United States District Court, W.D. Pennsylvania
MAURICE B. COHILL, Jr., Senior District Judge.
This case is before us on appeal from a final decision by the defendant, Commissioner of Social Security ("the Commissioner"), denying Melissa Dawn Christensen's claim for disability insurance benefits and supplemental security income under Titles II and XVI of the Social Security Act, 42 U.S.C. §§ 401-434 and 1381-1383f. The parties have submitted cross-motions for summary judgment. For the reasons stated below, we will grant the Plaintiff's motion for summary judgment to the extent she seeks a remand for further proceedings, deny Plaintiff's motion for summary judgment to the extent she seeks a reversal of the ALJ's decision and an award of benefits, and deny the Defendant's motion for summary judgment.
II. Procedural History
Melissa Dawn Christensen applied for Disability Insurance Benefits ("DIB") and Supplemental Security Income ("SSI") under Titles II and XVI of the Social Security Act, 42 U.S.C. §§ 401-434 and 1381-1383f on February 18, 2009, alleging a disability due to depression, back problems, and foot problems, with an alleged onset date of December 29, 2008. Plaintiffs claim was initially denied on June 8, 2009. A timely request for a hearing was filed by Plaintiff on June 26, 2009. A hearing was held before an Administrative Law Judge ("ALJ") on August 12, 2010, at which Plaintiff was represented by counsel, Gerald M. Sullivan, and testified. R. at 36-67. A vocational expert also testified at the hearing. R. 67-71.
By decision dated September 17, 2010, the ALJ determined that Plaintiff is not disabled under §§ 216(i), 223(d) and 1614(a)(3)(A) of the SSA. R. at 18-28.
Plaintiff filed a timely review of the ALJ's determination, which was denied by the Appeals Council on April 10, 2012. R. 1-6. Having exhausted her administrative remedies, Plaintiff filed the instant action seeking judicial review of the final decision of the Commissioner of Social Security denying her DIB and SSI application.
III. Standard of Review.
The Congress of the United States provides for judicial review of the Commissioner's denial of a claimant's benefits. See 42 U.S.C. § 405(g)(2012). This court must determine whether or not there is substantial evidence which supports the findings of the Commissioner. See id. "Substantial evidence is 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). This deferential standard has been referred to as "less than a preponderance of evidence but more than a scintilla." Burns v. Barnhart , 312 F.3d 113, 118 (3d Cir. 2002). This standard, however, does not permit the court to substitute its own conclusions for that of the fact-finder. See id.; Fargnoli v. Massonari , 247 F.3d 34, 38 (3d Cir. 2001) (reviewing whether the administrative law judge's findings "are supported by substantial evidence" regardless of whether the court would have differently decided the factual inquiry). So long as the ALJ's decision is supported by substantial evidence and decided according to the correct legal standards, the decision will not be reversed. Id . To determine whether a finding is supported by substantial evidence, however, the district court must review the record as a whole. 5 U.S.C. § 706(1)(F)(2012).
IV. ALJ Decision.
Under the SSA, the term "disability" is defined as the:
inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months...
42 U.S.C. § 423. A person is unable to engage in substantial activity when he:
is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work....
42 U.S.c. §§ 423(d)(1)(A), (d)(2)(A).
In determining whether a claimant is disabled under the SSA, a sequential evaluation process must be applied. 20 C.F.R. § 416.920(a). See McCrea v. Commissioner of Social Security , 370 F.3d 357, 360 (3d Cir. 2004). The evaluation process proceeds as follows. At step one, the Commissioner must determine whether the claimant is engaged in substantial gainful activity for the relevant time periods; if not, the process proceeds to step two. 20 C.F.R. 20 C.F.R. § 416.920(b). At step two, the Commissioner must determine whether the claimant has a severe impairment or a combination of impairments that is severe. 20 C.F.R. § 416.920(c). If the Commissioner determines that the claimant has a severe impairment, he must then determine whether that impairment meets or equals the criteria of an impairment listed in 20 C.F.R., part 404, Subpart P, Appendix. 1. 20 C.F.R. § 416.920(d).
