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Raposo v. Berryhill

United States District Court, D. Massachusetts

March 28, 2018

NANCY A. BERRYHILL, Commissioner of Social Security, Defendant.



         Plaintiff Cremilde C. Raposo (“Ms. Raposo” or “Claimant”) brings this action pursuant to section 205(g) of the Social Security Act, 42 U.S.C. § 405(g), challenging the final decision of the Commissioner of the Social Security Administration (the “Commissioner”) denying her claim for Supplemental Security Income (“SSI”) benefits. Currently pending before the Court are Claimant's motion to reverse or remand the Commissioner's decision denying her SSI benefits [ECF No. 15], and the Commissioner's cross-motion for an order affirming the decision. [ECF No. 21]. For the reasons described herein, the Court finds that the decision of the Administrative Law Judge (“ALJ”) was not supported by substantial evidence and therefore VACATES the decision of the Commissioner and REMANDS the case for further administrative proceedings consistent with this opinion.

         I. BACKGROUND

         A. Statutory and Regulatory Framework: Five-Step Process to Evaluate Disability Claims

         “The Social Security Administration is the federal agency charged with administering both the Social Security disability benefits program, which provides disability insurance for covered workers, and the Supplemental Security Income program, which provides assistance for the indigent aged and disabled.” Seavey v. Barnhart, 276 F.3d 1, 5 (1st Cir. 2001) (citing 42 U.S.C. §§ 423, 1381a).

         The Social Security Act (the “Act”) provides that an individual shall be considered to be “disabled” if he or she is:

unable 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 that has lasted or can be expected to last for a continuous period of not less than twelve months.

42 U.S.C. § 1382c(a)(3)(A); see also 42 U.S.C. § 423(d)(1)(A). The disability must be severe, such that the claimant is unable to do his or her previous work or any other substantial gainful activity that exists in the national economy. See 42 U.S.C. § 1382c(a)(3)(B); 20 C.F.R. § 416.905.

         When evaluating a disability claim under the Act, the Commissioner uses a five-step process, which the First Circuit has explained as follows:

All five steps are not applied to every applicant, as the determination may be concluded at any step along the process. The steps are: 1) if the applicant is engaged in substantial gainful work activity, the application is denied; 2) if the applicant does not have, or has not had within the relevant time period, a severe impairment or combination of impairments, the application is denied; 3) if the impairment meets the conditions for one of the “listed” impairments in the Social Security regulations, then the application is granted; 4) if the applicant's “residual functional capacity” is such that he or she can still perform past relevant work, then the application is denied; 5) if the applicant, given his or her residual functional capacity, education, work experience, and age, is unable to do any other work, the application is granted.

Seavey, 276 F.3d at 5 (citing 20 C.F.R. § 416.920).

         B. Procedural Background

         Claimant filed her application for SSI benefits on November 15, 2013. [R. 25].[1] She alleged that she became disabled on July 30, 1992 due to Raynaud's Syndrome (“Raynaud's”), [2]Systematic Lupus Erythematosus (“Lupus”), rheumatoid arthritis, irregular heartbeat, hyperlipidemia, a blood disorder, a muscle disorder, chronic tinnitus, vision problems, and stomach problems. [R. 26, 158].

         The Social Security Administration (“SSA”) denied Claimant's application for SSI benefits on February 27, 2014, and again upon reconsideration on August 8, 2014. [R. 25]. Thereafter, Claimant timely requested an administrative hearing, and a hearing took place before Administrative Law Judge (“ALJ”) Paul W. Goodale on November 2, 2015. [R. 44]. Claimant, who was represented by counsel, appeared and testified at the hearing. [R. 44]. On December 22, 2015, the ALJ issued a decision finding that Claimant was not disabled. [R. 21]. On January 9, 2017, the SSA Appeals Council denied Claimant's Request for Review [R. 2]. On February 24, 2017, Claimant filed a timely complaint with this Court, seeking review of the Commissioner's decision pursuant to section 205(g) of the Act. [ECF No. 1].

