Sanford v. Berryhill

          RULING ON CROSS MOTIONS

          HON. SARAH A. L. MERRIAM UNITED STATES MAGISTRATE JUDGE

         Plaintiff Gerald Sanford (“plaintiff”), brings this appeal under §205(g) of the Social Security Act (the “Act”), as amended, 42 U.S.C. §405(g), seeking review of a final decision by the Commissioner of the Social Security Administration (the “Commissioner” or “defendant”) denying his application for Supplemental Security Income (“SSI”) under the Act. Plaintiff has moved for an order reversing the decision of the Commissioner. [Doc. #20]. Defendant has filed a cross-motion seeking an order affirming the decision of the Commissioner. [Doc. #22].

         For the reasons set forth below, defendant's Motion for an Order Affirming the Decision of the Commissioner [Doc. #22] is DENIED, and plaintiff's Motion for Order Reversing the Decision of the Commissioner [Doc. #20] is GRANTED, to the extent plaintiff seeks a remand for further administrative proceedings.

         I. PROCEDURAL HISTORY

         ^[1] Plaintiff filed an application for SSI on May 3, 2012, alleging disability beginning June 17, 2008. See Certified Transcript of the Administrative Record, Doc. #16-1, compiled on July 15, 2018, (hereinafter “Tr.”) at 181-89.^[2] Plaintiff's application for SSI was denied initially on June 1, 2012, see Tr. 109-12, and upon reconsideration on November 20, 2012, see Tr. 116-18.

         Following the denial of plaintiff's SSI application, on June 12, 2014, plaintiff, represented by Attorney John P. Spilka, appeared and testified by video teleconference at a hearing before Administrative Law Judge Daniel J. Driscoll (“ALJ Driscoll”). See Tr. 35-72. Vocational Expert (“VE”) Lawrence P. Takki also testified at the hearing. See Tr. 62-68; see also Tr. 155-57. On July 3, 2014, ALJ Driscoll issued an unfavorable decision. See Tr. 17-34. On July 30, 2015, the Appeals Council denied plaintiff's request for review, thereby making ALJ Driscoll's July 3, 2014, decision the then-final decision of the Commissioner. See Tr. 1-7.

         On September 25, 2015, plaintiff, still represented by Attorney Spilka, filed a complaint in the United States District Court for the District of Connecticut seeking review of ALJ Driscoll's July 3, 2014, decision. See Sanford v. Colvin, No. 3:15CV1412(VLB) (D. Conn. Sept. 25, 2015). On April 18, 2016, defendant filed a Consent Motion to Remand to Agency Under Sentence Four of 42 U.S.C. §405(g). See Id. at Doc. #15. On April 20, 2016, Judge Vanessa L. Bryant granted that motion. See Id. at Doc. #16. Following the Court's remand, on August 3, 2016, the Appeals Council issued a Notice of Order of Appeals Council Remanding Case to Administrative Law Judge. See Tr. 897-902.

         Following the Appeals Council's remand of plaintiff's case, on January 23, 2017, plaintiff, again represented by Attorney Spilka, appeared and testified in person at a second hearing before a different administrative law judge, Alexander Peter Borré (hereinafter the “ALJ” or “ALJ Borré”). See Tr. 818-53. VE Renee Jubry testified at the hearing by telephone. See Tr. 821, Tr. 844-49; see also Tr. 987-89. On April 24, 2017, ALJ Borré issued an unfavorable decision. See Tr. 797-817. On April 20, 2018, the Appeals Council denied plaintiff's request for review, thereby making ALJ Borré's April 24, 2017, decision the final decision of the Commissioner. See Tr. 785-90. The case is now ripe for review under 42 U.S.C. §405(g).

         Plaintiff timely filed this action for review. See Doc. #1. He now moves to reverse the Commissioner's decision. [Doc. #20]. On appeal, plaintiff argues:

1. The ALJ erred at step two of the sequential evaluation;

2. The ALJ failed to properly weigh the medical opinion evidence;

3. The ALJ failed to properly assess plaintiff's subjective symptoms of pain; and

4. The ALJ's Residual Functional Capacity (“RFC”) determination is undermined by his errors in weighing the opinion evidence and assessing plaintiff's subjective complaints.^[3]

         See generally Doc. #20-1. As set forth below, the Court finds that the ALJ erred by placing “great weight” on the opinion of the state reviewing, non-examining physician, Dr. Heller. See Tr. 808.

