KAROLINE MEHALCHICK, Magistrate Judge.
This is an action brought under Section 1631(c)(3) of the Social Security Act, 42 U.S.C. § 1383(c)(3), seeking judicial review of the final decision of the Commissioner of Social Security ("Commissioner") denying Plaintiff Tanya Fitts's claim for supplemental security income under the Social Security Act. This matter has been referred to the undersigned United States Magistrate Judge on consent of the parties, pursuant to the provisions of 28 U.S.C. § 636(c) and Rule 73 of the Federal Rules of Civil Procedure. (Doc. 13; Doc. 14). For the reasons expressed herein, the Commissioner's decision shall be VACATED and this matter shall be REMANDED to the Commissioner to conduct a new administrative hearing.
Ms. Fitts was forty five years old when she filed the instant application for supplemental security income. (Admin. Tr. 29, Doc. 11-2, at 30). She testified that she attended special education classes in school until she dropped out at the end of her eleventh grade year. Ms. Fitts reported that she tried to get her GED, but could not pass the exam. (Admin. Tr. 45, Doc. 11-2, at 46). Ms. Fitts has past work at the light exertional level as a Cashier, Housekeeping Cleaner, and Fast Food Worker. As noted in her brief, Ms. Fitts's work history is somewhat sporadic. She has accrued only 13 quarters of covered earnings between 1993 and 2012 (the year she applied for benefits). (Admin. Tr. 157, Doc. 11-5, at 12). The sum of her lifetime earnings amounts to less than twenty thousand dollars. Id. Ms. Fitts initially alleged that she was unable to word due to her heart, back and hip pain, vertigo, migraines, and acid reflux. (Admin. Tr. 192, Doc. 11-6, at 30). After IQ testing conducted during the pendency of the Social Security Administration's review of her claim yielded scores indicative of borderline intellectual functioning, she added the allegation that her intellectual disability also contributed to her inability to work. (Admin. Tr. 217, Doc. 11-6, at 55).
In response to Ms. Fitts allegations that she attended special education classes in school, the Social Security Administration referred Ms. Fitts to Dr. Anthony Fischetto for IQ and achievement testing. (Admin. Tr. 338, Doc. 11-7, at 114). Ms. Fitts was examined by Dr. Fischetto on June 5, 2012. Dr. Fischetto observed that Ms. Fitts appeared to be "a little slow cognitively." (Admin. Tr. 331, Doc. 11-7, at 107). Dr. Fischetto administered the fourth edition of the Wechsler Adult Intelligence Scale ("WAIS-IV") and received the following results: Verbal Comprehension score of 66, Perceptual Reasoning Score of 73, Working Memory score of 77, Processing Speed score of 86, and Full Scale IQ score of 70. (Admin. Tr. 332, Doc. 11-7, at 108). Dr. Fischetto noted that Ms. Fitts's scores appeared to be valid and consistent with her degree of functional restriction. Dr. Fischetto diagnosed Ms. Fitts with a Borderline IQ. Id.
Dr. Fischetto also submitted a medical source statement expressing his opinions about Ms. Fitts's functional abilities. (Admin. Tr. 329-30, Doc. 11-7, at 105-06). Dr. Fischetto assessed that Ms. Fitts would be markedly limited in the following activities: understanding and remembering detailed instructions; carrying out detailed instructions; making judgments on simple work-related decisions; responding appropriately to changes in a routine work setting; and responding appropriately to work pressures in a usual work setting. Dr. Fischetto assessed that Ms. Fitts would be moderately limited in the following activities: understanding, remembering and carrying out short, simple instructions; and carrying out short, simple instructions. Dr. Fischetto assessed that Ms. Fitts would be slightly limited in the following activities: interacting appropriately with the public; interacting appropriately with supervisors, and interacting appropriately with co-workers. Further, despite Ms. Fitts's assurances that she was able to manage money, Dr. Fischetto opined that Ms. Fitts would only be able to do so with some assistance.
On June 14, 2012, nonexamining State Agency psychologist Erin Urbanowicz completed a psychiatric review technique (PRT) assessment in which she opined that Ms. Fitts had a medically determinable severe impairment of intellectual disability.
Ms. Fitts's claim was denied at the initial level of administrative review on June 18, 2012. Thereafter, she requested an administrative hearing. On November 22, 2013, Ms. Fitts appeared with a non-attorney representative before Administrative Law Judge ("ALJ") Patrick S. Cutter.
