REPORT AND RECOMMENDATION

HENRY PITMAN, Magistrate Judge.

TO THE HONORABLE GEORGE B. DANIELS, III, United States District Judge,

I. Introduction

Plaintiff Almarene Jusino brings this action pursuant to Section 205(g) of the Social Security Act (the "Act"), 42 U.S.C. § 405(g), seeking judicial review of a final decision of the Commissioner of Social Security (the "Commissioner"), denying her applications for disability insurance benefits ("DIB") and supplemental security income ("SSI") for the period between May 23, 2013 and September 1, 2014 (Complaint, dated June 16, 2017 (Docket Item ("D.I.") 1) ¶ 1). Plaintiff and the Commissioner have both moved for judgment on the pleadings pursuant to Rule 12(c) of the Federal Rules of Civil Procedure (D.I. 18, 22). For the reasons set forth below, I respectfully recommend that plaintiff's motion for judgment on the pleadings be granted, and that the Commissioner's motion for judgment on the pleadings be denied.

II. Facts2

A. Procedural Background

On March 20 and March 21, 2014, plaintiff filed an application for DIB and SSI, respectively, alleging disability due to, inter alia, anxiety, depression, borderline bipolar disorder, hypothyroidism,3 anemia,4 asthma, obesity, fibromyalgia5 and back problems (Tr. 162-67, 178). She initially alleged a disability onset date of November 1, 2010, but subsequently amended that date to May 23, 2013 (Tr. 162, 164, 230).6 The SSA denied plaintiff's applications on June 11, 2014 (Tr. 100). Plaintiff timely requested and was granted a hearing before an ALJ (Tr. 120-47). She appeared by video-conference at a hearing before ALJ Dennis J. Katz on March 17, 2016, at which she was represented by counsel (Tr. 15-27). ALJ Katz issued a decision on April 5, 2016, finding that plaintiff was "not disabled" within the meaning of the Act (Tr. 15-27). ALJ Katz's decision became the final decision of the Commissioner on April 8, 2016, when the Appeals Council denied plaintiff's request for review (Tr. 1-2).

B. Social Background

Plaintiff was born on March 19, 1971 and was 45 years old at the time of ALJ Katz's decision (Tr. 167). She earned her GED in 1998 (Tr. 179). She has not completed any type of specialized job training nor has she attended vocational school (Tr. 179). Plaintiff worked as a "medical biller" from approximately June 1999 through approximately April 2007 (Tr. 179). She was subsequently employed as a "billings and collections manager" from approximately November 2007 through approximately October 2010 (Tr. 179). Plaintiff was unemployed from approximately October 2010 through September 1, 2014, with the exception of a one-week stint as an "account representative" in late 2013 (Tr. 179). On approximately September 1, 2014, plaintiff returned to work, full time, in an unidentified position at Monroe Family Eyecare (Tr. 176, 230).

According to a "Function Report" that plaintiff completed on April 7, 2014, she lived in her home in New Windsor, New York with her two children, ages five and ten (Tr. 192). She was the primary care giver of her children, but she also received assistance in that regard from her ex-husband, a grandmother and friends (Tr. 192). Plaintiff had difficulty getting out of bed and only left her home when necessary (Tr. 192). Plaintiff had a driver's license and regularly drove or was a passenger in a car (Tr. 194). She was capable of leaving her home by herself (Tr. 194). Plaintiff's hobbies included watching television, which she did daily (Tr. 195). Due to her purported anxiety and racing thoughts, she had difficulty paying her bills and managing her money (Tr. 195).

Plaintiff stated that she had issues socializing and getting along with friends and family (Tr. 196). According to plaintiff, her family, friends and neighbors found her "angry, emotional and confrontational" (Tr. 196). As a result she did not spend time with others and stated that she had "no social life" (Tr. 196). Plaintiff also stated that she disliked taking commands, and had been terminated from one of her previous jobs due to a confrontation with her supervisor (Tr. 198)

C. Medical Background

1. Information Reported by the Plaintiff

Plaintiff filed two "Disability Reports" in connection with her applications for DIB and SSI (Tr. 177-90, 205-14). Plaintiff completed her first Disability Report on March 21, 2014, in which she listed the following medical conditions: (1) anxiety; (2) depression; (3) hypothyroidism; (4) anemia; (5) arthritis; (6) asthma; (7) borderline bipolar disorder; (8) back problems; (9) rheumatism;7 (10) fibromyalgia and (11) obsessive compulsive disorder (Tr. 178). She took Buspar to treat her anxiety and Ibuprofen to treat her pain (Tr. 181). Plaintiff completed and filed her second Disability Report on July 26, 2014 in connection with her appeal of the SSA's initial denial of her disability benefits; it was essentially identical to her first Disability Report (Tr. 205-13).

Plaintiff's Function Report also contained information concerning her mental and physical health (Tr. 191). With respect to her mental impairments, plaintiff stated that she had difficulty sleeping and that she was "so depressed" (Tr. 192). Plaintiff stated that as a result of her depression she was bedridden and could not dress, bathe or cook and prepare meals herself (Tr. 192-93). She stated that her grandmother, friends or ex-husband prepared her meals (Tr. 194). Plaintiff claimed that she required special assistance for her personal needs because she was forgetful (Tr. 193). She stated that stress or changes in her schedule made her nervous, sad and angry (Tr. 200). In addition, plaintiff suffered from panic attacks due to her anxiety, which she claimed had worsened over the past ten years (Tr. 200-01). During a typical panic attack, plaintiff felt as though her heart beat abnormally fast, her hands shook and she had difficulty breathing (Tr. 201). She stated that she had daily panic attacks (Tr. 202).

With respect to her physical health, plaintiff stated that her pain and lack of energy also prevented her from performing certain activities (Tr. 192). According to plaintiff, she: (1) could not lift heavy objects; (2) could not stand for more than ten minutes; (3) could not walk for more than a few minutes before stopping for rest; (4) could not walk long distances; (5) could sit for only a few minutes before her hips and back began to hurt; (6) could not kneel and (7) could not squat, reach or climb stairs without difficulty and discomfort (Tr. 197). Plaintiff also complained of frequent, limiting headaches, typically brought on by her stress and anxiety, as well as feeling dizzy and light-headed (Tr. 199). According to plaintiff, her headaches caused throbbing pain around her eyes and in the back of her head; she described the pain as a ten on a scale of one to ten, with ten being the worst pain (Tr. 199). Plaintiff suffered from headaches three to four times per week; they were typically resolved by Ibuprofen (Tr. 200).

2. Treatment Records

a. Treatment Records Prior to Alleged Disability Onset Date

i. Horizon Family Medical Group

Plaintiff's primary care was provided by Dr. Arthur Klein of Horizon Family Medical Group ("Horizon") (Tr. 326-29). Plaintiff was treated at Horizon on ten occasions between November 1, 2010 and May 23, 2013.8 On November 1, 2010, plaintiff presented with complaints of anemia, fatigue, asthma and anxiety and depression (Tr. 326). Plaintiff reported that she had been anemic her entire life (Tr. 326). Plaintiff also reported that she had a "great deal of work related stress" and was having difficulty sleeping (Tr. 326). Dr. Klein noted that plaintiff took medication to treat her asthma and treated her anemia with a combination of intravenous iron infusions and oral iron supplements (Tr. 326).9

On March 2, 2012, plaintiff presented to Horizon complaining of stress and depression and seeking medication (Tr. 294). Plaintiff stated that she was bedridden, had "no desire to do things", had lost her appetite and had difficulty sleeping (Tr. 294-95). Dr. Klein noted that plaintiff appeared to be alert and did not appear to be anxious or in distress (Tr. 294). Plaintiff denied headaches (Tr. 294). Dr. Klein noted that plaintiff's gait and stance were normal (Tr. 294). Dr. Klein assessed plaintiff with, among other things, a "depressive disorder, not elsewhere classified" (Tr. 294).

On April 10, 2012, plaintiff sought a letter from Dr. Klein approving her for an abdominal "lap band" procedure (Tr. 291-92).10 According to Dr. Klein's notes from that appointment, plaintiff had previously undergone the same procedure in 2008, but the band had been removed after approximately one year (Tr. 291). Plaintiff did not complain of feeling depressed or anxious (Tr. 291-92). She denied fatigue and headaches, and admitted that she had pain in her sinuses only (Tr. 292). The results of a general physical examination were within normal limits (Tr. 292).

Plaintiff saw Dr. Klein again on September 20, 2012, complaining of, among other things, memory loss, headaches, fatigue and muscle aches (Tr. 289). Dr. Klein encouraged plaintiff to pursue therapy and develop other coping strategies to treat her anxiety and depression (Tr. 288). In addition, Dr. Klein noted that plaintiff had had a gastric sleeve procedure for obesity11 and that plaintiff had lost approximately 38 pounds since then, although plaintiff still weighed 251 pounds and was 63 inches tall (Tr. 289). In addition, Dr. Klein noted that plaintiff had normal gait and stance, and that she appeared alert and in no distress (Tr. 289).

b. Treatment Records Following Alleged Disability Onset Date

i. Horizon Family Medical Group

On July 23, 2013, plaintiff saw Nurse Practitioner ("NP") Karen Feliciano complaining of, among other things, depression and anxiety and having suicidal ideations (Tr. 283-84). NP Feliciano observed that plaintiff had logical and goal directed thought processes and that plaintiff appeared alert, oriented and in no acute distress (Tr. 284). NP Feliciano prescribed plaintiff Buspar to be taken twice daily to treat her anxiety (Tr. 284). On January 31, 2014 plaintiff reported headaches, body aches and joint aches due to her fibromyalgia and her anxiety (Tr. 274). Plaintiff felt "unmotivated", "anxious at times" and "not herself" (Tr. 274). However, NP Feliciano noted that plaintiff was alert, in no distress and without suicidal ideations, delusions or illogical thought processes (Tr. 274-75). NP Feliciano diagnosed plaintiff with anxiety and depression and joint pain (Tr. 275). NP Feliciano noted that plaintiff was not then taking medication to treat her anxiety or depression and prescribed plaintiff Cymbalta (Tr. 275).

Following a referral from NP Feliciano, Dr. Joseph Racanelli of St. Luke's Cornwall Hospital conducted an x-ray study of both of plaintiff's hips on July 7, 2014 (Tr. 302). Dr. Racanelli found no evidence of any fracture, dislocation or arthritis, nor did he observe soft tissue calcifications or masses (Tr. 302). However, Dr. Racanelli did find "diffuse degenerative changes" in both of plaintiff's hips (Tr. 302).

Physician Assistant ("PA") Nicholas Cruz treated plaintiff on April 20, 2015 for complaints of, among other things, headaches and feeling fatigued and dizzy (Tr. 356). PA Cruz observed that plaintiff appeared alert and oriented (Tr. 356-58). PA Cruz noted that plaintiff was not taking any medication for her anxiety or depression (Tr. 356-58).

