Saltos v. O'Malley

IN THE UNITED STATES DISTRICT COURT

FOR THE MIDDLE DISTRICT OF PENNSYLVANIA

THOMAS NICHOLAS SALTOS, : Civil No. 3:24-CV-006

:

Plaintiff, :

:

v. : (Magistrate Judge Carlson)

:

MARTIN O’MALLEY, :

Commissioner of Social Security :

:

Defendant. :

MEMORANDUM OPINION

I. Introduction

This Social Security appeal illustrates a cardinal principle in the art of

advocacy: astute issue selection. Through the careful identification of legal issues,

counsel can greatly advance the cause of their clients. Conversely, unwise issue

selection may, on occasion, snatch defeat from the jaws of success.

That is almost what happened here. On appeal, the focus of Saltos’ argument

was his contention that the Administrative Law Judge (ALJ) erred at Step 3 of the

sequential analysis which governs disability claims. Given the very exacting nature

of the plaintiff’s burden at Step 3 to show disability per se, this argument fails.

However, embedded within this sweeping but unpersuasive claim was a narrower

argument with much greater persuasive power. Specifically, Saltos contends that the

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ALJ completely failed to analyze, address, or acknowledge two treating source

medical opinions, both of which supported Saltos’ disability claim.

On this narrow ground, which we find was barely preserved for appeal,

plaintiff in this case, Saltos, is correct. Therefore, we will remand this case for further

consideration of this particular issue.

II. Statement of Facts and of the Case

With respect to this medical opinion issue, the administrative record of Saltos’

disability application reveals the following essential facts: On August 28, 2020,

Saltos, who was born in 1984, filed an application for child’s insurance benefits,

alleging disability beginning September 1, 1995. (Tr. 14). In this application for

disability benefits, Saltos alleged that he was disabled due to an array of emotional

impairments, including depression, anxiety with social phobia, obsessive

compulsive disorder, and body dysmorphic disorder. (Tr. 16).

With respect to this constellation of emotional impairments, the

administrative record reveals at least five medical opinions, however, only three of

these opinions are acknowledged by the ALJ in his decision.

First, on October 28, 2020, a state agency expert, Dr. John Gavazzi, opined

that Saltos suffered from no medically determinable impairments. (Tr. 67-69). Five

months later, on March 12, 2021, a second state agency expert, Dr. Frederic Small

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issued a reconsideration decision which reached slightly different conclusions,

Specifically, Dr. Small found that Saltos’ emotional impairments were medically

determinable but concluded that their severity could not be readily identified. (Tr.

71-79). In the decision denying this application for benefits, the ALJ characterized

both of these opinions as unpersuasive. (Tr. 22).

In addition, the ALJ acknowledged some medical opinions provided by a

former treating source, Dr. Uma Devi. (Tr. 21). Dr. Devi had opined in 2002 that

Saltos’ emotional impairments limited his ability to work before large groups and

adjust to sudden stresses or changes in his work environment. (Tr. 308). Later in

2021, Dr. Devi explained that Saltos was disabled due to chronic mental health

issues, and as an “ideal” candidate for disability benefits. (Tr, 756-57). In the

decision denying Saltos’ application for benefits, the ALJ described Dr. Devi’s

opinions as “partially persuasive.” (Tr. 20).

The record, however, reveals two other medical opinions from treatment

sources, both of whom found that Saltos was totally disabled due to his emotional

impairments. On August 10, 2022, Dr. Johar Shah and Dr. Angelo Fordimondo, both

of whom were treating Saltos, completed disability assessment forms which

described Saltos as totally disabled due to the anxiety he experienced as a result of

his body dysmorphia. (Tr. 766-777). Neither of these treating source opinions was

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analyzed, addressed, or even acknowledged by the ALJ in the decision denying

Saltos’ application for benefits.

Fourteen days after these two treating sources opined that Saltos was disabled,

on August 24, 2022, a disability hearing was conducted by an ALJ in this case, at

which Saltos, his mother, and a vocational expert testified. (Tr. 29-65). Following

the hearing, on October 4, 2022, the ALJ issued a decision denying Saltos’

application for benefits. (Tr. 11-24).1 In that decision, the ALJ first concluded that

Saltos had not attained the age of 22 at the time of the alleged onset of his disability

in 1995 and had not engaged in substantial gainful activity since that time. (Tr. 16).