The ALJ must also determine the claimant's residual functional capacity; that is, the claimant's ability to do physical and mental work activities on a sustained basis despite limitations from his impairments. 20 C.F.R. § 416.920(e). If the claimant does not have an impairment which meets or equals the criteria, at step four the Commissioner must determine whether the claimant's impairment or impairments prevent him from performing his past relevant work. 20 C.F.R. § 416.920(f). If so, the Commissioner must determine, at step five, whether the claimant can perform other work which exists in the national economy, considering his residual functional capacity and age, education and work experience. 20 C.F.R. § 416.920(g). See also McCrea , 370 F.3d at 360; Sykes v. Apfel , 228 F.3d 259, 262-63 (3d Cir. 2000).
In the instant matter, in support of his Decision, the ALJ first focused on those records relevant to Plaintiffs obesity and back pain. He discussed the medical records from Plaintiffs primary care providers to the extent they contained a diagnosis of obesity. R. 21. He then discussed Plaintiff being diagnosed with lumbago and that although she was referred to physical therapy for her back, and testified that she went to therapy and it made her back pain worse, so she stopped attending therapy, there was not any evidence in the medical record that she ever attended physical therapy. R. 21. Next, the ALJ discussed Plaintiffs testimony that she'd had x-rays that showed narrowing of the spine, and that a January 12, 2009 x-ray of Plaintiff's lumbar spine noted mild posterior element sclerosis at LS-S1 but no evidence of acute fracture, malalignment, or significant degenerative change. R. 21. The ALJ further noted that there were no real positive findings on Plaintiff's back impairment in the Record, that treatment records regularly reflected that there was no known injury, that no objective testing had established the etiology of Plaintiffs back pain, and although she had received treatment for her complaints of back pain, the treatment had been excessively conservative in nature. R. 21. Based on all of the above, the ALJ concluded that "the evidence of record fails to establish that [Plaintiffs] back impairment causes more than a minimal limitation on [her] ability to perform basic work activities" and' [i]t is therefore, nonsevere under Social Security Regulations." R. 21.
The ALJ next focused on the evidence of record, both medical and non-medical, with respect to Plaintiffs mental health impairments. The ALJ first discussed Plaintiffs activities of daily living and found that she "has no restriction." In support thereof he noted:
[she] is the sole provider of care for her two-year-old son. [She] testified that she drives 45 minutes to her mother's house every other weekend. She reports that she cares for her son, cleans her house, cooks, and takes care of her dog. She cares for her personal needs, and does laundry, dishes, and yard work. She does errands on a daily basis and is able to go shopping in stores alone. Claimant reports hobbies that include sewing, playing games, horses, and watching television, although she indicates that she does not engage in them as frequently as she used to due to her depression.
R. 22. The ALJ also referenced the conclusion of state agency psychologist Manella Link ("Dr. Link") that Plaintiff had no restriction in the area of activities of daily living. R.22. Concerning activities of daily living, thus, the ALJ concluded: "[t]he evidence of record, taken as a whole, supports a finding that [Plaintiff] has no restrictions in this domain." R. 22 (citations omitted)
The ALJ next discussed Plaintiffs social functioning and found that she has "moderate difficulties:"
[She] testified that she gets irritable if people talk to her and she lashes out at them. [She] reports that she does not spend time with others and that she does not normally go anywhere. This is contradictory to her testimony, however, that she has a close friend who is an almost constant companion and her report that she does errands on a daily basis. Additionally, she maintains some sort of an agreeable relationship with her husband. Furthermore, she is able to go shopping in stores alone. Although [she] reports that she does not engage in social activities anymore, she reports no problems getting along with family, friends, neighbors, authority figures, or others, and she has never lost a job because of problems getting along with other people.
R. 22 (citations omitted). The ALJ also referenced state agency psychologist Dr. Link's conclusion that Plaintiff had no difficulties in maintaining social functioning. R. 22. The ALJ concluded that "the preponderance of evidence in this case favors a finding that [Plaintiff] has moderate difficulties in this category. "R. 22.