On November 2, 2015, Dr. Klein conducted a screening for depression (Tr. 353). Plaintiff denied having "little interest or pleasure in doing things" or feeling "down, depressed or hopeless" (Tr. 353). Plaintiff appeared to be alert and in no distress (Tr. 353-54). Dr. Klein observed that plaintiff's mood and affect were in full range, that she was oriented to person, place and time and that she did not appear anxious (Tr. 354). Her gait and stance were normal (Tr. 354). Dr. Klein noted that plaintiff was taking Lexapro and Trazadone to treat her depression and anxiety (Tr. 343).

ii. Licensed Clinical Social Worker Kristen Spada12

Plaintiff was treated by Licensed Clinical Social Worker ("LCSW") Spada more than 20 times between September 25, 2013 and September 13, 2014 (Tr. 366-92).13 LCSW Spada's treatment notes from her September 25, 2013 therapy session with plaintiff state that plaintiff "continue[d] to experience significant stress related to family, chronic medical issues, m[ental] h[ealth] issues and financial distress" (Tr. 366). LCSW Spada noted that plaintiff's mood was distressed and that her symptoms had not improved (Tr. 366). She recommended that plaintiff continue psychotherapy (Tr. 366).

LCSW Spada saw plaintiff eight times between October 4, 2013 and December 13, 2013 (Tr. 365-72). On October 11, 2013, plaintiff discussed her "chronic stress and [the] impact [it had] on her physical and emotional well-being" with LCSW Spada (Tr. 368). She reported excessive fatigue, chronic pain and a general loss of interest in things (Tr. 368). On October 22, 2013, plaintiff admitted having feelings of guilt and low-self worth relating to her financial situation, and that she was concerned that her mental condition adversely impacted her children (Tr. 369). LCSW Spada concluded that plaintiff was depressed and that her symptoms were unchanged; LCSW Spada recommended that plaintiff continue psychotherapy (Tr. 369).

On November 7, 2013, plaintiff presented with complaints of emotional and physical fatigue and difficulty sleeping (Tr. 370). LCSW Spada recommended that plaintiff meditate and continue psychotherapy (Tr. 370).

On December 5, 2013, plaintiff saw LCSW Spada and discussed her "ongoing medical issues" and how her physical pain negatively impacted her mood and disposition (Tr. 373). LCSW Spada found plaintiff to be anxious and depressed, and noted that plaintiff's symptoms of depression had worsened since her preceding appointment (Tr. 373).

Plaintiff did not see LCSW Spada in January or February 2014. However, plaintiff saw LCSW Spada four times in March 2014 (Tr. 376-79). On March 4, 2014, LCSW Spada noted that she discussed with plaintiff the possibility that plaintiff had bipolar disorder, but the notes from this session do not contain such a diagnosis (Tr. 376). LCSW Spada encouraged plaintiff to undergo a psychiatric evaluation and to consider managing her mental condition with medication (Tr. 376). LCSW Spada also opined that plaintiff's symptoms had gotten worse (Tr. 376). Plaintiff showed no improvement in her symptoms during her sessions with LCSW Spada on March 11, March 18 or March 25, 2014 (Tr. 377-79). LCSW Spada observed that plaintiff continued to be anxious and depressed throughout April 2014, with increases in the severity of her symptoms on April 8 and April 29, 2014 (Tr. 380-81).

As noted above, see supra footnote 13, LCSW Spada completed her Medical Source Statement on April 21, 2014 (Tr. 251-57). LCSW Spada's Medical Source Statement details her relationship with plaintiff and sets forth her findings and opinions as to plaintiff's mental conditions (Tr. 251-57). LCSW Spada stated that she had treated plaintiff once a week between February 22, 2013 and April 15, 2014, and that plaintiff exhibited the following symptoms: (1) "depressed mood"; (2) "tearful[ness]"; (3) "loss of interest"; (4) "weight gain"; (5) "insomnia"; (6) "fatigue"; (7) "low self-worth" (8) "guilt"; (9) a diminished capacity to concentrate and (10) excessive and uncontrollable anxiety (Tr. 251). LCSW Spada diagnosed plaintiff with major depressive disorder and generalized anxiety disorder (Tr. 251). LCSW Spada opined that plaintiff's feelings of depression and anxiety were due, in part, to events from plaintiff's childhood and plaintiff's financial circumstances (Tr. 253). According to LCSW Spada, plaintiff took Klonopin and Lexapro to treat her mental conditions (Tr. 252).

LCSW Spada's Medical Source Statement also contained her findings from the mental status examination that she had apparently conducted earlier in April 2014 (Tr. 254). LCSW Spada opined that plaintiff's attitude, appearance, behavior, speech, thought processes and perception were all within normal limits (Tr. 254). She also observed that plaintiff's memory was intact, her insight and judgment were good and that she was oriented to person, place and time (Tr. 254). However, LCSW Spada found that plaintiff's mood and affect were depressed, anxious and tearful, and that plaintiff's attention and concentration were impaired (Tr. 254). LCSW Spada determined that plaintiff was capable of "adequately" performing the activities of daily living (Tr. 255). In addition, LCSW Spada found that plaintiff was not suffering from suicidal ideations and was capable of handling her finances (Tr. 255). LCSW Spada concluded that (1) plaintiff's ability to focus and concentrate was impaired due to her depression and (2) plaintiff's ability to interact with others was limited due to her irritability and feelings of low self-worth (Tr. 256). LCSW Spada further opined that plaintiff's "depression and anxiety prohibit[ed] her from functioning effectively in the work place" (Tr. 255).

LCSW Spada saw plaintiff ten times between May 13 and September 13, 2014 (Tr. 383-92). LCSW Spada's notes from those therapy sessions indicate that plaintiff continued to present as depressed, anxious and tearful (see Tr. 391). LCSW Spada noted some improvement in plaintiff's symptomatology on July 22 and September 6, 2014 (see Tr. 385, 387). However, during her other eight sessions with plaintiff during that period, LCSW Spada stated that plaintiff's symptomatology remained mostly unchanged (Tr 383-92). LCSW Spada consistently recommended that plaintiff continue to attend psychotherapy (Tr. 383-84, 386-92).

On August 11, 2014, LCSW Spada completed a "Mental Impairment Questionnaire (RFC & Listings)" ("Mental Impairment Questionnaire") form at the request of plaintiff's counsel (Tr. 343-48). LCSW Spada stated that plaintiff had diagnoses of major bipolar disorder and depressive disorder, and assigned plaintiff a Global Assessment of Functioning ("GAF") score of 55 (Tr. 343).14 LCSW Spada noted that plaintiff had been prescribed Klonapin and Lexapro (Tr. 343). LCSW Spada stated that during her most recent mental status examination, plaintiff: (1) was depressed and anxious; (2) had difficulty focusing; (3) suffered from impaired memory; (4) had difficulty sleeping and (5) was emotionally disconnected (Tr. 343). LCSW Spada described plaintiff's prognosis as "guarded" (Tr. 343). LCSW Spada checked boxes on the form indicating plaintiff's signs and symptoms of her mental condition included: (1) "pervasive loss of interest in almost all activities", (2) "decreased energy", (3) "feelings of guilt and worthlessness", (4) "generalized persistent anxiety", (5) "difficulty concentrating", (6) "memory impairment" and (7) "sleep disturbance" (Tr. 344).

LCSW Spada also checked boxes on the Mental Impairment Questionnaire that described the status of plaintiff's "mental abilities and aptitude . . . to do unskilled work" (Tr. 345). Overall, LCSW Spada checked boxes assessing plaintiff as "limited but satisfactory" in twelve of the sixteen categories concerning plaintiff's ability to perform unskilled work (Tr. 345). LCSW Spada also checked boxes indicating that plaintiff had "seriously limited, but not precluded", capability to "maintain attention for [a] two hour segment" and to "deal with normal work stress" (Tr. 345). LCSW Spada also checked boxes indicating that plaintiff was unable to complete a normal workday without interruptions from symptoms of her mental condition and unable to perform at a consistent pace without needing a number of lengthy rest periods (Tr. 345).

In addition, LCSW Spada assessed plaintiff's general functional limitations (Tr. 347-48). She concluded that plaintiff had only mild limitations in performing activities of daily living and in maintaining social functioning, and that plaintiff had moderate difficulty in maintaining concentration, persistence or pace (Tr. 347). Furthermore, LCSW Spada concluded that plaintiff had had only "one or two" episodes of decompensation within a 12 month period that lasted at least two weeks (Tr. 347). LCSW Spada opined that plaintiff's mental impairments would cause her to miss about four days of work per month (Tr. 348).

iii. Vitality Physicians Group

Plaintiff began treating with Vitality Physicians Group on October 21, 2013, and was treated there four times through August 6, 2014 (Tr. 331-39). Plaintiff completed a "New Patient Registration Form" in which she indicated that she was sad, anxious and irritable and had panic attacks, headaches and body aches (Tr. 330). However, plaintiff noted that she did not have suicidal thoughts or audio-visual hallucinations or delusions (Tr. 330). Plaintiff reported that her only medication was Levothyroxine (Tr. 330). Licensed Mental Health Counselor ("LMHC") Annie Kalotschke conducted plaintiff's intake interview (Tr. 332). Plaintiff complained that Buspar did not help her depression and anxiety, and that she had poor concentration, lacked motivation to work or pursue interests and had "passively" suicidal feelings (Tr. 332). LMHC Kalotschke observed that plaintiff's appearance, perception, thought patterns, dress and speech were normal (Tr. 332). Plaintiff was also oriented to person, place and time (Tr. 332). Furthermore, plaintiff had good judgment and insight (Tr. 332). However, LMHC Kalotschke noted that plaintiff was distractible, had a depressed mood and had a poor remote memory (Tr. 332). LMHC Kalotschke diagnosed plaintiff with major depressive disorder and anxiety disorder, and assigned plaintiff a GAF score of 60 (Tr. 333).

Dr. Varinder Rathore, a psychiatrist, treated plaintiff on April 14, 2014 (Tr. 334-35). Plaintiff reported that she had been diagnosed with bipolar disorder by LCSW Spada and that she had taken Cymbalta, Buspar and Effexor previously to treat her psychiatric conditions (Tr. 334). Plaintiff complained that these medications were ineffective and caused adverse side effects (Tr. 334). Dr. Rathore found plaintiff cooperative, alert and oriented as to person, place and time (Tr. 344). In addition, he found that plaintiff's mood was good, her affect congruent and her thought process logical (Tr. 334). Plaintiff denied suicidal ideations or audio-visual hallucinations and delusions (Tr. 335). Dr. Rathore diagnosed plaintiff with "bipolar disorder, single manic episode, in full remission" and "rule[d] out" major depression and generalized anxiety order (Tr. 335). Dr. Rathore prescribed Klonopin for plaintiff's anxiety and Trazadone to help her sleep; he noted that plaintiff would begin taking a mood stabilizer following her next visit (Tr. 335).

