UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE
Stephanie Amaral
v. Civil No. 15-cv-359-JD Opinion No. 2016 DNH 076 Carolyn W. Colvin, Acting Commissioner Social Security Administration
O R D E R
Stephanie Amaral seeks judicial review, pursuant to 42
U.S.C. § 405(g), of the decision of the Acting Commissioner of
the Social Security Administration, denying her application for
social security disability benefits after Amaral was awarded
supplemental security income. Amaral moves to reverse and
remand the decision, contending that the Administrative Law
Judge (“ALJ”) erred in failing to call a medical expert to
determine Amaral’s disability onset date, erred in the weight
given to her treating physician’s opinion, erred in evaluating
her mental health impairments, and erred in assessing Amaral’s
residual functional capacity. The Acting Secretary moves to
affirm.
Standard of Review
In reviewing the final decision of the Acting Commissioner
in a social security case, the court “is limited to determining whether the ALJ deployed the proper legal standards and found
facts upon the proper quantum of evidence.” Nguyen v. Chater,
172 F.3d 31, 35 (1st Cir. 1999); accord Seavey v. Barnhart, 276
F.3d 1, 9 (1st Cir. 2001). The court defers to the ALJ’s
factual findings as long as they are supported by substantial
evidence. § 405(g). “Substantial evidence is more than a
scintilla. It means such relevant evidence as a reasonable mind
might accept as adequate to support a conclusion.” Astralis
Condo. Ass’n v. Sec’y Dep’t of Housing & Urban Dev., 620 F.3d
62, 66 (1st Cir. 2010).
Background
Amaral applied for supplemental security income (“SSI”),
under Title XVI, and disability insurance benefits (“DIB”),
under Title II, on September 9, 2012, when she was fifty-two
years old. For purposes of SSI, she was determined to be
disabled because of anxiety related disorders and affective/mood
disorders beginning on June 1, 2012, but she was not awarded SSI
because she had too much income. For purposes of DIB, the
agency concluded that she had not been disabled through her last
insured date on December 31, 2008.
The administrative record of medical treatment begins in
2004 when Amaral required a physical and mental examination for
purposes of her application to be a foster care provider. The
2 results were normal. In June of 2005, Amaral was treated at a
hospital emergency department for symptoms she associated with
anxiety but a CT scan revealed pulmonary emboli in her lungs.
She was admitted to the hospital and was prescribed
anticoagulant medication.
Just after she was released from the hospital, on June 13,
2005, Amaral saw her treating physician, Dr. Badman, and
reported having difficulty with anxiety. A week later, Amaral
told Dr. Badman that she continued to have anxiety but her
medication was very beneficial. Ten days later, however, Amaral
again experienced breakthrough anxiety and began counselling.
In July of 2005, Dr. Badman explained to Amaral that
anxiety medication was not a long-term solution and discussed
alternatives. Amaral reported a panic attack to Dr. Badman on
July 21, 2005, and he told her to stop the new medication.
Through the remainder of 2005, Dr. Badman’s treatment notes show
that Amaral was diagnosed with anxiety disorder but that she was
doing well on her medication.
The treatment notes in 2006 generally show diagnoses of
anxiety disorder and depression. In September, Dr. Badman noted
that Amaral’s anxiety was stable. In 2007, Amaral reported
during a neurological examination that she had had severe
depression and anxiety but also said that her medication had
3 done a good job of taking care of her anxiety. Treatment notes
in 2008 are similar and include one report that Amaral felt she
was always on the verge of anxiety decompensation.
Two state agency medical experts reviewed Amaral’s records
in December of 2012. They found insufficient evidence to assess
her condition before December 31, 2008, her last insured date.
In February of 2014, Jeffrey Wagner, Ph.D. conducted a
psychological evaluation of Amaral. He completed a Mental
Impairment Medical Source Statement in which he assessed panic
disorder, agoraphobia, major depression, attention deficit
disorder, and generalized anxiety. Dr. Wagner found that Amaral
was seriously limited in all mental aptitudes and abilities to
do unskilled work. He also found marked limitations in Amaral’s
activities of daily living, social functioning, and
concentration, persistence, and pace. Dr. Wagner checked a box
to show that Amaral’s impairments had existed since September of
2003.
