The opinion of the court was delivered by: Judge Nora Barry Fischer
Deborah Metz ("Plaintiff") brings this action pursuant to 42 U.S.C. § 405(g), seeking review of the final determination of the Commissioner of Social Security ("Defendant" or "Commissioner") denying her application for disability insurance benefits ("DIB") and supplemental security income ("SSI") under Titles II and XVI of the Social Security Act, 42 U.S.C. §§ 1318-1383 (the "Act"). This matter comes before the Court on cross-motions for summary judgment filed by the parties pursuant to Rule 56 of the Federal Rules of Civil Procedure. (Docket Nos. 8-10). The record has been developed at the administrative level. For the following reasons, the Court finds that the decision of the Administrative Law Judge ("ALJ") is not supported by substantial evidence. Therefore, Plaintiff's Motion for Summary Judgment (Docket No. 8) is GRANTED, Defendant's Motion for Summary Judgment (Docket No. 10) is DENIED, and the matter is REMANDED for further consideration by the ALJ.
On January 29, 2007, Plaintiff filed her initial application for SSI and DIB due to depression, anxiety, asthma, and hypertension, alleging an onset date of September 1, 2006. (R at 70).*fn1 *fn2 The claims were denied on July 2, 2007 because Plaintiff failed to attend an examination that was scheduled for her. (Id.; R. at 72; 77-84). Plaintiff did not file an appeal. (R. at 12). Consequently, the July 2, 2007 decision is a final decision of the Commissioner through that date.
On November 21, 2007, Plaintiff filed a second application for SSI and DIB benefits due to depression, anxiety, panic attacks, bipolarity, asthma, high blood pressure, hypertension, and legal blindness in the left eye, again alleging an onset date of September 1, 2006. (R. at 85; 90).*fn3
Her claims were denied initially on March 5, 2008. (Id.). Her request for a hearing was granted and a hearing was held on August 12, 2009 before ALJ Lamar W. Davis. (R. at 12-22; 95-97). Plaintiff was represented by Steven F. Kessler, Esquire, at said hearing. (R. at 12; 101-02). ALJ Davis issued an unfavorable decision on September 21, 2009. (Id.). On January 29, 2010, the Appeals Council denied Plaintiff's request for review, thereby making the ALJ's September 21, 2009 decision the final decision of the Commissioner. (R. at 1-3).
The instant action was initiated by Plaintiff filing her Complaint in this Court on March 22, 2010, pursuant to 42 U.S.C. § 405(g). (Docket No. 3). Defendant filed his Answer on June 6, 2010. (Docket No. 5). Plaintiff's Motion for Summary Judgment and accompanying Brief were filed on July 7, 2010. (Docket Nos. 8-9). Defendant's Motion for Summary Judgment and accompanying Briefwere filed on August 2, 2010. (Docket No. 10). Plaintiff filed her Reply Brief in Support of Motion for Summary Judgment on August 18, 2010. (Docket No. 12).
Judicial review of the Commissioner's final decisions on disability claims is provided by statute. 42 U.S.C. §§ 405(g)*fn4 and 1383(c)(3).*fn5 Section 405(g) permits a district court to review transcripts and records upon which a determination of the Commissioner is based. Because the standards for eligibility under Title II, 42 U.S.C. §§ 401-433 (regarding DIB), and judicial review thereof are virtually identical to the standards under Title XVI, 42 U.S.C. §§ 1381-1383(f) (regarding SSI), regulations and decisions rendered under the Title II disability standard, 42 U.S.C. § 423, are pertinent and applicable in Title XVI decisions rendered under 42 U.S.C. § 1381(a). Sullivan v. Zebley, 493 U.S. 521, 525 n. 3 (1990); Burns v. Barnhart, 312 F.3d 113, 119 n. 1 (3d Cir. 2002).
When reviewing a decision denying DIB and SSI, the district court's role is limited to determining whether substantial evidence exists in the record to support the ALJ's findings of fact. Burns, 312 F.3d at 118. Substantial evidence is defined as "more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate." Ventura v. Shalala, 55 F.3d 900, 901 (3d Cir. 1995) (quoting Richardson v. Perales, 402 U.S. 389, 401 (1971)). Additionally, if the ALJ's findings of fact are supported by substantial evidence, they are conclusive. 42 U.S.C. § 405(g); Richardson, 402 U.S. at 390. A district court cannot conduct a de novo review of the Commissioner's decision nor re-weigh evidence of record. Palmer v. Apfel, 995 F.Supp. 549, 552 (E.D. Pa. 1998); see also Monsour Medical Center v. Heckler, 806 F.2d 1185, 90-91 (3d. Cir. 1986) ("even where this court acting de novo might have reached a different conclusion [.] so long as the agency's factfinding is supported by substantial evidence, reviewing courts lack power to reverse either those findings or the reasonable regulatory interpretations that an agency manifests in the course of making such findings."). To determine whether a finding is supported by substantial evidence, however, the district court must review the record as a whole. See 5 U.S.C. §706.
