MARGARET A. NAGLE, Magistrate Judge.
Plaintiff filed a Complaint on August 23, 2012, seeking review of the denial by the Social Security Commissioner ("Commissioner") of plaintiff's applications for disability insurance benefits ("DIB") and supplemental security income ("SSI"). On September 26, 2012, the parties consented to proceed before the undersigned United States Magistrate Judge pursuant to 28 U.S.C. § 636(c). The parties filed a Joint Stipulation on May 30, 2013, in which: plaintiff seeks an order reversing the Commissioner's decision and remanding this case for payment of benefits or, alternatively, for further administrative proceedings; and the Commissioner requests that her decision be affirmed or, alternatively, remanded for further administrative proceedings.
Plaintiff, who was born on January 26, 1951, filed applications for DIB and SSI on June 25, 2009.
After the Commissioner denied plaintiff's claims initially and upon reconsideration (A.R. 55-60, 61-65), plaintiff requested a hearing (A.R. 66-67). On April 5, 2011, plaintiff, who was not represented by counsel or otherwise,
The ALJ found that plaintiff last met the insured status requirements of the Social Security Act on December 31, 2008, and that she has not engaged in substantial gainful activity ("SGA") since the alleged onset date of July 13, 2005. (A.R. 28.) With respect to his step one finding, the ALJ explained as follows:
(A.R. 28.)
At step two, the ALJ found that plaintiff has the severe impairments of degenerative disc disease of the spine and degenerative joint disease of the knees. (A.R. 28.) The ALJ noted that he had considered the potential impact of plaintiff's obesity on her severe impairments, notwithstanding that plaintiff did not allege that her weight limited her in any way. (A.R. 29.) The ALJ also noted that plaintiff takes medication for high cholesterol and Type 2 Diabetes, but the ALJ found no evidence of secondary diseases other than diabetes. (Id.) The ALJ concluded that there is no objective evidence indicating that plaintiff's diabetes would preclude the performance of SGA within plaintiff's assessed residual functional capacity. (Id.) At step three, the ALJ found that plaintiff does not have an impairment or combination of impairments that meet or medically equal one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1 (20 C.F.R. §§ 404.1520(d), 404.1525, 404.1526, 416.920(d), 416.925, and 416.926). (Id.)
Before proceeding to step four, the ALJ determined that plaintiff has the residual functional capacity ("RFC") to perform "a narrowed range of" light work as defined in 20 C.F.R. §§ 404.1567(b) and 416.967(b), "except she can occasionally bend, stoop, and twist." (A.R. 29, 31-32.) The ALJ found that plaintiff: "can sit for 6 hours out of an 8-hour period with normal breaks, and she can stand and/or walk for 6 hours out of an 8-hour period. [Plaintiff] can lift and/or carry 10 pounds frequently and 20 pounds occasionally." (Id.)
The ALJ also rendered a negative credibility finding with respect to plaintiff's allegations regarding her symptoms and limitations, to wit, that plaintiff's "statements concerning the intensity, persistence and limiting effect of [her alleged] symptoms are not credible to the extent they are inconsistent with the [ALJ's] residual functional capacity assessment." (A.R. 30.) The ALJ reasoned as follows:
(A.R. 30.)
In addition, the ALJ found that plaintiff's credibility was diminished with respect to the alleged severity of the symptoms she experienced based on her degenerative disc and joint diseases, because although there was objective medical evidence of lumbosacral tenderness and decreased motion, radiculopathy, and hyperalgesia, plaintiff had a normal range of motion in her cervical spine and knees, no muscle spasms or tenderness on palpation, and normal gait and balance, and there was no evidence of generalized neuropathy. (A.R. 31.) The ALJ also noted that plaintiff reported incidents of falling and having to use a cane, but the record contained no evidence that a cane was medically prescribed. (Id.)
At step four, the ALJ determined that plaintiff is capable of "performing past relevant work as a desk clerk, resort," because the activities of that job — as it was performed by plaintiff and as generally performed in the national economy — are not precluded by her RFC. (A.R. 32) The ALJ determined that plaintiff's work as a motel desk clerk for approximately six months was "past relevant work" within the meaning of the Social Security regulations, because plaintiff "performed it within 15 months of the date of this decision, for a sufficient length of time to learn, provide average performance and at the level of substantial gainful activity." (Id.) Based on his step four finding, the ALJ concluded that plaintiff has not been under a disability, as defined in the Social Security Act, from July 13, 2005, through the date of the ALJ's decision. (A.R. 32-33.)
Under 42 U.S.C. § 405(g), this Court reviews the Commissioner's decision to determine whether it is free from legal error and supported by substantial evidence in the record as a whole.
Although this Court cannot substitute its discretion for that of the Commissioner, the Court nonetheless must review the record as a whole, "weighing both the evidence that supports and the evidence that detracts from the [Commissioner's] conclusion."