Dr. Badman completed a Physical Impairment Medical Source
Statement on February 7, 2014. He indicated diagnoses of
anxiety, GERD, TMJ syndrome, lower back pain/degenerative disc
disorder, and DVT/pulmonary embolism. Dr. Badman also indicated
that Amaral’s limitations had existed since 2005 and would
frequently interfere with her attention and concentration. He
4 found that she could not do even a low stress job and was likely
to be absent more than four days per month.
In 2012, Amaral stated in her function report that she was
overwhelmed by tasks outside of her house and that her panic
attacks frequently caused her to seek care. She said that she
took care of her children with help from her mother. She also
said that she slept little and felt exhausted but that she could
take care of household cleaning and pets, attend to
appointments, shop, and drive during daylight hours.
A hearing before an ALJ was held on Amaral’s application on
February 28, 2014. Amaral testified that she started having
severe panic attacks in 2006. After a near accident, she only
drove short distances on back roads. Amaral and her husband and
mother started caring for foster children in 2004 and sometimes
had six children in the home. She adopted three of the foster
children and stopped taking foster children in 2011.
The ALJ issued her decision on March 27, 2014, finding that
Amaral had not been disabled before her last insured date,
December 31, 2008, and that jobs existed that Amaral could do.
Amaral sought review by the Appeals Council, which was denied,
making the ALJ’s decision the final decision of the Acting
Commissioner.
5 Discussion
In support of her motion to reverse and remand the Acting
Commissioner’s decision, Amaral contends that the ALJ was
required by Social Security Ruling (“SSR”) 83-20 to consult with
a medical expert, that the ALJ improperly assessed Dr. Badman’s
opinion, that the ALJ relied on her lay knowledge in assessing
Amaral’s residual functional capacity, and that the ALJ did not
follow the Psychiatric Review Technique required by 20 C.F.R.
§ 404.1520a(e). The Acting Commissioner moves to affirm,
arguing that the ALJ properly found that Amaral was not disabled
before December 31, 2008.
A. Medical Expert Consultation
To be eligible for DIB, a claimant must demonstrate, among
other things, that she was insured for disability benefits when
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UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE
Stephanie Amaral
v. Civil No. 15-cv-359-JD Opinion No. 2016 DNH 076 Carolyn W. Colvin, Acting Commissioner Social Security Administration
O R D E R
Stephanie Amaral seeks judicial review, pursuant to 42
U.S.C. § 405(g), of the decision of the Acting Commissioner of
the Social Security Administration, denying her application for
social security disability benefits after Amaral was awarded
supplemental security income. Amaral moves to reverse and
remand the decision, contending that the Administrative Law
Judge (“ALJ”) erred in failing to call a medical expert to
determine Amaral’s disability onset date, erred in the weight
given to her treating physician’s opinion, erred in evaluating
her mental health impairments, and erred in assessing Amaral’s
residual functional capacity. The Acting Secretary moves to
affirm.
Standard of Review
In reviewing the final decision of the Acting Commissioner
in a social security case, the court “is limited to determining whether the ALJ deployed the proper legal standards and found
facts upon the proper quantum of evidence.” Nguyen v. Chater,
172 F.3d 31, 35 (1st Cir. 1999); accord Seavey v. Barnhart, 276
F.3d 1, 9 (1st Cir. 2001). The court defers to the ALJ’s
factual findings as long as they are supported by substantial
evidence. § 405(g). “Substantial evidence is more than a
scintilla. It means such relevant evidence as a reasonable mind
might accept as adequate to support a conclusion.” Astralis
Condo. Ass’n v. Sec’y Dep’t of Housing & Urban Dev., 620 F.3d
62, 66 (1st Cir. 2010).
Background
Amaral applied for supplemental security income (“SSI”),
under Title XVI, and disability insurance benefits (“DIB”),
under Title II, on September 9, 2012, when she was fifty-two
years old. For purposes of SSI, she was determined to be
disabled because of anxiety related disorders and affective/mood
disorders beginning on June 1, 2012, but she was not awarded SSI
because she had too much income. For purposes of DIB, the
agency concluded that she had not been disabled through her last
insured date on December 31, 2008.
