Patel v. Colvin
Patel v. Colvin
Opinion of the Court
MEMORANDUM OPINION
1. INTRODUCTION
Plaintiff Shivangi Patel filed this action seeking judicial review of the final decision of the Acting Commissioner of the Social Security Administration (“Commissioner”) denying her claim for Supplemental Security Income (“SSI”) under Title XVI of the Social Security Act. Plaintiff seeks reversal of the Commissioner’s decision, arguing that the Administrative Law Judge’s (“ALJ”) finding that she is not disabled was not based on substantial evidence. The Commissioner argues that the ALJ’s determination was supported by substantial evidence and should be upheld.
United States Magistrate Judge Carol Sandra Moore Wells issued a Report and Recommendation (“R & R”),
II. STANDARD OF REVIEW
A court reviewing a Social Security case must base its decision on the record of the administrative proceedings and the pleadings of the parties.
“A district court, after reviewing the decision of the Secretary may, under 42 U.S.C. § 405(g) affirm, modify, or reverse the Secretary’s position with or without a remand to the Secretary for a rehearing.”
III. SOCIAL SECURITY LAW
In order to qualify for benefits, a person must be found to have a disability, defined as an “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”
IV. DISCUSSION
A. The ALJ’s Decision
The ALJ issued his written decision denying benefits to Plaintiff after reviewing the evidence regarding Plaintiffs claim and holding a hearing at which Plaintiff and a vocational expert testified. Plaintiff, who was born in 1988, filed the application on August 5, 2011, alleging disability beginning May 1, 2010.
At step 3, the ALJ found that Plaintiffs severe impairments did not meet or equal an impairment in the Listings. The Listings for Plaintiffs impairments may be met in two ways. The “B” requirements are met if the impairments result in at least two of the following: marked restriction of activities of daily living; marked difficulties in maintaining social functioning; marked difficulties in maintaining concentration, persistence, or pace; or repeated episodes of decompensation, each of extended duration.
The “C” requirements are met if the claimant has a medically documented history of a chronic affective disorder of at least two years’ duration that has caused more than a minimal limitation of ability to do basic work activities, with symptoms or signs currently attenuated by medication or psychosocial support, and either: repeated episodes of decompensation, each of extended duration; a residual disease process that has resulted in such marginal adjustment that even a minimal increase in mental demands or change in the environment would be predicted to cause the claimant to decompensate; or a current
At step 4, the ALJ found that Plaintiff had no past relevant work, and at step 5 concluded that, considering Plaintiffs age, education, work experience, and RFC, Plaintiff is capable of making a successful adjustment to work that exists in the significant numbers in the national economy. Therefore, the ALJ concluded that Plaintiff is not disabled.
B. The R & R
The R & R concluded that the ALJ’s opinion was supported by substantial evidence, and rejected Plaintiffs arguments to the contrary. Specifically, the R & R agreed with the ALJ that hospitalizations that predated Plaintiffs application were properly discounted, but that even considering those hospitalizations, Plaintiff did not meet the Listings,
C. Analysis
Upon careful review of the record, the Court agrees with Plaintiffs contention
The relevant Listing describes what an episode of decompensation is and what constitutes repeated episodes of extended duration:
Episodes of decompensation are exacer-bations or temporary increases in symptoms or signs accompanied by a loss of adaptive functioning, as manifested by difficulties in performing activities of daily living, maintaining social relationships, or maintaining concentration, persistence, or pace. Episodes of decom-pensation may be demonstrated by an exacerbation in symptoms or signs that would ordinarily require increased treatment or a less stressful situation (or a combination of the two). Episodes of decompensation may be inferred from medical records showing significant alteration in medication; or documentation of the need for a more structured psychological support system (e.g., hospitalizations, placement in a halfway house, or a highly structured and directing household); or other relevant information in the record about the existence, severity, and duration of the episode. The term repeated episodes of decom-pensation, each of extended duration in these listings means three episodes within 1 year, or an average of once every 4 months, each lasting for at least 2 weeks. If you have experienced more frequent episodes of shorter duration or less frequent episodes of longer duration, we must use judgment to determine if the duration and functional effects of the episodes are of equal severity and may be used to substitute for the listed finding in a determination of equivalence.32
Plaintiff stated that her disability began on May 1, 2010, and filed the application on August 5, 2011.
