JACQUELINE CHOOLJIAN, Magistrate Judge.
On June 9, 2016, JoAnne Pommerville ("plaintiff") filed a Complaint on behalf of her late daughter, Debra Ragland ("claimant"), seeking review of the Commissioner of Social Security's denial of claimant'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"). The Court has taken both 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 April 2, 2012, the claimant filed applications for Supplemental Security Income and Disability Insurance Benefits alleging disability beginning on March 8, 2008, due to neck problems after surgery and a sciatic nerve problem. (Administrative Record ("AR") 14, 156, 158, 183). The claimant passed away on November 27, 2013. (AR 14, 543). The Administrative Law Judge ("ALJ") examined the medical record and heard testimony from plaintiff (who was represented by counsel on behalf of the claimant) and a vocational expert on September 10, 2014. (AR 25-42).
On September 26, 2014, the ALJ determined that the claimant was not disabled through the date of her death. (AR 14-20). Specifically, the ALJ found that prior to the claimant's death: (1) the claimant suffered from the following severe impairments: chronic pain syndrome, degenerative disc disease of the lumbar and cervical spines, and carpal tunnel syndrome (AR 16-17); (2) the claimant's impairments, considered singly or in combination, did not meet or medically equal a listed impairment (AR 17); (3) the claimant retained the residual functional capacity to perform light work (20 C.F.R. §§ 404.1567(b), 416.967(b)) with additional limitations
On April 13, 2016, the Appeals Council denied plaintiff's application for review. (AR 1).
To qualify for disability benefits, a claimant must show that the claimant 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."
In assessing whether a claimant is disabled, an ALJ is required to use the following five-step sequential evaluation process:
The claimant has the burden of proof at steps one through four, and the Commissioner has the burden of proof at step five.
Pursuant to 42 U.S.C. section 405(g), a court may set aside a denial of benefits only if it is not supported by substantial evidence or if it is based on legal error.
Substantial evidence is "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion."
While an ALJ's decision need not discuss every piece of evidence or be drafted with "ideal clarity," at a minimum it must explain the ALJ's reasoning with sufficient specificity and clarity to "allow[] for meaningful review."
An ALJ's decision to deny benefits must be upheld if the evidence could reasonably support either affirming or reversing the decision.
Even when an ALJ's decision contains error, it must be affirmed if the error was harmless.
A reviewing court may not conclude that an error was harmless based on independent findings gleaned from the administrative record.
Plaintiff contends, in part, that the ALJ failed properly to consider her hearing testimony about the claimant, and failed to provide germane reasons for rejecting the competent lay testimony. (Plaintiff's Motion at 11-22). The Court agrees. As the Court cannot confidently conclude that the ALJ's errors were harmless, a remand for additional investigation and/or explanation is appropriate.
The ALJ's decision summarized plaintiff's entire hearing testimony as follows: "The claimant's mother [plaintiff] testified that the claimant had problems with back and neck pain, pain in her hands, and depression. She testified that the claimant was working a couple of months before she died." (AR 18).
Lay witness testimony about a claimant's symptoms or how an impairment impacts the claimant's ability to work is competent evidence that "cannot be disregarded without comment."
When an ALJ disregards or fails to provide germane reasons for rejecting competent lay evidence, reversal is not warranted if the ALJ's error was harmless.
Here, the ALJ's consideration of plaintiff's lay testimony was deficient in at least two material respects.
First, as plaintiff pointed out, the ALJ's decision failed to address a significant portion of plaintiff's hearing testimony — specifically, plaintiff's testimony regarding the manner in which the claimant's impairments impacted her ability to work.
Second, the ALJ apparently gave no reasons at all for disregarding any of plaintiff's lay testimony.
The Court cannot confidently conclude that the foregoing errors were harmless. For example, the vocational expert testified, in part, that if a hypothetical individual with the same characteristics as the claimant were more functionally restricted, the claimant would be unable to perform any past relevant work. (AR 40). As noted above, plaintiff's testimony suggests that the claimant's functioning was significantly more limited than the ALJ's residual functional capacity assessment reflects. Thus, if such testimony were fully credited, a reasonable ALJ could very well have concluded at step four that the claimant was not able to perform her past relevant work. In addition, the vocational expert also testified there would be other work at the sedentary exertion level that a hypothetical individual like the claimant could do even with additional functional restrictions. (AR 40-41). Nonetheless, if fully credited, plaintiff's testimony suggests that due to her impairments, the claimant might need to take significant unscheduled breaks during a typical workday, and possibly be absent from work at least one or two days each week. Hence this Court cannot confidently conclude that a reasonable ALJ would not have reached a different disability determination even if the ALJ had proceeded to step five.