To be eligible for social security benefits under the Act, a claimant must demonstrate that he cannot engage in substantial gainful activity because of a 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 at least 12 months. 42 U.S.C. §423(d)(1)(A); Brewster v. Heckler, 786 F.2d 581, 583 (3d Cir. 1986).
The ALJ must utilize a five-step sequential analysis when evaluating the disability status of each claimant. 20 C.F.R. §404.1520. The ALJ must determine: (1) whether the claimant is currently engaged in substantial gainful activity; (2) if not, whether the claimant has a severe impairment or a combination of impairments that is severe; (3) whether the medical evidence of the claimant's impairment or combination of impairments meets or equals the criteria listed in 20 C.F.R., pt. 404 subpt. P., appx. 1; (4) whether the claimant's impairments prevent him from performing his past relevant work; and (5) if the claimant is incapable of performing his past relevant work, whether he can perform any other work which exists in the national economy. 20 C.F.R. §404.1520(a)(4); see Barnhart v. Thomas, 540 U.S. 20, 24-25 (2003).
If the claimant is determined to be unable to resume previous employment, the burden shifts to the Commissioner (Step 5) to prove that, given claimant's mental or physical limitations, age, education, and work experience, he or she is able to perform substantial gainful activity in jobs available in the national economy. Doak v. Heckler, 790 F.2d 26, 28 (3d Cir. 1986).
Plaintiff, born on August 4, 1961, was 45 years old as of her alleged onset date, September 1, 2006, and 48 years old on the date of her hearing before the ALJ, August 12, 2009. (R. at 27). Plaintiff has an 11th grade education with no GED. (Id.). Plaintiff was married to Russell Metz on November 9, 1981, and their marriage ended by divorce on October 1, 1990.
(R. at 113). Plaintiff is the mother of four children, one of whom has been diagnosed with Marfan syndrome.*fn6 (R. at 242). Additionally, at the time of the hearing Plaintiff was living with her 17 year-old son. (R. at 28). Around that time, Plaintiff had a live-in boyfriend whom she claimed was abusive toward her. (R. at 242).
Plaintiff had some difficulty maintaining relationships with her family. (R. at 176). Plaintiff's parents are both deceased, as her father died of diabetes and high blood pressure, and her mother's death in 2008 left her grieving for almost a year. (R. at 242; 452). Plaintiff has two sisters, both of whom have been treated for depression, and a brother with a history of heroin addiction. (R. at 242). She also admits to having a history of drug problems, specifically crack cocaine and alcohol abuse. (Id.). Additionally, according to Plaintiff, her brother sexually abused her and her sisters when they were children. (Id.). He later killed a man in self defense in 2006. (Id.).
Her past relevant work*fn7 includes some work as a cashier and stock person at a pharmacy.
(R. at 43). This type of work is considered both light and unskilled, and it is Plaintiff's only employment experience that lasted more than three months. (Id.).
B. Plaintiff's Medical Background
In Plaintiff's initial request for benefits, she included claims related to her depression, anxiety, panic attacks, bipolar condition, asthma, high blood pressure, hypertension, and legal blindness in her left eye. (R. at 85). On appeal, Plaintiff only disputes the ALJ's decision with regard to her mental impairments. Thus, the Court will only detail her medical background related to her mental impairments.
1. UPMC McKeesport: November 6, 2006 through December 22, 2006
On November 21, 2006, Plaintiff visited her primary treating doctors at UPMC McKeesport Internal Medicine, complaining that she had been depressed for the last several months. (R. at 299). She claimed to have experienced frequent thoughts of committing suicide and informed them that she attempted suicide by taking pills ten years ago. (R. at 299). Plaintiff was escorted to the Emergency Room where she was admitted to the psychiatric floor. (R. at 240; 300). She was diagnosed with Major Depression*fn8 , severe, non-psychotic, and Anxiety Disorder*fn9 , Not Otherwise Specified (NOS). (R. at 243). Additionally, the attending physician noted that Plaintiff might be bipolar.*fn10 (Id.). Further, the toxicology report returned positive for cocaine. (R. at 239). Plaintiff was treated with psychotropic medications, including Klonopin*fn11 , Lamictal*fn12 , and Remeron*fn13 . (R. at 238). Dr. Carlos Placci observed Plaintiff to be "obviously depressed" and noted that she cried easily and appeared tense. (R. at 242). Additionally, he found that Plaintiff's intelligence was within a normal range and her language was understandable, with some pressured speech, but her articulation was not very good. (Id.). By November 26, 2006, Plaintiff told Dr. Placci she felt better, and he assigned her a global assessment of functioning ("GAF") score of 60.*fn14 (R. at 238). On November 28, 2006, Plaintiff was discharged with instructions to follow up on an outpatient basis. (Id.).
