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Martinez v. Astrue

United States District Court, Third Circuit

May 30, 2013

MICHAEL J. ASTRUE, Commissioner of Social Security.


TIMOTHY J. SAVAGE, District Judge.

In this appeal from a denial of Supplemental Security Income ("SSI") benefits under Title XVI of the Social Security Act ("Act"), 42 U.S.C. §§ 401-33, the plaintiff Fidel Sosa Martinez requests review of the Administrative Law Judge's ("ALJ") decision to deny him benefits.[1] He contends the ALJ failed to: (1) properly evaluate and consider the opinions of examining psychologist-experts; (2) properly "combine" Martinez's limitations at steps three through five of the sequential evaluation process; (3) properly evaluate Martinez's subjective complaints of pain; and (4) include all of Martinez's limitations in the hypothetical posed to the vocational expert because it was based on a deficient residual functional capacity.

We conclude that the ALJ did not adequately explain why she accorded more weight to the opinion of a non-examining, non-treating psychologist than to the opinions of a psychologist who personally evaluated Martinez and another psychologist who treated him. Also, we find that the ALJ did not discuss why the claimant's combined impairments did not meet or equal a listing under 20 C.F.R. Part 404, Subpart P, App. 1. Therefore, we shall remand the case to the Commissioner.

Background and Procedural History

On July 9, 2009, Martinez, who was then fifty-two, applied for SSI benefits, alleging disability as of February 16, 2007 due to, among other things, severe back pain and major depression. After his application was denied, Martinez timely requested a hearing before an ALJ. Following a hearing held on April 8, 2010, at which Martinez was represented by counsel, the ALJ determined that Martinez had severe impairments, including degenerative disc disease of the lumbar spine, chronic prostatitis, and major depression. She concluded these impairments did not preclude him for performing light duty work. Relying upon a vocational expert's opinion, she then determined that there were jobs available in the national economy for persons with Martinez's physical and vocational characteristics. Accordingly, on January 4, 2011, the ALJ concluded that Martinez was not "disabled."

On June 25, 2012, the Appeals Council denied Martinez's request for review, making the ALJ's decision final. Martinez then filed this action under 42 U.S.C. § 405(g) seeking judicial review of the Commissioner's decision.

ALJ Findings

The ALJ made the following findings in her January 4, 2011 decision:

1. The claimant has not engaged in substantial gainful activity since July 9, 2009, the application date (20 CFR 416.971 et seq. ).
2. The claimant has the following severe impairments: degenerative disc disease of the lumbar spine, chronic prostatitis, and major depression (20 CFR 416.920(c)).
3. The claimant does not have an impairment or combination of impairments that meets or medically equals one of the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR 416.920(d), 416.925 and 416.926).
4. After careful consideration of the entire record, the undersigned finds that the claimant has the residual functional capacity to perform medium work as defined in 20 CFR 416.967(c) except that he must work in proximity to a bathroom and is limited to routine, unskilled work involving limited contact with the public or co-workers.
5. The claimant has no past relevant work (20 CFR 416.965).
6. The claimant was born on April 24, 1957 and was 52 years old, which is defined as an individual closely approaching advanced age, on the date the application was filed (20 CFR 416.963).
7. The claimant has a marginal education and is able to communicate in English (20 CFR 416.964).
8. Transferability of job skills is not an issue because the claimant does not have past relevant work (20 CFR 416.968).
9. Considering the claimant's age, education, work experience, and residual functional capacity, there are jobs that exist in significant numbers in the national economy that the claimant can perform (20 CFR 416.969 and 416.969(a)).
10. The claimant has not been under a disability, as defined in the Social Security Act, since July 9, 2009, the date the application was filed (20 CFR 416.920(g)).

Standard of Review

On judicial review, the court determines whether the Commissioner's decision is supported by substantial evidence. 42 U.S.C. §§ 405(g); 1383(c)(3); Hartranft v. Apfel, 181 F.3d 358, 360 (3d Cir. 1999). Substantial evidence is "more than a mere scintilla'; it means such relevant evidence as a reasonable mind might accept as adequate.'" Thomas v. Comm'r of Soc. Sec. Admin., 625 F.3d 798, 800 (3d Cir. 2010) (quoting Plummer v. Apfel, 186 F.3d 422, 427 (3d Cir. 1999)). The examination for substantial evidence "is not merely a quantitative exercise.'" Lozada v. Barnhart, 331 F.Supp.2d 325, 328 (E.D. Pa. 2004) (quoting Kent v. Schweiker, 710 F.2d 110, 114 (3d Cir. 1983)).

To facilitate meaningful judicial review, the ALJ must explain clearly and fully the basis of her decision. Barren Creek Coal Co. v. Witmer, 111 F.3d 352, 356 (3d Cir. 1997) (quoting Cotter v. Harris, 642 F.2d 700, 704-05 (3d Cir. 1981)). The ALJ must discuss what evidence supports her determination, what evidence she rejected, and her reasons for accepting some evidence while rejecting other evidence. Cotter, 642 F.2d at 705.

Sequential Evaluation

To determine whether a claimant is disabled, the ALJ must apply the familiar five-step sequential process prescribed in the Social Security regulations, 20 C.F.R. § 404.1520(a)(4); Phillips v. Astrue, 671 F.3d 699, 701 (8th Cir. 2012); Rutherford v. Barnhart, 399 F.3d 546, 551 (3d Cir. 2005). In the first four steps, the claimant must make a prima facie showing of disability by demonstrating that he has a severe impairment that prevents him from performing work he has done in the past. Hoopai v. Astrue, 499 F.3d 1071, 1074 (9th Cir. 2007). At step one, the claimant must demonstrate that he is not engaged in gainful employment. Id. At step two, the claimant must show that he has a "severe impairment, " defined as "any impairment or combination of impairments which significantly limits [the claimant's] physical or mental ability to do basic work activities." 20 C.F.R. §§ 404.1520(c), 416.920(c). At the third step, the ALJ determines whether the claimant's impairment or impairments are equal to one of the impairments listed in an appendix to the social security regulations. See 20 C.F.R. Pt. 404, Subpt. P, Appx. 1. The Commissioner has decided that those impairments listed are so severe that they conclusively render a ...

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