EDWARD J. DAVILA, District Judge.
Plaintiff Joseph A. Taroni ("Plaintiff") brings this action pursuant to 42 U.S.C. § 405(g) to obtain review of a final decision by the Commissioner of the Social Security Administration
Because the record reveals the Commissioner's decision is not supported by substantial evidence in several aspects that cannot be classified as harmless, Plaintiff's motion will be granted and the Commissioner's cross-motion will be denied for the reasons explained below.
Plaintiff applied for SSD on February 28, 2013, alleging a disability onset of August 23, 2005. Tr., Dkt. No. 11, at 75. Plaintiff's claim was initially denied by the Commissioner on November 12, 2013.
Plaintiff subsequently requested a hearing before an administrative law judge ("ALJ"), which occurred before ALJ Betty Roberts Barbeito on October 8, 2014.
Plaintiff sought administrative review of the ALJ's determination.
According to his testimony before the ALJ, Plaintiff was born on August 23, 1987, and was 27 years old at the time of the hearing.
Plaintiff filed for SSD due to cancer, back injury and borderline intellectual functioning. On December 22, 2011, Plaintiff was examined by Dr. Henry S. Chua due to a neck mass.
Plaintiff fell off of a bicycle in June, 2012, and a CT scan in September, 2013, showed a severe compression fracture in part of his spine, and a mild fracture deformity in another part of his spine.
Plaintiff was examined at the direction of the Commissioner by Dr. Sara Hyatt-Boyd, a psychologist, on July 10, 2013.
Plaintiff was also examined by Dr. Clark Gable on September 26, 2013, at the direction of the Commissioner.
At the hearing before the ALJ, Plaintiff testified he could not do his job full-time because of back problems.
Plaintiff's mother testified that Plaintiff could not live on his own because he is "kind of like a young teenager mentally."
Pursuant to 42 U.S.C. § 405(g), the district court has authority to review an ALJ decision. The court's jurisdiction, however, is limited to determining whether the denial of benefits is supported by substantial evidence in the administrative record.
"Substantial evidence" is more than a scintilla, but less than a preponderance.
The Social Security Act defines disability as the "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 twelve months." 42 U.S.C. § 423(d)(1)(A). The impairment must also be so severe that a claimant is unable to do previous work, and cannot "engage in any other kind of substantial gainful work which exists in the national economy," given the claimant's age, education, and work experience. 42 U.S.C. § 423(d)(2)(A).
"The claimant carries the initial burden of proving a disability."
The ALJ evaluates Social Security disability cases using a five-step evaluation process. 20 C.F.R. § 416.920. The steps require the following analysis:
The ALJ made the following findings and conclusions on the five steps: (1) for step one, the ALJ determined that Plaintiff had not engaged in substantial gainful activity since August 23, 2005; (2) for step two, the ALJ determined Plaintiff had severe impairments, including Hodgkin's lymphoma in remission, healed or healing compression fractures, and a learning disorder, but had no evidence of these conditions prior to 2012; (3) for step three, the ALJ determined that Plaintiff does not have an impairment or combination of impairments that meets or medically equals the requirements of the Listing of Impairments; (4) for step four, the ALJ determined that Plaintiff had the residual functional capacity to perform medium work as defined in 20 C.F.R. § 404.1567(c),
In his motion, Plaintiff argues: (1) the ALJ improperly found Plaintiff had past relevant work as a stock clerk; (2) the ALJ erroneously evaluated the opinions of Dr. Kivowitz and Dr. Hyatt-Boyd in the assessment of Plaintiff's residual functional capacity; (3) the ALJ erred by finding Plaintiff did not meet Listing 12.05(C), one of the listed impairments for intellectual disability; and (5) the ALJ erred by finding Plaintiff obtained at least a high school education.
Examining the arguments in sequential order, Plaintiff's arguments are each meritorious.
Plaintiff argues the ALJ erred at Step Three by finding that Plaintiff's intellectual disability did not satisfy Listing 12.05(C). The Commissioner disagrees. The record reveals the ALJ's finding of non-disability under Listing 12.05(C) is not supported by substantial evidence.
Listing 12.05 defines intellectual disability as "significantly subaverage general intellectual functioning with deficits in adaptive functioning initially manifested during the developmental period; i.e., the evidence demonstrates or supports onset of the impairment before age 22." 20 C.F.R. pt. 404, subpt. P, App. 1, § 12.05. As it existed at the time of the hearing before the ALJ, a claimant could demonstrate intellectual disability by satisfying subsection (C) of Listing 12.05, which requires "[a] valid verbal, performance, or full scale IQ of 60 through 70 and a physical or other mental impairment imposing an additional and significant work-related limitation of function."
