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Quinshara Colvin v. Michael J. Astrue

July 22, 2011


The opinion of the court was delivered by: William M. Skretny Chief Judge United States District Court


1. Plaintiff Quinshara Colvin challenges an Administrative Law Judge's ("ALJ") determination that she is not disabled within the meaning of the Social Security Act ("the Act"). Plaintiff alleges that she has been disabled since January 4, 1997, due to knee problems. Plaintiff contends that this impairment renders her unable to work, and therefore asserts that she is entitled to payment of Supplemental Security Income ("SSI") under the Act.

2. Plaintiff filed an application for SSI payments and Childhood Disability Benefits on June 14, 2000. Her application was initially denied, after which she timely filed a request for a hearing. Pursuant to that request, administrative hearings were held on June 14 and August 19, 2002, but were then postponed to allow Plaintiff to retain counsel. Plaintiff did not do so, however, and on January 27, 2003, ALJ Marilyn D. Zahn held a hearing at which Plaintiff appeared without counsel and testified. The ALJ considered the case de novo, and on February 21, 2003, issued a decision denying Plaintiff's application for benefits. Plaintiff filed a request for review with the Appeals Council which, on March 4, 2004, remanded the case for further administrative hearings. ALJ Zahn held another administrative hearing on May 23, 2005. Plaintiff appeared with counsel and testified. ALJ Zahn considered the case de novo and issued another unfavorable decision on May 4, 2006. On February 27, 2008, the Appeals Council denied Plaintiff's request for review. Plaintiff filed the current civil action on November 3, 2009, challenging Defendant's final decision.*fn1

3. On June 18, 2010, the Commissioner filed a Motion for Judgment on the Pleadings pursuant to Rule 12(c) of the Federal Rules of Civil Procedure. Briefing of the motion concluded on September 9, 2010, at which time this Court took the motion under advisement without oral argument. For the reasons set forth below, the Commissioner's motion is granted.

4. A court reviewing a denial of disability benefits may not determine de novo whether an individual is disabled. See 42 U.S.C. §§ 405(g), 1383(c)(3); Wagner v. Sec'y of Health & Human Servs., 906 F.2d 856, 860 (2d Cir. 1990). Rather, the Commissioner's determination will be reversed only if it is not supported by substantial evidence or there has been a legal error. See Grey v. Heckler, 721 F.2d 41, 46 (2d Cir. 1983); Marcus v. Califano, 615 F.2d 23, 27 (2d Cir. 1979). Substantial evidence is that which amounts to "more than a mere scintilla," and it has been defined as "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401, 91 S. Ct. 1420, 1427, 28 L. Ed. 2d 842 (1971). Where evidence is deemed susceptible to more than one rational interpretation, the Commissioner's conclusion must be upheld. See Rutherford v. Schweiker, 685 F.2d 60, 62 (2d Cir. 1982).

5. "To determine on appeal whether the 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 on Behalf of Williams v. Bowen, 859 F.2d 255, 258 (2d Cir. 1988). If supported by substantial evidence, the Commissioner's finding must be sustained "even where substantial evidence may support the plaintiff's position and despite that the court's independent analysis of the evidence may differ from the [Commissioner's]." Rosado v. Sullivan, 805 F. Supp. 147, 153 (S.D.N.Y. 1992). In other words, this Court must afford the Commissioner's determination considerable deference, and 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).

6. The Commissioner has established a five-step sequential evaluation process to determine whether an individual is disabled as defined under the Social Security Act. See 20 C.F.R. §§ 404.1520, 416.920. The United States Supreme Court recognized the validity of this analysis in Bowen v. Yuckert, 482 U.S. 137, 140-142, 107 S. Ct. 2287, 2291, 96 L. Ed. 2d 119 (1987), and it remains the proper approach for analyzing whether a claimant is disabled.

7. This five-step process is detailed below: First, the [Commissioner] considers whether the claimant is currently engaged in substantial gainful activity. If he is not, the [Commissioner] next considers whether the claimant has a "severe impairment" which significantly limits his physical or mental ability to do basic work activities. If the claimant suffers such an impairment, the third inquiry is whether, based solely on medical evidence, the claimant has an impairment which is listed in Appendix 1 of the regulations. If the claimant has such an impairment, the [Commissioner] will consider him disabled without considering vocational factors such as age, education, and work experience; the [Commissioner] presumes that a claimant who is afflicted with a "listed" impairment is unable to perform substantial gainful activity. Assuming the claimant does not have a listed impairment, the fourth inquiry is whether, despite the claimant's severe impairment, he has the residual functional capacity to perform his past work. Finally, if the claimant is unable to perform his past work, the [Commissioner] then determines whether there is other work which the claimant could perform.

