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Edwards v. Berryhill

United States District Court, D. Connecticut

January 31, 2018



          Janet C. Hall United States District Judge


         Plaintiff Bonnie Rae Edwards (“Edwards”) brings this action under title 42, section 405(g) of the United States Code, appealing from the final determination of the Commissioner of Social Security (“the Commissioner”), who denied her application for Title II disability insurance benefits in whole and her application for Title XVI supplemental security income in part, based on a finding that Edwards became disabled on November 1, 2012. Motion to Reverse the Decision of the Commissioner (“Pl.'s Mot.”) (Doc. No. 20). The Commissioner cross-moves for an order affirming that Decision. Defendant's Motion for Judgment on the Pleadings (“Def.'s Mot.”) (Doc. No. 21).

         For the reasons set forth below, the Motion to Reverse the Decision of the Commissioner (Doc. No. 20) is granted, and the Motion for Judgment on the Pleadings (Doc. No. 21) is denied. The ALJ's October 2016 Decision is vacated with respect to the period before November 1, 2012, and the case is remanded to the ALJ for proceedings consistent with this Ruling.


         The court assumes the parties' familiarity with the evidence of Record, and it will therefore only briefly describe the facts relevant to this opinion.

         Bonnie Rae Edwards was born in April 1958. See, e.g., Certified Transcript of Record (“R.”) (Doc. No. 16) at 2190. During her childhood, many of her family members, including her stepfather and her grandmother, were alcoholics. See id. at 1251, 1264. At age eight, friends of her older brother sexually abused her. See id. at 1251. She has been married twice (and divorced twice) and was physically abused by both her ex-husbands, as well as other men with whom she has been in relationships. See id. at 1251-52, 2255-56. These experiences led to the development of post-traumatic stress disorder (“PTSD”). See, e.g., id. at 484. Edwards had four children, one of whom was murdered in June 2012. See id. at 2648-49.

         Edwards has a long history of substance abuse, including addictions to alcohol, heroin, and cocaine, as well as the abuse of prescription opiates and crack cocaine. See, e.g., id. at 2206. Although she has had periods of sobriety, she also had frequent relapses through approximately 2009. See id. For at least some of the time in which she was actively abusing substances, Edwards was homeless, staying variously with family, in shelters, or on the street. Id. at 1250.

         From the last nineties through 2002, Edwards was employed in various administrative roles at Yale University. See id. at 2244. In 2002, Edwards was terminated as a result of excessive absences stemming from her drug use. Id. Although she has briefly obtained work since then, she has not been able to hold a position long enough to constitute “substantial work” since her employment with Yale. See id. at 2203.

         Her medical history indicates that she has been diagnosed with depression, bipolar disorder, PTSD, anxiety disorder, borderline personality disorder, heroin dependence, and cocaine dependence. See, e.g., id. at 436, 450, 1264. She has also been diagnosed with asthma; carpal tunnel syndrome; degenerative disc disease; sciatica; gastrointestinal reflux disease; varicose veins; hepatitis A, B, and C; and genital herpes. See, e.g., id. at 1264-66, 1691, 1841, 2206-10 (summarizing medical history).


         To say that this case has a lengthy procedural history would be an understatement. In total, the case has been before two different ALJs, who have held a total of six hearings and issued four decisions, and has reached the District of Connecticut on two occasions prior to this case. The following is a summary of the relevant procedural history.

         Edwards filed a Title II application for a period of disability and disability insurance benefits on April 17, 2006. See R. at 224-28. She also filed a Title XVI application for supplemental security income on April 17, 2006. See id. at 229-33. Both applications alleged that her disability onset date was January 1, 2003. The Social Security Administration denied her claims initially on August 3, 2006, and upon reconsideration denied them again on January 12, 2007. See id. at 139-41, 148-50. Edwards then requested a hearing, which took place before Administrative Law Judge (“ALJ”) Ronald Thomas on December 17, 2007. Id. at 1315-45. Following that hearing, ALJ Thomas issued a partially favorable Decision on January 25, 2008, finding Edwards disabled as of July 1, 2007, but not before that date. Id. at 113-32. ALJ Thomas found that Edwards was unable to work between January 1, 2003, and July 1, 2007, but that she was not eligible for disability benefits during this period because “she failed to follow treatment prescribed by a treating source that can be expected to restore her ability to work.” Id. at 129.

