noting that “an ALJ may not make speculative inferences from medical reports”
How later courts described this case
- noting that “an ALJ may not make speculative inferences from medical reports”
- describing the DAA materiality determination evaluation process
- describing standard of judicial review for social security disability insurance benefits and supplemental security income administrative decisions
- describing the five-step sequential evaluation process
Written by the judges who cited it.
The opinion
UNITED STATES DISTRICT COURT
MIDDLE DISTRICT OF PENNSYLVANIA
JENNIFER L. HOROS,
Plaintiff, CIVIL ACTION NO. 3:21-cv-01803
v. (SAPORITO, M.J.)
KILOLO KIJAKAZI, Acting
Commissioner of Social Security,
Defendant.
MEMORANDUM
In this matter, the plaintiff, Jennifer L. Horos, seeks judicial review
of the final decision of the Commissioner of Social Security denying her
claims for disability insurance benefits and supplemental security
income, pursuant to 42 U.S.C. § 405(g) and 42 U.S.C. § 1383(c)(3). The
matter has been referred to the undersigned United States magistrate
judge on consent of the parties, pursuant to 28 U.S.C. § 636(c) and Fed.
R. Civ. P. 73.
I. BACKGROUND
On October 28, 2019, Horos protectively filed a claim for disability
insurance benefits and supplemental security income, asserting a
disability onset date of August 31, 2018. Her claim was initially denied
by state agency reviewers on December 24, 2019, and upon
reconsideration on October 23, 2020. The plaintiff then requested an
administrative hearing.
A hearing was subsequently held on April 6, 2021, before an
administrative law judge, Mike Oleyar (the “ALJ”). In addition to the
plaintiff herself, the ALJ received testimony from an impartial vocational
expert, Patricia Chilleri. The plaintiff was represented by counsel at the
hearing.
On June 16, 2021, the ALJ denied Horos’ application for benefits in
a written decision. The ALJ followed the familiar five-step sequential
evaluation process in determining that Horos was not disabled under the
Social Security Act. See generally Myers v. Berryhill, 373 F. Supp. 3d 528,
534 (M.D. Pa. 2019) (describing the five-step sequential evaluation
process). But, because there was medical evidence that Horos suffered
from drug addiction or alcoholism (“DAA”), the ALJ was also required to
make an additional determination of whether her DAA was a
contributing factor material to the determination that she was disabled—
that is, whether she would still be disabled if she stopped abusing drugs
or alcohol. See generally 42 U.S.C. §§ 423(d)(2)(C), 1382c(a)(3)(J)
(providing that “an individual shall not be considered to be disabled . . .
if alcoholism or drug addiction would . . . be a contributing factor
material to the Commissioner’s determination that the individual is
disabled”); 20 C.F.R. §§ 404.1535, 416.935 (implementing this statute);
Soc. Sec. Ruling 13-2p, 2013 WL 621536 (Feb. 20, 2013) (interpreting this
regulation), amended by 2013 WL 1221979 (Mar. 22, 2013) (correcting
typographical errors); Voorhees v. Colvin, 215 F. Supp. 3d 358, 389 (M.D.
Pa. 2015) (describing the DAA materiality determination evaluation
process).
At step one, the ALJ found that Horos had not engaged in
substantial gainful activity since her alleged disability onset date—
August 31, 2018. At step two, the ALJ found that Horos had the severe
impairments of: generalized anxiety disorder; major depressive disorder;
substance induced psychotic disorder; schizoaffective disorder; substance
addiction disorder (heroin, cocaine and methamphetamine);
amphetamine use disorder; obesity; and asthma.
