United States District Court, D. Connecticut
RULING AND ORDER
N. Chatigny United States District Judge
brings this action against the Commissioner of Social
Security pursuant to 42 U.S.C. § 405(g), challenging the
denial of his application for Title II disability insurance
benefits (“DIB”). The Administrative Law Judge
(“ALJ”) determined that plaintiff was not
disabled at the pertinent time, although he did have several
severe impairments. Plaintiff moves for an order reversing
the decision and remanding for payment of benefits or further
proceedings in accordance with the fourth sentence of 42
U.S.C. § 405(g). The Commissioner moves for an order
affirming the denial of benefits. I conclude that a remand is
necessary to ensure that proper consideration is given to the
opinions of plaintiff’s treating physicians.
Accordingly, plaintiff’s motion to reverse is granted
in part and the Commissioner’s motion to affirm is
assume the parties’ familiarity with the facts and
procedural history of this case and therefore provide only a
brief summary. Plaintiff applied to the Social Security
Administration (“SSA”) for DIB in 2006 and 2010.
His deemed onset date is July 1, 1999. He met the insured
status requirements of the Social Security Act (“the
Act”) through March 31, 2005, his “date last
insured.” Accordingly, to receive DIB, plaintiff must
establish that he had a disability on or before March 31,
has had problems with his back since at least 1990, when he
was in a car accident. He also has a history of Lyme disease
that dates to at least 2004. The existing record does not
contain all his medical records prior to his date last
insured. There are records from 1990 and 1993, followed by a
gap until 2004. The record is comparatively voluminous after
plaintiff’s date last insured.
denied plaintiff’s application initially and on
reconsideration. On September 23, 2011, he appeared with
counsel for a hearing before an ALJ and testified
extensively. On June 1, 2012, he and his counsel appeared
before the ALJ for a supplemental hearing. They were
accompanied by plaintiff’s father, who appeared as a
witness. On July 27, 2012, the ALJ issued a decision finding
that the 2010 application was barred by res judicata. The
Appeals Council disagreed and remanded the case for further
proceedings. On May 1, 2014 and January 16, 2015, plaintiff
again appeared with counsel at hearings before the ALJ. A
medical expert testified at the January 2015 hearing.
27, 2015, the ALJ issued the decision that is the subject of
this appeal. The ALJ concluded that plaintiff was not
disabled as of his date last insured and thus not eligible
for DIB. The Appeals Council denied plaintiff’s request
for review on November 29, 2016. This appeal followed.
district court reviewing a final . . . decision [of the
Commissioner] pursuant to . . . 42 U.S.C. § 405(g), is
performing an appellate function.” Zambrana v.
Califano, 651 F.2d 842, 844 (2d Cir. 1981). Accordingly,
the Court may not make a de novo determination of whether a
plaintiff is disabled. See id.; Wagner v.
Sec’y of Health & Human Servs., 906 F.2d 856,
860 (2d Cir. 1990). Rather, the Court’s function is to
ascertain (1) whether the Commissioner applied the correct
legal principles and (2) whether the decision is supported by
substantial evidence. Johnson v. Bowen, 817 F.2d
983, 985 (2d Cir. 1987). “The findings of the
Commissioner of Social Security as to any fact, if supported
by substantial evidence, [are] conclusive . . . .” 42
U.S.C. § 405(g). If the Commissioner’s decision is
supported by substantial evidence, it will be sustained, even
if there may also be substantial evidence to support the
plaintiff’s position. Schauer v. Schweiker,
675 F.2d 55, 57 (2d Cir. 1982).
evidence is “such relevant evidence as a reasonable
mind might accept as adequate to support a conclusion,
” which means “more than a mere scintilla or a
touch of proof here and there in the record.”
Williams v. Bowen, 859 F.2d 255, 258 (2d Cir. 1988)
(quoting Richardson v. Perales, 402 U.S. 389, 401
establishes that benefits are payable to individuals who have
a disability. 42 U.S.C. § 423(a)(1). I assume the
parties’ familiarity with the five steps of a
disability determination. 20 C.F.R. §
404.1520(a)(4)(i)-(v); e.g., DeMico v.
Berryhill, No. 3:17CV00805(SALM), 2018 WL 2254544, at
*3-4 (D. Conn. May 17, 2018) (quoting Berry v.
Schweiker, 675 F.2d 464, 467 (2d Cir. 1982) (per
found that during the relevant time period, plaintiff had
three severe impairments: spondylosis of the lumbar spine
with possible pars defect, degenerative disc disease of the
lumbar spine, and a history of Lyme disease. Nevertheless,
the ALJ found that as of March 31, 2005, plaintiff had the
residual functional capacity (“RFC”) to perform
the full range of light work as defined in 20 C.F.R. §
404.1567(b). Consulting the Medical-Vocational Guidelines, 20
C.F.R. pt. 404, subpt. P, app. 2, the ALJ found that based on
plaintiff’s RFC, age, education, and work experience, a
finding of “not disabled” was directed by
Medical-Vocational Rule 202.20.
appeal, plaintiff argues that the ALJ erred in three ways. He
asserts that the ALJ erred at the RFC-determination phase by
(1) determining that plaintiff could perform the full range
of light work, despite contrary opinions from treating
physicians, and (2) relying on a medical expert whose
testimony plaintiff faults as internally contradictory,
biased, and based on an incomplete review of the record. In
addition, he argues that the ALJ erred by (3) failing to
obtain vocational expert testimony despite the presence of
significant non-exertional limitations.
first two arguments have merit. I agree with him that in the
context of this case, the opinions of his treating
physicians, particularly that of his primary care doctor, Dr.
