DONETTA W. AMBROSE, Senior District Judge.
Plaintiff filed an application for disability insurance benefits pursuant to Titles II and XVI of the Social Security Act, based on allegations of mental and physical impairments, with a date of onset of August 24, 2012. Plaintiff's claim was denied initially and upon hearing before an administrative law judge ("ALJ"). The ALJ's decision denying benefits was issued on July 25, 2014. Subsequently, Plaintiff received an award of benefits dated November 24, 2015 (the "2015 Award"), based on an application filed soon after the ALJ denied his initial application. Before the Court are the parties' Cross-Motions for Summary Judgment. For the following reasons, Plaintiff's Motion will be denied, and Defendant's granted.
Judicial review of the Commissioner's final decisions on disability claims is provided by statute. 42 U.S.C. §§ 405(g) 6 and 1383(c)(3)7. Section 405(g) permits a district court to review the transcripts and records upon which a determination of the Commissioner is based, and the court will review the record as a whole.
A district court cannot conduct a
First, Plaintiff contends that the ALJ failed to properly consider the opinions of his treating physicians, Dr. Lamago and Dr. Wolz. In particular, he notes that Dr. Lamago indicated that Plaintiff was temporarily disabled, and that Dr. Wolz indicated on December 31, 2012 that Plaintiff would be off work pending reevaluation on January 28, 2013.
The ALJ gave little weight to the opinions of Drs. Lamago and Wolz. He explained that the opinions were not consistent with the medical record, which the ALJ thoroughly discussed, and because the physicians did not explain why Plaintiff would be disabled. Neither Dr. Wolz nor Dr. Lamago opined as to Plaintiff's functional capacity, in more than conclusory fashion; Plaintiff does not contend otherwise. Dr. Lomago simply checked "temporarily disabled" on a Pennsylvania Department of Welfare Employability Assessment Form, and listed Plaintiff's diagnoses. Similarly, Dr. Wolz simply authored a letter stating, "The above named patient will continue to be off work and will be re-evaluated for his condition at his next appointment." A treating physician's assertion that a plaintiff is "disabled" or "unable to work" is not dispositive of disability, which is an issue for the ALJ.
Next, Plaintiff complains that the ALJ erred in determining his residual functional capacity ("RFC"), because there is evidence that he cannot do the work noted in the RFC. Plaintiff points to his medical records, as well as his own testimony regarding fatigue and pain, and posits that they contradict the RFC. Similarly, Plaintiff argues that because he needs to lie down for an hour or so daily, and due to the fatigue reflected in his medical records, he would be off task more than ten percent of the workday. Thus, he says, the ALJ should not have ignored the vocational expert's testimony that being off task for that percentage would render a person unable to engage in work activity. It is true that "[r]arely can a decision be made regarding a claimant's [RFC] without an assessment from a physician regarding the functional abilities of the claimant."
Finally, Plaintiff asserts that Defendant's subsequent finding of disability entitles him to disability as alleged in his initial application. This argument rests on the 2015 Award, relating to Plaintiff's benefits application filed subsequent to the ALJ decision at bar. The Explanation of Determination accompanying the 2015 Award stated as follows:
In the face of new and material evidence, and good cause existing for not presenting that evidence to the ALJ, a Court may issue a so-called "sentence six remand" pursuant to 42 U.S.C. § 405(g). "[T]he materiality standard requires that there be a reasonable possibility that the new evidence would have changed the outcome of the Secretary's determination."
I note, first, that Plaintiff merely attaches Social Security Administration Documents relating to the 2015 Award, and argues that the new evidence relied on therein justifies remand. Plaintiff does not specify which particular evidence should be deemed new and material; likewise, the Explanation of Determination of the 2015 Award does not offer any indication of which evidence was material to its conclusion that Plaintiff was disabled on August 23, 2012. Because the Explanation of Determination lists only the dates of "reports received" for each piece of evidence, and those dates appear unrelated to the dates on which the evidence itself was generated, I am unable to conduct a complete assessment of materiality, novelty, and good cause, as required by applicable standards.
Nonetheless, the evaluation made possible by the record leads to the conclusion that Plaintiff has not met those standards. To the extent that the second decision relied on documents dated prior to the ALJ's decision, which were not presented to the ALJ, those documents are not new, and Plaintiff has not offered any explanation for a failure to present such documents to the ALJ. To the extent that Plaintiff relies on reports that, as he broadly asserts, "didn't exist" prior to the ALJ hearing, I will assume for present purposes that they are new and that Plaintiff had good cause for failing to present them to the ALJ. However, it appears that several of these are not material, as they facially do not relate to the time period for which benefits were denied. Instead, the physical capacity evaluation completed by Dr. Zaggers, as well as the assessment completed by Dr. Humphreys and Ms. Pearson, both completed post-hearing, specifically relate to Plaintiff's "current" condition on the date on which the forms were completed. Moreover, the record suggests that Plaintiff was not treated at Glade Run Lutheran Services, as well as by Dr. Zagger, until after the ALJ's decision. As regards other potentially new evidence on which the 2015 Award was based, I cannot definitively determine the nature or chronology of that evidence, and thus cannot conduct the required evaluation. In sum, the new decision, and the evidence on which it relies, is insufficient grounds for remand or reversal on the present state of the record.
While Plaintiff's argument appeals to one's sense of justice, it does so in vain, as applicable standards do not allow for overruling the ALJ's determination here. In sum, Plaintiff's Motion will be denied, and Defendant's granted. An appropriate Order follows.
AND NOW, this 6th day of October, 2016, it is hereby ORDERED, ADJUDGED, and DECREED that Plaintiff's Motion is denied, and Defendant's granted.