At Step 2 of the sequential analysis that governs Social Security cases, the ALJ found

that Saltos had the following severe impairments: depression, anxiety with social

phobia, obsessive compulsive disorder, and body dysmorphic disorder. (Id.)

The ALJ then concluded at Step 3 of this sequential analysis that none of

Saltos’ impairments were per se disabling, and provided the following analysis in

support of this conclusion:

The severity of the claimant’s mental impairments, considered singly

and in combination, do not meet or medically equal the criteria of

listings 12.04 and 12.06. In making this finding, the undersigned has

1 We note that the ALJ’s decision seems, at times, to conflate adult and juvenile

disability standards, but need not address this issue, which has not been highlighted

by the parties, in light of our disposition of this case on other grounds.

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considered whether the “paragraph B” criteria are satisfied. To satisfy

the “paragraph B” criteria, the mental impairments must result in one

extreme limitation or two marked limitations in a broad area of

functioning. An extreme limitation is the inability to function

independently, appropriately, or effectively, and on a sustained basis.

A marked limitation is a seriously limited ability to function

independently, appropriately, or effectively, and on a sustained basis.

In understanding, remembering or applying information, the claimant

has no limitation. The claimant asserts that his conditions limited his

ability to follow instructions, focus, concentrate, complete tasks, and

manage his finances (Exhibit 6E). He also asserts that he needed special

reminders to care for his personal needs and grooming, to take

medications, and to go places (Exhibit 6E). However, the claimant

failed to submit any evidence of mental status examinations that noted

any significant limitation in his orientation, thought processing,

judgment, or insight. Despite the fact that treatment records note the

claimant had an Individualized Education Program (IEP) plan that

allowed repetition of instructions, they do not note any significant and

ongoing issues in the claimant’s ability to function in this area. Instead,

the record notes that the claimant generally performed well in his

academic course load with accommodations in place to address his

concentration, social concerns, and anxiety (Exhibit 1F; 2F; 7F).

Similarly, the claimant’s activities of daily living indicate the claimant

is able to care for his personal needs and grooming, including his ability

to dress, bathe, care for his hair, shave, feed himself, and use the

bathroom (Exhibit 6E). He is also able to prepare meals on a regular

basis and perform house and yard work, including mowing the lawn,

vacuuming, and performing other chores (Exhibit 6E; Hearing

Testimony). The claimant is able to go outside alone and shop in stores

(Exhibit 6E). Given the overall evidence of record, the undersigned

finds the claimant has no limitation in this functional area.

In interacting with others, the claimant has a moderate limitation. The

claimant asserts that his conditions caused anxiousness around people

or crowds, panic attacks, and dizziness and anxiety during oral

presentations (Hearing Testimony). He also asserts that he could not

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handle stress or changes in routine (Exhibit 6E). Moreover, the overall

evidence of record establishes the claimant has a history of mental

health conditions that impacted his ability to interact with others during

the relevant period (Exhibit 6E). The record also notes the claimant had

an IEP plan in place that limited his social interactions in his academics

and dormitory housing (Exhibit 1F; 2F; 7F). However, the record notes

that the claimant was able to attend regular educational courses that was

sufficient to obtain his bachelor’s and master’s degree (Exhibit 1F; 2F;

7F). In addition, the claimant is able to regularly spend time with others

via in person and electronic means (Exhibit 6E). He has never been

fired or laid off from a job because of problems getting along with other

people (Exhibit 6E). He is also able to go outside alone and shop in

stores (Exhibit 6E; Hearing Testimony). Given the overall evidence of

record, the undersigned finds the claimant has a moderate limitation in

this functional area.

