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Kumar v. Berryhill

United States District Court, D. Connecticut

September 26, 2017

ASHOK KUMAR, Plaintiff,


          VANESSA L. BRYANT, U.S.D.J.

         This is an administrative appeal following the denial of Ashok Kumar's application for disability insurance benefits under 42 U.S.C. §§ 405(g). Ashok Kumar (“Kumar”) has moved for an order reversing or remanding the decision of the Commissioner of the Social Security Administration (“Commissioner”). [Dkt. No. 14.] The Commissioner has moved for an order affirming the decision. [Dkt. No. 22.] For the following reasons, Kumar's motion is GRANTED, the Commissioner's motion is DENIED, and the case is remanded for rehearing. I. Factual Background The parties failed to file a joint stipulation of facts as required in this District's Standing Scheduling Order on Social Security Cases. [Dkt. 4 at 2; Dkt. 14 at 1.] Given the parties' failure to file a stipulation of facts, the Court has spent an inordinate amount of time reviewing the record, which includes medical records which were and were not before the ALJ. The following facts are taken from the Court's own review.

         a. Plaintiff's Background

         Kumar was born in 1960. [Dkt. No. 13-4 at 40.] He worked as a chemist for the Department of Public Health for 30 years before his alleged disability arose. [Id. at 44-45; Dkt. 13-8 at 7.] Kumar meets the insured status requirements of the Social Security Act through December 31, 2019. [Dkt. No. 13-4 at 16.] On May 20, 2014, Kumar applied for a Period of Disability and Disability Insurance Benefits. [Dkt. 13-4 at 14.] On September 30, 2014, a disability adjudicator denied his initial request for disability benefits and thereafter denied his request for reconsideration. [Dkt. 13-6 at 3; Dkt. 13-6 at 11.] On August 19, 2015, Kumar appeared with counsel for a hearing before an Administrative Law Judge (“ALJ”). [Dkt. 13-4 at 36.] On December 2, 2015, the ALJ issued a decision denying benefits. Id. at 11. On January 27, 2016, the appeals council denied Kumar's request for review of that decision thereby making the ALJ's decision the final decision of the Commissioner. Id. at 2. This appeal followed.

         b. Kumar's Medical History Presented to the ALJ

         On February 12, 2013, Dr. Surendra Chawla conducted a CT scan on Kumar's chest which showed an ascending aortic aneurysm. [Dkt. 13-9 at 4.] In the following months, Kumar had three follow-up appointments regarding his CT scan. [Dkt. 13-9 at 2 (appointment with Dr. Anil Vithala); Dkt. 13-9 at 79 (appointment with Dr. Joseph Sappington); Dkt. 13-9 at 3 (appointment with Dr. Vithala).] Each doctor recommended heart surgery. Id.

         On November 12, 2013, Kumar reported to Middlesex Hospital experiencing chest pain. [Dkt. 13-9 at 8.] A physician at Middlesex Hospital conducted multiple tests which confirmed Kumar's aortic aneurysm. Id. at 9. Id. Kumar left the hospital against medical advice. Id. Shortly thereafter, on November 25, 2013, Kumar ceased working. [Dkt. 13-4 at 16.]

         On December 19, 2013, at Yale New Haven Hospital, Kumar underwent a cardiac catheterization in preparation for an aortic aneurysm repair surgery. [Dkt. 13-9 at 29.] The catheterization confirmed that the aortic aneurysm required surgical intervention. Id. at 30. Thereafter, Kumar met with multiple physicians to discuss his catheterization results, undergo further tests, and evaluate whether to have heart surgery. See Id. at 31 (January 31, 2014 meeting with Dr. John Elefteriades); id. at 43-45 (June 4, 2014 and July 10, 2014 meetings with Dr. Sappington and EKG); id. at 68, 73 (November 26, 2014 and April 28, 2015 meetings with Dr. Sappington). At each appointment, the physicians confirmed that Kumar has an aortic aneurysm requiring surgery.

         c. Medical Examinations and Opinions Before the ALJ

         The only medical opinions in the record before the ALJ were produced by agency consultative physicians. Dr. Jaimie Burns, Dr. Robert Sutton, and Dr. Adrian Brown each evaluated Kumar's mental health and determined he had no functional limitation or only mild functional limitation stemming from mental health conditions. [Dkt. 13-9 at 7-8, 18, 60.]

         As to Kumar's physical limitations, Dr. Firooz Golkar and Dr. Abraham Bernstein each opined that Kumar could occasionally lift 20 pounds, frequently lift 10 pounds, stand, sit, or walk for 6 hours in an 8 hour workday, frequently climb ramps or stairs or balance, and occasionally climb ladders or scaffolds, stoop, kneel, crouch, or crawl. [Dkt. 13-5 at 9, 19-20.] Dr. Golkar attributed Kumar's limitations to his ascending aorta aneurysm, hypertension (“htn”), and gout. Id. at 9. Dr. Bernstein cited Kumar's aneurysm only. Id. at 20.

         d. Medical Records and Opinions Not Presented to the ALJ

         Kumar as also submitted to the Court medical records and opinions which were not part of the record before the ALJ. Those additional records are described below.

         i. Files from Other Disability Claims Not Included in the Record Before the ALJ

         Prior to applying for social security benefits, Kumar applied for Connecticut state disability retirement benefits claiming an effective retirement date of September 1, 2014. [Dkt. 13-3 at 168.] The State of Connecticut's Medical Examining Board granted Kumar's claim on January 9, 2015. Id. at 193. The file includes letters from some of Kumar's treating physicians discussing his heart condition and opining on his ability to function. See, e.g., id. at 174 (note from Dr. Chawla stating Kumar should avoid activities which can lead to increased blood pressure); id. at 182 (letter from Dr. Vithala stating Kumar should avoid “any stress or anxiety” because “any increase in blood pressure can cause increased ballooning [of his aorta] and this can be fatal”) (emphasis in original).

         The file also includes a letter from Dr. Rekha Rande-Kapur, Kumar's treating mental health physician. [Dkt. 13-3 at 183.] Dr. Rande-Kapur stated it is “well known” that stress can “exacerbate any illness, especially heart disease, ” and opined that Kumar could not cope with a high-stress job or one which required him to work more than four hours per day. Id. at 184.

         Kumar also offers his applications for FMLA benefits dated June 10, 2013 and June 19, 2013. [Dkt. 13-4 at 27.] In those forms, Dr. Vithala states Kumar has a chronic condition requiring treatment and remarks that Kumar could ...

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