Shelly J. v. Comm'r of Soc. Sec.

SHELLY J., Plaintiff, v. COMMISSIONER OF SOCIAL SECURITY, Defendant.

No. 20-CV-204-HKS

United States District Court, W.D. New York

September 13, 2021

DECISION AND ORDER

H KENNETH SCHROEDER, JR. United States Magistrate Judge

Plaintiff Shelly J., brings this action pursuant to the Social Security Act (“the Act”) seeking review of the final decision of Commissioner of Social Security (the “Commissioner”), which denied her applications for supplemental security income (“SSI”) and disability insurance benefits (“DIB”). Dkt. No 1. This Court has jurisdiction over this action under 42 U.S.C. § 405(g) and the parties have consented to the disposition of this case by the undersigned pursuant to 28 U.S.C. § 636(c). Dkt. No. 23.

Both parties have moved for judgment on the pleadings pursuant to Federal Rule of Civil Procedure 12(c). Dkt. Nos. 19, 21. For the reasons that follow, Plaintiff's Motion for Judgment on the Pleadings (Dkt. No. 19) is GRANTED, and Defendant's Motion for Judgment on the Pleadings (Dkt. No. 21) is DENIED.

BACKGROUND

On January 24, 2017, Plaintiff protectively filed applications for SSI and DIB with the Social Security Administration (“SSA”) alleging disability beginning on October 22, 2016, due to injuries sustained in a severe car accident, including a severed artery requiring heart surgery; hip and arm fractures requiring surgery; blood clots; carpal tunnel; an inability to use her right hand; difficulty bending and breathing; and reliance upon a wheelchair. Tr.^[1] 157-165, 192. On May 2, 2017, Plaintiff's claims were denied, and she requested review. Tr. 61-84. On April 25, 2019, Plaintiff appeared with her attorney and testified, along with a vocational expert (“VE”) before Administrative Law Judge, Timothy M. McGuan (“the ALJ”). Tr. 33-60. On May 15, 2019, the ALJ issued a decision finding Plaintiff was not disabled within the meaning of the Act. Tr. 16-28. Plaintiff timely requested review of the ALJ's decision, which the Appeals Council denied on December 20, 2019. Tr. 1-6. Thereafter, Plaintiff commenced this action seeking review of the Commissioner's final decision. Dkt. No. 1.

LEGAL STANDARD

I. District Court Review

“In reviewing a final decision of the SSA, this Court is limited to determining whether the SSA's conclusions were supported by substantial evidence in the record and were based on a correct legal standard.” Talavera v. Astrue, 697 F.3d 145, 151 (2d Cir. 2012) (quotation marks omitted); see also 42 U.S.C. § 405(g). The Act holds that a decision by the Commissioner is “conclusive” if it is supported by substantial evidence. 42 U.S.C. § 405(g). “Substantial evidence means more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Moran v. Astrue, 569 F.3d 108, 112 (2d Cir. 2009) (quotation marks omitted). It is not the Court's function to “determine de novo whether [the claimant] is disabled.” Schaal v. Apfel, 134 F.3d 496, 501 (2d Cir. 1998) (quotation marks omitted); see also Wagner v. Sec'y of Health & Human Servs., 906 F.2d 856, 860 (2d Cir. 1990) (holding that review of the Secretary's decision is not de novo and that the Secretary's findings are conclusive if supported by substantial evidence). However, “[t]he deferential standard of review for substantial evidence does not apply to the Commissioner's conclusions of law.” Byam v. Barnhart, 336 F.3d 172, 179 (2d Cir. 2003) (citing Townley v. Heckler, 748 F.2d 109, 112 (2d Cir. 1984)).

II. Disability Determination

An ALJ must follow a five-step process to determine whether an individual is disabled under the Act. See Bowen v. Yuckert, 482 U.S. 137, 140-142 (1987). At step one, the ALJ must determine whether the claimant is engaged in substantial gainful work activity. See 20 C.F.R. § 404.1520(b). If so, the claimant is not disabled. If not, the ALJ proceeds to step two and determines whether the claimant has an impairment, or combination of impairments, that is “severe” within the meaning of the Act, meaning that it imposes significant restrictions on the claimant's ability to perform basic work activities. 20 C.F.R. § 404.1520(c). If the claimant does not have a severe impairment or combination of impairments, the analysis concludes with a finding of “not disabled.” If the claimant does, the ALJ continues to step three.

