Opinion

Aponte v. Saul

Court
District Court, E.D. New York
Filed
Jul 6, 2022
Cited by
0 cases
Authority
More cited than 26.7%

“Because an RFC determination is a medical determination, an ALJ who makes an RFC determination in the absence of supporting expert medical opinion has improperly substituted his own opinion for that of a physician, and has committed legal error.”

How later courts described this case

  • “Because an RFC determination is a medical determination, an ALJ who makes an RFC determination in the absence of supporting expert medical opinion has improperly substituted his own opinion for that of a physician, and has committed legal error.”

Written by the judges who cited it.

The opinion

UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF NEW YORK

-----------------------------------------------x

JESUS APONTE

MEMORANDUM AND ORDER

Plaintiff,

Case No. 20-cv-4150

-against-

COMMISSIONER OF SOCIAL

SECURITY,

Defendant.

------------------------------------------------x

Appearances: For the Defendant:

For the Plaintiff: DENNIS J. CANNING

RICHARD BLAKE SEELIG MEGHAN MCEVOY

Seelig Law Offices, LLC Social Security Administration

299 Broadway, Suite 1600 Office of the General Counsel

New York, NY 10007 601 E. 12th St, Rm. 965

K ansas City, MO 64106

BLOCK, Senior District Judge:

Jesus Aponte seeks review of the Commissioner of Social Security’s denial of

his application for disability insurance benefits. Both parties move for judgment on

the pleadings.1 For the following reasons, Aponte’s motion should be granted, the

Commissioner’s motion should be denied, and the case should be remanded for

further administrative proceedings.

1 Aponte moves for relief under 42 U.S.C. 405(g), which authorizes the Court to enter

“a judgment affirming, modifying, or reversing the decision of the Commissioner of

Social Security, with or without remanding the cause for a rehearing.”

I.

Aponte applied for Social Security Disability Insurance (“SSDI”) on or about

June 4, 2018, claiming a disability onset date of November 30, 2015. The

Commissioner denied his application about three months later, and Aponte requested

a hearing before an administrative law judge (“ALJ”). Plaintiff appeared before ALJ

Dina Lowey on December 17, 2019.

After the hearing, the ALJ determined that Aponte suffered from several

“severe impairments,” including: “degenerative disc disease of the cervical, thoracic,

and lumbar spine; degenerative joint disease of the right shoulder; bilateral carpal

tunnel syndrome; obstructive sleep apnea; and obesity.” A.R. 18.

However, the ALJ concluded that the plaintiff “does not have an impairment or

combination of impairments that meets or medically equals the severity of one of the

listed impairments in 20 CFR Part 404, Subpart P, Appendix .1.” A.R. 19. As such,

the ALJ labeled the plaintiff not disabled under sections 216(1) and 22(d) of the

Social Security Act, denying Aponte the disability insurance benefits for the period

for which he had applied. On July 10, 2020, the Appeals Council denied Aponte’s

request for review. This appeal followed.

II.

“In reviewing a final decision of the Commissioner, a district court must

determine whether the correct legal standards were applied and whether substantial

evidence supports the decision.” Butts v. Barnhart, 388 F.3d 377, 384 (2d Cir. 2004);

see also 42 U.S.C. § 405(g). “[S]ubstantial evidence ... means such relevant evidence

as a reasonable mind might accept as adequate to support a conclusion.” Richardson v.

Perales, 402 U.S. 389, 401 (1971); see also Selian v. Astrue, 708 F.3d 409, 417 (2d Cir.

2013).

III.

Remand is appropriate in this case. In making her determination, the ALJ

improperly relied on her own judgement rather than the substantiated medical

opinions presented. This is an error of law that necessitates remand.

The ALJ is a layperson, not a medical doctor. Therefore, she is neither capable

of nor permitted to interpret or judge the validity of raw medical data in determining a

plaintiff’s residual functional capacity (“RFC”). See Peed v. Sullivan, 778 F. Supp.

1241, 1246-47 (E.D.N.Y. 1991). While in certain cases she may afford greater weight

to a medical opinion that conflicts with another, she may not substitute her own

opinion for any medical recommendations with which she personally disagrees:

With no statements in the record about functional abilities, however, the Court

is forced to conclude that the ALJ crossed the line between selecting credible

providers and filling in where those providers were wholly silent. The latter is

not permitted and requires remand.

