United States District Court, M.D. Pennsylvania
KAROLINE MEHALCHICK, Magistrate Judge.
This is an action brought under Section 1631(c)(3) of the Social Security Act, 42 U.S.C. §1383(c)(3)(incorporating 42 U.S.C. § 405(g) by reference), seeking judicial review of the final decision of the Commissioner of Social Security ("Commissioner") denying the Plaintiff's claim for Supplemental Security Income ("SSI") under Title XVI of the Social Security Act. This matter has been referred to the undersigned United States Magistrate Judge on consent of the parties, pursuant to the provisions of 28 U.S.C. § 636(c) and Rule 73 of the Federal Rules of Civil Procedure. (Doc. 16, Doc. 17).
Among other issues, we are called upon to decide whether the ALJ properly denied Plaintiff's request for IQ testing and discredited Plaintiff's allegations that she suffered from an intellectual disability where three treating psychiatrists, a consultative psychological examiner, and a consultative medical examiner diagnosed Plaintiff with some combination of mild mental retardation, borderline intellectual functioning, or illiteracy. For the reasons expressed herein, it is ordered that the decision of the Commissioner be VACATED and REMANDED for further proceedings consistent with this opinion.
I. BACKGROUND & PROCEDURAL HISTORY
On August 24, 2010, Plaintiff Esther M. Sinkler filed an application for SSI, alleging that she became totally disabled on January 1, 2007, due to attention deficit hyperactivity disorder ("ADHD"); learning disability; major depressive disorder with psychotic features; borderline intellectual functioning; cardiac dysrhythmia; allergies; possible arthritis; asthma; and illiteracy. (Admin Tr. 397; Doc. 8-6 p 53). In a pre-hearing memorandum, Sinkler amended her alleged onset date to August 24, 2010. (Admin Tr. 460; Doc. 8-6 p. 116). Sinkler's claim was initially denied on February 7, 2011. Sinkler requested, and was granted, an opportunity to have her claim re-evaluated during an administrative hearing. The requested hearing took place on May 16, 2012, in Harrisburg, Pennsylvania. Sinkler, assisted by counsel, appeared and testified before ALJ Patrick S. Cutter. Sinkler's case worker, Joanne White, drove her to the hearing and testified on her behalf. Impartial vocational expert ("VE") Brian Bierley also appeared and testified at the hearing.
At her May 2012 hearing, Sinkler, age 38, testified that she lives in an apartment with her boyfriend, daughter, and infant grandchild. Sinkler has five children between the ages of fifteen and twenty-one who were raised by Sinkler's mother, all of which allegedly have some sort of psychiatric problems. (Admin Tr. 50, 55; Doc. 8-2 pp. 51, 56). Sinkler testified that she was unable to raise them herself because it "was too much" and she "didn't have the patience." (Admin Tr. 50; Doc. 8-2 p. 51). Sinkler left high school after completing tenth grade because she became pregnant. (Admin Tr. 42; Doc. 8-2 p. 43). She asserts that, while in school, she was in special education classes and that she is functionally illiterate though can read small words and sign her own name. (Admin Tr. 45, 54; Doc. 8-2 pp. 46, 55). Sinkler alleges that her illiteracy has prevented her from getting a driver's license (because she is unable to read the test), and has hindered her past efforts to find employment because she could not read or write well enough to complete job applications. (Admin Tr. 42, 44; Doc. 8-2 pp. 43, 45). She also asserts that she was let go from her most recent employment as a housekeeper in 2007 because of a new policy that required her to greet hotel guests by name - which she allegedly could not do because she was unable to read the name from a list. (Admin Tr. 43; Doc. 8-2 p. 44). Her employment records, however, paint a different picture - that she was let go for absenteeism after she called off work 28 times, was tardy 22 times, and failed to show up at work twice over a period of ten months. (Admin Tr. 325; Doc. 8-5 p. 90). Her previous employer noted that when she was there, Sinkler was one of its best housekeepers. Id.
