WILLIAM M. SKRETNY, District Judge.
1. Plaintiff Tamika S. Alexander brings this action pursuant to the Social Security Act ("the Act"), seeking review of the final decision of the Commissioner of Social Security that denied her applications for disability insurance benefits ("DIB") and Supplemental Security Income ("SSI") under Titles II and XVI of the Act. (Docket No. 1). The Court has jurisdiction over this action under 42 U.S.C. § 405(g).
2. Plaintiff protectively filed applications for DIB and SSI on February 28 and September 9, 2015, respectively. (R.
3. On May 6, 2016, ALJ Raymond L. Souza held a video hearing at which Plaintiff—assisted by counsel—and vocational expert ("VE") Stella Doering appeared and testified. (R. at 26-49). At the time of the hearing, Plaintiff was 35 years old (R. at 29, 51), with at least an 11th grade education (R. at 30), and past work experience as a garment presser and a cosmetics presser. (R. at 30-31, 47, 148).
4. ALJ Souza considered the case de novo and, on June 29, 2016, issued a written decision denying Plaintiff's applications. (R. at 14-21). The Appeals Council denied Plaintiff's request to review the ALJ's decision on May 18, 2017. (R. at 1-4).
5. Plaintiff filed the current action, challenging the Commissioner's final decision,
6. A court reviewing a denial of disability benefits may not determine de novo whether an individual is disabled.
7. "To determine on appeal whether an ALJ's findings are supported by substantial evidence, a reviewing court considers the whole record, examining the evidence from both sides, because an analysis of the substantiality of the evidence must also include that which detracts from its weight."
8. The Commissioner has established a five-step sequential evaluation process to determine whether an individual is disabled within the meaning of the Act.
9. The five-step process is as follows:
10. Although the claimant has the burden of proof on the first four steps, the Commissioner has the burden of proof on the fifth and final step.
11. ALJ Souza analyzed Plaintiff's claim for benefits under the process set forth above. At step one, the ALJ found that Plaintiff has not engaged in substantial gainful activity since January 2, 2013, the alleged onset date. (R. at 16). At step two, the ALJ found that Plaintiff's schizophrenia and depression are severe impairments.
12. Next, the ALJ determined that Plaintiff had the residual functional capacity ("RFC") to perform a full range of work at all exertional levels, but with the following nonexertional limitations: "[Plaintiff] should not work at unprotected heights or around moving mechanical parts, and she is limited to simple. routine tasks (SVP 1-2) with only occasional interaction with the public, co-workers, and supervisors." (R. at 18-21). At step four, the ALJ found Plaintiff capable of performing her past relevant work as a garment presser. (R. at 21). Accordingly, the ALJ found that Plaintiff is not disabled.
13. Plaintiff argues that the ALJ's decision "fails to provide a clear basis for finding that [P]laintiff's episodes of decompensation did not meet [...] Listing [12.03(C)(1)]." (Docket No. 10 at 9). For the reasons that follow, this argument fails.
14. Under SSA regulations in effect during the relevant period
C.F.R. Pt. 404, Subpt. P, App'x 1, § 12.03(C)(1)
15. "Episodes of decompensation are exacerbations or temporary increases in symptoms or signs accompanied by a loss of adaptive functioning, as manifested by difficulties in performing activities of daily living, maintaining social relationships, or maintaining concentration, persistence, or pace."
16. In this case, it is undisputed that Plaintiff experienced five periods of decompensation, each of which included a period of hospitalization as follows:
(Docket No. 10 at 8); (R. at 17).
17. Listing 12.03 is met when a claimant has experienced episodes of decompensation that meet certain frequency and durational criteria.
18. These criteria may also be met if an ALJ judges the duration and functional effect of "more frequent episodes of shorter duration or less frequent episodes of longer duration" to be of "equal severity."
19. Defendant contends that substantial evidence supports the ALJ's determination that Plaintiff's schizophrenia does not meet or medically equal the relevant Listing criteria. (Docket No. 12 at 19).
20. Here, the ALJ found that "[a]s for periods of decompensation, [Plaintiff] has experienced three episodes of decompensation, each of extended duration." (R. at 17). Specifically, the ALJ found that "[Plaintiff] had inpatient treatment in 2013 with one episode of extended duration from August 26, 2013 to September 9
21. Plaintiff disputes the ALJ's determination that her schizophrenia does not meet the criteria of Listing 12.03 as clear error, stating "there is no question that [P]laintiff's episodes of decompensation each lasted well in excess of two weeks" and thus "the `C' criteria of Listing 12.03 are satisfied." (Docket No. 10 at 9).
22. Of Plaintiff's five episodes of decompensation, the only three that occurred within any rolling 12-month period of each other occurred in 2013. That year, Plaintiff was hospitalized for 12 days in March (R. at 217-19), for 4 days in June (R. at 220-25), and for 11 days in August/September (R. at 241-96).
23. Plaintiff experienced a fourth episode of decompensation more than a year later, in November 2014 (R .at 363-419), and a fifth episode several months after that in February/March 2015 (R .at 420-77). However, neither of these episodes occurred within one year of any third episode as required to meet the frequency criterion of Listing 12.03.
24. With respect to the three episodes in 2013, Plaintiff acknowledges that none of these hospital stays lasted for at least two weeks. (Docket No. 10 at 8-9). Nevertheless, Plaintiff maintains that "the medical evidence [...] establishes that each of [P]laintiff's five documented episodes of decompensation lasted for more than two weeks."