With regard to concentrating, persisting or maintaining pace, the

claimant has a moderate limitation. The claimant asserts that his

conditions limited his ability to follow instructions, focus, concentrate,

and complete tasks (Exhibit 6E). He also asserts that he needed special

reminders to care for his personal needs and grooming, to take

medications, and to go places (Exhibit 6E). In addition, he asserts that

he could not handle stress or changes in routine (Exhibit 6E). Notably,

the claimant failed to submit any evidence of mental status

examinations that noted any significant limitations in this functional

area. However, treatment records note the claimant was under an IEP

plan to address his concentration, social concerns, and anxiety (Exhibit

1F; 2F; 7F). The record also notes the claimant had a history of

obsessive compulsive disorder that presented as body dysmorphic

disorder and limited his ability to concentrate (Hearing Testimony;

Exhibit 1F; 2F; 7F). Similarly, the claimant’s activities of daily living

indicate the claimant is able to care for his personal needs and

grooming, including his ability to dress, bathe, care for his hair, shave,

feed himself, and use the bathroom (Exhibit 6E). He is also able to

prepare meals on a regular basis and perform house and yard work,

including mowing the lawn, vacuuming, and performing other chores

(Exhibit 6E; Hearing Testimony). The claimant is able to go outside

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alone and shop in stores (Exhibit 6E). Given the overall evidence of

record, the undersigned finds the claimant has a moderate limitation in

this functional area.

As for adapting or managing oneself, the claimant has experienced a

moderate limitation. The record notes the claimant has a history of

mental health conditions that caused subjective reports of symptoms

that limited his ability to function during the relevant period (Exhibit

1F; 2F; 7F; Hearing Testimony). The record also notes the claimant had

an IEP in place to address his concentration, social concerns, and

anxiety to allow him to sufficiently progress in learning (Exhibit 1F;

2F; 7F). In addition, the claimant required family supports to help

manage his conditions (Exhibit 1F; 2F; 7F; Hearing Testimony).

However, the claimant failed to submit any additional evidence of

mental status examinations to show the impact of his conditions in this

area of functioning. Similarly, the claimant’s activities of daily living

indicate the claimant is able to care for his personal needs and

grooming, including his ability to dress, bathe, care for his hair, shave,

feed himself, and use the bathroom (Exhibit 6E). He is also able to

prepare meals on a regular basis and perform house and yard work,

including mowing the lawn, vacuuming, and performing other chores

(Exhibit 6E; Hearing Testimony). The claimant is able to go outside

alone and shop in stores (Exhibit 6E). Given the overall evidence of

record, the undersigned finds the claimant has a moderate limitation in

this functional area.

Because the claimant’s mental impairments do not cause at least two

“marked” limitations or one “extreme” limitation, the “paragraph B”

criteria are not satisfied.

The undersigned has also considered whether the "paragraph C" criteria

are satisfied. In this case, the evidence fails to establish the presence of

the "paragraph C" criteria as the record does not establish that the

claimant has marginal adjustment, meaning minimal capacity to adapt

to changes in his environment or to demands that are not already part

of his daily life.

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The limitations identified in the “paragraph B” criteria are not a residual

functional capacity assessment but are used to rate the severity of

mental impairments at steps 2 and 3 of the sequential evaluation

process. The mental residual functional capacity assessment used at

steps 4 and 5 of the sequential evaluation process requires a more

detailed assessment of the areas of mental functioning. The following

residual functional capacity assessment reflects the degree of limitation

the undersigned has found in the “paragraph B” mental function

analysis.

(Tr. 16-18).

Between Steps 3 and 4, the ALJ then fashioned a residual functional capacity

(“RFC”) for the plaintiff which found that:

After careful consideration of the entire record, the undersigned finds

that, prior to attaining age 22, the claimant had the residual functional

capacity to perform a full range of work at all exertional levels. The

claimant retains the mental capacity to concentrate, persist, or maintain

pace for two hour segments sufficient to perform two to three step tasks

or instructions in an environment that does not involve fast-paced

production quotas. The claimant can frequently interact with public,

supervisors, or coworkers in an environment that does not require

working in a large group or making presentations to large audiences.

The claimant can perform work that involves no more than occasional

changes in work situations in a routine work setting.

(Tr. 18-19).

In making the RFC determination, the ALJ considered the medical opinions

of the state agency experts, which he found to be unpersuasive, and Dr. Devi’s

treating source opinion, which he deemed partially persuasive, but never mentioned

the most recent treating source statements from Dr. Shah and Dr. Fordimondo. (Tr.

