Canales v. Commissioner of Social Security

698 F. Supp. 2d 335, 2010 U.S. Dist. LEXIS 29266
CourtDistrict Court, E.D. New York
DecidedMarch 26, 2010
DocketCase 08-CV-5019 (FB)(SMG)
StatusPublished
Cited by49 cases

This text of 698 F. Supp. 2d 335 (Canales v. Commissioner of Social Security) is published on Counsel Stack Legal Research, covering District Court, E.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Canales v. Commissioner of Social Security, 698 F. Supp. 2d 335, 2010 U.S. Dist. LEXIS 29266 (E.D.N.Y. 2010).

Opinion

MEMORANDUM AND ORDER

BLOCK, Senior District Judge:

Plaintiff Marin Canales (“Canales”) seeks judicial review of the final determination of the Commissioner of Social Security (“the Commissioner”) denying his applications for Social Security Disability and Supplemental Security Income benefits (collectively, “DIB”).’ Both parties move for judgment on the pleadings. For the following reasons, the Commissioner’s determination is vacated and the matter is remanded for further proceedings.

I

From 2000 until 2005, Canales worked in construction. He was struck by an automobile while crossing a street on March 9, 2005; he has not worked since. He claims that he is disabled due to back pain and depression. Canales filed for DIB on December 13, 2005; his date last insured was December 31, 2006. After a hearing before an administrative law judge (“ALJ”), Canales’s application was denied. See generally AR 1 at 256-293 (transcript of hearing before ALJ held November 13, 2007); AR at 16-28 (ALJ decision issued August 1, 2008). The ALJ concluded that Canales had no severe mental impairments, and one severe physical impairment, lumbar disc disease. The parties agree that the ALJ’s evaluation of Canales’s physical limitations was correct insofar as he was limited to sedentary work. See Canales Mem. of Law at 1; Comm’r Mem. of Law at 20. Since Canales could only do sedentary work, the ALJ concluded he could not return to his past work in construction; however, after evaluating Canales’s limitations under the Commissioner’s Medical-Vocational Guidelines (“the Grids”), she concluded that he was still able to perform other jobs, and was therefore not entitled to DIB. The Appeals Council declined review.

Canales’s principal contention is that the ALJ erroneously concluded that he had no severe mental impairments; he demands remand for the calculation of benefits, or, at a minimum, a new hearing. The Court *337 concludes a new hearing is warranted because: (1) new evidence from treating psychiatrist Dr. Miriam Ewaskio (“Dr. Ewaskio”) supports Canales’s claims of mental impairments; (2) the ALJ failed to apply the treating physician rule properly to the findings of Dr. Maria Diaz (“Dr. Diaz”), Canales’s primary care physician; and (3) the ALJ failed to apply the Commissioner’s regulations properly to the findings of Elizabeth Rodriguez (“Rodriguez”), a licensed social worker.

A. Evidence of Canales’s Mental Limitations

Canales’s medical records reflect that he was referred for psychiatric consultation by Dr. Diaz in the spring of 2007. A note dated April 11 from social worker Angela Flores (“Flores”) at Montefiore Medical Center stated that Canales was “guarded” and “appeared [to be] under alcohol [and] substance influence.” 2 Because she was “unable to communicate” with Canales, Flores called Dr. Diaz, who was able to “calm him down”; they rescheduled his psychiatric consultation for the following day. Flores concluded that the session “was tense and inconclusive.” AR at 241. Flores noted on April 12 that Canales failed to appear for his scheduled appointment; she noted in his file that she referred him to a detoxification program at St. Barnabas Hospital. Id. Flores did not see Canales again until May 9, 2007; on that date she referred him, at his request, to a psychiatrist at Montefiore Medical Center, noting that he was “very aggressive” and “appeared to be intoxicated.” AR at 240. On June 29, Flores saw Canales a third time. She referred him to a psychiatric clinic at Bronx-Lebanon Hospital, noting his “alcohol abuse history” and “[v]ery aggressive personality.” Id.

On August 15, 2007, Canales was seen by Elizabeth Rodriguez (“Rodriguez”), a licensed clinical social worker at a psychiatric clinic at Bronx-Lebanon Hospital. Rodriguez noted that Canales’s chief complaint was “depression,” and that Canales “was neat in appearance and well groomed,” and had a “logical” thought process. Rodriguez further noted that Canales’s mood was “depressed and affect appropriate,” and that he admitted “to suicidal ideation however denies any plan or intent ... [or] hallucinations.” AR at ISO-82.

Rodriguez completed a “Psycho-Social History” on the same date; she noted that Canales had “symptoms of PTSD-depression,” 3 and noted the presence of the following symptoms: (1) aggressive behavior; (2) depressed mood; (3) emotional/physical/sexual trauma victim; (4) crying spells; (5) hopelessness; (6) irritability; (7) sleep disorder; (8) paranoia; (9) substance use (in remission); and (10) poor memory. AR at 192. She noted “functional deficit areas” of “coping skills” and “management of medical problems.” Id. Canales again reported suicidal ideation; he also told Rodriguez that he was raped when he was a child. AR at 193. He denied using any alcohol or other substances for 12 months, and reported a “mild” impact of alcohol and drugs on his life. AR at 194.

Rodriguez completed a “Medical Assessment of Ability To Do Work-Related Activities (Mental)” on the same date. With respect to Canales’s ability to “mak[e] occupational adjustments,” Rodriguez rated *338 his abilities as “poor to none” — the lowest rating — with respect to six of eight categories, and “fair” — the second-lowest rating — with respect to the remaining two categories. AR at 148. In her assessment of Canales’s abilities to “mak[e] performance adjustments,” Rodriguez gave a “poor to none” rating in all three categories. AR at 149. In her assessment of Canales’s abilities to “mak[e] personal-social adjustments,” Rodriguez rated Canales as “good” with respect to maintaining personal appearance and reliability; “fair” with respect to behaving in an “emotionally stable manner”; and “poor to none” with respect to relating “predictably” in social situations. Id.

On September 6, 2007, Canales was seen by Dr. Upendra Bhatt (“Dr. Bhatt”), a psychiatrist with Bronx-Lebanon’s Department of Psychiatry. Dr. Bhatt reported that Canales was “angry and irritable and cursing a lot,” had “alcohol on his breath,” and “expressed homicidal and suicidal ideaftion].” AR at 179. Dr. Bhatt transferred him to Bronx-Lebanon’s psychiatric emergency room via ambulance. Id. The results of this hospitalization, if any, are not clear, though a subsequent note indicates Canales was referred to an alcohol program at Martin Luther King Health Center (“MLKHC”). AR at 175.

One week later, on September 13, Canales presented to the psychiatric clinic at Bronx-Lebanon with a “very strong smell of alcohol on his breath.” AR at 175. Social worker Theresa Carey (“Carey”) reminded him of his referral to MLKHC and explained to him that “he could get his alcohol [treatment] and psych [treatment] in the same place.” AR at 175. Canales “became angry stating he did not want to go.” Id. Carey informed personnel at MLKHC that Canales would be coming, but a note from Rodriguez the next day indicates that he never went. AR at 175.

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Bluebook (online)
698 F. Supp. 2d 335, 2010 U.S. Dist. LEXIS 29266, Counsel Stack Legal Research, https://law.counselstack.com/opinion/canales-v-commissioner-of-social-security-nyed-2010.