United States District Court, D. New Jersey
For ALICIA CINTRON, Plaintiff: JON C. DUBIN, LEAD ATTORNEY, RUTGERS SCHOOL OF LAW-NEWARK, NEWARK, NJ.
For COMMISSIONER OF SOCIAL SECURITY, Defendant: LAUREN ELIZABETH MYERS, LEAD ATTORNEY, SOCIAL SECURITY ADMINISTRATION, OFFICE OF THE GENERAL COUNSEL, NEW YORK, NY; MICHELLE LYNN CHRIST, LEAD ATTORNEY, UNITED STATES ATTORNEY'S OFFICE - DISTRICT OF NEW JERSE, NEW YORK, NY.
KEVIN MCNULTY, United
States District Judge.
Alicia Cintron brings this action pursuant to 42 U.S.C. § 405(g) and 42 U.S.C. § 1383(c)(3) to review a final decision of the Commissioner of Social Security (" Commissioner") denying her claim for Title II Disability Insurance Benefits (" DIB") and Title XVI Supplemental Security Income (" SSI"). Cintron alleges that she is unable to engage in substantial gainful activity because she suffers from depression, anxiety, and panic attacks. (PL Letter 1, ECF No. 10).
Because the Administrative Law Judge misapplied the step-two analysis of the five-step process for adjudicating claims, I will remand this matter for further proceedings. Cintron raises other claims of error: essentially, that the ALJ failed to discharge his special duty to develop the record when an applicant appears pro se, and erred in his evaluation of the medical records in the case. As the analysis proceeds past step two on remand, those objections may be mooted. On remand, the ALJ should: 1) further develop the record regarding Cintron's impairments, 2) evaluate the Norgren report; and 3) provide justifications for why certain reports have been discredited, in whole or in part
Cintron seeks DIB and SSI benefits for a period of disability beginning December 15, 2009. (Administrative Record 107-112, 114-118, ECF No. 8). Cintron's original applications for benefits were denied (Id. 44-46, 52-54), and she requested that her claim be reconsidered (Id. 55-56). After holding a hearing, Administrative Law Judge (" ALJ") Richard De Steno denied Cintron's claim in a decision dated July 6, 2012. (Id. 28-29, 17-24). In a letter dated September 26, 2013, the Appeals Council denied the appeal, making the ALJ's decision the " final decision" of the Commissioner. (Id. 1-5). Cintron now appeals that decision.
To qualify for Title II DIB benefits, a claimant must meet the insured status requirements of 42 U.S.C. § 423(c). To be eligible for SSI benefits, a claimant must meet the income and resource limitations of 42 U.S.C. § 1382. To qualify under either statute, a claimant must show that she is unable to engage in substantial gainful activity by reason of any medically determinable physical or mental impairment that can be expected to result in death or that has lasted (or can be expected to last) for a continuous period of not less than twelve months. 42 U.S.C. § § 423(d)(1)(A), 1382c(a)(3)(A).
Cintron submits that the Commissioner's decision is not supported by substantial evidence. Specifically, Cintron argues that the ALJ: 1) erroneously found that her medical condition did not meet Step Two of the Five-Step Process for reviewing her claim; 2) failed to develop the record fully and fairly, in light of her mental impairment and her status as a pro se applicant; 3) failed to substantiate his findings that she lacked credibility; and 4) improperly evaluated her medical records. (Pl. Br., ECF No. 13).
a. Five-Step Process and this Court's Standard of Review
Under the authority of the Social Security Act, the Social Security Administration has established a five-step evaluation process for determining whether a claimant is entitled to benefits. 20 CFR § § 404.1520, 416.920. Review necessarily incorporates a determination of whether the ALJ properly followed the five-step process prescribed by regulation. The steps may be briefly summarized as follows:
Step 1: Determine whether the claimant has engaged in substantial gainful activity since the onset date of the alleged disability. 20 CFR § § 404.1520(b), 416.920(b). If not, move to step two.
Step 2: Determine if the claimant's alleged impairment, or combination of impairments, is " severe." Id. § § 404.1520(c), 416.920(c). If the claimant has a severe impairment, move to step three.
Step 3: Determine whether the impairment meets or equals the criteria of any impairment found in the Listing of Impairments. 20 CFR Part 404, Subpart P, Appendix 1, Part A. If so, the claimant is automatically eligible to receive benefits; if not, move to step four. Id. § § 404.1520(d), 416.920(d).
Step 4: Determine whether, despite any severe impairment, the claimant retains the Residual Functional Capacity (" RFC") to perform past relevant work. Id. § § 404.1520(e)-(f), 416.920(e)-(f). If not, move to step five.
