noting that “‘[t]he findings of the Commissioner of Social Security as to any fact, if supported by substantial evidence, shall be conclusive’” (quoting 42 U.S.C. § 405(g))
How later courts described this case
- noting that “‘[t]he findings of the Commissioner of Social Security as to any fact, if supported by substantial evidence, shall be conclusive’” (quoting 42 U.S.C. § 405(g))
- stating that the court has plenary review of all legal issues, and reviews the ALJ’s findings of fact to determine whether they are supported by substantial evidence
Written by the judges who cited it.
The opinion
IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF PENNSYLVANIA
ERIN LYNN HART, )
)
Plaintiff, )
)
-vs- ) Civil Action No. 20-1786
)
COMMISSIONER OF SOCIAL SECURITY, )
)
Defendant. )
ORDER
AND NOW, this 13th day of April, 2022, upon consideration of Defendant’s Motion for
Summary Judgment (Doc. No. 15) filed in the above-captioned matter on August 23, 2021,
IT IS HEREBY ORDERED that said Motion is DENIED.
AND, further, upon consideration of Plaintiff’s Motion for Summary Judgment (Doc. No.
13) filed in the above-captioned matter on July 21, 2021,
IT IS HEREBY ORDERED that said Motion is GRANTED. Accordingly, this matter is
hereby remanded to the Commissioner of Social Security (“Commissioner”) for further
evaluation under sentence four of 42 U.S.C. §405(g) in light of this Order.
I. Background
Plaintiff Erin Lynn Hart protectively filed a claim for Disability Insurance Benefits under
Title II of the Social Security Act (the “Act”), 42 U.S.C. §§401-434, claiming that she became
disabled on June 7, 2014, due to epilepsy, anxiety, depression, cognitive issues, and
complications from seizures. (R. 67). After being denied initially on February 27, 2019,
Plaintiff sought, and obtained, a hearing before an Administrative Law Judge (“ALJ”) on
December 2, 2019. (R. 30-64). On January 23, 2020, the ALJ issued a decision denying
Plaintiff’s request for benefits. (R. 12-25). The Appeals Counsel declined to the review the
ALJ’s decision on October 6, 2020. (R. 1-3). Plaintiff filed a timely appeal with this Court, and
the parties have filed cross-motions for summary judgment.
II. Standard of Review
Judicial review of a social security case is based upon the pleadings and the transcript of
the record, and the scope of that review is limited to determining whether the Commissioner
applied the correct legal standards and whether the record, as a whole, contains substantial
evidence to support the Commissioner’s findings of fact. See 42 U.S.C. §405(g); Matthews v.
Apfel, 239 F.3d 589, 592 (3d Cir. 2001) (noting that “‘[t]he findings of the Commissioner of
Social Security as to any fact, if supported by substantial evidence, shall be conclusive’”
(quoting 42 U.S.C. § 405(g))); Schaudeck v. Comm’r of Soc. Sec. Admin., 181 F.3d 429, 431 (3d
Cir. 1999) (stating that the court has plenary review of all legal issues, and reviews the ALJ’s
findings of fact to determine whether they are supported by substantial evidence). If the district
court finds this to be so, it must uphold the Commissioner’s final decision. See Rutherford v.
Barnhart, 399 F.3d 546, 552 (3d Cir. 2005). The Court may not set aside a decision that is
supported by substantial evidence “even if [it] would have decided the factual inquiry
differently.” Hartranft v. Apfel, 181 F.3d 358, 360 (3d Cir. 1999) (citing § 405(g)); Monsour
Med. Ctr. v. Heckler, 806 F.2d 1185, 1190-91 (3d Cir. 1986)).
“Substantial evidence” is defined as “‘more than a mere scintilla. It means such relevant
evidence as a reasonable mind might accept as adequate’” to support a conclusion. Plummer v.
Apfel, 186 F.3d 422, 427 (3d Cir. 1999) (quoting Ventura v. Shalala, 55 F.3d 900, 901 (3d Cir.