Dr. Rathore saw plaintiff again on April 28, 2014 (Tr. 336-37). Plaintiff complained of anxiety and depression (Tr. 336). Dr. Rathore's observations were unchanged, but he diagnosed plaintiff with "major depressive affective disorder, recurrent episode, moderate degree" (Tr. 337). Dr. Rathore increased plaintiff's Klonopin dosage and prescribed Lexapro for anxiety and depression (Tr. 336).

Plaintiff next saw Dr. Rathore on August 6, 2014 and complained that she was unhappy and in pain due to her fibromyalgia (Tr. 338). Dr. Rathore decreased plaintiff's Klonopin dosage and prescribed plaintiff Xanax and Wellbutrin (Tr. 338-39). Dr. Rathore assigned plaintiff a GAF score of 55 (Tr. 338-39).

3. Consultative Examinations

a. Dr. Leslie Helprin

On May 21, 2014, Dr. Leslie Helprin, a consultative psychologist, evaluated plaintiff's mental health and produced a written report of her observations, findings and opinions (Tr. 258-62). Plaintiff told Dr. Helprin that she lived with her 10-year-old son and 5-year-old daughter (Tr. 258). Plaintiff reported that she had been unable to work since October 2010 due to physical and psychiatric problems (Tr. 258). Plaintiff told Dr. Helprin that she had never been hospitalized for her psychiatric issues and had obtained outpatient treatment from various therapists (Tr. 258). Dr. Helprin noted that plaintiff took Klonopin and Lexapro to treat her mental condition (Tr. 258). Plaintiff reported sadness, crying spells, frustration, anger and suicidal ideations without any prior attempts or plan (Tr. 258-59). Plaintiff reported "manic-related symptomatology", including yelling and screaming (Tr. 259). Plaintiff also reported having difficulty finding her words, being unable to concentrate and losing her short-term memory (Tr. 259).

Plaintiff reported being able to dress, bathe and groom herself, cook and prepare foods, clean and do the laundry (Tr. 260). Plaintiff did not like being around large groups of people, such as when she was shopping for food (Tr. 260). She did not use public transportation (Tr. 260). Plaintiff reported that her leisure activities included watching television, but that she also spent a significant amount of her time seeing doctors and caring for her children (Tr. 260-61).

Dr. Helprin noted that plaintiff was cooperative and that her social skills and overall presentation were "adequate" (Tr. 259). Dr. Helprin noted that plaintiff had focused eye contact, was dressed appropriately and was well groomed (Tr. 259). Dr. Helprin found plaintiff's speech to be fluent, clear and adequately expressive and receptive (Tr. 259). Plaintiff's thought processes were coherent and goal directed (Tr. 260). However, plaintiff's affect was "restricted" and her mood was "neutral to tense" (Tr. 260). Dr. Helprin concluded that plaintiff was oriented as to person, place and time, but found that plaintiff's attention was "mildly impaired" (Tr. 260).15 Dr. Helprin also found plaintiff's recent and remote memory skills to be mildly impaired (Tr. 260). Dr. Helprin concluded that plaintiff's intellectual skills were below average, but that plaintiff's insight and judgment were good and that her general fund of information was appropriate (Tr. 260).

Dr. Helprin opined that plaintiff had no limitations in her ability to: (1) follow and understand simple directions and instructions; (2) cognitively perform simple and complex tasks independently or (3) maintain a regular schedule (Tr. 261). She further opined that plaintiff had "mild limitations" in her ability to maintain attention and concentration, and that plaintiff had "moderate" limitations in her ability to (1) make appropriate decisions and (2) relate adequately with others (Tr. 261). Finally, Dr. Helprin concluded that plaintiff had "marked" limitations in her ability to deal appropriately with stress (Tr. 261).

Accordingly, Dr. Helprin diagnosed plaintiff with (1) panic disorder with agoraphobia and (2) bipolar disorder (Tr. 261). She found that plaintiff's prognosis was "fair" given that plaintiff followed a treatment regimen (Tr. 261). In addition, Dr. Helprin opined that plaintiff would be able to manage her own funds should she be awarded disability benefits (Tr. 261).

b. Dr. Richard Goccia

On May 21, 2014, plaintiff saw Dr. Richard Goccia for a consultative internal medicine examination (Tr. 263-67). Plaintiff reported, among other things, that she had suffered from headaches for the past three years, but did not undergo any specific treatments for her headaches (Tr. 263). She also reported back pain due to an accident at work in 2002 (Tr. 263). According to plaintiff, she had been diagnosed with degenerative disc disease, but no surgery was recommended (Tr. 263). Plaintiff reported that her pain was worsened by activity and improved with rest and medications (Tr. 263). She reported taking Levothyroxine, Klonopin and Lexapro (Tr. 264). With respect to activities of daily living, plaintiff reported that she was able to do the laundry and shower and dress herself (Tr. 264). However, she told Dr. Helprin that her children, ages five and ten, did her cooking, cleaning and shopping (Tr. 264).

Plaintiff weighed 252 pounds and was 63 inches tall without shoes (Tr. 265). Dr. Goccia observed that plaintiff could walk on her heels and toes without difficulty, that she required no assistive devices and that she was able to rise from a chair without any difficulty (Tr. 264). Plaintiff refused to attempt to squat (Tr. 264). Dr. Goccia noted that plaintiff's gait and stance were normal (Tr. 264). Plaintiff's physical examination was within normal limits (Tr. 264-66). Specifically, Dr. Goccia found that plaintiff's cervical spine and lumbar spine16 showed "full flexion, extension, lateral flexion bilaterally. . . and full rotary movement" (Tr. 265). Plaintiff showed no signs of scoliosis,17 kyphosis18 or abnormality in the thoracic spine, and had full range of motion in her extremities (Tr. 265). Dr. Goccia noted that plaintiff's joints were stable and that no trigger points were evident (Tr. 265). In addition, plaintiff exhibited full strength in her legs and arms, and had full motor activity of her hands (Tr. 265). Dr. Goccia deferred to Dr. Helprin with respect to plaintiff's mental condition (Tr. 263).

In connection with this consultative physical examination, Dr. Goccia referred plaintiff to Dr. Lawrence Liebman for x-rays of her lumbosacral spine on May 21, 2014 (Tr. 268-69). The x-rays indicated no significant abnormalities (Tr. 266). Specifically, Dr. Liebman found that the height of plaintiff's vertebral bodies and the disc spaces in her lumbosacral spine both appeared "relatively well maintained" (Tr. 267).

Dr. Goccia diagnosed plaintiff with, among other things, hypothyroidism, anemia, "fibromyalgia by history", asthma, back pain and obesity (Tr. 267). He assessed her prognosis as fair (Tr. 267). Dr. Goccia opined that plaintiff was "mildly to moderately limited for activities which require squatting" (Tr. 267). Furthermore, in light of plaintiff's asthma, Dr. Goccia opined that plaintiff should be restricted from working environments that are dusty or contain noxious fumes (Tr. 267).

c. Dr. James Alpert

On June 9, 2014, a State agency medical consultant, psychologist, Dr. James Alpert, completed a "Disability Determination" form based on his review of LCSW Spada's notes from February 22, 2013 through April 15, 2014 and Dr. Helprin's examination (Tr. 77-81).19 Dr. Alpert found that plaintiff was not significantly limited in her ability: (1) to carry out very short and simple instructions; (2) to carry out detailed instructions; (3) to maintain attention and concentration for extended periods; (4) to sustain an ordinary routine without special supervision; (5) to work in coordination with or in proximity to others without being distracted by them; (6) to make simple work-related decisions; (7) to interact appropriately with the general public, (8) to ask simple questions or request assistance; (9) to maintain socially appropriate behavior and adhere to basic standards of neatness and cleanliness; (10) to be aware of normal hazards and take appropriate precautions; (11) to travel in unfamiliar places or use public transportation and (12) to set realistic goals or make plans independently of others (Tr. 78-79). Dr. Alpert concluded that plaintiff was moderately limited in her ability: (1) to perform activities within a schedule, maintain regular attendance and be punctual within customary tolerances; (2) to complete a normal workday and workweek without interruptions from psychologically based symptoms; (3) to perform at a consistent pace without an unreasonable number and length of rest periods and (4) to respond appropriately to changes in the work setting (Tr. 78-79).

D. Proceeding Before the ALJ

1. Plaintiff's Testimony

Plaintiff testified at the March 17, 2016 hearing before ALJ Katz; she was represented by counsel (Tr. 35-43). Plaintiff testified that she had previously worked in medical billing and collections, which involved contacting insurance companies on behalf of medical care providers to obtain payments (Tr. 38). Plaintiff also testified that she had obtained gainful employment as of approximately September 1, 2014 (Tr. 42). When asked by ALJ Katz whether she had applied for jobs during the period of time that she was allegedly disabled, plaintiff responded that she did, but only after foreclosure proceedings had been commenced against her home (Tr. 39). Plaintiff testified that despite working full-time, her physical and psychiatric conditions were still a "work in progress" (Tr. 43).

Plaintiff testified that she had suffered from depression and anxiety since before her alleged disability onset date of May 23, 2013, but that her symptoms had gotten worse around that time (Tr. 36-37). When asked by ALJ Katz to explain in what ways her symptoms had worsened, plaintiff answered that she sunk into "a deeper state of depression and anxiety" each day after May 23, 2013 (Tr. 37). She also testified that, around that time, she began to have pain throughout her body (Tr. 37). Plaintiff testified that she received psychiatric treatment from LCSW Spada and medication from Dr. Rathore (Tr. 37).

Plaintiff testified that her symptoms included sadness, crying and "not being able to function daily" (Tr. 38). When ALJ Katz asked whether she was bed- or home-ridden during the relevant time period, plaintiff answered "I guess I kind of restricted myself with the medications I was on, the way I felt, not being able to just really feel like I was capable of doing anything" (Tr. 39). Plaintiff testified that she suffered from migraines and nausea as the side effects of her medication (Tr. 39).

Plaintiff's attorney asked plaintiff whether her "physical conditions affected [her] mental conditions" (Tr. 41). Plaintiff answered in the affirmative, noting that her obesity and hair loss due to hypothyroidism exacerbated the symptoms of her depression and anxiety (Tr. 42).

2. Vocational Expert's Testimony

Vocational expert Amy Leopold (the "VE") also testified at the hearing (Tr. 44-45). ALJ Katz asked the VE to describe or classify plaintiff's prior work experience (Tr. 44). The VE testified that plaintiff was previously employed as a "Medical Biller", Dictionary of Occupational Titles ("DOT") Code No. 214.482-018 (Tr. 44). The VE described this occupation as sedentary (Tr. 44). The VE testified that plaintiff was also previously employed as a "Collections Clerk", DOT Code No. 216.362-014, which is a sedentary and semi-skilled occupation (Tr. 44). ALJ Katz asked the VE whether she considered the position of a Medical Biller to be complex or a simple and routine job (Tr. 44). The VE responded that the occupation was routine and repetitive, but that it could not be described as "simple" given that someone in that position would "really [need] [to] be able to concentrate, focus and have a good attention span" (Tr. 45). ALJ Katz then asked whether a person would be able to sustain her position as a Medical Biller if they missed one work day per week due to, for instance, "decompensation" (Tr. 45). The VE answered that such a person would be unable to sustain employment (Tr. 45).

