Casanova v. Saul

Norberto Casanova, Plaintiff, v. Andrew Saul, Commissioner of Social Security, Defendant.

Civil No. 3:19-cv-00886-TOF

UNITED STATES DISTRICT COURT DISTRICT OF CONNECTICUT

August 14, 2020

RULING ON PENDING MOTIONS

The Plaintiff, Norberto Casanova, appeals the final decision of the Defendant, Andrew Saul, Commissioner of Social Security ("the Commissioner"), on his application for Title XVI Supplemental Security Income benefits. This appeal is brought pursuant to 42 U.S.C. § 405(g). Currently pending are the Plaintiff's motion to reverse and remand for an award and calculation of benefits, or in the alternative, for an order reversing and remanding for a new hearing (ECF No. 15), along with the Commissioner's motion for entry of judgment under sentence four of § 42 U.S.C. 405(g), with an order reversing and remanding for a new hearing. (ECF No. 22.) For the reasons explained below, the Plaintiff's motion to reverse with an order for an award and calculation of benefits is DENIED, but his alternative motion to reverse and remand for a new hearing is GRANTED. The Commissioner's motion for entry of judgment is DENIED. The Commissioner's decision is VACATED and REMANDED for further proceedings consistent with this decision.

The parties agree that the Administrative Law Judge ("ALJ") committed legal error. Specifically, they agree that ALJ erred in failing to obtain opinion evidence from a medical expert, despite being explicitly ordered to do so by the Appeals Council. (ECF No. 15-1, at 2; ECF No. 22-1, at 2.) Where they differ, however, is in the remedy. The Plaintiff argues that there is "persuasive proof" of disability; that "remand for further evidentiary proceedings" would therefore "serve no useful purpose;" and that the Court should accordingly remand the case solely for a calculation of benefits. (ECF No. 15, at 24.) The Commissioner argues that remand for further development of the record is required.

The Court agrees with the parties that the ALJ committed legal error by not obtaining evidence from a medical expert. Yet the Court does not agree with the Plaintiff that the record contains "persuasive proof" of disability - and, by extrapolation, it does not agree that remand for calculation of benefits is the appropriate remedy. The Court will therefore remand the case for rehearing, as discussed more fully in Section IV below. In recognition of the fact that almost seven years have elapsed since the Plaintiff applied for benefits, the Court will enter further orders to ensure prompt adjudication of this claim on remand. See Section IV, infra.

I. APPLICABLE LEGAL PRINCIPLES

To be considered disabled under the Social Security Act, "a claimant must establish an 'inability to do 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 [twelve] months.'" Smith v. Berryhill, 740 F. App'x 721, 722 (2d Cir. 2018) (summary order) (quoting 20 C.F.R. § 404.1505(a)). To determine whether a claimant is disabled, the ALJ follows a familiar five-step evaluation process.

At Step One, the ALJ determines "whether the claimant is currently engaged in substantial gainful activity . . . ." McIntyre v. Colvin, 758 F.3d 146, 150 (2d Cir. 2014) (citing Burgess v. Astrue, 537 F.3d 117, 120 (2d Cir. 2008)). At Step Two, the ALJ analyzes "whether the claimanthas a severe impairment or combination of impairments . . . ." Id. At Step Three, the ALJ evaluates whether the claimant's disability "meets or equals the severity" of one of the specified impairments listed in the regulations. Id. At Step Four, the ALJ uses a "residual functional capacity" assessment to determine whether the claimant can perform any of her "past relevant work . . . ." Id. At Step Five, the ALJ assesses "whether there are significant numbers of jobs in the national economy that the claimant can perform given the claimant's residual functional capacity, age, education, and work experience." Id. The claimant bears the burden of proving her case at Steps One through Four. Id. At Step Five, "the burden shift[s] to the Commissioner to show there is other work that [the claimant] can perform." Brault v. Soc. Sec. Admin., Comm'r, 683 F.3d 443, 445 (2d Cir. 2012) (per curiam).

The Court's role is to determine whether the Commissioner's decision is supported by substantial evidence and free from legal error. "A district court may set aside the Commissioner's determination that a claimant is not disabled only if the factual findings are not supported by substantial evidence or if the decision is based on legal error." Shaw v. Chater, 221 F.3d 126, 131 (2d Cir. 2000) (internal quotation marks omitted). The decision is supported by substantial evidence if a "reasonable mind" could look at the record and make the same determination as the Commissioner. See Williams v. Bowen, 859 F.2d 255, 258 (2d Cir. 1988) (defining substantial evidence as "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion . . .") (internal citations omitted). Though the standard is deferential, "[s]ubstantial evidence is more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Lamay v. Comm'r of Soc. Sec., 562 F.3d 503, 507 (2d Cir. 2009) (internal quotation marks and citations omitted). When the decision is supported by substantial evidence, the Court defers to the Commissioner's judgment. "Where theCommissioner's decision rests on adequate findings supported by evidence having rational probative force, [this Court] will not substitute [its] judgment for that of the Commissioner." Veino v. Barnhart, 312 F.3d 578, 586 (2d Cir. 2002).