1995)); Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019). However, a “‘single piece of
evidence will not satisfy the substantiality test if the [Commissioner] ignores, or fails to resolve,
a conflict created by countervailing evidence.’” Morales v. Apfel, 225 F.3d 310, 317 (3d Cir.
2000) (quoting Kent v. Schweiker, 710 F.2d 111, 114 (3d Cir. 1983)). “‘Nor is evidence
substantial if it is overwhelmed by other evidence – particularly certain types of evidence (e.g.,
that offered by treating physicians) – or if it really constitutes not evidence but mere
conclusion.’” Id. So to facilitate the district court’s review, an ALJ’s findings must “be
accompanied by a clear and satisfactory explication of the basis on which [they] rest[].” Cotter
v. Harris, 642 F.2d 700, 704 (3d Cir. 1981). Decisions that are conclusory in their findings or
indicated the ALJ’s failure to consider all the evidence are not supported by substantial evidence.
See id. at 705-06. Moreover, the Court must ensure that the ALJ did not “reject evidence for no
reason or for the wrong reason.” Id. at 706 (citing King v. Califano, 615 F.2d 1018 (4th Cir.
1980)).
A disability is established when the claimant can demonstrate some medically
determinable basis for an impairment that prevents him or her from engaging in any substantial
gainful activity for a statutory twelve-month period. See Fargnoli v. Massanari, 247 F.3d 34,
38-39 (3d Cir. 2001). “‘A claimant is considered unable to engage in any substantial gainful
activity ‘only if his physical or mental impairment or impairments are of such severity that he is
not only unable to do his previous work but cannot, considering his age, education, and work
experience, engage in any other kind of substantial gainful work which exists in the national
economy….’” Id. at 39 (quoting 42 U.S.C. §423 (d)(2)(A)).
The Social Security Administration (“SSA”) has promulgated regulations incorporating a
five-step sequential evaluation process in guiding ALJs in determining whether a claimant is
under a disability as defined by the Act. See 20 C.F.R. § 404.1520. In Step One, the ALJ must
determine whether the claimant is currently engaging in substantial gainful activity. See 20
C.F.R. § 404.1520(a)(4)(i). If so, the disability claim will be denied. See Bowen v. Yuckert, 482
U.S. 137, 140 (1987). If not, the second step of the process is to determine whether the claimant
is suffering from a severe impairment. See 20 C.F.R. § 404.1520(a)(4)(ii). “An impairment or
combination of impairments is not severe if it does not significantly limit [the claimant’s]
physical or mental ability to do basic work activities.” 20 C.F.R. § 404.1522. If the claimant
fails to show that his or her impairments are “severe,” he or she is ineligible for disability
benefits. If the claimant does have a severe impairment, however, the ALJ must proceed to Step
Three and determine whether the claimant’s impairment meets or equals the criteria for a listed
impairment. See 20 C.F.R. § 404.1520(a)(4)(iii). If a claimant meets a listing, a finding of
disability is automatically directed. If the claimant does not meet a listing, the analysis proceeds
to Steps Four and Five.
Step Four requires the ALJ to consider whether the claimant retains the residual
functional capacity (“RFC”) to perform his or her past relevant work. See 20 C.F.R. §
404.1520(a)(4)(iv). A claimant’s RFC is defined as the most that an individual is still able to do
despite the limitations caused by his or her impairments. See Fargnoli, 247 F.3d at 40; 20 C.F.R.
§ 404.1545(a). The claimant bears the burden of demonstrating an inability to return to his or
her past relevant work. See Adorno v. Shalala, 40 F.3d 43, 46 (3d Cir. 1994). If the ALJ
determines that the claimant lacks the RFC to resume his or her former occupation, the
evaluation moves to the fifth and final step. See 20 C.F.R. § 404.1520(a)(4)(iv).
