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Delk v. Astrue

March 4, 2009

TANGIA M. DELK, PLAINTIFF,
v.
MICHAEL J. ASTRUE, COMMISSIONER OF SOCIAL SECURITY, DEFENDANT.



The opinion of the court was delivered by: John T. Curtin United States District Judge

Plaintiff Tangia M. Delk initiated this action pursuant to section 405(g) of the Social Security Act, 42 U.S.C. § 405(g), to review the final determination of the Commissioner of Social Security (the "Commissioner") denying plaintiff's application for Social Security disability insurance ("SSDI") and Supplemental Security Income ("SSI") benefits. The Commissioner has filed a motion for judgment on the pleadings pursuant to Rule 12(c) of the Federal Rules of Civil Procedure (Item 9), and plaintiff has filed a cross-motion for summary judgment reversing the decision of the Commissioner (Item 16). For the following reasons, the Commissioner's motion is denied, plaintiff's cross-motion is granted, and the matter is remanded for calculation of benefits.

BACKGROUND

Plaintiff was born on January 11, 1963 (Tr. 31, 71).*fn1 She applied for SSDI and SSI benefits on August 28, 2002, alleging disability as of February 6, 2002, due to back, neck, and knee impairments (Tr. 25, 71-73, 610-612). Plaintiff's applications were denied on December 6, 2002, upon agency review by the Social Securty Administration ("SSA") (Tr. 25, 34-37, 613-618). Plaintiff requested a hearing, which was held on September 25, 2005, before Administrative Law Judge ("ALJ") Larry Banks (Tr. 25-32, 714-734). Plaintiff testified and was represented at the hearing by counsel.*fn2

By decision dated October 26, 2005, ALJ Banks found that plaintiff was not under a disability within the meaning of the Social Security Act (Tr. 22-32). Following the sequential evaluation process outlined in the SSA Regulations (see 20 C.F.R. Parts 404 (SSDI) and 416 (SSI)), the ALJ reviewed the medical evidence and determined that plaintiff's impairments, while severe, did not meet or equal the criteria of an impairment listed in the Regulations at 20 C.F.R. Part 404, Subpt. P, App. 1 (the "Listings") (Tr. 28). The ALJ considered plaintiff's allegations and testimony regarding her functional limitations, but found plaintiff to be "not totally credible" in this regard (Tr. 29). The ALJ then found that while plaintiff was unable to perform her past work as a housekeeper, plaintiff had the residual functional capacity ("RFC") for a full range of sedentary work (Tr. 29-31). Considering this RFC along with plaintiff's age (39 years old on the alleged disability onset date), educational background (limited, completed 11th grade), and work experience (unskilled), the ALJ determined that application of Rule 201.24 of the Medical-Vocational Guidelines set forth at 20 C.F.R. Pt. 404, Subpt. P, App. 2 (the "Grids"),*fn3 directed a finding that plaintiff was not under a disability at any time from February 6, 2002, through the date of the ALJ's decision (Tr. 31). The ALJ's decision became the Commissioner's final determination on February 16, 2007, when the Appeals Council denied plaintiff's request for review (Tr. 6-9).

Plaintiff filed this action on March 20, 2007, seeking judicial review pursuant to 42 U.S.C. § 405(g). In accordance with the court's routine scheduling order for dispositive motion practice in Social Security Appeals, the Commissioner moved for judgment on the pleadings, seeking affirmance on the ground that the ALJ's decision is supported by substantial evidence in the record (see Item 9). Plaintiff responded by cross-motion, seeking reversal of the Commissioner's determination, asserting that ALJ Banks erred in assessing plaintiff's credibility, the combined effect of plaintiff's multiple impairments, and the opinions of her treating physicians (see Item 16). Plaintiff also makes reference to the SSA's "fully favorable decision" on her second application for SSDI and SSI benefits (id., Ex. A), which was filed in May 2006 while the agency appeal was pending on her present application, and which plaintiff argues should be given binding effect in this court's "substantial evidence" inquiry.

DISCUSSION

I. Scope of Judicial Review

The Social Security Act states that upon district court review of the Commissioner's decision, "[t]he findings of the Commissioner . . . as to any fact, if supported by substantial evidence, shall be conclusive . . . ." 42 U.S.C. § 405(g). Substantial evidence is defined as evidence which "a reasonable mind might accept as adequate to support a conclusion."

Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229 (1938), quoted in Richardson v. Perales, 402 U.S. 389, 401 (1971); see also Tejada v. Apfel, 167 F.3d 770, 773-72 (2d Cir. 1999). Under these standards, the scope of judicial review of the Commissioner's decision is limited, and the reviewing court may not try a case de novo or substitute its findings for those of the Commissioner. Richardson, 402 U.S. at 401. The court's inquiry is "whether the record, read as a whole, yields such evidence as would allow a reasonable mind to accept the conclusions reached" by the Commissioner. Sample v. Schweiker, 694 F.2d 639, 642 (9th Cir. 1982), quoted in Winkelsas v. Apfel, 2000 WL 575513, at *2 (W.D.N.Y. February 14, 2000).

However, "[b]efore the insulation of the substantial evidence test comes into play, it must first be determined that the facts of a particular case have been evaluated in light of correct legal standards." Klofta v. Mathews, 418 F. Supp. 1139, 1141 (E.D.Wis. 1976), quoted in Gartmann v. Secretary of Health and Human Services, 633 F. Supp. 671, 680 (E.D.N.Y. 1986). The Commissioner's determination cannot be upheld when it is based on an erroneous view of the law that improperly disregards highly probative evidence. Tejada, 167 F.3d at 773.

II. Standard for Determining Eligibility for Disability Benefits

To be eligible for SSDI or SSI benefits under the Social Security Act, plaintiff must show that she suffers from a 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), and is "of such severity that [s]he is not only unable to do h[er] previous work but cannot, considering h[er] 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); see also 20 C.F.R. §§ 404.1505(a), 416.905(a). The Regulations set forth a five-step process to be followed when a disability claim comes before an ALJ for evaluation of the claimant's eligibility for benefits. See 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4). First, the ALJ must determine whether the claimant is presently engaged in substantial gainful activity. If the claimant is not, the ALJ must decide if the claimant has a "severe" impairment, which is an impairment or combination of impairments that "significantly limits [the claimant's] physical or mental ability to do basic work activities . . . ." 20 C.F.R. §§ 404.1520(c), 416.920(c). If the claimant's impairment is severe, the ALJ then determines whether it meets or equals the criteria of an impairment found in the Listings. If the impairment meets or equals a listed impairment, the claimant will be found to be disabled. If the claimant does not have a listed impairment, the fourth step requires the ALJ to determine if, notwithstanding the impairment, the claimant is capable of performing his or her past relevant work. Finally, if the claimant is not capable of performing the past relevant work, the fifth step requires that the ALJ determine whether the claimant is capable of performing other work which exists in the national economy, considering the claimant's age, education, past work experience, and residual functional capacity. See Curry v. Apfel, 209 F.3d 117, 122 (2d Cir. 2000); Reyes v. Massanari, 2002 WL 856459, at *3 (S.D.N.Y. April 2, 2002).

The claimant bears the burden of proof with respect to the first four steps of the analysis. If the claimant demonstrates an inability to perform past work, the burden shifts to the Commissioner to show that there exists other work that the claimant can perform. See Rosa v. Callahan, 168 F.3d 72, 77 (2d Cir. 1999). The Commissioner ordinarily meets his burden at the fifth step by resorting to the medical-vocational guidelines set forth in the Grids. However, where the Grids fail to describe the full extent of a claimant's physical limitations, the ALJ must "introduce the testimony of a vocational expert (or other similar evidence) that jobs exist in the economy which claimant can obtain and perform." Bapp v. Bowen, 802 F.2d 601, 603 (2d Cir. 1986).

As indicated above, ALJ Banks followed the sequential evaluation process in this case, and determined that plaintiff had not engaged in substantial gainful activity since her alleged onset date of February 6, 2002, when she was involved in a motor vehicle accident (Tr. 27-28). Upon review of the objective medical evidence, the ALJ found that plaintiff's discogenic and degenerative back disorders, while severe, did not meet the criteria of Listing 1.04 (Disorders of the Spine), and that no other Listings were implicated (Tr. 28). Based on the evidence contained in the reports of treating and consulting physicians, as well as plaintiff's testimony regarding her subjective complaints, the ALJ found that plaintiff had the RFC for a full range of sedentary work which, considered along with her age, education, and work experience, and by application of Rule 201.24 of the Grids, directed a finding that plaintiff was not disabled because there were a significant number of jobs in the national economy she could perform (Tr. 29-31).

Plaintiff contends that these findings were based on a misapplication of the Regulations governing the assessment of credibility, the combined effect of multiple impairments, and the opinions of treating physicians. Plaintiff also contends that the court should consider the SSA's favorable determination on her second application to be binding on the Commissioner, or at ...


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