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Ashley v. Commissioner of Social Security

United States District Court, N.D. New York

December 30, 2014



THOMAS J. McAVOY, Senior District Judge.


Timothy Brian Ashley ("Plaintiff") brought this action under the Social Security Act, 42 U.S.C. § 405(g), to review a final determination by the Commissioner of Social Security ("Commissioner") denying Plaintiff's application for benefits. Plaintiff contends, inter alia, that Administrative Law Judge Elizabeth W. Koennecke ("ALJ") erred by failing to properly follow the treating physician rule. See Pl. Brief at 3, 6-9 (Dkt. No. 10). The Commissioner argues that the ALJ's decision is supported by substantial evidence and made in accordance with the correct legal standards. Pursuant to Northern District of New York General Order No. 8, the Court proceeds as if both parties had accompanied their briefs with a motion for judgment on the pleadings. For the reasons that follow, Plaintiff's motion is granted and the matter is remanded to the Commissioner.


The Court assumes familiarity with the facts and procedural history of the case, as well as the undisputed medical record.


a. The ALJ's Opinion Improperly Applied the Treating Physician Rule

Plaintiff contends, inter alia, that the ALJ failed to follow the treating physician rule. The Court agrees.

"[W]hile a treating physician's retrospective diagnosis is not conclusive, it is entitled to controlling weight unless it is contradicted by other medical evidence or overwhelmingly compelling non-medical evidence.'" Woodmancy v. Colvin, 577 F.Appx. 72, 74 (2d Cir. 2013)(Summary Order)(quoting Byam v. Barnhart, 336 F.3d 172, 183 (2d Cir. 2003) and citing Perez v. Chater, 77 F.3d 41, 48 (2d Cir. 1996)). "If the ALJ chooses not to afford such an opinion controlling weight, then the ALJ must consider the following factors in deciding what weight to assign the opinion: (1) examining relationship; (2) treatment relationship, including its length, nature and extent; (3) supportability with medical evidence; (4) consistency with the record as a whole; (5) specialization of the examiner; and (6) any other relevant factors." Id. (citing 20 C.F.R. § 404.1527(c)(1)-(6)).

"In addition to considering the required factors, an ALJ must ultimately give good reasons in [the] notice of determination or decision for the weight [the ALJ] give[s] [a claimant's] treating source's opinion.'" Rolon v. Comm'r of Soc. Sec., 994 F.Supp.2d 496, 508 (S.D.N.Y. 2013)(quoting 20 C.F.R. §§ 404.1527(c)(2), 416.927(c)(2)); see e.g. Snell v. Apfel, 177 F.3d 128, 134 (2d Cir. 1999)(Even though the final question of disability is reserved to the Commission, "this does not exempt administrative decision makers from their obligation... to explain why a treating physician's opinions are not being credited."). This requirement allows courts to properly review ALJs' decisions and provides information to claimants regarding the disposition of their cases, especially when the dispositions are unfavorable. Snell, 177 F.3d at 134.

While claimants are not entitled to have their treating physician's opinion be automatically controlling, "[they are] entitled to be told why the Commissioner has decided... to disagree with [the claimant's treating physician]." Id .; see Rolon, 994 F.Supp.2d at 509 (When an ALJ determines that a treating physician's opinion is to be given less than controlling weight, the ALJ must provide "good reason.").

Treating sources are owed deference because they "are likely to be the medical professionals most able to provide a detailed, longitudinal picture of [the claimant's] medical impairment(s) and may bring a unique perspective to the medical evidence that cannot be obtained from the objective medical findings alone or from reports of individual examinations." 20 C.F.R. §§ 404.1527(c)(2), 416.927(c)(2) (2013). The treating physician rule imposes upon the ALJ, at a minimum, a higher duty of explanation when determining the weight that must be given to a treating source's opinion.

Rolon, 994 F.Supp.2d at 506.

"The ALJ must fulfill the heightened duty of explanation [that exists] when a treating physician's medical opinion is discredited.'" Id., at 508 (quoting Gunter v. Comm'r of Soc. Sec., 361 Fed.App'x 197, 199 (2d Cir. 2010). Failure to do so warrants remand. Selian v. ...

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