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20-22). Having arrived at this RFC assessment, the ALJ found that Saltos could

perform work in the national economy, did not meet the stringent standard for

disability set by the Act, and denied this claim. (Tr. 22-23).

This appeal followed. (Doc. 1). On appeal, the primary thrust of Saltos’

argument is that the ALJ erred at Step 3 of this analysis when he found that Saltos

was not disabled per se. (Doc. 15). We find this main argument unavailing.

However, on appeal Saltos also advances the following additional contention:

In Mr. Saltos’ case, his treating psychiatrist, Dr. Shah, completed a

residual functional capacity assessment that stated “Mr. Salto’s anxiety

and body dysmorphic disorder seem to preclude employment at this

time.” (R. 776). The ALJ’s decision did not even consider this treating

source opinion. In addition, the ALJ failed to consider the Residual

Functional Capacity form completed by Angelo J. Fordimondo, PhD, a

psychologist who opined that given his experience with Mr. Saltos as a

patient, and his diagnosis and the patient’s disability, he does not

believe Mr. Saltos should continue or resume work at any current or

previous employment. (R. 772). He also opined that the disability is not

likely to change. (R.772). This constitute [sic] reversible error

warranting remand.

(Id. at 8).

This latter argument, while presented in a curiously cursory fashion, is both

sufficiently developed to warrant consideration and is undeniably meritorious since

the ALJ never even acknowledged the existence of these medical opinions.

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Therefore, on this ground we will direct that this case be remanded for further

consideration by the Commissioner.

III. Discussion

A. Substantial Evidence Review – the Role of this Court

When reviewing the Commissioner’s final decision denying a claimant’s

application for benefits, this Court’s review is limited to the question of whether the

findings of the final decision-maker are supported by substantial evidence in the

record. See 42 U.S.C. §405(g); Johnson v. Comm’r of Soc. Sec., 529 F.3d 198, 200

(3d Cir. 2008); Ficca v. Astrue, 901 F. Supp.2d 533, 536 (M.D. Pa. 2012).

Substantial evidence “does not mean a large or considerable amount of evidence, but

rather such relevant evidence as a reasonable mind might accept as adequate to

support a conclusion.” Pierce v. Underwood, 487 U.S. 552, 565 (1988). Substantial

evidence is less than a preponderance of the evidence but more than a mere scintilla.

Richardson v. Perales, 402 U.S. 389, 401 (1971). A single piece of evidence is not

substantial evidence if the ALJ ignores countervailing evidence or fails to resolve a

conflict created by the evidence. Mason v. Shalala, 994 F.2d 1058, 1064 (3d Cir.

1993). But in an adequately developed factual record, substantial evidence may be

“something less than the weight of the evidence, and the possibility of drawing two

inconsistent conclusions from the evidence does not prevent [the ALJ’s decision]

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from being supported by substantial evidence.” Consolo v. Fed. Maritime Comm’n,

383 U.S. 607, 620 (1966). “In determining if the Commissioner’s decision is

supported by substantial evidence the court must scrutinize the record as a whole.”

Leslie v. Barnhart, 304 F. Supp.2d 623, 627 (M.D. Pa. 2003).

The Supreme Court has recently underscored for us the limited scope of our

review in this field, noting that:

The phrase “substantial evidence” is a “term of art” used throughout

administrative law to describe how courts are to review agency

factfinding. T-Mobile South, LLC v. Roswell, 574 U.S. ––––, ––––,

135 S.Ct. 808, 815, 190 L.Ed.2d 679 (2015). Under the substantial-

evidence standard, a court looks to an existing administrative record

and asks whether it contains “sufficien[t] evidence” to support the

agency's factual determinations. Consolidated Edison Co. v. NLRB,

305 U.S. 197, 229, 59 S.Ct. 206, 83 L.Ed. 126 (1938) (emphasis

deleted). And whatever the meaning of “substantial” in other contexts,

the threshold for such evidentiary sufficiency is not high. Substantial

evidence, this Court has said, is “more than a mere scintilla.” Ibid.; see,

e.g., Perales, 402 U.S. at 401, 91 S.Ct. 1420 (internal quotation marks

omitted). It means—and means only—“such relevant evidence as a

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

Consolidated Edison, 305 U.S. at 229, 59 S.Ct. 206. See Dickinson v.