The Commissioner's conclusions of law are not entitled to the same deference. The Court does not defer to the Commissioner's decision "[w]here an error of law has been made that might have affected the disposition of the case." Pollard v. Halter, 377 F.3d 183, 189 (2d Cir. 2004) (internal quotation marks omitted). "Even if the Commissioner's decision is supported by substantial evidence, legal error alone can be enough to overturn the ALJ's decision." Ellington v. Astrue, 641 F. Supp. 2d 322, 328 (S.D.N.Y. 2009) (citing Johnson v. Bowen, 817 F.2d 983, 986 (2d Cir. 1987)).

If a decision is reversed because it contains legal error or is not supported by substantial evidence, the Court may "either remand for a new hearing or remand for the limited purpose of calculating benefits." Henningsen v. Comm'r of Soc. Sec. Admin., 111 F. Supp. 3d 250, 263 (E.D.N.Y. 2015) (internal quotation marks omitted); see also Tejada v. Apfel, 167 F.3d 770, 776 (2d Cir. 1999) (remanding for rehearing but directing Commissioner "to calculate and dispense SSI benefits" if he could not bear his burden at Step Five). Remand for calculation of benefits is not appropriate when the record requires further development. "In deciding whether a remand is the proper remedy, we have stated that where the administrative record contains gaps, remand to the Commissioner for further development of the evidence is appropriate." Butts v. Barnhart, 388 F.3d 377, 385 (2d Cir. 2004), as amended on reh'g in part, 416 F.3d 101 (2d Cir. 2005). To award benefits, a district court must find that, irrespective of the legal error, the record contains "persuasive proof" of the claimant's disability and "a remand for further evidentiary proceedings would serve no purpose." Parker v. Harris, 626 F.2d 225, 235 (2d Cir. 1980). A record contains"persuasive proof" of disability when there is "no apparent basis to conclude" that additional evidence "might support the Commissioner's decision." Rosa v. Callahan, 168 F.3d 72, 83 (2d Cir. 1999).

II. BACKGROUND

a. Facts and Procedural History

On December 11, 2013, the Plaintiff submitted concurrent applications for Supplemental Security Income ("SSI") and Social Security Disability Insurance ("SSDI"). (R. 183-95.) He alleged a disability onset date of December 30, 2002. (R. 183, 187.) The Plaintiff later withdrew his SSDI application and amended his onset date to November 15, 2013. (R. 297.) He initially alleged that he was disabled due to a combination of physical and mental conditions, including depression, diabetes, and glaucoma. (R. 99.) He later expanded this list to include borderline cognitive impairment (R. 297), degenerative disc disease, dizziness and vertigo, hypertension and right coronary artery ischemia, sleep apnea, plantar fasciitis, degenerative changes to the knees, and a right shoulder impairment. (R. 1276-78.) The Social Security Administration denied his application and a subsequent request for reconsideration. (R. 123, 131.) He then requested a hearing before an ALJ. (R. 134.)

The Plaintiff had his first hearing on February 6, 2016 before ALJ Ryan Alger, and it resulted in an unfavorable decision. (R. 23-49.) The Plaintiff appealed the decision to the Appeals Council, and eventually to the District Court, Casanova v. Berryhill, Docket No. 3:17-CV-1302 (MPS). (R. 1339-43.) The Commissioner agreed to a voluntary remand for further development of the record. (R. 1341.) Upon receipt of the District Court remand, the Appeals Council ordered that the ALJ:

Further evaluate the claimant's mental impairments in accordance with the special technique described in 20 CFR 416.920a, documenting application of the techniquein the decision by providing specific findings and appropriate rationale for each of the functional areas described in 20 CFR 416.920a(c). In doing so, obtain evidence from a medical expert related to the nature and severity of and functional limitations resulting from the claimant's mental impairments (20 CFR 416.913a(b)(2)).

(R. 1351.)

ALJ Alger held a second hearing on March 5, 2019. (R. 1299-1310.) The ALJ did not obtain evidence from a medical expert related to the...