Torres v. Berryhill

          RULING ON PENDING MOTIONS

          ROBERT A. RICHARDSON UNITED STATES MAGISTRATE JUDGE.

         Melanie Virginia Torres (“plaintiff”) appeals the final decision of the Commissioner of Social Security (“the Commissioner”) pursuant to 42 U.S.C. § 405(g). The Commissioner denied plaintiff's application for Social Security Disability Benefits in a decision dated June 22, 2018. Plaintiff timely appealed to this court. Currently pending are plaintiff's motion for an order reversing and remanding her case for a hearing (Dkt. #17-1) and defendant's motion to affirm the decision of the Commissioner. (Dkt. #21-1.)

         For the reasons that follow, the plaintiff's motion to reverse, or in the alternative, remand is GRANTED and the Commissioner's motion to affirm is DENIED.

         STANDARD

         “A 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 findings of the Commissioner of Social Security as to any fact, if supported by substantial evidence, [are] conclusive . . . .” 42 U.S.C. § 405(g). Accordingly, the court may not make a de novo determination of whether a plaintiff is disabled in reviewing a denial of disability benefits. Id.; Wagner v. Sec'y of Health and 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 her conclusion, and whether the decision is supported by substantial evidence. Johnson v. Bowen, 817 F.2d 983, 985 (2d Cir. 1987).

         Therefore, absent legal error, this court may not set aside the decision of the Commissioner if it is supported by substantial evidence. Berry v. Schweiker, 675 F.2d 464, 467 (2d Cir. 1982). Further, 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. Schauer v. Schweiker, 675 F.2d 55, 57 (2d Cir. 1982).

         The Second Circuit has defined substantial evidence as “‘such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'” Williams on Behalf of 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 scintilla or touch of proof here and there in the record.” Williams, 859 F.2d at 258.

         The Social Security Act (“SSA”) provides that benefits are payable to individuals who have a disability. 42 U.S.C. § 423(a)(1). “The term ‘disability' means . . . [an] inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment. . . .” 42 U.S.C. § 423(d)(1). In order to determine whether a claimant is disabled within the meaning of the SSA, the ALJ must follow a five-step evaluation process as promulgated by the Commissioner.^[2]

         In order to be considered disabled, an individual's impairment must be “of such severity that he is not only unable to do his previous work but cannot . . . engage in any other kind of substantial gainful work which exists in the national economy.” 42 U.S.C. § 423(d)(2)(A). “[W]ork which exists in the national economy means work which exists in significant numbers either in the region where such individual lives or in several regions of the country.” Id.^[3]

         PROCEDURAL HISTORY

         Plaintiff initially filed for disability insurance benefits under Title II on November 16, 2009. (R. 181.)^[4] Plaintiff alleged a disability onset date of April 20, 2000. (R. 181.) At the time of application, plaintiff alleged that she suffered from fibromyalgia, lupus, Sjogren's syndrome, and migraines. (R. 98.) The initial application was denied on January 14, 2010, and again upon reconsideration on March 17, 2010. (R. 98- 101, 106-108). Plaintiff then filed for an administrative hearing which was held by ALJ Kim K. Griswold on February 3, 2011. (R. 34-74.) The ALJ issued an unfavorable decision on February 25, 2011. (R. 13-28.) The Decision Review Board selected plaintiff's claim for review and issued a decision on May 27, 2011 affirming ALJ Griswold's decision. (R. 1-4, 13.)

         On March 2, 2012, upon judicial review, plaintiff's case was remanded. (R. 1107.) The Appeals Counsel then remanded plaintiff's case to ALJ Griswold on April 6, 2012. (R. 1114- 18.) ALJ Griswold held a second hearing on June 20, 2013 and issued an unfavorable decision on September 27, 2013. (R. 998- 1021; 1030-80.)

         Upon a second judicial review, plaintiff's case was remanded on March 29, 2016. (R. 1757.) On June 19, 2017, the Appeals Council remanded plaintiff's case to ALJ Ryan A. Alger (hereinafter the “ALJ”). (R. 1758-60.) The ALJ held a hearing on May 15, 2018 and issued an unfavorable decision on June 22, 2018. (R. 1593-1616; 1678-1709.) Plaintiff then filed this action seeking judicial review. (Dkt. #17-1.)

         DISCUSSION

         Plaintiff asserts that the ALJ's opinion is not supported by substantial evidence; the ALJ failed to adequately develop the record; and that the ALJ violated the treating physician rule by assigning little weight to the opinions of Advanced Practice Registered Nurse (“APRN”) Wisniewski and Doctors Brumberger, Manning, and Vice-Hlavacek. (Pl. Br. 1-11, 14.) Based on the following, the Court finds that the ALJ did not violate the treating physician rule, but the ALJ's evaluation of Dr. Manning's opinion is not supported by substantial evidence. The Court reverses without considering the remaining arguments. I. The ALJ Did Not Violate the Treating Physician Rule Plaintiff asserts that the ALJ violated the treating physician rule by assigning little weight to the opinions of Doctors Brumberger, Manning, and Vice-Hlavacek and APRN Wisniewski. (Pl. Br. 1-11, 14.) Plaintiff asserts that each of these individuals is a treating physician and therefore his or her opinion is entitled to controlling weight. (Pl. Br. 2.) The Court finds that while Dr. Manning is not a treating physician, the ALJ's evaluation of Dr. Manning's opinion is not supported by substantial evidence.

         The medical opinions of treating physicians are generally given more weight than other evidence. The treating physician rule stipulates that “the opinion of a claimant's treating physician as to the nature and severity of the impairment is given ‘controlling weight' as 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.'” Burgess v. Astrue, 537 F.3d 117, 128 (2d Cir. 2008) (quoting 20 C.F.R. § 404.1527(d)(2)); see also Mariani v. Colvin, 567 Fed.Appx. 8, 10 (2d Cir. 2014) (“A treating physician's opinion need not be given controlling weight where it is not ...