HUGH B. SCOTT, Magistrate Judge.
Before the Court are the parties' respective motions for judgment on the pleadings (Docket Nos. 10 (plaintiff), 11 (defendant Commissioner)). Having considered the Administrative Record, filed as Docket No. 7 (references noted as "[R. __]"), and the papers of both sides, this Court reaches the following decision.
This is an action brought pursuant to 42 U.S.C. § 405(g) to review the final determination of the Commissioner of Social Security that plaintiff is not disabled and, therefore, is not entitled to Supplemental Security Income benefits. The parties consented to proceed before a Magistrate Judge (Docket No. 13, reassignment Order, Oct. 4, 2019).
The plaintiff ("Iman Mahdi Mohamad" or "plaintiff") filed an application for disability insurance benefits on November 21, 2014 [R. 19]. That application was denied initially. The plaintiff appeared before an Administrative Law Judge ("ALJ"), who considered the case
Plaintiff commenced this action on November 9, 2018 (Docket No. 1). The parties moved for judgment on the pleadings (Docket Nos. 10, 11), and plaintiff duly replied (Docket No. 12). Upon further consideration, this Court then determined that the motions could be decided on the papers.
Plaintiff, a 42-year-old Iraqi refugee with an equivalent high school education, attended junior high school in Iraq and was fluent in Arabic but not in English [R. 410, 32, 23, 22, 24]. Plaintiff is a mother of two children (ages 7 and 11) [R. 24] but had no past relevant work [R. 32].
The ALJ deemed the following as severe impairments: reported anxiety disorder, possible intellectual impairment, personality disorder, and PTSD [R. 21]. Plaintiff also claims having ovarian cysts but the ALJ concluded that this was not severe because it was treatable for a limited duration and only slight work-related limitation [R. 21]. She also claimed as impairments left knee pain, psoriasis, and obesity [R. 21, 22, 410]. As for the knee pain, plaintiff was prescribed ice, anti-inflammatory, and exercises at home; the ALJ concluded that this was not a severe impairment [R. 21, 410]. Plaintiff's psoriasis was treated with ointment [R. 22]. As for plaintiff's obesity, she did not know her weight but during an examination she weighed 205 pounds and was 5'7", with a body mass index of 32.1 (with obesity deemed at 30), the ALJ factored in obesity in assessing her eligibility for disability coverage [R. 22, 391, 395].
Plaintiff claimed she was disabled due to PTSD and major depression [R. 24]. At Step Two of the five-step analysis (described below), the ALJ evaluated plaintiff's mental impairments under Listing 12.04, 12.06, 12.08, and 12.15 and "Paragraph B" criteria [R. 22]. The ALJ found that plaintiff had mild limitations for most of the "Paragraph B" criteria and moderate limitation for adapting or managing oneself, concluding that plaintiff did not meet those criteria [R. 22]. The ALJ also found that "Paragraph C" criteria were not met since the record did not show plaintiff did not have only marginal adjustment and that she was able to manage daily activities independently, can shop with her husband, and spend time with others [R. 22]. As for Listing 12.05, intellectual disorder, to meet this listing plaintiff needed to satisfy either "Paragraph A" or "Paragraph B" criteria for that listing and needed deficits in adaptive functioning [R. 23]. The ALJ then found that "Paragraph A" was not met because plaintiff was found to have participated in normal daily activities [R. 23, 269, 183-86]. ALJ concluded that plaintiff had no deficits in adaptive functioning [R. 23]. As for "Paragraph B" criteria, the ALJ found that these also were not met, since plaintiff did not have an IQ score 70 or below, or IQ score between 71 and 75 and verbal IQ of 70 or less and had no cognitive deficit concerns [R. 23]. Her treatment notes from January 16, 2015, found that plaintiff's fund of knowledge "seems at least average" [R. 262, 23].