The Court will uphold the Commissioner's decision when the evidence is susceptible to more than one rational interpretation.
Plaintiff claims that the ALJ committed legal error in two respects. First, plaintiff contends that the ALJ's step four finding — i.e., that plaintiff's approximately six months of work as a motel desk clerk is "past relevant work" she is capable of performing, thus precluding a finding of disability — is erroneous, because her earnings were too low to constitute SGA, as the ALJ earlier found at step one. (Joint Stipulation ("Joint Stip.") at 4-9, 12-15.) Second, plaintiff contends that the ALJ improperly discounted plaintiff's credibility. (Id. at 15-23, 27.)
At step one, an ALJ considers whether the claimant is engaged in "substantial gainful activity." See 20 C.F.R. §§ 404.1520(a)(4)(i), 416.920(a)(4)(i) ("At the first step, we consider your work activity, if any. If you are doing substantial gainful activity, we will find that you are not disabled"); see also
Plaintiff ceased working her longtime job as a warehouse shipping and receiving clerk in July 2005, following an injury. (A.R. 45, 155.) Thereafter, from August 2005, through January 23, 2006, she worked as a desk clerk at a motel in Arizona. (A.R. 41, 130.) She worked six hours a day, seven days a week, although she would be sent home if it was slow. (A.R. 45.) Plaintiff stopped performing the motel desk clerk job, because she lives with her daughter and her daughter was transferred to California. (A.R. 41-42.) She applied for another desk job, but was told she lacked experience. (A.R. 42.)
Plaintiff argues that the motel desk clerk job does not qualify as "past relevant work," because the low level of her earnings precludes finding this job to constitute "substantial gainful activity." (Joint Stip. at 5-8.) As plaintiff correctly notes, the ALJ, at step one, expressly determined that plaintiff's earnings as a motel desk clerk were insufficient to "rise to the level of substantial gainful activity." (Id. at 6-7; see also A.R. 28, the ALJ's finding that plaintiff "has not engaged in substantial gainful activity since July 13, 2005," her alleged onset date.)
Plaintiff made $650 a month from August through December 2005, and she made $896 in January 2006. (A.R. 124, 131.) According to the Social Security Administration ("SSA") website, the baseline earnings amount (sighted individuals) for SGA was $830 per month in 2005 and $860 per month in 2006. (See Joint Stip., Ex. 1; http://www.ssa.gov/OACT/COLA/sga.html.) Plaintiff's $650 monthly income as a motel desk clerk during the last five months of 2005 fell below the requisite baseline amount for SGA. Even though plaintiff earned $896 in January 2006, as the ALJ recognized (A.R. 28), this amount, when averaged over a 12-month period, falls well below the $860 SGA baseline amount.
Based on these earnings levels, the ALJ correctly found, at step one, that plaintiff's income as a motel desk clerk for six months after her alleged disability onset date was too low to satisfy the SSA's requirements for SGA. (A.R. 28.)
Ignoring the potentially inconsistent nature of the ALJ's step one and step four findings, the Commissioner argues that no error occurred, because the ALJ was entitled to find that plaintiff's motel desk clerk work constituted SGA and, thus, was past relevant work. Relying on 20 C.F.R. §§ 404.1510, 404.1574(a)(1), 416.910, and 416.974(a)(1), the Commissioner argues that, regardless of a claimant's earnings level, prior work will constitute SGA as long as it involves doing significant and productive physical or mental duties and is done for pay or profit, and that plaintiff's duties as a motel desk clerk satisfy these requirements. (Joint Stip. at 10-11.)
The Commissioner's argument fails, because it disregards the SSA's regulations as a whole, as well as the governing caselaw regarding the Commissioner's burden of proof at step four. The regulations on which the Commissioner relies merely set forth general language regarding what type of activity will be deemed to constitute both substantial and gainful "work" activity, as opposed to other activities, such as school attendance or household tasks. See 20 C.F.R. §§ 404.1572(c), 416.972(c). While insubstantial earnings will not necessarily establish an inability to engage in SGA, the regulations make clear that the SSA's "primary consideration" in determining if work activity is SGA "will be the earnings" the claimant derived from such work activity. 20 C.F.R. §§ 404.1574(a)(1), 416.974(a)(1). Further:
20 C.F.R. §§ 404.1574(b)(3)(i), 416.974(b)(3)(i).
In short, when low earnings are shown, the SSA's regulations establish a "presumption" that prior work was not SGA, and that presumption "shifts the step-four burden of proof from the claimant to the Commissioner."