The ALJ next discussed Plaintiffs "concentration, persistence, and pace" and concluded that in this area she has moderate difficulties:
[Plaintiff] testified that she has a hard time concentrating and that she will start things and forget to finish them. [She] reported experiencing difficulty with memory, completing tasks, and concentration. She stated that she can only pay attention for ten minutes. She reported a poor ability to follow written instructions, although she indicated she can follow spoken instructions fairly well. She testified, however, that she is taking two online college courses in which her grades are As and Bs.
R. 22 (citations omitted). The ALJ also referenced Dr. Link's conclusion that Plaintiff had moderate difficulties in maintaining concentration, persistence, or pace." R. 22. (citation omitted)
The ALJ also concluded that Plaintiff had not had any episodes of decompensation which have been of extended duration. R. 22. In support of this conclusion, the ALJ noted:
[Plaintiff] has no record of psychiatric emergency room or inpatient hospitalizations. There is no evidence that [she] has experienced the kind of acute symptomatology associated with what is considered an episode of decompensation. There is no clinical evidence of acute psychosis, suicidal intent, or homicidal ideation. [She] is capable of functioning independently outside of her home.
R. 22. The ALJ further noted that Dr. Link had also found that Plaintiff had not experienced any episodes of decompensation. R. 22 (citation omitted).
The ALJ also concluded that H[t]he record does not show a chronic affective disorder persisting for two or more years, despite pharmalogical treatment, resulting in repeated' episodes of decompensation, or acceptable medical evidence supporting a prospective opinion that the [Plaintiffs] mental status would deteriorate if she were required to perform a minimum increase in mental demands, or a current history of one or more years of an inability to function outside a highly supportive living arrangement." R. 23.
The ALJ then decided, "after careful consideration of the entire record, I find that the [Plaintiff] has the residual functional capacity to perform medium work as defined in 20 CFR 404.1567(c) and 416.967(c) except that she is limited to simple tasks requiring little or no judgment; no interaction with the public, although the public could be around but no interacting required; and only occasional interaction with coworkers." R. 23. In so concluding, the ALJ stated: "[Plaintiff] testified that she is unable to perform the basic requirements of work activity because of the stressors of dealing with depression and that she is unable to do much of anything. She becomes irritable when other people talk to her. She is unable to concentrate, does not like being around other people, and is unable to keep up, according to her testimony. She reports loss of memory, lack of concentration, and crying all the time as factors which limit her ability to engage in work-like activities, and states that doing ajob would be difficult because her thoughts become preoccupied with problems in her personal life outside of work." R. 24 (citation omitted).
The ALJ then made the following conclusion with respect to Plaintiff's credibility: "after careful consideration of the evidence, I find that the [Plaintiff's] medically determinable impairments could reasonably be expected to cause the alleged symptoms; however, the [Plaintiffs] statements concerning the intensity, persistence and limiting effects of these symptoms are not credible to the extent they are inconsistent with the above residual functional capacity assessment." R. 24. In support of this credibility determination, the ALJ cited first to the fact that Plaintiff has been receiving unemployment benefits since January 2009, which means she "is representing to the state she is willing and able to work. While entitlement to unemployment benefits and a finding of disability under the Social Security Regulations are not mutually exclusive, the inherent inconsistency is not without significance." R. 24. Second, the ALJ noted an inconsistency between Plaintiffs explanation for why she stopped working in December 2008 and what was in the Record. "Although [Plaintiff] reported that she lost her job due to her inability to concentrate at work, the record indicates that the claimant left her job because her child was being returned to her by social services." R. 24. Third, the ALJ stated: "[Plaintiff] testified that the child was taken by social services at the hospital because of issues in her husband's past of which she was unaware. However, the record reflects that in May 2006, over a year before the child was born, she was, in fact, aware of the situation." R. 24 (citations omitted). Fourth, the ALJ noted: "[h]er testimony that she does not believe that she could perform her past work as a housekeeper now because of stressors with her family and husband is inconsistent with the basic principle of disability ...