Step 5: At this point, the burden shifts to the SSA to demonstrate that the claimant, considering her age, education, work experience, and RFC, is capable of performing jobs that exist in significant numbers in the national economy. 20 CFR § § 404.1520(g), 416.920(g); see Poulos v. Comm'r of Soc. Sec., 474 F.3d 88, 91-92 (3d Cir. 2007). If so, benefits will be denied; if not, they will be awarded.
As to all legal issues, this Court conducts a plenary review. Schaudeck v. Comm'r of Soc. Sec., 181 F.3d 429, 431 (3d Cir. 1999). As to factual findings, this Court adheres to the ALJ's findings, as long as they are supported by substantial evidence. Jones v. Barnhart, 364 F.3d 501, 503 (3d Cir. 2004) (citing 42 U.S.C. § 405(g)). Where facts are disputed, this Court will " determine whether the administrative record contains substantial evidence supporting the findings." Sykes v. Apfel, 228 F.3d 259, 262 (3d Cir. 2000). Substantial evidence " means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Jones v. Barnhart, 364 F.3d 501, 503 (3d Cir. 2004) (citation omitted). That is " less than a preponderance of the evidence but more than a mere scintilla." Id.
[I]n evaluating whether substantial evidence supports the ALJ's findings . . . leniency should be shown in establishing the claimant's disability, and ... the Secretary's responsibility to rebut it should be strictly construed. Due regard for the beneficent purposes of the legislation requires that a more tolerant standard be used in this administrative proceeding than is applicable in a typical suit in a court of record where the adversary system prevails.
Reefer v. Barnhart, 326 F.3d 376, 379 (3d Cir. 2003) (internal citations and quotations omitted). When there is substantial evidence to support the ALJ's factual findings, this Court must abide by them. See Jones, 364 F.3d at 503 (citing 42 U.S.C. § 405(g)).
This Court may, under 42 U.S.C. § 405(g) and the Third Circuit's Podedworny opinion, affirm, modify, or reverse the Secretary's decision, with or without a remand to the Secretary for a rehearing. Podedworny v. Harris, 745 F.2d 210, 221 (3d Cir. 1984); Bordes v. Commissioner, 235 Fed.Appx. 853, 865-66 (3d Cir. 2007).
Outright reversal with an award of benefits is appropriate only when a fully developed administrative record contains substantial evidence indicating that the claimant is disabled and entitled to benefits. Podedworny, 745 F.2d at 221-222; Morales v. Apfel, 225 F.3d 310, 320 (3d Cir. 2000); see also Bantleon v. Comm'r of Soc. Sec., 2010 U.S. Dist.
LEXIS 99537, at *38-39 (D.N.J. 2010).
Remand is proper if the record is incomplete, or if there is a lack of substantial evidence to support a definitive finding on one or more steps of the five step inquiry. See Podedworny, 745 F.2d at 221-22. Remand is also proper if the ALJ's decision lacks adequate reasoning or support for its conclusions, or if it contains illogical or contradictory findings. See Burnett v. Commissioner of SSA, 220 F.3d 112, 119-20 (3d Cir. 2000); Leech v. Barnhart, 111 F.App'x 652, 658 (3d Cir. 2004) (" We will not accept the ALJ's conclusion that Leech was not disabled during the relevant period, where his decision contains significant contradictions and is therefore unreliable."). It is also proper to remand where the ALJ's findings are not the product of a complete review which " 'explicitly' weigh[s] all relevant, probative and available evidence" in the record. Adorno v. Shalala, 40 F.3d 43, 48 (3d Cir. 1994).
b. The ALJ's decision
The ALJ truncated the five-step analysis at step two. At step one, the ALJ determined that Cintron had not engaged in substantial gainful activity since December 15, 2009, her alleged onset date. (R. 19). At step two, the ALJ conducted a two-part analysis pursuant to 20 CFR Pt. 404, Subpt. P, App. 1, and found that: 1) Cintron had " medically determinable impairments" of depression and anxiety; but 2) Cintron did not suffer from " severe impairment[s]" because her impairments did not significantly limit her " ability to perform basic work-related activities for 12 consecutive months." (R. 19 (citing 20 CFR § § 404.1521 et seq . and 416.921 et seq .)). In evaluating the " intensity, persistence, and limiting effects" of Cintron's impairments, the ALJ considered the four broad functional areas outlined in the regulation: 1) daily living, 2) social functioning, 3) concentration, persistence, or pace; and 4) episodes of decompensation. (R. 20-22); 20 CFR Pt. 404, Subpt. P, App. 1. The ALJ found that Cintron suffered from " mild limitation" in the first three functional areas and that she had not experienced any episodes of decompensation of extended duration. (R. 22-23). Overall, the ALJ found that Cintron's depression and anxiety have not have " any greater than a slight or minimal effect on her ability to perform basic work activities for 12 continuous months." (R. 23). The ALJ based this decision on differing ...