United States District Court, D. Massachusetts
For Angela Rascoe, Plaintiff: Francis M. Jackson, LEAD ATTORNEY, PRO HAC VICE, Jackson & MacNichol, South Portland, ME; Marc D. Pepin, LEAD ATTORNEY, Jackson & MacNichol, South Portland, ME.
For Commissioner of Social Security, Defendant: Shelbey D. Wright, LEAD ATTORNEY, United States Attorney's Office, Boston, MA.
For Social Security Administration, Interested Party: Thomas D. Ramsey, Office of the General Counsel, Social Security Administration, Boston, MA.
MEMORANDUM OF DECISION AND ORDER ON CROSS-MOTIONS REGARDING DENIAL OF SOCIAL SECURITY DISABILITY INSURANCE BENEFITS
Judith Gail Dein, United States Magistrate Judge.
The plaintiff, Angela Rascoe (" Rascoe" ), has brought this action pursuant to section 205(g) of the Social Security Act, 42 U.S.C. § 405(g), in order to challenge the final decision of the Commissioner of the Social Security Administration (the " Commissioner" ) denying Rascoe's claim for Social Security Disability Insurance (" SSDI" ) benefits. The Commissioner had found that the plaintiff was disabled as of January 1, 2010 due to a major depressive disorder, and had granted the plaintiff's application for Supplemental Security Income (" SSI" ) benefits. However, following a hearing, an Administrative Law Judge (" ALJ" ) determined that the plaintiff's impairments were not severe on or prior to March 31, 2009, the date when Rascoe was last insured for purposes of her claim for SSDI. Based on the ALJ's decision, the Commissioner concluded that Rascoe was not disabled during the relevant time period, and denied her application for such benefits. By her Complaint in this action, Rascoe is seeking judicial review of that decision.
The matter is presently before the court on the plaintiff's " Motion to Reverse" (Docket No. 24) by which the plaintiff is seeking an order vacating the Commissioner's decision, and remanding the matter to the Social Security Administration for further administrative proceedings. It is also before the court on the " Defendant's Motion for Order Affirming the Decision of the Commissioner" (Docket No. 28), by which the Commissioner is seeking an order upholding her decision to deny Rascoe's claim for SSDI benefits. At issue is whether the ALJ, in reaching his decision that Rascoe was not disabled through her date last insured, erred by finding that Rascoe's mental and physical impairments were not " severe" at step two of the sequential evaluation process, and by failing to apply the procedures set forth in Social Security Ruling (" SSR" ) 83-20, in order to determine the precise date when Rascoe's mental disability began. For all the reasons detailed herein, this court finds that the ALJ erred by failing to comply with the mandate of SSR 83-20, which required the ALJ to establish the onset date of Rascoe's major depressive disorder in consultation with a medical advisor. This court also finds that the ALJ failed to present an adequate justification for rejecting the opinion of the plaintiff's treating physician regarding the extent to which the plaintiff's physical impairments limited her ability to perform work-related activities during the insured period. Accordingly, the Commissioner's motion to affirm is DENIED, the plaintiff's motion to reverse is ALLOWED, and the matter is remanded to the Social Security Administration for further administrative proceedings consistent with this opinion.
II. STATEMENT OF FACTS
Rascoe was born on June 9, 1967, and was 45 years old at the time of her hearing before the ALJ. (Tr. 26, 80). She is a high school graduate, has three grown children, and has held jobs as a secretary, a nanny, a personal care attendant, and a counselor. (Tr. 26, 32, 117, 201, 216-17). Rascoe's earnings records show that she maintained some form of employment for approximately 20 years, and that at one point, in 2002, she earned over $70,000 in income. (Tr. 91). However, with the exception of a three-month period in 2008, when Rascoe attempted to return to work as a receptionist at a spa, the plaintiff has remained unemployed since 2005, the year her maternal grandmother passed away. (See Tr. 27, 89, 91).
