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.
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.C § 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).
plaintiff argues, inter alia, that the Administrative Law
Judge (“ALJ”) failed to properly weigh medical
opinion evidence. See Pl.'s Mem. to Reverse (Doc. No.
14-2) at 2.
defendant argues that the ALJ applied the correct legal
standard and that the Decision is supported by substantial
evidence. See Def.'s Mem. to Affirm (“Doc. No.
19-1”) at 18.
court concludes that, at minimum, the ALJ failed to follow
the treating physician rule when weighing the opinion of the
plaintiff's treating physician, Dr. Aurora Leon
Conde which, standing alone, warrants remand.
opinion of a claimant's treating physician as to the
nature and severity of the impairment is given
‘controlling weight' if 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)).
controlling weight is not given to the opinions of the
treating physician, the ALJ . . . 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)).
“Failure 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)). These reasons
must be stated explicitly and set forth comprehensively. See
Burgin v. Asture, 348 Fed.Appx. 646, 649 (2d Cir
2009) (“The ALJ's consideration must be explicit in
the record.”); Tavarez v. Barnhart, 124
Fed.Appx. 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” analysis required).
ALJ's explanation should be supported by the evidence and
be specific enough to make clear to the claimant and any
subsequent reviewers the reasons and the weight given. See 20
C.F.R. § 404.1527(f)(2); SSR 96-2p (applicable but
rescinded March 27, 2017, after the date of the ALJ's
determining the amount of weight to give to a medical
opinion, the ALJ must consider all of the factors set forth
in § 404.1527(c): 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
[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).
Rosa v. Callahan, 168 F.3d 72, 79 (2d Cir. 1999).
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 751, 755-56 (2d Cir. 1982).
. . .
The ALJ must request additional information from a treating
physician . . . when a medical report contains a
conflict or ambiguity that must be resolved, the
report is missing necessary information, or the report does
not seem to be based on medically acceptable clinical and
diagnostic techniques. Id. § 404.1512(e)(1).
When “an ALJ perceives inconsistencies in a
treating physician's report, the ALJ bears an affirmative
duty to seek out more information fromthe
treating physician and to develop the administrative record
accordingly, ” Hartnett, 21 F.Supp.2d
at 221, by making every reasonable effort to