Zurko, 527 U.S. 150, 153, 119 S.Ct. 1816, 144 L.Ed.2d 143 (1999)

(comparing the substantial-evidence standard to the deferential clearly-

erroneous standard).

Biestek, 139 S. Ct. at 1154.

The question before this Court, therefore, is not whether the claimant is

disabled, but rather whether the Commissioner’s finding that he is not disabled is

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supported by substantial evidence and was reached based upon a correct application

of the relevant law. See Arnold v. Colvin, No. 3:12-CV-02417, 2014 WL 940205,

at *1 (M.D. Pa. Mar. 11, 2014) (“[I]t has been held that an ALJ’s errors of law denote

a lack of substantial evidence”) (alterations omitted); Burton v. Schweiker, 512 F.

Supp. 913, 914 (W.D. Pa. 1981) (“The Secretary’s determination as to the status of

a claim requires the correct application of the law to the facts.”); see also Wright v.

Sullivan, 900 F.2d 675, 678 (3d Cir. 1990) (noting that the scope of review on legal

matters is plenary); Ficca, 901 F. Supp.2d at 536 (“[T]he court has plenary review

of all legal issues . . . .”).

Several fundamental legal propositions which flow from this deferential

standard of review. First, when conducting this review “we are mindful that we must

not substitute our own judgment for that of the fact finder.” Zirnsak v. Colvin, 777

F.3d 607, 611 (3d Cir. 2014) (citing Rutherford v. Barnhart, 399 F.3d 546, 552 (3d

Cir. 2005)). Thus, we are enjoined to refrain from trying to re-weigh the evidence.

Rather our task is to simply determine whether substantial evidence supported the

ALJ’s findings. However, we must also ascertain whether the ALJ’s decision meets

the burden of articulation demanded by the courts to enable informed judicial

review. Simply put, “this Court requires the ALJ to set forth the reasons for his

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decision.” Burnett v. Comm'r of Soc. Sec. Admin., 220 F.3d 112, 119 (3d Cir. 2000).

As the Court of Appeals has noted on this score:

In Burnett, we held that an ALJ must clearly set forth the reasons for

his decision. 220 F.3d at 119. Conclusory statements . . . are

insufficient. The ALJ must provide a “discussion of the evidence” and

an “explanation of reasoning” for his conclusion sufficient to enable

meaningful judicial review. Id. at 120; see Jones v. Barnhart, 364 F.3d

501, 505 & n. 3 (3d Cir.2004). The ALJ, of course, need not employ

particular “magic” words: “Burnett does not require the ALJ to use

particular language or adhere to a particular format in conducting his

analysis.” Jones, 364 F.3d at 505.

Diaz v. Comm'r of Soc. Sec., 577 F.3d 500, 504 (3d Cir. 2009).

Thus, in practice ours is a twofold task. We must evaluate the substance of the

ALJ’s decision under a deferential standard of review, but we must also give that

decision careful scrutiny to ensure that the rationale for the ALJ’s actions is

sufficiently articulated to permit meaningful judicial review.

B. Legal Benchmarks for the ALJ’s Assessment of Medical Opinion

Evidence.

The plaintiff filed this disability application in 2020 after a paradigm shift in

the manner in which medical opinions were evaluated when assessing Social

Security claims. Prior to March 2017, ALJs were required to follow regulations

which defined medical opinions narrowly and created a hierarchy of medical source

opinions with treating sources at the apex of this hierarchy. However, in March of

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2017, the Commissioner’s regulations governing medical opinions changed in a

number of fundamental ways. The range of opinions that ALJs were enjoined to

consider were broadened substantially, and the approach to evaluating opinions was

changed from a hierarchical form of review to a more holistic analysis. As one court

as aptly observed:

The regulations regarding the evaluation of medical evidence have been

amended for claims filed after March 27, 2017, and several of the prior

Social Security Rulings, including SSR 96-2p, have been rescinded.