At issue here are the opinions of the consultative psychologist and the medical expert retained to review plaintiff's medical records. Dr. Susan Santarpia, Ph.D., examined plaintiff for a psychiatric evaluation [R. 265]. Plaintiff's husband served as interpreter during the evaluation [R. 265]. Plaintiff reported PTSD, having left her mother's house in Iraq on an errand in 2006 when an explosion killed her mother; plaintiff felt guilt and dysphoric mood due to this [R. 265-66]. Plaintiff then moved to the United States in 2009, leaving behind family and not being present for the death of her father [R. 266]. Plaintiff reported that counseling at Lake Shore Behavioral Health and medication control and stabilize her symptoms [R. 266]. Dr. Santarpia noted mild impairment with attention and concentration due to difficulty with interpretation [R. 267]. While plaintiff reports not doing any cleaning, cooking, laundry or shopping, Dr. Santarpia states that plaintiff is able to manage her own money [R. 267]. Dr. Santarpia concluded that plaintiff could follow simple directions, perform simple tasks independently, maintain attention and concentration, maintain a regular schedule, learn new tasks, make appropriate decisions, relate adequately with others, and appropriately deal with stress within normal limits [R. 267, 30]. Dr. Santarpia recommended vocational training and rehabilitation [R. 268]. The ALJ then commented that this evaluation was consistent with psychiatric problems "but alone did not appear to be significant enough to interfere with daily functioning" [R. 30, 268].
The ALJ posed interrogatories to medical expert Dr. Alfred Jonas after the hearing [R. 453, 519, 19]. It is unclear from the record why a medical expert was called. On June 19, 2017, Dr. Jonas found it hard to conclude from the record to determine whether plaintiff met Listings 12.05, 12.06, 12.08, or 12.15 [R. 515, 23]. Since plaintiff's husband could only work for 20 hours a week to be home for the other time, Dr. Jonas concluded that plaintiff could manage during those 20 hours and care for herself and their two children, and then plaintiff could perform simple and many complex tasks [R. 510, 31]. Dr. Jonas guessed as to plaintiff's ability to interact with supervisors, co-workers and the public [R. 511,
On August 28, 2017, Dr. Jonas updated his findings, noting that nothing changed from his assessment of plaintiff's ability to understand, remember, and carry out instructions [R. 532] or her ability to interact with others [R. 533] or his earlier findings in general [R. 535, 536, 537]. Dr. Jonas did not know plaintiff's other capabilities (such as her ability to concentrate or her ability to adapt or manage herself) were affected by her impairment [R. 533]. Dr. Jonas found that plaintiff "seemingly [could] not" manage benefits in her own best interest [R. 534]. Dr. Jonas noted ambiguity between mental retardation and exaggerated portrayal of symptoms in plaintiff's testimony [R. 539]. The ALJ gave significant weight to Dr. Jonas' opinions [R. 32].
The ALJ found that plaintiff now had a residual functional capacity ("RFC") that she should avoid heavy exertion work, but she could perform medium exertion work [R. 23]. Plaintiff could lift/carry 50 pounds occasionally and 25 pounds frequently. A secondary possible mental impairment, she could understand, remember, and carry out instructions for routine, repetitive type of unskilled work. She could sustain attention and concentration for two-hour segments of time in and eight-hour day. She could tolerate brief and superficial contact with others on an occasional basis. She could adapt to changes in the work setting, for routine, repetitive type unskilled work. Plaintiff should avoid fast paced or high production goal work. [R. 23.]
The ALJ states that this RFC is supported by the medical evidence of record, the analysis of Dr. Jonas, psychological consultant Dr. Santarpia's assessment, plaintiff's conservative treatment of her ailments, her non-compliance with some of the treatment prescribed, her reported activities, and inconsistencies in other areas [R. 32, 31]. Assessing plaintiff's allegations, the ALJ concluded that her allegations were "less than fully consistent with the evidence," and the limitations in the RFC "contain all inferences regarding the claimant's impairments and the degree of severity thereof" [R. 32].