In the ALJ's January 2014 decision denying Ms. Fitts's claims, the ALJ found that Ms. Fitts had not engaged in substantial gainful activity, and that Ms. Fitts's alleged impairment of intellectual disability was one of several impairments that were both medically determinable and severe. At step three, however, the ALJ found that Ms. Fitts did not have an impairment or combination of impairments that met or medically equaled the severity of an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. With respect to listing 12.05 (intellectual disability) in particular, the ALJ found that:
The ALJ ultimately concluded that Ms. Fitts was not under a disability as defined in the Social Security Act because Ms. Fitts retained the ability to engage in other work that exists in significant numbers in the national economy.
Following the ALJ's denial of her claims, Ms. Fitts requested administrative review of the ALJ's decision by the Appeals Council of the Office of Disability Adjudication and Review. Together with her request, Ms. Fitts submitted additional medical evidence that was not before the ALJ when he issued his decision. (Admin. Tr. 4, Doc. 11-2, at 5; Admin. Tr. 549-555, Doc. 11-10, at 76-82). The Appeals Council denied Ms. Fitts's request for review on February 2, 2015, making the ALJ's January 2014 decision the Commissioner's final decision subject to review by this Court.
Ms. Fitts appealed the Commissioner's final decision by filing the complaint in this action on March 31, 2015, requesting "such relief as may be proper." (Doc. 1). On July 24, 2015, the Commissioner filed her answer. (Doc. 10). In her answer, the Commissioner maintains that the final decision denying Ms. Fitts's claim is correct and in accordance with the law and regulations, and that the ALJ's findings of fact are supported by substantial evidence. (Doc. 10 ¶5). Together with her Answer, the Commissioner filed a certified copy of the transcript of the entire record of proceedings relating to this case. (Doc. 11). This matter has been fully briefed by the parties and is now ripe for decision. (Doc. 12; Doc. 15; Doc. 16).
To receive benefits under Title XVI of the Social Security Act, the claimant must demonstrate an inability 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. § 1382c(a)(3)(A). To satisfy this requirement, the claimant must have a severe physical or mental impairment that makes it impossible to do his or her previous work or any other substantial gainful activity that exists in significant number in the national economy. 42 U.S.C. § 1382c(a)(3)(B).
In evaluating the question of whether a claimant is under a disability as it is defined in the Social Security Act, the Commissioner follows a five-step sequential evaluation process. 20 C.F.R. § 416.920(a). Under this process, the Commissioner must determine, in sequence: (1) whether the claimant is engaged in substantial gainful activity; (2) whether the claimant has a severe impairment; (3) whether the claimant's impairment meets or equals the severity of an impairment listed in 20 C.F.R. § 404, Subpart P, Appendix 1 ("Listing of Impairments"); (4) whether the claimant is able to do her past relevant work, considering his current residual functional capacity ("RFC");
When reviewing the Commissioner's final decision denying a claimant's application for benefits, this Court's review is limited to the question of whether the findings of the final decision-maker are supported by substantial evidence in the record. See 42 U.S.C. §1383(c)(3)(incorporating 42 U.S.C. §405(g) by reference); Johnson v. Comm'r of Soc. Sec., 529 F.3d 198, 200(3d Cir. 2008); Ficca v. Astrue, 901 F.Supp.2d 533, 536(M.D.Pa. 2012). Substantial evidence "does not mean a large or considerable amount of evidence, but rather such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Pierce v. Underwood, 487 U.S. 552, 565 (1988). Substantial evidence is less than a preponderance of the evidence but more than a mere scintilla. Richardson v. Perales, 402 U.S. 389, 401 (1971). A single piece of evidence is not substantial evidence if the ALJ ignores countervailing evidence or fails to resolve a conflict created by the evidence. Mason v. Shalala, 994 F.2d 1058, 1064 (3d Cir. 1993). But in an adequately developed factual record, substantial evidence may be "something less than the weight of the evidence, and the possibility of drawing two inconsistent conclusions from the evidence does not prevent [the ALJ's decision] from being supported by substantial evidence." Consolo v. Fed. Maritime Comm'n, 383 U.S. 607, 620 (1966). "In determining if the Commissioner's decision is supported by substantial evidence the court must scrutinize the record as a whole." Leslie v. Barnhart, 304 F.Supp.2d 623, 627 (M.D.Pa. 2003). The question before this Court, therefore, is not whether Ms. Fitts is disabled, but whether the Commissioner's finding that he is not disabled is supported by substantial evidence and was reached based upon a correct application of the relevant law. See Arnold v. Colvin, No. 3:12-CV-02417, 2014 WL 940205, at *1 (M.D.Pa. Mar. 11, 2014)("[I]t has been held that an ALJ's errors of law denote a lack of substantial evidence.")(alterations omitted); Burton v. Schweiker, 512 F.Supp. 913, 914 (W.D.Pa. 1981)("The Secretary's determination as to the status of a claim requires the correct application of the law to the facts."); see also Wright v. Sullivan, 900 F.2d 675, 678 (3d Cir. 1990)(noting that the scope of review on legal matters is plenary); Ficca, 901 F.Supp.2d at 536 ("[T]he court has plenary review of all legal issues . . . .").
