United States District Court, W.D. Pennsylvania
DONETTA W. AMBROSE, Senior District Judge.
Pending before the Court are Cross-Motions for Summary Judgment. (ECF Nos. 9 and 12). Both parties have filed Briefs in Support of their Motions. (ECF Nos. 10 and 13). After careful consideration of the submissions of the parties, and based on my Opinion set forth below, I am granting in part and denying in part Plaintiff's Motion for Summary Judgment (ECF No. 9) and denying Defendant's Motion for Summary Judgment. (ECF No. 12).
Plaintiff has brought this action for review of the final decision of the Commissioner of Social Security ("Commissioner") denying her applications for disability insurance benefits ("DIB") and for supplemental security income ("SSI") pursuant to the Social Security Act ("Act"). Plaintiff filed her applications alleging she had been disabled since June 1, 2011. (ECF No. 7-5, pp. 2, 8). Administrative Law Judge ("ALJ"), Lamar W. Davis, held a video hearing on July 17, 2012. (ECF No. 7-2, pp. 31-51). On February 27, 2013, the ALJ found that Plaintiff was not disabled under the Act. (ECF No. 7-2, pp. 19-27).
After exhausting all administrative remedies, Plaintiff filed the instant action with this court. The parties have filed Cross-Motions for Summary Judgment. (Docket Nos. 9 and 12). The issues are now ripe for review.
II. LEGAL ANALYSIS
A. Standard of Review
The standard of review in social security cases is whether substantial evidence exists in the record to support the Commissioner's decision. Allen v. Bowen, 881 F.2d 37, 39 (3d Cir. 1989). Substantial evidence has been 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, the Commissioner's findings of fact, if supported by substantial evidence, are conclusive. 42 U.S.C. §405(g); Dobrowolsky v. Califano, 606 F.2d 403, 406 (3d Cir. 1979). A district court cannot conduct a de novo review of the Commissioner's decision or re-weigh the evidence of record. Palmer v. Apfel, 995 F.Supp. 549, 552 (E.D. Pa. 1998). Where the ALJ's findings of fact are supported by substantial evidence, a court is bound by those findings, even if the court would have decided the factual inquiry differently. Hartranft v. Apfel, 181 F.3d 358, 360 (3d Cir. 1999). 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, the plaintiff 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 Commissioner has provided the ALJ with a five-step sequential analysis to use when evaluating the disabled status of each claimant. 20 C.F.R. §404.1520(a). 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; (3) if the claimant has a severe impairment, whether it meets or equals the criteria listed in 20 C.F.R., pt. 404, subpt. P., appx. 1; (4) if the impairment does not satisfy one of the impairment listings, 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, in light of his age, education, work experience and residual functional capacity. 20 C.F.R. §404.1520. The claimant carries the initial burden of demonstrating by medical evidence that he is unable to return to his previous employment (steps 1-4). Dobrowolsky, 606 F.2d at 406. Once the claimant meets this burden, the burden of proof shifts to the Commissioner to show that the claimant can engage in alternative substantial gainful activity (step 5). Id.
A district court, after reviewing the entire record may affirm, modify, or reverse the decision with or without remand to the Commissioner for rehearing. Podedworny v. Harris, 745 F.2d 210, 221 (3d Cir. 1984).
B. Residual Functional Capacity ("RFC")
Plaintiff first asserts that the ALJ erred in determining Plaintiff's RFC because it was made without the benefit of any expert medical opinion. (ECF No. 10, pp. 3-7). Plaintiff submits that "the ALJ relied on his own lay opinion in determining the extent to which Plaintiff's functioning was diminished by her severe impairments of degenerative disc disease of the lumbar spine and depression." (ECF No. 10, p. 3). With regard to Plaintiff's psychological impairments specifically, Plaintiff argues that "this court cannot be assured that her serious symptoms could be ameliorated in the workplace by simply limiting Plaintiff to simple tasks without interacting with the public." Id. at p. 7. "[T]he ALJ reviewed the raw medical evidence himself, and using his own personal opinion, translated that raw medical evidence into an RFC assessment. Id. at 4. Based on the same, Plaintiff submits that the RFC is not based on substantial evidence. Therefore, Plaintiff argues, remand is necessary.
A review of the record reveals that the only opinion evidence of record is from a state agency psychological consultant, Emanuel Schnepp, Ph.D., who indicated that a consultative examination was required to determine both mental and physical functional limitations. (ECF No. 7-3, pp. 4, 10). He further indicated that while Plaintiff was scheduled for examinations, she failed to appear and without the same there is insufficient evidence to support a valid determination. (ECF No. 7-3, pp. 4, 6, 10-12). As a result, Dr. Schnepp's determination is that Plaintiff is not disabled. Id. In essence, therefore, there was no medical opinion evidence in this case. "Rarely can a decision be made regarding a claimant's [RFC] without an assessment from a physician regarding the functional abilities of the claimant." Gormont v. Astrue, No. 11-2145, 2013 WL 791455 at *7 (M.D. Pa. Mar. 4, 2013), citing Doak v. Heckler, 790 F.2d 26 (3d Cir. 1986). After a review of the record, I am unable to discern ...