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Demars v. Commissioner Of Social Security

United States District Court, D. Connecticut

March 31, 2019




         Plaintiff, Joseph John Demars, brings this appeal pursuant to §205(g) of the Social Security Act (“the Act”), as amended, seeking review of a final decision by the Acting Commissioner of the Social Security Administration (the “Commissioner”) denying his application for Disability Insurance Benefits (“DIB”). Plaintiff has moved for an order reversing the decision of the Commissioner, or in the alternative, for remand [Doc. #27]. Defendant has filed a motion for an order affirming the decision of the Commissioner [Doc. #33]. Plaintiff has filed a “Notice Regarding the Commissioner's Statements of Medical Evidence” [Doc. #35]. This document contains some argument, and the Court will construe it as plaintiff's timely reply.

         For the reasons set forth below, plaintiff's Motion to Reverse or Remand [Doc. #27] is DENIED, and defendant's Motion for an Order Affirming the Decision of the Commissioner [Doc. #33] is GRANTED.


         Plaintiff filed an application for DIB on September 8, 2014, [2] alleging disability beginning January 6, 2004, when plaintiff “slipped off a truck at work and twisted his right knee.” Doc. #27-2 at 1; see Certified Transcript of the Administrative Record, Doc. #17 and attachments, compiled on May 13, 2018, (hereinafter “Tr.”) at 262-265. Plaintiff's application was denied initially on October 1, 2014, see Tr. 102-111, and upon reconsideration on January 14, 2015, see Tr. 112-122.

         On August 11, 2016, plaintiff, represented by Attorney Christopher W. Dilworth, [3] appeared and testified before Administrative Law Judge (“ALJ”) Matthew Kuperstein. See Tr. 61- 82, 85-89. Vocational Expert (“VE”) Edmond J. Calandra testified telephonically at the hearing. See Tr. 83-85, 90-99. On June 13, 2017, ALJ Martha Bower issued an unfavorable decision pursuant to HALLEX I-2-8-40, as ALJ Kuperstein was unavailable to issue a decision.[4] See Tr. 26-39. On January 9, 2018, the Appeals Council denied plaintiff's request for review, making the ALJ's June 13, 2017, decision the final decision of the Commissioner. See Tr. 1-7. The case is now ripe for review under 42 U.S.C. §405(g).


         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. See Balsamo v. Chater, 142 F.3d 75, 79 (2d Cir. 1998). Second, the court must decide whether the determination is supported by substantial evidence. See Id. 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).

         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.”). “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 [his] 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). 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). It is well established that “an ALJ's credibility determination is generally entitled to deference on appeal.” Selian v. Astrue, 708 F.3d 409, 420 (2d Cir. 2013); see also Kessler v. Colvin, 48 F.Supp.3d 578, 595 (S.D.N.Y. 2014) (“A federal court must afford great deference to the ALJ's credibility finding, since the ALJ had the opportunity to observe the claimant's demeanor while the claimant was testifying.” (citation and internal quotation marks omitted)); Pietrunti v. Dir., Office of Workers' Comp. Programs, 119 F.3d 1035, 1042 (2d Cir. 1997) (“Credibility findings of an ALJ are entitled to great deference and therefore can be reversed only if they are patently unreasonable.” (citation and internal quotation marks omitted)).

         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). “[W]hether there is substantial evidence supporting the appellant's view is not the question here; rather, we must decide whether substantial evidence supports the ALJ's decision.” Bonet ex rel. T.B. v. Colvin, 523 Fed.Appx. 58, 59 (2d Cir. 2013).


         Under the Social Security Act, every individual who is under a disability is entitled to disability insurance benefits. 42 U.S.C. §423(a)(1).

         To be considered disabled under the Act and therefore entitled to benefits, plaintiff must demonstrate that he is unable to work after a date specified “by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” 42 U.S.C. §423(d)(1)(A). Such impairment or impairments must be “of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy.” 42 U.S.C. §423(d)(2)(A); see also 20 C.F.R. §404.1520(c) (requiring that the impairment “significantly limit[] ... physical or mental ability to do basic work activities[]” to be considered “severe”).[5]

         There is a familiar five-step analysis used to determine if a person is disabled. See 20 C.F.R. §404.1520. In the Second Circuit, the test is described as follows:

First, the Secretary considers whether the claimant is currently engaged in substantial gainful activity. If he is not, the Secretary next considers whether the claimant has a “severe impairment” which significantly limits his physical or mental ability to do basic work activities. If the claimant suffers such an impairment, the third inquiry is whether, based solely on medical evidence, the claimant has an impairment which is listed in Appendix 1 of the regulations. If the claimant has such an impairment, the Secretary will consider him disabled without considering vocational factors such as age, education, and work experience; the Secretary presumes that a claimant who is afflicted with a “listed” impairment is unable to perform substantial gainful activity.