Berry v. Schweiker, 675 F.2d 464, 467 (2d Cir. 1982) (per curiam); see also Rosa v. Callahan, 168 F.3d 72, 77 (2d Cir. 1999); 20 C.F.R. § 404.1520.

8. Although the claimant has the burden of proof as to the first four steps, the Commissioner has the burden of proof on the fifth and final step. See Bowen, 482 U.S. at 146 n.5; Ferraris v. Heckler, 728 F.2d 582, 584 (2d Cir. 1984). The final step of this inquiry is, in turn, divided into two parts. First, the Commissioner must assess the claimant's job qualifications by considering his physical ability, age, education, and work experience. Second, the Commissioner must determine whether jobs exist in the national economy that a person having the claimant's qualifications could perform. See 42 U.S.C. § 423(d)(2)(A); 20 C.F.R. § 404.1520(f); Heckler v. Campbell, 461 U.S. 458, 460, 103 S. Ct. 1952, 1954, 76 L. Ed. 2d 66 (1983).

9. In this case, the ALJ made the following findings with regard to the five-step process set forth above: (1) Plaintiff has not engaged in any substantial gainful activity since the alleged onset of the disability (R. at 40);*fn2 (2) Plaintiff's knee disorder is considered a "severe" impairment within the meaning of the Act (Id.); (3) Plaintiff does not have an impairment that meets or medically equals one of the listed impairments in Appendix 1, Subpart P, Regulation No. 4 (Id.); (4) Plaintiff has the residual functional capacity ("RFC") to perform the full range of sedentary work as defined in 20 CFR § 416.967(a) (Id.); and (5) Although Plaintiff has no past relevant work under 20 CFR §§ 404.1564 and 416.965, considering Plaintiff's status as a younger individual, limited education, work experience, and residual functional capacity, the ALJ determined that Medical-Vocational Rule 201.24 directs a finding of "not disabled." (Id.) Ultimately, the ALJ determined that Plaintiff was not under a disability, as defined by the Act, at any time through the date of her decision, May 4, 2006. (R. at 41.)

10. Plaintiff first argues that the ALJ's decision must be reversed because she failed to follow the Appeals Council's remand instructions. On remand the Appeals Council directed the ALJ to (1) update the record with any available evidence from treating and/or examining sources; (2) seek clarification from the treating physician, Dr. Bax; (3) obtain a consultative orthopedic exam, if necessary to complete the record; (4) obtain expert medical evidence concerning the longitudinal assessment to assist in resolving any conflicts or inconsistencies in the evidence; (5) evaluate the claimant's symptoms and assess credibility; (6) weigh all opinion evidence; and (7) reassess and rationalize a maximum RFC.

Having reviewed the ALJ's decision in light of Plaintiff's arguments and the Appeals Council's remand order, this Court finds no error. The ALJ adequately followed the Appeal's Council's instructions and discussed and assessed medical evidence supporting the determination that Plaintiff was not disabled. The ALJ considered medical evidence from numerous doctors, including Drs. Gadallah, Bax, Swetz, Yu, Miller, and Gosy, along with the objective results of MRIs and X-rays. (R. at 34-38.) Contrary to Plaintiff's assertion, the ALJ updated the record from the earlier February 23, 2003 decision by considering the treatment notes and recommendations of Plaintiff's pain specialist, Dr. Gosy, and MRI results from 2005. (R. at 36-38.) As directed by the Appeals Council, the ALJ also sought clarification from Dr. Bax, but he did not respond to her requests for clarification or to her inquiries concerning his assessment of Plaintiff's RFC. (R. at 235-242.)

Also contrary to Plaintiff's assertion, the Appeals Council did not require the ALJ to obtain an orthopedic consultive exam concerning Plaintiff's RFC; such an exam was ordered only "if necessary." (R. at 114.) The ALJ's determination that a consultative orthopedic exam was not necessary is supported, because sufficient data was already present in the record to document the extent of Plaintiff's condition. Along with the treatment notes from Plaintiff's numerous examining physicians, full knee ...

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