United States District Court, D. New Jersey
MCNULTY, UNITED STATES DISTRICT JUDGE.
Woods brings this action pursuant to 42 U.S.C. §§
405(g) and 1383(c) to review a final decision of the
Commissioner of Social Security ("Commissioner")
denying Woods's claims for Disability Insurance Benefits
("DIB") under Title II of the Social Security Act
(the "SSA") and for Supplemental Security Income
("SSI") under Title XVI of the SSA. See 42
U.S.C. §§ 401-403 and 1381-1385. For the reasons
set forth below, the careful and well-reasoned decision of
the Administrative Law Judge ("ALJ") is largely
affirmed, but is REVERSED and REMANDED for further
proceedings as to certain discrete issues, listed in the
Conclusion to this opinion.
applied for DIB and SSI benefits on August 23, 2012, alleging
a November 10, 2011 onset of disability (R
529-38). Her claim was denied initially on January
17, 2013 (R 452-63), and again on reconsideration on May 22,
2013 (R 473-75). Woods subsequently requested and received a
hearing before an ALJ (see R 30-61, 476), at which she
testified on June 17, 2014 (see R 36-51).
Kimberly L. Schiro issued a decision dated July 29, 2014,
finding Woods "not disabled" (see R 15-25). On
October 2, 2014, Woods filed a request for review of the
ALJ's decision (see R 9-11), which the Appeals Council
denied on January 27, 2016 (see R 1-5), thereby rendering the
ALJ's July 29, 2014 decision the final decision of the
Commissioner. Woods now appeals that decision.
application is relevant. Woods filed for Title II DIB on
August 13, 2009, alleging that she had been disabled since
February 26, 2009. (See R 15) Another ALJ, Miachel L. Lissek,
denied Woods's 2009 application in a decision dated
November 9, 2011. See Woods v. Colvin, No.
12-CV-06088 DMC JBC, 2013 WL 5730539. (See also R
235-378 (Exhibits 1F-18F)) On appeal to the United States
District Court for the District of New Jersey, Judge
Cavanaugh affirmed ALJ Lissek's decision on October 21,
2013. See Woods, 2013 WL 5730539, at *1. Referring
to this history, ALJ Schiro concluded in her July 29, 2014
decision that Woods likely had an even greater residual
functional capacity than she had possessed in 2011. (R 15)
qualify for Title II DIB benefits, a claimant must meet the
insured status requirements of 42 U.S.C. § 423. 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 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); see, e.g., Diaz v. Comm'r of Soc.
Sec, 577 F.3d 500, 503 (3d Cir. 2009).
Five-Step Process and this Court's Standard of
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. 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 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 3: Determine whether the impairment
meets or equals the criteria of any impairment found in the
Listing of Impairments. 20 CFR Pt. 404, Subpt. P, App. 1, Pt.
A. If so, the claimant is automatically eligible to receive
benefits (and the analysis ends); 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 Social Security Administration 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
purpose of this appeal, the Court conducts a plenary review
of the legal issues. See Schaudeck v. Comm'r of Soc.
Sec, 181 F.3d 429, 431 (3d Cir. 1999). The factual
findings of the ALJ are reviewed "only to 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 "less than a preponderance of the evidence
but more than a mere scintilla." Jones v.
Barnhart, 364 F.3d 501, 503 (3d Cir. 2004) (citation
omitted). "It means such relevant evidence as a
reasonable mind might accept as adequate to support a
conclusion." Id. When substantial evidence
exists to support the ALJ's factual findings, this Court
must abide by the ALJ's determinations. See Id.
(citing 42 U.S.C. § 405(g)).
Court may, under 42 U.S.C. § 405(g), 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) (non-precedential). Outright reversal with an
award of benefits is appropriate only when a fully developed
administrative record contains substantial evidence that the
claimant is disabled and entitled to benefits.
Podedwomy, 745 F.2d at 221-222; Morales v.
Apfel, 225 F.3d 310, 320 (3d Cir. 2000).
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
Podedwomy, 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); Leech v.
Barnhart, 111 F.App'x 652, 658 (3d Cir. 2004)
("We will not accept the ALJ's conclusion that [the
claimant] was not disabled during the relevant period, where
his decision contains significant contradictions and is
therefore unreliable.") (not precedential). 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. Adomo v. Shalala, 40 F.3d 43, 48 (3d Cir.
1994) (internal quotation marks omitted).
The ALJ's Decision
Schiro properly followed the five-step process. I summarize
her conclusions here:
At step one, ALJ Schiro found that Woods met the insured
requirements of the SSA through December 31, 2014, and had
not engaged in substantial gainful activity from the alleged
onset date of November 10, 2011 (R 17).
At step two, the ALJ found that Woods had the following
severe impairments: insulin dependent diabetes mellitus,
degenerative joint disease of the spine, and depression with
anxiety (R 18).
At this step, the ALJ rejected Woods's claim that she
suffers a severe impairment attributable to fibromyalgia.
Substantial evidence in the record, which the ALJ thoroughly
evaluated, supported this conclusion. Specifically, ALJ
Schiro recognized that Woods reported to consultative
examiner Rahel Eyassu, MD that she had been diagnosed with
fibromyalgia. But the ALJ also observed that medical records
from Woods's treating physicians did not show any such
diagnosis or evidence of the tender points typically
associated with fibromyalgia. (R 18; see, e.g., R
555, 604-606, 617-23) Woods was not receiving medication or any
other treatment for fibromyalgia. (Id.)
