FRANK D. WHITNEY, Chief District Judge.
Having reviewed and considered the written arguments, administrative record, and applicable authority, and for the reasons set forth below, the Plaintiff's Motion for Summary Judgment is GRANTED and Defendant's Motion is DENIED. The Court VACATES the decision of the Administrative Law Judge ("ALJ") and REMANDS the case to the Commissioner for further proceedings.
Michael L. Prater ("Plaintiff") filed for a period of Disability Benefits on May 3, 2012, under Title II and Title XVIII Part A, initially alleging a disability onset date of May 31, 2011, (later amended to November 24, 2012) due to Post Traumatic Stress Disorder ("PTSD"), Anxiety, Obsessive Compulsive Disorder ("OCD"), high blood pressure, and sleep problems. (Tr. 245). At the time of the application, Plaintiff was 57 years old. Plaintiff submitted evidence of his disability from Sonora Behavioral Healthcare, Inc.; Asheville Veterans Affairs Medical Center; and Olympus Health North Carolina, LLC.; including records from psychologist Dr. Barry Rand, psychiatrist Dr. Susan Glover, and therapist Dr. E. Lynn Marlow. (Tr. 25-28). These records were reviewed by Social Security Administration's ("SSA") medical consultants. (Tr. 138-39). Plaintiff's application was initially denied and then again upon his request for reconsideration. (Tr. 138, 143). Plaintiff then filed a written request for a hearing before an Administrative Law Judge on April 2, 2013, pursuant to 20 C.F.R. 404.929. (Tr. 117).
Administrative Law Judge Sherman Schwartzberg ("the ALJ") held a hearing on January 27, 2014. (Tr. 152). Before the ALJ issued his decision, the Department of Veterans Affairs ("VA") found Plaintiff completely disabled due to service-connected disabilities on February 11, 2014. (Tr. 775). Then, on March 7, 2014, the ALJ denied Plaintiff's application for disability. (Tr. 129). Plaintiff appealed the ALJ's decision to the Appeals Council and the case was remanded to explain, inter alia, why the ALJ assigned "little weight" to the VA's determination and other medical source opinions and to resolve conflicts in the Vocational Expert's testimony. (Tr. 134-36). The ALJ reconsidered the claim and issued a second decision denying Plaintiff's application on September 16, 2015. (Tr. 15-33). The Appeals Council denied further administrative review (Tr. 1), thereby rendering the ALJ's decision the final decision of the Commissioner of Social Security. Plaintiff filed timely review to this court pursuant to on March 24, 2016, (Doc. No. 1), and the parties' Motions for Summary Judgment are now ripe for review pursuant to 42 U.S.C. § 405(g).
Under 42 U.S.C. § 405(g), this court is authorized to review the final decision of the Commissioner of Social Security to determine that (1) the Commissioner's decision is supported by substantial evidence,
Substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion, which comprises more than a mere scintilla of evidence but may be less than a preponderance.
The issue before the ALJ was whether Plaintiff was disabled under the Social Security Act from November 24, 2012, to the date of the ALJ's decision. Disability is defined by 42 U.S.C. § 301 as "an inability 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." The SSA requires an ALJ to follow a five-step process to make this determination. 20 C.F.R. § 404.1520(a)(1). If the claimant is found to be disabled or not disabled at any step in the process, the inquiry ends and the adjudicator does not need to proceed further in the evaluation process.
In step 1, an ALJ must determine whether the claimant is engaged in a substantial gainful activity. In step 2, the ALJ determines whether the claimant has a severe medically determinable impairment or a combination of impairments. In step 3, an ALJ will find whether the claimant's impairments meets or medically equals one of the "paragraph B or C" listings in 20 C.F.R. Part 404, Subpart P, Appendix 1. If an ALJ determines that the impairments are not so severe, the ALJ will pause to determine the claimant's Residual Functional Capacity ("RFC"). An ALJ will then use the RFC finding in step 4 to examine whether the claimant can perform the requirements of his past relevant work or, in step 5, whether the claimant can do any other work, considering the claimants RFC, age, education, and work experience. 20 C.F.R. § 404.1520(a)(4)(i-v).