Berry v. Schweiker, 675 F.2d 464, 467 (2d Cir. 1982) (per curiam). If and only if the claimant does not have a listed impairment, the Commissioner engages in the fourth and fifth steps:

Assuming the claimant does not have a listed impairment, the fourth inquiry is whether, despite the claimant's severe impairment, he has the residual functional capacity to perform his past work. Finally, if the claimant is unable to perform his past work, the Secretary then determines whether there is other work which the claimant could perform. Under the cases previously discussed, the claimant bears the burden of proof as to the first four steps, while the Secretary must prove the final one. Id.

         “Through the fourth step, the claimant carries the burdens of production and persuasion, but if the analysis proceeds to the fifth step, there is a limited shift in the burden of proof and the Commissioner is obligated to demonstrate that jobs exist in the national or local economies that the claimant can perform given his residual functional capacity.” Gonzalez ex rel. Guzman v. Dep't of Health and Human Serv., 360 Fed.Appx. 240, 243 (2d Cir. 2010) (citing 68 Fed. Reg. 51155 (Aug. 26, 2003)); Poupore v. Astrue, 566 F.3d 303, 306 (2d Cir. 2009) (per curiam)). “Residual functional capacity” (“RFC”) is what a person is still capable of doing despite limitations resulting from her physical and mental impairments. See 20 C.F.R. §404.1545(a)(1).

         “In assessing disability, factors to be considered are (1) the objective medical facts; (2) diagnoses or medical opinions based on such facts; (3) subjective evidence of pain or disability testified to by the claimant or others; and (4) the claimant's educational background, age, and work experience.” Bastien v. Califano, 572 F.2d 908, 912 (2d Cir. 1978). “[E]ligibility for benefits is to be determined in light of the fact that the Social Security Act is a remedial statute to be broadly construed and liberally applied.” Id. (citation and internal quotation marks omitted).


         Following the above-described five-step evaluation process, the ALJ concluded that plaintiff was not disabled under the Act. See Tr. 35. At step one, the ALJ found that plaintiff had not engaged in substantial gainful activity during the relevant period, between his alleged onset date of January 6, 2004, and his last insured date of March 31, 2009. See Tr. 28. At step two, the ALJ found that plaintiff had the severe impairments of “obesity, degenerative joint disease of the right knee with a history of knee replacement, and osteoarthritis of the left knee[.]” Tr. 29.

         At step three, the ALJ found that plaintiff's impairments, either alone or in combination, did not meet or medically equal the severity of any of the listed impairments in 20 C.F.R. Pt. 404, Subpt. P, App. 1. See Tr. 29. The ALJ specifically considered Listing 1.02 (dysfunction of a major weight-bearing joint due to any cause). See Tr. 29. Before moving on to step four, the ALJ found plaintiff had the RFC

to perform sedentary work as defined in 20 CFR 404.1567(a) except: The claimant was limited to only occasional use of foot controls with the right lower extremity, to only occasional climbing of ramps or stairs, balancing, and stooping, and to no climbing of ladders, ropes, or scaffolds, kneeling, crouching, or crawling. Tr. 29.

         At step four, the ALJ concluded that plaintiff is unable to perform any of his past relevant work. See Tr. 37. At step five, and after considering the testimony of the VE as well as plaintiff's age, education, work experience, and RFC, the ALJ found “there were jobs that existed in significant numbers in the national economy that plaintiff could have performed” during the relevant period. Tr. 37.

         V. DISCUSSION

         Plaintiff claims that the ALJ erred by:

1. Concluding that plaintiff's lower right extremity impairment did not meet Listings 1.02 and/or 1.03, see Doc. #27-1 at 3-6;
2. Failing to properly apply the treating physician rule to the May 13, 2016, medical opinion of Dr. Vincent Williams, see Id. at 9-12; and
3. Failing to properly apply SSR 02-1p, relating to the evaluation of plaintiff's obesity at step three and subsequent steps, see Id. at 6-9.

         Before turning to plaintiff's arguments, the Court pauses briefly to address plaintiff's Workers' Compensation claim, and the impact that claim had on the development of plaintiff's medical records. Plaintiff alleges that his disability began on January 6, 2004, when he slipped at work and twisted his right knee. See Tr. 26; Doc. #27-2 at 1. At the time, plaintiff was working as a cement truck driver, and needed use of his right leg to operate the truck's foot pedals continuously. See Tr. 62. The ALJ expressly acknowledged in her RFC determination that plaintiff, during the relevant period, “was limited to only occasional use of foot ...

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