Crystal Z. v. Comm'r of Soc. Sec.

Crystal Z., Plaintiff, v. Commissioner of Social Security, Defendant.

Civil Action No. 2:19-cv-24-jmc

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF VERMONT

April 24, 2020

OPINION AND ORDER

(Docs. 14, 16)

Plaintiff Crystal Z. brings this action pursuant to 42 U.S.C. § 405(g) of the Social Security Act, requesting review and remand of the decision of the Commissioner of Social Security denying her application for Disability Insurance Benefits (DIB). Pending before the Court are Plaintiff's motion to reverse the Commissioner's decision (Doc. 14), and the Commissioner's motion to affirm the same (Doc. 16). For the reasons stated below, Plaintiff's motion is GRANTED, in part; the Commissioner's motion is DENIED; and the matter is REMANDED for further proceedings and a new decision.

Background

Plaintiff was 28 years old on her alleged disability onset date of July 19, 2016. She completed her GED, and has work experience as an office clerk, a data entry clerk, a chiropractor assistant, a laundry laborer, and a healthcare specialist for the state of Vermont. She is married, and lives in Fairfax with her husband, son, and stepson.

Plaintiff has chronic pain syndrome and a longstanding history of back pain. (AR 511.) In February 2015, she underwent back surgery, specifically a laminectomy and posterior lateral fusion at the L5-S1 level. (AR 286-89.) Thereafter, her pain lessened and she thus returned to work. (AR 42.) Less than two years after the surgery, however, her pain returned, and she was unable to work. (AR 52, 313, 511.) Plaintiff stopped working in July 2016 because her pain prevented her from sitting for longer than one hour at a time and limited her ability to stand, walk, lift, twist, and rise from a seated position. (AR 64-65, 72, 202, 212-13, 217.) To alleviate her pain, Plaintiff lies down, takes breaks throughout the day, and takes narcotic pain medication to help her sleep. (AR 43, 56, 64-65, 511.) She has tried physical therapy, but it "severely exacerbated" her pain. (AR 511.) She has undergone epidural injections but sometimes encounters problems obtaining insurance coverage for them. (AR 42-43, 55.)

Plaintiff has also struggled with anxiety and panic attacks since she was 12 years old; and she suffers from depression and has been diagnosed with hypochondriasis (a mental disorder characterized by excessive fear of or preoccupation with a serious illness, despite medical testing and reassurance to the contrary). (AR 485.) Her mental health has significantly declined since her chronic pain has increased. (Id.; AR 44.)

In a September 2016 Function Report, Plaintiff reported that she cannot sit or stand for longer than 15 minutes without "an immense amount of pain in [her] mid[-]to[-]low back and hips." (AR 212.) She stated that, although she cares for her two-year old son at home, she often lies on the couch to relieve her pain (AR 213); she is unable to cook meals that require standing for longer than 10 minutes (AR 214); and she needs to take breaks when washing dishes (id.). Plaintiff further reported that she "hardly ever" goes outside; she is "unable to do activities"; and, although she can drive and go food shopping once a week, her husband brings her to the store, does the lifting, and pushes the cart. (AR 215.) At the October 2017 administrative hearing, Plaintiff testified that her sister and mother help her care for her son; and she is unable to pick up her son or bathe him. (AR 59, 61.) She also testified that she cannot do household chores without pain, and if she attempts to do the dishes or vacuum, she needs to lie down after. (AR 60.)

In June 2016, Plaintiff filed her application for DIB, alleging that she has been unable to work since July 19, 2016 due to anxiety, depression, back pain, and hip pain. (AR 202.) The application was denied initially and upon reconsideration, and Plaintiff timely requested an administrative hearing. On October 5, 2017, Administrative Law Judge (ALJ) Joshua Menard conducted a hearing on the application. (AR 36-81.) Plaintiff appeared and testified, and was represented by counsel. A vocational expert (VE) also testified at the hearing. On February 16, 2018, the ALJ issued a decision finding that Plaintiffwas not disabled under the Social Security Act from her alleged disability onset date through the date of the decision. (AR 20-31.) Thereafter, the Appeals Council denied Plaintiff's request for review, rendering the ALJ's decision the final decision of the Commissioner. (AR 1-6.) Having exhausted her administrative remedies, Plaintiff timely filed the Complaint in this action on February 12, 2019. (Doc. 3.)

