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Spadaccini v. Colvin

United States District Court, D. New Jersey

March 30, 2017

STEPHEN SPADACCINI, Plaintiff,
v.
CAROLYN W. COLVIN, Acting Commissioner of Social Security, Defendant.

          OPINION

          KEVIN MCNULTY, United States District Judge

         Stephen Spadaccini brings this action pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3) to review a final decision of the Commissioner of Social Security ("Commissioner") denying in its entirety his claim for Disability Insurance Benefits ("DIB") and denying in part his claim for Supplemental Security Income ("SSI") under Titles II and XVI of the Social Security Act, 42 U.S.C. §§ 401-434 and 1381-1385. For the reasons set forth below, the decision of the Administrative Law Judge ("ALJ") is VACATED and REMANDED for consideration of Dr. Brabston's opinion as it may bear on Spadaccini's RFC from January 1, 2009 through March 5, 2011.

         I. BACKGROUND

         Spadaccini seeks to reverse an ALJ's finding that he was not disabled from September 1, 2007, through December 31, 2008, Spadaccini's date last insured. (Complaint, ECF no. 1, ¶¶ 8-9) Spadaccini also states that the ALJ failed to determine whether he was disabled from January 1, 2009, to March 5, 2011, for purposes of his claim for SSI, and he seeks a ruling on that issue. (Id.)

         Spadaccini applied for DIB and SSI on August 1, 2008, [1] claiming that he was disabled since September 1, 2007, due to chronic heart failure, ischemic heart disease, recurrent arrhythmias, cardiomyopathy, coronary heart disease, stroke, arthritis, and depression. (R. 508)[2] His application was denied initially on January 23, 2008 (R. 81-84), and upon reconsideration on June 26, 2009 (R. 83-84). On April 15, 2011, following a hearing at which Spadaccini testified and was represented by counsel (R. 30-50), and a supplementary hearing so that Spadaccini could question medical expert Dr. Martin Fechner (R. 51-80), ALJ Richard West found that Spadaccini was "disabled, " as defined in the Social Security Act, starting on March 6, 2011, and awarded SSI from that date. (R. 19-29). However, the ALJ also denied Spadaccini DIB because his insured status expired on December 31, 2008. (Id.) On August 9, 2012, the Appeals Council denied Spadaccini's request for review (R. 1-5), rendering the ALJ's decision the final decision of the Commissioner. Spadaccini then appealed to this Court, challenging the ALJ's determination that he was not disabled from September 1, 2007 through March 5, 2011.

         On November 15, 2013, District Judge Martini of this Court vacated and remanded for reconsideration the Commissioner's decision. (R. 512) First, Judge Martini found that substantial evidence supported the ALJ's finding that Spadaccini does not have a listing-level impairment. (R. 509) Second, Judge Martini found that the ALJ did not err in affording greater weight to the opinion of medical expert Dr. Martin Fechner than to Spadaccini's treating physician Dr. Fuad Ahmad. [Id.) However, Judge Martini did find that the ALJ failed to adequately consider the assessment of Dr. Timothy Brabston, another of Spadaccini's treating physicians. Although the ALJ did mention Dr. Brabston's opinion, the ALJ neither indicated the weight he accorded to Dr. Brabston's opinion, nor did he adequately explain his implicit rejection of that opinion. (R. 511) As a result, the Court could not determine whether the ALJ's determination regarding Spadaccini's residual functional capacity ("RFC") was supported by substantial evidence. (Id.) As a further consequence, Judge Martini was unable to assess whether vocational expert testimony was required to determine whether Spadaccini was capable of performing jobs that exist in significant numbers in the national economy. (Id.)

         On remand, on June 15, 2015, ALJ West determined that Spadaccini was not under a disability, as defined in the Social Security Act, at any time from September 1, 2007, through December 31, 2008, the date last insured. (R. 428) However, the ALJ did not make a determination on remand as to whether Spadaccini was disabled at any time from January 1, 2009, through March 5, 2011. Spadaccini now appeals the ALJ's decision.

         II. DISCUSSION

         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 Title XVI 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 he 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); see, e.g., Diaz v. Comm'r of Soc. Sec, 577 F.3d 500, 503 (3d Cir. 2009).

         A. Five-Step Process and this Court's Standard of Review

         Under the authority of the Social Security Act, the Social Security Administration (the "Commissioner") has established a five-step evaluation process for determining whether a claimant is entitled to benefits. 20 C.F.R. §§ 404.1520, 416.920. This Court's 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 C.F.R. §§ 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 C.F.R. Pt. 404, Subpt. P, App. 1, Pt. A. (Those Part A criteria are purposely set at a high level, to identify clear cases of disability without further analysis.) 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 Commissioner to demonstrate that the claimant, considering his age, education, work experience, and RFC, is capable of performing jobs that exist in significant numbers in the national economy. 20 C.F.R. §§ 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. See 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 is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Zirnsak v. Colvin, 777 F.3d 607, 610 (3d Cir. 2014) (internal quotation marks and citation omitted). Substantial evidence "is more than a mere scintilla but may be somewhat less than a preponderance of the evidence." Id. (internal quotation marks and citation omitted).

[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, however, this Court must abide by them. See Jones, 364 F.3d at 503 (citing 42 U.S.C. § 405(g)); Zirnsak, 777 F.3d at 610-11 ("[W]e are mindful that we must not substitute our own judgment for that of the fact finder.").

         This Court may, under 42 U.S.C. §§ 405(g) and 1383(c)(3), affirm, modify, or reverse the Commissioner's decision, or it may remand the matter to the Commissioner for a rehearing. Podedwomy v. Harris, 745 F.2d 210, 221 (3d Cir. 1984); Bordes v. Comm'r of Soc Sec, 235 F.App'x 853, 865-66 (3d Cir. 2007) (not precedential).

         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. Comm'r of Soc. Sec, 220 F.3d 112, 119-20 (3d Cir. 2000). 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) (internal quotation marks omitted).

         B. The ALJ's Decision

         ALJ West properly followed the five-step process in determining that Spadaccini was not disabled for the period from September 1, 2007, through December 31, 2008. His findings may be summarized as follows.

         Step 1

         At step one, the ALJ determined that Spadaccini had not engaged in substantial gainful activity in the relevant period. (R. 423 ¶ 2)

         Step 2

         At step two, the ALJ found that Spadaccini had the following severe impairments: "coronary artery disease, cardiac dysrhythmia, hypertension, osteoarthritis, and a history of cocaine and ...


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