III. Analysis

A. Applicable Legal Principles

1. Standard of Review

The Court may set aside the final decision of the Commissioner only if it is not supported by substantial evidence or if it is based upon an erroneous legal standard. 42 U.S.C. § 405(g); Selian v. Astrue, 708 F.3d 409, 417 (2d Cir. 2014) (per curiam); Talavera v. Astrue, 697 F.3d 145, 151 (2d Cir. 2012); Burgess v. Astrue, 537 F.3d 117, 127 (2d Cir. 2008). Moreover, the court cannot "affirm an administrative action on grounds different from those considered by the agency." Lesterhuis v. Colvin, 805 F.3d 83, 86 (2d Cir. 2015), quoting Burgess v. Astrue, supra, 537 F.3d at 128.

The Court first reviews the Commissioner's decision for compliance with the correct legal standards; only then does it determine whether the Commissioner's conclusions were supported by substantial evidence. Byam v. Barnhart, 336 F.3d 172, 179 (2d Cir. 2003), citing Tejada v. Apfel, 167 F.3d 770, 773 (2d Cir. 1999). "Even if the Commissioner's decision is supported by substantial evidence, legal error alone can be enough to overturn the ALJ's decision." Ellington v. Astrue, 641 F.Supp.2d 322, 328 (S.D.N.Y. 2009) (Marrero, D.J.). However, "where application of the correct legal principles to the record could lead to only one conclusion, there is no need to require agency reconsideration." Johnson v. Bowen, 817 F.2d 983, 986 (2d Cir. 1987).

"`Substantial evidence' is `more than a mere scintilla. It means such evidence as a reasonable mind might accept as adequate to support a conclusion.'" Talavera v. Astrue, supra, 697 F.3d at 151, quoting Richardson v. Perales, 402 U.S. 389, 401 (1971). Consequently, "[e]ven where the administrative record may also adequately support contrary findings on particular issues, the ALJ's factual findings `must be given conclusive effect' so long as they are supported by substantial evidence." Genier v. Astrue, 606 F.3d 46, 49 (2d Cir. 2010) (per curiam), quoting Schauer v. Schweiker, 675 F.2d 55, 57 (2d Cir. 1982). Thus, "[i]n determining whether the agency's findings were supported by substantial evidence, `the reviewing court is required to examine the entire record, including contradictory evidence and evidence from which conflicting inferences can be drawn.'" Selian v. Astrue, supra, 708 F.3d at 417 (citation omitted).

2. Determination Of Disability

Under Title II and Title XVI of the Act, a claimant is entitled to DIB or SSI if she can establish an "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to . . . last for a continuous period of not less than 12 months." 42 U.S.C. § 423(d)(1)(A); see Barnhart v. Walton, 535 U.S. 212, 217-22 (2002) (both impairment and inability to work must last twelve months).20 The impairment must be demonstrated by "medically acceptable clinical and laboratory diagnostic techniques," 42 U.S.C. § 423(d)(3), and it must be

42 U.S.C. § 423(d)(2)(A). In addition, to obtain DIB, the claimant must have become disabled between the alleged onset date and the date on which he was last insured. See 42 U.S.C. §§ 416(i), 423(a); 20 C.F.R. §§ 404.130, 404.315; McKinstry v. Astrue, 511 F. App'x 110, 111 (2d Cir. 2013) (summary order), citing Kohler v. Astrue, 546 F.3d 260, 265 (2d Cir. 2008). In making the disability determination, 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.'" Brown v. Apfel, 174 F.3d 59, 62 (2d Cir. 1999) (per curiam), quoting Mongeur v. Heckler, 722 F.2d 1033, 1037 (2d Cir. 1983) (per curiam).

In determining whether an individual is disabled, the Commissioner must follow the five-step process required by the regulations. 20 C.F.R. §§ 404.1520(a)(4)(i)-(v), 416.920(a)(4)(i)-(v); see Selian v. Astrue, supra, 708 F.3d at 417-18; Talavera v. Astrue, supra, 697 F.3d at 151. The first step is a determination of whether the claimant is engaged in substantial gainful activity ("SGA"). 20 C.F.R. §§ 404.1520(a)(4)(i), 416.920(a)(4)(i). If she is not, the second step requires determining whether the claimant has a "severe medically determinable physical or mental impairment." 20 C.F.R. §§ 404.1520(a)(4)(ii), 416.920(a)(4)(ii). If the claimant does not have a severe medically determinable impairment or combination of impairments, she is not disabled. See Henningsen v. Comm'r of Soc. Sec. Admin., 111 F.Supp.3d 250, 264 (E.D.N.Y. 2015); 20 C.F.R. §§ 404.1520(c), 416.920(c). If she does, the inquiry at the third step is whether any of claimant's impairments meet one of the listings in Appendix 1 of the regulations. 20 C.F.R. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii). If the answer to this inquiry is affirmative, the claimant is disabled. 20 C.F.R. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii).

If the claimant does not meet any of the listings in Appendix 1, step four requires an assessment of the claimant's residual functional capacity ("RFC") and whether the claimant can still perform her past relevant work given her RFC. 20 C.F.R. §§ 404.1520(a)(4)(iv), 416.920(a)(4)(iv); see Barnhart v. Thomas, supra, 540 U.S. at 24-25. If she cannot, then the fifth step requires assessment of whether, given the claimant's RFC, she can make an adjustment to other work. 20 C.F.R. §§ 404.1520(a)(4)(v), 416.920(a)(4)(iv). If she cannot, she will be found disabled. 20 C.F.R. §§ 404.1520(a)(4)(v), 416.920(a)(4)(v).

RFC is defined in the applicable regulations as "the most [the claimant] can still do despite [her] limitations." 20 C.F.R. §§ 404.1545(a)(1), 416.945(a)(1). To determine RFC, the ALJ "`identif[ies] the individual's functional limitations or restrictions and assess[es] . . . her work-related abilities on a function-by-function basis, including the functions in paragraphs (b), (c), and (d) of 20 [C.F.R. §§] 404.1545 and 416.945.'" Cichocki v. Astrue, 729 F.3d 172, 176 (2d Cir. 2013) (per curiam), quoting Social Security Ruling ("SSR") 96-8p, 1996 WL 374184 at *1 (July 2, 1996). The results of this assessment determine the claimant's ability to perform the exertional demands of sustained work which may be categorized as sedentary, light, medium, heavy or very heavy.21 20 C.F.R. §§ 404.1567, 416.967; see Schaal v. Apfel, 134 F.3d 496, 501 n.6 (2d Cir. 1998). This ability may then be found to be limited further by nonexertional factors that restrict the claimant's ability to work.22 See Michaels v. Colvin, 621 F. App'x 35, 38 n.4 (2d Cir. 2015) (summary order); Zabala v. Astrue, 595 F.3d 402, 410-11 (2d Cir. 2010).

The claimant bears the initial burden of proving disability with respect to the first four steps. Once the claimant has satisfied this burden, the burden shifts to the Commissioner to prove the final step — that the claimant's RFC allows the claimant to perform some work other than her past work. Selian v. Astrue, supra, 708 F.3d at 418; Burgess v. Astrue, supra, 537 F.3d at 128; Butts v. Barnhart, 388 F.3d 377, 383 (2d Cir. 2004), amended in part on other grounds on reh'g, 416 F.3d 101 (2d Cir. 2005).

In some cases, the Commissioner can rely exclusively on the Medical-Vocational Guidelines (the "Grids") contained in C.F.R. Part 404, Subpart P, Appendix 2 when making the determination at the fifth step. Gray v. Chater, 903 F.Supp. 293, 297-98 (N.D.N.Y. 1995). "The Grid[s] take[] into account the claimant's RFC in conjunction with the claimant's age, education and work experience. Based on these factors, the Grid[s] indicate[] whether the claimant can engage in any other substantial gainful work which exists in the national economy." Gray v. Chater, supra, 903 F. Supp. at 298; see Butts v. Barnhart, supra, 388 F.3d at 383.

Exclusive reliance on the Grids is not appropriate where nonexertional limitations "significantly diminish [a claimant's] ability to work." Bapp v. Bowen, 802 F.2d 601, 603 (2d Cir. 1986); accord Butts v. Barnhart, supra, 388 F.3d at 383. "Significantly diminish" means "the additional loss of work capacity beyond a negligible one or, in other words, one that so narrows a claimant's possible range of work as to deprive [her] of a meaningful employment opportunity." Bapp v. Bowen, supra, 802 F.2d at 606 (footnote omitted); accord Selian v. Astrue, supra, 708 F.3d at 421; Zabala v. Astrue, supra, 595 F.3d at 411. Before an ALJ determines that sole reliance on the Grids is proper in determining whether a plaintiff is disabled under the Act, he must ask and answer the intermediate question — whether the claimant has nonexertional limitations that significantly diminish her ability to work; an ALJ's failure to explain how he reached his conclusion to this question is "plain error". See Maldonado v. Colvin, 15 Civ. 4016 (HBP), 2017 WL 775829 at *21-*23 (S.D.N.Y. Feb. 23, 2017) (Pitman, M.J.); see also Bapp v. Bowen, supra, 802 F.2d at 606; St. Louis ex rel. D.H. v. Comm'r of Soc. Sec., 28 F.Supp.3d 142, 148 (N.D.N.Y. 2014); Baron v. Astrue, 11 Civ. 4262 (JGK) (MHD), 2013 WL 1245455 at *19 (S.D.N.Y. Mar. 4, 2013) (Dolinger, M.J.) (Report & Recommendation), adopted at, 2013 WL 1364138 (S.D.N.Y. Mar. 26, 2013) (Koeltl, D.J.); accord Lewis v. Astrue, 11 Civ. 7538 (JPO), 2013 WL 5834466 at *22 (S.D.N.Y. Oct. 30, 2013) (Oetken, D.J.) ("Courts in this Circuit have long held that an ALJ's failure to acknowledge relevant evidence or to explain its implicit rejection is plain error."); Camilo v. Comm'r of Soc. Sec. Admin., 11 Civ. 1345 (DAB) (MHD), 2013 WL 5692435 at *15 (S.D.N.Y. Oct. 2, 2013) (Batts, D.J.). When the ALJ finds that the nonexertional limitations do significantly diminish a claimant's ability to work, then the Commissioner must introduce the testimony of a vocational expert or other similar evidence in order to prove "that jobs exist in the economy which [the] claimant can obtain and perform." Butts v. Barnhart, supra, 388 F.3d at 383-84 (internal quotation marks omitted); see Heckler v. Campbell, 461 U.S. 458, 462 n.5 (1983) ("If an individual's capabilities are not described accurately by a rule, the regulations make clear that the individual's particular limitations must be considered.").