Need for longitudinal evidence. Your level of functioning may vary considerably over time. The level of your functioning at a specific time may seem relatively adequate or, conversely, rather poor. Proper evaluation of your impairments) must take into account any variations in the level of your functioning in arriving at a determination of severity •over time. Thus, it is vital to obtain evidence from relevant sources over a sufficiently long period prior to the date of adjudication to establish your impairment severity.36
More specifically, the regulations state that a “complete medical history,” means “the records of your medical source(s) cov
Although this error alone warrants remand, and the Court need not reach Plaintiffs remaining arguments, the remand is for purposes of a full hearing to consider all of the evidence relating to Plaintiffs claimed disability. In this regard, although the Court will not require the ALJ to obtain the assistance of a medical expert in evaluating the medical evidence, the Court notes that such evidence may be required if there is an issue of determining medical equivalence,
V. CONCLUSION
For the foregoing reasons, the Court sustains Plaintiffs objections to the R & R, grants Plaintiffs request for review, and remands for further consideration pursuant to the fourth sentence of 42 U.S.C. § 405(g). An appropriate order will be entered.
. See Local R. Civ. Pro. 72.1.1(a); 28 U.S.C. § 636(b)(1)(B).
. 42 U.S.C. § 405(g).
. Schaudeck v. Comm'r of Soc. Sec., 181 F.3d 429, 431 (3d Cir. 1999).
. See Fargnoli v. Massanari, 247 F.3d 34, 38 (3d Cir. 2001).
. Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971) (internal citation omitted); Jesurum v. Sec’y of the U. S. Dep’t of Health & Human Servs., 48 F.3d 114, 117 (3d Cir. 1995).
. Brown v. Bowen, 845 F.2d 1211, 1213 (3d Cir. 1988).
.Fargnoli, 247 F.3d at 38.
. Schaudeck, 181 F.3d at 431.
. Reefer v. Barnhart, 326 F.3d 376, 379 (3d Cir. 2003) (quoting Smith v. Califano, 637 F.2d 968, 970 (3d Cir. 1981)).
. Gilliland v. Heckler, 786 F.2d 178, 184 (3d Cir. 1986) (internal citations omitted).
. 28 U.S.C. § 636(b)(1)(c).
. 42 U.S.C. § 423(d)(1)(A); see also Barnhart v. Thomas, 540 U.S. 20, 23, 124 S.Ct. 376, 157 L.Ed.2d 333 (2003).
. Sykes v. Apfel, 228 F.3d 259, 262-63 (3d Cir. 2000); 20 C.F.R. § 404.1520.
. See 20 C.F.R. §§ 404.1520(d), 416.920(d).
. R. 116-19. It appears that Plaintiff's representative requested an appointment on August 5, 2011, and the appointment occurred on August 26, 2011. R. 116.
. R. 14.
. R. 14.
. 20 C.F.R. pt. 404, subpt. P, app. 1, § 12.04(B). As discussed below, episodes of decompensation are “exacerbations or temporary increases in symptoms or signs accompanied by a loss of adaptive functioning, as manifested by difficulties in performing activities of daily living, maintaining social relationships, or maintaining concentration, persistence, or pace.” 20 C.F.R. pt. 404, subpt. P, app. 1, § 12.00(C)(4).
. R. 15-16.
. 20 C.F.R. pt. 404, subpt. P, app. 1, § 12.04(C).
. R. 16.
. R. 16, 23.
. R. 24.
. R & R at 14.
. R & R at 15.
. R& Rat 17-18.
. R& Rat 19-21.
. R& Rat 22-24.
. Pl.’s Objections at 2.
. Def.’s Response to Objections at 5-6.
. R 16-17.
. 20 C.F.R. pt. 404, subpt. P, app. 1, § 12.00(C)(4).
. R. 116.
. R. 18.
. R. 19.
. 20 C.F.R. pt. 404, subpt. P, app. 1, § 12.00(D)(2).
. 20 C.F.R. § 416.912(d)(2) (emphasis added). Although the ALJ’s opinion stated at the outset that he considered "the complete medical history consistent with 20 CFR 416.912(d),” R. 12, the fair reading of the opinion is that little or no weight was given to hospitalizations occurring before the application date.
. The ALJ stated that "[t]his would count as an episode of decompensation of extended duration, although it also occurred before the alleged onset date.” R. 19.
. 20 C.F.R. pt. 404, subpt. P, app. 1, § 12.00(C)(4). The Court disagrees with the conclusion of the R & R that even if all of the hospitalizations were considered, they did not meet or equal the Listing. That finding is better reached in the first instance by the ALJ upon full consideration of all the evidence.
. SSR 96-6p.
Reference
- Full Case Name
- Shivangi PATEL v. Carolyn W. COLVIN, Acting Commissioner of Social Security
- Status
- Published