The administrative record of medical treatment begins in
2004 when Amaral required a physical and mental examination for
purposes of her application to be a foster care provider. The
2 results were normal. In June of 2005, Amaral was treated at a
hospital emergency department for symptoms she associated with
anxiety but a CT scan revealed pulmonary emboli in her lungs.
She was admitted to the hospital and was prescribed
anticoagulant medication.
Just after she was released from the hospital, on June 13,
2005, Amaral saw her treating physician, Dr. Badman, and
reported having difficulty with anxiety. A week later, Amaral
told Dr. Badman that she continued to have anxiety but her
medication was very beneficial. Ten days later, however, Amaral
again experienced breakthrough anxiety and began counselling.
In July of 2005, Dr. Badman explained to Amaral that
anxiety medication was not a long-term solution and discussed
alternatives. Amaral reported a panic attack to Dr. Badman on
July 21, 2005, and he told her to stop the new medication.
Through the remainder of 2005, Dr. Badman’s treatment notes show
that Amaral was diagnosed with anxiety disorder but that she was
doing well on her medication.
The treatment notes in 2006 generally show diagnoses of
anxiety disorder and depression. In September, Dr. Badman noted
that Amaral’s anxiety was stable. In 2007, Amaral reported
during a neurological examination that she had had severe
depression and anxiety but also said that her medication had
3 done a good job of taking care of her anxiety. Treatment notes
in 2008 are similar and include one report that Amaral felt she
was always on the verge of anxiety decompensation.
Two state agency medical experts reviewed Amaral’s records
in December of 2012. They found insufficient evidence to assess
her condition before December 31, 2008, her last insured date.
In February of 2014, Jeffrey Wagner, Ph.D. conducted a
psychological evaluation of Amaral. He completed a Mental
Impairment Medical Source Statement in which he assessed panic
disorder, agoraphobia, major depression, attention deficit
disorder, and generalized anxiety. Dr. Wagner found that Amaral
was seriously limited in all mental aptitudes and abilities to
do unskilled work. He also found marked limitations in Amaral’s
activities of daily living, social functioning, and
concentration, persistence, and pace. Dr. Wagner checked a box
to show that Amaral’s impairments had existed since September of
2003.
Dr. Badman completed a Physical Impairment Medical Source
Statement on February 7, 2014. He indicated diagnoses of
anxiety, GERD, TMJ syndrome, lower back pain/degenerative disc
disorder, and DVT/pulmonary embolism. Dr. Badman also indicated
that Amaral’s limitations had existed since 2005 and would
frequently interfere with her attention and concentration. He
4 found that she could not do even a low stress job and was likely
to be absent more than four days per month.
In 2012, Amaral stated in her function report that she was
overwhelmed by tasks outside of her house and that her panic
attacks frequently caused her to seek care. She said that she
took care of her children with help from her mother. She also
said that she slept little and felt exhausted but that she could
take care of household cleaning and pets, attend to
appointments, shop, and drive during daylight hours.
A hearing before an ALJ was held on Amaral’s application on
February 28, 2014. Amaral testified that she started having
severe panic attacks in 2006. After a near accident, she only
drove short distances on back roads. Amaral and her husband and
mother started caring for foster children in 2004 and sometimes
had six children in the home. She adopted three of the foster
children and stopped taking foster children in 2011.
The ALJ issued her decision on March 27, 2014, finding that
Amaral had not been disabled before her last insured date,
December 31, 2008, and that jobs existed that Amaral could do.
Amaral sought review by the Appeals Council, which was denied,
making the ALJ’s decision the final decision of the Acting
Commissioner.
5 Discussion
In support of her motion to reverse and remand the Acting
Commissioner’s decision, Amaral contends that the ALJ was
required by Social Security Ruling (“SSR”) 83-20 to consult with
a medical expert, that the ALJ improperly assessed Dr. Badman’s
opinion, that the ALJ relied on her lay knowledge in assessing
Amaral’s residual functional capacity, and that the ALJ did not
follow the Psychiatric Review Technique required by 20 C.F.R.