In addition to the five-step analysis outlined in 20 C.F.R. §§ 404.1520 and 416.920, the Commissioner has promulgated additional regulations governing the severity of mental impairments in 20 C.F.R. §§ 404.1520a and 416.920a (eff. June 13, 2011).23

Ornelas-Sanchez v. Colvin, 632 F. App'x 48, 49 (2d Cir. 2016) (summary order) (emphasis in original); accord Aung Winn v. Colvin, 541 F. App'x 67, 70 (2d Cir. 2013) (summary order); Petrie v. Astrue, 412 F. App'x 401, 408 (2d Cir. 2011) (summary order); Kohler v. Astrue, supra, 546 F.3d at 265-66.

B. The ALJ's Decision

ALJ Katz applied the five-step analysis described above, relying on plaintiff's testimony, the VE's testimony and medical evidence to determine that plaintiff was "not disabled" under the Act between May 23, 2013 and September 1, 2014 (Tr. 15-27).

At step one, ALJ Katz found that plaintiff had not engaged in SGA from May 23, 2013 through September 1, 2014 (Tr. 17, citing 20 C.F.R. §§ 404.1571 et seq., 416.971 et seq.).24

At step two, ALJ Katz concluded that plaintiff suffered from the following severe impairments: (1) a thyroid disorder, (2) anemia, (3) fibromyalgia, (4) obesity, (5) lumbar/cervical degenerative disc disease, (6) asthma;25 (7) a depressive disorder and (8) an anxiety disorder (Tr. 18, citing 20 C.F.R. §§ 404.1520(c), 416.920(c)).

At step three, ALJ Katz concluded that plaintiff's disabilities did not meet or medically equal the criteria of the listed impairments and that plaintiff was not, therefore, entitled to a presumption of disability (Tr. 18-19, citing 20 C.F.R. Pt. 404, Subpt. P, App'x 1 and 20 C.F.R. §§ 404.1520(d), 404.1526, 416.920(d), 416.926). Specifically, ALJ Katz stated that he had considered whether plaintiff's physical impairments met the criteria of listings 1.00 (musculoskeletal system disorder), 3.03 (asthma), 7.00 (hematological disorders), 9.00 (endocrine disorders), Social Security Ruling 02-01p (obesity), and Social Security Ruling 12-2p (fibromyalgia),26 and concluded that they did not (Tr. 18). In so finding, ALJ Katz explained

(Tr. 18).

In addition, ALJ Katz determined whether the severity of plaintiff's mental impairments, both singularly or in combination, met or was medically equal to the criteria of listings 12.04 (depressive, bipolar and related disorders) and 12.06 (anxiety and obsessive-compulsive disorder) (Tr. 18-19, citing 20 C.F.R. Pt. 404, Subpt. P, App'x 1 and 20 C.F.R. §§ 404.1520(d), 404.1526, 416.920(d), 416.926). ALJ Katz explained that a claimant's mental impairments meet or are medically equal to the requirements of listings 12.04 and 12.06 only if her impairments satisfy the criteria set forth in paragraph A and paragraph B or the criteria set forth in paragraph C of those listings (Tr. 18). In order for a claimant's impairments to satisfy paragraph B of listings 12.04 and 12.06, she must have at least two of the following: (1) marked restriction of activities of daily living; (2) marked difficulties in maintaining social functioning; (3) marked difficulties in maintaining concentration, persistence or pace or (4) episodes of decompensation, each of extended duration (see Tr. 19).27 In order for a claimant's impairments to satisfy paragraph C of listings 12.04 and 12.06, she must have a "serious and persistent" mental disorder, namely, one that has lasted over a period of at least two years and with evidence of both (1) "medical treatment, mental therapy, psychosocial support(s), or a highly structured setting(s) that is ongoing and that diminishes the symptoms and signs of your mental disorder" and (2) "marginal adjustment, that is, . . . minimal capacity to adapt to changes in [her] environment or to demands that are not already part of [her] daily life." 20 C.F.R. Pt. 404, Subpt. P, App'x 1 §§ 12.04(C), 12.06(C).

ALJ Katz found that, despite plaintiff's "moderate" limitations in concentration, persistence or pace, plaintiff failed to meet the requirements of paragraph B because plaintiff experienced no episodes of decompensation and had no difficulties in activities of daily living and social functioning (Tr. 19). ALJ Katz found it significant that Dr. Helprin noted that plaintiff was able to care for both herself and her two young children adequately, and that plaintiff was able to drive, shop, cook and clean (Tr. 19, see Tr. 260). ALJ Katz also cited Dr. Rathore's observation that plaintiff appeared in control, alert and awake, that her mood was good and that she reported having a "few" close friends and family members (Tr. 19, see Tr. 333). ALJ Katz also appeared to find it significant that plaintiff was able to return to work on September 1, 2014, despite her alleged limitations (Tr. 19). After considering the paragraph B criteria of listing 12.04 and 12.06, ALJ Katz stated that he had considered the criteria required to satisfy paragraph C these listings, and concluded that nothing in the record indicated that plaintiff met those requirements (Tr. 19). ALJ Katz did not list the criteria required to satisfy paragraph C and did not specify how plaintiff failed to meet the paragraph C criteria (Tr. 19).

ALJ Katz then determined that plaintiff retained the physical RFC to:

(Tr. 20). ALJ Katz stated that his physical RFC determination had taken into account the possibility that plaintiff's capacity to stand and/or walk had been "adversely impacted by the combination of her [obesity] and joint pain associated with fibromyalgia and degenerative changes in the musculoskeletal system" (Tr. 24).

ALJ Katz also determined that plaintiff had the mental RFC to perform "unskilled work"29 without any additional restrictions (Tr. 20). Specifically, ALJ Katz concluded at that despite plaintiff's noted psychiatric impairments, she was "not preclude[d] from performing basic unskilled work tasks[,]" including "(a) understand[ing] instructions, (b) respond[ing] to supervision and (c) deal[ing] with changes in a routine work setting" (Tr. 25, citing 20 C.F.R. §§ 404.1521, 416.921; SSR 85-15, 1985 WL 57857 at *4 (Jan. 1, 1985)). ALJ Katz further concluded that, based on the medical record, plaintiff is "mentally capable of performing substantially all unskilled jobs even though she may have had difficultly performing highly complex work tasks during the period at issue" (Tr. 25).

To reach his RFC determination, ALJ Katz examined the opinions of plaintiff's treating and consultative physicians and other sources, and assessed the weight to be given to each opinion based on the objective medical record (Tr. 20-26).

First, ALJ Katz gave "little weight" to Dr. Helprin's opinion that plaintiff had "marked difficulty in dealing with stress" because Dr. Helprin did not define the term "stress" and, thus, this opinion was not instructive in ALJ Katz's mental RFC analysis (Tr. 22). ALJ Katz also gave "little weight" to Dr. Helprin's opinion that plaintiff had "moderate" limitations in relating adequately with others because it was inconsistent with the objective medical record, including mental status examinations conducted by Dr. Klein and Dr. Rathore, which indicated plaintiff was "cooperative" and had good relationships with some friends and family (Tr. 22, see Tr. 270-342). However, ALJ Katz accorded "some weight" to Dr. Helprin's other opinions, with the understanding that Dr. Helprin was a consultative psychologist who had assessed plaintiff only once (Tr. 22).

Second, ALJ Katz granted "great weight" to Dr. Goccia's opinion that plaintiff was moderately limited in activities which required squatting, but otherwise had a considerable range of physical functioning (Tr. 24). ALJ Katz found it significant that Dr. Goccia's opinions were consistent with Dr. Klein's treatment notes that recount plaintiff's history of obesity and her generalized complaints of pain, but do not indicate plaintiff had any limiting neurological or musculoskeletal deficits (Tr. 24).

Third, ALJ Katz accorded "some weight" to Dr. Alpert's opinion that plaintiff had no restrictions with respect to the activities of daily living; moderate restrictions in maintaining concentration, persistence or pace and in maintaining social functioning and no episodes of decompensation of an extended duration (Tr. 26). ALJ Katz acknowledged that Dr. Alpert, who examined plaintiff's medical record on June 9, 2014, did not have the benefit of reviewing plaintiff's complete medical record, but found it significant that Dr. Alpert was familiar with the SSA's regulations (Tr. 26).

Fourth, noting that LCSW Spada was not an "acceptable medical source" under the regulations, ALJ Katz granted "little evidentiary weight" to her opinions "to the extent that [her] treatment notes merely summarize[d] [plaintiff's] subjective complaints" and because her Medical Source Statement and Mental Impairment Questionnaire were not completed for the purpose of treating plaintiff, but rather for the purpose of helping plaintiff obtain disability benefits (Tr. 25). ALJ Katz also found it significant that some of LCSW Spada's opinions were inconsistent with the objective medical record, namely Dr. Rathore's clinical treatment notes (Tr. 25).

Fifth, ALJ Katz gave "greater evidentiary weight" to Dr. Rathore's treatment notes that indicated plaintiff "was well functioning with a good mood and effect" (Tr. 25). ALJ Katz found it significant that Dr. Rathore consistently concluded, among other things, that plaintiff's mood and affect were good, and that the GAF scores Dr. Rathore accorded plaintiff were longitudinally consistent and, moreover, showed that plaintiff had only moderate restrictions (Tr. 25).

Next, ALJ Katz found that, although plaintiff's medically determinable impairments could reasonably be expected to cause some of her alleged symptoms, plaintiff's testimony and self-reporting concerning the intensity, persistence and limiting effects of these symptoms were not entirely consistent with the objective medical evidence (Tr. 24). ALJ Katz found that plaintiff's testimony at the hearing to the effect that she was unable to work due to her physical and mental impairments — in particular, that her sadness and depression rendered her bedridden — was belied by the fact that she "suddenly" returned to work on September 1, 2014 despite there being no evidence in the medical record reflecting a significant improvement in her physical or mental conditions on or around that date (Tr. 20, 24). Moreover, ALJ Katz concluded that plaintiff's claims concerning the disabling nature of her psychiatric impairment and severe pain were not consistent with Dr. Rathore's treatment notes and observations (Tr. 21). Specifically, Dr. Rathore found plaintiff's mood to be consistently good and noted that plaintiff had minimal side effects from her medications such as headaches and sedation; Dr. Rathore merely re-calibrated plaintiff's doses to resolve these side effects (Tr. 21).

At step four, ALJ Katz found that plaintiff was not capable of performing her prior work as a Medical Biller or as a Collections Clerk — both semiskilled occupations — based on the VE's testimony that an individual with plaintiff's age, education, work experience and RFC could not perform such work (Tr. 26).

At step five, ALJ Katz observed that plaintiff was 39 years old as of the date of her application, had at least a high school education and was able to communicate in English (Tr. 26). Relying exclusively on the Grids, ALJ Katz found that jobs existed in significant numbers in the national economy that plaintiff could have performed (Tr. 26, citing 20 C.F.R. §§ 404.1569, 404.1569(a), 416.969, 416.969(a)). ALJ Katz did not consider the transferability of plaintiff's job skills because he found that the Grids supported a finding that plaintiff was not disabled (Tr. 26).

