United States District Court, D. Connecticut
ORDER AFFIRMING THE COMMISSIONER'S
W. Thompson, United States District Judge
Gabriel Rivera appeals the Commissioner's final decision
denying the plaintiff's application for supplemental
security income (“SSI”) benefits pursuant to 42
U.S.C. § 405(g) of the Social Security Act.
plaintiff filed a motion for reversal or remand, contending
that the Administrative Law Judge (“ALJ”)
“1) failed to develop the record and to procure and
exhibit evidence that was in the exclusive possession of the
Social Security Administration; 2) failed to properly
evaluate Mr. Rivera's credibility, citing factors
attributable directly to his impairments and not to failures
of credibility; and 3) failed to properly formulate Mr.
Rivera's Residual Functional Capacity
[(“RFC”)], leaving out several important
factors.” Pl.'s Mem. to Reverse (“ECF No.
19-1”) at 2.
Commissioner filed a motion for an order affirming the
Commissioner's decision, maintaining that
“substantial evidence supports the Commissioner's
final decision that Plaintiff was not disabled from his April
11, 2014 SSI application date through January 30, 2017, the
date of the Commissioner's decision.” Def.'s
Mot. to Affirm (“ECF No. 22”) at 1.
reasons set forth below, the court concludes that the ALJ
applied the correct legal principles and that the ALJ's
findings are supported by substantial evidence. Thus, the
Commissioner's final decision is being affirmed.
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). Substantial evidence is “‘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. Absent
legal error, this court may not set aside the decision of the
Commissioner if it is supported by substantial evidence.
See Berry v. Schweiker, 675 F.2d 464, 467 (2d Cir.
1982); 42 U.S.C. § 405(g)(“The findings of the
Commissioner of Social Security as to any fact, if supported
by substantial evidence, shall be conclusive . . . .”).
Thus, 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. See Schauer v.
Schweiker, 675 F.2d 55, 57 (2d Cir. 1982).
Duty to Develop the Record
The Prior SSI Claim Record
plaintiff contends that the ALJ had a duty to procure the
plaintiff's prior SSI records because 1) “there
exists evidence that shows Mr. Rivera's disabling
conditions” and 2) “continued disability reviews
during that time period showed continuing disabling
impairments.” ECF No. 19-1 at 12.
defendant maintains that 1) the defendant's previous
claim benefits were suspended in February 2010, over four
years prior to filing the April 2014 SSI application; 2) SSI
is only payable starting one month
after the application is filed; and
3) the ALJ has discretion to determine whether evidence is
adequate to make a disability determination and how best to
resolve insufficiency. See ECF No. 22 at 5.
regulations state: “[W]e will develop your complete
medical history for at least the 12 months preceding the
month in which you file your application unless there is a
reason to believe that development of an earlier period is
necessary . . . .” See 20 C.F.R. §
416.912(b)(1). “[W]here there are no obvious gaps in
the administrative record, and where the ALJ already
possesses a ‘complete medical history,' the ALJ is
under no obligation to seek additional information in advance
of rejecting a benefits claim.” Rosa v.
Callahan, 168 F.3d 72, 79 n.5 (2d Cir. 1999) (citing
Perez v. Chater, 77 F.3d 41, 48 (2d Cir. 1996)). A
“[c]omplete medical history means the records of your
medical source(s) covering at least the 12 months preceding
the month in which you file your application.” 20
C.F.R. § 416.912(b)(1)(ii). The ALJ has discretion to
“determine the best way to resolve [an] inconsistency
or insufficiency.” 20 C.F.R. § 416.920b(b)(2).
Moreover, “the earliest month for which we can pay you
benefits is the month following the month you filed the
application”. 20 C.F.R. § 416.335. “[W]e
cannot pay you for the month in which your application is
filed or any months before that month.” Id.
DeChirico v. Callahan, 134 F.3d 1177 (2d Cir. 1998),
the court held that the ALJ was not required to requisition
or subpoena SSI records for a claim existing prior to
incarceration where the plaintiff (1) “was represented
by counsel at the administrative proceedings”, (2)
“the fact of his impairment was not in dispute, ”
and (3) “counsel offered no other reasons that the
ten-year old file might be relevant” other than to
state that “there is material in” the
plaintiff's “previous file that may be useful to
the present case.” DeChirico, 134 F.3d at
1177, 1179, 1183-85 (The Commissioner also relied “in
part on Social Security Administration guidelines providing
that ‘an ALJ May Not Need the Prior Claim File'
when ‘[a]t least four years have elapsed between the
date of the prior notice of initial determination and the
date of the new application.' Social Security
Administration Office of Hearings and Appeals, HALLEX:
Hearings, Appeals and Litigation Law Manual , I-2-110D
as in DeChirico, the plaintiff filed his application
approximately four years after his previous benefits were
discontinued due to incarceration. The plaintiff was
represented by counsel as of December 2, 2015, five months
prior to the administrative hearing held on May 4, 2016; only
his limitations are disputed, not corresponding impairments;
and the stated reason for obtaining the prior records is to
demonstrate continuing disabling impairments during the
prior claim period. The plaintiff
fails to provide “a reason to believe that development
of an earlier period is necessary” or point to an
obvious gap in the record that precludes a fair determination
in this case.
the court finds that the ALJ did not abuse his discretion on
this issue, and the plaintiff's motion to reverse or
remand on this ground is being denied.
Dr. Perrino's Medical Source Statement
plaintiff contends that the ALJ should have obtained the
medical source statement (“MSS”) mentioned in a
December 10, 2014 treatment note by Dr. Phillip Perrino. The
plaintiff notes 1) that counsel appeared one year later; 2)
that it is unclear if or how the state agency examiner
reviewed the MSS; and 3) that if
the ALJ had the MSS, he needed to apply the factors to the
doctor's opinion and seek a medical expert's
clarification of the limiting effects of glaucoma and mental
and intellectual effects if
necessary. ECF No. 19-1 at 12-13.
defendant maintains 1) that it is unclear who asked Dr.
Perrino to prepare the MSS; 2) that the ALJ satisfied his
duty to develop the record by requesting Dr. Perrino's
medical records and an MSS from Royal Vision Associates on
January 8, 2015; 3) that the records were received on January
9, 2015, without the MSS; 4) that the burden of proving
disability rests on the plaintiff; 5) that the plaintiff was
represented by counsel as of December 2, 2015, and his
counsel could have obtained the MSS and submitted it to the
ALJ prior to the administrative hearing held on May 4, 2016,
and also submitted it to both the Appeals Council and this
court; and 6) that the record was adequate for, and
substantial evidence supported, the ALJ's determination.
See ECF No. 22 at 6-7.
Janes v. Berryhill, 710 Fed.Appx. 33, 34 (2d Cir.
2018), the court held that the ALJ was not required to
develop the record further where evidence was “adequate
for [the ALJ] to make a determination as to