At step three, the ALJ found that, including her substance use
disorders, Horos had an impairment or combination of impairments that
met listing 12.03 (schizophrenia spectrum and other psychotic disorders)
of 20 C.F.R. Part 404, Subpart P, Appendix 1. The ALJ considered Horos’s
limitations in four broad functional areas as a result of her mental
disorders, finding marked limitations in all four functional areas—
(1)understanding, remembering, or applying information, (2) interacting
with others, (3) concentrating, persisting, or maintaining pace, and (4)
adapting or managing oneself. See generally 20 C.F.R. §§ 404.1520a(c),
416.920a(c) (explaining functional limitation rating process for mental
impairments); 20 C.F.R. pt. 404, subpt. P, app.1, § 12.00(E) (explaining
the four areas of mental functioning); id. § 12.00(F) (explaining the
process for using paragraph B criteria to evaluate mental impairments).
The ALJ then re-considered the step three criteria, this time
evaluating whether Horos would still be found disabled at step three if
she stopped abusing drugs or alcohol. The ALJ found that, if she stopped
abusing drugs and alcohol, Horos would not have an impairment or
combination of impairments that meets or medically equals the severity
of an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1.
The ALJ once again considered Horos’s limitations in four broad
functional areas as a result of her mental disorders, assuming cessation
of any drug or alcohol abuse, and he found moderate limitations in all
four functional areas.
Between steps three and four of the sequential-evaluation process,
the ALJ assessed Horos’s residual functional capacity (“RFC”) assuming
the cessation of any drug or alcohol abuse. See generally Myers, 373 F.
Supp. 3d at 534 n.4 (defining RFC). After evaluating the relevant
evidence of record, the ALJ found that Horos had the RFC to perform
“medium work”1 as defined in 20 C.F.R. § 404.1567(c) and § 416.967(c),
with the following non-exertional limitations:
The claimant can tolerate occasional exposure to
atmospheric condition. The claimant is limited to
understanding, remembering or applying simple
instructions. The claimant is limited to occasional
interaction with supervisors, coworkers and the public.
The claimant is limited to perform detailed, but
uninvolved instructions, generally described as simple
routine unskilled work, but not at a production rate
pace (assembly line work). The claimant is limited to
simple work-related decisions with occasional changes
in the work setting.
(Tr. 20).
In making these factual findings regarding Horos’s prospective
1 The Social Security regulations define “medium work” as a job
that “involves lifting no more than 50 pounds at a time with frequent
lifting or carrying of objects weighing up to 25 pounds.” 20 C.F.R.
§ 404.1567(c) and 416.967(c).
RFC without drug or alcohol abuse, the ALJ considered her symptoms
and the extent to which they could reasonably be accepted as consistent
with the objective medical evidence and other evidence of record. See
generally 20 C.F.R. §§ 404.1529, 416.929; Soc. Sec. Ruling 16-3p, 2017
WL 5180304 (revised Oct. 25, 2017). The ALJ also considered and
articulated how persuasive he found the medical opinions and prior
administrative medical findings of record. See generally 20 C.F.R.
§§ 404.1520c, 416.920c.
At step four, based on this RFC and on testimony by the vocational
expert, the ALJ concluded that, if she stopped abusing drugs or alcohol,
Horos was still unable to perform her past relevant work as actually and
generally performed.
At step five, the ALJ concluded that, if she stopped abusing drugs
or alcohol, Horos was capable of performing other jobs that exist in
significant numbers in the national economy. Based on her age,
education, work experience, and RFC, the ALJ concluded that Horos
would be capable of performing the requirements of representative
occupations such as: rod assembler (DOT # 739.687-186), retail stubber
(DOT # 222.687-034), or order selector (DOT # 922.687-058).
Based on these findings, the ALJ concluded that DAA was a
contributing factor material to the determination of disability because
Horos would not be disabled if she stopped abusing drugs or alcohol.
Because DAA was a contributing factor material to the determination of
disability, the ALJ concluded that Horos was not disabled for Social
Security purposes.
The plaintiff sought further administrative review of her claims by
the Appeals Council, but her request was denied on September 16, 2021,
making the ALJ’s June 2021 decision the final decision of the
Commissioner subject to judicial review by this court.
The plaintiff timely filed her complaint in this court on October 22,
2021. The Commissioner has filed an answer to the complaint, together
with a certified copy of the administrative record. Both parties have filed
their briefs, and this matter is now ripe for decision.