Accordingly, ALJ Katz denied plaintiff's claim for DIB and SSI pursuant to Section 1614(a)(3)(A) of the Act (Tr. 27).

C. Analysis of the ALJ's Decision

Plaintiff contends that ALJ Katz committed legal error and that his decision is not supported by substantial evidence (Plaintiff's Memorandum of Law in Support of her Motion for Judgment on the Pleadings, dated Dec. 1, 2017 (D.I. 19) ("Pl.'s Mem."); Plaintiff's Reply Memorandum of Law in Support of her Motion for Judgment on the Pleadings, dated Mar. 25, 2018 (D.I. 24) ("Pl.'s Reply Mem.")). The Commissioner contends that ALJ Katz's decision is supported by substantial evidence and should be affirmed (Memorandum of Law in Support of the Commissioner's Cross-Motion for Judgment on the Pleadings, dated Mar. 6, 2018 (D.I. 23) ("Def.'s Mem.")).

1. ALJ's Analysis at Step Three: Listings 12.04 and 12.06

Plaintiff argues that ALJ Katz's finding that plaintiff did not meet or medically equal listings 12.04 and/or 12.06 is not supported by substantial evidence (Pl.'s Mem. at 20-22; Pl.'s Reply Mem. at 4-7). Plaintiff first asserts that the determination of whether a mental impairment medically equals a listing requires the ALJ to obtain the testimony of a medical expert, and that an ALJ is not permitted to rely on his own lay judgment in this regard (Pl.'s Reply Mem. at 4-6). Second, plaintiff argues that the medical evidence demonstrates that plaintiff met listings 12.04 and 12.06 (Pl.'s Mem. at 20-22). The Commissioner contends that ALJ Katz appropriately assessed plaintiff's mental conditions with respect to the requirements of listings 12.04 and 12.06, and that ALJ Katz's determination was supported by substantial evidence (Def.'s Mem. at 17).

a. Failure to Call a Medical Expert

An ALJ is not required to consult a medical expert to determine whether a plaintiff meets or medically equals a listing. The regulations contain permissive language, stating that an ALJ "may . . . ask for and consider opinions from medical experts on the nature and severity of a [claimant's] impairment(s) and on whether [her] impairment(s) equals the requirements of any impairment in the listings. 20 C.F.R. §§ 404.1527(e) (2) (iii), 416.927(e) (2) (iii) (emphasis added); see Rivera v. Comm'r Soc. Sec., 15 Civ. 8439 (GBD)(HBP), 2017 WL 120974 at *10 (S.D.N.Y. Jan. 12, 2017) (Pitman, M.J.) (Report & Recommendation), adopted at, 2017 WL 946296 (S.D.N.Y. Mar. 9, 2017) (Daniels, D.J.); Carter v. Comm'r of Soc. Sec., No. 06-CV-186C(F), 2008 WL 1995122 at *5 (W.D.N.Y. May 6, 2008); see also Ortiz v. Colvin, No. 13-CV-6463 (MAT), 2014 WL 3784108 at *7 (W.D.N.Y. July 31, 2014); Van Valkenberg ex rel. B.G. v. Astrue, No. 1:08-CV-0959 (DNH/VEB), at *17 (N.D.N.Y. May 27, 2010) (Report & Recommendation), adopted at, 2010 WL 2400443 (N.D.N.Y. June 10, 2010); Van Orden v. Astrue, No. 1:09-cv-81 (GLS/VEB), 2010 WL 841103 at *9 (N.D.N.Y. Mar. 11, 2010).

Plaintiff cites SSR 96-6p, supra, 1996 WL 374180, in support of her argument that an ALJ is "require[d]" to" call a medical expert on the issue of medical equivalence (Pl.'s Mem. at 4). However, this argument is unavailing. According to SSR 96-6p, although "longstanding policy requires that the judgment of a physician . . . designated by the Commissioner on the issue of equivalence . . . must be received into the record as expert opinion evidence and given appropriate weight," the "signature of a State agency medical or psychological consultant on an SSA-831-U5 (Disability Determination and Transmittal Form) . . . ensures that . . . a physician designated by the Commissioner has [considered] the question of medical equivalence." The record here contains a Disability Determination form completed and signed by state appointed psychologist, Dr. Alpert, on June 9, 2014 that satisfies this requirement (Tr. 70-82). The Disability Determination form contains Dr. Alpert's assessment of plaintiff's medical record and determination as to whether plaintiff's psychological impairments, singularly or in their combination, meet listings 12.04 or 12.06 (Tr. 70-82). As noted above at pages 28-29, Dr. Alpert found that they did not and set forth reasons germane to his conclusions (Tr. 79-80).

In addition, SSR 96-6p directs that an ALJ must obtain an "updated medical opinion from a medical expert" concerning equivalence in only two circumstances: (1) if the ALJ concludes that the record suggests that a "judgment of equivalence may be reasonable," if no additional medical evidence has been received, or (2) if additional medical evidence has been received that may change "the State agency medical . . . consultant's finding that the impairment(s) is not equivalent" to a listing. SSR 96-6p, 1996 WL 374180 at *4. Those circumstances are not present here; there is no evidence that ALJ Katz concluded that plaintiff's mental impairments may have met listings 12.04 and 12.06, nor was there additional evidence that would have altered Dr. Alpert's findings. Based on his review of LCSW Spada's treatment notes from February 22, 2013 through April 15, 2014 and Dr. Helprin's notes, findings and opinions, Dr. Alpert concluded that plaintiff did not have "marked" restrictions in any of the four aspects of cognitive function set forth as criteria in paragraph B of listings 12.04 and 12.06 (Tr. 79-80). Although Dr. Alpert did not have LCSW Spada's treatment notes after April 15, 2014 or Dr. Rathore's clinical treatment notes, nothing contained in this additional medical evidence suggest that plaintiff's limitations were more serious than the record Dr. Alpert reviewed had suggests. As an initial matter, for reasons explained in greater detail below, LCSW Spada is not an "acceptable medical source" within the meaning of 20 C.F.R. §§ 404.1527(c) and 416.927(c) and, thus, her opinions and observations cannot form the basis of a finding of a disability. See 20 C.F.R. §§ 404.1502, 416.902. Moreover, her treatment notes from April 15, 2014 through September 14, 2014 consistently show no change in plaintiff's psychiatric status, and at two points even show improvements (Tr. 385). In addition, Dr. Rathore's clinical notes indicate that plaintiff's mental status examinations are consistently within normal limits, and assign plaintiff GAF scores between 55 and 60. In addition, plaintiff returned to SGA less than three months after Dr. Alpert's evaluation, suggesting that her symptoms improved.

Because neither of the two situations in which an ALJ is required to obtain an updated medical expert opinion existed in this case, ALJ Katz did not err in failing to obtain medical expert testimony on the issue of medical equivalence.

b. Whether the ALJ's Determination Was Supported by Substantial Evidence

ALJ Katz's determination that plaintiff's mental impairments did not meet or medically equal listing 12.04 and/or 12.06 is supported by substantial evidence.

Listing 12.04 addresses depressive, bipolar and related disorders, and listing 12.06 addresses anxiety and obsessive-compulsive disorder. 20 C.F.R. Pt. 404, Subpt. P, App'x 1 §§ 12.04, 12.06 and 20 C.F.R. §§ 416.920(d), 416.925, 416.926. As noted above, both listings contain criteria divided into paragraphs A, B and C. 20 C.F.R. Pt. 404, Subpt. P, App'x 1, §§ 12.04, 12.06. The criteria set forth in paragraphs B and C in listing 12.04 and 12.06 are identical. 20 C.F.R. Pt. 404, Subpt. P, App'x 1, §§ 12.04, 12.06. "The required level of severity of these disorders is met when the requirements in both A and B are satisfied, or when the requirements in C are satisfied." 20 C.F.R. Pt. 404, Subpt. P, App'x §§ 12.04, 12.06. ALJ Katz concluded that plaintiff's mental impairments failed to meet the requirements of listings 12.04 and/or 12.06 because plaintiff failed to satisfy the criteria set forth in both paragraph B and paragraph C.30

To satisfy paragraph B of listings 12.04 and 12.06, plaintiff must show that his mental impairment resulted in at least two of the following:

20 C.F.R. Pt. 404, Subpt. P, App'x 1, §§ 12.04(B), 12.06(B); see Cienfuegos v. Comm'r of Soc. Sec., supra, 2015 WL 256134 at *15. The regulations define "marked" as meaning "more than moderate but less than extreme." 20 C.F.R. Pt. 404, Subpt. P, App'x 1 § 12.00(C).

To satisfy paragraph C, a claimant must show a "[m]edically documented history of the existence of the disorder over a period of at least two years" and evidence of both (1) "[m]edical treatment, mental health therapy, psychosocial support(s). . . or a highly structured setting that is ongoing and that diminishes the symptoms and signs of [the] mental disorder" and (2) "marginal adjustment," i.e., the claimant has minimal capacity "to adapt to changes in [her] environment or to demands that are not already part of [her] life." 20 C.F.R. Pt. 404, Subpt. P, App'x 1 §§ 12.04(C) 12.06(C).

ALJ Katz first assessed the paragraph B criteria. He found that there was no restriction in plaintiff's activities of daily living (Tr. 19). ALJ Katz cited to Dr. Helprin's consultative psychiatric evaluation of plaintiff, which constitutes substantial evidence supporting this aspect of ALJ Katz's findings (Tr. 19, see 258-62). Specifically, Dr. Helprin noted that plaintiff reported that she was able to dress, bathe and groom herself, cook and prepare foods, clean and launder, drive, manage her money and care for her two young children (Tr. 260-61). ALJ Katz's finding is also supported by LCSW Spada's Medical Source Statement and Mental Impairment Questionnaire (Tr. 251-57, 343-48). In her Medical Source Statement, LCSW Spada stated that plaintiff was able to "adequately perform" the activities of daily living, without providing any further detail (Tr. 255). In her Mental Impairment Questionnaire, LCSW Spada checked a box indicating that plaintiff had either no, or only mild, restrictions in performing the activities of daily living (Tr. 347).

Next, ALJ Katz found that plaintiff had no difficulties as to social functioning (Tr. 19). ALJ Katz acknowledged that the medical record was replete with plaintiff's statements concerning her lack of a social life, dislike of being around large groups of people and difficulties with friends, families and neighbors. However, these subjective statements from plaintiff are not, as ALJ Katz concluded, supported by the objective medical record (Tr. 24). In particular, ALJ Katz found that plaintiff's complaints were belied by Dr. Rathore's notes indicating that she was able to care for her children, had a "few" close friends and had a good relationship with her grandmother (Tr. 334). He also found that plaintiff's claims concerning the severity of her symptoms were inconsistent with Dr. Rathore's observations that plaintiff's mood, insight and judgment were good, she was cooperative and she had good control over her impulses (Tr. 334-39). The medical record also provides other substantial evidence supporting ALJ Katz's conclusion. For example, Dr. Helprin noted that plaintiff was cooperative and that her social skills and overall presentation were "adequate" (Tr. 259). LCSW Spada found in her Mental Impairment Question-naire that plaintiff had either no, or only mild, impairments in her social functioning (Tr. 347).

