UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE
Christopher David Clark
v. Civil No. 22-cv-375-LM Opinion No. 2023 DNH 055 P Kilolo Kijakazi, Acting Commissioner, Social Security Administration
ORDER
Christopher Clark seeks judicial review, pursuant to 42 U.S.C. § 405(g), of
the decision of the Acting Commissioner of the Social Security Administration that
denied his applications for disability insurance benefits and supplemental security
income under Titles II and XVI of the Social Security Act. Clark moves to reverse
the decision (doc. no. 5) on the grounds that the Administrative Law Judge (“ALJ”)
erred in evaluating the medical opinions, which resulted in a residual functional
capacity assessment that is not supported by substantial evidence. The Acting
Commissioner moves to affirm the decision (doc. no. 8). For the reasons that follow,
the court grants Clark’s motion to reverse and remand and denies the Acting
Commissioner’s motion to affirm.
STANDARD OF REVIEW
In reviewing the final decision of the Commissioner under § 405(g), 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 Sacilowski v. Saul, 959 F.3d 431, 437 (1st Cir. 2020). The court defers to the ALJ’s factual findings if they are supported by substantial
evidence. Biestek v. Berryhill, 139 S. Ct. 1148, 1153 (2019). “Substantial-evidence
review is more deferential than it might sound to the lay ear: though certainly ‘more
than a scintilla’ of evidence is required to meet the benchmark, a preponderance of
evidence is not.” Purdy v. Berryhill, 887 F.3d 7, 13 (1st Cir. 2018) (citation omitted);
see also Biestek, 139 S. Ct. at 1154. Rather, the court “must uphold the [Acting]
Commissioner’s findings if a reasonable mind, reviewing the evidence in the record
as a whole, could accept it as adequate to support her conclusion.” Purdy, 887 F.3d
at 113 (citation and internal modifications omitted).
DISABILITY ANALYSIS FRAMEWORK
The Social Security Administration’s regulations set out a five-step process
that ALJs must follow to evaluate whether a person is “disabled” under the Social
Security Act—that is, unable to engage in any “substantial gainful activity.” See 42
U.S.C. § 423(d)(1)(A); 20 C.F.R. § 404.1520.1 The five steps are as follows:
• Step One: If the claimant is presently engaging in substantial gainful activity, he is not disabled. § 404.1520(b).
• Step Two: If the claimant does not have any impairment or any combination of impairments that significantly limits his physical or mental ability to do basic work activities, he is not disabled because he lacks a “severe” impairment. § 404.1520(c).
1 Unless otherwise noted, the court will cite the regulations under Title II
(disability insurance), 20 C.F.R. pt. 404, which are not materially different from those under Title XVI (supplemental income), 20 C.F.R. pt. 416, in the context of this case. See, e.g., Kimball v. Kijakazi, No. 21-cv-943-LM, 2022 WL 2702819, at *1 n. 1 (D.N.H. July 7, 2022).
2 • Step Three: If any of the claimant's impairments meet or equal one of the impairments listed in 20 C.F.R. Part 404, Subpart P, Appendix 1, he is disabled—and the ALJ need not proceed to steps four and five. § 404.1520(d).
• Step Four: If the claimant’s impairments do not prevent him from doing his past relevant work, then he is not disabled. § 404.1520(e)-(f).
• Step Five: If the claimant’s impairments do not prevent him from doing other work that exists in the national economy, then he is not disabled. § 404.1520(g).
At steps one through four, the claimant has the burden of proof. Sacilowski,
959 F.3d at 433-34. At step five, however, the Commissioner has the burden of
proof. Id.
If the claimant meets his burden at the first two steps of the sequential
analysis, but not at the third, the ALJ proceeds to steps four and five, which begin
with a determination of the claimant’s “residual functional capacity,” i.e., a
determination of what kind of things the claimant can and cannot do, mentally and
physically. See 20 C.F.R. § 404.1545(a)(1). A person’s residual functional capacity
is an assessment of “the most” the claimant can do despite his limitations. Id. After
the ALJ formulates the claimant’s residual functional capacity, he compares that
assessment against the demands of the claimant’s past work (at step four) and
against other jobs that exist in the national economy (at step five). § 404.1520(e)-
(g). If the claimant’s residual functional capacity allows him to perform his past
relevant work or work that exists in the national economy, the claimant is not
disabled. See § 404.1520(a)(4)(iv)-(v), (e), (f).
3 BACKGROUND2
Clark filed applications for social security benefits on October 7, 2019, with
an onset date of February 1, 2018. He alleged disability due to bipolar 1 disorder,
ADHD (attention deficit hyperactivity disorder), cannabis use disorder, and
excoriation disorder.3 His applications were denied initially and on
reconsideration. At Clark’s request, an ALJ held a hearing on Clark’s applications.
The ALJ issued an unfavorable decision on February 29, 2021.
I. Medical History
Clark’s medical history begins with an evaluation by a neuropsychologist,
Bryan T. Vogel, Psy.D., in July 2015 when Clark was 21 years old. Dr. Vogel
diagnosed severe and recurrent major depressive disorder and anxiety disorder. In
June 2016, the police were called to Clark’s workplace because of Clark’s disruptive
behavior. Following that incident, Clark was held on an involuntary basis at New
Hampshire Hospital in Hampstead, New Hampshire. The court ordered an
evaluation for involuntary commitment to New Hampshire Hospital. After the
evaluation, Clark was recommended for commitment for one year.
2 The background information is taken from the parties’ statements of facts.
Doc. nos. 6 & 9; see LR 9.1(c) & (d).
