least two of the following “paragraph B” criteria:

1. Marked restriction of activities of daily living; or
2. Marked difficulties in maintaining social functioning; or
3. Marked difficulties in maintaining concentration, persistence, or pace; or 4. Repeated episodes of decompensation, each of extended duration[.]

         The ALJ concluded that none of the paragraph C criteria applied in plaintiff's case. In addition, she found that plaintiff had mild limitations in the first two paragraph B criteria, moderate difficulties in the third ...

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