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Osborne v. Astrue

July 9, 2010




In June of 2003, Amanda L. Osborne ("Plaintiff") filed an application for supplemental security income benefits and disability insurance benefits under the Social Security Act ("the Act"). Plaintiff alleged that she had been unable to work since January 31, 2003. The Commissioner of Social Security ("the Commissioner") denied Plaintiff's application for lack of disability.

Plaintiff, through her attorney, commenced this action on March 26, 2007, by filing a Complaint in the United States District Court for the Northern District of New York. Compl. (Dkt. No. 1). Plaintiff seeks judicial review of the Commissioner's decision pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3).


The relevant procedural history may be summarized as follows. Plaintiff filed an application for disability and disability insurance benefits pursuant to the Social Security Act §§ 216(I) and 223, as amended, 42 U.S.C. §§ 416(I) and 423 on June 6, 2003. Compl. ¶ 4. Her application was initially denied on December 5, 2003. R. at 43-47.*fn1 Plaintiff timely filed a request for a hearing before an Administrative Law Judge ("ALJ") on December 29, 2003. R. at 48. On May 9, 2005, Plaintiff appeared before ALJ Christine McCafferty. R. at 16. The ALJ rendered her decision denying Plaintiff's application for benefits on June 23, 2005. R. at 13-28. Plaintiff appealed this decision to the Social Security Administration Appeals Council on July 18, 2005. R. at 12. On January 23, 2007, the Appeals Council refused to review the ALJ's ruling, thereby rendering it the Commissioner's final decision and exhausting Plaintiff's administrative remedies. R. at 6.

Plaintiff, acting through counsel, initiated the present action by filing a Complaint on March 26, 2007. Dkt. No. 1. The Commissioner interposed an Answer on September 4, 2007. Dkt. No. 9. Thereafter, Plaintiff filed a supporting Brief on October 12, 2007, Pl.'s Br. in Supp. (Dkt. No. 11), and the Commissioner filed a Brief in opposition on January 22, 2008, Def.'s Br. in Opp'n (Dkt. No. 14), each seeking judgment on the pleadings.


A. Standard of Review

District courts have jurisdiction to review claims contesting a final decision by the Commission of Social Security denying disability benefits. 42 U.S.C. § 405(g); 42 U.S.C. § 1383(c)(3). In reviewing any such claim, a district court may not determine de novo whether an individual is disabled. 42 U.S.C. § 405(g); Wagner v. Sec'y of Health & Human Servs., 906 F.2d 856, 860 (2d Cir. 1990). Rather, it must defer to the Commissioner's determination unless the correct legal standards were not applied or that substantial evidence in the record does not support determination. Johnson v. Bowen, 817 F.2d 983, 986 (2d Cir. 1987) ("[w]here there is a reasonable basis for doubt whether the ALJ applied correct legal principles, application of the substantial evidence standard to uphold a finding of no disability creates an unacceptable risk that a claimant will be deprived of the right to have her disability determination made according to the correct legal principles").

"Substantial evidence" requires more than a mere scintilla of evidence, yet less than a preponderance. Sanchez v. NLRB, 785 F.2d 409 (2d Cir. 1986). It has been defined as "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Poupore v. Astrue, 566 F.3d 303, 305 (2d Cir. 2009) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)). "To determine on appeal whether the ALJ's findings are supported by substantial evidence, a reviewing court considers the whole record, examining evidence from both sides, because an analysis of the substantiality of the evidence must also include that which detracts from its weight." Williams ex rel. Williams v. Bowen, 859 F.2d 255, 258 (2d Cir. 1988) (citing Universal Camera Corp. v. NLRB, 340 U.S. 474, 488 (1951)); Ryan v. Astrue, 650 F. Supp. 2d 207, 216 (N.D.N.Y. 2009). Where evidence is susceptible to more than one rational interpretation, a court may not substitute "its own judgment for that of the [Commissioner], even if it might justifiably have reached a different result upon a de novo review." Valente v. Sec'y of Health & Human Servs., 733 F.2d 1037, 1041 (2d Cir. 1984) (citation omitted); see also Rutherford v. Schweiker, 685 F.2d 60, 62 (2d Cir. 1982); Barnett v. Apfel, 13 F. Supp. 2d 312, 314 (N.D.N.Y. 1998).