In this case, the ALJ determined that Plaintiff was not disabled because his impairments did not meet or equal the "paragraph B or C" criteria in step 3 and that he could perform the requirements of past relevant work and other jobs available in the national economy in steps 4 and 5. (Tr. 31-33). On appeal, Plaintiff alleges the ALJ committed four errors in the evaluation of Plaintiff's RFC and a further errors in the ALJ's application of the RFC in steps 4 and 5. This Court agrees with Plaintiff that the ALJ committed error warranting remand because the failed to explain why Plaintiff's moderate limitation in concentration, persistence, and pace in step 3 was not incorporated into the ALJ's finding of Plaintiff's RFC. This Court finds Plaintiff's three additional assignments of error in the RFC analysis unavailing: that the ALJ improperly assigned weight to Plaintiff's treating mental health examiners' opinions, the VA determination, and some of Plaintiff's Global Assessment of Functioning scores. Finally, Plaintiff also alleges that the ALJ failed to resolve conflicts between the Vocational Expert's testimony and the Dictionary of Occupational Titles in steps 4 and 5. However, because the Court finds that there was an error in the RFC finding, which provides the basis of the VE's testimony in steps 4 and 5, this Court will reserve judgment on this final argument asserted by Plaintiff. (Tr. 20-21).
Plaintiff argues this case should be remanded because the ALJ failed to explain why Plaintiff's moderate limitation in the ability to maintain concentration, persistence, and pace in step 3 was not incorporated into Plaintiff's RFC. The Commissioner argues that the ALJ's decision accounted for Plaintiff's limitation by including Plaintiff's social limitations.
In step 3 of an ALJ's analysis, the functional limitations of mental impairments are assessed within four broad categories: the ability to understand, remember, or apply information; to work with others; to concentrate, persist, or maintain pace; and to adapt or manage oneself. 20 C.F.R. § 404.1520a(c)(3). The ability to work with others refers to the ability to relate to and work with supervisors, co-workers, and the public. The ability to concentrate, persist, or maintain pace refers to the abilities to focus attention on work activities and stay on task at a sustained rate. 20 C.F.R. pt. 404, subpt. P, app. 1, § 404 12.00(E)(1-2). A limitation is assessed on a five-point scale: none, mild, moderate, marked, and extreme. 20 C.F.R. § 404.1520a(c)(4). If a claimant's limitations in these four broad categories do not meet or equal those listed in the "paragraph B or C" listings, the ALJ will determine the claimant's Residual Functional Capacity. 20 C.F.R. 404.1520(a).
When determining a claimant's RFC, an ALJ reviews all the evidence of record and performs a detailed analysis by itemizing the various functions contained in the broad categories found in the step 3 analysis. SSR 96-8p, 1996 WL 34184 at *4 (July 2, 1996). An ALJ concludes the analysis by issuing a finding of the claimant's RFC that describes the claimant's physical and mental capacities. The United States Court of Appeals for the Fourth Circuit has held that an RFC does not inferentially incorporate a limited ability to concentrate, persist, or maintain pace if it merely restricts the claimant RFC to "simple, routine, repetitive work."
In step 3 of this case, the ALJ found that Plaintiff has "moderate difficulties" in social functioning and in concentrating, persisting, and maintaining pace but found that these limitations were not as severe to meet or equal "paragraph B or C" criteria. (Tr. 22-23). However, in the subsequent RFC analysis, the ALJ's assessment of Plaintiff's mental limitations is not so clear. As for Plaintiff's ability to work with others, the ALJ concurred with Dr. Lynn Marlow, Plaintiff's treating therapist, finding that Plaintiff was moderately limited in his ability to function in most stress situations and engage in most interpersonal relations. (Tr. 30). By contrast, the record of ALJ's finding of Plaintiff's ability to concentrate, persist, and maintain pace is ambiguous. While the ALJ found that Dr. Marlow's assessment of Plaintiff's ability to maintain pace was not consistent with the record, the ALJ only disagreed with the
Nonetheless, at the conclusion of Plaintiff's RFC assessment, the ALJ omits a limitation in concentration, persistence and pace altogether, finding that Plaintiff's RFC was only restricted to "simple, routine, repetitive work; occasional contact with co-workers and supervisors; and no contact with the public."
The Commissioner cites three cases to argue that the ALJ satisfies
In conclusion, the decision must be remanded because the ALJ erred by failing to explain why Plaintiff's moderate limitation in concentration, persistence, and pace in step 3 did not translate into a limitation in Plaintiff's RFC. The error is not harmless, as this potentially incomplete RFC formed the basis of the hypothetical submitted to the VE, (Tr. 77), and VE testimony based on incomplete hypotheticals may not provide basis for an ALJ's disability determination.