II. DISCUSSION
Under the Social Security Act, the question before this court is not
whether the claimant is disabled, but whether the Commissioner’s
finding that he or she is not disabled is supported by substantial evidence
and was reached based upon a correct application of the relevant law. See
generally 42 U.S.C. § 405(g)(sentence five); id. § 1383(c)(3); Myers, 373 F.
Supp. 3d at 533 (describing standard of judicial review for social security
disability insurance benefits and supplemental security income
administrative decisions).
Horos asserts on appeal that the ALJ’s decision is not supported by
substantial evidence because: (1) each of the representative jobs
described by the vocational expert and identified by the ALJ as work that
Horos could perform that also existed in significant numbers in the
national economy, required more than occasional interaction with
supervisors or co-workers during an initial training period of up to thirty
days, and thus conflicted with her RFC, which limited her to no more
than occasional interaction with supervisors or coworkers; and (2) the
ALJ’s RFC determination failed to incorporate identical and
uncontradicted findings by two state agency psychological consultants
that Horos was limited to performing “1-2 step tasks,” despite the ALJ
having expressly found these opinions to be “persuasive.”2
2 The plaintiff’s brief has broken this second issue into two separate
arguments—one focused on the ALJ’s rejection of a “1-2 step task”
limitation in favor of an unsupported “simple tasks” limitation in the
plaintiff’s RFC, and the second focused on the impact of this error on the
(continued on next page)
A. Interaction During Training
The ALJ adopted an RFC that limited the plaintiff to work that
required no more than occasional interaction with supervisors,
coworkers, and the public. At the plaintiff’s hearing, the vocational expert
testified that a hypothetical individual with Horos’s age, education, work
experience, and RFC could perform three representative jobs that existed
in significant numbers in the national economy: (1) rod assembler;
(2) retail stubber; and (3) order selector. Each of these jobs is classified in
the Dictionary of Occupational Titles as unskilled work with an SVP of
“2,” indicating that each job required up to thirty days of initial training.
On cross-examination by the plaintiff’s counsel, the vocational expert
acknowledged that, during this initial training period, an employee may
be subject to more than occasional interaction with supervisors and
coworkers. Based on that, the plaintiff argues here that her RFC, as
determined by the ALJ, precludes her from doing these jobs.
The plaintiff’s argument is not well taken. As this court and others
have previously found in considering this very same argument, an
vocational evidence considered by the ALJ at step five. But the two issues
are really just one single error and the prejudice that flows from it. Thus,
we address them as a single issue.
interaction level during a probationary training period that briefly
exceeds occasional does not preclude an individual limited to only
occasional interaction from doing that job. See Rebecca L. v. Comm’r of
Soc. Sec., ___ F. Supp. 3d ____, 2022 WL 3025908, at *12 (D.N.J. July 31,
2022); see also Drozd v. Kizakaji, Civil No. 1:21-CV-2063, 2023 WL
122387, at *9–*12 (M.D. Pa. Jan. 6, 2023); Vargas v. Saul, Civil No. 1:19-
CV-1858, 2020 WL 2468401, at *7–*9 (M.D. Pa. May 13, 2020). Despite a
brief initial period of more than occasional interaction, the jobs identified
by the vocational expert and ALJ here require no more than occasional
interaction in general.
B. Limitation to “1-2 Step Tasks”
In the agency’s initial administrative decision, a state agency
psychological consultant, Marci Cloutier, Ph.D., opined that Horos was
able to “perform 1-2 step tasks.” (Tr. 75, 89.) In the agency’s
administrative decision on reconsideration, a second state agency
psychological consultant, Phyllis Reams Brentzel, Psy.D., likewise
opined that Horos was able to “perform 1-2 step tasks” or “to meet the
basic mental demands to complete 1-2 step tasks on a sustained basis.”