         II. STANDARD OF REVIEW

         The review of a Social Security disability determination involves two levels of inquiry. First, the Court must decide whether the Commissioner applied the correct legal principles in making the determination. Second, the Court must decide whether the determination is supported by substantial evidence. See Balsamo v. Chater, 142 F.3d 75, 79 (2d Cir. 1998) (citation omitted). Substantial evidence is evidence that a reasonable mind would accept as adequate to support a conclusion; it is more than a “mere scintilla.” Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)). The reviewing court's responsibility is to ensure that a claim has been fairly evaluated by the ALJ. See Grey v. Heckler, 721 F.2d 41, 46 (2d Cir. 1983) (citation omitted).

         The Court does not reach the second stage of review - evaluating whether substantial evidence supports the ALJ's conclusion - if the Court determines that the ALJ failed to apply the law correctly. See Norman v. Astrue, 912 F.Supp.2d 33, 70 (S.D.N.Y. 2012) (“The Court first reviews the Commissioner's decision for compliance with the correct legal standards; only then does it determine whether the Commissioner's conclusions were supported by substantial evidence.” (citing Tejada v. Apfel, 167 F.3d 770, 773-74 (2d Cir. 1999))). “Where there is a reasonable basis for doubt whether the ALJ applied correct legal principles, application of the substantial evidence standard to uphold a finding of no disability creates an unacceptable risk that a claimant will be deprived of the right to have her disability determination made according to the correct legal principles.” Johnson v. Bowen, 817 F.2d 983, 986 (2d Cir. 1987).

         “[T]he crucial factors in any determination must be set forth with sufficient specificity to enable [a reviewing court] to decide whether the determination is supported by substantial evidence.” Ferraris v. Heckler, 728 F.2d 582, 587 (2d Cir. 1984) (alterations added) (citing Treadwell v. Schweiker, 698 F.2d 137, 142 (2d Cir. 1983)). The ALJ is free to accept or reject the testimony of any witness, but a “finding that the witness is not credible must nevertheless be set forth with sufficient specificity to permit intelligible plenary review of the record.” Williams ex rel. Williams v. Bowen, 859 F.2d 255, 260-61 (2d Cir. 1988) (citing Carroll v. Sec. Health and Human Servs., 705 F.2d 638, 643 (2d Cir. 1983)). “Moreover, when a finding is potentially dispositive on the issue of disability, there must be enough discussion to enable a reviewing court to determine whether substantial evidence exists to support that finding.” Johnston v. Colvin, No. 3:13CV00073(JCH), 2014 WL 1304715, at *6 (D. Conn. Mar. 31, 2014) (citing Peoples v. Shalala, No. 92CV4113, 1994 WL 621922, at *4 (N.D. Ill. Nov. 4, 1994)).

         It is important to note that in reviewing the ALJ's decision, this Court's role is not to start from scratch. “In reviewing a final decision of the SSA, this Court is limited to determining whether the SSA's conclusions were supported by substantial evidence in the record and were based on a correct legal standard.” Talavera v. Astrue, 697 F.3d 145, 151 (2d Cir. 2012) (quoting Lamay v. Comm'r of Soc. Sec., 562 F.3d 503, 507 (2d Cir. 2009)).

         Finally, some of the Regulations cited in this decision, particularly those applicable to the review of medical source evidence, were amended effective March 27, 2017. Those “new regulations apply only to claims filed on or after March 27, 2017.” Smith v. Comm'r, 731 Fed.Appx. 28, 30 n.1 (2d Cir. 2018) (summary order). Where a plaintiff's claim for benefits was filed prior to March 27, 2017, “the Court reviews the ALJ's decision under the earlier regulations[.]” Rodriguez v. Colvin, No. 3:15CV1723(DFM), 2018 WL 4204436, at *4 n.6 (D. Conn. Sept. 4, 2018); White v. Comm'r, No. 17CV4524(JS), 2018 WL 4783974, at *4 (E.D.N.Y. Sept. 30, 2018) (“While the Act was amended effective March 27, 2017, the Court reviews the ALJ's decision under the earlier regulations because the Plaintiff's application was filed before the new regulations went into effect.” (citation omitted)).

         III. SSA LEGAL STANDARD

         Under the Social Security Act, every individual who is under a disability is entitled to disability insurance ...