Consistently, the consultative examiner found no joint
swelling, crepitus, or instability, and could not identify
any particular trigger/tender points because, during a
trigger point examination, Woods complained of pain
The ALJ also acknowledged Woods's alleged fibroids and
anemia, but again concluded that the treatment records did
not establish that either caused a medically determinable
severe impairment. (R 18, 555; see, e.g., 604,
616-33) Substantial evidence supported this conclusion as
At step three, ALJ Schiro stated that Woods's impairment
or combination of impairments neither met nor medically
equaled the severity of one of the listed impairments in 20
C.F.R. Part 404, Subpart P, Appendix 1 (R 18). With respect
to physical impairments, she found that Woods failed to meet
the criteria for medical listing 1.02, Major dysfunction of
joint(s); for medical listing 1.04, Disorders of the
Spine; and for medical listing 9.08, Diabetes
mellitus. ALJ Schiro specifically found that there
was no evidence of neuropathy, acidosis, retinopathy, or any
end organ damage to support Listing 9.08. I find that
substantial evidence supports these conclusions.
also found that Woods's mental impairments, alone and in
combination, did not meet or medically equal listings 12.04,
Depressive, bipolar and related disorders, or 12.06, Anxiety
and obsessive-compulsive disorders.
Schiro acknowledged that Woods reported to the psychiatric
consultative examiner, Dr. Tolchin, that she has received
outpatient care for mental disorders since 2012. But the ALJ
found no evidence regarding mental health care in the record.
She noted that Woods also testified at her hearing that she
is not receiving mental health treatment or being prescribed
psychotropic medication. (R 18) ALJ Schiro also considered
record evidence and Woods's own testimony indicating that
Woods handles her own personal care, drives and shops
independently, pays bills and handles money, and gets along
with others including authority figures. (R 19; see
R 586-92) The only indication of Woods's mental health
impairments in the record from the relevant time frame, ALJ
Schiro reasoned, were Dr. Tolchin's report that Woods has
mildly impaired attention and concentration, and trouble with
handling stress. (R 19) Dr. Tolchin also diagnosed Woods with
major depression secondary to chronic pain. (Id.)
using the former or newer 12.04 and 12.06 listing criteria, I
find that substantial evidence supports ALJ Schiro's
conclusion that the record evidence satisfies neither the
"paragraph B" nor the "paragraph C criteria.
(See R 18-19)
4 - RFC and Ability to Perform Past Work
ALJ Schiro defined Woods's RFC as follows:
[T]he claimant has the [RFC] to perform sedentary
work as defined in 20 CFR 404.1567(a) and 416.967(a) except
that she can perform simple, routine tasks at the sedentary
exertional level. She cannot climb ladders/ropes/scaffolds or
work around hazards (moving mechanical parts or at
unprotected heights). She cannot crawl and can occasionally
climb ramps and stairs, stoop, kneel and crouch. She is
limited to low stress work, which I define as follows: there
are only occasional changes in work routines: the work only
involves simple decision-making: there is occasional contact
with coworkers and supervisors: there is no public contact:
the work cannot require working on teams or in collaboration
with others. Finally, she requires a five-minute break for
every hour of sitting.
arrive at this RFC, ALJ Schiro comprehensively evaluated the
record evidence, following a two-step process in which she
determined (1) whether the evidence supports the existence of
medically determinable physical or mental impairments and
whether the impairment could reasonably be expected to
produce the pain and other symptoms Woods reports; and (2)
the extent to which the "intensity, persistence, and
limiting effects" of Woods's symptoms limit
Woods's functioning, assigning credibility-based weight
to statements concerning intensity, persistence, and limiting
effect in the record. (R 20)
to the record, ALJ Schiro considered that Woods reports
chronic pain throughout her body but particularly in her
back, hips, and shoulders. (R 21) The ALJ recited Woods's
allegations that she wakes with pain in the morning, has
difficulty sitting, concentrating, and falling asleep due to
pain, uses a cane to walk, and depends in part on her
mother-with whom Woods and her young daughter live-to cook
and clean. (R 20-21) Woods also occasionally requires her
mother's help in the shower, ALJ Schiro noted. The ALJ
found it significant that Woods is, however, capable of
driving to pick up her daughter from school, of handling her
own personal care (albeit with some difficulty), of preparing
simple foods and performing very light cleaning, and of going
shopping with assistance. (R 20, 22) ALJ Schiro also noted
that Woods avoids taking medication for fear of side effects
and dependency. (Id.) She further observed that
Woods's "only modality of relief is a heating [pad],
" which Woods uses to fall asleep. (R 20, 22)
Schiro then listed several types of medical evidence that
would support Woods's subjective reports but which are
lacking in the record: evidence of significant
musculoskeletal impairment; reports of positive straight leg
or range of motion testing; evidence of neurological
deficits; a fibromyalgia diagnosis, evidence of tender
points, or other clinical indicia of fibromyalgia; evidence
that Woods sought treatment from an orthopedist; evidence
that Woods cannot ambulate without a cane or that a physician
prescribed such an assistive device; and evidence of
acidosis, neuropathy, retinitis, lower extremity edema,
neurological deficits, or abdominal abnormalities (i.e.,
evidence of complications due to diabetes mellitus). (R 21)
Schiro weighed the absence of this evidence against the
presence of the following evidence: a diagnosis of
degenerative joint disease of the cervical and lumbosacral
aspects of the spine (although the record shows no associated
positive clinical findings, the ALJ cautioned); annual
treatment records from Woods's nephrologist, Dr. Gandhi,
who manages Woods's diabetes mellitus and ...