ANDREW J. PECK, Magistrate Judge.
Plaintiff Labar Paulin, represented by counsel, brings this action pursuant to § 205(g) of the Social Security Act, 42 U.S.C. § 405(g), challenging the final decision of the Commissioner of Social Security denying his application for Disability Insurance Benefits ("DIB") and Supplemental Security Income ("SSI"). (Dkt. No. 1: Compl.) Presently before the Court are the parties' cross motions for judgment on the pleadings pursuant to Fed. R. Civ. P. 12(c). (Dkt. No. 14: Paulin Notice of Mot.; Dkt. No. 21: Comm'r Notice of Mot.) The parties have consented to decision of the case by a United States Magistrate Judge pursuant to 28 U.S.C. § 636(c). (Dkt. No. 16.)
For the reasons set forth below, Paulin's motion for judgment on the pleadings (Dkt. No. 14) is
Paulin filed for DIB and SSI on January 27, 2014, alleging a disability onset date of July 1, 2010. (Dkt. No. 12: Administrative Record ("R.") 197-205.) On June 17, 2015, Paulin, represented by counsel, had a hearing before Administrative Law Judge ("ALJ") Joani Sedaca (R. 37-101), who denied Paulin's benefits application in a written decision issued on August 5, 2015 (R. 20-32). ALJ Sedaca's decision became the Commissioner's final decision when the Appeals Council denied review on December 12, 2016. (R. 1-3.)
Born on March 10, 1990, Paulin was twenty years old at the alleged July 1, 2010 onset of his disability. (R. 197.) Paulin testified that he "suffer[s] from anxiety, depression, [fear of] crossing the streets, panic attacks, and headaches," but has no physical issues and does not suffer from any illnesses. (R. 43.)
Paulin testified that his "mother usually takes [him] places . . . because [he] ha[s] difficulties going some places . . . by [him]self," and that "for the last seven years" he only used public transportation when accompanied by his mother due to his "nervousness, . . . panic attacks, fears of crossing the street, and feeling paranoid." (R. 47-48.) Paulin testified that he was diagnosed with "[a]goraphobia, social anxiety, and panic attacks," which cause hyperventilation and chest pains and resulted in his admission to the emergency room in 2009. (R. 48-50.) Paulin attended "talk therapy" from 2009 through 2010, but stopped when his insurance benefits were reduced; although Paulin testified that he now has insurance, he has not attended talk therapy because he has not received a referral from his psychiatrist. (R. 51-53.)
Paulin worked as a security guard with Epic Security from February 2012 through June 2012 when he was fired for lateness and "[t]hey started seeing that . . . [Paulin] couldn't be around people." (R. 61-63.) Prior to joining Epic Security, Paulin took a one-week security training course and passed a certification exam. (
Paulin last worked as a security guard with Cambridge Security from October 2012 through the fall of — (R. 53), when his employer informed him that he "wasn't equipped for the job . . . because of [his] awkwardness" (R. 56-57). Paulin took too long to complete assignments and often was late to work. (R. 57-58.) Paulin has not looked for work since being terminated from Cambridge Security. (R. 71.)
Paulin testified that he got to work by taking the bus or getting a ride from his brother. (R. 59.) When ALJ Sedaca remarked that Paulin previously testified that for the past seven years he only used public transportation when accompanied by his mother (
Paulin testified that he bathes but sometimes his clothes are not "on properly or correctly" because he does not "care how [he] look[s]." (R. 60.) In a February — function report, Paulin wrote that it "takes 2 hours to get dress[ed]," over an hour to "shower with difficulty," and he "can't do hair mom has to pay for barber" (R. 256), although he can feed himself and use the bathroom (R. 259). Paulin testified that he has difficulty sleeping and sometimes "can't sleep at all." (R. 70-71.) Paulin's mother cleans, cooks, and does the laundry and grocery shopping; Paulin testified that his "weirdness" and "awkwardness" completely prevent him from doing any of the foregoing or assisting his mother in doing so. (R. 65-68.)