ALJ Decision

The Commissioner uses a five-step sequential process to evaluate disability claims. See Butts v. Barnhart, 388 F.3d 377, 380-81 (2d Cir. 2004). The first step requires the ALJ to determine whether the claimant is presently engaging in "substantial gainful activity." 20 C.F.R. §§ 404.1520(b), 416.920(b). If the claimant is not so engaged, step two requires the ALJ to determine whether the claimant has a "severe impairment." 20 C.F.R. §§ 404.1520(c), 416.920(c). If the ALJ finds that the claimant has a severe impairment, the third step requires the ALJ to make a determination as to whether that impairment "meets or equals" an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1 ("the Listings"). 20 C.F.R. §§ 404.1520(d), 416.920(d). The claimant is presumptively disabled if his or her impairment meets or equals a listed impairment. Ferraris v. Heckler, 728 F.2d 582, 584 (2d Cir. 1984).

If the claimant is not presumptively disabled, the ALJ is required to determine the claimant's residual functional capacity (RFC), which means the most the claimant can still do despite his or her mental and physical limitationsbased on all the relevant medical and other evidence in the record. 20 C.F.R. §§ 404.1520(e), 404.1545(a)(1), 416.920(e), 416.945(a)(1). The fourth step requires the ALJ to consider whether the claimant's RFC precludes the performance of his or her past relevant work. 20 C.F.R. §§ 404.1520(f), 416.920(f). Finally, at the fifth step, the ALJ determines whether the claimant can do "any other work." 20 C.F.R. §§ 404.1520(g), 416.920(g). The claimant bears the burden of proving his or her case at steps one through four, Butts, 388 F.3d at 383; and at step five, there is a "limited burden shift to the Commissioner" to "show that there is work in the national economy that the claimant can do," Poupore v. Astrue, 566 F.3d 303, 306 (2d Cir. 2009) (clarifying that the burden shift to the Commissioner at step five is limited, and the Commissioner "need not provide additional evidence of the claimant's [RFC]").

Employing this sequential analysis, ALJ Menard first determined that Plaintiff had not engaged in substantial gainful activity since her alleged disability onset date of July 19, 2016. (AR 22.) At step two, the ALJ found that Plaintiff had the severe impairments of degenerative disc disease of the lumbar spine, anxiety disorder, and depressive disorder. (AR 23.) Conversely, the ALJ found that Plaintiff's obesity was a "nonsevere impairment" but stated that he nonetheless considered it in formulating Plaintiff's RFC. (Id.) At step three, the ALJ determined that none of Plaintiff's impairments, alone or in combination, met or medically equaled a listed impairment. (Id.) Next, the ALJ determined that Plaintiff had the RFC to perform "light work," as defined in 20 C.F.R. §404.1567(b), except that she "require[d] the ability to change position every hour for [three to five] minutes;" she could "frequently climb ramps and stairs; occasionally climb ladders, ropes, or scaffolds; occasionally stoop; and frequently crouch;" and she was "limited to simple, routine tasks." (AR 25.) Given this RFC, the ALJ found that Plaintiff was unable to perform her past relevant work as an office clerk, a data entry clerk, a chiropractor assistant, and a laundry laborer. (AR 29.) Based on testimony from the VE, however, the ALJ determined that there were other jobs existing in significant numbers in the national economy that Plaintiff could perform, including the representative occupations of market retail worker, order caller, and tanning salon attendant. (AR 30.) The ALJ concluded that Plaintiff had not been under a disability from her alleged disability onset date of July 19, 2016 through the date of the decision. (AR 31.)

Standard of Review

The Social Security Act defines the term "disability" as the "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. § 423(d)(1)(A). A person will be found disabled only if it is determined that his "impairments are of such severity that he is not only unable to do his previous work[,] but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy." 42 U.S.C. § 423(d)(2)(A).

In considering the Commissioner's disability decision, the court "review[s] the administrative record de novo to determine whether there is substantial evidence supporting the . . . decision and whether the Commissioner applied the correct legal standard." Machadio v. Apfel, 276 F.3d 103, 108 (2d Cir. 2002) (citing Shaw v. Chater, 221 F.3d 126, 131 (2d Cir. 2000)); see 42 U.S.C. § 405(g). The court's factual review of the Commissioner's decision is thus limited to determining whether "substantial evidence" exists in the record to support such decision. 42 U.S.C. § 405(g); Rivera v. Sullivan, 923 F.2d 964, 967 (2d Cir. 1991); see Alston v. Sullivan, 904 F.2d 122, 126 (2d Cir. 1990) ("Where there is substantial evidence to support either position, the determination is one to be made by the factfinder."). "Substantial evidence" is more...