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Donna G. v. saul

United States District Court, D. Maine

June 27, 2019

DONNA G., Plaintiff
ANDREW M. SAUL, Commissioner of Social Security, Defendant



         On Plaintiff's application for disability insurance benefits under Title II and supplemental security income benefits under Title XVI of the Social Security Act, Defendant Saul, the Social Security Administration Commissioner, found that Plaintiff has severe impairments, but retains the functional capacity to perform substantial gainful activity. Defendant, therefore, denied Plaintiff's request for disability benefits. Plaintiff filed this action to obtain judicial review of Defendant's final administrative decision pursuant to 42 U.S.C. § 405(g).

         Following a review of the record, and after consideration of the parties' arguments, I recommend the Court vacate the administrative decision and remand the matter for further proceedings.

         The Administrative Findings

         The Commissioner's final decision is the November 28, 2017, decision of the Administrative Law Judge. (ALJ Decision, ECF No. 9-2.)[1] 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.

         The ALJ found that Plaintiff has severe, but non-listing-level impairments consisting of degenerative disc disease of the cervical spine, degenerative disc disease of the lumbar spine, right knee osteoarthritis, obesity, anxiety and depression. (R. 17.) The ALJ further found that as the result of the impairments, Plaintiff has a residual functional capacity (RFC) to perform sedentary work, except that the workplace must not have temperature extremes of hot and cold and concentrated exposure to humidity, must be within a low stress work environment (defined as a job with few changes and few production pace demands on the Plaintiff), and with the expectation that Plaintiff can be off task up to ten percent of each workday, in addition to normal breaks. (R. 20.) Given this RFC and relying in part on the testimony of a vocational expert, the ALJ concluded that Plaintiff can perform past relevant work as a receptionist and billing clerk and, consequently, is not disabled for purposes of the Social Security Act. (R. 26.)

         Standard of Review

         A court must affirm the administrative decision provided the decision is based on the correct legal standards and 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 the ALJ erred in assessing Plaintiff's mental RFC because the ALJ rejected the only relevant medical opinion of record and thus impermissibly interpreted raw medical data. Plaintiff also argues the ALJ erred when she determined that Plaintiff could perform her past relevant work.

         Plaintiff applied for disability benefits on June 4, 2015. Plaintiff did not allege any mental impairments at the time she applied for benefits.[2] (R. 297.) Plaintiff began counseling with Thomas Knox, Ph.D., in March 2016; in December 2016, Dr. Knox completed an assessment of Plaintiff's mental limitations.

         In his assessment, Dr. Knox found that Plaintiff had marked limitations in dealing with work stresses, maintaining attention/concentration, performing at a consistent pace without an unreasonable number and length of rest periods, and completing a normal workday or workweek without interruptions from psychological symptoms. (R. 610.) He found only mild to moderate limitations in other areas of functioning. (Id.) He further determined that Plaintiff could understand, remember, and carry out tasks “only in the security/familiarity of her home, ” and “not in a normal workplace setting” or on a sustained basis. (R. 611.) He also identified moderate to marked limitations in relating predictably in social situations and in demonstrating reliability. (R. 612.) He attributed the limitations to anxiety and depression (manifested by “anxiety attacks with dissociative experiences” and crying episodes), which allegedly caused Plaintiff to “blank out” at times and to have difficulty with concentration and focus. (R. 611.)

         The ALJ discounted much of Dr. Knox's assessment.[3] The ALJ found that while Dr. Knox's assessment of mild limitations in most areas of functioning (including following work rules, interacting with co-workers and supervisors, using judgment, and functioning independently) was consistent with the record, she maintained Dr. Knox's assessment of marked limitations in other areas was neither supported by, nor consistent with, the record. (Id.) She noted the record lacked evidence of formal psychological testing or any referral for such testing; lacked evidence of a hospitalization, a partial hospitalization, a crisis care visit, or an emergency room visit for exacerbation of symptoms; lacked objective or clinically determinable evidence of “blackouts” or “dissociative” states; and included evidence of Plaintiff's activities of daily living, which suggested a greater functioning level. (Id.)

         In general, an ALJ may not substitute her judgment for that of an expert, nor translate raw medical data into an RFC assessment. See, e.g., Nguyen, 172 F.3d at 35; Manso-Pizzaro, 67 F.3d at 16. Moreover, a “treating source's opinion on the nature and severity of a claimant's impairments is entitled to controlling weight if it is ‘well-supported by medically acceptable clinical and laboratory diagnostic techniques and … not inconsistent with the other substantial evidence in [the claimant's] case record.'” Gilson v. Colvin, No. 1:12-cv-376-GZS, 2013 WL 5674359, at *2 (D. Me., Oct. 17, 2013) (quoting 20 C.F.R. §§ 404.1527(c)(2), 416.927(c)(2)). The question of a claimant's RFC is, however, “among the issues reserved to the commissioner, with respect to ...

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