Paulin remains in his apartment "most of the time" watching television and sometimes using his computer, and spends time with his friend who visits "maybe twice a week." (R. 68-69.) Paulin's cousin visits him "often" (R. 49), and Paulin's brother visits as well (R. 70). Paulin testified that he "[s]ometimes" speaks with his friend and grandmother on the phone (R. 70), but wrote in his function report that he does not "socialize with neighbors [and] only see[s] family sometime[s]" (R. 258). Paulin's function report lists his hobbies as "watching tv, playing sports[,] hanging with friends, [and] movies." (R. 257.) However, aside from watching television "daily," Paulin wrote that he was "[n]o longer able to play sports or go out with friends" and he did not "have friends anymore have not seen movie in years." (
Lisa O'Neal, Paulin's mother, also testified at the hearing before ALJ Sedaca. (R. 80.) O'Neal testified that she first noticed Paulin's mental limitations when he was a child and "[h]e was a little slower than [O'Neal's] other kids." (R. 81.) O'Neal stated that, in 2008, Paulin dropped out of college after a month because "he locked himself in the room. He wouldn't go to classes. He lost weight. He couldn't function." (R. 84.) According to O'Neal, "that was around the time that everything . . . fell apart for" Paulin. (R. 85.)
O'Neal stated that Paulin "is not comfortable around people. He has . . . fears of social anxiety." (R. 87.) O'Neal reiterated that she "do[es] everything in the home" and that Paulin does not "assist [her] at all" because "he's very awkward in doing things . . . so it's easier for [O'Neal] to do." (R. 87-88.) O'Neal stated that Paulin spends most of his time in his room sometimes watching television or "he'll sit there with no TV, no nothing on." (R. 90-91.) Paulin's friend visits Paulin or takes Paulin to his home, and sometimes Paulin socializes with neighbors "downstairs but he'll come right back up." (R. 90.)
O'Neal testified that Paulin sees Dr. Hameedi once a month (R. 85), for an hour to an hour and a half each session (R. 87). Although Paulin attended talk therapy in the past, O'Neal stated that Paulin stopped doing so when his insurance benefits terminated; yet, as Paulin testified, although Paulin now has insurance benefits, Paulin has not been referred for talk therapy. (R. 85-86.)
Vocational expert Julie Andrews testified at the hearing before ALJ Sedaca. (R. 92.) ALJ Sedaca posed four hypothetical questions to Andrews, the first of which asked:
(R. 93.) Andrews testified that an individual with these limitations would not be able to perform Paulin's past relevant work as a security guard. (R. 93-94.) However, there were unskilled jobs in the national economy that such an individual could perform, including laundry laborer, industrial cleaner and kitchen helper. (R. 94.)
ALJ Sedaca's second hypothetical asked: "In addition to the above limitations, the individual is now limited to unscheduled absences more than . . . two times per month." (R. 95.) Andrews testified that such absences would affect the above positions "to the point where there would not be any full-time competitive employment positions that would be viable." (
ALJ Sedaca's third hypothetical "in place of [hypothetical] two" asked: "So we're no longer talking about unscheduled absences. In addition to the above limitations [outlined in hypothetical one], . . . the individual is now limited to being off task due to psychological issues more than 10% of the time. Would that [a]ffect the above job[s]?" (
ALJ Sedaca's fourth hypothetical "in place of both [hypotheticals] two and three" asked: "So we're not talking about the unscheduled absences or the psychological off-task but instead . . . — let's say lateness to work — we'll say if it is more than . . . five times per month, would that [a]ffect the above jobs?" (R. 95-96.) Andrews responded that "[i]t would be unlikely that the individual would be able to maintain employment because of that." (R. 96.)
On November 21, 2008, psychiatrist Dr. Faiq Hameedi wrote a note stating that Paulin suffered from major depression and agoraphobia since September 2008. (R. 360.) Dr. Hameedi wrote that Paulin was "not able to attend school due to depression and anxiety." (
On the same date, November 21, 2008, Dr. Hameedi completed an "Outpatient Clinical Assessment Form" listing Paulin's symptoms as depression, anhedonia, feelings of worthlessness and guilt, decreased energy and motivation, panic attacks, flashbacks and social anxiety. (R. 454.) Paulin was well groomed, had a guarded and suspicious attitude, constricted affect, depressed and anxious mood, delayed expressive speech, age-appropriate receptive language comprehension, slowed psychomotor activity, intact thought process, and no hallucinations, delusions or suicidal/homicidal ideation. (R. 456-57.) Paulin was alert, oriented to time, place and person, had intact immediate recall and remote memory, was able to perform simple calculations and serial sevens, and had intact abstraction, judgment and insight, as well as good impulse control. (R. 457.) Dr. Hameedi also completed a treatment plan stating that Paulin suffered from a panic disorder with major depression, and had a GAF of 50. (R. 458.)