The ALJ posed hypotheticals to the vocational expert of a claimant with similar age, education, language fluency, work experience, and plaintiff's RFC and the expert opined that a hypothetical claimant that can perform medium or light unskilled work could perform medium exertion occupations such as kitchen helper, cleaner, laborer, conveyor feeder or light exertion occupation as a housekeeper, cleaner [R. 33, 54-56]. The ALJ asked a further hypothetical, what occupation could a claimant with plaintiff's age, education, work experience, language proficiency (not in English), having rare to no public contact perform [R. 33, 56-57]. The vocational expert replied that the number of housecleaning jobs erodes by half, but the medium cleaner occupation does not require public contact [R. 33, 57]. ALJ then asked if the hypothetical claimant is off task 25% of the workday, requires 2-3 unscheduled breaks, and would miss work 3-4 days a month; the vocational expert stated that such periods of being off task or not at work would preclude employment [R. 34, 57]. The ALJ rejected this last opinion because the evidence did not support the hypothetical limitations [R. 34]. Accepting the first opinion from the vocational expert, the ALJ concluded that plaintiff is not disabled [R. 34].
The only issue to be determined by this Court is whether the ALJ's decision that the plaintiff was not under a disability is supported by substantial evidence.
For purposes of both Social Security Insurance and disability insurance benefits, a person is disabled when unable "to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. §§ 423(d)(1)(A) & 1382c(a)(3)(A).
Such a disability will be found to exist only if an individual's "physical or mental impairment or impairments are of such severity that [he or she] is not only unable to do [his or her] previous work but cannot, considering [his or her] age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy. . . ." 42 U.S.C. §§ 423(d)(2)(A) & 1382c(a)(3)(B).
The plaintiff bears the initial burden of showing that the impairment prevents the claimant from returning to his or her previous type of employment.
In order to determine whether the plaintiff is suffering from a disability, the ALJ must employ a five-step inquiry:
20 C.F.R. §§ 404.1520 & 416.920;
To determine whether an admitted impairment prevents a claimant from performing past work, the ALJ is required to review the plaintiff's residual functional capacity and the physical and mental demands of the work that she has done in the past. 20 C.F.R. §§ 404.1520(e) & 416.920(e). When the plaintiff's impairment is a mental one, special "care must be taken to obtain a precise description of the particular job duties which are likely to produce tension and anxiety, e.g. speed, precision, complexity of tasks, independent judgments, working with other people, etc., in order to determine if the claimant's mental impairment is compatible with the performance of such work."
In the instant case, the issue is whether the ALJ had substantial evidence to support the decision rendered denying disability coverage. Plaintiff argues that the ALJ improperly relied on opinion of consultative examiner Dr. Santarpia [R. 26, 30, 265] and medical expert Dr. Jonas [R. 19, 31, 510, 532] (Docket No. 10, Pl. Memo. At 1, 13-15, 15-17). Plaintiff next contends that the ALJ failed to develop the record (
Defendant responds that the ALJ properly considered the medical opinions (Docket No. 11, Def. Memo. at 4-7) and properly developed the record (
In reply, plaintiff still contends that the ALJ improperly relied upon Drs. Jonas and Santarpia's opinions (Docket No. 12, Pl. Reply at 1-3). One part of the record not developed was the lack of intellectual testing noted by Dr. Jonas and not fully developed by the ALJ (
The ALJ has the discretion to call medical experts, but one commentator stated that they rarely do so, Frank Bloch,
The record here, however, appears not to be complex The ALJ referred the objective record to Dr. Jonas for his opinion [R. 19, 453, 519]. Plaintiff cautioned against the ALJ relying upon a non-treating, non-examining doctor's opinion such as was done here, especially evaluating the psychiatric diagnosis (Docket No. 10, Pl. Memo. at 16 (citing cases)). Plaintiff finds error in giving Dr. Jonas' opinion great weight because it violates standards in this Circuit and that Dr. Jonas never rendered an opinion (
The ALJ relies upon the opinions of Dr. Jonas and Dr. Santarpia but these opinions are inclusive and rely upon plaintiff's translated statements about her condition. Dr. Jonas asked if plaintiff was independent during the 20 hours a week her husband was at work [R. 510] but Dr. Santarpia reported that plaintiff did not perform household chores [R. 267], presumably during the 20 hours a week her husband was away at work. While Dr. Santarpia examined plaintiff Dr. Jonas reviewed her files before making his opinion [R. 453, 519] (
In
Similarly, Dr. Santarpia made findings based upon plaintiff's translated statements by her husband [R. 265] that the ALJ gave it some weight [R. 30]. This reliance, as discussed below, rests upon plaintiff's translated impressions of her mental condition.