A district court has the authority to affirm, reverse, or modify a final decision of the Commissioner with or without remand. 42 U.S.C. § 405(g). Granting judgment on the pleadings is appropriate where the material facts are undisputed and where a court may make a judgment on the merits with reference only to the contents of the pleadings. Fed. R. Civ. P. 12(c); Sellers v. M.C. Floor Crafters, Inc., 842 F.2d 639 (2d Cir. 1988). Remand is warranted where there are gaps in the record and further development of the evidence is needed, or where the ALJ has applied an improper legal standard. See Butts, 388 F.3d at 385; Rosa v. Callahan, 168 F.3d 72, 82-83 (2d Cir. 1999); Parker v. Harris, 626 F.2d 225, 235 (2d Cir. 1980). Remand is most appropriate where further findings or explanation will clarify the rationale for the ALJ's decision. Pratts v. Chater, 94 F.3d 34, 39 (2d Cir. 1996) (citation omitted). Additionally, remand is appropriate to allow for the consideration of additional new evidence which is material to the case and where good cause exists for the failure to submit that evidence in prior proceedings. Melkonyan v. Sullivan, 501 U.S. 89 (1991); Mongeur v. Heckler, 722 F.2d 1033, 1038 (2d Cir. 1983). By contrast, reversal and remand solely for calculation of benefits is appropriate when there is "persuasive proof of disability" and further development of the record would not serve any purpose. Rosa, 168 F.3d at 83; Parker, 626 F.2d at 235; Carroll v. Sec'y of Health & Human Servs., 705 F.2d 638, 644 (2d Cir. 1983).

B. Analysis

Under the Social Security Act, an individual is disabled if he or she is unable "to do 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." 20 C.F.R. § 416.905(a). The Social Security Administration ("SSA") has established a five-step sequential evaluation process to determine whether a claimant over the age of 18 is disabled under the Social Security Act. See 20 C.F.R. §§ 416.920, 404.1520; see also Bowen v. Yuckert, 482 U.S. 137 (1987) (upholding the validity of this evaluation process); Berry v. Schweiker, 675 F.2d 464, 467 (2d Cir. 1982). The plaintiff bears the burden of proof for the first four steps, and the Commissioner bears that burden in step five. See Bowen, 482 U.S. at 146; Berry, 675 F.2d at 467.

20 C.F.R. § 404.1520 details the SSA's five step analysis: in step one, the ALJ considers whether the claimant is currently engaged in substantial gainful activity.*fn2 If the claimant is not engaged in such activity, the ALJ advances to step two of the analysis and considers whether the claimant has a severe impairment meeting the "durational requirement"*fn3 and significantly limiting her physical or mental ability to perform basic work activities. In making this determination, the ALJ does not consider the claimant's age, education, or work experience. Assuming the ALJ finds the claimant has a severe impairment(s), the ALJ continues to step three and determines whether the impairment(s) meets or equals any of those listed in Appendix 1, Subpart P of Regulation No. 4 ("the Listings"). If the ALJ concludes that the claimant's impairment(s) does meet or equal one or more of the Listings, the claimant shall be deemed disabled. If the claimant's impairment(s) does not meet or equal one of the Listings, the fourth step of the evaluation requires the ALJ to assess whether, despite the claimant's severe impairment, the claimant's residual functional capacity ("RFC")*fn4 allows her to perform her past work. If the answer to that inquiry is that the claimant is unable to perform her past work, the fifth step asks the ALJ to determine, in light of the claimant's RFC and other vocational factors, including the claimant's age, education, and work experience, whether the claimant could perform other work that exists in significant numbers in the national economy. 20 C.F.R. § 404.1520; 20 C.F.R. § 404.1560; see also Heckler v. Campbell, 461 U.S. 458, 460 (1983).

I. The Commissioner's Decision

The ALJ determined that Plaintiff "ha[d] not engaged in substantial gainful activity since her alleged onset date, January 31, 2003." R. at 18. The ALJ found that Plaintiff "ha[d] a history of bilateral shoulder surgeries, cervical disc disease, obesity, asthma, sleep apnea, depression, and a history of drug and alcohol dependence." R. at 18. The ALJ concluded that the combination of these impairments were "'severe' within the meaning of the Regulations, but not 'severe' enough to meet or medically equal, either singly or in combination to one of the impairments listed in Appendix 1, Subpart P, Regulations No. 4." R. at 18. The ALJ further found that Plaintiff had the residual functional capacity to perform a significant range of light work, and necessarily, sedentary work. R. at 26. The ALJ next concluded that, considering Plaintiff's RFC, age, education, and past work ...

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