United States District Court, D. Massachusetts
MEMORANDUM AND ORDER REGARDING PLAINTIFF'S MOTION FOR JUDGMENT ON THE PLEADINGS and DEFENDANT'S MOTION FOR JUDGMENT AFFIRMING THE COMMISSIONER'S DECISION (Document Nos. 21 and 28)
KENNETH P. NEIMAN, Magistrate Judge.
Suzanne Wood ("Plaintiff") brings this action pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3) for judicial review of a partially favorable decision by the Commissioner of the Social Security Administration ("Commissioner") denying her Supplemental Security Income ("SSI") and Social Security Disability Insurance ("SSDI") benefits from November 13, 2008, through October 25, 2012, and finding her to be eligible for disability benefits thereafter. Plaintiff asserts that the portion of this determination that denied her benefits, memorialized in a May 1, 2013 decision of an administrative law judge, was not based on substantial evidence and contained errors of law. She has filed a motion for judgment on the pleadings and the Commissioner, in turn, has moved to affirm.
The parties have consented to this court's jurisdiction. See 28 U.S.C.§ 636(c); Fed.R.Civ.P. 73. For the reasons which follow, the court will deny the Commissioner's motion and grant Plaintiff's motion to the extent it can fairly be read to include a request for a remand. The court will also direct, for reasons which will become evident, that the remanded hearing be held before a different administrative law judge.
The parties are well aware of the factual and procedural history of this case, the standard of review, and the applicable five-step sequential analysis. Nonetheless, the court finds it necessary to note certain particularly relevant facts and the procedural history pertinent to its analysis.
Plaintiff applied for SSI and SSDI benefits alleging an amended onset date of disability of November 13, 2008. Her applications were denied, prompting her to request an administrative hearing. Following the hearing held on September 16, 2010, the administrative law judge ("ALJ") issued a wholly unfavorable decision on November 19, 2010. (Administrative Record ("A.R.") at 4-19.) That decision became final on March 1, 2011, when the Decision Review Board ("DRB") failed to review it within the allotted 90-day period. (A.R. 1-3.)
Plaintiff filed a complaint in this forum on April 19, 2011, seeking a remand of the ALJ's decision denying her benefits. The Commissioner chose not to defend the action, and, on February 7, 2012, the Appeals Council vacated the ALJ's decision and remanded the matter for a further hearing. (A.R. at 669-71.) The remand order directed the ALJ to (1) obtain any available additional evidence related to Plaintiff's impairments during the period at issue in order to complete the administrative record, (2) give further consideration to Plaintiff's maximum residual functional capacity ("RFC") and provide a rationale with specific references to evidence of record in support of the assessed limitations, (3) evaluate the treating source opinions and explain the weight given to such evidence, and (4) obtain supplemental evidence from a vocational expert to clarify the effect of the assessed limitations on the Plaintiff's occupational base, if warranted by the expanded record. (A.R. at 670.) The Appeals Council also questioned the ALJ's failure to acknowledge and weigh a change in Dr. Patrick Connolly's opinion or to adequately analyze the opinion of Carleen McQuaid, a nurse. (A.R. at 669-70.)
Following the second hearing, on February 28, 2013, the ALJ issued a partially favorable decision finding Plaintiff disabled beginning on October 25, 2012, the date of her 50th birthday, but not disabled from November 13, 2008, through October 24, 2012. (A.R. at 630.) In support of the denial, the ALJ accorded greater weight to the 2009 medical assessments of the Disability Determination Service ("DDS") than to opinion evidence from the following three years because he found those earlier assessments to be objective, rather than "premised substantially on the self-reported limitations of the claimant." (A.R. at 628.)
Plaintiff advances two main arguments as to why the ALJ erred. First, Plaintiff asserts that the ALJ assigned improper weight to DDS assessments, as they were themselves incomplete and not reflective of the entire record. Second, Plaintiff asserts that the ALJ provided an insufficient rationale for discounting the functional assessments of two of her medical providers. The Commissioner, in response, argues that substantial evidence supports the ALJ's findings.
A. Sufficiency of Review of the Medical Records
The Commissioner argues that the ALJ properly relied on the DDS analyses from 2009 because they are "unbiased assessments of the medical evidence as a whole." (A.R. at 628.) Plaintiff, for her part, contends that the ALJ should not have relied on those assessments because they predated significant developments in the record. Plaintiff has the better argument.
The First Circuit has directed that an administrative law judge "may rely on older evidence when the information in that evidence remains accurate." Abubakar v. Astrue, 2012 WL 957623, at *12 (D. Mass. 2012); see also Ferland v. Astrue, 2011 WL 5199989, at *4 (D. N.H. 2011) ("an ALJ may rely on such an opinion where the medical evidence postdating the reviewer's assessment does not establish any greater limitations... or where the medical reports of claimant's treating providers are arguably consistent with... the reviewer's assessment"). To be sure, "the resolution of conflicts in the evidence and the determination of the ultimate question of disability is for [the administrative law judge], " Rodriguez v. Sec'y of Health & Human Servs., 647 F.2d 218, 222 (1st Cir.1981), but medical evidence found to be "too far removed from the relevant time period may not be utilized to serve as substantial evidence if there is an indication in the more recent records that there has been a significant change in the claimant's condition." Abubakar, 2012 WL 957623 at *12; see Soto-Cedeno v. Astrue, 380 Fed.Appx. 1, 3 (1st Cir. 2010) (consulting psychiatrist opinion from 2003 did not undermine treating psychiatrist's reports from 2004 and 2005 which noted that the claimant "sustained deterioration" postdating the consulting psychiatrist's report). Ultimately, an administrative law judge's decision to prefer an older opinion of a reviewing physician to that of a more-recent opinion must be supported by substantial evidence. Cooper v. Astrue, 2011 WL1163127, at *6 (D. Mass. 2011). Substantial evidence is that which a reasonable mind finds adequate to support a conclusion. Rodriguez, 647 F.2d at 222.
Here, there is inadequate evidence to support the ALJ's conclusion that Plaintiff maintained a stable condition throughout the relevant time period. Plaintiff originally injured her tail bone in a slip and fall in December of 2005. (A.R. at 38.) Since then, she has been treating with Dr. Paul Harrington and Nurse McQuaid. In March 2007, Dr. Harrington referred Plaintiff to Dr. Gerald McGillicuddy, a board-certified neurosurgeon, for her first back surgery, a lumbar diskectomy. (A.R. at 270-83.) While that surgery alleviated her pain temporarily, she opted for a second surgery in November 2008, a spinal fusion procedure performed by Dr. Connolly. Following ...