Defendant argues the ALJ's errors were harmless essentially because the ALJ had already expressed "adequate reasons for rejecting the claimant's [substantively identical] testimony." (Defendant's Motion at 15-16). An ALJ's failure to give germane reasons for rejecting competent lay testimony may be harmless to the extent (1) the lay witness described the same, specific limitations as the claimant did in his or her own testimony; (2) the ALJ provided well-supported and valid (i.e., clear and convincing) reasons for rejecting the claimant's own testimony regarding the specific limitations; and (3) the reasons the ALJ articulated for rejecting the claimant's testimony regarding such limitations "apply with equal force to the lay testimony" the ALJ failed to address.
First, plaintiff and the claimant did not, as defendant asserts (Defendants' Motion at 15, 17), provide "substantively identical" statements regarding any impairment-related limitations addressed in the ALJ's decision. For example, the ALJ mostly discredited the claimant's statements with respect to broad categories of subjective symptoms — i.e., "back pain and mental symptoms," "complaints of severe pain and debilitating anxiety and depression," "pain and dysfunction," and "pain [that] was disproportionate" (AR 18-19) — which did not identify with sufficient clarity any subjective statement regarding a specific functional limitation the ALJ intended to reject. In contrast, the plaintiff testified about her personal observations of the specific impact the claimant's impairment-related symptoms had on the claimant's day-to-day functioning. (AR 37).
Second, in any event, it does not appear that the ALJ provided clear and convincing reasons for finding the claimant's statements "not entirely credible." For example, the ALJ wrote that the claimant's "complaints of severe pain and debilitating anxiety and depression" were "less than fully credible" in light of evidence that claimant missed an unspecified number of "scheduled appointments" and engaged in "significant drug-seeking behavior." (AR 18-19). Nonetheless, the ALJ did not link any statement by the claimant about a specific functional limitation to particular parts of the record that undermined the credibility of such statement. The same is true for the ALJ's conclusory statements that the treating physician found unspecified pain complaints "disproportionate," and that "the claimant's [poor] work history . . . suggests that the claimant's unemployment after the alleged onset date may not have been due to medical impairments[.]" (AR 19). Without more, this Court is unable adequately to determine whether the ALJ discredited the claimant's specific subjective complaints on permissible grounds.
The ALJ also wrote that "[a]lthough the claimant complained of back pain and was in pain management, she had no surgery and very little therapy other than medications[,]" which "suggests that the claimant's condition was manageable with medication alone and did not cause as much pain and dysfunction as [claimant] alleged[.]" (AR 19). Nonetheless, plaintiff testified at the hearing that at some point the claimant had undergone surgery for her neck. (AR 33). The medical records reflect that in 2011 the claimant was treated for lumbar radiculopathy with epidural injections on one occasion, and given medial branch blocks for thoracolumbar spondylosis on two others. (AR 531-33). Moreover, examination notes from the claimant's treating physician reflect, in pertinent part, that the medication prescribed to the claimant had "not changed [claimant's] pain," did not seem to "last long enough for [the claimant's] pain," and/or relieved the claimant's pain for only four hours, and also that even "with medications" the claimant's pain, at times, remained at a level of five to seven (on a severity scale of one to ten). (AR 304, 308, 441, 445, 449, 453, 457, 461, 465). The ALJ's apparent incorrect characterization of the medical evidence calls into question the validity of both the ALJ's credibility evaluation and the ALJ's decision as a whole.
Finally, even so, the reasons the ALJ articulated for discrediting the claimant's subjective complaints do not apply "with equal force" to plaintiff's lay testimony about the claimant. For example, evidence of drug-seeking behavior by the claimant arguably would support inferences that the claimant had exaggerated the severity of her pain during doctor visits in order to obtain more prescription drugs than necessary. Nonetheless, evidence that the claimant engaged in drug-seeking behavior with her doctors raises no questions about plaintiff's overall veracity as a witness, much less provide a germane reason for rejecting testimony regarding plaintiff's personal observations of specific conduct in which the claimant engaged (i.e., taking unscheduled breaks or going home when the claimant told plaintiff "she just couldn't take [the pain] anymore[,]" or that plaintiff would "see" that the claimant's inability to get out of bed/get to work "at least once or twice a week") under entirely different circumstances (i.e., while the claimant was working under plaintiff's supervision). (AR 36-37).
Similarly, the ALJ discredited the claimant's overall subjective statements, in part, due to "no evidence of any medical treatment in the record until 2011," and unexplained failure to seek or receive treatment commensurate with the alleged severity of the claimant's subjective complaints. (AR 18-19). Nonetheless, an ALJ may not discredit otherwise competent lay statements solely because they are "not supported by medical evidence in the record."
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.