JACQUELINE CHOOLJIAN, Magistrate Judge.
On August 8, 2017, plaintiff Stanley M. Watson filed a Complaint seeking review of the Commissioner of Social Security's denial of plaintiff's application for benefits. The parties have consented to proceed before the undersigned United States Magistrate Judge.
This matter is before the Court on the parties' cross motions for summary judgment, respectively ("Plaintiff's Motion") and ("Defendant's Motion") (collectively "Motions"). The Court has taken the Motions under submission without oral argument.
Based on the record as a whole and the applicable law, the decision of the Commissioner is REVERSED AND REMANDED for further proceedings consistent with this Memorandum Opinion and Order of Remand.
On August 16, 2013, plaintiff filed an application for Disability Insurance Benefits alleging disability beginning on January 15, 2009, due to neuropathy in his feet and legs, muscle spasms, and headaches. (Administrative Record ("AR") 22, 220, 234). The ALJ examined the medical record, and on March 16, 2016, heard testimony from plaintiff (who was represented by counsel) as well as vocational and medical experts. (AR 35-56).
On March 29, 2016, the ALJ determined that plaintiff was not disabled through December 1, 2014 (i.e., the "date last insured"). (AR 22-29). Specifically, the ALJ found: (1) plaintiff suffered from the following severe impairments: diabetes mellitus with bilateral peripheral neuropathy, degenerative disc disease of the lumbar spine, and status post right second and third finger injury status post repair surgery (AR 24); (2) plaintiff's impairments, considered individually or in combination, did not meet or medically equal a listed impairment (AR 24); (3) plaintiff retained the residual functional capacity to perform light work (20 C.F.R. § 404.1567(b)) with additional limitations
On June 23, 2017, the Appeals Council denied plaintiff's application for review. (AR 1).
To qualify for disability benefits, a claimant must show that he is unable "to engage in any substantial gainful activity 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."
To assess whether a claimant is disabled, an ALJ is required to use the five-step sequential evaluation process set forth in Social Security regulations.
A federal court may set aside a denial of benefits only when the Commissioner's "final decision" was "based on legal error or not supported by substantial evidence in the record." 42 U.S.C. § 405(g);
Substantial evidence is "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion."
Federal courts review only the reasoning the ALJ provided, and may not affirm the ALJ's decision "on a ground upon which [the ALJ] did not rely."
A reviewing court may not conclude that an error was harmless based on independent findings gleaned from the administrative record.
In Social Security cases, the amount of weight given to medical opinions generally varies depending on the type of medical professional who provided the opinions, namely "treating physicians," "examining physicians," and "nonexamining physicians" (e.g., "State agency medical or psychological consultant[s]"). 20 C.F.R. §§ 404.1527(c)(1)-(2) & (e), 404.1502, 404.1513(a);
An ALJ is required to evaluate "every medical opinion" in a claimant's case record. 20 C.F.R. § 404.1527(b), (c). While not bound by statements about a claimant's condition provided by nonexamining physicians, ALJs must consider such findings as "opinion evidence," and determine the weight to be given such opinions using essentially the same factors for weighing opinion evidence generally, including "supportability of the opinion in the evidence," "the consistency of the opinion with the record as a whole," "any explanation for the opinion provided by the [nonexamining physician]," as well as "all other factors that could have a bearing on the weight to which an opinion is entitled, [such as] any specialization of the [nonexamining physician]." 20 C.F.R. § 404.1527(b), (c). Since nonexamining physicians, by definition, have no examining or treating relationship with a claimant, the weight given to their opinions will primarily depend on the degree to which the opinions provided are supported by evidence in the case record and the extent to which the physicians explained their opinions. 20 C.F.R. § 404.1527(c)(2)(ii);
An ALJ "must explain in the decision the weight given to [nonexamining] opinions" in the same manner as "opinions from treating [and] nontreating sources. . . ." 20 C.F.R. § 404.1527(e)(2)(ii); SSR 96-6p (ALJ not bound by, but may not "ignore" findings of state agency doctors, and ALJ's decision must explain the weight given to such opinions);
Plaintiff contends, among other things, that the ALJ failed properly to evaluate the opinions of the testifying medical expert. (Plaintiff's Motion at 6-8). The Court agrees. As the Court cannot find that the ALJ's error was harmless, a remand is warranted.
