United States District Court, D. Maine
JOHN C. NIVISON, Magistrate Judge.
In this action, Plaintiff Joseph Richard Jenkins seeks supplemental security income benefits under the Social Security Act. Upon review of Plaintiff's application, Defendant Commissioner found that Plaintiff was disabled as of February 10, 2013. Plaintiff contends that his disability commenced on May 15, 2009.
As explained below, following a review of the record, and after consideration of the parties' written and oral arguments, the recommendation is that the Court remand the matter for further proceedings.
THE ADMINISTRATIVE FINDINGS
The Commissioner's final decision is the April 23, 2013, decision of the Administrative Law Judge (ALJ) (ALJ Decision, ECF No. 6-2). The ALJ's decision tracks the familiar five-step sequential evaluation process for analyzing social security disability claims, 20 C.F.R. §§ 404.1520, 416.920.
Plaintiff's application for disability benefits is based on symptoms secondary to Pick's Disease, a form of Frontotemporal Dementia (FTD). The ALJ found that Plaintiff did not establish that he suffered disabling symptoms between his alleged onset date (May 15, 2009) and February 10, 2013. The ALJ, however, determined that as the result of complications secondary to a myocardial infarction, Plaintiff's residual functional capacity and age directed a finding of "disabled" under the Medical-Vocational Guidelines as of February 10, 2013.
In rejecting Plaintiff's claim of disability between May 15, 2009, and February 10, 2013, the ALJ concluded that Plaintiff was not limited in his exertional capacity, but was restricted to "simple" work involving no public interaction and only occasional changes in routine. (ALJ Decision ¶ 5.) Although the ALJ found that this residual functional capacity would not permit Plaintiff to engage in his past relevant work, based on the framework of the Medical-Vocational Guidelines, the ALJ determined that Plaintiff would be able to perform other work that existed in substantial numbers in the national economy. ( Id. ¶ 11.)
STANDARD OF REVIEW
A court must affirm the administrative decision provided that the ALJ applied the correct legal standard and that the decision is supported by substantial evidence, even if the record contains evidence capable of supporting an alternative outcome. Manso-Pizarro v. Sec'y of HHS, 76 F.3d 15, 16 (1st Cir. 1996) (per curiam); Rodriguez Pagan v. Sec'y of HHS, 819 F.2d 1, 3 (1st Cir. 1987). Substantial evidence is evidence that a reasonable mind might accept as adequate to support a finding. Richardson v. Perales, 402 U.S. 389, 401 (1971); Rodriguez v. Sec'y of HHS, 647 F.2d 218, 222 (1st Cir. 1981). "The ALJ's findings of fact are conclusive when supported by substantial evidence, but they are not conclusive when derived by ignoring evidence, misapplying the law, or judging matters entrusted to experts." Nguyen v. Chater, 172 F.3d 31, 35 (1st Cir. 1999).
Plaintiff argues that the ALJ erred when he concluded that Plaintiff was not disabled as of May 15, 2009. More specifically, Plaintiff maintains (1) that the ALJ should have made a finding of disability at step 3 based on the Listings, and that the ALJ erred when he failed to call an expert to assess whether Plaintiff's degree of impairment met or was medically equivalent to a listing; (2) that the ALJ failed to perform a proper function-by-function assessment in his RFC analysis, and improperly weighed the expert opinion evidence; and (3) that the ALJ erred in his reliance on the framework of the Guidelines to satisfy Defendant's burden at step 5.
A. Medical equivalency
In his analysis, the ALJ considered whether Plaintiff's FTD-related symptoms met listing 12.02 (organic mental disorders). The ALJ concluded that the impairment did not meet the listing because marked limitations were not present in any area of mental functioning and the record lacked evidence of an episode of decompensation. ( Id. ¶ 4.) The ALJ also found that the record did not establish the existence of limitations that would satisfy the "C criteria" of Listing 12.02. ( Id. )
Plaintiff argues that the ALJ erred when he failed to obtain an expert opinion on whether Plaintiff's symptoms were equivalent to those identified in listing 11.04 (central nervous system vascular accident) or listing 12.02. Plaintiff observes that FTD is a disorder recognized by Defendant as one deserving special consideration under Defendant's "compassionate allowance" program, which provides for the expedited handling of claims of individuals with certain impairments. 20 C.F.R. §§ 404.1602, 416.1002. ...