United States District Court, D. Connecticut
ORDER REMANDING CASE
W. Thompson United States District Judge
reasons set forth below, the decision of the Commissioner is
reversed and this case is remanded for additional proceedings
consistent with this order.
court's function when reviewing a denial of disability
benefits is first to ascertain whether the Commissioner
applied the correct legal principles in reaching a
conclusion, and then whether the decision is supported by
substantial evidence. See Johnson v. Bowen, 817 F.2d 983, 985
(2d Cir. 1987). Absent legal error, this court may not set
aside the decision of the Commissioner if it is supported by
substantial evidence. See Berry v. Schweiker, 675 F.2d 464,
467 (2d Cir. 1982).
plaintiff contends, inter alia, that given the nature of an
autoimmune illness like systemic lupus erythematosus
(“Lupus”), the ALJ erred, at a minimum, by
dismissing Lupus symptoms as intermittent without evaluating
how the symptoms affect functional limitations. The court
agrees that the ALJ's opinion does not reflect that he or
she properly addressed the fact that intermittent symptoms
are characteristic of Lupus.
Green-Younger v. Barnhart, 335 F.3d 99 (2d Cir. 2003), where
the impairment at issue was fibromyalgia, the court
recognized the need for remand when an ALJ appears to have
misunderstood the nature of the plaintiff's condition.
Thus, the court concluded that the decision was “based
on an erroneous legal standard and . . . not supported by
substantial evidence, ” Id. at 109, because
the ALJ “effectively required ‘objective'
evidence for a disease that eludes such measurement.”
Id. at 108. The court observed that “a growing
number of courts, . . . have recognized that fibromyalgia is
a disabling impairment and that ‘there are no objective
tests which can conclusively confirm the disease.' . . .
Yet each of the AJL's determinations turned on a
perceived lack of objective evidence.” Id.
Also, in Herrick v. Colvin, No. 3:14-cv-01426 (SRU)
(Recommended Ruling Jan. 4, 2016), another case involving
fibromyalgia, the court concluded:
The ALJ's analysis, which centers on Plaintiff's
subjective complaints of pain as not supported by objective
medical evidence, fails to meaningfully consider whether
fibromyalgia resulted in Plaintiff's symptoms
fluctuating, and whether there were any resulting functional
limitations stemming from that fluctuation. As a result, the
Court cannot say that substantial evidence supports the RFC
finding because the ALJ did not explain how Plaintiff's
symptoms - on their worst days - would be addressed by the
Id. at 7-8.
was the condition at issue in Johnson v. Astrue, 628 F.3d 991
(8th Cir. 2011). There the court observed:
SLE causes a person's immune system to attack and injure
the body's own organs and tissues. Its cause is unknown,
and diagnosis can be difficult. Symptoms vary greatly and may
include: joint pain including arthritis, skin
rashes, coughing and shortness of breath, fever, fatigue,
weight loss, nausea and vomiting, headaches and confused
thinking, kidney malfunction, and pericarditis
(inflammation of the tissue surrounding the heart).
“Almost every system of the body can be
Id. at 993. The court took note of the fact that
“[t]he severity of lupus fluctuates over time, with
‘periods with mild or no symptoms, followed by a flare
[during which] symptoms increase in severity and new organ
systems may become affected.'” Id. (citing
4 The Gale Encyclopedia of Medicine 3616-17 (3d ed. 2006)).
case, the ALJ concluded that the plaintiff's Lupus was a
severe impairment and found that the plaintiff's
medically determinable impairments could reasonably be
expected to cause the symptoms testified to by the claimant.
The ALJ's opinion reflects that Andre Diaz, M.D. had
diagnosed the plaintiff with Lupus. When discussing Listing
14.02, the ALJ noted that the plaintiff “often reports
dramatic symptoms, but physical examinations were less than
impressive and revealed no more than mild clinical signs. . .
.” (Tr. 27). When determining residual functional
capacity, the ALJ noted that, at the hearing, the plaintiff
testified that she experiences weekly flare-ups and her
symptoms included chronic pain, inflammation, fever, and
infections. The ALJ concluded with respect to Lupus that the
plaintiff's symptoms occurred
Regarding the claimant's systemic lupus erythematosus,
the claimant's symptoms occur intermittently, and though
the claimant often reports dramatic symptoms, clinical signs
were less impressive. For instance, treatment records from
August, 2012 through October, 2012, showed that the claimant
reported joint pain, and generalized weakness, but physical
examination was unremarkable except for tenderness to
palpation over the trapezius muscles. (Exhibit 19). Yet on
other occasions, the claimant reported no joint pain or other
the ALJ acknowledged that the plaintiff's symptoms with
respect to Lupus occurred intermittently, instead of
considering that fact as something to be expected when
reviewing a claim involving Lupus and taking that factor into
account as part of the analysis, the ALJ concluded that the
fact that the plaintiff's symptoms occurred
intermittently undermined the credibility of the
plaintiff's reports about her symptoms. Nor does it
appear that the ALJ's analysis took into account the fact
that because the cause of Lupus is unknown and diagnosis can
be difficult, symptoms vary greatly. Moreover, the extent to
which the ALJ did not credit the claimant's testimony
because her claimed symptoms were greater than the ALJ
expected in light of the objective, clinical evidence and
treatment notes is unclear. For instance, ...