(Tr. 107–08, 123–24.). But the ALJ adopted an RFC that limited Horos
to “understanding, remembering or applying simple instructions,” to
“perform[ing] detailed, but uninvolved instructions, generally described
as simple routine unskilled work,” and “to simple work related decisions.”
(Tr. 20.) The plaintiff contends that there is a significant distinction
between the “simple” work with “uninvolved instructions” set forth in the
RFC and the capability to perform “1-2 step tasks” found in the only two
medical opinions to address the plaintiff’s mental residual functional
capacity in this case.
The distinction highlighted by the plaintiff is indeed significant. In
determining whether a claimant is capable of performing work that exists
in significant numbers in the national economy, the agency and the
courts routinely rely on the Dictionary of Occupational Titles (4th ed.
1991) (“DOT”), a publication by the U.S. Department of Labor that
identifies thousands of jobs by name and describes the skills and other
attributes required to perform each. See 20 C.F.R. § 416.966(d)(1) (“[W]e
will take administrative notice of reliable job information available from
various governmental and other publications. For example, we will take
notice of . . . [the] Dictionary of Occupational Titles, published by the
Department of Labor . . . .”); see also Evans v. Metro. Life Ins. Co., 190
Fed. App’x 429, 436 n.7 (6th Cir. 2006) (recognizing that courts may take
judicial notice of the DOT as well). The DOT includes a description of the
“general educational development” (“GED”) for each of the jobs
catalogued therein. “General Educational Development embraces those
aspects of education (formal and informal) which are required of the
worker for satisfactory job performance.” DOT app. C, 1991 WL 688702.
The GED scale is composed of three divisions, one of which is relevant
here—“Reasoning Development.” See id. In occupations described as
having Reasoning Development Level 1, satisfactory job performance
requires that an employee be able to “[a]pply commonsense
understanding to carry out simple one- or two-step instructions” and to
“[d]eal with standardized situations with occasional or no variables in or
from these situations encountered on the job.” Id. (emphasis added).
Meanwhile, occupations described as having Reasoning Development
Level 2 require an employee be able to “[a]pply commonsense
understanding to carry out detailed but uninvolved written or oral
instructions” and to “[d]eal with problems involving a few concrete
variables in or from standardized situations.” Id.
Courts—including this one—have found that a limitation to one- to
two-step tasks is consistent with GED Reasoning Development Level 1,
but inconsistent with GED Reasoning Development Level 2. See Stanton
v. Comm’r, Soc. Sec. Admin., 899 F.3d 555, 560 (8th Cir. 2018);
Henderson v. Colvin, 643 Fed. App’x 273, 277 (4th Cir. 2016) (per curiam);
Rounds v. Comm’r Soc. Sec. Admin., 807 F.3d 996, 1003 (9th Cir. 2015);
Skeens v. Astrue, 903 F. Supp. 2d 1200, 1210–11 (W.D. Wash. 2012);
Wisziwaty v. Astrue, 861 F. Supp. 2d 924, 946 (N.D. Ind. 2012); see also
Shingler v. Kijakazi, Civil Action No. 4:20-CV-01344, 2022 WL 273426,
at *12 (M.D. Pa. Jan. 28, 2022); Brown v. Kijakazi, Civil Action No. 4:20-
CV-00836, 2021 WL 4711242, at *7 n.4 (M.D. Pa. Oct. 8, 2021).
Here, at step five, the ALJ found that Horos was capable of
performing other jobs that exist in significant numbers in the national
economy. Two of the three occupations identified by the ALJ were
Reasoning Development Level 2 positions, which a one- or two-step tasks
limitation would preclude. See DICOT 222.687-034, 1991 WL 672136
(“stubber”); DICOT 922.687-058, 1991 WL 688132 (“laborer, stores,”
“order picker,” “parts picker,” “stock selector,” or “warehouse worker”).
But two of the positions identified—night cleaner and machine feeder—
were Reasoning Development Level 1 positions, which are consistent
with a one- or two-step tasks limitation. See DICOT 323.687-014, 1991
WL 672783 (“cleaner, housekeeping” or “night cleaner”); DICOT 699.686-
010, 1991 WL 678871 (“machine feeder”).
