P. KEVIN CASTEL, District Judge.
Plaintiff Samuel Cancel seeks judicial review under 42 U.S.C. § 405(g) of a final decision of the Commissioner of Social Security (the "Commissioner") that he is not eligible for Disability Insurance Benefits ("DIB") under Title II of the Social Security Act (the "Act"), 42 U.S.C. § 401
Cancel and the Commissioner have each moved for judgment on the pleadings pursuant to Rule 12(c), Fed. R. Civ. P. (Dkt. Nos. 11, 16.) Because the Court concludes that the ALJ did not discharge his duty fully to develop the medical record before him, both motions are denied and the case is remanded to the Commissioner for further development of the evidence.
Cancel applied to the Social Security Administration ("SSA") for DIB and SSI on March 31, 2009, claiming that he was unable to work because of a disabling condition beginning on April 1, 2007. (R. 198-208.)
Cancel then requested review of the ALJ's decision by the SSA Appeals Council, and on March 30, 2012, the Appeals Council remanded the claim for further administrative proceedings, directing that the ALJ should further evaluate Cancel's mental impairments and maximum residual functional capacity ("RFC"), and should obtain testimony from a vocational expert. (R. 113-15.) A second hearing before ALJ Friedman was held on August 23, 2012. (R. 45-72.) Cancel, represented by counsel, again testified, as did a vocational expert, Pat Green.
On September 24, 2012, the ALJ issued a twelve-page decision once again finding that Cancel was not disabled. (R. 30-41.) Cancel again sought review by the Appeals Council (R. 26), but the Appeals Council denied review, in a letter dated January 23, 2014. (R. 1-8.) This made the ALJ's ruling the final decision of the Commissioner on Cancel's application. Cancel then filed this action on March 24, 2014, (Dkt. No. 2), and moved for judgment on the pleadings on October 27, 2014. (Dkt. No. 11.) The Commissioner cross-moved for judgment on the pleadings on January 30, 2015. (Dkt. No. 16.)
A motion to dismiss under Rule 12(c), Fed. R. Civ. P., may be granted only if the movant establishes his entitlement to judgment on the pleadings as a matter of law.
In reviewing a denial of benefits, if the Commissioner's findings are free of legal error and supported by substantial evidence, the court must uphold the decision. 42 U.S.C. § 405(g) ("The findings of the Commissioner of Social Security as to any fact, if supported by substantial evidence, shall be conclusive, and where a claim has been denied . . . the court shall review only the question of conformity with [the] regulations. . . .");
A court's review thus involves two levels of inquiry.
An ALJ's "[f]ailure to apply the correct legal standards is grounds for reversal."
It is the function of the Commissioner, not the reviewing court, "to resolve evidentiary conflicts and to appraise the credibility of witnesses, including claimant."
Before deciding whether the Commissioner's determination is supported by substantial evidence, the reviewing court must first be satisfied that the claimant received "a full hearing under the Secretary's regulations and in accordance with the beneficent purposes of the Act."
Cancel does not challenge the ALJ's findings with respect to his physical limitations, and confines his arguments to the ALJ's treatment of his mental impairments. (Pl.'s Mem. 2 n.5.) He asserts that the ALJ failed properly to weigh the available medical evidence and erred in evaluating Cancel's credibility in determining his mental RFC. He also claims that remand is warranted based on new evidence that was submitted to the Appeals Council.
The mental health evidence before the ALJ included, first, three identical questionnaires filled out by doctors at the Metropolitan Hospital Center ("MHC"), whom Cancel characterizes as his treating physicians. The first was completed on March 23, 2010 by Dr. H. David Goodman. (R. 421-28.) The second was completed on June 30, 2010 by Dr. Faith Aimua and cosigned by Dr. Scott Schwartz. (R. 431-38.) The third was completed on January 23, 2012 by Dr. Michael Carpenter and cosigned by Dr. Gilbert L. Alicea. (R. 445-53.) All three state that Cancel was treated monthly, and Goodman questionnaire states that Cancel first began treatment in March 2000. (R. 421.)