According to the new regulations, the Commissioner “will no longer

give any specific evidentiary weight to medical opinions; this includes

giving controlling weight to any medical opinion.” Revisions to Rules

Regarding the Evaluation of Medical Evidence (“Revisions to Rules”),

2017 WL 168819, 82 Fed. Reg. 5844, at 5867–68 (Jan. 18, 2017), see

20 C.F.R. §§ 404.1520c(a), 416.920c(a). Instead, the Commissioner

must consider all medical opinions and “evaluate their persuasiveness”

based on the following five factors: supportability; consistency;

relationship with the claimant; specialization; and “other factors.” 20

C.F.R. §§ 404.1520c(a)-(c), 416.920c(a)-(c).

Although the new regulations eliminate the perceived hierarchy of

medical sources, deference to specific medical opinions, and assigning

“weight” to a medical opinion, the ALJ must still “articulate how [he

or she] considered the medical opinions” and “how persuasive [he or

she] find[s] all of the medical opinions.” Id. at §§ 404.1520c(a) and

(b)(1), 416.920c(a) and (b)(1). The two “most important factors for

determining the persuasiveness of medical opinions are consistency and

supportability,” which are the “same factors” that formed the

foundation of the treating source rule. Revisions to Rules, 82 Fed. Reg.

5844-01 at 5853.

An ALJ is specifically required to “explain how [he or she] considered

the supportability and consistency factors” for a medical opinion. 20

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C.F.R. §§ 404.1520c (b)(2), 416.920c(b)(2). With respect to

“supportability,” the new regulations provide that “[t]he more relevant

the objective medical evidence and supporting explanations presented

by a medical source are to support his or her medical opinion(s) or prior

administrative medical finding(s), the more persuasive the medical

opinions or prior administrative medical finding(s) will be.” Id. at §§

404.1520c(c)(1), 416.920c(c)(1). The regulations provide that with

respect to “consistency,” “[t]he more consistent a medical opinion(s) or

prior administrative medical finding(s) is with the evidence from other

medical sources and nonmedical sources in the claim, the more

persuasive the medical opinion(s) or prior administrative medical

finding(s) will be.” Id. at §§ 404.1520c(c)(2), 416.920c(c)(2).

Under the new regulations an ALJ must consider, but need not

explicitly discuss, the three remaining factors in determining the

persuasiveness of a medical source's opinion. Id. at §§ 404.1520c(b)(2),

416.920c(b)(2). However, where the ALJ has found two or more

medical opinions to be equally well supported and consistent with the

record, but not exactly the same, the ALJ must articulate how he or she

considered those factors contained in paragraphs (c)(3) through (c)(5).

Id. at §§ 404.1520c(b)(3), 416.920c(b)(3).

Andrew G. v. Comm'r of Soc. Sec., No. 3:19-CV-0942 (ML), 2020 WL 5848776, at

*5 (N.D.N.Y. Oct. 1, 2020).

Oftentimes, an ALJ must evaluate various medical opinions. Judicial review

of this aspect of ALJ decision-making is still guided by several settled legal tenets.

First, when presented with a disputed factual record, it is well-established that “[t]he

ALJ – not treating or examining physicians or State agency consultants – must make

the ultimate disability and RFC determinations.” Chandler v. Comm’r of Soc. Sec.,

667 F.3d 356, 361 (3d Cir. 2011). Thus, when evaluating medical opinions “the ALJ

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may choose whom to credit but ‘cannot reject evidence for no reason or for the

wrong reason.’” Morales v. Apfel, 225 F.3d 310, 317 (3d Cir. 2000) (quoting Mason,

994 F.2d at 1066). Therefore, provided that the decision is accompanied by an

adequate, articulated rationale, it is the province and the duty of the ALJ to choose

which medical opinions and evidence deserve greater weight.

Further, in making this assessment of medical evidence:

An ALJ is [also] entitled generally to credit parts of an opinion without

crediting the entire opinion. See Thackara v. Colvin, No. 1:14–CV–

00158–GBC, 2015 WL 1295956, at *5 (M.D. Pa. Mar. 23, 2015);

Turner v. Colvin, 964 F. Supp. 2d 21, 29 (D.D.C. 2013) (agreeing that

“SSR 96–2p does not prohibit the ALJ from crediting some parts of a

treating source's opinion and rejecting other portions”); Connors v.