         The Social Security Appeals Commission vacated and remanded ALJ Thomas's January 2008 Decision on January 15, 2009. Id. at 133-38. The Appeals Commission observed that ALJ Thomas had reached conflicting conclusions in his Decision, namely that Edwards would have been able to work prior to July 1, 2007, had she not been abusing substances, while at the same time concluding that Edwards became eligible for benefits on July 1, 2007, because of her sobriety. Id. at 137. The Appeals Commission noted, too, that “[i]rrespective of this apparent contradiction, the Appeals Council is of the opinion that the real issue in this case is whether or not drug addiction is a contributing factor material to the issue of disability, and not whether the claimant failed to follow prescribed treatment.” Id. The Appeals Council ordered, among other things, that ALJ Thomas obtain testimony from a medical expert. Id.

         On June 24, 2009, ALJ Thomas held another hearing. Id. at 60-107. During this hearing, medical expert Dr. Billings Fuess, PhD, [1] testified by phone, over the objection of counsel for Edwards, Attorney Ivan Katz. See id. at 63-64. Following this hearing, ALJ Thomas issued a Decision on November 23, 2009. Id. at 7-37. In his 2009 Decision, ALJ Thomas concluded that Edwards met the listing 12.09, finding that she had behavioral changes associated with the regular use of substances, marked limitations in activities of daily living (noting specifically that she had experienced homelessness), marked difficulties in social functioning (including engaging in destructive relationships and committing crimes resulting in incarceration), and marked difficulties in concentration, persistence, or pace. Id. at 14. ALJ Thomas further concluded that, “[i]f the claimant stopped the substance use, the remaining limitations would not meet or medically equal the criteria of listings 12.04 or 12.06. Id. He found, specifically, that if she stopped abusing substances Edwards would have only mild restrictions in activities of daily living; moderate difficulties with social functioning; moderate difficulties with concentration, persistence, or pace; and no episodes of decompensation. Id. ALJ Thomas concluded that “the claimant would not be disabled if she stopped the substance use” and therefore “the claimant has not been disabled within the meaning of the Social Security Act at any time from the alleged onset date through the date of this decision.” Id. at 26.

         Edwards appealed Thomas's 2009 Decision, and the Appeals Council denied review, rendering ALJ Thomas's 2009 Decision a final order appealable to the District Court. Id. at 1-4. On appeal, Judge Mark Kravitz of the District of Connecticut concluded that ALJ Thomas had committed legal error when he took the telephonic testimony of Dr. Fuess without notice to the claimant and over the objection of Attorney Katz.[2] See Edwards v. Astrue, No. 3:10-cv-1017 (MRK), 2011 WL 3490024 (D. Conn. Aug. 10, 2011). He therefore vacated ALJ Thomas's 2009 Decision and remanded the case to the Social Security Administration for proceedings consistent with his Ruling. Id. at *11.

         On remand, the case was assigned to ALJ Deirdre Horton. ALJ Horton held an initial hearing in the matter on April 29, 2013, at which Edwards did not appear but counsel for Edwards, Attorney Katz, was present. See R. at 1346-73. During the April 2013 hearing, ALJ Horton took the testimony of medical expert James Claiborn, Ph.D., [3]by live video conference. See id. at 1348. A supplemental hearing was held on September 4, 2013, at which Edwards was present and testified. Id. at 1315-45. Following these hearings, ALJ Horton issued a Decision on February 19, 2014. Id. at 1267-94. In that Decision, ALJ Horton denied benefits, stating “the claimant is under a disability, but . . . a substance use disorders [sic] is a contributing factor material to the determination of disability” and consequently “the claimant has not been disabled under the Social Security Act any time from the alleged onset date through the date of this decision.” Id. at 1271. ALJ Horton further found that “[t]he severity of the claimant's mental impairments, considered singly and in combination, did not meet or medically equal the criteria of listings 12.04, 12.06, 12.08, or 12.09.” Id. at 1274. She found that Edwards had marked restrictions in activities of daily living (noting that Edwards had lost her long-term job, experienced homelessness, that her driver's license was suspended and then expired, and that she lost custody of her daughter). Id. She also found that Edwards had moderate difficulties in social functioning (noting her tumultuous relationships and run-ins with the law), moderate difficulties in concentration, pace, or persistence (leading to the loss of her long-term job), and had “one to two” episodes of decompensation (in the form of inpatient hospitalizations). Id. Because she found that Edwards had “marked” limitations in only one category, she disagreed with Dr. Claiborn's opinion that Edwards met or medically equaled listing 12.09 while she was abusing substances. Id. at 1275.[4]

