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Tarsia v. Astrue

December 16, 2009

MARTHA E. TARSIA, PLAINTIFF,
v.
MICHAEL J. ASTRUE, COMMISSIONER OF SOCIAL SECURITY, DEFENDANT.



The opinion of the court was delivered by: David N. Hurd United States District Judge

MEMORANDUM-DECISION and ORDER

I. INTRODUCTION

Plaintiff Martha E. Tarsia ("plaintiff") brings this action pursuant to 42 U.S.C. §§ 405(g) & 1383(c)(3) to review a final decision of the Commissioner of Social Security denying plaintiff's application for Social Security disability and supplemental security income disability benefits ("benefits"). The parties filed their briefs, including the Administrative Record on Appeal (cited to as "R."), and the matter was submitted for decision without oral argument.

II. BACKGROUND

Plaintiff is currently 71 years old and began working as an optical inspector in 1961. In 1976, she underwent surgery on her left knee to treat a prior injury. Despite the surgery, her knee pain worsened over time, and she began to experience substantial difficulty walking or sitting for long periods. She alleges her physical limitations compelled her to retire from her job as an optical inspector on February 26, 1993.

In May of 1998, plaintiff's general practitioner, Dr. Peter LaFaso, treated plaintiff for diabetes and high blood pressure. An MRI performed in May of 1999 revealed advanced degenerative disease of her left knee. Plaintiff first filed an application for benefits on October 15, 1999. The Administrative Law Judge ("ALJ") denied her initial application on September 18, 2000. (R. at 18.) Although the Appeals Council denied plaintiff's request for review of the ALJ's decision on April 1, 2002 (id. at 5), the parties later stipulated to reverse and remand the ALJ's decision for a rehearing of plaintiff's application. (Id. at 159.) Following the rehearing, the ALJ again denied plaintiff's application on May 14, 2004 on the basis that she was not entirely credible and that her Residual Functional Capacity ("RFC") did not preclude her from participating in sedentary work. (Id. at 157.) Accordingly, the ALJ determined plaintiff was not disabled as defined within the Social Security Act on or prior to the date she was last insured, December 31, 1998. (Id.) In support of her second appeal, plaintiff submitted new opinion evidence from another evaluating physician, Dr. Irwin Rosenberg. (Id. at 137, 143.) On May 7, 2007, the Appeals Council again denied plaintiff's request for review of the ALJ decision, thereby rendering the ALJ's determination the final decision of the Commissioner of Social Security ("Commissioner"). (Id. at 137.)

III. SOCIAL SECURITY DISABILITY CLAIM DECISIONS

A. Standard of Review of a Final Decision

The scope of a court's review of the Commissioner's final decision is limited to determinating whether the decision is supported by substantial evidence and whether the correct legal standards were applied. Poupore v. Astrue, 566 F.3d 303, (2d Cir. 2009) (per curiam) (citing Machadia v. Apfel, 276 F.3d 103, 108 (2d Cir. 2002)); Martone v. Apfel, 70 F. Supp. 2d 145, 148 (N.D.N.Y. 1999) (citing Johnson v. Bowen, 817 F.2d 983, 985 (2d Cir. 1987)). "Substantial evidence means 'more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'" Poupore, 566 F.3d at 305 (quoting Consol. Edison Co. v. NLRB, 305 U.S. 197, 229, 59 S.Ct. 206, 217 (1938)). "To determine on appeal whether an ALJ's findings are supported by substantial evidence, a reviewing court considers the whole record, examining the evidence from both sides, because an analysis of the substantiality of the evidence must also include that which detracts from its weight." Williams v. Bowen, 859 F.2d 255, 258 (2d Cir. 1988) (citing Universal Camera Corp. v. NLRB, 340 U.S. 474, 488, 715 S.Ct. 456, 464 (1951)). If the disability determination is supported by substantial evidence, that determination is conclusive. Id. However, "where there is a reasonable basis for doubting whether the appropriate legal standards were applied," the decision should not be affirmed even though the ultimate conclusion reached is arguably supported by substantial evidence. Martone, 70 F. Supp. 2d at 148 (citing Johnson, 817 F.2d at 986).

A reviewing court may enter "a judgment affirming, modifying, or reversing the decision of the Commissioner of Social Security, with or without remanding the cause for a rehearing." 42 U.S.C. § 405(g); see Martone, 70 F. Supp. 2d at 148. "Remand is appropriate where there are gaps in the record or further development of the evidence is needed," such as where new, material evidence has become available. 42 U.S.C. § 405(g); Martone, 70 F. Supp. 2d at 148 (citing Parker v. Harris, 626 F.2d 225, 235 (2d Cir. 1980)). A remand for rehearing directing the taking of additional evidence is warranted only if it is shown that there is new, material evidence "'and that there is good cause for the failure to incorporate such evidence into the record'" at the administrative hearing. Carroll v. Sec'y of Health and Human Servs., 705 F.2d 638, 643-44 (2d Cir. 1983) (quoting 42 U.S.C. § 405(g), as amended in 1980)). Remand may also be appropriate if the Commissioner "misapplies the law or failed to provide a fair hearing." Id. at 644. However, where the underlying administrative decision is not supported by substantial evidence, reversal is appropriate because there would be no useful purpose in remanding the matter for further proceedings. Id. (reversing and remanding solely for calculation of benefits, subject to determination by the district court of any motion by the agency to remand to consider new evidence); Parker, 626 F.2d at 235 (reversing and remanding solely for calculation and payment of benefits); Simmons v. United States R.R. Ret. Bd., 982 F.2d 49, 57 (2d Cir. 1992) (same); Williams, 859 F.2d at 261 (same).

B. The Five Step Evaluation Process

The Social Security Act defines "disability" to include the "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. § 423(d)(1)(A). In addition, the Act requires that a claimant's physical or mental impairment or impairments [must be] of such severity that he 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, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work.

Id. § 423(d)(2)(A).

The ALJ must follow a five step evaluative process in determining whether an individual is disabled. See 20 C.F.R. ยงยง 404.1520, 416.920. In the first step the ALJ must determine whether the claimant is engaging in substantial gainful activity. If the claimant is engaging in substantial gainful activity, he is not ...


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