Lloyd v. Comm'r of Soc. Sec.
Lloyd v. Comm'r of Soc. Sec.
Opinion of the Court
INTRODUCTION
Represented by counsel, Plaintiff Tracy Lynn Lloyd ("Plaintiff") brings this action pursuant to Titles II and XVI of the Social Security Act (the "Act"), seeking review of the final decision of the Commissioner of Social Security (the "Commissioner," or "Defendant") denying her applications for disability insurance benefits ("DIB") and supplemental security income ("SSI"). (Dkt. 1). This Court has jurisdiction over this matter pursuant to
*476BACKGROUND
Plaintiff protectively filed her application for DIB on November 13, 2013. (Dkt. 7 at 70).
A hearing on Plaintiff's claim was held before ALJ Stephen Cordovani in Buffalo, New York, on April 18, 2016. (Id. at 39-69). On May 25, 2016, the ALJ issued an unfavorable decision. (Id. at 20-38). Plaintiff requested Appeals Council review; that request was denied on May 16, 2017, making the ALJ's determination the Commissioner's final decision. (Id. at 5-9). This action followed.
LEGAL STANDARD
I. District Court Review
"In reviewing a final decision of the [Social Security Administration ("SSA") ], this Court is limited to determining whether the SSA's conclusions were supported by substantial evidence in the record and were based on a correct legal standard." Talavera v. Astrue ,
II. Disability Determination
An ALJ follows a five-step sequential evaluation to determine whether a claimant is disabled within the meaning of the Act. See Bowen v. City of New York ,
At step three, the ALJ examines whether a claimant's impairment meets or medically equals the criteria of a listed impairment in Appendix 1 of Subpart P of Regulation No. 4 (the "Listings").
The ALJ then proceeds to step four and determines whether the claimant's RFC permits the claimant to perform the requirements of his or her past relevant work.
DISCUSSION
I. The ALJ's Decision
In determining whether Plaintiff was disabled, the ALJ applied the five-step sequential evaluation set forth in
At step two, the ALJ found that Plaintiff suffered from the severe impairments of: "status post-cervical spine fusion; multiple musculoskeletal and neurological conditions of the upper right extremity and left elbow; myofascial pain; bilateral knee patellofemoral arthritis status post-left knew meniscectomy [;] and total knee replacement." (Id. ). The ALJ did not identify any non-severe medically determinable impairments. (Id. ).
At step three, the ALJ found that Plaintiff did not have an impairment or combination of impairments that met or medically equaled the severity of any Listing. (Id. at 25-26). The ALJ particularly considered the criteria of Listings 1.02 and 1.04 in reaching his conclusion. (Id. at 26).
Before proceeding to step four, the ALJ determined that Plaintiff retained the RFC to perform sedentary work as defined in
could perform occasional, non-repetitive lifting on the right side, up to 1 pound and that, otherwise, the right arm can be used only to assist with lifting performed with the left arm or hand. [Plaintiff] could occasionally twist, stoop and bend, but could never kneel, crouch, crawl, or climb ladders/ropes/scaffolds. [Plaintiff] could perform no overhead work or overhead reaching. [Plaintiff] could frequently reach, handle, and finger with the left hand, and occasionally reach, handle, and finger with the right hand. [Plaintiff] could perform no repetitive pushing or pulling with the right *478arm. [Plaintiff] could perform no work requiring field of vision greater than 15 degrees above or below the horizon, or 45 degrees left or right of center, and [Plaintiff] could tolerate no exposure to extreme cold or humidity.
(Id. at 26-27). At step four, the ALJ relied on the testimony of a vocational expert ("VE") to conclude that Plaintiff was capable of performing her past relevant work as a Senior Research Associate. (Id. at 32-33). Accordingly, the ALJ found that Plaintiff was not disabled as defined in the Act. (Id. at 33).
II. Remand of this Matter for Further Proceedings is Necessary
Plaintiff asks the Court to reverse the Commissioner's decision, arguing that: (1) the ALJ's conclusion that Plaintiff was capable of performing the sitting, standing, and walking required by sedentary work was unsupported by substantial evidence; (2) the ALJ failed to identify good reasons for affording less than controlling weight to the opinion of treating physician Dr. Eugene Gosy; (3) the ALJ's RFC finding regarding Plaintiff's ability to move her head was unsupported by substantial evidence; and (4) the ALJ failed to properly assess Plaintiff's credibility. For the reasons set forth below, the Court finds that the ALJ failed to set forth good reasons for the weight assigned to Dr. Gosy's opinion and that this error necessitates remand for further administrative proceedings.
A. Assessment of Dr. Gosy's Opinion
Because Plaintiff's claim was filed before March 27, 2017, the ALJ was required to apply the treating physician rule, under which a treating physician's opinion is entitled to "controlling weight" when it is "well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in [the] case record[.]"
(i) the frequency of examination and the length, nature and extent of the treatment relationship; (ii) the evidence in support of the treating physician's opinion; (iii) the consistency of the opinion with the record as a whole; (iv) whether the opinion is from a specialist; and (v) other factors brought to the Social Security Administration's attention that tend to support or contradict the opinion.
Whatever weight the ALJ assigns to the treating physician's opinion, he must "give good reasons in [his] notice of determination or decision for the weight [he gives to the] treating source's medical opinion."