         Once again, Edwards appealed the Decision to the District Court.[5] On November 20, 2014, the Commissioner stipulated to a remand to develop the record further. That stipulation provided that the ALJ would develop the record as follows:

1. Update the medical evidence of record and attempt to obtain all of the treatment notes from Richard H. Feuer, M.D., and the records from Community Health Center with the help of Plaintiff's representative;
2. Determine whether Plaintiff is under a disability taking into consideration all of the impairments, including the polysubstance use, following the sequential evaluation process outlined in 20 C.F.R. §§ 404.1520 and 416.920; and, if Plaintiff is found disabled, determine whether the polysubstance use is material to the determination of disability (20 C.F.R. §§ 404.1535 and 416.935 and Social Security Ruling 13-2p);
3. Further evaluate Plaintiff's subjective complaints pursuant to 20 C.F.R. §§ 404.1529 and 416.929 and Social Security Ruling 96-7p;
4. Obtain supplemental evidence from a medical expert to assist in determining the nature and severity of Plaintiff's mental impairments, with and without the polysubstance use pursuant to 20 C.F.R. §§ 404.1527(e) and 416.927(e) and Social Security Ruling 96-6p;
5. Further evaluate whether Plaintiff's past jobs meet the requirements of past relevant work (i.e., performed within the past fifteen years at substantial gainful activity level and long enough to learn how to perform the job) and, if so, with the assistance of a vocational expert, determine whether she can perform the physical and mental demands of this work, and;
6. If the case proceeds to step five, with the assistance of a vocational expert, determine whether Plaintiff could perform other jobs existing in significant numbers in the national economy with the assessed limitations.

Edwards v. Colvin, No. 3:14-CV-776 (JGM) (Doc. No. 19).

         On remand, ALJ Horton held additional hearings on December 18, 2015, R. at 2230-71, and August 30, 2016, id. at 2272-324. Edwards, with Attorney Katz, was present at both hearings, the second of which was primarily devoted to taking the testimony of Dr. Fuess--who, as noted above, testified before ALJ Thomas in 2009-- and vocational expert Edmond Calandra. At the August 2016 hearing, Attorney Katz objected to Dr. Fuess's testimony on the basis that Dr. Fuess had previously offered testimony in Edwards's case, id. at 2275, and objected to Calandra as unqualified, id. at 2308. ALJ Horton overruled both objections. Id. at 2276, 2309. Following these hearings, ALJ Horton issued the Decision currently pending before this court on October 21, 2016. See id. 2194-229.

         In her October 2016 Decision, ALJ Horton concluded that Edwards meets the insured status requirements of the Social Security Act through December 31, 2007. Id. at 2203. She further found that Edwards has not engaged in substantial gainful activity since the alleged onset date of January 1, 2003. Id. She found that Edwards suffers from the following severe impairments: polysubstance abuse; post-traumatic stress disorder (“PTSD”); major depressive disorder; bipolar disorder; cervical and lumbar degenerative disc disease; and asthma. Id. She noted that Edwards had suffered from carpal tunnel syndrome in the past, but found that it is a non-severe impairment. Id. at 2203-04. She further noted that, although Edwards has suffered from intermittent gastrointestinal issues and varicose veins, the Record contained no evidence that they have caused more than minimal limitations. Id. at 2204. ALJ Horton found that Edwards's severe physical impairments did not meet the listings and concluded that Edwards's mental health conditions, including polysubstance abuse, did not meet or medically equal a listing at any time. Id. In so concluding, she noted that Dr. Fuess testified “that the claimant had mild restrictions in activities of daily living; moderate restrictions in social functioning; mild limitations in concentration, persistence, and pace, and no episodes of decompensation.” Id. Although ALJ Horton acknowledged that title 20, sections 404.1535 and 416.935 of the Code of Federal Regulations requires an ALJ to determine whether a claimant's drug and alcohol abuse (“DAA”) is a contributing factor material to the determination of disability “when (1) the adjudicator finds that the claimant is disabled, and (2) there is medical evidence of DAA during the relevant time period, ” she concluded that this analysis was unnecessary in light of her finding that Edwards had not been disabled at any time. Id. at 2208.