25. Plaintiff's first hospitalization, on March 15, 2013, occurred prior to any diagnosis or treatment of her psychiatric conditions. (R. at 217). At that time, Plaintiff had no known past psychiatric history and was taking no medication but was observed behaving "in a bizarre manner during a meeting" at her daughter's school.
26. Plaintiff's mother bought her to the hospital for psychiatric evaluation. (R. at 217). Plaintiff exhibited paranoia, disorganized thoughts, irritable mood, and restricted affect.
27. Plaintiff was diagnosed with psychosis, not otherwise specified, and schizophreniform disorder was ruled out. (R. at 218). The record indicates Plaintiff responded adequately to medication with no side effects and upon discharge on March 27, 2013, Plaintiff had no suicidal ideations, no auditory or visual hallucinations, her mood was improved, and she was deemed "ready for outpatient followup."
28. On June 2, 2013, Plaintiff was again hospitalized after she became agitated while at her sister's house and was reportedly "in the streets screaming." (R. at 220). Plaintiff had stopped taking her prescribed medications "as soon as the prescription ran out," "because she felt it was making her back fat."
29. A mental status examination found Plaintiff to be paranoid and seemingly delusional, as well as somewhat vague in thought content. (R. at 221). Plaintiff's insight and judgment were limited, and she did not understand why she was hospitalized.
30. Plaintiff was discharged home on June 7, 2013, "showing no clear psychotic symptoms" and having denied "any suicidal or homicidal ideation." (R. at 224-25). It was also noted that "[Plaintiff] is making good future plans, and has a supportive family" and "[s]he is agreeable to tak[ing] medications."
31. On August 26, 2013, Plaintiff's mother brought her to the hospital once again. (R. at 226). This time, Plaintiff presented with auditory hallucinations and psychosis and stated that she had been unable to sleep because she had been hearing voices in her head for the past two weeks.
32. Hospital records note Plaintiff "has not taken her meds since being discharged in [A]pril this year." (R. at 226). Plaintiff's treatment noncompliance was confirmed by her mother, who stated, "[Plaintiff] never followed up with outpatient services" (R. at 226) and "had not been compliant with any medications other than possibly Adderall," which may have exacerbated her condition (R. at 242).
33. With prescribed medication, Plaintiff "continued to improve." (R. at 242). Kyle Wiktor, N.P. stressed the importance of Plaintiff's continued compliance with treatment and spoke with both Plaintiff and her mother about the fact that "[Plaintiff's] prognosis is going to be determined by her medication compliance."
34. It is well-settled that "[g]enuine conflicts in the medical evidence are for the Commissioner to resolve."
35. In arguing that the ALJ erred in finding that Plaintiff's schizophrenia does not meet Listing 12.03, Plaintiff asks this Court to find that the length of Plaintiff's hospitalizations is not substantial evidence of the duration of her episodes of decompensation. However, Plaintiff does not provide caselaw to support this position, and instead relies solely on vague statements from family members about Plaintiff's allegedly "bizarre" behavior preceding her hospitalizations.
36. In fact, courts have frequently found that the length of a psychiatric hospitalization is substantial evidence of the duration of a claimant's episodes of decompensation.
37. Contrary to Plaintiff's assertions, her family members' statements about Plaintiff's behavior prior to each admission do not clearly establish that "[P]laintiff's episodes of decompensation each lasted well in excess of two weeks." (Docket No. 10 at 9). Far from constituting compelling proof of a totally disabling condition, these statements fail to give examples or details regarding Plaintiff's allegedly "bizarre" behavior and are equally vague with respect to timing of the episodes.
38. Moreover, each time Plaintiff was hospitalized in 2013, her symptoms were effectively addressed with medication and resolved in less than two weeks. For these reasons, this Court finds that substantial evidence supports the ALJ's determination that Plaintiff's schizophrenia does not meet the decompensation criteria of Listing 12.03.
39. Plaintiff also argues the ALJ erred in considering her noncompliance with prescribed medications. (Docket Nos. 10 at 8, 13 at 1). Referencing the RFC determination, Plaintiff claims that the ALJ found her not disabled "because [...] [P]laintiff's hospitalizations and/or episodes of decompensation were attributable to her willful noncompliance with her psychiatric medication."
40. This is a distortion of the ALJ's holding. In determining Plaintiff's RFC, the ALJ first considered "whether the `paragraph C' criteria are satisfied" and found no evidence of "repeated episodes of decompensation, each of extended duration." (R. at 17-18). As detailed above, the ALJ noted that "some" of Plaintiff's multiple hospitalizations "met the definition for extended duration."
41. This Court finds no legal error in this discussion. As explained above, substantial evidence supports a finding that Plaintiff's episodes of decompensation do not meet the frequency and durational criteria of Listing 12.03. This evaluation is unchanged regardless of whether Plaintiff decompensated because of willful noncompliance with treatment or otherwise.
42. Thus, Plaintiff's argument that she "has a justifiable excuse for her noncompliance insofar as this behavior was and is a product of her disabling mental illness" is irrelevant to the question of whether the ALJ's decision is supported by substantial evidence and does not warrant remand.
IT HEREBY IS ORDERED, that Plaintiff's Motion for Judgment on the Pleadings (Docket No. 10) is DENIED.
FURTHER, that Defendant's Motion for Judgment on the Pleadings (Docket No. 12) is GRANTED.
FURTHER, that the Clerk of Court is directed to CLOSE this case.
SO ORDERED.