In this case, Ms. Fitts has raised one assignment of error. She argues that the ALJ's determination that she did not meet listing 12.05C of 20 C.F.R. Part 404, Subpart P, Appendix 1 is not supported by substantial evidence because the ALJ did not apply the appropriate legal standard in finding that she did not suffer from "deficits in adaptive functioning consistent with listing-level intellectual disability." (Admin. Tr. 19, Doc. 11-2, at 20).
Listing 12.05 is as follows:
20 C.F.R. Part 404, Subpart P, Appendix 1 §12.05. "The structure of listing 12.05 is different from that of the other mental disorders listings." 20 C.F.R. Part 404 Subpart P, Appendix 1 §12.00A. In order to satisfy listing 12.05C, Ms. Fitts must meet the preliminary substantive requirement of the description ("significantly subaverage intellectual functioning with deficits in adaptive functioning"), the temporal requirement of the diagnostic description (onset of the impairment before age 22), and one of the four sets of criteria — in this case the paragraph C criteria. Id. ("If your impairment satisfies the diagnostic description in the introductory paragraph and any one of the four sets of criteria, we will find that your impairment meets the listing."). Here, the ALJ found that Ms. Fitts did not meet the preliminary substantive requirement of the diagnostic description, and as a result did not reach the issue of whether Ms. Fitts met the remaining criteria.
As an initial matter, the regulations that pertain to the diagnostic description of listing 12.05 do not purport to establish any standard for determining whether a claimant shows deficits in adaptive functioning that are consistent with a listing-level intellectual disability. Instead, the Social Security Administration has offered the following comment in explanation of its decision to not adopt a specific standard, or articulate a specific method of measurement:
Technical Revisions to Medical Criteria for Determinations of Disability, 67 Fed.Reg. 20018, 20022 (Apr. 4, 2002).
The issue raised by the parties in this matter is not unique. Several courts have grappled with the several issues relating to the obligations imposed by the Social Security Administration's 2002 comment, and remain divided on issues relating to the ALJ's evaluation of whether a claimant has adequately demonstrated deficits in adaptive functioning. One of the first cases to address such an issue was Barnes v. Barnhart, 116 F. App'x 934 (10th Cir. 2004)(not selected for publication). In Barnes, the Court reasoned that an ALJ's analysis was legally insufficient because it did not comply with the 2002 notice of proposed rulemaking requiring ALJs to choose and apply one of the measurement methods recognized and endorsed by a professional organization that deals with intellectual disability. Id. at 940. Conversely, the Seventh Circuit recently reached the opposite conclusion in Charette v. Astrue when it held that the ALJ is not required to use a specific measurement method when assessing deficits in adaptive functioning. 508 F.App'x 551 (7th Cir. 2013)(not selected for publication). District Courts have also remained divided on this issue. Some courts have held that an ALJ is required to adopt a definition and method of measurement recognized and endorsed by one of the professional organizations identified in the 2002 comment, see e.g., Lancaster v. Colvin, No. 15-cv-154, 2016 WL 705222 at *6 (W.D.Okla. Feb. 19, 2016)(remanding where the ALJ adopted his own standard of whether the capsule definition of intellectual disability was met); Thomas v. Colvin, No. 13-cv-267, 2014 WL 584048 at *11 (W.D.Pa. Feb. 14, 2014)(rejecting the Commissioner's argument that an ALJ is not required to articulate which standard or guideline he or she utilizes from one of the four major professional organizations in determining whether a claimant has deficits in adaptive functioning), while other courts have permitted an ALJ to improvise his or her own definition. Harper v. Colvin, No. 2:13-cv-00446, 2014 WL 1278094 (W.D.Pa. Mar. 27, 2014)(holding that an ALJ is permitted to improvise his own definition and method of measurement for deficits in adaptive functioning so long as he articulates that standard in his decision). At least one court formulated its own definition. Moore v. Colvin, No. 4:12-cv-3132, 2013 WL 5466910 at *15 (D.Neb. Sept. 30, 2013)(noting that the Eighth Circuit has not required the use of criteria endorsed by outside organizations, and has instead interpreted "deficits in adaptive functioning" as the inability to cope with the challenges of everyday life).