         ALJ Horton concluded that Edwards had the residual functional capacity (“RFC”) to perform light work “with frequent climbing of ramps / stairs; balancing; stooping; kneeling; crouching; crawling; no ladders / ropes / scaffolds; frequent handling and fingering” and that she was limited to “[s]hort simple tasks and occasional contact with the general public; can work around others but no collaborative work.” Id. at 2205. Based on that RFC, ALJ Horton concluded that Edwards could perform occupations such as Maid, Dictionary of Occupational Titles (“DOT”) number 323.687-014; Mail Clerk, DOT number 209.687-026; and Assembler, DOT number 706.684-022. Id. at 2212. ALJ Horton found that there were 800, 000 Maid jobs nationally, 100, 000 Mail Clerk jobs nationally, and 900, 000 Assembler jobs nationally. Id. She therefore concluded that jobs exist in “significant numbers in the national economy” that Edwards could have performed prior to November 1, 2012, making a finding of “not disabled” appropriate. Id. at 2212-13.

         With respect to the time period from November 1, 2012, onward, however, ALJ Horton noted that a person of advanced age (fifty-five years old) who is limited to light work is considered disabled, and that the designation of “advanced age” can be applied “non-mechanically” under certain limited circumstances to as early as six months before a claimant's fifty-fifth birthday. Id. at 2211. Finding that Edwards's psychiatric condition worsened in the wake of her son's death and constituted an “additional adversity” justifying a “non-mechanical application of the rules, ” and, on this basis, found Edwards disabled as of November 1, 2012. Id. Neither Edwards nor the Commissioner challenged this finding in the pending Motions, and therefore this court has not reviewed, and is not vacating, that aspect of ALJ Horton's 2016 Decision.


         Under title 42, section 405(g) of the United States Code, it is not the district court's function to determine de novo whether the claimant was disabled. See Schaal v. Apfel, 134 F.3d 496, 501 (2d Cir. 1998). Instead, the court is limited to two lines of inquiry: whether the ALJ applied the correct legal standard, and whether the record contains “substantial evidence” to support her decision. See Rosa v. Callahan, 168 F.3d 72, 77 (2d Cir. 1999). “Substantial evidence” is “more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting Consol. Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)).

         V. ANALYSIS

         In her Memorandum of Law in Support of her Motion to Reverse the decision of the Commissioner, Edwards makes four arguments: (1) that ALJ Horton erred in her application of the treating physician rule, Pl.'s Mem. at 11-19; (2) that ALJ Horton failed to develop the record adequately, id. at 19-25; (3) that ALJ Horton's credibility determination was not supported by substantial evidence, id. at 25-27; and (4) that the ALJ's determination that work existed in substantial numbers in the national economy that Edwards could perform prior to November 1, 2012, was not supported by substantial evidence, id. at 27-36. The court addresses each of these arguments in turn.

         A. Treating Physician Rule

         The Record for this case includes treating source statements from the following practitioners: (1) Dr. Julia Shi, internist, dated March 1, 2005, R. at 1126-30; (2) Dr. Luis Gonzalez, psychiatrist, dated March 29, 2006, id. at 2164-71; (3) Gustavo Nava, Licensed Clinical Social Worker (co-signed by Dr. J.L. Kurt), dated December 14, 2006, id. at 1113-16; (4) Michael J. Kolpinski, M.S., dated October 30, 2007, id. at 976; and (5) Dr. Richard H. Feuer, psychiatrist, dated November 8, 2012, id. at 2190-93. The Record also contains a report dated July 20, 2006, written by state agency consultant Jesus Lago, MD, which is based on an interview with Edwards. Id. at 448-49. In addition, the Record contains written opinions from four state agency consultants, including: (1) a case analysis by Dr. Thomas Hanny, MD, dated May 18, 2006, id. at 447; (2) a psychiatric review technique form by Dr. Warren Leib, Ph.D, dated August 3, 2006, id. at 450-63; (3) a case analysis by Anita Bennett, MD, dated January 4, 2007, id. at 489; and (4) a mental RFC assessment, case analysis, and psychiatric ...

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