At this stage, the burden of production shifts to the Commissioner, who must demonstrate
that the claimant is capable of performing other available work in the national economy in order
to deny a claim of disability. See 20 C.F.R. § 404.1520(a)(4)(v). In making this determination,
the ALJ should consider the claimant’s RFC, age, education, and past work experience. See id.
The ALJ must further analyze the cumulative effect of all the claimant’s impairments in
determining whether he or she is capable of performing work and is not disabled. See 20 C.F.R.
§ 404.1523.
III. The ALJ’s Decision
In his January 23, 2020 decision, the ALJ found that Plaintiff last met the insured
requirements for the Act on December 31, 2019. (R. 14). The ALJ then proceeded to apply the
sequential evaluation process in reviewing Plaintiff’s claim for benefits. In particular, the ALJ
found that Plaintiff had not been engaged in substantial gainful activity since the alleged onset
date of June 7, 2014, through her date last insured of December 31, 2019. (R. 14). The ALJ also
found that Plaintiff met the second requirement of the process insofar as Plaintiff had the
following severe impairments: obesity, partial symptomatic epilepsy with complex partial
seizures, adjustment disorder with dressed mood, depression, and anxiety disorder. (R. 14).
However, the ALJ found that Plaintiff’s alleged cervical strain and irritable bowel syndrome did
not qualify as severe impairments. (R. 14-15).
The ALJ proceeded to conclude that Plaintiff’s impairments did not meet any of the
listings that would satisfy Step Three and, therefore, moved on to determine Plaintiff’s RFC. (R.
15). The ALJ found that Plaintiff retained the RFC to perform sedentary work, except that
Plaintiff was further restricted as follows:
[S]he can never climb a ladder, rope, or scaffold; must avoid all exposure to
unprotected heights, dangerous machinery, and like workplace hazards; is limited
to understanding, remembering, and carrying out simple instructions and
performing simple, routine tasks, such as those akin to requirements of work at
the SVP 1 or SVP 2 levels; is limited to no work related interaction with the
public, only occasional and superficial interaction with co-workers, and
occasional supervision; and is limited to a low stress work environment, which
means no production rate pace work (that is, no assembly line or conveyer belt
line work driven by strict time and/or production quotas and no tandem work),
but, rather, goal oriented work (meaning low quota requirements with flexible
time limits driven only by final daily quota production requirements) with only
occasional and routine changes in work setting, defining routine changes as that
which does not require alteration in work method.
(R. 17). The ALJ then found that Plaintiff was unable to perform her past relevant work;
therefore, he moved on to the next and final step. (R 23). At Step Five, the ALJ used a
vocational expert (“VE”) to determine whether or not there were a significant number of jobs in
the national economy that Plaintiff could perform. The VE testified that, based on Plaintiff’s
age, education, work experience, and RFC, she could perform jobs that exist in significant
numbers in the national economy, including the representative occupations of document
specialist, table worker, and stuffer. (R.23-24). Accordingly, the ALJ found that Plaintiff was
not disabled. (R. 24-25).
IV. Legal Analysis
Plaintiff argues that the ALJ erred by failing to fully account in the RFC for all of the
ways that her seizures affect her ability to work. To that end, Plaintiff submits that “the ALJ’s
RFC fails to account for the most obvious limitation of her seizures, that they cause her to be
‘off-task’…while she recovers from the physical and mental effects of the seizure itself….”
(Doc. No. 14 at p. 4). Based on the same, Plaintiff concludes that remand is warranted. (Id. at p.
13). After a careful review of the record, this Court agrees.
As set forth above, RFC refers to the most a claimant can still do despite his or her
limitations. See Fargnoli, 247 F.3d at 40; 20 C.F.R. § 404.1545(a). The assessment must be
based upon all of the relevant evidence, including the medical records, medical source opinions,
and the individual’s subjective allegations and description of his or her own limitations. See id.