As the ALJ discussed in detail (AR 27), Dr. Arnold Ostrow, an independent medical expert, testified at the administrative hearing to the following (collectively "Dr. Ostrow's Opinions"):
For the period from June 1, 2011, through April 30, 2013, plaintiff had the residual functional capacity to (i) lift 20 pounds occasionally and 10 pounds frequently; (ii) stand and walk for two hours and sit for six hours; (iii) do frequent handling, fingering, gripping, frequent push/pull, and frequent reaching with the bilateral upper extremities; (iv) do frequent foot pedals bilaterally with the lower extremities; (v) do occasional "posturals" including climbing stairs; (vii) not climb ropes, ladders, or scaffolding; and (viii) not do work at unprotected heights. (AR 42). Beginning in May 2013 (i.e., after plaintiff's hand injury and repair surgery), in addition to the limitations above, plaintiff was also limited to (i) "only occasional gripping, handling, and [] fingering on the right"; (ii) "occasional push/pull on the right"; and (iii) "frequent reaching in all directions on the right. . . ." (AR 42).
The ALJ gave "great weight" to Dr. Ostrow's Opinions, but expressly rejected Dr. Ostrow's opinion that plaintiff was limited to "only occasional gripping, handling, and fingering" ("rejected limitation"), stating simply that "[the rejected limitation] is not consistent with the [plaintiff's] self-described activities of driving, preparing meals, doing laundry, paying bills, and shopping subsequent to the right hand injury." (AR 27). The ALJ materially erred in evaluating the medical expert's testimony.
First, the ALJ's conclusory assertion that the rejected limitation was inconsistent with plaintiff's "self-described activities," followed by a seriatim list of generic activities apparently drawn from plaintiff's function report, is not sufficiently specific to permit the Court to determine whether the ALJ discredited the rejected limitation on permissible grounds. In short, the ALJ did not explain how any of the cited activities materially conflicted with the rejected limitation and why.
Second, in any event, the ALJ's conclusion as to the rejected limitation is not supported by substantial evidence. For example, the ALJ wrote that the rejected limitation was inconsistent with plaintiff's "self-described activities of . . . preparing meals, doing laundry . . . and shopping subsequent to the right hand injury." (AR 27) (citing Exhibit 6E at 3-4 [AR 262-63]; "Hearing"). An ALJ may reject a medical opinion to the extent it is inconsistent with a plaintiff's own statements regarding his activities.
The ALJ also found the rejected limitation inconsistent with plaintiff's abilities to drive and pay bills. (AR 27). At the hearing, however, plaintiff testified that although he did drive a car, he was "not able to sit for long periods in [the] car[,]" and he could only drive for about 15 to 20 minutes before needing to "stop and stretch [his] legs[.]" (AR 49-50). Also, the cursory indication in plaintiff's function report that plaintiff was generally able to "[p]ay bills" did not include any detail regarding the amount of exertion such activity actually required of plaintiff, much less detail which suggests that plaintiff's method of bill paying involved more than "occasional" gripping, handling, or fingering. The ALJ's imprecise characterization of plaintiff's statements calls into question the validity of both the ALJ's evaluation of Dr. Ostrow's Opinions overall and the ALJ's decision as a whole.
Third, it appears that the ALJ also failed properly to account for Dr. Ostrow's opinion that plaintiff was limited to "occasional push/pull on the right." (
Finally, the Court cannot confidently conclude that the ALJ's errors were harmless. For example, at the administrative hearing, the vocational expert testified that plaintiff (or a hypothetical person with plaintiff's characteristics) "[could not] do past work or any other work" if such person was "limited to occasional push/pull" and "occasional gross and fine manipulation" with the "right upper extremity[.]" (AR 54). Therefore, considering the foregoing specifically, and the overall record as a whole, the Court cannot say that the ALJ would necessarily have reached the same result absent the errors discussed above.
Accordingly, this case must be remanded to permit the ALJ to reevaluate the medical opinion evidence.
For the foregoing reasons, the decision of the Commissioner of Social Security is REVERSED in part, and this matter is REMANDED for further administrative action consistent with this Opinion.
LET JUDGMENT BE ENTERED ACCORDINGLY.