The opinion of the court was delivered by: Simandle, District Judge
HONORABLE JEROME B. SIMANDLE
This matter comes before the Court pursuant to Section 205(g) of the Social Security Act, as amended, 42 U.S.C. § 405(g) (2006), to review the final decision of the Commissioner of the Social Security Administration denying the application of Claimant Deborah E. Brown ("Mrs. Brown" or "Claimant") for Disability Insurance Benefits ("DIB") under Title II of the Social Security Act. See 42 U.S.C. §§ 401-34 (2006). Mrs. Brown filed for DIB on March 10, 2003, alleging she has been disabled since December 24, 2002, due to constant pain in her back, left leg and left hip. (R. at 140.) Claimant urges this Court to reverse the administrative decision and award Claimant benefits, or alternatively, to vacate the administrative decision and remand the case to the Commissioner for an award of benefits.
At issue in this case is whether there is substantial evidence in the record to support the determination of the Administrative Law Judge ("ALJ") that Claimant does not qualify as "disabled" under the Social Security Act. This Court must therefore assess whether, in light of the medical evidence and relevant testimony, the ALJ properly assessed Claimant's residual functional capacity to perform her past relevant work. In answering that question, this Court must assess 1) whether the ALJ properly assessed the credibility of Claimant's complaints of pain, 2) whether the ALJ afforded appropriate deference to the opinion of Claimant's treating physician and 3) whether the ALJ conducted a proper function-by-function assessment of Claimant's work-related abilities.
The Court has considered the submissions of the parties pursuant to Local Civil Rule 9.1. Because the ALJ's decision fails to consider whether Claimant's migraine headaches and trigeminal neuralgia*fn1 would impact her ability to perform work-related functions on a regular and continuing basis pursuant to 20 C.F.R. §§ 416.945(b)-(d) and 404.145(b)-(d) in performing the function-by-function assessment at Step Four of the analysis, the Court will remand to the ALJ to reconsider his opinion in accordance with the reasoning set out in this decision.
A. Standard for Judicial Review
Under 42 U.S.C. § 405(g), Congress provided for judicial review of the Commissioner's decision to deny a claimant's application for Disability Insurance Benefits. See Ventura v. Shalala, 55 F.3d 900, 901 (3d Cir. 1995). A reviewing court must uphold the Commissioner's factual decisions where they are supported by "substantial evidence." 42 U.S.C. §§ 405(g), 1383(c)(3); Fargnoli v. Massanari, 247 F.3d 34, 38 (3d Cir. 2001). Substantial evidence means more than "a mere scintilla." Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)). It means "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Id. The inquiry is not whether the reviewing court would have made the same determination, but whether the Commissioner's conclusion was reasonable. See Brown v. Bowen, 845 F.2d 1211, 1213 (3d Cir. 1988). Indeed, the "substantial evidence standard is deferential and includes deference to inferences drawn from the facts if they, in turn, are supported by substantial evidence." Shaudeck v. Comm'r of Soc. Sec., 181 F.3d 429, 431 (3d Cir. 1999).
A reviewing court has a duty to review the evidence in its totality. See Daring v. Heckler, 727 F.2d 64, 70 (3d Cir. 1984). "[A] court must 'take into account whatever in the record fairly detracts from [a particular piece of evidence's] weight.'" Schonewolf v. Callahan, 972 F. Supp. 277, 284 (D.N.J. 1997) (quoting Willbanks v. Sec'y of Health & Human Servs., 847 F.2d 301, 303 (6th Cir. 1988) (quoting Universal Camera Corp. v. NLRB, 340 U.S. 474, 488 (1951))).
The ALJ has a duty "to develop the record fully and fairly." Thompson v. Sullivan, 878 F.2d 1108, 1110 (8th Cir. 1089). The ALJ must set out a specific factual basis for each finding. Baerga v. Richardson, 500 F.2d 309 (3d Cir. 1974), cert. denied, 420 U.S. 931 (1975); Boot v. Heckler, 618 F. Supp. 76, 79 (D. Del. 1985). Simply referring to the "record" is insufficient. Abshire v. Bowen, 662 F. Supp. 8 (E.D. Pa. 1986). However, an ALJ need not explicitly discuss every piece of relevant evidence in his or her decision. See Fargnoli, 247 F.3d at 42. Additionally, the ALJ "must adequately explain in the record [the] reasons for rejecting or discrediting competent evidence," Ogden v. Bowen, 677 F. Supp 273, 278 (M.D. Pa. 1987) (citing Brewster v. Heckler, 786 F.2d 581 (3d Cir. 1986)), including medical evidence and all non-medical evidence presented. Burnett v. Comm'r of Soc. Sec., 220 F.3d 112, 122 (3d Cir. 2000).
The Third Circuit has held that access to the Commissioner's reasoning is indeed essential to a meaningful court review:
Unless the [Commissioner] has analyzed all evidence and has sufficiently explained the weight he has given to obviously probative exhibits, to say that his decision is supported by substantial evidence approaches an abdication of the court's duty to scrutinize the record as a whole to determine whether the conclusions reached are rational.
Gober v. Matthews, 574 F.2d 772, 776 (3d Cir. 1978) (citing Arnold v. Sec'y of Health, Educ. & Welfare, 567 F.2d 258, 259 (4th Cir. 1977)). A district court is not "empowered to weigh the evidence or substitute its conclusions for those of the fact-finder." Williams v. Sullivan, 970 F.2d 1178, 1182 (3d Cir. 1992).