In
Plaintiff's earnings as a motel desk clerk fell below the SSA's baseline amounts for SGA, as the ALJ recognized at step one. Thus, a presumption arose that her motel desk clerk work was not SGA for purposes of the step four past relevant work question, which the Commissioner was required to rebut. The Commissioner's argument is fatally flawed in two respects. First, the Commissioner completely disregards the effect of plaintiff's low earnings level, contrary both to her own regulations and governing case law. Second, the Commissioner's argument rests on what the ALJ could have done but did not do, i.e., how the ALJ could have assessed the evidence of record and the findings he could have made to rebut the governing presumption that plaintiff's motel desk clerk job was not SGA.
The ALJ did not address the 20 C.F.R. §§ 404.1573 and 416.973 factors cited in
The ALJ gave no indication that he recognized the presumption triggered by his step one finding that plaintiff's motel desk clerk job was not SGA, because her earning were too low. He made no effort to reconcile that finding with his facially inconsistent step four finding that the job was performed at the level of substantial gainful activity. Indeed, he made no effort to meet the Commissioner's burden of pointing to substantial evidence that plaintiff engaged in substantial gainful activity during the approximately six months period of her motel desk clerk work. The Commissioner's arguments about why the prior motel desk clerk job was "substantial" and "gainful" activity are after-the-fact; they do not reflect any findings actually made by the ALJ, and they are post hoc rationalizations which this Court may not entertain. See, e.g.,
The ALJ's step four finding that plaintiff's motel desk clerk job was past relevant work is not supported by substantial evidence, because the ALJ failed to rebut the presumption that the work was not SGA due to plaintiff's low earning levels. Because the ALJ failed to set forth adequate reasons to establish that plaintiff's work as a motel desk clerk was SGA, then under the SSA's regulations, it could not constitute "past relevant work." See 20 C.F.R. §§ 404.1560(b)(1), 416.960(b)(1). The ALJ's step four finding is inconsistent with 20 C.F.R. §§ 404.1560(b)(1) and 416.960(b)(1), and he should have proceeded to step five. See
Once a disability claimant produces objective medical evidence of an underlying impairment that is reasonably likely to be the source of claimant's subjective symptom(s), all subjective testimony as to the severity of the symptoms must be considered.
Here, the ALJ found that, "[a]fter careful consideration of the evidence, . . . [plaintiff]'s medically determinable impairments could reasonably be expected to cause the alleged symptoms." (A.R. 30.) Further, the ALJ cited no evidence of malingering by plaintiff. Nonetheless, the ALJ concluded that plaintiff's "statements concerning the intensity, persistence and limiting effects of [her] symptoms are not credible" to the extent they varied from the ALJ's own RFC assessment. (Id.) Accordingly, the ALJ's reasons for finding that plaintiff was not credible with respect to her subjective symptom and pain testimony must be "clear and convincing."
Plaintiff testified that pain in her back and legs prevented her from working as of the hearing's date. (A.R. 42.) She indicated that she cannot stand and walk all day long, can only occasionally bend, stoop, or twist, does not walk up the stairs, and is careful when she walks because her knees buckle without warning, resulting in nine falls in the span of four months. (A.R. 43-44.) Plaintiff also testified that she wishes she was not in so much pain, because she loves to work. (A.R. 45.)
On an exertion questionnaire dated July 7, 2009, plaintiff reported that her back was in a lot of pain, rendering her unable to sit, stand, or lie down for long periods of time. (A.R. 152.) She indicated that her legs and arms are numb and that her knees give out. (Id.) She can only walk about 100 feet before feeling pain in her back, and she carries only small, light things. (A.R. 152-53.) She reported that she does not do her own grocery shopping, does not clean her own area, does not drive, and completes no yard work. (A.R. 153.) Later, on a disability report dated October 30, 2009, plaintiff reported a worsening of her condition since her last report in June 2009, which began in August, including daily headaches, continued pain in the lower back, right leg and right side. (A.R. 172.)
The ALJ discounted plaintiff's testimony and credibility for the following reasons: (1) inconsistencies exist between plaintiff's reported daily activities and what she reported on her application for SSI and an SSA employee's observations during plaintiff's initial interview; (2) there is no objective medical evidence to support plaintiff's allegations of high blood pressure, headaches, and shoulder pain; and (3) the severity of plaintiff's symptoms/pain is not supported by the medical evidence, which shows a normal range of motion for her spine and knees, no neuropathy in her lower extremities, no muscle spasms, and normal gait and balance. (A.R. 30-31.) For the following reasons, the Court finds that the reasons the ALJ provided for discounting plaintiff's symptom/pain testimony and credibility are not clear and convincing.