The record indicates that Rascoe's grandmother served as her primary caretaker throughout her childhood, and remained an integral part of her adult life. (Tr. 223). It also indicates that Rascoe was present when her grandmother suffered the stroke that led to her death in 2005. (Id.). According to Rascoe, she felt as if her " whole world crashed" when her grandmother died. (Tr. 27). This is consistent with medical records showing that the plaintiff was diagnosed with a major depressive disorder in April 2006. (Tr. 238, 249, 258). It is also consistent with Rascoe's reports that she began hearing voices and experiencing visual hallucinations soon after her grandmother's death. (See Tr. 216, 247).
The plaintiff continued to live in her grandmother's house until 2009 when she moved to Boston. (Tr. 217). In 2010, she was again diagnosed with a major depressive disorder, " recurrent severe," with psychotic features, along with chronic pain and post-traumatic stress disorder. (Tr. 226). By 2011, she had also been diagnosed with dissociative identity disorder. (Tr. 210). Rascoe claims that she became disabled from working beginning on March 1, 2009, due to symptoms resulting from her major depressive disorder, chronic pain syndrome and/or fibromyalgia. (Tr. 39; Pl. Mot. (Docket No. 24) at 1).
On August 30 and 31, 2010, Rascoe filed applications for SSI and SSDI, claiming that she had become disabled and incapable of working since December 1, 2006. (Tr. 41-42, 80). She later amended the alleged date of onset of her disability to March 1, 2009. (Tr. 39). The Social Security Administration determined that Rascoe was disabled as of January 1, 2010 due to her mental impairments. (Tr. 42). Accordingly, the agency granted her application for SSI. In order to qualify for SSDI, however, Rascoe had to establish that she was disabled on or before March 31, 2009, the last date on which she was insured by the program. (Dec. 3; Tr. 14; see also 20 C.F.R. § 404.131). Because the agency determined that she did not become disabled until January 2010, her application for SSDI was denied. (See Tr. 41, 44). It was denied again, upon reconsideration, on June 24, 2011. (Tr. 43).
The plaintiff requested and was granted a hearing before an ALJ, which took place on June 15, 2012. (Tr. 23-40, 51). Rascoe, who was represented by counsel, appeared and testified at the hearing. (Tr. 23-39). No other witnesses appeared, and no experts were called to testify. (See Tr. 23-40). On June 26, 2012, the ALJ issued a decision denying the plaintiff's application for SSDI benefits. (Tr. 9-18). Rascoe then filed a request for review of the ALJ's decision by the Social Security Appeals Council. (Tr. 8). On June 10, 2013, the Appeals Council denied the plaintiff's request for review, thereby making the ALJ's decision the final decision of the Commissioner for purposes of judicial review. (Tr. 1-4). Thus, the plaintiff has exhausted all of her administrative remedies, and the case is ripe for review by this court pursuant to 42 U.S.C. § 405(g).
The ALJ's Decision
As described above, in order to qualify for SSDI benefits, Rascoe had to establish that she was disabled prior to the expiration of her insured status on March 31, 2009. The ALJ concluded that from March 1, 2009, the alleged onset date, to March 31, 2009, the date when Rascoe was last insured, the plaintiff " was not under a disability within the meaning of the Social Security Act[,]" which defines " [d]isability" as " the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment or combination of impairments that can be expected to result in death or that has lasted or can be expected to last for a continuous period of not less than 12 months." (Dec. 1; Tr. 12). See also 42 U.S.C. § 423(d)(1)(A). There is no dispute that the ALJ, in reaching his decision that Rascoe was not disabled through her date last insured, applied the five-step sequential evaluation required by 20 C.F.R. § 404.1520. The procedure resulted in the following analysis, which is detailed in the ALJ's " Findings of Fact and Conclusions of Law." (See Dec. 3-6; Tr. 14-17).
The first inquiry in the five-step evaluation process is whether the claimant is " engaged in substantial gainful work activity[.]"
