United States District Court, D. Connecticut
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 ...