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.
plaintiff argues, in substance, (1) that the Administrative
Law Judge (“ALJ”) failed to follow the treating
physician rule because he did not make weight assessments
with respect to the opinions of her treating psychiatrist
Leela Panoor, M.D. (“Panoor”), her treating
therapist Erica Wilcox, MS, CRC, LPC (“Wilcox”),
and her examining therapist Alison Rutherford, MSWI
(“Rutherford”), and the opinions of each were
entitled to some, if not significant or controlling weight;
(2) that the ALJ's analysis with respect to the RFC
determination did not account for the opinions of the
plaintiff's treating physicians and the plaintiff's
statements; and (3) that the ALJ erred in concluding that the
defendant had met its burden of proof at Step Five of the
Sequential Evaluation Process.
defendant argues that the ALJ properly weighed the medical
opinions of record and that substantial evidence supports the
ALJ's Step Five Determination.
court concludes that this case must be remanded because the
ALJ failed to follow the treating physician rule as to Panoor
and Wilcox. The court does not address the remaining
arguments because application of the treating physician rule
at a rehearing may moot those issues.
district court reviewing a final  decision . . . [of the
Commissioner of Social Security] pursuant to section 205(g)
of the Social Security Act, 42 U.S.§ 405(g), is
performing an appellate function.” Zambrana v.
Califano, 651 F.2d 842, 844 (2d Cir. 1981). The court
may not make a de novo determination of whether a plaintiff
is disabled in reviewing a denial of disability benefits.
See 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 Commissioner
applied the correct legal principles in reaching a conclusion
and whether the decision is supported by substantial
evidence. See Johnson v. Bowen, 817 F.2d 983, 985
(2d Cir. 1987). 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) (quoting Richardson v.
Perales, 402 U.S. 389, 401 (1971)). Substantial evidence
must be “more than a mere scintilla or touch of proof
here and there in the record.” Williams, 859
F.2d at 258.
opinion of a claimant's treating physician as to the
nature and severity of the impairment is given
‘controlling weight' so long as it ‘is
well-supported by medically acceptable clinical and
laboratory diagnostic techniques and is not inconsistent with
the other substantial evidence in [the] case
record.'” Burgess v. Astrue, 537 F.3d 117,
128 (2d Cir. 2008) (quoting 20 C.F.R. § 404.1527(d)(2)).
This is “particularly true [i]n the context of a
psychiatric disability diagnosis[, ] such as in this case. In
such a case, it is improper to rely on the opinion of a
non-treating, non-examining doctor because the inherent
subjectivity of a psychiatric diagnosis requires the
physician rendering the diagnosis to personally observe the
patient.” Griffin v. Colvin, No. 3:15CV105
(JGM), 2016 WL 912164, at *16 (D. Conn. Mar. 7, 2016)
(internal quotations and citation omitted); Santiago
v. Barnhart, 441 F.Supp.2d 620, 629 (S.D.N.Y.
July 27, 2006) (“The Treating Physician Rule recognizes
that a physician who has a long history with a patient is
better positioned to evaluate the patient's disability
than a doctor who observes the patient once for the purposes
of a disability hearing. The rule is even more relevant in
the context of mental disabilities, which by their nature are
best diagnosed over time.”).
regulations further provide that even if controlling weight
is not given to the opinions of the treating physician, the
ALJ may still assign some weight to those views, and must
specifically explain the weight that is actually given to the
opinion.” Schrack v. Astrue, 608 F.Supp.2d
297, 301 (D. Conn. 2009) (citing Schupp v. Barnhart,
No. Civ. 3:02CV103 (WWE), 2004 WL 1660579, at *9 (D. Conn.
Mar. 12, 2004)).
to provide ‘good reasons' for not crediting the
opinion of a claimant's treating physician is a ground
for remand.” Snell v. Apfel, 177 F.3d 128,
133-34 (2d Cir. 1999) (citing Schaal v. Apfel, 134
F.3d 496, 505 (2d Cir. 1998)). The “good reasons”
must be stated explicitly and set forth comprehensively.
See Burgin v Asture, 348 F. App'x 646, 649 (2d
Cir 2009) (“The ALJ's consideration must be
explicit in the record.”); Tavarez v.
Barnhart, 124 F. App'x 48, 49 (2d Cir. 2005)
(“We do not hesitate to remand when the Commissioner .
. . do[es] not comprehensively set forth reasons for the
weight assigned . . . .”) (internal quotation marks and
citation omitted); Reyes v. Barnhart, 226 F.Supp.2d
523, 529 (E.D.N.Y. 2002)(“rigorous and detailed”
determining the amount of weight to give to a medical
opinion, the ALJ must consider all of the § 404.1527(c)
factors: the examining relationship, the treatment
relationship (the length, the frequency of examination, the
nature and extent), evidence in support of the medical
opinion, consistency with the record, specialty in the
medical field, and any other relevant factors. See
Schaal, 134 F.3d at 504 (“all of the factors
cited in the regulations” must be considered to avoid
Rosa v. Callahan, 168 F.3d 72 (2d Cir. 1999), the
court explained the ALJ's duty in a case where there are
deficiencies in the record:
[W]here there are deficiencies in the record, an ALJ is under
an affirmative obligation to develop a claimant's medical
history “even when the claimant is represented by
counsel or . . . by a paralegal.” Perez, 77
F.3d at 47; see also Pratts, 94 F.3d at 37
(“It is the rule in our circuit that ‘the ALJ,
unlike a judge in a trial, must  affirmatively develop the
record' in light of ‘the essentially
non-adversarial nature of a benefits proceeding.'[. . .
].”) (citations omitted).
Id. at 79. See also Clark v. Comm'r of Soc.
Sec., 143 F.3d 115, 118-19 (2d Cir. 1998) (holding that
the ALJ should have sought clarifying information sua sponte
because the doctor might have been able to provide a
supporting medical explanation and clinical findings, that
failure to include support did not mean that support did not
exist, and that the doctor might have included it had he
known that the ALJ would consider it dispositive).
Gaps in the administrative record warrant remand . . . .
Sobolewski v. Apfel,985 F.Supp. 300, 314
(E.D.N.Y.1997); see Echevarria v. Secretary of Health
& Hum. Servs.,685 F.2d ...