ROBERT A. RICHARDSON, Magistrate Judge.
George C. Knoll ("plaintiff") appeals the final decision of the Commissioner of Social Security ("the Commissioner") pursuant to 42 U.S.C. § 405(g). The Commissioner denied plaintiff's application for Social Security Disability Benefits in a decision dated October 4, 2018. Plaintiff timely appealed to this Court. Currently pending are plaintiff's motion for an order reversing and remanding his case for a hearing (Dkt. #14-2) and defendant's motion to affirm the decision of the Commissioner. (Dkt. #15-1.)
For the reasons that follow, the plaintiff's motion to reverse, or in the alternative, remand is GRANTED and the Commissioner's motion to affirm is DENIED.
"A district court reviewing a final . . . decision [of the Commissioner of Social Security] pursuant to section 205(g) of the Social Security Act, 42 U.S.C § 405(g), is performing an appellate function."
Therefore, absent legal error, this court may not set aside the decision of the Commissioner if it is supported by substantial evidence.
The Second Circuit has defined substantial evidence as "`such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'"
The Social Security Act ("SSA") provides that benefits are payable to individuals who have a disability. 42 U.S.C. § 423(a)(1). "The term `disability' means . . . [an] inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment. . . ." 42 U.S.C. § 423(d)(1). In order to determine whether a claimant is disabled within the meaning of the SSA, the ALJ must follow a five-step evaluation process as promulgated by the Commissioner.
In order to be considered disabled, an individual's impairment must be "of such severity that he is not only unable to do his previous work but cannot . . . engage in any other kind of substantial gainful work which exists in the national economy." 42 U.S.C. § 423(d)(2)(A). "[W]ork which exists in the national economy means work which exists in significant numbers either in the region where such individual lives or in several regions of the country."
Plaintiff initially filed for disability insurance benefits under Title II on March 2, 2016. (R. 162.)
Plaintiff asserts that the ALJ's opinion is not supported by substantial evidence at steps three and five, and that the ALJ violated the treating physician rule, failed to develop the record, and improperly examined plaintiff's pain. (Pl. Br. 1, 11, 13, 15, 21.) Based on the following, the Court finds that the ALJ's determination at step three is not supported by substantial evidence. The Court therefore reverses the ALJ's decision without considering plaintiff's remaining arguments.
Plaintiff asserts that the ALJ's step three findings are insufficient. (Pl. Br. 21.) Plaintiff asserts that the ALJ merely referenced plaintiff's mental and physical impairments but undertook no analysis of whether her impairments satisfied any listings. (Pl. Br. 22.) As such, plaintiff asserts that the ALJ's findings at step three are not supported by substantial evidence. The Court agrees.
"A finding of disability will ordinarily be justified when the individual's impairment is one which is as severe as the impairments contained in the Listing of Impairments."
"[T]he ALJ's decision at step three was not supported by substantial evidence" where the ALJ "state[d] that he ha[s] considered the criteria in [the listing] and recited the criteria without any further discussion" and failed to explicitly state that the plaintiff did not meet the criteria.
As such, the ALJ may not "summarily dispose[] of step three with conclusory statements that [the plaintiff] does not meet either listing, followed by a recitation of the elements of each listing."
However, where there is little or no evidence in the record to support that the plaintiff meets the criteria of the listing, the ALJ's analysis is sufficient if the ALJ "spoke to a lack of evidence in the record that those criteria were met" in addition to listing the criteria.
At step three, the ALJ determined that plaintiff does not satisfy any listed impairment under Section 12.00 because he does not satisfy paragraphs B and C. (R. 13.) Paragraph B is a requirement to all listings under Section 12.00 except 12.05. 20 C.F.R. § Pt. 404, Subpt. P, App. 1, 12.00(a)(2)(b). Paragraph C is a requirement of listings 12.02, 12.03, 12.04, 12.06, and 12.15. 20 C.F.R. § Pt. 404, Subpt. P, App. 1, 12.00(a)(2)(c).
As the ALJ noted,
there is evidence of both:
The ALJ stated the criteria for paragraph B and then conclusively stated plaintiff's limitations regarding the criteria. The ALJ stated that the opinion would later discuss plaintiff's anxiety disorder and affective disorder in greater detail. (R. 13.) When examining whether plaintiff satisfied the paragraph C criteria, the ALJ failed to engage in any analysis. Instead, the ALJ merely stated that the record did not establish that plaintiff satisfied the criteria. (R. 14.) Finally, the ALJ noted that no state agency psychologists opined that plaintiff equaled a listed impairment. (R. 14.)