For the first element, the Commissioner argues Plaintiff failed to submit qualifying evidence describing his condition prior to age 22. That may be true in light of what types of evidence the Listing of Impairments explains can satisfy this element. However, the Commissioner has not cited a relevant portion of the ALJ's decision embodying an opinion on this issue, and the court is unable to find any such opinion in the record. This argument therefore exceeds the scope of the court's review.
For the second element, the ALJ apparently dismissed Plaintiff's IQ score of 69 as determined by Dr. Hyatt-Boyd based on "full consideration of the record, including the consultative reports and two impartial medical experts testimony." Tr. at 18. The ALJ found the score was "questionable in accuracy" without "further documentation anywhere else" since Plaintiff was able to graduate from high school and maintain a regular work schedule for several years.
Similarly, the facts that Plaintiff graduated from high school and maintained a regular work schedule are not clear and convincing reasons to reject the result of an IQ test, at least as presented here. As will be explained in more detail below, the ALJ erred in concluding Plaintiff attained a "high school education" under the regulations, and absent further detail, it is not plainly evident why maintenance of a work schedule is inconsistent with an IQ in the extremely low range.
For the third element, the ALJ did not provide a direct assessment of Plaintiff's separate physical or mental impairments in conjunction with the requirement of Listing 12.05(C). The court observes, however, that this element was effectively satisfied by the ALJ's Step Two finding that Plaintiff had other severe impairments.
Because the ALJ's Step Three decision is not supported by substantial evidence and may have constituted legal error in part, this case must be returned to the Commissioner to reconsider whether Plaintiff satisfies Listing 12.05.
At Step Four, the ALJ found that Plaintiff was not disabled because he is capable of performing "past relevant work" as a stock clerk. Plaintiff argues the ALJ's finding that his position as a stock clerk constituted past relevant work is not supported by substantial evidence and inconsistent with the Step One finding that Plaintiff was not engaged in "substantial gainful activity." The court agrees with Plaintiff.
If the record shows the claimant's residual functional capacity ("RFC") permits performance of past relevant work, the Commissioner may find non-disability at Step Four. Under the regulations, "past relevant work" is work a claimant has done in the past 15 years, that was "substantial gainful activity," and that lasted long enough for the claimant to learn how to do the work. 20 C.F.R. § 404.1560(b)(1). Whether a claimant has engaged in "substantial gainful activity," or "SGA," is determined by applying 20 C.F.R § 404.1574 to the subject work. The Commissioner primarily considers the earnings derived from the work and compares the claimant's monthly earnings to amounts calculated under § 404.1574(b)(2)(ii). If the earnings exceed the amount provided by the regulation, the claimant is ordinarily considered to have engaged in substantial gainful activity. 20 C.F.R § 404.1574(b)(2). If they do not, the Commissioner will generally find the claimant has not engaged in substantial gainful activity unless "there is evidence indicating that [the claimant] may be engaging in substantial gainful activity or that [the claimant is] in a position to control when earnings are paid . . . or the amount of wages paid. . . ." 20 C.F.R. §§ 404.1574(b)(3).
Though the record does not reveal a § 404.1574 calculation, the ALJ found at Step One after recounting Plaintiff's earnings history that his job as a stock clerk suggested "very close to, but not quite, SGA criteria." Tr. at 15. At Step Four, the ALJ reiterated that Plaintiff "arguably has not performed SGA in any single year," but then found that "[a]n equals past relevant work determination is inferred."
The obvious problem with the ALJ's reasoning between Steps One and Four is its inconsistency. Because the definition of "past relevant work" relies partly on such work also constituting "substantial gainful activity," and since the definition of "substantial gainful activity" is common to both steps, the same job cannot fail to meet the definition when applied at Step One, but then qualify as "past relevant work" at Step Four. As it stands, the ALJ's finding at Step Four, presumably based on one of the exceptions described in § 404.1574(b)(3), is not supported by substantial evidence. The Commissioner's arguments in opposition fail to properly account for this deficiency in the record. It must therefore be clarified by the ALJ.
Plaintiff argues the RFC applied by the ALJ is not supported by substantial evidence because the ALJ improperly assessed the opinions of Dr. Kivowitz and Dr. Hyatt-Boyd. Since the record does not adequately specify what medical or other evidence the ALJ relied on in designating the mental limitation included in the RFC, the court must concur.
RFC refers to what the claimant "can still do despite existing exertional and nonexertional limitations."
Here, the record contains two medical opinions relevant to determining whether some form of mental limitation should be included in the RFC applicable to Plaintiff. The first was Dr. Hyatt-Boyd's report which, as recited, stated that Plaintiff had limitations in several areas, but not in the ability to maintain concentration, attention, persistence and pace. Tr. at 604. The second was Dr. Kivowitz's testimony, through which he related that in "the area of concentration," Plaintiff should be limited to "simple repetitive tasks."