Rabindranath Mahabir, require fuller consideration. I also
agree with his argument that the ALJ gave too much weight to
the testimony of the medical expert. Under Second Circuit
law, a remand is necessary in accordance with the treating
physician rule and the Commissioner’s duty to develop
The Treating Physician Rule
the treating physician rule, “the opinion of a
claimant’s treating physician as to the nature and
severity of the impairment is given controlling weight so
long as it is well-supported by medically acceptable clinical
and laboratory diagnostic techniques and is not inconsistent
with the other substantial evidence in the case
record.” Greek v. Colvin, 802 F.3d 370, 375
(2d Cir. 2015) (citation, internal quotation marks, and
brackets omitted). The treating physician rule
“generally requires a measure of deference to the
medical opinion of a claimant’s treating
physician.” Halloran v. Barnhart, 362 F.3d 28,
32 (2d Cir. 2004) (per curiam).
the treating physician’s opinion must be consistent
with other substantial evidence to be given controlling
weight. Such “other substantial evidence” can
include “the opinions of other medical experts.”
Greek, 802 F.3d at 375 (quoting Halloran,
362 F.3d at 32). Thus, it is possible for other
doctors’ contrasting opinions to limit the weight
assigned to a treating physician’s opinion.
if the treating physician’s opinion is not given
controlling weight, the ALJ must consider certain factors to
determine the appropriate weight to give the
opinion. Id. (citing 20 C.F.R. §
404.1527(c)). Moreover, whatever weight is assigned to a
treating physician’s opinion, the ALJ must
“always give good reasons” for that weight. 20
C.F.R. § 404.1527(c)(2) (2015); e.g., Smith
v. Berryhill, 740 Fed.App’x 721, 724 (2d Cir.
2018) (“An ALJ must provide ‘good reasons’
for affording limited weight to the treating source’s
opinion and more weight to a non-treating source.”
(citations omitted)). In other words, if the treating
physician’s opinion is to be disregarded, the ALJ must
explain why. Snell v. Apfel, 177 F.3d 128, 134 (2d
Cir. 1999) (“[A]dministrative decisionmakers . . .
[have an] obligation, under Schaal and §
404.1527(d)(2), to explain why a treating physician’s
opinions are not being credited.” (citing Schaal v.
Apfel, 134 F.3d 496 (2d Cir. 1998))). Courts “do
not hesitate to remand when the Commissioner has not provided
‘good reasons’ for the weight given” to a
treating physician’s view, and remand is appropriate
when the ALJ’s opinion “do[es] not
comprehensively set forth reasons for the weight
assigned to a treating physician’s opinion.”
Halloran, 362 F.3d at 33 (emphasis added).
treating physician rule thus imposes a strict duty on the ALJ
to analyze the opinions of treating physicians. “[T]he
fact that there may have been reasons to discount the
treating physicians’ opinions does not relieve the ALJ
of [her] obligation to discuss the opinions and assign them
weight.” Budnick v. Comm’r of Soc. Sec.,
No. 3:17-CV-01546(SALM), 2018 WL 4253172, at *7 (D. Conn.
Sept. 6, 2018) (citing Snell, 177 F.3d at 134);
see also Perez v. Astrue, No. 07–CV–958
(DLJ), 2009 WL 2496585, at *8 (E.D.N.Y. Aug. 14, 2009)
(“Even if [the treating physician’s] opinions do
not merit controlling weight, the ALJ must explain what
weight she gave those opinions and must articulate good
reasons for not crediting the opinions of a claimant’s
The Duty to Develop the Record
also has a duty to develop and fill gaps in the record.
See 20 C.F.R. § 404.1545(a)(3). The ALJ has the
“affirmative obligation to develop the administrative
record . . . even when the claimant is represented by
counsel.” Rogers v. Astrue, 895 F.Supp.2d 541,
549-50 (S.D.N.Y. 2012) (quoting Perez v. Chater, 77
F.3d 41, 47 (2d Cir. 1996)) (citing Butts v.
Barnhart, 388 F.3d 377, 386 (2d Cir. 2004); Blanda
v. Astrue, No. 05–CV–5723, 2008 WL 2371419,
at *7 (E.D.N.Y. June 9, 2008)); see also Martinez v.
Massanari, 242 F.Supp.2d 372, 378 (S.D.N.Y. 2003)
(citations omitted). Second Circuit law “places the
burden on the ALJ, not the claimant, to develop the
administrative record.” DeMico, 2018 WL
2254544, at *7 (emphasis in original) (citing Tejada v.
Apfel, 167 F.3d 770, 774 (2d Cir. 1999)).
“an ALJ cannot reject a treating physician’s
diagnosis without first attempting to fill any clear gaps in
the administrative record.” Rosa, 168 F.3d at
79 (citing Schaal, 134 F.3d at 505; Hartnett v.
Apfel, 21 F.Supp.2d 217, 221 (E.D.N.Y. 1998)). An
ALJ’s duty to develop the record may require her to
seek clarifying information from a physician whose notes are
in the record or to attempt to obtain records from other
physicians identified by the claimant. See Rosa, 168
F.3d at 80, 83; Rogers, 895 F.Supp.2d at 550-51;
Molt v. Comm’r of Soc. Sec., No.
05–CV–418, 2009 WL 5214920, at *6 (N.D.N.Y. Dec.
28, 2009) (finding that the ALJ erred in not
“re-contact[ing]” treating sources to
“supply opinions”). When gaps in the record leave
the accuracy and fairness of the disability determination in
doubt, the appropriate disposition is to remand the case
“for further development ...