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Andrea B. v. Social Security Administration Commissioner

United States District Court, D. Maine

August 28, 2019

ANDREA B., Plaintiff,
v.
SOCIAL SECURITY ADMINISTRATION COMMISSIONER,

          ORDER

          JON D. LEVY CHIEF U.S. DISTRICT JUDGE

         Andrea B. challenges the final administrative decision of the Social Security Administration Commissioner which determined that Andrea B. was not disabled and affirmed the denial of her application for disability insurance benefits. Andrea B. seeks remand on the basis that the determination of her residual functional capacity (“RFC”) was flawed. I conclude that the Appeals Council's RFC determination was supported by substantial evidence. Accordingly, the administrative decision is affirmed.

         I. ADMINISTRATIVE FINDINGS

         The Commissioner's final decision is the September 11, 2018, decision of the Appeals Council upholding the administrative law judge's (“ALJ”) decision. See ECF No. 6-2 at 5-9. The ALJ's decision tracked the familiar five-step sequential evaluation process for analyzing social security disability claims. See 20 C.F.R. § 404.1520 (West 2019). The claimant carries the burden of production on the first four steps, and the burden shifts to the Commissioner at Step 5. Purdy v. Berryhill, 887 F.3d 7, 9-10 (1st Cir. 2018). The five steps proceed as follows:

1) if the applicant is engaged in substantial gainful work activity, the application is denied; 2) if the applicant does not have, or has not had within the relevant time period, a severe impairment or combination of impairments, the application is denied; 3) if the impairment meets the conditions for one of the “listed” impairments in the Social Security regulations, then the application is granted[.]

Seavey v. Barnhart, 276 F.3d 1, 5 (1st Cir. 2001). If the impairment does not meet a listed impairment at Step 3, the ALJ must, as an interim step, determine the claimant's “residual functional capacity, ” § 404.1520(a)(4), (e), which is the most a claimant can still do despite their limitations. § 416.945(a)(1). The RFC is used to assess Step 4 and Step 5:

4) [I]f the applicant's “residual functional capacity” is such that he or she can still perform past relevant work, then the application is denied; 5) if the applicant, given his or her residual functional capacity, education, work experience, and age, is unable to do any other work, the application is granted.

Seavey, 276 F.3d at 5. Put differently, the steps ask (1) was the claimant working during the period of disability, (2) did they have a severe impairment during that period, (3) did the impairment impose limitations that the Social Security Administration deems per se disabling, (4) if not, could the claimant still do their past jobs given their maximum capacity to engage in mental and physical work, and (5) if not, were there any jobs the claimant could perform?

         At Step 1, the ALJ found that Andrea B. had not engaged in substantial gainful activity during the disability period. ECF No. 6-2 at 21. At Step 2, the ALJ found that Andrea B. had the following severe impairments: osteoarthritis, chronic fatigue, obesity, obsessive compulsive disorder, depression, and post-traumatic stress disorder. Id. At Step 3, the ALJ found that Andrea B.'s impairments did not meet or medically equal the severity of an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. Id. at 22-24. The ALJ was therefore required to make a determination of Andrea B.'s RFC before Step 4, and he found that she had the RFC to perform light work with the following limitations:

[S]he is capable of lifting and carrying 20 pounds occasionally and 10 pounds frequently. She must be able to stretch or change position, such as the freedom of a sit-stand option to be exercised at her sole discretion throughout the day. She is able to walk up to four hours with normal breaks. She can occasionally climb ramps and stairs, but can never climb ladders ropes or scaffolds. She can occasionally balance, stoop, kneel, crouch and crawl. She should avoid concentrated exposure to extreme cold. She should avoid all exposure to unprotected heights. Lastly, she is limited to a low stress work environment with only simple, routine, repetitive tasks and no interaction with the public.

Id. at 24-31. Based on that RFC, the ALJ found at Step 4 that Andrea B. was unable to perform any past relevant work. Id. at 31. At Step 5, however, he found that there were jobs that exist in significant numbers in the national economy that she could perform. Id. at 31-33. The ALJ therefore concluded that Andrea B. was not disabled during the alleged period of disability, and denied her disability insurance benefits. Id. at 33.

         Andrea B. asked the Appeals Council to review the ALJ's decision. The Appeals Council agreed with the ALJ's conclusion that Andrea B. was not disabled during the alleged period of disability but found that the ALJ's evaluation of the opinion evidence of Dr. Harold Van Lonkhuyzen, a psychiatrist, was not supported by substantial evidence. In making his mental RFC determination, the ALJ gave “significant” weight to the 2017 opinion of Dr. Van Lonkhuyzen. ECF No. 6-2 at 29. Dr. Van Lonkhuyzen's opinion included a finding that Andrea B. could not deal with changes in a routine work setting, which would support an ultimate finding of disability. Id. However, the ALJ's decision did not include that limitation in the RFC despite giving Dr. Van Lonkhuyzen's opinion significant weight. Thus, as the Commissioner acknowledges, the ALJ decision had an inherent conflict: “The ALJ gave significant weight to Dr. Van Lonkhuyzen's opinion, but did not incorporate or explain the reason for failing to incorporate the purported inability to deal with changes in a routine work setting.” ECF No. 10 at 2. The Appeals Council resolved this conflict by affording “little” weight to Dr. Van Lonkhuyzen's 2017 opinion that Andrea B. could not deal with changes in a routine work setting. ECF No. 6-2 at 6.

         II. STANDARD OF REVIEW

         The administrative decision must be affirmed if it 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 Health & Human Servs., 76 F.3d 15, 16 (1st Cir. 1996) (per curiam). Substantial evidence is evidence that a reasonable mind might accept as adequate to support a finding. Biestek v. Berryhill, 139 S.Ct. 1148, 1154 (2019); Applebee v. Berryhill, 744 Fed.Appx. 6 (1st Cir. 2018) (per curiam). “The ALJ's findings of fact are conclusive when supported by substantial evidence, but are not conclusive when ...


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