The remaining position was a Reasoning Development Level 1
position. See DICOT 739.687-186, 1991 WL 680218 (“traverse-rod
assembler”). Under the applicable regulations, “[w]ork exists in the
national economy when there is a significant number of jobs (in one or
more occupations) having requirements which [the claimant is] able to
meet with [his or her] physical or mental abilities and vocational
qualifications.” 20 C.F.R. §§ 404.1566(b), 416.966(b) (emphasis added).
Here, based on testimony by the vocational expert, the ALJ found a single
occupation with requirements that Horos was able to meet with her
vocational qualifications, her physical abilities, and the more limited
mental abilities found by the state agency psychological consultants. But,
based on testimony by the vocational expert, the ALJ found that only
7,000 such jobs exist nationally. This number of positions, however, is
insufficient to establish that this last occupation standing exists in
significant numbers in the national economy. See Leonard v. Heckler, 582
F. Supp. 389, 391–92 (M.D. Pa. 1983) (finding vocational expert
testimony that 5,000 jobs existed in the national economy was
insufficient to establish that work exists in significant numbers); see also
Alvarez v. Berryhill, Civil Action No. 1:16-CV-00707, 2017 WL 1709400,
at *7–*8 (M.D. Pa. May 3, 2017) (finding 2,077 jobs insufficient); cf.
Sanchez v. Comm’r of Soc. Sec., 705 Fed. App’x 95, 99 (3d Cir. 2017)
indicating that 18,000 jobs is sufficient).
As noted above, the two state agency psychological consultants’
opinions were the only medical opinions in the record to address the
plaintiff’s mental RFC. Both found that she was limited to work involving
the performance of “1-2-step tasks.” In her brief in opposition, the
Commissioner notes the other medical and non-medical evidence in the
record that the ALJ considered in evaluating Horos’s RFC. But this is
simply a case of an ALJ improperly supplanting the medical judgment of
a medical specialist with the ALJ’s own “personal observation and
speculation.” See Morales v. Apfel, 225 F.3d 310, 317 (3d Cir. 2000)
(noting that “an ALJ may not make speculative inferences from medical
reports”).
“It is by now axiomatic that an ALJ may not substitute his own lay
medical opinion for competent medical opinion in the record.” Harris v.
Astrue, 138 Soc. Sec. Rep. Serv. 1020, 2009 WL 189845, at *13 (W.D. Pa.
2009); see also Slotcavage v. Berryhill, Civil No. 3:18-CV-1214, 2019 WL
2521634, at *10 (M.D. Pa. June 3, 2019) (“It is axiomatic that an ALJ
may not unilaterally reject all medical opinions in favor of the ALJ’s own
subjective impressions.”). Furthermore, it is well established that “[s]tate
agency physicians and psychologists are considered to be highly qualified
physicians and psychologists who are also experts in Social Security
disability evaluation . . . .” Poulos v. Comm’r of Soc. Sec., 474 F.3d 88, 93
n.2 (3d Cir. 2007) (internal quotation marks omitted); Harris, 2009 WL
189845, at *13 (reviewing ALJ rejection of state agency medical
consultant’s opinion). “The principle that an ALJ should not substitute
his lay opinion for the medical opinion of experts is especially profound
in a case involving a mental disability.”
Accordingly, in light of the foregoing, we are unable to conclude that
substantial evidence supports the ALJ’s RFC determination.
III. CONCLUSION
Based on the foregoing, we conclude that the Commissioner’s
finding that Horos was not disabled is not supported by substantial
evidence. Accordingly, the Commissioner’s decision denying her
application for disability insurance benefits and supplemental security
income will be reversed and the case will be remanded for further
proceedings consistent with this opinion.
An appropriate order follows.
Dated: March 31, 2023 s/Joseph F. Saporito, Jr.
JOSEPH F. SAPORITO, JR.
United States Magistrate Judge