Sinkler reportedly did attempt to complete a literacy course after she left school, but asserted that the people in her group laughed at her so she "quit going." (Admin Tr. 43; Doc. 8-2 p. 44). As far as other social activities, Sinkler "walks a lot, " plays Pac-Man video games, watches Lifetime movies and cartoons, and goes to church two times a month. (Admin Tr. 48, 50; Doc. 8-2 pp. 49, 51). Sinkler depends on her daughter and caseworker to take her to medical appointments. (Admin Tr. 52; Doc. 8-2 p. 53). She helps maintain the household by washing dishes "a little, " going grocery shopping with her sister and daughter, and cooking microwave meals. In a function report from October 2010, transcribed by a paralegal, Sinkler reported that she fixes a sandwich for herself for lunch each day, her boyfriend reminds her to clean their apartment three times per week. (Admin Tr. 422; Doc. 8-6 p. 78).
Sinkler testified that she is unable to work because she cannot stand too long without experiencing pain in her foot and back; read or write well enough to complete job applications. (Admin Tr. 45; Doc. 8-2 p. 46). She testified that she takes prescription medications for her asthma, high blood pressure, and depression. (Admin Tr. 45; Doc. 8-2 p. 46). She could not recall the names of any of these medications, but insisted that her caseworker knew the names. (Admin Tr. 46-47; Doc. 8-2 pp. 47-48). She also reported that her boyfriend sets out her medications in the correct dosage each day because she cannot read the bottles. (Admin Tr. 422; Doc. 8-6 p. 78).
The ALJ denied Sinkler's application in a written decision dated August 6, 2012. Sinkler sought review of the ALJ's decision denying her application for benefits by the Appeals Council. Sinkler's request for review was denied on January 16, 2014, making the ALJ's written decision dated August 6, 2012, the final decision subject to judicial review by this Court.
Sinkler initiated this action by filing a complaint on March 12, 2014, alleging that the ALJ's decision is not supported by substantial evidence and is based on a flawed application of the relevant legal principles. (Doc. 1). She requests that this Court enter an order awarding benefits, or in the alternative, enter an order vacating the ALJ's decision be vacated and remanding this case for a new administrative hearing. On May 14, 2014, the Commissioner filed an Answer, in which she maintains that Sinkler is not entitled to SSI, and that the ALJ's decision was issued in accordance with the law and is supported by substantial evidence. (Doc. 7). Together with her answer, the Commissioner filed a copy of the administrative record. (Doc. 8). Having been fully briefed by the parties, this matter is now ripe for disposition. (Doc. 9; Doc. 12; Doc. 13).
II. STANDARD OF REVIEW
Resolution of the instant social security appeal involves an informed consideration of the respective roles of two adjudicators - the ALJ and this Court. At the outset, it is the responsibility of the ALJ in the first instance to determine whether a claimant has met the statutory prerequisites for entitlement to benefits.
To receive benefits under the Social Security Act by reason of disability, a claimant must demonstrate an 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 which has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C.1382c(a)(3)(A); see also 20 C.F.R. § 416.905(a). To satisfy this requirement, a claimant must have a severe physical or mental impairment that makes it impossible to do his or her previous work or any other substantial gainful activity that exists in the national economy. 42 U.S.C. § 1382c(a)(3)(B); 20 C.F.R. § 416.905(a).
In making this determination at the administrative level, the ALJ follows a five-step sequential evaluation process. 20 C.F.R. §416.920(a). Under this framework, the ALJ must sequentially determine: (1) whether the claimant is engaged in substantial gainful activity; (2) whether the claimant has a severe impairment; (3) whether the claimant's impairment meets or equals a listed impairment; (4) whether the claimant is able to do his or her past relevant work; and (5) whether the claimant is able to do any other work, considering his or her age, education, work experience and residual functional capacity ("RFC"). 20 C.F.R. §416.920. Between steps three and four, the ALJ must also assess a claimant's RFC. RFC is defined as "that which an individual is still able to do despite the limitations caused by his or her impairment(s)." Burnett v. Comm'r of Soc. Sec., 220 F.3d 112, 121 (3d Cir. 2000) (citations omitted); see also 20 C.F.R. §416.945(a)(1); SSR ...