United States District Court, W.D. Pennsylvania
Donetta W. Ambrose United States Senior District Judge
before the Court are Cross-Motions for Summary Judgment. (ECF
Nos. 10 and 12). Both parties have filed Briefs in Support of
their Motions. (ECF Nos. 11 and 13). After careful
consideration of the submissions of the parties, and based on
my Opinion set forth below, I am granting Plaintiff's
Motion for Summary Judgment (ECF No. 10) and denying
Defendant's Motion for Summary Judgment. (ECF No. 12).
brought this action for review of the final decision of the
Commissioner of Social Security denying her application for
supplemental security income pursuant to the Social Security
Act. Plaintiff filed her application alleging she has been
disabled since March 1, 2000. (ECF No. 8-8, p. 2).
Administrative Law Judge (“ALJ”), Natalie
Appetta, held a hearing on July 22, 2015. (ECF No. 8-3, pp.
2-46). On September 8, 2015, the ALJ issued an unfavorable
decision finding Plaintiff was not disabled under the Act.
(ECF No. 8-2, pp. 34-45).
exhausting all administrative remedies, Plaintiff filed the
instant action with this court. The parties have filed
Cross-Motions for Summary Judgment. (ECF Nos. 10 and 12). The
issues are now ripe for review.
Standard of Review
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
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.
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).
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).
Residual Functional Capacity (RFC)
case, the ALJ determined Plaintiff has the RFC to perform
light work with both mental and physical limitations. (ECF
No. 8-2, pp. 39-44). Plaintiff argues that the ALJ erred by
rejecting the only medical source statement on record. (ECF
No. 11, pp. 10-12). While the ALJ gave “great
weight” to the decision of the state agency medical
consultant's determination, Plaintiff submits that the
state agency medical consultant never performed a psychiatric
review technique, “nor found that there was any mental
impairment due to insufficient evidence at that time.”
(ECF No. 11, p. 11). Therefore, Plaintiff contends that the
record contains no medical opinion evidence upon which to
base an RFC. Id. As such, Plaintiff maintains that
the ALJ's decision is not supported by substantial
evidence and remand is appropriate. Id. After a
review of the record, I agree.
August 28, 2013, the state agency psychological consultant,
Michelle R. Santilli, Psy.D., indicated that a consultative
examination was required to determine Plaintiff's mental
health issues. (ECF No. 8-4, p. 4). She further indicated
that Plaintiff failed to attend her consultative examination
and neither “her nor the third party have responded to
calls.” Id. As a result, the evidence was
insufficient for Dr. Santilli to make a determination.
Id. (ECF No. 8- 4, p. 5). Therefore, Dr. Santilli
offered no ...