Astrue, No. 10–CV–197–PB, 2011 WL 2359055, at *9 (D.N.H. June

10, 2011). It follows that an ALJ can give partial credit to all medical

opinions and can formulate an RFC based on different parts from the

different medical opinions. See e.g., Thackara v. Colvin, No. 1:14–CV–

00158–GBC, 2015 WL 1295956, at *5 (M.D. Pa. Mar. 23, 2015).

Durden v. Colvin, 191 F.Supp.3d 429, 455 (M.D. Pa. 2016).

Finally, one other cardinal principle governs this medical opinion analysis. An

ALJ may not simply ignore and fail to address material medical opinion evidence.

As the Third Circuit has noted:

This Court has long been concerned with ALJ opinions that fail

properly to consider, discuss and weigh relevant medical evidence. See

Dobrowolsky v. Califano, 606 F.2d 403, 406–07 (3d Cir.1979) (“This

Court has repeatedly emphasized that the special nature of proceedings

for disability benefits dictates care on the part of the agency in

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developing an administrative record and in explicitly weighing all

evidence.”). Where there is conflicting probative evidence in the

record, we recognize a particularly acute need for an explanation of the

reasoning behind the ALJ's conclusions, and will vacate or remand a

case where such an explanation is not provided. See Cotter, 642 F.2d at

706 (listing cases remanded for ALJ's failure to provide explanation of

reason for rejecting or not addressing relevant probative evidence).

Fargnoli v. Massanari, 247 F.3d 34, 42 (3d Cir. 2001). Therefore, a complete failure

to analyze, address, or acknowledge relevant medical opinions compels a remand.

D. This Case Will Be Remanded to Consider the Medical Opinion

Evidence

As we noted at the outset, this case is marked by some curious issue selections

by the plaintiff, who devotes great energy on appeal to attacking the ALJ’s Step 3

determinations. In our view these arguments are unavailing when considered under

the governing legal standards which define Step 3 analysis.

The dichotomy between the Act's deferential standard of review and caselaw's

requirement that ALJs sufficiently articulate their findings to permit meaningful

judicial review is particularly acute at Step 3 of this disability evaluation process.

At Step 3 of this sequential analysis, the ALJ is required to determine whether,

singly or in combination, a claimant's ailments and impairments are so severe that

they are per se disabling and entitle the claimant to benefits. As part of

this step three disability evaluation process, the ALJ must determine whether a

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claimant's alleged impairment is equivalent to a number of listed impairments,

commonly referred to as listings, that are acknowledged as so severe as to preclude

substantial gainful activity. 20 C.F.R. § 416.920(a)(4)(iii); 20 C.F.R. pt. 404, subpt.

P, App. 1; Burnett, 220 F.3d 112, 119.

In making this determination, the ALJ is guided by several basic principles

set forth by the social security regulations and case law. First, if a claimant's

impairment meets or equals one of the listed impairments, the claimant is considered

disabled per se and is awarded benefits. 20 C.F.R. § 416.920(d); Burnett, 220 F.3d

at 119. However, to qualify for benefits by showing that an impairment, or

combination of impairments, is equivalent to a listed impairment, a plaintiff bears

the burden of presenting “medical findings equivalent in severity to all the criteria

for the one most similar impairment.” Sullivan v. Zebley, 493 U.S. 521, 531 (1990);

20 C.F.R. § 416.920(d). An impairment, no matter how severe, that meets or equals

only some of the criteria for a listed impairment is not sufficient. Id.

The determination of whether a claimant meets or equals a listing is a medical

one. To be found disabled under step three, a claimant must present medical

evidence or a medical opinion that his or her impairment meets or equals a listing.

An administrative law judge is not required to accept a physician's opinion when that

opinion is not supported by the objective medical evidence in the record. Maddox v.