The moderate limitation in concentration included in Plaintiff's RFC is not supported by substantial evidence in the record because the basis for it is not explained in the ALJ's written decision or evident from the record. Indeed, the limitation cannot be based on Dr. Hyatt-Boyd's report since she found Plaintiff had no limitation in that area. Nor can it be based on Dr. Kivowitz's testimony, since he opined Plaintiff's impairment in concentration would limit him to simple repetitive tasks — a limitation the ALJ specifically rejected. And to add to the confusion, the ALJ appears to have accepted the opinions of both doctors in their entirety, despite the fact their opinions are partially in conflict.
In short, and despite the Commissioner's attempt to rationalize the ALJ's fragmented reasoning, the RFC is defective because there is simply no way for the court to understand how the moderate limitation in concentration came about on the current state of the record. For this and the preceding reason, the ALJ's Step Four decision cannot be sustained.
A claimant's educational level is considered at Step Five when determining whether the claimant can perform substantial gainful work in the national economy. 20 C.F.R. § 416.920(g). Plaintiff disputes the ALJ's finding that he completed "at least a high school education" as unsupported by substantial evidence. In opposition, the Government contends the ALJ did not err because Plaintiff testified he graduated from high school. On this record, the ALJ's finding cannot be sustained.
When assessing an application for Social Security benefits, "education is primarily used to mean formal schooling or other training which contributes to [a claimaint's] ability to meet vocational requirements, for example, reasoning ability, communication skills, and arithmetical ability." 20 C.F.R. § 404.1564(a). The numerical grade level a claimant completes may not represent educational abilities, and may be higher or lower depending on other factors, such as past work experience, daily activities, hobbies, or the results of testing. 20 C.F.R § 404.1564(a), (b). However, the numerical grade level may be used to determine a claimant's educational abilities if there is no evidence to contradict it. 20 C.F.R. § 404.1564(b).
"High school education" is defined in the regulations as follows:
20 C.F.R. § 404.1564(b)(4).
Here, it appears the ALJ concluded Plaintiff has a high school education based solely on his testimony he completed "senior year" and graduated from high school. But the record also contains other significant, contrary evidence demonstrating that Plaintiff may not have acquired the level of reasoning, arithmetic and language skills contemplated by the regulation's definition. To that end, Plaintiff testified he completed school through separate special education courses, which he attended "the whole time." Tr. at 51. He also stated he did not take the high school exit exam when he graduated.
The ALJ did not address or follow-up on Plaintiff's testimony concerning participation in special education or the high school exit exam, and therefore made no attempt to dismiss or reconcile that testimony with her educational finding. This was error.
Additionally, though the WAIS-IV testing results are particularly probative of Plaintiff's educational level as defined under the regulations, the ALJ never directly discussed them in her decision; and if at all, the ALJ dismissed them at Step Three as "questionable in accuracy." Tr. at 18. But for reasons similar to those already stated, the ALJ's articulation is not a clear and convincing reason to reject the testing results.
Since the ALJ did not discuss the considerable evidence that Plaintiff may not have a high school education, she failed to conduct a proper evaluation of the record by perfunctorily relying on the numerical grade level Plaintiff completed.
This court could still affirm the ALJ's Step 5 decision if the error was harmless.
At Step Five, "the burden shifts to the Commissioner to show that the claimant can perform some other work that exists in `significant numbers' in the national economy, taking into consideration the claimant's [RFC], age, education, and work experience."
In this case, the ALJ prefaced the hypothetical questions by instructing the vocational evaluator to assume an individual "who has the same age, education and experience as our claimant." Tr. at 68. The ALJ did not further specify what level of education should be assumed for Plaintiff, nor was the vocational expert made aware of the WAIS-IV testing results through testimony at the hearing or her review of the record.
The Commissioner suggests any error was harmless because the ALJ identified two other unskilled jobs Plaintiff could perform, industrial cleaner and warehouseman, which carry specific vocational preparation ("SVP") times of 2. An SVP of 2 corresponds to unskilled work, as opposed to SVPs of 3 or 4, which each correspond to work requiring increasing skill.
While the court understands the basis for it, the Commissioner's argument is nonetheless problematic because the court is unable to determine Plaintiff's educational level — and the corresponding SVP — on the ambiguous record. Only the ALJ can appropriately evaluate the effect, if any, of the WAIS-IV testing on how Plaintiff's educational attainment should be evaluated under § 404.1564(b).
In sum, the alternative decision at Step Five is not supported by substantial evidence.
Based on the foregoing, Plaintiff's Motion for Summary Judgment (Dkt. No. 16) is GRANTED and the Commissioner's Motion for Summary Judgment (Dkt. No. 19) is DENIED.
The Commissioner's final decision is REVERSED and this case is REMANDED for further administrative proceedings consistent with this order. Judgment will be entered in favor of Plaintiff and the Clerk shall close this file.