As to concentration, persistence and pace, ALJ Katz found that plaintiff had "moderate" restrictions in these areas (Tr. 19). This finding is consistent with Dr. Helprin's opinion that plaintiff suffered from mild limitations in plaintiff's ability to maintain attention and concentration after she conducted a series of tests on plaintiff (Tr. 260-61). It is also consistent with Dr. Alpert's analysis and his finding that plaintiff had moderate limitations in her ability to make appropriate decisions and to relate adequately with others (Tr. 80). Nothing in the medical record, or in plaintiff's own complaints and testimony, suggests that plaintiff suffered from "marked difficulties" as required by paragraph B of listings 12.04 and 12.06 20 C.F.R. Pt. 404, Subpt. P, App. 1, §§ 12.00, 12.04(B), 12.06(B).

Finally, ALJ Katz's finding that plaintiff had no extended episodes of decompensation was amply supported by the record (Tr. 19). Plaintiff reported to Dr. Helprin that she was never hospitalized due to her psychiatric impairments (Tr. 258). In her Mental Impairment Questionnaire, LCSW Spada checked a box indicating that plaintiff had between one and two episodes of decompensation of sufficient duration, but her treatment notes, as well as the entire medical record, do not contain any evidence supporting LCSW Spada's assertion (Tr. 347).

ALJ Katz's conclusion that plaintiff's condition failed to meet the requirements of paragraph C is also supported by substantial evidence; plaintiff does not appear to challenge this finding. As discussed above, there was no evidence of repeated episodes of decompensation as defined in the Act, nor was there any evidence that plaintiff lacked the capacity to adapt to environmental changes or demands that she was not already familiar with. 20 C.F.R. Pt. 404, Subpt. P, App'x 1 §§ 12.04(c), 12.06(c).

Plaintiff appears to argue in the alternative that this case should be remanded so that the Commissioner can apply the revised listings that went into effect after ALJ Katz's decision (Pl.'s Mem. at 20-21). Plaintiff merely notes that the revised listings no longer require that a claimant has "marked" difficulties in activities of daily living as one of the four paragraph B criterion, but does not explain how the objective medical record would support a finding that plaintiff's mental impairments would meet or medically equal the requirements set forth in the revised listings (Pl.'s Mem. at 20-21). As noted above at footnote 27, the revisions to listings 12.04 and 12.06 became effective on January 17, 2017. To satisfy paragraph B of the revised listings, must show that her mental impairment resulted in "marked" limitations in at least two of the following:

In revising mental impairment listings, the SSA expressly stated that "we expect that Federal courts will review our final decisions using the rules that were in effect at the time we issued the decisions." 81 Fed. Reg. 66, 138 n.1 (Sept. 26, 2016). Moreover, in reviewing a denial of DIB or SSI benefits, Judges in this district generally apply the regulations that were in effect at the time of the Commissioner's decision. See e.g., Jenkins v. Acting Comm'r of Soc. Sec., supra, 2017 WL 4217147 at *7 n.7; Paredes v. Comm'r of Soc. Sec., supra, 2017 WL 2210865 at *11 n.13. Plaintiff provides no good reason to justify a departure from this practice.31

Accordingly, substantial evidence supports ALJ Katz's determination that plaintiff did not have an impairment or combination of impairments that either met or were medically equivalent to the listings in 20 C.F.R. Part 404, Supt. P, App'x 1, §§ 12.04(B), 12.06(B) and, thus, plaintiff was not entitled to a finding of disability per se.

3. ALJ's Analysis at Step 4: Mental RFC Assessment

Plaintiff contends that ALJ Katz's mental RFC assessment was flawed because ALJ Katz failed to apply the treating physician rule correctly when he failed to accord controlling weight to LCSW Spada's opinions and findings (Pl.'s Mem. at 19-20). Plaintiff also claims that ALJ Katz's determination of plaintiff's mental RFC is unsupported by substantial evidence (Pl.'s Mem. at 20). The Commissioner argues that ALJ Katz adhered to the appropriate standards in making his mental RFC determination and that his conclusion that plaintiff retained the RFC to engage in unskilled work is supported by substantial evidence (Def.'s Mem. at 12-16, 16 n.7).

a. Application of the Treating Physician Rule

In considering the evidence in the record, the ALJ must afford deference to the opinions of a claimant's treating physicians. A treating physician's opinion will be given controlling weight if it is "well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in . . . [the] record." 20 C.F.R. §§ 404.1527(c)(2), 416.927(c)(2);32 see also Shaw v. Chater, 221 F.3d 126, 134 (2d Cir. 2000); Diaz v. Shalala, 59 F.3d 307, 313 n.6 (2d Cir. 1995); Schisler v. Sullivan, 3 F.3d 563, 567 (2d Cir. 1993).

"[G]ood reasons" must be given for declining to afford a treating physician's opinion controlling weight. 20 C.F.R. §§ 404.1527(c)(2), 416.927(c)(2); Schisler v. Sullivan, supra, 3 F.3d at 568; Burris v. Chater, 94 Civ. 8049 (SHS), 1996 WL 148345 at *4 n.3 (S.D.N.Y. Apr. 2, 1996) (Stein, D.J.). The Second Circuit has noted that it "`do[es] not hesitate to remand when the Commissioner has not provided "good reasons" for the weight given to a treating physician[']s opinion.'" Morgan v. Colvin, 592 F. App'x 49, 50 (2d Cir. 2015) (summary order), quoting Halloran v. Barnhart, 362 F.3d 28, 33 (2d Cir. 2004); accord Greek v. Colvin, 802 F.3d 370, 375 (2d Cir. 2015).

However, as explained by the Honorable Ronald L. Ellis, United States Magistrate Judge (retired), the Commissioner's regulations

Bailey v. Colvin, 15 Civ. 9287 (LTS) (RLE), 2016 WL 11272144 at *17 (S.D.N.Y. Dec. 13, 2016) (Ellis, M.J.) (Report & Recommendation), adopted in part at, 2017 WL 1102671 (S.D.N.Y. Mar. 24, 2017) (Swain, D.J.).

Therefore, ALJ Katz's decision to assign less weight to LCSW Spada's opinion based in part on the ground that she is not an acceptable medical source "is not in itself erroneous." Bailey v. Colvin, supra, 2016 WL 11272144 at *17, citing Everett v. Colvin, 15-CV-6215 (MAT), 2016 WL 524404 at *4 (W.D.N.Y. Feb. 10, 2015).33

b. LCSW Spada's Credibility

Citing SSR 06-03p, supra, 2006 WL 2329939, plaintiff argues that ALJ Katz failed to evaluate LCSW Spada's notes and opinions properly when he decided to accord them "little evidentiary weight" (Pl.'s Mem. at 19-20; Tr. 25). Plaintiff claims that ALJ Katz should have given more weight to LCSW Spada's opinion despite the fact that she is an "other source." (Pl.'s Mem. at 20). Had ALJ Katz done so, plaintiff argues, he would have found that plaintiff lacked the mental RFC for even unskilled work.

Social Security Ruling 06-03p provides, in pertinent part:

SSR 06-03p, supra, 2006 WL 2329939 at *2-*3.34

"SSR 06-03p further directs ALJs to use the same factors for the evaluation of the opinions of `acceptable medical sources' to evaluate the opinions of `medical sources who are not "acceptable medical sources,'" such as licensed social workers." Canales v. Comm'r of Soc. Sec., 698 F.Supp.2d 335, 344 (E.D.N.Y. 2010), citing 20 C.F.R. § 404.1527(d) and SSR 06-03p, supra, 2006 WL 2329939. Specifically, the Commissioner instructs that the following factors should be considered in weighing medical sources:

SSR 06-03p, supra, 2006 WL 2329939 at *2-*3.

Although SSR 06-03p contemplates situations in which, after application of the foregoing factors, "an opinion from a medical source who is not an `acceptable medical source' may outweigh the opinion of an `acceptable medical source,' including the medical opinion of a treating source[,]" SSR 06-03p, supra, 2006 WL 2329939 at *5, an ALJ has "full discretion to determine the appropriate weight to accord the opinion of an `other source' based on all the evidence before him." Veino v. Barnhart, 312 F.3d 578, 588 (2d Cir. 2002) ("Genuine conflicts in the medical evidence are for the Commissioner to resolve."), citing Richardson v. Perales, supra, 402 U.S. at 399; Porter v. Colvin, 14-CV-547S, 2016 WL 1084162 at *4 (W.D.N.Y. Mar. 21, 2016) ("[N]ot every factor for weighing opinion evidence will apply in every case." (quotation marks and citation omitted)); accord Canales v. Comm'r of Soc. Sec., supra, 698 F. Supp. 2d at 344; Figueroa v. Astrue, 04 Civ. 7805 (KMK) (LMS), 2009 WL 4496048 at *12 (S.D.N.Y. Dec. 3, 2009) (Karas, D.J.) (holding that ALJ satisfied requirements of SSR 06-03p where he assigned minimal weight to the opinion of a chiropractor after expressly noting that the chiropractor's opinion was "contradicted by the opinion of the consultative physician who is an acceptable medical source").

ALJ Katz determined that two of the factors set forth in SSR 06-03p — (1) LCSW Spada's potential bias in favor of plaintiff and (2) the inconsistencies between LCSW Spada's medical opinion and the objective medical record as a whole — warranted the conclusion that "little evidentiary weight be assigned to [LCSW Spada's opinions] to the extent they relied on her [treatment notes]" (Tr. 25). Moreover, ALJ Katz concluded that LCSW Spada's opinions were contradicted by the treatment notes of plaintiff's treating psychiatrist, Dr. Rathore, who evaluated plaintiff for "treatment" only (Tr. 25). In particular, ALJ Katz found it significant that the GAF scores Dr. Rathore assigned to plaintiff were longitudinally consistent, that Dr. Rathore consistently found plaintiff to have a good mood and to be alert and oriented to all spheres, that his mental examinations of plaintiff were within normal limits and that Dr. Rathore noted minimal side effects from plaintiff's medication (Tr. 21, 25).

Accordingly, ALJ Katz satisfied his obligation to "explain the weight given to" the opinion of LCSW Spada, an "other source, and his determination is supported by substantial evidence." See Porter v. Colvin, supra, 2016 WL 1084162 at *5 ("The [ALJ] should explain the weight given to opinions from these `other sources', or otherwise ensure that the discussion of the evidence allows a . . . reviewer to follow the [ALJ's] reasoning," (alterations in original), citing Piatt v. Colvin, 80 F.Supp.3d 480, 493 (W.D.N.Y. 2015); see Kuchenmeister v. Berryhill, 16 Civ. 7975 (HBP), 2018 WL 526547 at *20 (S.D.N.Y. Jan. 19, 2018) (Pitman, M.J.).

b. Whether the ALJ's RFC Determination Was Supported by Substantial Evidence

The regulations do not require an ALJ to refer to every piece of evidence that supports his RFC determination.