Dr. Hameedi's December 15, 2008 progress note states that Paulin was non-compliant with his medication regimen. (R. 459.)
On March 24, 2009, Dr. Hameedi completed a "Confidential Medical Report Psychiatric Disability." (R. 462-63.) Dr. Hameedi wrote that Paulin's "[m]ental health estimate," personal awareness and motivation were fair, and that Paulin "need[ed] encouragement to inspire social interaction." (R. 463.) Dr. Hameedi further wrote that while Paulin had difficulty dealing with new people, his "[w]ork ability estimate" was good. (
On April 13, 2009, Dr. Hameedi wrote that Paulin was "[s]till afraid to go out" and increased Paulin's Zoloft prescription. (R. 464.)
On May 11, 2009, Dr. Hameedi completed a disability questionnaire listing Paulin's diagnoses as social anxiety disorder, panic disorder, major depression and agoraphobia. (R. 359.) Dr. Hameedi wrote that Paulin had "poor memory and concentration and [was] afraid to go out," and that his future employability was "undetermined." (
On June 8, August 15 and October 26, 2009, Dr. Hameedi reported that Paulin was still afraid to go out and suffered from social anxiety. (R. 467-69.)
On September 8, 2009, Paulin had an annual visit at Montefiore Children's Hospital with Dr. Marc Orgel. (R. 299.) Dr. Orgel noted that Paulin was "diagnosed with depression, social anxiety, [and] agoraphobia" and that Paulin's psychiatrist recommended imaging of his head after he sustained a sports injury. (
On October 8, 2009, Paulin underwent an MRI of his brain that was normal. (R. 308.)
On November 23, 2009, Dr. Hameedi wrote that Paulin continued to experience social anxiety; Paulin, however, was non-compliant with his medication and informed Dr. Hameedi that he did "not want to take anti psychotics." (R. 470.) The same date, November 23, 2009, Dr. Hameedi completed a "Treatment Plan Update" form. (R. 471.) Dr. Hameedi assigned Paulin a GAF of 45 and, in the "Review of Progress" portion of his notes, Dr. Hameedi checked a box stating that Paulin "[c]ontinues with/or recurrence of acute presenting symptoms." (
On February 5, 2010, Paulin was admitted to New York Presbyterian Hospital's Emergency Department for depression, anxiety and agoraphobia. (R. 335.) Paulin was admitted to the Emergency Department "after a call from his mother" who "was concerned that [Paulin was] isolative and withdrawn. [Paulin] refuse[d] to leave the house to do anything." (R. 342.) The triage notes further state that Paulin was "isolative, depressed [and] ha[d] not left house since Nov," though the "Reassessments" section states that Paulin was "stable, alert, playing Nintendo in no distress." (R. 340.) Paulin denied suicidal or homicidal ideation, denied visual or auditory hallucinations, was oriented "x3," had an appropriate appearance, a cooperative attitude, a linear thought process, clear speech and a flat affect. (R. 341.) Paulin's recent memory, remote memory and concentration were good, but his insight and judgment were poor. (
After his initial assessment, Dr. Caraballo completed a "CCPEP Evaluation." (R. 346-50.) Paulin "report[ed] that he feels very nervous sometimes . . . mostly when he is around other people," although he denied fearing harm from others or auditory/visual hallucinations. (R. 346.) Paulin stated that he stayed home all day listening to music and watching television, "ha[d] not been getting out of the house much" and did "not have many friends." (
Dr. Caraballo wrote that Paulin had a cooperative attitude, poor hygiene, euthymic mood, slow psychomotor activity, flat affect, monotone speech, appropriate thought content, poor insight, appropriate judgment and impulse control, and good "Orientation/Memory/Concentration." (R. 348-49.) Dr. Caraballo diagnosed Paulin with "Psychotic Disorder NOS" and generalized anxiety disorder with a GAF of 45. (R. 349-50.) Dr. Caraballo discharged Paulin with instructions to follow up with his psychiatrist Dr. Hameedi and resume taking his medication after concluding that Paulin was not a danger to himself or others. (R. 350.)
On April 12, 2010, Dr. Hameedi wrote that Paulin "feels much less anxiety and is able to go outside without family. Denies any panic attacks. Reduced agoraphobia." (R. 472.)