To support his first reason for discounting plaintiff's credibility, the ALJ noted that plaintiff's SSI application indicated that she does not "need help in personal care, hygiene or upkeep of a home" (A.R. 115), and further, in June 25, 2009, an SSA field representative observed that plaintiff appears "to be perfectly normal," because the employee did not observe plaintiff to have difficulty walking, standing, sitting, etc. (A.R. 143-44). (A.R. 30.) Although there is a facial inconsistency between this evidence and plaintiff's reports that she needs help taking care of herself (A.R. 174, 183), this discrepancy is explained by the fact that, about a month after plaintiff indicated she needed no help in June 2009, and appeared "perfectly normal" she reported a worsening of her condition. (A.R. 172.) Her later reports — in October 2009, and April 2010 — of needing assistance doing daily activities, like showering and household chores (A.R. 174, 183), thus, have an explanation in the record.
The ALJ next discounted plaintiff's credibility on the ground that, although she alleged having high blood pressure and headaches, there was no objective evidence to support these allegations. (A.R. 30.) The ALJ stated that the "only blood pressure reading" in the record was 100/70, within the normal range. (Id.) This blood pressure reading, however, in only one piece of the evidence. Not only does the record show that plaintiff comes from a family with a history of high blood pressure (A.R. 200), but it also contains evidence that on at least one office visit in March 2010, plaintiff's blood pressure reading was 150/100, well above the normal range (A.R. 221), on another in April 2008, it was 133/80, slightly above the normal range (A.R. 227), and in March 2008, her blood pressure reading was 132/80, again slightly above the normal range (A.R. 230). The record, thus, does not support the ALJ's characterization that plaintiff had normal blood pressure during the entire period in question, and his second reason also is not convincing.
The ALJ also found that plaintiff was not credible, because although she reported shoulder pain in October 2009 (A.R. 172), three months earlier (in July 2009), a consultative examiner found that plaintiff had a normal range of motion in her shoulders (A.R. 202). (A.R. 30.) This reason is not convincing, because again, the ALJ ignored that plaintiff reported a worsening of her condition beginning in August 2009. There is no evidence of record demonstrating that plaintiff exhibited a normal range of motion in her shoulders after her condition allegedly worsened in August 2009. Perhaps more importantly, the crux of plaintiff's condition that prevents her from working, as the ALJ found, is degenerative disc disease of the spine and degenerative joint disease of the knees. (A.R. 28.) Plaintiff's disability report from July 7, 2009, only 12 days after she filed for benefits, states that she cannot sit, stand or walk too long and that she has a lower back injury. (A.R. 146.) Plaintiff's exertion questionnaire dated July 7, 2009, confirms that plaintiff's claim of disability is based on her back and knee problems, not on any claim of disabling shoulder pain. (A.R. 152-54.) The ALJ's discounting of plaintiff's credibility based on her shoulder complaints, therefore, is not convincing.
Finally, the ALJ discounted plaintiff's testimony about her symptoms and pain on the ground that the medical evidence showed a normal range of motion for her spine and knees, no neuropathy in her lower extremities, no muscle spasms, and normal gait and balance.
None of the reasons cited by the ALJ for finding plaintiff to lack credibility with respect to her claimed symptoms and pain is legally adequate. Accordingly, the ALJ's adverse credibility finding is not supported by substantial evidence and is reversible error.
The decision whether to remand for further proceedings or order an immediate award of benefits is within the district court's discretion.
As noted earlier, the ALJ stopped the sequential evaluation process at step four, at which he failed to make adequate findings regarding whether plaintiff's motel desk clerk job constituted SGA and past relevant work. The ALJ did not adduce any evidence about, much less make any findings regarding, what skills plaintiff acquired in her prior jobs and whether any such skills are transferrable to any other jobs existing in significant numbers in the national economy that plaintiff could do given her RFC, age, education, and work experience. Additional evidence, including from a medical expert and/or a vocational expert, likely will be needed to resolve these issues. The Court concludes that there are outstanding issues that must be resolved before a determination of disability can be made, including with respect to the applicability (or not) of the Grids.
Remand is the appropriate remedy so that the above-mentioned errors may be rectified. See, e.g.,
Accordingly, for the reasons stated above, IT IS ORDERED that the decision of the Commissioner is REVERSED, and this case is REMANDED for further proceedings consistent with this Memorandum Opinion and Order. IT IS FURTHER ORDERED that the Clerk of the Court shall serve copies of this Memorandum Opinion and Order and the Judgment on counsel for plaintiff and for defendant.
Respondent notes that the ALJ stated that plaintiff "answered telephones, gave room keys to customers and occasionally cleaned rooms" and referenced the DOT classification for desk clerk, resort. (A.R. 32.) Respondent, however, overlooks that these brief comments were made in the context of the ALJ's explanation of why plaintiff's RFC did not preclude her from performing the prior motel desk clerk job; they plainly did not reflect any findings by the ALJ that the prior work was substantial gainful activity within the meaning of 20 C.F.R. §§ 404.1572-414.1573 and 416.972-416.973.