Seavey v. Barnhart, 276 F.3d 1, 5 (1st Cir. 2001). If so, the claimant is automatically considered not disabled and the application for benefits is denied. See id. In this case, the ALJ determined that Rascoe did not engage in substantial gainful work activity during the period from March 1, 2009, the alleged onset date of her disability, through her last insured date of March 31, 2009. (Dec. Finding #2; Tr. 14). Therefore, the ALJ proceeded to the second step in the sequential analysis.
The second inquiry is whether the claimant has a " severe impairment," meaning an " impairment or combination of impairments which significantly limits [her] physical or mental ability to do basic work activities[.]" 20 C.F.R. § 404.1520(c). If not, the claimant is considered not disabled and the application for benefits is denied. See Seavey, 276 F.3d at 5. Here, the ALJ determined that Rascoe's medical records, and the opinion of her treating physician regarding the extent of her physical limitations, did not substantiate her claim that she was impaired as a result of chronic pain and/or fibromyalgia through the date when she was last insured. (See Dec. 3-4; Tr. 14-15). Accordingly, he found that she did not have a medically determinable physical impairment for purposes of the disability analysis.
The ALJ did find that Rascoe had a history of major depressive disorder during the relevant time period. (Finding #3; Tr. 14). However, after considering her symptoms and " the extent to which [those] symptoms [could] reasonably be accepted as consistent with the objective medical evidence and other evidence," including the available opinion evidence, the ALJ determined that Rascoe's mental impairment did not significantly limit her ability to perform basic work-related activities. (Dec. 4-5; Tr. 15-16). Consequently, he concluded that Rascoe did not have an impairment, or combination of impairments, that were severe within the meaning of the social security regulations, and that she " was not under a disability, as defined in the Social Security Act, at any time from March 1, 2009, the amended alleged onset date, through March 31, 2009, the date last insured[.]" (Finding #4 & #5; Tr. 16-17). As detailed more fully below, the plaintiff contends that the ALJ erred by finding that her mental and physical impairments were not severe, and by failing to apply SSR 83-20, to infer the onset date of her major depressive disorder.
Because the ALJ found that Rascoe was not suffering from a severe impairment, and was therefore not disabled through the date when she was last insured, there was no need to reach the remaining steps of the disability analysis. Accordingly, he had no occasion to consider whether Rascoe had an impairment that met the conditions for one of the " listed" impairments set forth in the Social Security regulations or whether her " residual functional capacity" was such that she could still perform her past relevant work. See Seavey, 276 F.3d at 5. Nor did he reach the question whether, given her residual functional capacity, education, work experience, and age, Rascoe was able to perform other work. See id. The plaintiff argues that it was improper for the ALJ to terminate his analysis at step two, and that the matter should be remanded for further administrative proceedings.
Additional factual details relevant to this court's analysis are set forth below where appropriate.
A. Standard of Review
By her complaint, Rascoe is seeking judicial review of the Commissioner's " final decision" pursuant to section 205(g) of the Social Security Act, 42 U.S.C. § 405(g) (the " Act" ). Section 205(g) of the Act provides in relevant part as follows:
Any individual, after any final decision of the Commissioner of Social Security made after a hearing to which he was a party, irrespective of the amount in controversy, may obtain a review of such decision by a civil action .... The court shall have power to enter, upon the pleadings and transcript of the record, a judgment affirming, modifying, or reversing the decision of the Commissioner of Social Security, with or without remanding the cause for a rehearing. The findings of the Commissioner of Social Security as to any fact, if supported by substantial evidence, shall be conclusive ....
42 U.S.C. § 405(g) (emphasis added). The Supreme Court has defined " substantial evidence" to mean " more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales,402 U.S. 389, 401, 91 S.Ct. 1420, 1427, 28 L.Ed.2d 842 (1971) (quoting Consol. Edison Co. v. NLRB,305 U.S. 197, 229, 59 S.Ct. 206, 217, 83 L.Ed. ...