On November 22, 2010, Dr. Hameedi completed a second "Treatment Plan Update" form and reported that Paulin exhibited "[s]ignificant improvement" since his last treatment plan update on November 23, 2009, and had a GAF of 55. (R. 475;
On February 28, 2011, Dr. Hameedi wrote that Paulin had "[r]educed social anxiety." (R. 476.) Dr. Hameedi's notes on October 17, 2011, November 28, 2011, January 30, 2012, April 10, 2012, May 29, 2012, and December 3, 2012, include little legible detail aside from references to Paulin's social anxiety and his compliance with medication. (
On December 3, 2012, Dr. Hameedi completed a third "Treatment Plan Update" form and reported that Paulin exhibited "[s]ignificant improvement" since his last treatment plan update on November 22, 2010, and maintained his GAF of 55. (R. 483.) Dr. Hameedi also reported that Paulin had a new girlfriend. (
On September 30, 2014, Dr. Hameedi completed a fourth "Treatment Plan Update" form and checked a box stating that Paulin "[c]ontinues with/or recurrence of acute presenting symptoms" since his last treatment plan update on December 3, 2012. (R. 486.) Specifically, Dr. Hameedi wrote that Paulin "has a job" but is "[a]fraid to go to the store"; however, unlike previous treatment plans, Dr. Hameedi left the GAF assessment blank. (
On November 25, 2014, Dr. Hameedi wrote a note stating that he treated Paulin for agoraphobia and panic attacks. (R. 357.)
On March 18, 2013, Dr. Hameedi completed a psychiatric report diagnosing Paulin with moderate "Anxiety Disorder NOS" with a GAF of 60. (R. 370-75.) Dr. Hameedi opined that Paulin had marked limitations relating to others, interacting appropriately with the public and in his activities of daily living, and marked deterioration of his personal habits. (R. 373.) Paulin also was markedly limited in his ability to perform complex tasks, perform tasks requiring minimal contact with others, tolerate work-related stress, maintain concentration and attention, and set realistic goals or make plans independently. (R. 373-74.) Dr. Hameedi further opined that Paulin had moderate limitations comprehending and following simple or detailed instructions, and performing simple or repetitive tasks. (R. 373.) Paulin had additional moderate limitations performing varied tasks, performing tasks requiring frequent contact with others, responding appropriately to supervision and criticism, and meeting production, quality and attendance standards. (R. 374.) Dr. Hameedi wrote that Paulin had "additional difficulties in organizing, regulating or managing himself" due to his "poor interpersonal skills," and Paulin could not use public transportation alone as he was "afraid of being hit by cars." (R. 371, 374-75.) Dr. Hameedi wrote that Paulin's symptoms lasted or were expected to last at least twelve months. (R. 372.)
On April 23, 2014, Dr. Hameedi completed a medical source statement regarding Paulin's ability to do work-related activities. (R. 450-52.) Dr. Hameedi wrote that Paulin had moderate limitations in his ability to understand, remember and carry out simple instructions, and make judgments on complex work-related decisions. (R. 450.) Paulin was markedly limited in his ability to make judgments on simple work-related decisions; understand, remember and carry out complex instructions; interact appropriately with the public, supervisors and coworkers; and respond appropriately to usual work situations and to changes in a routine work setting. (R. 450-51.) Dr. Hameedi noted that Paulin's mental impairments also resulted in his "[p]oor memory and concentration." (R. 451.) Dr. Hameedi stated that Paulin "remains socially isolated [because of] fear of going out." (
However, on April 25, 2014, Dr. Hameedi wrote that Paulin was "feeling happy," "[d]enied any acute depression" and only "ha[d] some residual social anxiety." (R. 490.) On August 22, 2014, Dr. Hameedi wrote that Paulin was "socially isolated but [was] able to go out with friends." (R. 491.)