Deubell v. Comm’r of Soc. Sec., No. 18-CV-935 HBS, 2019 WL 5781860, at *4

(W.D.N.Y. Nov. 6, 2019) (collecting cases); see also Hilsdorf v. Comm’r. of Soc. Sec.,

724 F. Supp. 2d 330, 347 (E.D.N.Y. 2010) (“Because an RFC determination is a

medical determination, an ALJ who makes an RFC determination in the absence of

supporting expert medical opinion has improperly substituted his own opinion for that

of a physician, and has committed legal error.”).

Dr. Perez, one of Aponte’s treating physicians, is a board-certified physiatrist

who specializes in treating patients with disabilities. In October 2016, Dr. Perez began

treating Aponte for his low back and bilateral leg pain and examined him more than

one dozen times over approximately three years, conducting multiple X-rays, MRIs

and an electrodiagnostic examination. See A.R. 682. In December of 2019, Dr. Perez

found Aponte to be “disabled and unable to maintain even a ‘sedentary type job’”

A.R. 27. Despite Dr. Perez supporting this finding with detailed treatment records and

a narrative report, the ALJ found his recommendation “unpersuasive.” Id. Instead, the

ALJ concluded that:

[W]hile the record reflects significant degenerative disc disease on MRI’s [sic],

the claimant’s daily activities which include being the primary caretaker for his

two elderly obese parents, and the conservative course of treatment are

inconsistent with the debilitating degree of functional limitation that Dr. Perez

described.

A.R. 27. With this conclusion, the ALJ dismissed the severity of Aponte’s condition

based on her own judgement of Aponte’s activities and medical state. As such, the

ALJ provided a recommendation based on cherry-picked evidence which together did

not demonstrate Aponte to be severely disabled. Then, in her residual functional

capacity assessment (“RFC”), the ALJ determined that the plaintiff:

[H]as the residual functional capacity to perform light work . . . except that he

can occasionally climb ramps or stairs but never climb ladders, ropes or

scaffolds. He can occasionally balance, stoop, kneel, crouch, and crawl. He can

occasionally engage in overhead reaching with the right arm. He can

occasionally push and pull with the right arm. He can frequently handle and

finger. He can never have even moderate exposure to hazardous machinery and

unprotected heights.

A.R. 20.

As with Dr. Perez, the ALJ willfully dismissed certain medical evidence

presented by Dr. Silvia Aguiar, prescribing a recommendation based on her own

assessment of Aponte’s health rather than the physician’s findings. On July 25, 2018,

Dr. Aguiar, an internal medicine practitioner, performed a consultive examination on

Aponte, which included a physical examination and two x-rays. A.R. 563. She opined

that Aponte had:

[M]arked limitations to perform any positional activities that require balance,

operate heavy machinery, operate motor vehicles, and heights [. . .] The

claimant also has moderate to marked limitations to bending, heavy lifting,

carrying, prolonged standing, prolonged walking, reaching overhead with the

right upper extremity and pushing, pulling with the right upper extremity, and

crouching.

A.R. 563-564.

In analyzing Dr. Aguiar’s conclusions, the ALJ instead decided that such limitations –

namely that the plaintiff suffered from marked to moderate limitations – were

unfounded because they were inconsistent with “claimant’s activities during the

period at issue that included caring for, and lifting, his obese and elderly parents.”

A.R. 27. However, the ALJ did not have the authority to come to this medically

driven conclusion. “[An ALJ] is not allowed to play doctor by using her own lay

opinions to fill in evidentiary gaps in the record.” Suide v. Astrue, 317 Fed. Appx.

684, 690 (7th Cir. 2010); see also Collins v. Berryhill, No. 16-CV-6673 (PKC), 2018

WL 259282 (E.D.N.Y. Jan. 2, 2018) (adopting Suide’s reasoning).

As such, the ALJ replaced substantiated medical evidence with her own

layperson’s conclusions. This is an impermissible legal error which requires remand.

CONCLUSION

Aponte’s motion is GRANTED, and the Commissioner’s motion is DENIED.

The ALJ’s judgement of the severity of Aponte’s impairment was undermined by legal

error. Accordingly, the case is REMANDED for further administrative proceedings

consistent with this order.

SO ORDERED.

_/S/ Frederic Block___________

FREDERIC BLOCK

Senior United States District Judge

Brooklyn, New York

July 6, 2022

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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