United States District Court, D. Massachusetts
MEMORANDUM AND ORDER REGARDING PLAINTIFF'S MOTION
FOR ORDER REVERSING THE COMMISSIONER'S DECISION OR REMAND
AND DEFENDANT'S MOTION TO AFFIRM THE DECISION OF THE
COMMISSIONER (Dkt. Nos. 15 & 20)
KATHERINE A. ROBERTSON, United States Magistrate Judge
the court is an action for judicial review of a final
decision by the Acting Commissioner of the Social Security
Administration ("Commissioner") regarding an
individual's entitlement to Supplemental Security Income
("SSI") pursuant to 42 U.S.C. § 1381(c)(3).
Plaintiff Edwin Ortiz ("Plaintiff") asserts that
the Commissioner's decision denying him such benefits --
memorialized in a July 28, 2014 decision of an administrative
law judge ("ALJ") -- is not supported by
substantial evidence. Plaintiff has filed a motion to reverse
or remand (Dkt. No. 15) and the Commissioner, in turn, has
moved to affirm (Dkt. No. 20).
parties have consented to this court's jurisdiction.
See 28 U.S.C. § 636(c); Fed. R. Civ. P. 73. For
the following reasons, the court will ALLOW the
Commissioner's motion to affirm and DENY Plaintiff's
motion to reverse or remand.
was born in Puerto Rico and, at the time of the ALJ hearing,
was 49 years old and had lived in the United States for
approximately thirty years (Administrative Record
("A.R.") at 42, 62). Although he is unable to read
or write in either English or Spanish, he speaks and
understands both languages (id. at 44-46, 73). He
worked as a welder for about five years (id. at
43-44). Because asthma and wrist surgery prevented him from
performing his job, he stopped working as a welder in January
2008 when he was 43 years old (id. at 19, 46-48). In
his application for SSI, Plaintiff alleged that he was
disabled due to liver disease, specifically hepatitis C, pain
in his back and right hand, asthma, and depression
(id. at 90, 112, 860).
applied for SSI on May 7, 2012 alleging an onset of
disability on January 25, 2008 (id. at 90, 291). The
application was denied initially and upon reconsideration
(id. at 105-12, 116-18). Following a hearing on May
21, 2014, the ALJ issued his decision on July 28, 2014
finding Plaintiff was not disabled (id. at 12, 19,
29). The Appeals Council denied review (id. at 1-5).
This appeal followed.
Standard of Review
District Court may enter a judgment affirming, modifying, or
reversing the final decision of the Commissioner, with or
without remanding for a rehearing. See 42 U.S.C.
§ 1383(c)(3). Judicial review "is limited to
determining whether the ALJ used the proper legal standards
and found facts upon the proper quantum of evidence."
Ward v. Comm'r of Soc. Sec., 211 F.3d 652, 655
(1st Cir. 2000). The court reviews questions of law de novo,
but must defer to the ALJ's findings of fact if they are
supported by substantial evidence. See id. (citing
Nguyen v. Chater, 172 F.3d 31, 35 (1st Cir. 1999)).
Substantial evidence exists "'if a reasonable mind,
reviewing the evidence in the record as a whole, could accept
it as adequate to support [the] conclusion.'"
Irlanda Ortiz v. Sec'y of Health & Human
Servs., 955 F.2d 765, 769 (1st Cir. 1991) (quoting
Rodriguez v. Sec'y of Health & Human Servs.,
647 F.2d 218, 222 (1st Cir. 1981)). "Complainants face a
difficult battle in challenging the Commissioner's
determination because, under the substantial evidence
standard, the [c]ourt must uphold the Commissioner's
determination, 'even if the record arguably could justify
a different conclusion, so long as it is supported by
substantial evidence.'" Amaral v. Comm'r of
Soc. Sec., 797 F. Supp. 2d 154, 159 (D. Mass. 2010)
(quoting Rodriguez Pagan v. Sec'y of Health &
Human Servs., 819 F.2d 1, 3 (1st Cir. 1987)). In
applying the substantial evidence standard, the court must be
mindful that it is the province of the ALJ, and not the
courts, to determine issues of credibility, resolve conflicts
in the evidence, and draw conclusions from such evidence.
See Irlanda Ortiz, 955 F.2d at 769. That said, the
Commissioner may not ignore evidence, misapply the law, or
judge matters entrusted to experts. See Nguyen, 172
F.3d at 35.
