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Francis J. Paradise, Jr v. Commissioner of Social Security

August 31, 2011

FRANCIS J. PARADISE, JR., PLAINTIFF,
v.
COMMISSIONER OF SOCIAL SECURITY, DEFENDANT.



The opinion of the court was delivered by: Honorable Jerome B. Simandle

OPINION

SIMANDLE, District Judge:

I. INTRODUCTION

This matter comes before the Court pursuant to 42 U.S.C. § 405(g) for review of the final decision of the Commissioner of the Social Security Administration denying Plaintiff Francis J. Paradise, Jr.'s application for Disability Insurance Benefits and Supplemental Security Income under Title II and Title XVI of the Social Security Act.

At issue in this case is whether the Administrative Law Judge properly rejected the findings of one of Plaintiff's treating physicians regarding the effect and severity of Plaintiff's kidney stones. As explained below, the Court finds that the ALJ did not determine with sufficient specificity the frequency of Plaintiff's kidney stones, nor did the ALJ determine how frequent the stones could be before Plaintiff would be considered disabled. The Court will therefore vacate and remand this case.

II. BACKGROUND

Plaintiff, Francis J. Paradise, Jr., is a 44-year-old high school graduate who worked as a carpet cleaner from 1997 to 2001.

R. 32, 126-127. He has not worked at all since February 12, 2006. R. 34. He seeks Disability Insurance Benefits and Supplemental Security Income because he claims to be unable to work, primarily because of pain from recurring kidney stones, coupled with lower back pain and loss of hearing.

In order to be eligible for Supplemental Security Income, an individual must demonstrate that he or she is unable to engage in any substantial gainful activity due to any medically determinable physical or mental impairment which has lasted, or can be expected to last, for a continuous period of at least twelve months. 42 U.S.C. § 1382c(a)(3)(A). A disabling physical or mental impairment is defined as "an impairment that results from anatomical, physiological, or psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques." 42 U.S.C. § 1382c(a)(3)(D). An individual will be determined to be under a disability only if his impairment is of such severity that he is not only unable to do his previous work, but also cannot, given his age, education, and work experience, engage in any other kind of substantial gainful work. 42 U.S.C. § 1382c(a)(3)(B).

The Commissioner has promulgated regulations for determining whether a claimant has a disability. 20 C.F.R. § 416.920.*fn1 It is the claimant's burden to show that he or she is severely impaired, and either that the severe impairment meets or equals a listed impairment and lasts for the requisite duration, or that it prevents the claimant from performing the claimant's past work. Wallace v. Secretary of Health and Human Services, 722 F.2d 1150, 1153 (3d Cir. 1983). If the claimant meets those burdens by a preponderance of the evidence, the Commissioner bears the burden of proving that work is available for the claimant. Kangas v. Bowen, 823 F.2d 775, 777 (3d Cir. 1987). Ultimately, entitlement to benefits is dependent upon finding the claimant is incapable of performing work in the national economy.

Paradise filed an application for insurance and supplemental income benefits on June 29, 2006, alleging a disability as of February 12, 2006. R. 11. The applications were denied initially on November 20, 2006, and again on reconsideration on August 1, 2007. R. 11. Plaintiff filed a request for a hearing before an ALJ on October 31, 2007. R. 11.

A hearing was held on April 22, 2009. R. 11. The ALJ found that Paradise was eligible for benefits, and had three severe impairments: recurrent kidney stones, lower back pain, and sensorineural hearing loss. R. 13. However, the ALJ concluded that none of the three impairments meets or equals a listed impairment, and that Paradise has sufficient residual functional capacity to perform his former job as carpet cleaner.

In particular, the ALJ acknowledged that multiple treating physicians had diagnosed Plaintiff with recurring kidney stones, causing severe pain. R. 15. However, the ALJ rejected Paradise's treating physician's finding that Plaintiff was disabled because that finding was "inconsistent with the overall clinical findings and diagnostic studies," based on the fact that the kidney stones were only "intermittent." R. 16. The ALJ instead relied on the assessment of Dr. Ken Klausman, a consulting physician who examined Plaintiff once in April 2009, and who opined that when not afflicted by kidney stones Plaintiff was physically capable of performing ordinary tasks. R. 16; Ex. 32F. The ALJ ...


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