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James v. Berryhill

United States District Court, W.D. New York

June 27, 2018




         1. Plaintiff Tacara James challenges the determination of an Administrative Law Judge (“ALJ”) that she is not disabled within the meaning of the Social Security Act (“the Act”). Plaintiff alleges she has been disabled since April 24, 2011, due to Schizophrenia, vertebrogenic disorder, and chiari malformation[1] with headaches. Plaintiff contends that her impairments render her unable to work, and thus, she is entitled to disability benefits under the Act.

         2. Plaintiff filed an application for disability benefits and supplemental security income on January 31, 2012, which was denied on April 5, 2012. Plaintiff thereafter requested a hearing before an ALJ on April 10, 2012. On April 2, 2013, ALJ Nancy L. Pasiecznik held a hearing at which Plaintiff appeared with counsel and testified. On April 10, 2015, ALJ Donald T. McDougall held a second administrative hearing at which Plaintiff again appeared with counsel and testified. At the time of the second hearing, Plaintiff was 32 years old, with a General Educational Development (“GED”) degree, and past work experience as a counselor aide. The ALJ considered the case de novo and, on April 23, 2015, issued a written decision denying Plaintiff's application for benefits. The Appeals Council denied Plaintiff's request for review on November 21, 2016. Plaintiff filed the current action on January 23, 2017, challenging the Commissioner's final decision.[2]

         3. On August 31, 2017, Plaintiff filed a Motion for Judgment on the Pleadings under Rule 12(c) of the Federal Rules of Civil Procedure. (Docket No. 10.) On November 27, 2017, the Commissioner filed a Motion for Judgment on the Pleadings. (Docket No. 16.) Plaintiff filed a reply on December 18, 2017 (Docket No. 17), at which time this Court took the matter under advisement without oral argument. For the following reasons, Plaintiff's motion is denied, and Defendant'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 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 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 will 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 under the Act. See 20 C.F.R. §§ 404.1520, 416.920. The Supreme Court of the United States recognized the validity of this analysis in Bowen v. Yuckert, and it remains the proper approach for analyzing whether a claimant is disabled. 482 U.S. 137, 140-42, 107 S.Ct. 2287, 2291, 96 L.Ed.2d 119 (1987).

         7. The five-step process is as follows:

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 her 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 her 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, she has the residual functional capacity to perform her past work. Finally, if the claimant is unable to perform her 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) (quotations in original); see also 20 C.F.R. § 404.1520; Rosa v. Callahan, 168 F.3d 72, 77 (2d Cir. 1999).

         8. Although the claimant has the burden of proof on 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 is divided into two parts. First, the Commissioner must assess the claimant's job qualifications by considering her 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 substantial gainful activity since April 24, 2011, the alleged onset date (R. at 10);[3] (2) Plaintiff's Schizophrenia, vertebrogenic disorder, and chiari malformation with headaches are severe impairments within the meaning of the Act (R. at 10); (3) Plaintiff does not have an impairment or combination of impairments that meet or medically equal any of the impairments listed in 20 C.F.R. Part 404, Subpart P, Appendix 1 (R. at 10); (4) Plaintiff retained the residual functional capacity (“RFC”) to perform medium work as defined in 20 CFR 404.1567(c) and 416(c), with certain exceptions, [4] and that this RFC precluded Plaintiff from performing any past relevant work (R. at 19); and (5) considering Plaintiff's age, education, work experience, and RFC, there are jobs that exist in significant No. in the national economy that Plaintiff can perform (R. at 20-21). Accordingly, the ALJ determined that Plaintiff was not under a disability as defined by the Act during the relevant period-April 24, 2011, through April 23, 2015. (R. at 21.)

         10. Plaintiff makes two challenges to the ALJ's decision. First, Plaintiff contends that the ALJ's physical RFC determination is not supported by substantial evidence because the ALJ (1) failed to consider the medical opinions of Drs. Huckell, Sterman, and Calabrese; (2) violated the treating physician rule; and (3) interpreted raw medical findings in fashioning his RFC assessment. Plaintiff filed her application for benefits on January 31, 2012, claiming a disability onset date of April 24, 2011. From the record, it appears that Dr. Huckell treated Plaintiff from May 2009 through December 2009 (R. at 818-30, 832-35); Dr. Sterman saw Plaintiff in December 2008 and again in June 2009 (R. at 876-78, 880-81); and Dr. Calabrese treated Plaintiff from April 2009 through June 2010 (R. at 755-817). Courts have found medical opinions provided prior to the alleged onset date to be relevant in some situations, particularly where there is scant evidence from the disability period. See Binder v. Comm'r of Soc. Sec., No. 5:15-CV-738 (NAM), 2016 WL 4079533, at *4 (N.D.N.Y. July 29, 2016) (collecting cases). But that is not the case here, as Plaintiff has several treatment records from the relevant period, as well as the March 16, 2015 opinion of Dr. Bennett, all of which the ALJ took into consideration. (R. at 18-19.). Because the record was complete, the ALJ was under no obligation to look outside the relevant period for additional evidence. See 20 C.F.R. § 404.1512(d) (complete medical history includes the 12 months preceding the month in which application is filed); McManus v. Comm'r of Soc. Sec., 298 Fed.Appx. 60, 61 (2d Cir. 2008) (“no error in the ALJ's decision to exclude additional evidence proffered by” plaintiff where the “evidence pre-dated the time period the ALJ was required to consider under 20 C.F.R. § 404.1512(d)”); Kentile v. Colvin, No. 8:13-CV-880 MAD/CFH, 2014 WL 3534905, at *14 n.10 (N.D.N.Y. July 17, 2014) (“The administrative record contains treatment notes from other providers. However, the ALJ is not compelled to consider or assign weight to treatment that predates plaintiff's application for disability benefits.”). Accordingly, there was no error in excluding or discounting the opinions of Drs. Huckell, Sterman, and Calabrese. See Williams v Colvin, 98 F.Supp.3d 614, 631 (W.D.N.Y. 2015).

         11. With respect to Plaintiff's argument regarding the treating physician rule, it is true that an ALJ is obligated to give a treating source's medical opinion controlling weight if it is “well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in your case record.” 20 C.F.R. § 404.1527(c)(2). Here, Dr. Bennett's assessment of Plaintiff's abilities was not consistent with his own internal notes or with the remainder of the record. For example, on March 16, 2015, Dr. Bennett completed a physical residual functional capacity questionnaire for Plaintiff. (R. at 1194-98.) He diagnosed Plaintiff with chronic back pain and decreased range of motion and opined that Plaintiff was limited to sitting one hour at a time, standing fifteen minutes at a time, and lifting less than ten pounds rarely. (R. at 1194-96.) This marked limitation is contradicted by his own records, which state that Plaintiff consistently reported that her back pain was “relieved by over-the-counter medication.” ...

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