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Harper v. Berryhill

United States District Court, D. Connecticut

July 20, 2017




         Plaintiff Julia R. Harper (“plaintiff”), an adult aged 47, 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” or “defendant”) denying her application for Supplemental Security Income (“SSI”) under the Act and for Adult Child's Insurance Benefits (“CIB”) based on disability. Plaintiff has moved to reverse the decision of the Commissioner, or in the alternative, for remand. [Doc. #19].

         For the reasons set forth below, plaintiff's Motion to Reverse the Decision of the Commissioner [Doc. #19] is DENIED, and defendant's Motion to Affirm the Decision of the Commissioner [Doc. #21] is GRANTED.


         Plaintiff filed concurrent applications for SSI, CIB, and Disability Insurance Benefits (“DIB”) on January 10, 2013, alleging disability beginning January 1, 1986. See Certified Transcript of the Administrative Record, compiled on August 24, 2016, (hereinafter “Tr.”) 449-465. Plaintiff's applications were denied initially on April 4, 2013, see Tr. 87-140, 186, 189, and upon reconsideration on September 24, 2013. See Tr. 144-179.[1]

         On July 20, 2015, plaintiff, accompanied and represented by attorney Ivan Katz, appeared and testified at a hearing before Administrative Law Judge (“ALJ”) Ronald J. Thomas. See Tr. 46-85. Vocational Expert (“VE”) Warren D. Maxim testified at the hearing by telephone. See Tr. 74-85. On September 17, 2015, the ALJ issued an unfavorable decision. See Tr. 14-30. On May 17, 2016, the Appeals Council denied plaintiff's request for review, thereby making the ALJ's September 17, 2015, decision the final decision of the Commissioner. See Tr. 1-4. The case is now ripe for review under 42 U.S.C. §405(g).

         Plaintiff filed this timely action for review and moves to reverse the Commissioner's decision, or to remand for a new hearing. [Doc. #19]. On appeal, plaintiff argues:

1. The ALJ erred at step two of the analysis;
2. The ALJ erred by failing to develop the administrative record and by failing to fill a gap in the administrative record;
3. The ALJ's Residual Functional Capacity (“RFC”) determination is not supported by substantial evidence;
4. The ALJ erred in evaluating the evidence; and
5. The ALJ's step five analysis is not supported by substantial evidence.

         As set forth below, the Court finds that the ALJ did not err as contended by plaintiff, and that the ALJ's determination is supported by substantial evidence.


         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) (citation omitted). 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. See 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.” (citing Tejada v. Apfel, 167 F.3d 770, 773-74 (2d Cir. 1999))). “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) (alterations added) (citing Treadwell v. Schweiker, 698 F.2d 137, 142 (2d Cir. 1983)). 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) (citing Carroll v. Sec. Health and Human Servs., 705 F.2d 638, 643 (2d Cir. 1983)). “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) (citing Peoples v. Shalala, No. 92CV4113, 1994 WL 621922, at *4 (N.D. Ill. Nov. 4, 1994)).

         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.” Talavera v. Astrue, 697 F.3d 145, 151 (2d Cir. 2012) (quoting Lamay v. Comm'r of Soc. Sec., 562 F.3d 503, 507 (2d Cir. 2009)).


         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, plaintiff 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 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[.]” 42 U.S.C. §423(d)(2)(A); 20 C.F.R. §416.920(c) (requiring that the impairment “significantly limit[] ... physical or mental ability to do basic work activities” to be considered “severe”).

         The SSA “provides disability insurance benefits for a disabled adult child on the earnings record of an insured person who is entitled to old-age or disability benefits or who has died if the claimant is 18 years old or older and has a disability that began before the claimant became 22 years old.” Doerr v. Colvin, No. 13CV429(JTC), 2014 WL 4057446, at *3 (W.D.N.Y. Aug. 14, 2014) (quotation marks and citations omitted). See 42 U.S.C. §402(d)(1)(G); 20 C.F.R. §404.350(a)(5). See also Vella v. Astrue, 634 F.Supp.2d 410, 417 (S.D.N.Y. 2009) (“Disabled adult child disability benefits are available if such child was under a disability (as so defined) at the time [s]he attained the age of 18 or if [s]he was not under such a disability (as so defined) at such time but was under a disability (as so defined) at or prior to the time [s]he attained (or would attain) the age of 22.” (quotation marks and citations omitted)), aff'd sub nom., Vella v. Comm'r of Soc. Sec., 394 F. App'x 755 (2d Cir. 2010). “In the context of determining eligibility for disabled adult child's benefits, the term ‘disability' has substantially the same definition as it does in traditional, adult disability cases.” Doerr, 2014 WL 4057446, at *3 (citation omitted).