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Heckler, 619 F. Supp. 930, 935-936 (D.C. Okl. 1984); Carolyn A. Kubitschek & Jon

C. Dubin, Social Security Disability Law and Procedure in Federal Courts, § 3:22

(2014), available at Westlaw SSFEDCT. However, it is the responsibility of the ALJ

to identify the relevant listed impairments, because it is “the ALJ's duty to investigate

the facts and develop the arguments both for and against granting benefits.” Burnett,

220 F.3d at 120 n.2.

On this score, however, it is also clearly established that the ALJ's treatment

of this issue must go beyond a summary conclusion, since a bare conclusion “is

beyond meaningful judicial review.” Burnett, 220 F.3d at 119. Thus, case law “does

not require the ALJ to use particular language or adhere to a particular format in

conducting his analysis. Rather, the function . . . is to ensure that there is sufficient

development of the record and explanation of findings to permit meaningful

review.” Jones, 364 F.3d at 505. This goal is met when the ALJ's decision, “read as

a whole,” id., permits a meaningful review of the SLJ's Step 3 analysis. However,

when “the ALJ's conclusory statement [at Step 3] is . . . beyond meaningful judicial

review,” a remand is required to adequately articulate the reasons for rejecting the

claim at this potentially outcome-determinative stage. Burnett, 220 F.3d at 119.

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In this case, as we have discussed, the ALJ’s Step 3 analysis was thorough,

careful, and detailed. It addressed the pertinent listing criteria and was supported by

substantial evidence. There was no error in this regard.

However, as we have also noted, in this case Saltos has advanced another, far

more persuasive argument, albeit in a somewhat cursory fashion. On appeal, Saltos

also contends that:

In Mr. Saltos’ case, his treating psychiatrist, Dr. Shah, completed a

residual functional capacity assessment that stated “Mr. Salto’s anxiety

and body dysmorphic disorder seem to preclude employment at this

time.” (R. 776). The ALJ’s decision did not even consider this treating

source opinion. In addition, the ALJ failed to consider the Residual

Functional Capacity form completed by Angelo J. Fordimondo, PhD, a

psychologist who opined that given his experience with Mr. Saltos as a

patient, and his diagnosis and the patient’s disability, he does not

believe Mr. Saltos should continue or resume work at any current or

previous employment. (R. 772). He also opined that the disability is not

likely to change. (R.772). This constitute [sic] reversible error

warranting remand.

(Doc. 15, at 8).

This contention is well taken. The ALJ’s decision does not analyze, address,

or acknowledge these medical opinions which were issued a mere fourteen days

before the hearing in Saltos case. This is a material oversight since both doctors

opined that Saltos was totally disabled. Given the plain materiality of this evidence,

we find that this case is governed by the familiar proposition that:

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Where there is conflicting probative evidence in the record, we

recognize a particularly acute need for an explanation of the reasoning

behind the ALJ’s conclusions, and will vacate or remand a case where

such an explanation is not provided. See Cotter, 642 F.2d at 706 (listing

cases remanded for ALJ’s failure to provide explanation of reason for

rejecting or not addressing relevant probative evidence).

Fargnoli v. Massanari, 247 F.3d 34, 42 (3d Cir. 2001).

Therefore, finding that this issue was adequately raised and preserved by

Saltos,2 and that the complete failure to address these medical opinions compels a

remand, this case will be remanded for further consideration by the Commissioner.

Thus, we conclude that the ALJ’s failure to address these two treating source

opinions, both of which found Saltos to be disabled, now requires a remand of this

case for a more fulsome assessment of the medical opinion evidence. Accordingly,

we will remand this case to the Commissioner for further consideration of this

evidence. Yet, while we reach this result, we note that nothing in this Memorandum

Opinion should be deemed as expressing a judgment on what the ultimate outcome

of any reassessment of this evidence should be. Rather, the task should remain the

duty and province of the ALJ on remand.

2 We note and acknowledge the Commissioner’s argument that this medical opinion

issue was not sufficiently preserved on appeal. While we regard this as a close case,

we conclude that the plaintiff’s argument cited above sufficiently articulated this

issue to warrant merits consideration of this plainly meritorious claim.

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IV. Conclusion

Accordingly, for the foregoing reasons, the final decision of the

Commissioner denying these claims will be REMANDED for further consideration

by the Commissioner.

An appropriate order follows.

s/ Martin C. Carlson

Martin C. Carlson

United States Magistrate Judge

DATED: August 13, 2024

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