         C. Factual Background

         Claimant was born in 1966 in Portugal where she lived until the age of 12. [R. 60, 62]. In 1978, she immigrated to the United States and attended school through the ninth grade. [R. 61]. Claimant can read and write in Portuguese and English. [R. 29, 62-63]. Between 2000 and 2015, she held two jobs for short periods of time: prior to 2006, Claimant worked as a house cleaner with her sister [R. 71]; in 2012, she worked as a caretaker for a woman with cerebral palsy [R. 69]. She resides in a second floor apartment in Fall River, Massachusetts with her teenaged son and daughter. [R. 60-61, 99].

         D. Medical Evidence

         Because Claimant only challenges the ALJ's decision concerning her conditions of Lupus and Raynaud's, the following summary of the record is tailored accordingly. [ECF No. 16 at 3]. On October 24, 2012, Claimant began seeing Anis Rahman, M.D. as her treating rheumatologist. [R. 408]. He described her as a patient with a 15-year history of Lupus who presented with “diffuse arthralgia associated with Raynaud's” and noted that her fingers, toes, and knees were cold and blue. [R. 408-09]. Claimant denied any chest pain or shortness of breath, but stated that Raynaud's caused her some pain. [R. 408]. Dr. Rahman's examination of her joints showed “no synovitis involving any joint” and a normal range of motion. [R. 408]. He concluded that Claimant was “basically doing well” with the exception of Raynaud's and prescribed Nifedipine and advised her to avoid exposure to cold weather, especially in the winter, and to dress warmly whenever she went outside. [R. 409].

         On March 11, 2013, Claimant returned for a follow-up visit with Dr. Rahman, stating that her Raynaud's symptoms had improved with the use of Nifedipine. [R. 410]. Although she had pain in her fingers, her symptoms were briefer and less painful. Id. While her fingers and toes remained cold and discolored, her joints continued to show no synovitis and a normal range of motion. Id.

         Claimant saw Dr. Rahman twice in May 2013, at which times her fingers were cold and discolored but he found no other problems with her joints. [R. 411-12]. When she visited Dr. Rahman on July 3, 2013, he observed that although she was still experiencing problems from Raynaud's in warm weather, she felt better after using a steroid, and her “intermittent arthralgia” was “not bad.” [R. 413]. On August 14, 2013, Dr. Rahman diagnosed Claimant with shingles, but her Raynaud's condition remained the same. [R. 416].

         On December 31, 2013, Claimant reported increasing problems with Raynaud's in the cold weather and that she was having difficulty driving. [R. 559]. Her fingers appeared cold and discolored but an examination showed no synovitis. Id. On January 17, 2014, Claimant was reportedly “not bad” except for exacerbated Raynaud's symptoms in the colder weather and occasional arthralgia. [R. 561]. She also appeared unable to tolerate Nifedipine, as she had developed redness in her face and legs from using it. Id. Dr. Rahman characterized her Raynaud's as “severe” due to the combination Raynaud's and Lupus. Id. He prescribed medications to treat both conditions, and advised her to dress warmly with gloves and a hat. [R. 561-62].

         On February 26, 2014, state agency consulting physician John Benanti, M.D. completed a disability determination explanation form for Claimant. [R. 158]. With respect to Claimant's physical residual functional capacity (“RFC”), Dr. Benanti opined that Claimant could perform the following tasks with certain limitations: (a) lifting and/or carrying 20 pounds occasionally and 10 pounds frequently; (b) stooping and climbing ramps or stairs frequently; (c) climbing ladders, ropes, or scaffolds occasionally; (d) kneeling, crouching, or crawling occasionally; (e) standing or walking for about six hours in an eight-hour workday; and (f) sitting for about six hours in an eight-hour workday. [R. 163-64]. He also found that she was not limited in her ability to push, pull, or balance, and that she did not have any manipulative, visual, or communicative limitations. Id. With ...

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