GUSTAVE DIAMOND, District Judge.
AND NOW, this
When the Acting Commissioner determines that a claimant is not "disabled" within the meaning of the Act, the findings leading to such a conclusion must be based upon substantial evidence. "Substantial evidence has been defined as `more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate.'"
Despite the deference to administrative decisions required by this standard, reviewing courts "`retain a responsibility to scrutinize the entire record and to reverse or remand if the [Commissioner's] decision is not supported by substantial evidence.'"
Plaintiff filed his application for SSI on April 29, 2011, alleging disability due to right fifth toe amputation, diabetes, asthma, obesity and difficulty comprehending. Plaintiff's application was denied. At plaintiff's request, an ALJ held a hearing on October 2, 2012, at which he appeared and testified while represented by counsel. On November 20, 2012, the ALJ issued a decision finding that plaintiff is not disabled. The Appeals Council denied plaintiff's request for review on July 12, 2013, making the ALJ's decision the final decision of the Commissioner. The instant action followed.
Plaintiff, who has a marginal education, was 35 years old when he applied for SSI and is classified as a younger individual under the regulations. 20 C.F.R. §416.963(c). Plaintiff has past relevant work experience as a security guard and video rental clerk, but he has not engaged in substantial gainful activity at any time since filing his SSI application.
After reviewing plaintiff's medical records and hearing testimony from plaintiff and a vocational expert at the hearing, the ALJ concluded that plaintiff is not disabled within the meaning of the Act. The ALJ first found that the medical evidence established that plaintiff suffers from the severe impairments of a history of right fifth toe amputation, gangrene of the toe, asthma, chronic obstructive pulmonary disease, diabetes, obesity and mild mental retardation; however, those impairments, alone or in combination, do not meet or equal the criteria of any of the listed impairments set forth in Appendix 1 of 20 C.F.R., Subpart P, Regulation No. 4 ("Appendix 1").
The ALJ next found that plaintiff retains the residual functional capacity to perform sedentary work with a number of additional limitations. Plaintiff is limited to standing and walking a total of two hours in an eight-hour work day, and he must have the opportunity to alternate between standing and sitting every hour. In addition, he is limited to occasional balancing, stooping, kneeling, crouching, crawling and climbing of ramps and stairs, but he is precluded from climbing ladders, ropes and scaffolds. Further, plaintiff must avoid exposure to extreme temperatures, wetness, humidity, fumes, odors, dusts, gases, poor ventilation and workplace hazards, such as moving machinery and unprotected heights. Finally, plaintiff is limited to performing simple, routine tasks with only short and simple work-related decisions and is restricted to few work place changes (collectively, the "RFC Finding").
The ALJ concluded that plaintiff is unable to perform his past relevant work because it exceeds his residual functional capacity. However, based upon testimony by a vocational expert, the ALJ determined that plaintiff is capable of performing other work that exists in significant numbers in the national economy, such as an order clerk, addresser/mail sorter or document preparer. Accordingly, the ALJ found that plaintiff is not disabled within the meaning of the Act.
The Act defines "disability" as the inability to engage in substantial gainful activity by reason of a physical or mental impairment that can be expected to last for a continuous period of at least twelve months. 42 U.S.C. §1382c(a)(3)(A). The impairment or impairments must be so severe that the claimant "is not only unable to do his previous work but cannot, considering his age, education and work experience, engage in any other kind of substantial gainful work which exists in the national economy.. . ." 42 U.S.C. §1382c(a)(3)(3).
The Social Security Regulations delineate a five-step sequential evaluation process for determining whether a claimant is disabled. The ALJ must assess: (1) whether the claimant is currently engaged in substantial gainful activity; (2) if not, whether he has a severe impairment; (3) if so, whether his impairment meets or equals the criteria listed in Appendix 1; (4) if not, whether the claimant's impairment prevents him from performing his past relevant work; and (5) if so, whether the claimant can perform any other work that exists in the national economy, in light of his age, education, work experience and residual functional capacity.
In this case, plaintiff challenges the ALJ's findings at steps 3 and 5 of the sequential evaluation process. At step 3, plaintiff claims that the ALJ erred by finding that he does not meet listing §12.05C for mental retardation. Plaintiff also argues that the ALJ's step 5 Finding is not supported by substantial evidence because the RFC finding and hypothetical question to the vocational expert did not account for his claimed need to lie down during the day. Although plaintiff's step 5 argument is without merit, we conclude that the ALJ erred at step 3 for the reasons explained below.
Plaintiff first challenges the ALJ's findings at step 3 of the sequential evaluation process. At step 3, the ALJ must determine whether the claimant's impairment meets or equals one of the listed impairments.
Plaintiff claims that the ALJ erred by finding that he does not meet listing §12.05C for mental retardation. That listing provides as follows:
20 C.F.R. Pt. 404, Subpt. P, App. 1, §§12.05, 12.05(C).
The United States Court of Appeals for the Third Circuit has held that in order to meet the requirements of §12.05C, a claimant "must i) have a valid verbal, performance or full scale IQ of 60 through 70, ii) have a physical or other mental impairment imposing additional and significant work-related limitations of function, and iii) show that the mental retardation was initially manifested during the developmental period (before age 22)."
Here, the ALJ found that plaintiff's verbal IQ score is 69, his performance IQ score is 64 and his full scale IQ score is 64, which meet the requirement of §12.05C that said scores must fall between 60 through 70.
The ALJ's analysis of whether plaintiff's condition satisfies the requirements of §12.05C is defective for two reasons. First, the ALJ's determination that plaintiff does not have a physical impairment that imposes an additional and significant work-related limitation of function is not supported by substantial evidence. The ALJ found that plaintiff has the severe impairments of a history of right fifth toe amputation, gangrene of the toe, asthma, chronic obstructive pulmonary disease, diabetes and obesity, and that the plaintiff's severe impairments caused functional limitations which she accommodated in crafting the RFC Finding. (R. 14, 18). Those findings satisfy the second requirement of §12.05C, that is, a physical or other mental impairment imposing additional and significant work-related limitation of function.
The ALJ also erred by failing to address whether plaintiff satisfies the third requirement of listing §12.05C, that is, whether mental retardation (which refers to significantly subaverage general intellectual functioning with deficits in adaptive functioning) initially manifested before plaintiff reached age 22.
In accordance with
Plaintiff next argues that the ALJ's step 5 finding is not supported by substantial evidence.
Contrary to plaintiff's position, the ALJ's detailed RFC Finding adequately accounted for all of his physical functional limitations that the evidence of record supported. Likewise, the ALJ's hypothetical question incorporated all of plaintiff's physical functional limitations supported by the evidence, including all of the factors that were included in the RFC Finding.
For the foregoing reasons, plaintiff's motion for summary judgment will be granted, the Acting Commissioner's motion for summary judgment will be denied, and this case will be remanded to the Acting Commissioner for further proceedings consistent with this Opinion.