         There is a familiar five-step analysis used to determine if a person is disabled. See 20 C.F.R. §416.920. This process applies to cases in which a claimant applies for child's benefits after she reaches the age of 18. See Trombley v. Colvin, No. 8:15CV00567(TWD), 2016 WL 5394723, at *2 n.3 (N.D.N.Y. Sept. 27, 2016) (“In determining eligibility for disabled [adult] child's benefits... the five-step sequential process is applicable.” (citation omitted)); see also Gagnon v. Comm'r of Soc. Sec., No. 7:14CV1194(GLS), 2016 WL 482068, at *1 (N.D.N.Y. Feb. 5, 2016) (“The regulations under 42 U.S.C. §405(g) govern both disability insurance benefits (DIB) and child's insurance benefits (CIB).” (citation omitted)).

         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 fourth and fifth steps:

Assuming the claimant does not have a listed impairment, the fourth inquiry is whether, despite the claimant's severe impairment, he has the residual functional capacity to perform his past work. Finally, if the claimant is unable to perform his past work, the Secretary then determines whether there is other work which the claimant could perform. Under the cases previously discussed, the claimant bears the burden of proof as to the first four steps, while the Secretary must prove the final one.


         “Through the fourth step, the claimant carries the burdens of production and persuasion, but if the analysis proceeds to the fifth step, there is a limited shift in the burden of proof and the Commissioner is obligated to demonstrate that jobs exist in the national or local economies that the claimant can perform given his residual functional capacity.” Gonzalez ex rel. Guzman v. Dep't of Health and Human Serv., 360 F. App'x 240, 243 (2d Cir. 2010) (citing 68 Fed. Reg. 51155 (Aug. 26, 2003) (alteration added)); Poupore v. Astrue, 566 F.3d 303, 306 (2d Cir. 2009) (per curiam)). The RFC is what a person is still capable of doing despite limitations resulting from his physical and mental impairments. See 20 C.F.R. §416.945(a)(1).

         “In assessing disability, factors to be considered are (1) the objective medical facts; (2) diagnoses or medical opinions based on such facts; (3) subjective evidence of pain or disability testified to by the claimant or others; and (4) the claimant's educational background, age, and work experience.” Bastien v. Califano, 572 F.2d 908, 912 (2d Cir. 1978). “[E]ligibility for benefits is to be determined in light of the fact that ‘the Social Security Act is a remedial statute to be broadly construed and liberally applied.'” Id. (quoting Haberman v. Finch, 418 F.2d 664, 667 (2d Cir. 1969)).


         Following the above-described five-step evaluation process, ALJ Thomas concluded that plaintiff was not disabled prior to the date she attained age 22, and was not disabled from the SSI application date through the date of the ALJ's decision. See Tr. 18, 29. For plaintiff's CIB claim, the ALJ first determined that plaintiff attained age 22 on December 5, 1991. See Id. at 20. At step one, the ALJ found that plaintiff had not engaged in substantial gainful activity from the alleged onset date of 1986 through December 5, 1991. See Id. At step two, the ALJ did not find evidence of a severe impairment prior to December 5, 1991. See id.

         For plaintiff's SSI application, at step one, the ALJ found that plaintiff had not engaged in substantial gainful activity since January 1, 2013, the SSI application date. See Id. At step two, as of January 1, 2013, the ALJ found that plaintiff had the severe impairments of a right rotator cuff tear with impingement; lumbago; diabetes mellitus; obesity; and bipolar disorder. See Id. The ALJ also found that plaintiff suffered from a substance abuse disorder that was not severe during the period in question, and that plaintiff's HIV was also not a severe impairment. See Id. at 21.

         At step three, the ALJ found that plaintiff's impairments, either alone or in combination, did not meet or medically equal the severity of one of the listed impairments in 20 C.F.R. Pt. 404, Subpt. P, App. 1. See Tr. 21. The ALJ specifically considered Listings 1.02 (major dysfunction of a joint), 1.04 (disorders of the spine), and 12.04 (affective disorders). See id.

         Before proceeding to step four, the ALJ found plaintiff has the RFC

to perform sedentary work as defined in 20 CFR 404.1567(a) and 416.967(a) except she is limited to occasional overhead reaching with the master arm; occasional bending, twisting, squatting, kneeling, crawling, climbing and balancing. She is further limited to occasional interaction with supervisors, the public, and co-workers. She is capable of sustaining ...

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