United States District Court, E.D. Pennsylvania
AUSTIN MCHUGH, UNITED STATES DISTRICT JUDGE
case is an appeal from a denial of Social Security Disability
Insurance Benefits. Plaintiff asserts multiple errors by the
Administrative Law Judge who decided her case. The matter was
referred to a Magistrate Judge, who issued a Report and
Recommendation upholding the ALJ's decision. I adopt that
thorough and reasoned R & R in all respects but one.
Because I conclude that the ALJ ignored or discounted
probative evidence that supported Plaintiff's claim
without adequately explaining her reasons for doing so, I
will remand for further consideration.
Linda Barbiero filed for disability benefits in 2013,
claiming that she was disabled as of June 1, 2012 due to
clinical depression, anxiety, stress, short-term memory loss,
lack of focus, and chronic aches and pains. Barbiero's
initial application was denied. A hearing was held before an
ALJ who likewise concluded that Barbiero was not disabled.
The ALJ's decision was affirmed by the Social Security
Appeals Council, setting the stage for this appeal.
Social Security Administration reviews applications for
disability insurance benefits using a five-step inquiry. The
finder of fact must determine, in sequence, whether the
claimant: (1) is engaged in “substantial gainful
activity”; (2) has a severe medical impairment; (3) has
an impairment that the Commissioner has found to
presumptively preclude gainful activity; (4) can return to
previous employment despite their impairment; or (5) has the
“residual functional capacity” to perform other
work. 20 C.F.R. § 404.1520. Here, the ALJ resolved
Barbiero's case at Step 5, concluding that Barbiero was
unable to return to her previous occupation as a property
manager and billing clerk, but could perform “light
work, ” limited to “routine repetitive tasks,
infrequent changes in the work setting, and occasional
interaction with co-workers, supervisors, and the
public.” R. at 25.
reaching this conclusion, the ALJ placed “great
weight” on the opinion of Dr. Ronald Langberg, Ph.D.,
who conducted a single consultative examination of Barbiero
on June 3, 2013, at the behest of the Pennsylvania Bureau of
Disability Determination. R. at 30-31. In his examination
report, Langberg described Barbiero as “well-nourished,
appropriately dressed and groomed, [and] . . . fully
cooperative and pleasant.” R. at 298. He noted that her
“speech was normal in rate, rhythm, and volume, ”
that she “did not appear to be responding to internal
stimuli, ” that her “affective expression was
moderately depressed, ” and that her “thinking
was logical, goal-directed, and without loosening of
associations.” R. at 299. Langberg identified
Barbiero's medical conditions as “major depression,
recurrent, moderate, ” “anxiety disorder, not
otherwise specified, ” and “opioid dependence on
agonist therapy.” R. at 301. Based on Barbiero's
affect during the consultation and her performance on memory
tests, Langberg concluded that Barbiero's conditions
would cause “moderate limitations in her capacity to
relate to coworkers, employers, and the general public due to
anxiety, ” and “moderate limitations in her
capacity to sustain worklike-related activities.” R. at
301-02. Consistent with this assessment, Langberg assigned
Barbiero a GAF score of 60. R. at 301.
also placed “great weight” on the June 19, 2013,
“Mental Residual Functional Capacity Assessment”
of Dr. Elizabeth Hoffman, Ph.D. R. at 30-31. Hoffman, a
psychological consultant with the Disability Determination
Bureau, did not personally examine Barbiero. Instead, she
relied on Langberg's analysis to find that,
“[d]espite [Barbiero's] limitations, she is able to
meet the basic mental demands of simple routine work on a
sustained basis.” R. at 72. According to the ALJ,
Langberg and Hoffman's assessment was “consistent
with the evidence as a whole, ” which showed that
Barbiero's “residual symptoms related to her
depression and anxiety . . . have not caused any work
preclusive limitation.” R. at 31.