In addition to the defect above, Plaintiff alleges three additional assignments of error in the ALJ's RFC analysis, which the Court now addresses since they relate to the same step in the ALJ's analysis. An ALJ's RFC evaluation must be based on all of the relevant medical evidence in the case record. SSR 96-8p, 1996 WL 374184 (July 2, 1996). In general, an ALJ's assessment of the weight to be accorded to a medical opinion source will not be disturbed by a reviewing court.
The medical opinions of physicians who have long treated the claimant for impairments related to the disability determination are provided greater weight than those of non-examining physicians. 20 C.F.R. § 404.1527(c)(2)(i-ii);
In this case, the ALJ accorded Plaintiff's treating mental health examiners little weight and accorded great weight to the non-examining, state agency psychological consultants. Plaintiff alleges this violates 20 C.F.R. § 404.1527(c)(2) and therefore warrants remand. (Tr. 20). Plaintiff argument is unavailing. The ALJ expressly found that treating psychologist Dr. Rand and treating psychiatrist Dr. Glover's opinions were not consistent with the medical evidence of record. (Tr. 29). Both physicians found that Plaintiff would not be able to work given his social impairments.
The ALJ provided extensive explanation for why Dr. Marlow's opinion as to Plaintiff's social limitations and concentration, persistence and pace limitation was not consistent with the medical evidence of record. (Tr. 29-30). While the ALJ concurred that Plaintiff had moderate social functioning limitations, the ALJ found that Dr. Marlow's finding of four-or-more episodes of decompensation was without any documentation. Furthermore, the ALJ found that Dr. Marlow's finding that Plaintiff was markedly limited in social functioning was contradicted by her own treatment notes.
In conclusion, according the deferential standard of substantial evidence review,
Decisions by any other governmental agency that a claimant is disabled is not binding on an ALJ's determination. SSR 06-03P, 2006 WL 2329939 at *6 (Aug. 9, 2006). However, the Fourth Circuit has held that disability determinations by the Department of Veterans Affairs (VA) should be accorded substantial weight if it resulted from an evaluation of the same condition and same underlying evidence that was relevant to the ALJ's determination.
In this case, on February 11, 2014, the VA determined that Plaintiff was unemployable because he was seventy-percent disabled due to his major depressive disorder and twenty-percent disabled due to his limited supination and pronation, left elbow, S/P injury, and four surgeries. (Tr. 775). Plaintiff's major depressive disorder was based on, inter alia, near-continuous depression and obsessional rituals which interfere with routine activities. (Tr. 776). Because the ALJ determined that Plaintiff was severely impaired by major depressive disorder and obsessive compulsive disorder (Tr. 20), Plaintiff asserts that
However, the court in
In conclusion, the ALJ did not err by according less weight to the VA's determination due to evidence which a reasonable mind might find accept as adequate to support the ALJ's conclusion. Because the ALJ's determination was supported by substantial evidence, this Court may not disturb it upon review.
Global Assessment of Function (GAF) ratings are medical opinions that measure an adult's social, occupational, and psychological functioning. Like other medical opinions, GAF ratings are given weight according to, inter alia, the quality of explanation a source provides for the opinion. 20 C.F.R. 404.1527(c)(3). Generally, a GAF rating that is unaccompanied by a clinician's explanation may not provide evidence of a claimant's disability.
Here, the ALJ found that all of Plaintiff's submitted GAF ratings were unaccompanied by either a clinician's explanation or an indication as to which period the rating applied. (Tr. 31). For these reasons, the ALJ stated that the ratings could not provide a reliable longitudinal picture of Plaintiff's mental functioning for a disability analysis, and should therefore be accorded little weight.
Therefore, the ALJ decision's to accord little weight to Plaintiff's GAF scores is supported by substantial evidence and the determination may not be disturbed by this Court.
Plaintiff's Motion for Summary Judgment (Doc. No. 11) is GRANTED, and Defendant's Motion (Doc. No. 12) is DENIED. The Court VACATES the ALJ's decision and REMANDS the case to the Commissioner for further proceedings consistent with this ORDER.
IT IS SO ORDERED.