The three questionnaires state that Cancel suffers from some combination of schizoaffective disorder, borderline personality disorder, agoraphobia, and panic disorder. (R. 421, 431, 445.) Both the Goodman and Aimua/Schwartz questionnaires are particularly pessimistic in their prognoses, asserting that Cancel requires long-term psychiatric treatment (R. 421, 445), and rating Cancel as "markedly limited" (the highest level of limitation on the scale) in a large majority of the twenty mental functional areas listed in the questionnaire. (R. 424-26, 434-36.) The Carpenter/Alicea questionnaire is slightly more positive, rating Cancel as "markedly limited" in only three areas, "moderately limited" in thirteen areas, and mildly or not limited in the remaining four. (R. 449-51.) Nevertheless, all three questionnaires agree that Cancel is "markedly limited" in his ability to interact appropriately with the general public and his ability to respond appropriately to changes in the work setting. They also agree that Cancel is incapable of tolerating even "low stress" in a work environment (R. 427, 437, 452), and that he is likely to be absent from work more than three times per month as a result of his impairments or treatment. (R. 428, 438, 453.) All three questionnaires further assert that Cancel's impairments are likely to produce "good days" and "bad days." (R. 427, 437, 452.)
Next, the record before the ALJ included a psychiatric evaluation dated May 1, 2009, by Dr. Christina O'Flaherty, an SSA consultative examining psychiatrist. (R. 340-44.) Unlike the treating psychiatrists, Dr. O'Flaherty concluded that Cancel's psychiatric problems "do not impair his ability to function normally on a day-to-day basis." (R. 343.) She noted that his appearance, speech and affect at his evaluation were normal, that his mood was "euthymic," and that his thought processes appeared "coherent and goal directed." (R. 341-42.) His attention and concentration appeared "intact," and that although his memory was "mildly impaired," "this appeared to be related to lack of effort." (R. 342.) She determined that Cancel "can follow and understand simple directions and instructions, perform simple tasks independently, maintain attention and concentration, maintain a regular schedule, learn new tasks, perform complex tasks independently, make appropriate decisions, and relate adequately with others," but conceded that "[h]e would do best in a low-stress environment." (R. 343.) Dr. O'Flaherty's report notes no history of psychiatric hospitalizations or current psychiatric treatment, and none of the current medications listed relate to psychiatric problems. (R. 340.)
The record also contains a mental RFC assessment by a non-examining state medical consultant, Dr. Peter Kudler, dated May 11, 2009. (R. 370-73.) It appears to be mostly or entirely based on Dr. O'Flaherty's report, and similarly concludes that Cancel "[r]etains the capacity for simple work." (R. 372.) It contains a "summary conclusions" section rating Cancel's limitations in twenty listed areas, which are substantively identical to the twenty areas in the treating physicians' questionnaires. (R. 370-71.) Dr. Kudler rates Cancel as "moderately limited" in seven activities and as "not significantly limited" in the remaining thirteen activities—a significantly more positive assessment than that of any of the treating physicians. (
In his 2012 decision, the ALJ concluded that "[t]he objective evidence does not support any marked functional restrictions caused by the claimant's mental impairments" (R. 38), and that Cancel thus retained the mental RFC to perform "simple jobs requiring only one[-]to two-step instructions and only occasional contact with others." (R. 35.) That conclusion was in large part determined by the ALJ's decision not to "give great weight to the opinions of the claimant's three psychiatrists." (R. 39.) The ALJ stated that those opinions were "unsupported by any treatment notes" and "consist[ed] of checklist forms with little explanation." (
The ALJ's decision not to credit the three psychiatrists without further developing the record was an error of law requiring remand. As explained earlier, the ALJ was under an affirmative obligation to develop the record fully and fairly. Specifically, the applicable regulations require the SSA to "make every reasonable effort" to obtain a "complete medical history for at least the 12 months preceding the month in which [the claimant] file[s] [his] application." 20 C.F.R. §§ 404.1512(d), 416.912(d). They also require the SSA to attempt to resolve inconsistencies or insufficiencies in the medical record, and suggest, as the first two options for doing so, recontacting the claimant's treating physician or requesting additional existing records. 20 C.F.R. §§ 404.1520b(c)(1), 416.920b(c).
The record here indicates that the SSA made no attempt to obtain additional information from MHC or from the three psychiatrists that would substantiate their conclusions or resolve perceived inconsistencies. Although, prior to the 2010 hearing, the SSA did request Cancel's treatment records from MHC, the request form shows that Cancel's
It is somewhat troubling that Cancel's counsel at the 2012 hearing failed to bring these deficiencies in the medical record to the ALJ's attention; counsel is thus at least partly responsible for the ALJ's error. Nevertheless, the law is clear that an ALJ's duty to develop the record exists irrespective of whether the claimant is represented.
Because the ALJ failed to develop the record, this case is remanded to the Commissioner for further development of the evidence and reconsideration in light thereof. The Court expresses no view on how the matter should be determined on remand. Cancel's motion and the Commissioner's cross-motion for judgment on pleadings are both DENIED.
SO ORDERED.