United States District Court, D. Connecticut
REBECCA L. BELLINGER, Plaintiff,
COMMISSIONER OF SOCIAL SECURITY, Defendant.
RULING ON THE PLAINTIFF'S MOTION TO REVERSE AND
THE DEFENDANT'S MOTION TO AFFIRM THE DECISION OF THE
MICHAEL P. SHEA, U.S.D.J.
appeal from the Social Security Commission's denial of
benefits, plaintiff Rebecca L. Bellinger argues that the
Administrative Law Judge (ALJ) erred because he (1) did not
consider the weekly infusions required to treat
Bellinger's anemia in assessing the severity of that
condition or in evaluating her residual functional capacity
(RFC); (2) did not consider the severity of Bellinger's
neck pain; (3) failed to state his reasons for declining to
give controlling weight to the medical source opinion of
Bellinger's treating neurologist; (4) failed to apply the
treating physician rule to the joint opinion of
Bellinger's treating psychiatrist and therapist; and (5)
failed to explain how he considered the records from a
consultative examination with a psychologist. I agree with
Ms. Bellinger's first, third, and fourth arguments and
grant her motion to remand the case to the Commissioner. I
express no opinion on her remaining arguments.
assume familiarity with the procedural history of the case,
the ALJ's opinion, the record, and the five sequential
steps used in the analysis of disability claims. I
incorporate the relevant portions of Bellinger's medical
history as necessary to my analysis of her argument in this
district court reviewing a final . . . decision pursuant to
...42 U.S.C. § 405(g), is performing an appellate
function.” Zambrana v. Califano, 651 F.2d 842,
844 (2d Cir. 1981). “The findings of the Commissioner
of Social Security as to any fact, if supported by
substantial evidence, shall be conclusive.” 42 U.S.C.
§ 405(g). Accordingly, a district court may not make a
de novo determination of whether a plaintiff is disabled in
reviewing a denial of disability benefits. 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 correct legal principles were applied
in reaching the decision, and whether the decision is
supported by substantial evidence. Johnson v. Bowen,
817 F.2d 983, 985 (2d Cir. 1987). If the Commissioner's
decision is supported by substantial evidence, that decision
will be sustained, even where there may also be substantial
evidence to support the plaintiff's contrary position.
Schauer v. Schweiker, 675 F.2d 55, 57 (2d Cir.
1982). 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)
(citation and quotation marks omitted). Substantial evidence
must be “more than a mere scintilla or a touch of proof
here and there in the record.” Id.
ALJ Failed to Consider Mr. Bellinger's Frequent Anemia
Treatments in Formulating the RFC
Bellinger argues that the ALJ erred by failing to consider
the length and frequency of her treatments for anemia in in
formulating the RFC. I agree.
Bellinger developed anemia following gastric bypass surgery
in 2008. (ECF No. 16-3 at 25; ECF No. 16-11 at 262.) In June
2014, she began weekly intravenous infusions lasting 2-3
hours for 10 weeks followed by a one-month break. (ECF No.
16-3 at 25; ECF No. 16-11 at 153-262.) The treatments took
place at the New London Cancer Center. (ECF No. 16-11 at
196.) Ms. Bellinger reported feeling fatigued at several of
her infusion appointments. (See ECF No. 22-1 at 5; ECF No.
16-11 at 153, 156, 159, 260.)
two, the ALJ acknowledged Ms. Bellinger's anemia and
treatments. (ECF No. 16-3 at 25.) He concluded that the
anemia was “non-severe” because she
“responded well to treatment with no side effects or
evidence of end-stage organ disease . . . .”
(Id.) The ALJ also noted that, although Ms.
Bellinger was treated at a cancer center, there was “no
evidence of cancer in the record.”
(Id.) In formulating the RFC, the ALJ again
noted Ms. Bellinger's testimony regarding her treatments
but did not explain whether or how he incorporated that
information into his conclusion. (ECF No. 16-3 at 28.)
the ALJ need not explicitly analyze every piece of evidence
in the record, see Lowry v. Astrue, 474 Fed.Appx.
801, 805 (2d Cir. 2012), he “must include a narrative
discussion describing how the evidence supports each
conclusion.” Titles II & XVI: Assessing Residual
Functional Capacity in Initial Claims, SSR 96-8P, 1996 WL
374184 at *7 (S.S.A. July 2, 1996). A discussion is
sufficient when it allows a reviewing court to “glean
the rationale” of the ALJ's decision. Lowry 474
Fed.Appx. at 805; Quinto v. Berryhill, No.
3:17-CV-00024 (JCH), 2017 WL 6017931, at *5 (D. Conn. Dec. 1,
RFC assessment must be based on all of the evidence in the
case record . . . including limitations or restrictions
imposed by the mechanics of treatment (e.g., frequency of
treatment, duration, disruption to routine, side effects of
medication).” SSR 96-8P, 1996 WL 374184 at *5.
“Absenteeism due to the frequency of treatment is a
relevant factor so long as the treatment is medically
necessary and concerns the conditions on which the disability
claim is founded.” Griffin v. Comm'r of Soc.
Sec., No. 2:15-CV-13715, 2017 WL 991006, at *2 (E.D.
Mich. Mar. 15, 2017). “Where the ALJ has made no
findings about the limitations caused by the claimant's
need for treatment, courts have remanded because it is not
the role of the court to speculate as to the ALJ's
rationale.” Quinto, 2017 WL 6017931, at *5. In Quinto,
for example, the court concluded that remand was necessary
where the ALJ failed to consider testimony that the claimant
required nebulizer treatments every four to five hours.
Id. at *9. The court explained that the error was
not harmless because the vocational expert had opined that
using the nebulizer once or twice per day would preclude all
case, Ms. Bellinger's testimony and her medical records
establish that she received weekly IV infusions for anemia
that lasted 2-3 hours. (ECF No. 16-3 at 64; ECF No. 16-11 at
153-262.) The ALJ acknowledged that Ms. Bellinger was
concerned that she might lose her job due to absences from
her condition (id. at 36, 37), and that absences due to
appointments with specialists could affect her employment
prospects (id. at 39) (“Despite her medical conditions
and frequent appointments with specialists, the complainant
is able to perform . . . .”) (emphasis added). Although
the ALJ also acknowledged Ms. Bellinger's anemia and
treatments (ECF No. 16-3 at 25), he concluded that Ms.
the residual functional capacity to perform sedentary work as
defined in 20 CFR 404.1567(a) and 416.967(a) except she could
perform simple, routine and repetitive tasks. In addition,
she could occasionally bend, balance, twist, climb, crawl,
kneel, and squat. Furthermore, she could have occasional