disabled and the onset of his disability occurred prior to June 30, 1991. The plaintiff also points to (1) the November, 1991 residual functional capacity evaluation performed by Dr. Ringler, which allegedly indicates that Davis' range of physical exertion was less than sedentary, and (2) the November, 1990 emergency room diagnosis of a lumbar sprain.
The plaintiff also contends that the ALJ "mechanically" applied the GRID to determine Davis' non-disability. According to the plaintiff, Davis' age of forty nine years and nine months placed him in a borderline situation with respect to the GRIDs category for age. Davis argues that this borderline situation should have been considered by the ALJ in determining Davis' entitlement for disability, and that the mechanical application of the GRID with regard to Davis' age was erroneous.
On the other hand, the United States contends that the ALJ properly determined that Davis was not disabled prior to June 30, 1991, and that there was substantial evidence in the record to support this determination. Moreover, the United States contends that the ALJ's determination of non-disability based on the GRID was in every way proper. Accordingly, the United States moves pursuant to Rule 12(c) for a judgment on the pleadings in its favor.
STANDARDS OF REVIEW
Judgment on the Pleadings.
Judgment on the pleadings is appropriate where material facts are undisputed and a judgement on the merits is possible merely by considering the contents of the pleadings. Sellers v. M.C. Floor Crafters, Inc., 842 F.2d 639, 642 (2d Cir. 1988). In considering a motion for judgment on the pleadings, the court must accept as true all of the non-movant's well pleaded factual allegations, and draw all reasonable inferences therefrom in favor of the non-movant. Davidson v. Flynn, 32 F.3d 27, 29 (2d Cir. 1994); DeSantis v. United States, 783 F. Supp. 165, 168 (S.D.N.Y. 1992). Unless it appears beyond doubt that the plaintiff can prove no set of facts in support of his or her claim which would entitle the plaintiff to relief, the court can not grant a defendant's motion for judgment on the pleadings. Sheppard v. Beerman, 18 F.3d 147, 150 (2d Cir.) (when deciding a Rule 12(c) motion, the court applies the same standard as that applicable to a 12(b)(6) motion), cert. denied, 130 L. Ed. 2d 28, 115 S. Ct. 73 (1994);
Review of the Secretary's Decision.
The Court may set aside the Secretary's determination only if it is based upon legal error, or is not supported by substantial evidence in the record as a whole. Cruz v. Sullivan, 912 F.2d 8, 11 (2d Cir. 1990); Berry v. Schweiker, 675 F.2d 464, 467 (2d Cir. 1982). Substantial evidence is defined as what a reasonable mind might accept as adequate to support a conclusion. Such evidence is more than a scintilla, but less than a preponderance of the evidence. Richardson v. Perales, 402 U.S. 389, 401, 91 S. Ct. 1420, 1427, 28 L. Ed. 2d 842 (1971).
Moreover, as long as the Secretary's view is supported by substantial evidence, this Court cannot substitute its judgment for that of the Secretary's. Parker v. Harris, 626 F.2d 225, 232 (2d Cir. 1980).
When reviewing claims for disability, the weight assigned to various medical evidence by the Secretary is governed by the "treating source" rule, also known as the "treating physician" rule. As specified in 20 C.F.R. §§ 404.1527(d) and (d)(2), the rule provides that the treating physician's opinion as to the claimant's disability is controlling if it is well supported by medically acceptable clinical and laboratory diagnostic techniques, and is not inconsistent with the other substantial evidence in the record.
If the treating physician's opinion is not supported by medically acceptable techniques or is inconsistent with the substantial evidence, then the weight to be given to the opinion is determined by considering the following factors: (i) the length of the treatment relationship and the frequency of examination; (ii) the nature and extent of the treatment relationship; (iii) the relevant evidence supporting the opinion; (iv) the consistency of the opinion with the record; (v) whether the opinion is from a specialist; and (vi) other relevant information provided by the claimant to support the opinion. See 20 C.F.R. § 404.1527(d); Schisler v. Sullivan, 3 F.3d 563, 567 (2d Cir. 1993).
At the time of the ALJ's decision in this case the SSA had not promulgated the treating source rule. The ALJ had, instead, followed a more expansive version of the treating source rule formulated by the Second Circuit in Schisler v. Bowen, 851 F.2d 43, 46-47 (2d Cir. 1988). A comparison of the court's rule with agency's final rule is set forth in Schisler v. Sullivan, 3 F.3d at 567-68 (approving the agency rule and directing that it be followed by courts in this Circuit). Under the rule of United States v. Schooner Peggy, 5 U.S. 103, 2 L. Ed. 49 (1801), this Court is bound to follow the later agency rule in reviewing the ALJ's decision on appeal. See id. at 110 ("If . . . . before the decision of the appellate court, a law intervenes and positively changes the rule which governs, the law must be obeyed."); Axel Johnson Inc. v. Arthur Andersen & Co., 6 F.3d 78, 84 (2d Cir. 1993).
Preliminarily, the Court notes that the plaintiff must be insured for disability in order to qualify for disability benefits. See 42 U.S.C. §§ 423(a) and 423(c) (setting forth definition of insured status). If a claimant becomes disabled after their insured status has lapsed, they are not entitled to disability benefits. See Jones v. Sullivan, 949 F.2d 57, 58 (2d Cir. 1991); Arnone v. Bowen, 882 F.2d 34, 37-38 (2d Cir. 1989).
In this case, the parties agree that Davis' insured status lapsed as of June 30, 1991. As a result, Davis must prove that the onset of his disability occurred on or prior to that date in order to be entitled to disability benefits under Title II.
1. The Secretary's Decision That Davis Could Perform Sedentary Work is Not Supported by Substantial Evidence in the Record.