Standard for Entitlement to Social Security Disability
Insurance Benefits and Supplemental Security Income.
order to qualify for SSI, a claimant must demonstrate that he
was disabled within the meaning of the Social Security Act
(the "Act") and that he had financial need.
See 42 U.S.C. § 1381a. "Plaintiff's
need, for purposes of SSI, . . . [is] not challenged. The
only question is whether the ALJ had substantial evidence
with which to conclude that Plaintiff did not suffer from a
disability." Bitsacos v. Barnhart, 353 F. Supp.
2d 161, 165-66 (D. Mass. 2005).
defines disability, in part, as the "inability to engage
in any substantial gainful activity by reason of any
medically determinable physical or mental impairment which
can be expected to result in death or which has lasted or can
be expected to last for a continuous period of not less than
12 months." 42 U.S.C. § 423(d)(1)(A). An individual
is considered disabled under the Act
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, regardless
of whether such work exists in the immediate area in which he
lives, or whether a specific job vacancy exists for him, or
whether he would be hired if he applied for work.
42 U.S.C. §1382c(a)(3)(B). See generally Bowen v.
Yuckert, 482 U.S. 137, 146–49 (1987).
Commissioner evaluates a claimant's impairment under a
five-step sequential evaluation process set forth in
regulations promulgated under the Act. See 20 C.F.R.
§ 416.920(a). The hearing officer must determine: (1)
whether the claimant is engaged in substantial gainful
activity; (2) whether the claimant suffers from a severe
impairment; (3) whether the impairment meets or equals a
listed impairment contained in Appendix 1 to the regulations;
(4) whether the impairment prevents the claimant from
performing previous relevant work; and (5) whether the
impairment prevents the claimant from doing any work
considering the claimant's age, education, and work
experience. See id; see also Goodermote v.
Sec'y of Health & Human Servs., 690 F.2d 5, 6-7
(1st Cir. 1982) (describing the five-step process). If the
hearing officer determines at any step of the evaluation that
the claimant is or is not disabled, the analysis does not
continue to the next step. See 20 C.F.R. §
proceeding to steps four and five, the Commissioner must make
an assessment of the claimant's RFC, which the
Commissioner uses at step four to determine whether the
claimant can do past relevant work and at step five to
determine if the claimant can do other work. See id.
"The RFC is an administrative assessment of the extent
to which an individual's medically determinable
impairment(s), including any related symptoms, such as pain,
may cause physical or mental limitations or restrictions that
may affect his or her capacity to do work-related physical
and mental activities." Social Security Regulation
("SSR") 96-8p, 1996 WL 374187, at *2 (July 2,
1996). Put another way, "[a]n individual's RFC is
defined as 'the most you can still do despite your
limitations.'" Dias v. Colvin, 52 F. Supp.
3d 270, 278 (D. Mass. 2014) (quoting 20 C.F.R. §
claimant has the burden of proof through step four of the
analysis. At step five, the Commissioner has the burden of
showing the existence of jobs in the national economy that
the claimant can perform notwithstanding impairment(s).
See Goodermote, 690 F.2d at 7.
presented the ALJ and the court with medical records that
spanned the period from January 2007 through July 2014.
Northgate Medical P.C. ("Northgate") provided
Plaintiff's primary care. New England Orthopedic Surgeons
("NEOS"), Pioneer Spine and Sports Physicians, P.C.
("Pioneer"), and the Arthritis Treatment Center
treated Plaintiff's right wrist. An infectious disease
physician at Baystate Medical Center ("BMC")
treated Plaintiff's liver condition. Plaintiff also
received treatment at the Mercy Medical Center
received mental health treatment from the Center for
Psychological and Family Services ("CPFS") and
Behavioral Health Network Crisis Services ("BHN").
Margarita Hernandez, Ph.D. examined Plaintiff on January 26,
2013 at the request of the Massachusetts Rehabilitation
Commission's Disability Determination Services (A.R. at
644). Dr. Hernandez diagnosed Plaintiff with depressive
disorder not otherwise specified ("NOS") and
learning disorder NOS and assigned a Global Assessment of
Functioning ("GAF") score of 70 (id. at
648). Testing of reading and mathematics
revealed that Plaintiff's "level of intellectual