B. Standard for Disability Insurance Benefits under Title II of the Social Security Act
The Social Security Act defines "disability" for purposes of entitlement to DIB as the 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 twelve months." 42 U.S.C. §§ 423(d), 1382c(a)(3)(B) (2006). Under this definition, "a claimant qualifies as disabled only if [that claimant's] physical or mental impairments are of such severity that [the claimant] is not only unable to do his [or her] previous work, but cannot, considering [the claimant's] age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy. . ." 42 U.S.C. §§ 423(d)(2)(A), 1382c(a)(3)(B) (2006). Impairments must be considered in combination when making a disability determination. Burnam v. Schweiker, 682 F.2d 45 6, 458 (3d. Cir. 1982).
The Commissioner has promulgated regulations for determining disability that require application of a five-step sequential analysis. 20 C.F.R. § 404.1520 (2006). This process is summarized as follows:
1. If currently is engaged in substantial gainful employment, the claimant will be found "not disabled."
2. If not suffering from a "severe impairment," the claimant will be found "not disabled."
3. If the severe impairment meets or equals a listed impairment in 20 C.F.R. Part 404, Subpart P, Appendix 1 and has lasted or is expected to last for a continuous period of at least twelve months, the claimant will be found "disabled."
4. If able to still perform work done in the past despite the severe impairment, the claimant will be found "not disabled."
5. Finally, the Commissioner will consider the claimant's ability to perform work, age, education, and past work experience to determine whether or not the claimant is capable of performing other work which exists in the national economy. If incapable, the claimant will be found "disabled." If capable, the claimant will be found "not disabled."
20 C.F.R. § 404.1520(b)-(f). Entitlement to benefits is therefore dependent upon finding the claimant is incapable of performing work in the national economy.
This analysis involves a shifting burden of proof. Wallace, 722 F.2d at 1153. In the first four steps of the analysis, the burden is on the claimant to prove every element of his claim by a preponderance of the evidence. Id. In the final step, the Commissioner bears the burden of proving that work is available for the claimant: "Once a claimant has proved that he is unable to perform his former job, the burden shifts to the Commissioner to prove that there is some other kind of substantial gainful employment he is able to perform." Kangas v. Bowen, 823 F.2d 775, 777 (3d Cir. 1987) (citing Chicager v. Califano, 574 F.2d 161 (3d Cir. 1978)).
On March 10, 2003, Claimant filed an application for DIB, alleging a disability onset date of December 24, 2002 (R. at 111-13), due to constant pain in her back, left leg and hip. (R. at 140). The Social Security Administration ("SSA") denied the claim both initially, (R. at 53-57), and on reconsideration. (R. at 60-62). On December 2, 2003, Claimant subsequently filed a Request for an Administrative Hearing, (R. at 63), which was held before ALJ Linda Bernstein on January 27, 2005. (R. at 71, 402-32). The ALJ issued a denial of benefits on March 31, 2005, (R. at 36-47), at which time Claimant filed a request for review.
(R. at 86). On September 16, 2005, the Appeals Council vacated the ALJ's decision, citing, inter alia, the ALJ's failure to conduct a function-by-function assessment of the case. (R. at 18, 48-52.) The Appeals Council then remanded the case to the ALJ for further evaluation. (Id.)
The remand hearing was held on April 20, 2006 before AlJ Mark Barrett (R. at 433-490.) On June 30, 2006, the ALJ issued a decision ruling that Claimant was not entitled to DIB because she was not disabled within the meaning of the Social Security Act.
(R. at 19, 25.) The ALJ found that Claimant has not engaged in substantial gainful activity since her alleged date of disability, (R. at 25), and concluded that Claimant's cervical and lumbar degenerative arthritis, trigeminal neuralgia, migraine headaches, hypertension and right carpal tunnel syndrome are severe impairments, based on the requirements in federal regulations 20 CFR § 404.1520(c). (Id.) However, he also found that these impairments do not meet or medically equal one of the impairments listed in Appendix 1, Subpart P, Regulation No. 4. (Id.)
After reviewing all the evidence in the record, the ALJ concluded that although the Claimant has some subjective symptoms, they are not of the intensity, frequency, or duration alleged. (R. at 23.) Specifically, the ALJ found that Claimant's alleged functional limitations are not totally credible, in light of the medical findings and Claimant's alleged high level of daily activities. (R. at 23-24.) Accordingly, the ALJ found that Claimant has the residual functional capacity to lift and/or carry twenty pounds occasionally and ten pounds frequently; the ability to stand and/or walk at least two hours and sit for about six hours in an eight hour workday; and unlimited use of her upper and lower extremities for pushing/pulling, other than as shown for lifting/carrying. (R. 25-26.) Furthermore, the ALJ found that although Claimant can never climb ladders/ropes/scaffolds, she is able to occasionally climb ramps/stairs, balance, stoop, kneel, crouch and crawl; and she should avoid concentrated exposure to extremes in temperatures, wetness/humidity, noise/vibrations, excessive pollutants, and hazards such as moving machinery and unprotected heights (R. at 26.)
Finally, in finding that the Claimant's past relevant work as a Social Worker/Case Worker does not require the performance of work-related activities precluded by her residual functional capacity ("RFC"), and that the claimant's medically determinable impairments do not prevent her from performing her past relevant work, the ALJ was able to conclude that Claimant was not "disabled," as defined in the Social Security Act, at ...