Campbell v. Astrue, 465 F. App'x 4, 6 (2d Cir. 2012).

At this step, ALJ Katz determined that plaintiff retained the RFC to perform "light exertional work", as defined in 20 C.F.R. §§ 404.1567(b) and 416.967(b), at the "unskilled level" (Tr. 20).

As explained at footnote 29, "unskilled work" is "work which needs little or no judgment to do simple duties that can be learned on the job in a short period of time[;] a person can usually learn to do the job in 30 days, and little specific vocational preparation and judgment are needed." 20 C.F.R. §§ 404.1568(a), 416.968(a). ALJ Katz's RFC determination that plaintiff was limited to performing unskilled work is supported by substantial evidence.

As ALJ Katz noted, his assessment of plaintiff's mental RFC was consistent with Dr. Alpert's assessment of plaintiff (Tr. 78-79). Specifically, Dr. Alpert found that plaintiff's memory was not impaired and that she was capable of: (1) carrying out very short and simple instructions, as well as detailed instructions, (2) maintaining attention and concentration for extended periods; (3) sustaining ordinary and routine work without special supervision; (4) working in coordination with or in proximity to others without being distracted; (5) making simple work-related decisions; (6) interacting appropriately with the general public and colleagues; (7) seeking assistance and asking questions when necessary; (8) maintaining socially appropriate behavior and adhering to basic standards of neatness and cleanliness and (9) setting realistic goals and making plans independently with others (Tr. 78-79). In addition, Dr. Alpert found that plaintiff was moderately limited in her ability to (1) perform activities within a schedule, maintain regular attendance and be punctual, (2) complete a normal workday or week without interruptions from her psychologically-based symptoms, (3) accept instructions and respond appropriately to criticism from supervisors, (4) respond appropriately to changes in the work setting and (5) perform at a consistent pace without interruptions (Tr. 78-79). However, these limitations are not, as ALJ Katz correctly determined, inconsistent with a finding that plaintiff retained the mental RFC to perform unskilled work. Bartell v. Comm'r of Soc. Sec., 5:13-CV-843 (GLS) (ESH), 2014 WL 4966149 at *3 (N.D.N.Y. Sept. 30, 2014) ("Various courts have held that when medical evidence demonstrates that a claimant can engage in simple, routine tasks or unskilled work despite limitations in concentration, persistence and pace, limiting a claimant to only unskilled work sufficiently accounts for such limitations."); accord Dillard v. Colvin, 13 Civ. 279 (LTS) (HBP), 2015 WL 556448 at *16 (S.D.N.Y. Feb. 6, 2015) (Swain, D.J.) (holding that ALJ's determination that plaintiff had the RFC to perform unskilled work despite some limitations in her ability to interact with the public)).

Moreover, ALJ Katz and Dr. Alpert's determination of plaintiff's mental RFC is supported by other substantial evidence in plaintiff's objective medical record, including the clinical findings of Dr. Rathore and the report of Dr. Helprin. 20 C.F.R. §§ 404.1527(e), 416.927(e); Shrack v. Berryhill, 3:16 CV 2064 (RMS), 2018 WL 2926564 at *10 (D. Conn. June 7, 2018) ("The Second Circuit has recognized . . . the opinions of non-examining sources may `override treating sources' opinions, provided they are supported by evidence in the record." quoting Schisler v. Sullivan, supra, 3 F.3d 563 at 1993). Dr. Rathore consistently found that plaintiff was alert, oriented to person, place and time, cooperative and in control of her impulses (Tr. 334-36, 338-39). Dr. Rathore repeatedly observed that plaintiff had logical thought processes, had a good mood and good judgment and lacked suicidal ideation, hallucination or delusion (Tr. 334-36, 338-39). Dr. Rathore accorded plaintiff GAF scores between 55 and 60, indicating "moderate" difficulty in social or occupational functioning. See Global Assessment of Functioning, supra.

Similarly, Dr. Helprin observed that plaintiff was oriented to person, place and time, had good insight and judgment and had an appropriate fund of knowledge given her experience (Tr. 260). After performing a variety of tests on plaintiff to assess her cognitive capabilities, Dr. Helprin found that plaintiff's ability to follow instructions, perform simple and complex tasks independently and to maintain a schedule were not impaired (Tr. 261). Dr. Helprin's finding that plaintiff had only "mild" limitations in her ability to maintain attention, concentration and pace, and was "moderately" restricted in her ability to make appropriate decisions and relate adequately with others is inconsistent with ALJ Katz's finding that plaintiff could perform work at the unskilled level. See SSR 85-15, 1985 WL 56857 at *4 (Jan. 1, 1985) ("[Unskilled] jobs ordinarily involve dealing primarily with objects, rather than with data or people.")

Accordingly, ALJ Katz did not err when he stated that LCSW Spada's opinion should be accorded "little weight", and his determination that plaintiff maintained the mental RFC to perform unskilled work was supported by substantial evidence in the record.

4. ALJ's Analysis at Step Five: Exclusive Reliance on the Grids

Plaintiff challenges ALJ Katz's conclusion that she could perform work that exists in significant numbers in the national economy. Specifically, plaintiff contends that ALJ's exclusive reliance on the Grids at step five in determining that plaintiff was "not disabled" under the Act was improper in light of plaintiff's nonexertional limitations (Pl.'s Mem. at 3).

As explained above, see supra Section III.A.2, exclusive reliance on the Grids is not appropriate where nonexertional limitations "significantly diminish [a claimant's] ability to work." Bapp v. Bowen, supra, 802 F.2d at 603; accord Butts v. Barnhart, supra, 388 F.3d at 383-84; Cruz v. Colvin, 12 Civ. 7346 (PAC) (AJP), 2013 WL 3333040 at *18 (S.D.N.Y. July 2, 2013) (Peck, M.J.) (Report & Recommendation), adopted at, 2014 WL 774966 (S.D.N.Y. Feb. 21, 2014) (Crotty, D.J.). Rather, where the claimant's nonexertional limitations are significant, the ALJ must consult with a vocational expert. See Cruz v. Colvin, supra, 2013 WL 3333040 at *19, quoting, Zabala v. Astrue, supra 595 F.3d at 410; see Selian v. Astrue, supra, 708 F.3d at 421 ("We have explained that ALJ cannot rely on the Grids if a non-exertional impairment has any more than a `negligible' impact on a claimant's ability to perform the full range of work, and instead must obtain the testimony of a vocational expert."). Where, the ALJ relies exclusively on the Grids, the ALJ must explain in his decision "why he treated the Grid[s] as dispositive despite evidence in the record of [a claimant's] nonexertional limitations[.]" Cruz v. Colvin, supra, 2013 WL 3333040 at *19.

ALJ Katz expressly found that plaintiff suffered from a depressive disorder and an anxiety disorder, and that these impairments were "severe" (Tr. 18). ALJ Katz further found that these impairments, in conjunction with other impairments, "caused a significant limitation in the claimant's ability to perform work activities on a sustained, remunerative basis. . . ." (Tr. 18). Despite these findings of severe nonexertional impairments that significantly limited plaintiff's ability to work, ALJ Katz went on to conclude that a finding of "not disabled" was mandated by the Grids:

(Tr. 27). As the authorities cited at pages 40-41 teach, ALJ Katz's exclusive and unexplained reliance on the Grids notwithstanding his finding that plaintiff suffered from severe nonexertional impairments that significantly limited her ability to work, was error.35 Even if ALJ Katz had implicitly considered and determined that exclusive reliance on the Grid was permissible given that plaintiff's nonexertional limitations did not significantly erode from plaintiff's capacity to perform unskilled work, he was obligated to explain that finding in his decision. See Maldonado v. Colvin, supra, 2017 WL 775829 at *18-*20 (S.D.N.Y. Feb. 28, 2017) (Pitman, M.J.); Cruz v. Colvin, supra, 2013 WL 3333040 at *19; see also Pratts v. Chater, 94 F.3d 34, 38-39 (2d Cir. 1996); Bapp v. Bowen, supra, 802 F.2d at 605-06.

The Commissioner argues that ALJ Katz's citation to SSR 85-15, supra, 1985 WL 56857 at *1, obviates his error. However SSR 85-15 "applies only where the claimant suffers solely from nonexertional impairments. . . . Whether plaintiff's non-exertional impairments by themselves, warrant a finding of disability does not resolve the question of whether all of plaintiff's impairments, taken together, warrant a finding of disability." Maldonado v. Colvin, supra, 2017 WL 775829 at *21, citing Burgin v. Astrue, 348 F. App'x 646, 647 (2d Cir. 2009) (summary order) ("The Commissioner is required to `consider the combined effect of all of [the claimant's impairments without regard to whether any such impairment, if considered separately, would be of sufficient severity' to establish eligibility for Social Security benefits."); see 20 C.F.R. §§ 404.1523, 416.923. Because plaintiff here suffers from both exertional and nonexertional limitations, ALJ Katz's reference to SSR 85-15 does not justify his exclusive reliance on the Grids. On remand, the ALJ should re-evaluate whether the Commissioner has shown that plaintiff's capability to perform the full range of unskilled light work was not significantly diminished by her physical and mental limitations. If the ALJ determines that plaintiff's nonexertional limitations are significant, the ALJ must secure the relevant testimony from a vocational expert.

IV. Conclusion

Accordingly, for all the foregoing reasons, I respectfully recommend that plaintiff's motion for judgment on the pleadings should be granted, that the Commissioner's motion should be denied and that this case be remanded to the SSA for further proceedings consistent with the foregoing.

V. OBJECTIONS

Pursuant to 28 U.S.C. § 636(b)(1)(C) and Rule 72 of the Federal Rules of Civil Procedure, the parties shall have fourteen (14) days from receipt of this Report to file written objections. See also Fed.R.Civ.P. 6(a). Such objections (and responses thereto) shall be filed with the Clerk of Court, with courtesy copies delivered to the Chambers of the Honorable George B. Daniels, III, 500 Pearl Street, Room 1310, New York, New York 1007 and to the Chambers of the undersigned, 500 Pearl Street, Room 1670, New York, New York 10007. Any requests for an extension of time for filing objections must be directed to Judge Daniels. FAILURE TO OBJECT WITHIN FOURTEEN (14) DAYS WILL RESULT IN A WAIVER OF OBJECTIONS AND WILL PRECLUDE APPELLATE REVIEW. Thomas v. Arn, 474 U.S. 140, 155 (1985); United States v. Male Juvenile, 121 F.3d 34, 38 (2d Cir. 1997); IUE AFL-CIO Pension Fund v. Herrmann, 9 F.3d 1049, 1054 (2d Cir. 1993); Frank v. Johnson, 968 F.2d 298, 300 (2d Cir. 1992); Wesolek v. Canadair Ltd., 838 F.2d 55, 57-59 (2d Cir. 1988); McCarthy v. Manson, 714 F.2d 234, 237-38 (2d Cir. 1983) (per curiam).