United States District Court, D. Connecticut
RULING ON THE PLAINTIFF'S MOTION TO REVERSE AND
THE DEFENDANT'S MOTION TO AFFIRM THE DECISION OF THE
Michael P. Shea, U.S.D.J.
an administrative appeal following the denial of the
plaintiff, Paula Benjamin's, application for disability
insurance benefits. The appeal is brought pursuant to 42
U.S.C. §§ 405(g) and 1383(c)(3). Ms. Benjamin now
moves for an order reversing the decision of the Commissioner
of the Social Security Administration
(“Commissioner”). In the alternative, Ms.
Benjamin seeks an order remanding her case for a rehearing.
The Commissioner, in turn, has moved for an order affirming
Benjamin argues, among other things, that the Administrative
Law Judge (“ALJ”) erred in concluding that Ms.
Benjamin's medical conditions did not meet or medically
equal a listed impairment, which would have made her per
se disabled, and that the ALJ did not properly apply the
treating physician rule in determining Ms. Benjamin's
Residual Functional Capacity (“RFC”). Although I
find that the ALJ did not err in concluding that Ms.
Benjamin's conditions did not medically equal a listed
impairment, I agree with Ms. Benjamin that the ALJ improperly
applied the treating physician rule as to opinions about
concentration problems and the need for unscheduled breaks.
The case is therefore REMANDED. I do not reach Ms.
Benjamin's remaining arguments urging reversal or remand.
August 26, 2013, Ms. Benjamin filed an application for
disability benefits for an alleged disability that commenced
on March 15, 2013, and continued through the date of the
ALJ's decision. (Pl's Mem., ECF No. 15-1 at 2-3;
D's Mem., ECF No. 16-1 at 1.) On October 16, 2013, a
disability adjudicator in the Social Security Administration
denied her initial request for disability benefits and
thereafter denied her request for reconsideration.
(Id.) On December 17, 2014, Ms. Benjamin appeared
with counsel for a hearing before Administrative Law Judge
Denise Horton. (Id.) On February 20, 2015, the ALJ
issued a decision denying benefits. (Id.)
found that Ms. Benjamin was a 56 year old woman with severe
impairments of degenerative disc disease, chondromalacia of
the right knee, and obesity. (ALJ Decision, ECF No. 13-3 at
45.) The ALJ determined that Ms. Benjamin did not have a
listed impairment, had the RFC to perform “light
work” as defined in 20 C.F.R. § 404.1567, was able
to perform past relevant work, and was therefore not disabled
within the meaning of the Social Security Act. (Id.
at 45-56.) On October 8, 2015, the appeals council denied Ms.
Benjamin's request for review of that decision, thereby
making the ALJ's decision the final decision of the
Commissioner. (ECF No. 15-1 at 2-3; ECF No. 16-1 at 2.) This
facts and portions of the ALJ's decision will be
discussed below as necessary.
Social Security Act establishes that benefits are payable to
individuals who have a disability. 42 U.S.C. §
423(a)(1). “The term ‘disability' means...
[an] inability to engage in any substantial gainful activity
by reason of any medically determinable physical or mental
impairment....” 42 U.S.C. § 423(d)(1). To
determine whether a claimant is disabled within the meaning
of the Social Security Act, the ALJ must follow a five-step
evaluation process as promulgated by the
Commissioner. To be considered disabled, an
individual's impairment must be “of such severity
that he is not only unable to do his previous work but
cannot... engage in any other kind of substantial gainful
work which exists in the national economy.” 42 U.S.C.
district court reviewing a final... decision pursuant
to… 42 U.S.C. § 405(g), is performing an
appellate function.” Zambrana v. Califano, 651
F.2d 842, 844 (2d Cir. 1981). “The findings of the
Commissioner of Social Security as to any fact, if supported
by substantial evidence, shall be conclusive.” 42
U.S.C. § 405(g). Accordingly, a district court may not
make a de novo determination of whether a plaintiff
is disabled in reviewing a denial of disability benefits.
Wagner v. Sec'y of Health & Human Servs.,
906 F.2d 856, 860 (2d Cir. 1990). Rather, the court's
function is to ascertain whether the correct legal principles
were applied in reaching the decision, and whether the
decision is supported by substantial evidence. Johnson v.
Bowen, 817 F.2d 983, 985 (2d Cir. 1987). If the
Commissioner's decision is supported by substantial
evidence, that decision will be sustained, even where there
may also be substantial evidence to support the
plaintiff's contrary position. Schauer v.
Schweiker, 675 F.2d 55, 57 (2d Cir. 1982). The Second
Circuit has defined substantial evidence as “such
relevant evidence as a reasonable mind might accept as
adequate to support a conclusion.” Williams v.
Bowen, 859 F.2d 255, 258 (2d Cir. 1988) (internal
citation and quotation marks omitted). Substantial evidence
must be “more than a mere scintilla or a touch of proof
here and there in the record.” Id.
first decide whether substantial evidence supported the
determination that Ms. Benjamin's condition did not meet
or medically equal a listed impairment,  which would have
made her disabled per se. 20 C.F.R. §
404.1520(a)(4)(iii). “For a claimant to qualify for
benefits by showing that his unlisted impairment, or
combination of impairments, is ‘equivalent' to a
listed impairment, he must present medical findings equal in
severity to all the criteria for the one most
similar listed impairment.” Sullivan v.
Zebley, 493 U.S. 521, 531 (1990) (quoting 20 C.F.R.
§ 416.926(a); footnote omitted).
issue in this case is Listing 1.02A, the listed impairment of
“[m]ajor dysfunction of a joint(s), ” which
describes “[i]nvolvement of one major peripheral
weight-bearing joint (i.e., hip, knee, or ankle), resulting
in inability to ambulate effectively.” 20 C.F.R. §
Pt. 404, Subpt. P, App. 1, 1.02A. According to the
regulations, inability to ...