On March 13, 2015, Dr. Hameedi completed a second psychiatric report diagnosing Paulin with agoraphobia and panic attacks with a GAF of 60. (R. 444-49.) In contrast to his March 18, 2014 psychiatric report, Dr. Hameedi wrote that Paulin's sole moderate limitation was in his ability to perform repetitive tasks. (R. 447;
On June 12, 2015, Dr. Hameedi completed a "Mental Impairment Questionnaire." (R. 523-24.) Dr. Hameedi opined that Paulin was "[u]nable to meet competitive standards" in all but two categories of "mental abilities and aptitudes needed to do unskilled," "semiskilled and skilled work" and "particular types of jobs," including the ability to understand and remember very short and simple instructions, maintain attention for two hours at a time, deal with normal work stress, set realistic goals, and interact appropriately with others. (
On February 24, 2014, Paulin received a consultative psychiatric evaluation from Dr. Michael Kushner of Industrial Medicine Associates. (R. 366-69.) Paulin arrived at the evaluation via the "Access-a-Ride" service accompanied by his mother. (R. 366.) Paulin reported that he lived with his mother and obtained "a high school diploma under regular education." (
Paulin reported difficulty falling asleep, a loss of appetite, "depressive symptoms including social withdrawal," and no suicidal ideation although "he did have suicidal thoughts about one month ago." (
Dr. Kushner found that Paulin's "[d]emeanor and responsiveness to questions was cooperative [and his] [m]anner of relating, social sills, and overall presentation were fair." (R. 367.) Paulin had fair grooming and hygiene, normal posture and motor behavior, appropriate eye contact, fluent speech intelligibility, clear voice quality, and adequate expressive and receptive language. (
Dr. Kushner concluded that Paulin had mild limitations following and understanding simple directions and instructions and performing simple tasks independently; mild to moderate limitations maintaining attention, concentration and a regular schedule, learning new tasks and performing complex tasks under supervision; mild limitations making appropriate decisions; and "moderate to at times marked limitations" relating adequately with others and appropriately dealing with stress. (R. 368.)
Dr. Kushner concluded: "The results of the present evaluation appear to be consistent with psychiatric problems, but in itself, this does not appear to be significant enough to interfere with [Paulin's] ability to function on a daily basis." (
On February 28, 2014, Dr. E. Kamin completed a "Medically Determinable Impairments And Severity" form after reviewing some of Paulin's medical records. (R. 102-12.) Dr. Kamin opined that Paulin had mild limitations in activities of daily living, moderate limitations in maintaining social functioning, and moderate limitations maintaining concentration, persistence or pace. (R. 107.) Dr. Kamin found that Paulin was not significantly limited in his ability to remember locations and work-like procedures, understand, remember and carry out very short and simple instructions or make simple work-related decisions, although he was moderately limited in his ability to understand, remember and carry out detailed instructions. (R. 108-09.) Paulin also was moderately limited in his ability to maintain attention and concentration for extended periods, perform activities within a schedule, maintain regular attendance and be punctual, sustain an ordinary routine without special supervision, work in coordination with others without being distracted, and complete a normal workday and workweek without interruptions from psychologically based symptoms. (R. 109.) Paulin furthermore had moderate limitations in some categories of social interaction and adaptation, including his ability to interact with the general public and take public transportation. (R. 109-10.)
Based on his review, Dr. Kamin found that Paulin was not disabled (R. 112), and was capable of unskilled, entry level work in a low contact setting (R. 110-11).
On August 5, 2015, ALJ Sedaca denied Paulin's benefits application. (R. 20-32.) ALJ Sedaca applied the appropriate five step legal analysis. (R. 24-25.) First, she found that Paulin "has not engaged in substantial gainful activity since July 1, 2010, the alleged onset date." (R. 25.) Second, ALJ Sedaca found that Paulin had the "following severe impairments: social anxiety disorder and depressive disorder." (
(R. 27.)
ALJ Sedaca noted Paulin's "history of mental health problems" and treatment with psychiatrist Dr. Hameedi since 2008, whose treatment notes show that Paulin "has had consistent complaints of anxiety," as well as depression and agoraphobia. (R. 27-28.) ALJ Sedaca noted that Dr. Hameedi "opined that [Paulin] would never be capable of sustaining employment." (R. 27.)
ALJ Sedaca gave Dr. Hameedi's opinions "some weight," stating that the "extreme limitations noted by [Dr. Hameedi] are not fully credited because of the conservative treatment history and the absence of severe symptoms noted in the treatment records." (R. 30.) ALJ Sedaca discussed Dr. Hameedi's treatment notes from April 2014 in which Paulin denied any acute depression and suffered only some residual anxiety, and the August — notes stating that Paulin was socially isolated but able to go out with friends. (R. 28.) ALJ Sedaca noted that Dr. Hameedi twice assigned Paulin a GAF score of 60 in March 2014 and March 2015, which was "incompatible with the particular limitations reported." (R. 28-30.) ALJ Sedaca further "noted that [Paulin] is not receiving therapy despite his alleged severe limitations" aside from his treatment with Dr. Hameedi. (R. 30.)