While the ALJ's analysis under step three is inadequate, the Court may look elsewhere in the opinion for substantial evidence supporting the ALJ's decision.
At step three, the ALJ determined that plaintiff had moderate limitations in understanding, remembering, or applying information; moderate limitations in interacting with others; a moderate limitation in concentrating, persisting, or maintaining pace; and a moderate limitation in adapting or managing oneself. (R. 13.) While the ALJ failed to explain his determination at step three, the ALJ's RFC determination provides sufficient evidence to support the ALJ's conclusion.
Regarding the ALJ's determination that plaintiff suffered moderate limitations in understanding, remembering, or applying information, the ALJ noted that Dr. Roginsky determined that plaintiff only had "some issues" with memory and executive functioning. (R. 18, 277.) Dr. Bobulinski noted that plaintiff has been implementing strategies to improve his focus and memory and could complete more tasks and activities when encouraged. (R. 18, 291.) Dr. Bobulinski also noted that plaintiff demonstrated an intact fund of knowledge and was able to provide details of remote and recent events without difficulty. (R. 20, 290.)
Regarding, the ALJ's determination that plaintiff suffered moderate limitations in interacting with others, the ALJ noted that Dr. Bobulinski recommended plaintiff "continue to pursue an active and cognitively, socially, and emotionally stimulating lifestyle, and remain as independent as his medical status permits." (R. 18, 291-92.) Plaintiff also testified that he can tolerate being around a small group of people once a week when with his friend Chris. (R. 20, 48.)
Regarding, the ALJ's determination that plaintiff suffered moderate limitation in concentrating, persisting, or maintaining pace, APRN John Roy recorded that plaintiff was able to complete a moderate to high level word finding task with over 80% accuracy. (R. 19, 374.) When completed at a slower pace, plaintiff achieved 90% accuracy. (R. 19, 374.)
Regarding, the ALJ's determination that plaintiff suffered moderate limitation in adapting or managing oneself, Doctors Roginsky and Bobulinski noted that plaintiff presented pleasant and cooperative, well groomed, alert, and oriented. (R. 17-18, 275, 289.)
While the ALJ's RFC analysis may contain substantial evidence that plaintiff does not satisfy the paragraph B criteria, the analysis fails to support that plaintiff does not satisfy the paragraph C criteria.
First, the ALJ does not identify the paragraph C criteria. Without examining any evidence, the ALJ merely states that the record fails to support that plaintiff had a minimal capacity to adapt to changes in his environment. (R. 14.) The ALJ does not go on to provide evidence that his determination is supported by the record. Since, the ALJ does not state that there is no evidence in the record to support plaintiff's assertions, the ALJ was required to examine the evidence supporting his assertion and the paragraph C criteria.
Therefore, the ALJ's determination as to whether plaintiff satisfies the paragraph C criteria is not supported by substantial evidence.
At step three, the ALJ stated that plaintiff did not meet any of the physical impairment listings in Appendix 1 to Subpart P of Social Security Regulations No. 4. (R. 13.) The ALJ does not specify which, if any, specific listings were considered. (R. 13.) Plaintiff argues that the ALJ failed to meet the most minimum standard of review, which would be to indicate which listings were considered. (Pl. Br. 23.) Without such, plaintiff cannot decipher what criteria the ALJ examined. (Pl. Br. 23.)
The Court agrees with plaintiff. Even when the ALJ determines that plaintiff does not meet a listed impairment due to a lack of supporting evidence, the ALJ is still required to establish the criteria examined.
In light of the Court's findings above, the Court need not reach the merits of plaintiff's remaining arguments. Therefore, this matter is remanded to the Commissioner for further administrative proceedings consistent with this Ruling. On remand, the Commissioner will address the other claims of error not discussed herein.
Based on the foregoing reasons, plaintiff's motion for an order to remand the Commissioner's decision (Dkt. #14-2) is GRANTED and the Commissioner's motion to affirm that decision (Dkt. #15-1) is DENIED.
This is not a recommended ruling. The consent of the parties allows this magistrate judge to direct the entry of a judgment of the district court in accordance with the Federal Rules of Civil Procedure. Appeals can be made directly to the appropriate United States Court of Appeals from this judgment.
SO ORDERED.