On December 15, 2006, Plaintiff visited Dr. Ghobrial at UPMC McKeesport for shortness of breath. (R. at 295). In his report, Dr. Ghobrial stated that Plaintiff's anxiety and depression continued despite the use of psychotropic medication, and he instructed Plaintiff to continue taking Piroxicam*fn15 and Remeron for anxiety and depression. (Id.).
On December 22, 2006, Plaintiff attended a follow-up visit with Dr. Ghobrial regarding her shortness of breath. (R. at 291). He found that Plaintiff continued to be anxious and depressed. (Id.). Additionally, Plaintiff reported that she often had suicidal thoughts. (Id.). Dr. Ghobrial increased Plaintiff's dosage of her psychotropic medications. (R. at 292).
2. Mon-Yough Community Services Adult Mental Health
On December 15, 2006, Plaintiff began treatment with Mon-Yough Community Services Adult Mental Health ("Mon-Yough"), where she underwent a diagnostic evaluation with Dr. Omar Bhutta. (R. at 250). His report stated that despite taking Luvox*fn16 and Remeron, Plaintiff was still quite anxious and crying for no reason. (Id.). Dr. Bhutta diagnosed her with Major Depression, Recurrent and Severe and assigned her a GAF score of 50. (R. at 251).
Thereafter, Plaintiff attended regular treatment with several psychiatrists at Mon-Yough and attended group therapy three days a week for approximately 2-3 hours per day. (R. at 178). On February 2, 2007, Dr. Bhutta noted that Plaintiff appeared "very nervous" and that her impulse control was fragile. (R. at 249). He assigned her a GAF score of 50. (Id.). On February 9, 2007, Dr. Wayne noted that Plaintiff continued to appear very anxious and nervous and diagnosed her with Major Depressive Disorder, Recurrent and a Personality Disorder. (R. at 314-315). Additionally, he assigned a GAF score of 49. (R. at 315). On March 27, 2007, Plaintiff again met with Dr. Wayne, who noted that Plaintiff described a history of bipolar disorder with a two-year history of constant depression, racing thoughts, a desire for a spending spree, and anxiety. (Id.). He reported her GAF score of 35 and started her on Lithium*fn17 and Wellbutrin*fn18 .
(R. at 313). However, under the Mental Status Examination section of his report, Dr. Wayne reported Plaintiff to be within normal limits in the following areas: Appearance, Orientation, Impulse Control, Speech, Judgment/Insight, Thought Process, Thought Content, and Sui/Homicidal Idea/Plan. (R. at 312).
On an April 6, 2007 visit, Dr. Wayne noted that Plaintiff was anxious, trembling, and hyperventilating. (R. at 310). By May of 2007, Dr. Wayne noticed that Plaintiff had symptoms of Attention Deficit Disorder, was irritable, and had scattered thought content with focusing problems. (R. at 306). On a May 22, 2007 visit, Dr. Wayne reported Plaintiff was anxious and having panic attacks. (R. at 399). He assigned her a new GAF of 48. (R. at 400). During additional visits in 2007, Dr. Wayne documented that Plaintiff was anxious and stressed, not sleeping, irritable, emotionally unstable, and moody. Her GAF score was repeatedly assigned at 50. (R. at 389-394).
During several visits in 2008, Dr. Wayne noted that no change occurred in Plaintiff's condition, but he continued to increase her medications. (R. at 547; 549; 551). He also stated that Plaintiff was experiencing increasing depression symptoms. (Id.).
On February 12, 2009, Dr. Wayne observed an increase in Plaintiff's irritability, mood swings and anxiety after she ceased taking her medications for one week. (R. at 542). He continued to assign her a GAF score of 50, finding no change in her condition. (R. at 543).
Two months later, during an April 7, 2009 visit, Dr. Wayne found Plaintiff's affect, mood, appearance, orientation, impulse control, speech, judgment/insight, thought process and content, and suicidal or homicidal intent or plan to all be within normal limits. (R. at 540).
However, he still maintained her diagnoses of Bipolar I Disorder, most recent episode mixed*fn19 , and moderate Panic Disorder without agoraphobia. (Id.). He also ...