ALJ Sedaca discussed Dr. Kushner's consultative examination that stated Paulin had mild limitations following simple instructions, mild to moderate limitations maintaining attention and concentration, and moderate to marked limitations relating adequately with others and dealing with stress. (R. 28.) ALJ Sedaca gave Dr. Kushner's opinion "[s]ome to little weight . . . because his opinion was based only on a one-time examination and some of the more severe restrictions noted by Dr. Kushner [we]re not supported by the treatment records and the conservative treatment history." (R. 30.)
Finally, ALJ Sedaca noted that reviewing psychologist Dr. Kamin found that Paulin had mild restrictions of daily activities, and moderate limitations maintaining social functioning and maintaining concentration, persistence, or pace. (R. 29.) ALJ Sedaca gave Dr. Kamin's opinions "some weight" because "overall, the evidence suggest[ed] somewhat greater restrictions than were noted by Dr. Kamin." (R. 30.) "[L]ess weight" was given to Dr. Kamin's opinions because he never examined Paulin and did not review the entirety of the medical evidence. (
ALJ Sedaca found Paulin's "statements concerning the intensity, persistence and limiting effects of [his] symptoms [we]re not entirely credible." (
ALJ Sedaca concluded that the above RFC assessment was "supported by the treatment records showing some mental health problems but a consistent conservative treatment history." (R. 31.) Moreover, ALJ Sedaca wrote that the RFC was supported by Paulin's "reported activities like in fact being able to use public transportation when he worked and being able to concentrate well enough to watch television and even pass a training course for security guard work." (
ALJ Sedaca next determined that Paulin had no past relevant work, but was considered a younger individual with a high school education who spoke English. (
A person is considered disabled for Social Security benefits purposes when he 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." 42 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A);
42 U.S.C. §§ 423(d)(2)(A), 1382c(a)(3)(B);
In determining whether an individual is disabled for disability benefit purposes, the Commissioner must consider: "(1) the objective medical facts; (2) diagnoses or medical opinions based on such facts; (3) subjective evidence of pain or disability testified to by the claimant or others; and (4) the claimant's educational background, age, and work experience."
A court's review of the Commissioner's final decision is limited to determining whether there is "substantial evidence" in the record as a whole to support such determination.
The Supreme Court has defined "substantial evidence" as "`more than a mere scintilla [and] such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'"
The Court, however, will not defer to the Commissioner's determination if it is "`the product of legal error.'"
The Commissioner's regulations set forth a five-step sequence to be used in evaluating disability claims. 20 C.F.R. §§ 404.1520, 416.920;
The claimant bears the burden of proof as to the first four steps; if the claimant meets the burden of proving that he cannot return to his past work, thereby establishing a prima facie case, the Commissioner then has the burden of proving the last step, that there is other work the claimant can perform considering not only his medical capacity but also his age, education and training.
The "treating physician's rule" is a series of regulations set forth by the Commissioner in 20 C.F.R. § 404.1527 detailing the weight to be accorded a treating physician's opinion. Specifically, the Commissioner's regulations provide that:
20 C.F.R. § 404.1527(c)(2);
Further, the regulations specify that when controlling weight is not given a treating physician's opinion (because it is not "well-supported" by other medical evidence), the ALJ must consider the following factors in determining the weight to be given such an opinion: (1) the length of the treatment relationship and the frequency of examination; (2) the nature and extent of the treatment relationship; (3) the evidence that supports the treating physician's report; (4) how consistent the treating physician's opinion is with the record as a whole; (5) the specialization of the physician in contrast to the condition being treated; and (6) any other factors which may be significant. 20 C.F.R. § 404.1527(c)(2)-(6);
When a treating physician provides a favorable report, the claimant "is entitled to an express recognition from the [ALJ or] Appeals Council of the existence of [the treating physician's] favorable . . . report and, if the [ALJ or] Council does not credit the findings of that report, to an explanation of why it does not."