In this case, Dr. Gosy, a pain management specialist, began treating Plaintiff in March 2008. (Dkt. 7 at 483). On February 26, 2016, Dr. Gosy completed a "Physical Residual Functional Capacity Questionnaire" related to Plaintiff. (Id. at 483-87). In the questionnaire Dr. Gosy opined, among other things, that during the course of a workday Plaintiff would be able to use her right hand, fingers, and arm to twist objects, engage in fine manipulations, and reach only 10% of the time. (Id. at 486). Dr. Gosy further opined that Plaintiff would be able to perform those same activities with her left hand, fingers, and arm only 75% of the time. (Id. ).
In his decision, the ALJ gave "great weight" to much of Dr. Gosy's opinion. (See
The Court finds that the ALJ failed to give "good reasons" for his rejection of Dr. Gosy's opinion regarding Plaintiff's capacity to use her upper right extremity. The Court initially notes that "a reason ... that relies on a mischaracterization of the record cannot be a good reason [for disregarding a treating source's opinion]." Wilson v. Colvin ,
In this case, the ALJ claimed that Plaintiff had "help[ed] install a floor" and that this activity was inconsistent with Dr. Gosy's opinion. (Dkt. 7 at 31). However, a review of Plaintiff's testimony reveals that her participation in the floor installation project was limited to bringing drinks for the workers and "picking the color of the board that would go next." (Id. at 55). Plaintiff specifically stated that she had not personally installed the floor boards. (Id. ). The ALJ's decision mischaracterized the record, making it appear without basis that Plaintiff had used her right hand, fingers, and arm in a manner inconsistent with Dr. Gosy's opinion during the floor installation project. This was improper and cannot constitute a good reason for rejecting the opinion of a treating physician.
The Court further notes that while Plaintiff did report to her physicians on one occasion that she was mulching her garden using a wheelbarrow, she was immediately instructed to stop, in part because *480she "should not be pushing heavy wheel barrels [sic]." (Id. at 524). Plaintiff also told the ALJ that she did not garden consistently. (Id. at 60). As with the floor installation project, the ALJ's decision ignored these pertinent details and overstated the record regarding Plaintiff's activities. Similarly, with respect to the time Plaintiff painted the bathroom, Plaintiff testified that she had done so out of a sense of guilt regarding relying on her parents for care and that the activity had caused her "terrible pain." (Id. at 58). Moreover, the ALJ made no inquiry into Plaintiff's use of her hands during this activity-namely, whether and to what extent Plaintiff used her right hand, arm, and fingers. As such, the ALJ ignored relevant information and reached conclusions that were unwarranted when properly considering Plaintiff's activities in context. See Wilson ,
Moreover, even accepting the ALJ's characterization of Plaintiff's activities, "it is improper for the ALJ to substitute his judgment for that of the treating physician as to the significance of a claimant's ability to perform daily activities." Gray v. Astrue , No. 1:06-CV-0456 (NAM),
The ALJ's error in this regard was not harmless. At the hearing in this matter, the VE testified that an individual who was limited to sedentary work and "could manipulate with their dominant hand no more than 10 percent of the day and manipulate with their nondominant hand no more than 75 percent of the day" would "not be able to maintain competitive employment." (Dkt. 7 at 67). As such, had the ALJ afforded controlling weight to Dr. Gosy's opinion, a finding of disability would have followed.
In light of the VE's testimony, the Court has considered whether further administrative proceedings are required or if the matter should be remanded solely for calculation and payment of benefits.
*481"Under
Here, the evidence of record regarding the functionality of Plaintiff's right upper extremity is mixed and includes an opinion from treating orthopedic surgeon Dr. Jeffrey Jones that Plaintiff is capable of sedentary work with lifting no more than one pound on the right and no repetitive pushing or pulling. (See Dkt. 7 at 406). While the ALJ did not articulate good reasons for declining to afford Dr. Gosy's opinion controlling weight, because of these conflicts in the medical evidence, the Court cannot conclude on the record before it that no such reasons could potentially exist. The Court therefore cannot remand solely for calculation and payment of benefits, and further administrative proceedings are necessary. See Marthe v. Colvin , No. 6:15-CV-06436(MAT),
B. Plaintiff's Remaining Arguments
As set forth above, Plaintiff has identified a number of additional reasons why she contends the ALJ's decision was not supported by substantial evidence. However, because the Court has already determined, for the reasons previously discussed, that remand of this matter for further administrative proceedings is necessary, the Court declines to reach these issues. See, e.g., Bell v. Colvin , No. 5:15-CV-01160 (LEK),
CONCLUSION
For the foregoing reasons, Plaintiff's motion for judgment on the pleadings (Dkt. 9) is granted to the extent that the matter is remanded for further administrative proceedings. Defendant's motion for judgment on the pleadings (Dkt. 13) is denied. The Clerk of Court is directed to enter judgment and close this case.
SO ORDERED.
When referencing the page number(s) of docket citations in this Decision and Order, the Court will cite to the CM/ECF-generated page numbers that appear in the upper righthand corner of each document.
Reference
- Full Case Name
- Tracy Lynn LLOYD v. COMMISSIONER OF SOCIAL SECURITY
- Cited By
- 6 cases
- Status
- Published