The Commissioner argues that because the ALJ in this case "honed in on whether [Ms. Fitts] showed an inability to cope with the challenges of ordinary life," and cited to at least some evidence in support of that determination, the ALJ's decision should be affirmed. (Doc. 15, at 12). The Court is not persuaded by the Commissioner's argument. As discussed above, this Court is charged with the responsibility of reviewing not only whether the Commissioner's findings of fact are supported by substantial evidence, but also whether this finding was based upon the correct application of the law. It is also well-established that in order to facilitate this review, an ALJ's decision must be accompanied by "a clear and satisfactory explication of the basis on which it rests." Cotter v. Harris, 642 F.2d 700, 704 (3d Cir. 1981). In choosing not to adopt one definition or method of measurement for deficits in adaptive functioning, the Social Security Administration leaves it to the ALJ to choose among existing standards, or perhaps even devise his own. When read in conjunction with Cotter, the Court finds that this open-ended approach to evaluating deficits in adaptive functioning does impose at least some obligation upon the ALJ to identify or articulate the standard used, if only so that this Court can fulfill its obligation to provide meaningful judicial review. See e.g., Thomas, 2014 WL 584048 at *11 ("Courts should not be required to guess what standard an ALJ has chosen to apply when conducting its substantial evidence review of the ALJ's decision."); Harper, 2014 WL 1278094 at *8 (affirming an ALJ's determination that a claimant did not have listing level deficits in adaptive functioning because the ALJ sufficiently explained the benchmark he used to arrive at his conclusion).
Further, to the extent that the Commissioner argues that remand is not warranted in this case because there is no possibility that remand would change the result in this case, the Court disagrees. Ms. Fitts testified that she attended special education beginning in elementary school, (Admin. Tr. 50, Doc. 11-2, at 51), was unable to pass her GED test, (Admin. Tr. 45, Doc. 11-2, at 46), has never had a driver's license, (Admin. Tr. 49, Doc. 11-2, at 50), does not know how to use a computer, (Admin. Tr. 54, Doc. 11-2, at 55), and has only a sporadic part-time work history. Moreover, although the ALJ notes that Ms. Fitts was able to care for her grandchildren, attend to her personal care, complete household tasks, cook, use public transportation, shop, handle money, and manage her finances independently, he failed to address Ms. Fitts' testimony establishing her level of functioning in each of these tasks. For example, Ms. Fitts reported that she cares for her grandchildren as best she can, but is not left alone with young children who are unable to care for themselves or left alone with any of her grandchildren for more than short visits. (Admin. Tr. 62, Doc. 11-2, at 63). Ms. Fitts reported that she is able to use public transportation, but is unable to do so without assistance. She relies on her ex-husband, and bus drivers to know which bus to take. (Admin. Tr. 61, Doc. 11-2, at 62). Last, although Ms. Fitts reported that she could count money and bring it somewhere to pay a bill, she admitted that she has never managed her own finances or had a bill in her name. (Admin. Tr. 59-60, Doc. 11-2, at 61). Further, after meeting with Ms. Fitts, Dr. Fischetto opined that Ms. Fitts would be unable to manage her own finances without assistance. Based on this evidence, the Court finds that this is a borderline case requiring further review.
Based on the foregoing, the Commissioner's final decision shall be
A remand under sentence four of 42 U.S.C. § 405(g) requires the Court to enter a separate final judgment "affirming, modifying, or reversing the decision of the Commissioner" pursuant to Rule 58 of the Federal Rules of Civil Procedure. See Shalala v. Schaefer, 509 U.S. 292, 296-97 (1993); Kadelski v. Sullivan, 30 F.3d 399, 401 (3d Cir. 1994). Accordingly, the Clerk will be directed to enter final judgment in favor of Ms. Fitts.
An appropriate order shall follow.
While the Court does not make any findings of fact as to whether Ms. Fitts meets the other criteria of listing 12.05C, it notes that the record contains evidence that, if found credible by the ALJ, could satisfy the severity criteria of this listing. Ms. Fitts testified that she was in special education while in school. The result of her WAIS-IV IQ test revealed a full scale IQ of 70, and the ALJ found that Ms. Fitts suffered from other medically determinable severe impairments in addition to borderline intellectual functioning, including depressive disorder, cocaine and cannabis use disorder, arrhythmia, and obesity. See Revised Medical Criteria for Evaluating Mental Disorders and Traumatic Brain Injury, 65 Fed. Reg. 50746, 50772 (Aug. 21, 2000)("We have always intended the phrase ["significant work-related limitation of function"] to mean that the other impairment is a "severe" impairment, as defined in §§ 404.1520(c) and 416.920(c).").