§ 404.1520a(e). The Acting Commissioner moves to affirm,
arguing that the ALJ properly found that Amaral was not disabled
before December 31, 2008.
A. Medical Expert Consultation
To be eligible for DIB, a claimant must demonstrate, among
other things, that she was insured for disability benefits when
she became disabled. 42 U.S.C. § 423(a). For that reason, a
claimant must have been disabled on or before her last insured
date to qualify for DIB. Hughes v. Colvin, 2016 WL 225688, at
*1 (D. Me. Jan. 19, 2016). SSI, however, is not dependent on
the claimant’s insured status. Lennon v. Colvin, 2015 WL
4642827, at *3 n.2 (D.N.H. Aug. 4, 2015).
SSR 83–20, Titles II and XVI: Onset of Disability, 1983 WL
31249, *3 (S.S.A. 1983), provides that the determination of the
onset date of disabling impairments “depends on an informed
6 judgment of the facts in the particular case. This judgment,
however, must have a legitimate medical basis.” As a result, an
ALJ must consult a medical advisor when the medical evidence as
to the claimant’s onset date is ambiguous. Sullivan v. Colvin,
2015 WL 1097404, at *1 (D.N.H. Mar. 11, 2015).
Amaral contends that because she was found to be disabled
as of September 9, 2012, for purposes of SSI, the onset date of
her disability is ambiguous and the ALJ was required under SSR
83-20 to consult a medical advisor to make that determination.
The Acting Commissioner argues that SSR 83-20 does not apply
because the medical evidence before December 31, 2008, Amaral’s
last insured date, is not ambiguous. Instead, the Acting
Commissioner asserts, the contemporaneous medical evidence shows
that Amaral was not disabled by anxiety or affective disorders
before her last insured date.
“[A]n ALJ need not consult a medical advisor if the record
provides unambiguous evidence that the claimant did not become
disabled as of the date last insured.” Fischer v. Colvin, 2014
WL 5502922, at *6 (D.N.H. Oct. 30, 2014). Evidence is
unambiguous, however, “only if ‘no legitimate basis [in the
record] can support an inference of disability’ as of the date
last insured.” Id. (quoting Mason v. Apfel, 2 F. Supp. 2d 142,
149 (D. Mass. 1998)). Otherwise, an ALJ must consult a medical
7 advisor to determine whether a claimant was disabled as of her
last insured date. Fischer, 2014 WL 5502922, at *6.
Amaral’s medical records prior to her last insured date,
December 31, 2008, document diagnoses for anxiety and depression
and ongoing issues related to anxiety and depression. Dr.
Badman, who treated Amaral since at least 2005 and continued to
treat her through the time of the hearing, stated that Amaral’s
disabling limitations due to anxiety and depression had existed
since 2005. Further, the two agency doctors who reviewed
Amaral’s records in 2012 concluded that the medical records
prior to December 31, 2008, were insufficient to determine
whether she was disabled. As such, the record is ambiguous as
to whether Amaral was disabled before her last insured date.
Although the ALJ interpreted those records to show that
Amaral was not disabled prior to December 31, 2008, that was not
allowed under SSR 83-20. Instead, the ALJ was required to
consult a medical advisor to determine the onset date of
Amaral’s disability. Therefore, the case must be remanded for
further administrative proceedings.
B. Remaining Issues
Because the case will be remanded, it is not necessary to
address the issues Amaral raises about the ALJ’s evaluation of
8 Dr. Badman’s opinion, the residual functional capacity
assessment, or the ALJ’s Psychiatric Review Technique.
Conclusion
For the foregoing reasons, the claimant’s motion to reverse
and remand (document no. 9) is granted. The Acting
Commissioner’s motion to affirm (document no. 10) is denied.
The case is remanded pursuant to Sentence Four of § 405(g).
SO ORDERED.
__________________________ Joseph DiClerico, Jr. United States District Judge
April 4, 2015
cc: Laurie Smith Young, Esq. Michael T. McCormack, Esq.