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Kapilaben C. Patel v. Michael J. Astrue

December 10, 2010


The opinion of the court was delivered by: John Gleeson, United States District Judge:



Kapilaben Patel seeks review, pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3), of the Commissioner of Social Security's denial of her application for a period of disability and disability insurance benefits. The parties have cross-moved for judgment on the pleadings. I heard oral argument on November 10, 2010. Because the Commissioner's decision is not supported by substantial evidence in the record, I deny the Commissioner's motion, grant Patel's motion, and remand for further proceedings.


This case arises from a 12-year-long series of denials and remands of Patel's claim for a period of disability and disability insurance benefits. On September 16, 1998, Patel filed the instant application for benefits,*fn1 alleging that she had been disabled since November 15, 1994 due to bilateral shoulder impairments and borderline intellectual functioning. (R. 753.) Her claim was initially denied on July 26, 2000, by Administrative Law Judge ("ALJ") Sol Wieselthier. On September 28, 2001, the Appeals Council vacated ALJ Wieselthier's opinion and remanded the case to him for reconsideration. ALJ Wieselthier issued a second adverse opinion on March 20, 2003, which was vacated and remanded by the Appeals Council on October 15, 2004. The case was transferred to ALJ Hazel Strauss, who on December 11, 2006 determined that Patel was not disabled because she retained the residual functional capacity to perform a limited range of light work, as defined in 20 C.F.R. § 416.967(b). (R. 32.) This opinion was vacated and remanded on August 25, 2007 by the Appeals Council due to a technical issue,*fn2 and ALJ Strauss issued a substantially similar opinion on June 20, 2008.*fn3 The Appeals Council denied Patel's latest request for review on February 19, 2010, making the ALJ's adverse decision the final decision of the Commissioner. See DeChirico v. Callahan, 134 F.3d 1177, 1179 (2d Cir. 1998).

A. The Plaintiff's Statements and Testimony

Patel, a 62-year-old native Gujarati speaker, has a limited knowledge of English and an 11th-grade education. She worked as a sequin spooler from 1979 until 1994, but was laid off on April 20, 1994. (R. 641.) While working as a sequin spooler, Patel used primarily her right arm to perform activities such as lifting spools weighing between ten and twenty pounds.

(R. 23.) She alleges that this activity led to a repetitive stress injury to her right arm and shoulder. (Id.) She receives $100 per week in Workers' Compensation benefits arising from the injuries at issue in this case. (Id.)

Patel alleges that she has experienced disabling pain in her right and left shoulders since 1994, and specifically between November 15, 1994, her date of onset, and December 31, 1999, the date on which her insured status expired (the "period at issue"). She complains of burning pain, initially originating in her right shoulder, which spread to her left shoulder prior to the cessation of her insured period. (See, e.g., R. 490.) She also complains of stiffness in her fingers and a substantially restricted range of motion in her shoulders. (R. 381.) She testified that she could not sit down for any length of time without moving her right arm. (R. 774.)

Due to her injuries, Patel alleges that she can no longer lift more than two or three pounds and cannot lift her arms over her head. (R. 776.) Because of these restrictions, she can no longer perform many of the activities of daily life, such as shopping, cooking, and personal grooming. (R. 773.) She also has difficulty sleeping and staying asleep due to the pain. (R. 786-87.) She has little social interaction, and cries frequently due to the stress of her situation. (R. 784.)

B. Medical Evidence

1. Treating Physicians

On December 5, 1994, Patel visited the Union Health Center's occupational medicine clinic complaining of pain in her neck, right shoulder, and right arm, as well as weakness in her right hand and stiffness in her right and left middle fingers. She was initially diagnosed with tendinitis in her right shoulder, right medial epicondylitis, and right middle finger arthritis, and she was referred to physical therapy. (R. 265, 387.)

Between 1995 and 1999 Patel was treated and examined by Dr. George Piligian, her treating physician, on a monthly to bi-monthly basis. At each appointment she complained of pain in her right shoulder and middle finger, decreased range of motion in her right shoulder, and various other symptoms in her right and left upper extremities. Piligian made consistent diagnoses based on examinations, tests, and Patel's reported symptoms. For example: on March 6, 1995, Piligian diagnosed Patel with bilateral digital tenosynovitis and right shoulder arthropathy. (R. 396.) An MRI taken the following week revealed a rotator cuff tear. (Id.) Piligian repeated the diagnosis of rotator cuff tear again on May 15, 1995 (R. 400), June 5, 1995 (R. 404), October 4, 1995 (R. 414), February 7, 1996 (R. 272), and again at similar intervals through the end of the insured period. He also diagnosed left rotator cuff tendinitis on June 5, 1995 (R. 404), left shoulder bicipital tenderness on March 27, 1996 (R. 284), and tenderness of the left shoulder, stiffness of the shoulder muscles, and right third digit ulnar deviation on May 14, 1997 (R. 318).

In a Medical Assessment of Ability to do Work-Related Activities completed on June 4, 1997, Piligian reported limitations in reaching, handling, pushing, and pulling due to an MRI finding of rotator cuff tear, and for the same reason reported that Patel could not perform repetitive or static postural motor tasks. (R. 240.) On November 19, 1997, Piligian conducted an examination that revealed pulling in the suprascapular muscles, again diagnosing right shoulder rotator cuff tear and left rotator cuff tendinopathy. (R. 346.) On February 11, 1998, he examined Patel and reported tenderness of the bicipital tendons bilaterally; he diagnosed bilateral shoulder tendinopathy and probable bilateral tenosynovitis. (Id.) He repeated that diagnosis at approximately three-month intervals through August 18, 1999, when he added a diagnosis of right ulnar neuropathy and left rotator cuff impingement. (R. 468.) On September 2, 1998, he diagnosed early psoriatic arthritis ...

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