Here in this case, plaintiff was treated by Dr. Myron Glick who noted her severe PTSD [R. 30-31, 368-69]. The ALJ, however, gave these assessments little weight concluding that `no work-precluding mental impairment is shown. The assessment appears to be based on the claimant's self-reports, i.e., limited daily activities" [R. 31]. Plaintiff also saw nurse practitioner Adrienne Roy to manage her medication [R. 257, 25, 26-29, 31]. The ALJ reviewed Ms. Roy's notations and the note from June 3, 2016, that plaintiff had not been in tears during that session; the ALJ concluded that they were not corroborated by other sessions [R. 29]. Ms. Roy noted in March 18, 2016, that plaintiff stated that she was completely nonfunctional at home [R. 423-24, 31]. The ALJ found, however, no significant health problem noted there [R. 31].
Dr. Jonas pointed out areas where he could not conclude because the facts were not clear to him [R. 513, 514, 515], pointing out ambiguities not resolved in the testimony [R. 535, 539] (Docket No. 10, Pl. Memo. at 17). As plaintiff accurately characterizes Dr. Jonas' presentation, the "`opinion' is merely a statement that he cannot given an opinion" (
Plaintiff argues that the ALJ erred in considering her credibility as to her subjective complaints (Docket No. 10, Pl. Memo. at 23-30). SSR 16-3p, effective March 16, 2016, replaced an earlier Social Security Ruling that called for assessment of the credibility of a claimant's statement (SSR 96-7p),
Ruling 16-3p eliminated credibility from "the `sub-regulatory policy' because the regulations themselves do not use that term. Instead, symptom evaluation tracks the language of the regulations,"
Unlike most cases, plaintiff's statements come into question because they come to us in translation. That issue is considered next in development of the record.
Plaintiff objects to how the ALJ developed the record, as noted by Dr. Jonas in his opinion of the gaps in the record that precluded a conclusion about plaintiff's mental condition (Docket No. 10, Pl. Memo. at 19). She also argues that these gaps thus led the ALJ to come to conclusions based on her lay understanding of the medical evidence (
The key issue here is that plaintiff is an Iraqi who is not fluent in English. Plaintiff testified through an Arabic interpreter [R. 19, 40, 42-43]. Defendant states that the ALJ cited plaintiff's use of an interpreter in factoring plaintiff's concentration (Docket No. 11, Def. Memo. at 12, 5) [R. 267]. Although all parties note that plaintiff was not fluent in English but was fluent in Arabic (Docket No. 10, Pl. Memo. at 12;
This case is distinguishable from
The present case, however, the ALJ did not find that plaintiff understood despite translation. Especially crucial since plaintiff's claims are for mental impairment, it was essential that the ALJ understood plaintiff's contentions and that plaintiff understood the questioning about her mental condition. This is not a case in which the ALJ failed to provide an interpreter for the ALJ hearing,
On the one hand, with her husband translating, plaintiff's subjective complaints may have been embellished, as Dr. Jonas concluded [R. 539, 32]. This is akin to the doubts expressed in
Plaintiff's recent past was traumatic, witnessing her mother's horrific death, leaving her native country and family, and not being present for her father's death, but it is not clear if these events caused her to have impairments that preclude her employment or do not. Upon re-examination (with an independent translator), a consultative evaluator may determine if these traumas created plaintiff's mental impairment and whether those impairments meet a relevant Listing or otherwise rendered her disabled.
For the foregoing reasons, plaintiff's motion (Docket No. 10) judgment on the pleadings is
So Ordered.