The Commissioner's "treating physician" regulations were approved by the Second Circuit in
The first inquiry is whether Paulin was engaged in substantial gainful activity after his application for benefits. "Substantial gainful activity" is defined as work that involves "doing significant and productive physical or mental duties" and "[i]s done (or intended) for pay or profit." 20 C.F.R. § 404.1510. ALJ Sedaca's conclusion that Paulin did not engage in substantial gainful activity during the applicable time period (
The second step of the analysis is to determine whether Paulin proved that he had a severe impairment or combination of impairments that "significantly limit[ed his] physical or mental ability to do basic work activities." 20 C.F.R. § 404.1520(c). The ability to do basic work activities is defined as "the abilities and aptitudes necessary to do most jobs." 20 C.F.R. § 404.1522(b). "Basic work activities" include:
20 C.F.R. § 404.1522(b)(1)-(6).
ALJ Sedaca determined that Paulin's severe impairments were social anxiety disorder and depressive disorder. (
The third step of the five-step test requires a determination of whether Paulin had an impairment listed in Appendix 1 of the Regulations. 20 C.F.R. Pt. 404, Subpt. P, App. 1. "These are impairments acknowledged by the [Commissioner] to be of sufficient severity to preclude gainful employment. If a claimant's condition meets or equals the `listed' impairments, he or she is conclusively presumed to be disabled and entitled to benefits."
ALJ Sedaca found that notwithstanding Paulin's severe impairments, he did "not have an impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1," giving "special consideration to the listings for mental disorders (12.00)." (
"The failure to provide "`good reasons" for not crediting the opinion of a claimant's treating physician is a ground for remand.' The ALJ is not permitted to substitute his own expertise or view of the medical proof for the treating physician's opinion or for any competent medical opinion."
"`[B]ecause mental disabilities are difficult to diagnose without subjective, in-person examination, the treating physician rule is particularly important in the context of mental health.'"
ALJ Sedaca did not appropriately apply the treating physician rule in evaluating Dr. Hameedi's opinions. At the hearing, ALJ Sedaca asked Paulin why he was not attending "talk therapy," and questioned Paulin's mother why Paulin did not attend therapy in addition to his monthly treatment sessions with Dr. Hameedi. (
Both Paulin and his mother testified that Paulin did not receive any additional therapy because he had not obtained a referral from Dr. Hameedi. (
Moreover, as Paulin argues, Dr. Hameedi's opinion "was given `some weight,' but it was unclear how much. The ALJ did indicate that the extreme limitations found by Dr. Hameedi were `not fully credited,' but there was no mention as to the many marked limitations." (Paulin Br. at 10.) It is not clear whether ALJ Sedaca discounted all of the more severe (including marked) limitations that Dr. Hameedi noted in his March 18, 2014 and March 13, 2015 psychiatric reports, or was referring to the extreme limitations noted only in the latter report. (
Furthermore, ALJ Sedaca used similar language when assigning "[s]ome to little weight" to Dr. Kushner's report that included mild, moderate and marked limitations in different functional categories, finding that "some of the more severe restrictions noted by Dr. Kushner [we]re not supported by the treatment records and the conservative treatment history," without further explanation. (
Compounding the lack of clarity, when reviewing Dr. Kamin's report that included mild to moderate limitations, ALJ Sedaca gave Dr. Kamin's opinions "some weight" because "overall, the evidence suggest[ed] somewhat
Finally, ALJ Sedaca's credibility and RFC determinations were based, in part, on a mischaracterization of the hearing testimony. ALJ Sedaca wrote that, while Paulin "reported significant problems with difficulty leaving his home and inability to travel independently . . .[,] in other testimony and in other reports, he is noted to be able to socialize with friends and . . . neighbors." (
ALJ Sedaca placed undue emphasis on what she viewed as a "gotcha" moment during the hearing. Paulin testified that his "mother usually takes [him] places . . . because [he] ha[s] difficulties going some places . . . by [him]self," and that "for the last seven years" he only used public transportation when accompanied by his mother due to his "nervousness, . . . panic attacks, fears of crossing the street, and feeling paranoid." (
Whatever contradiction these statements present, ALJ Sedaca ignored that Paulin was fired from all three security guard positions for lateness, getting "to things slower than others" and "missing a lot of days." (
(R. 89;
Paulin's and his mother's testimony indicated that he was incapable of traveling alone. As such, and considering the testimony as a whole, that Paulin had to "force [him]self" to use public transportation evidences the severity of his psychiatric limitations, not his ability to work. (
ALJ Sedaca should have contacted Dr. Hameedi to ask whether his treatment sessions with Paulin encompassed "talk therapy," whether additional therapy would benefit Paulin and, if so, why Paulin was not referred, before rejecting Dr. Hameedi's opinions based on an allegedly conservative treatment history.
For the reasons set forth above, the Commissioner's motion (Dkt. No. 21) is
SO ORDERED.