contrast, the ALJ found that the assessment of Dale Myrtetus,
LCSW, was “not consistent with the evidence in its
entirety” and therefore entitled to “little
weight.” R. at 31. Myrtetus, a licensed therapist who
had seen Barbiero roughly twice a month since 2009,
submitted a “Mental Medical Source
Statement” on December 23, 2014, in which she opined
that Barbiero's impairments would make it impossible for
her to hold a job. R. at 455. Unlike Langberg and Hoffman,
Myrtetus characterized Barbiero's depression and anxiety
as “severe, ” and concluded that “even with
proper medication, ” Barbiero would be “unable to
maintain attention for 2 hours without major
distractibility.” R. at 455-57. Myrtetus attributed
Barbiero's condition, at least in part, to
“dramatic emergencies of adult daughter, ” a 29
year-old mother of two, whose struggles with untreated
bipolar disorder and methamphetamine addiction left Barbiero
“constantly worried and anticipating next [sic]
catastrophe.” R. at 457. While noting that Barbiero had
been assigned a GAF score of 60 in the past year, Myrtetus
put her GAF score as of December 2014 at 45. R. at 455.
According to Myrtetus, Barbiero's condition would cause
her to miss at least four days of work per month. R. at 459.
minimal significance to the ALJ's decision, but of
central relevance to this appeal, are the records of Dr.
Martha Murry, M.D., a psychiatrist to whom Myrtetus referred
Barbiero. Murry treated Barbiero from August 2013 until at
least March 2014. She did not render an opinion on
Barbiero's residual functional capacity, but did create
treatment notes, five of which are contained in the record.
Like Langberg, Murry consistently found that Barbiero was
appropriately groomed, spoke at a normal rate and volume, and
exhibited no signs of psychosis. Unlike Langberg, however,
she also observed that, from August through February,
Barbiero's mood was “dysphoric”; her affect
“constricted, ” “downcast, ” and
“distracted”; her thinking “tangential,
” or “circumstantial”; her appearance
“anxious” or “very anxious”; and her
insight “poor” or “fair.” R. at
415-22. Based on these observations, Murry diagnosed Barbiero
with “major depression, recurrent, severe, ”
“anxiety disorder, other unspecified, ” and
“ADHD, Predominantly Inattentive Presentation.”
R. at 418.
treatment notes show that Barbiero's condition fluctuated
over time. For instance, in January Barbiero reported that
her depression “was worse, ” and that “this
time of yr, (Jan) she always gets down.” Id.
And in February, Barbiero said that she had “highs and
lows, and her lows are really bad.” R. at 420. At this
time, Barbiero described her focus as “very low, worse
than it use to be, ” [sic] and said that she
“[couldn't] seem to get out of bed often in the
AM.” Id. By March, however, Barbiero was
feeling considerably better, an improvement that she
attributed to the end of winter. According to Murry's
treatment note from that month, Barbiero still exhibited
“signs of mild anxiety” and “some signs of
attentional difficulties, ” but her “[m]ental
status [had] no gross abnormalities, ” and her mood was
“euthymic with no signs of depression or manic
process.” R. at 418. Nevertheless, Murry left
undisturbed her diagnoses of anxiety disorder, ADHD, and
review is limited to determining whether “substantial
evidence” supports the ALJ's decision. 42 U.S.C.
§ 405(g). “‘Substantial evidence, ' . .
. is such relevant evidence as a reasonable mind might accept
as adequate to support a conclusion.” Chandler v.
Comm'r of Soc. Sec., 667 F.3d 356, 359 (3d Cir.
2011). “A single piece of evidence will not satisfy the
substantiality test if the Commissioner ignores, or fails to
resolve, a conflict created by countervailing
evidence.” Morales v. Apfel, 225 F.3d 310, 317
(3d Cir. 2000). “Where there is conflicting probative
evidence in the record, we recognize a particularly acute
need for an explanation of the reasoning behind the ALJ's
conclusions, and will vacate or remand a case where such an
explanation is not provided.” Fargnoli v.
Massanari, 247 F.3d 34, 42 (3d Cir. 2001).
that the ALJ's reasoning was flawed both because she (1)
failed to reasonably explain why Myrtetus's opinion was
inconsistent with the record as a whole, and (2) failed to
discuss credible medical evidence that corroborated
Myrtetus's assessment and undermined that of Langberg and
Hoffman. In light of these shortcomings, which I discuss in
turn below, I find that the ALJ's decision to favor
Langberg and ...