Here, the ALJ acknowledged Plaintiff’s seizures but did not address whether and to what extent
they affect her ability to be on-task. While an ALJ need only discuss the most pertinent, relevant
evidence bearing upon a claimant’s disability status, an ALJ must provide sufficient explanation
of his or her final determination to provide a reviewing court with the benefit of the factual basis
underlying the ultimate disability finding. See Cotter, 642 F.2d at 705. “Although the ALJ ‘may
properly accept some parts of the medical evidence and reject other parts ... (s)he must consider
all of the evidence and give some reason for discounting the evidence (s)he rejects.’” Lanza v.
Astrue, No. 08-301, 2009 WL 1147911, at *7 (W.D. Pa. April 28, 2009) (quoting Colon v.
Barnhart, 424 F.Supp.2d 805, 812 (E.D. Pa 2006)). “‘In the absence of such an indication, the
reviewing court cannot tell if significant probative evidence was not credited or simply
ignored.’” Burnett v. Comm’r of Soc. Sec., 220 F.3d 112, 121-22 (3d Cir. 2000) (quoting Cotter,
642 F.2d at 705); Fargnoli, 247 F.3d at 44. An ALJ’s findings should be as “comprehensive and
analytical as feasible,” so that the reviewing court may properly exercise its duties under 42
U.S.C. §405(g). Cotter, 642 F.2d at 705.
In the present case, the Court finds that the ALJ’s decision, although comprehensive,
failed to meet this standard. While the ALJ clearly credited the fact that Plaintiff has seizures,
the RFC contains no provision to account for any time off-task to recover after a seizure.
Presumably, therefore, the ALJ found that Plaintiff requires no time off-task to recover after a
seizure and/or that the frequency of the seizures does not significantly impact Plaintiff’s ability
to remain on-task. The Court does not suggest that such a finding would be incapable of being
supported by substantial evidence per se. However, the significant amount of evidence
presented by Plaintiff regarding her potential need to be off-task warranted a more focused
discussion.
At the hearing, for instance, Plaintiff testified that she requires a recovery period of “at
least an hour to five hours of laying down” after a seizure. (R. 53). The ALJ makes no mention
of this in his decision. Medical records also document Plaintiff’s limitations during and
following a seizure, including loss of consciousness and incontinence, as described by both
Plaintiff and others. (See, e.g., R. 247, 249-50, 261, 300, 330, 512, 521). Additionally, the ALJ
found Dr. Valeriano’s opinion partially persuasive and noted that Dr. Valeriano opined that
Plaintiff needed more than one hour to recover from a seizure. (R. 22; 412-13). Yet, the ALJ
does not discuss why he apparently rejected this portion of Dr. Valeriano’s opinion. The ALJ
simply did not discuss, in any appreciable manner, the alleged need to take time off after a
seizure to recover and the impact of that on Plaintiff’s ability to work. The closest he came to
doing so was to explain that the limitation in the RFC to low stress work was to account, in part,
for “residuals from seizure activity.” (R. 21). Given the volume of evidence relevant to the
issue, this mention of residual effects was not sufficient.
To be clear, the Court does not suggest a different outcome on remand but, rather, finds
that more detail is required so as to permit this Court to determine whether the ALJ’s decision is
supported by substantial evidence. Indeed, as the ALJ noted, the record reflects some potential
uncertainty regarding the gravity and frequency of Plaintiff’s seizures. (R. 20-22). The ALJ’s
failure to discuss this uncertainty with more precision and to provide an adequate explanation for
presumably finding either that Plaintiff would not be off-task at all after a seizure or that the
seizures were too infrequent to raise the issue prohibits this Court from conducting a proper and
meaningful review. Without more, this Court cannot find that the ALJ’s opinion is based on
substantial evidence. Consequently, remand is warranted for further consideration on this issue.
V. Conclusion
Accordingly, for the reasons stated herein, the Court remands this matter for
reconsideration consistent with this Order.
s/ Alan N. Bloch
United States Senior District Judge
ecf: Counsel of Record