At step three, the ALJ examines whether a claimant's impairment(s) meets or medically equals the criteria of a listed impairment in Appendix 1 of Subpart P of Regulation No. 4 (the “Listings”). 20 C.F.R. § 404.1520(d). If the impairment(s) meets or medically equals the criteria of a Listing and meets the durational requirement (20 C.F.R. § 404.1509), the claimant is disabled. If not, the ALJ determines the claimant's residual functional capacity (“RFC”), which is the ability to perform physical or mental work activities on a sustained basis, notwithstanding limitations for collective impairments. See 20 C.F.R. § 404.1520(e)-(f).

The ALJ then proceeds to step four and determines whether the claimant's RFC permits him or her to perform the requirements of his or her past relevant work. 20 C.F.R. § 404.1520(f). If the claimant can perform such requirements, then he or she is not disabled. If he or she cannot, the analysis proceeds to the fifth and final step, wherein the burden shifts to the Commissioner to demonstrate that the claimant “retains a residual functional capacity to perform the alternative substantial gainful work which exists in the national economy” in light of his or her age, education, and work experience. See Rosa v. Callahan, 168 F.3d 72, 77 (2d Cir. 1999) (quotation marks omitted); see also 20 C.F.R. § 404.1560(c).

If the claimant is found disabled at any point, the ALJ must also determine whether the disability continues through the date of the decision. In doing so, the ALJ must determine whether there has been any medical improvement in the claimant's impairment(s), and if so whether the medical improvement is related to the claimant's ability to work. 20 C.F.R. § 404.1594(a). If the claimant's impairment(s) has not medically improved, the ALJ must then consider whether one or more of the exceptions to medical improvement applies. Id. In determining whether a claimant's disability continues, the ALJ must follow the eight-step evaluation process set forth in 20 U.S.C. § 404.1594(f).^[2]

First, the ALJ must assess whether the claimant is engaging in substantial gainful activity. If so, then the disability has concluded. 20 U.S.C. § 404.1594(f)(1). If not, then the ALJ considers whether the claimant has an impairment or combination of impairments that meets or equals the severity of an impairment listed in Appendix 1 of Subpart P. Id. at (f)(2). If so, then the disability continues. If not, then the ALJ considers whether there has been medical improvement. Id. at (f)(3). If there has been medical improvement as shown by a decrease in medical severity, then the ALJ must determine whether it is related to the claimant's ability to do work. Id. at (f)(4). Specifically, the ALJ must assess whether there has been an increase in RFC based on the impairment(s) existing at the time of the most recent favorable medical determination. Id.

If medical improvement is not related to the claimant's ability to work, then the ALJ considers whether any of the exceptions to medical improvement applies. Id. at (f)(5). If an exception to medical improvement applies or the medical improvement is found to be related to the claimant's ability to do work, then the ALJ will determine whether all of the current impairments in combination are severe. Id. at (f)(6). Here, the ALJ will consider all current impairments and the impact of the combination of those impairments on your ability to function. Id. When the evidence demonstrates that all current impairments in combination do not significantly limit the claimant's physical or mental abilities to do basic work activities, the impairments will not be considered severe, and the claimant will no longer be considered disabled. Id. However, if the impairment(s) is severe or the RFC assessment shows significant limitation in the claimant's ability to do basic work activities, then the ALJ will assess the claimant's current ability to perform substantial gainful activity. Id. at (f)(7). Specifically, the ALJ will assess the claimant's RFC based on all current impairments and consider whether the claimant can still perform past work. Id. If so, then the ALJ will find the claimant is no longer disabled. If not, then the ALJ will assess whether the claimant can perform other work in consideration of the RFC, age, education, and past work experience. 20 U.S.C. § 404.1594 (f)(8).

DISCUSSION

I. The ALJ's Decision

1. October 22, 2016-February 28, 2018

The ALJ's decision analyzed Plaintiff's claim for benefits under the process described above. First, the ALJ found that Plaintiff meets the insured status requirements of the SSA through December 31, 2021. Tr. 20. At step one, the ALJ found Plaintiff had not engaged in substantial gainful activity since October 22, 2016, Plaintiff's disability date. Id. At step two, the ALJ found that from October 22, 2016 through February 28, 2018, Plaintiff had the following severe impairments: status post multiple trauma induced fractures and corresponding soft tissue injuries on the left side of her body, including her right arm and right knee; deep vein thrombosis in her right leg; stress-induced cardiomyopathy; atrial fibrillation; and traumatic contusion of the brain in the right caudate nucleus. Id. At step three, the ALJ found that these impairments, alone or in combination, did not meet or medically equal any listings impairment. Tr. 20-21.

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