United States District Court, D. Connecticut
RULING ON CROSS MOTIONS
SARAH A. L. MERRIAM UNITED STATES MAGISTRATE JUDGE.
Stacey Elizabeth Maltz (“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 her applications for Disability Insurance Benefits
(“DIB”) and Supplemental Security Income
(“SSI”). Plaintiff has moved to reverse or remand
the Commissioner's decision. [Doc. #22]. Defendant has
filed a cross-motion seeking an order affirming the decision
of the Commissioner. [Doc. #25].
reasons set forth below, plaintiff's Motion for Order
Reversing the Decision of the Commissioner and/or Remanding
the Matter for Further Proceedings [Doc.
#22] is GRANTED, to the extent
plaintiff seeks a remand for further proceedings, and
defendant's Motion for an Order Affirming the Decision of
the Commissioner [Doc. #25] is
protectively filed concurrent applications for DIB and SSI on
October 7, 2014, alleging disability beginning August 4,
2014. See Certified Transcript of the Administrative Record,
Doc. #10, compiled on June 27, 2018, (hereinafter
“Tr.”) at 280-95. Plaintiff's applications
were denied initially on May 6, 2015, see Tr. 149-58, and
upon reconsideration on September 21, 2015. See Tr. 161-78.
November 30, 2016, plaintiff, represented by Attorney Richard
Grabow, appeared and testified by videoconference at a
hearing before Administrative Law Judge (“ALJ”)
Edward F. Sweeney. See generally Tr. 43-68. Vocational Expert
(“VE”) Richard Hall appeared and testified by
telephone at the administrative hearing. See Tr. 68-74; see
also Tr. 373. Tommy Crutchfield, a friend of the plaintiff,
also appeared and testified by videoconference at this
hearing. See Tr. 75-88. On March 31, 2017, the ALJ issued an
unfavorable decision. See Tr. 9-29. On March 8, 2018, the
Appeals Council denied plaintiff's request for review of
the ALJ's decision, thereby making the ALJ's March
31, 2017, decision the final decision of the Commissioner.
See Tr. 1-8. The case is now ripe for review under 42 U.S.C.
timely filed this action for review and now moves to reverse
the decision of the Commissioner and/or to remand for further
administrative proceedings. [Doc. #22]. On appeal, plaintiff
argues: (1) the ALJ failed to follow the treating physician
rule; (2) the Residual Functional Capacity
(“RFC”) determination is not supported by
substantial evidence; and (3) the ALJ failed to develop the
administrative record. See generally Doc. #22-1 at 11-21. For
the reasons stated below, the Court finds that the ALJ erred
in his application of the treating physician rule.
STANDARD OF REVIEW
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).
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).
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)).
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)).
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.”
SSA LEGAL STANDARD
the Social Security Act, every individual who is under a
disability is entitled to disability insurance benefits. 42
considered disabled under the Act and therefore entitled to
benefits, plaintiff must demonstrate that she 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); 20 C.F.R.
§§404.1520(c), 416.920(c) (requiring that the
impairment “significantly limit ... physical or
mental ability to do basic work activities” to be
considered “severe” (alterations added)).
is a familiar five-step analysis used to determine if a
person is disabled. See 20 C.F.R. §§404.1520,
416.920. In the Second Circuit, the test is described as
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
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.
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 [her] residual functional
capacity.” Gonzalez ex rel. Guzman v. Dep't of
Health and Human Serv., 360 Fed.Appx. 240, 243 (2d Cir.
2010) (alteration added); Poupore v. Astrue, 566
F.3d 303, 306 (2d Cir. 2009) (per curiam)). The 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), 416.945(a)(1).
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. (quoting
Haberman v. Finch, 418 F.2d 664, 667 (2d Cir.
THE ALJ'S DECISION
the above-described evaluation process, the ALJ concluded
that plaintiff “has not been under a disability within
the meaning of the Social Security Act from August 4, 2014,
through the date of” his decision, March 31, 2017. Tr.
13. At step one, the ALJ found that plaintiff had not engaged
in substantial gainful activity since the alleged onset date
of August 4, 2014. See Tr. 15. At step two, the ALJ found
that plaintiff had the severe impairments of fibromyalgia,
sleep apnea, and Kleine-Levin syndrome. See Id. The
ALJ found plaintiff's asthma and depression to be
non-severe impairments. See Tr. 15-16.
three, the ALJ determined 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. 17. As to
plaintiff's “sleep disorders, ” the ALJ
“determined that the [plaintiff's] impairments do
not, singly or in combination, meet the requirements of any
listing described in listings 3.00, 11.00, or 14.00.”
Id. As to plaintiff's fibromyalgia, the ALJ
“determined that the [plaintiff's] impairments do
not, singly or in combination, meet the requirements of any
listing described in listing 14.00” and also
“considered the requirements outlined in SSR
12-2p.” Id. The ALJ next found that plaintiff
had the RFC
to perform light work as defined in 20 CFR 404.1567(b) and
416.967(b) except that the claimant can frequently climb
ramps and stairs. The claimant can never climb ladders,
ropes, and scaffolds. The claimant can frequently balance,
stoop, kneel, crouch, and crawl. The claimant would need to
avoid exposure to unprotected hazards such as machinery and
Tr. 17. At step four, the ALJ concluded that plaintiff was
unable to perform her past relevant work as a respiratory
therapist. See Tr. 22-23. At step five, and after considering
plaintiff's age, education, work experience and RFC, as
well as the testimony of the VE, the ALJ found that other
jobs existed in significant numbers in the national economy
that plaintiff could perform. See Tr. 23-24.
arguments in support of reversal and/or remand focus
primarily on what appears to be the ALJ's fundamental
misunderstanding of her Kleine-Levin syndrome
(“KLS”), a rare sleep disorder. Because the
symptomology of that disorder informs the Court's
analysis of the ...