3 Excoriation disorder is “chronic skin-picking.” Everson v. Kijakazi, 2022 WL 3656462, at *3 (E.D. Wis. Aug. 25, 2022); K.C. v. Saul, 2021 WL 411391, at *3 (D. Kan. Feb. 5, 2021).
4 In February 2018, immediately after the alleged onset date, Clark was
transported by ambulance to the emergency department at St. Joseph’s Hospital in
Nashua, New Hampshire. Dr. Vatti Deepak noted that Clark had a long history of
psychiatric issues, including bipolar disorder and schizophrenia, and had prior
psychiatric admissions. During Dr. Deepak’s evaluation, Clark left the building
through the ambulance bay doors. Dr. Deepak notified security but concluded that
Clark was not a danger to himself or others.
Clark was hospitalized for a week in March 2018 for a psychiatric inpatient
admission after expressing homicidal and suicidal thoughts to his father and having
an encounter with the police. Dr. Alexander de Nesnera examined him and
diagnosed bipolar I in a manic episode with psychotic features and cannabis abuse
disorder. At discharge, Clark’s father agreed to bring him to follow-up
appointments. Clark was again admitted to New Hampshire Hospital in June 2018
for six days, where he was held in the locked secure psychiatric unit.
During the summer of 2018, Clark’s treating physician, Dr. Emad Milad,
changed his medications. Clark also underwent electroconvulsive therapy at
Dartmouth Hitchcock Clinic to treat depression. Nevertheless, Clark was
hospitalized for psychiatric issues four additional times between the end of June
2018 and July 2019.
After his last psychiatric hospitalization in July 2019, Clark received mental
health treatment through Greater Nashua Mental Health, which included
medication and therapy. He met with a therapist weekly and with a psychiatrist
5 monthly. He also met with a case manager and a nutritionist once a week. With
that treatment, Clark improved. His mental status examinations were mostly
normal, and he reported feeling stable. Clark experienced no serious manic episodes
that required hospitalization or additional treatment after July 2019.
II. Daily activities
Except for a brief unsuccessful period on his own, Clark has always lived with
his parents. At the time of the hearing on January 28, 2021, and for some time
before that, Clark worked part-time, ranging from 4-5 hours to 15 hours per week,
for a wholesale floral distributor where his mother worked. He cut flowers and
helped pack orders. Clark testified that he was able to do that work because the
employer was flexible and accommodated his needs to come in late and leave early
when necessary. He also testified that when he tried to work longer hours he would
experience stress that triggered a manic feeling, which caused him to become
belligerent and adversarial with his co-workers.
Clark completed high school. Other than his part time work with his mother
at the floral distributor, he has had no significant work experience. He has a
driver’s license and is able to drive. Treatment notes from Greater Nashua Mental
Health during 2020 show that at times Clark reported feeling better on the
medication regimen, going out to eat with friends, playing video games, taking a
trip to North Carolina to hike with friends, and trying some free online courses. At
other times, Clark was depressed and isolated at home.
6 III. Medical Opinions
A. John J. Warren, Ed.D.
Dr. Warren, a state agency consultant, completed a “Psychiatric Review
Technique” form evaluation of Clark’s psychiatric impairments on December 18,
2019, for purposes of his application for benefits.4 Based on his review of the
medical record, Dr. Warren found that Clark had medically determinable
impairments due to depressive and bipolar disorders and substance addiction
disorder. Doc. no. 4-3 at 7. He found that Clark had moderate limitations in
sustaining concentration and persistence and moderate limitations in his ability to
work with or near others. He also found that Clark could sustain the mental
demands of work that involved simple tasks over a workday and work week but
that he was moderately limited in his ability to interact with the public, get along
with coworkers, and accept criticism from supervisors.
B. Philip Robbins, Ph.D.
Clark was referred to state agency consultant psychologist, Dr. Robbins, for
an evaluation as part of his application for disability benefits. Dr. Robbins
evaluated Clark through telehealth technology on September 16, 2020. He noted
that Clark reported that he played video games all day and smoked marijuana
except when he worked on Sundays and Mondays. Based on his examination and
Clark’s records, Dr. Robbins diagnosed bipolar disorder type I, depression, ADHD,
4 The ALJ mistakenly identified Warren as Ph.D. in the decision. Doc. no. 4-2
at 25. Dr. Warren is an Ed.D.
7 generalized anxiety disorder, social anxiety disorder, excoriation disorder, and
cannabis abuse. He found that Clark was functioning fairly well and that he could
understand, remember, and apply information; could interact with others; and could
concentrate and maintain motivation and focus. Dr. Robbins conditioned those
findings, however, on Clark not experiencing a manic episode. He also noted that
while Clark was able to work part time, Clark was concerned that additional work
time would cause a manic episode.
C. Craig E. Stenslie, Ph.D.
For purposes of Clark’s request for reconsideration of the denial of his
application for benefits, another state agency psychologist, Dr. Stenslie, reviewed
Clark’s records and completed a “Psychiatric Review Technique” form on September
21, 2020. As part of the record, Dr. Stenslie considered Dr. Robbin’s evaluation of
Clark that was done on September 16, 2020, and found that Dr. Robbin’s opinion
was consistent with other medical evidence in the record. Dr. Stenslie also found
that Dr. Robbins’s opinion confirmed that Clark had improved. Dr. Stenslie found
that Clark has medically determinable mental disorders of bipolar disorder,
depressive disorder, and “related disorders.” Doc. no. 4-3 at 34. He found that
Clark had no limitations in understanding and memory, concentration and
persistence, and social interactions. He did find that Clark was moderately limited
in his ability to respond appropriately to changes in the work setting.
8 D. John Pelletier, Sc.D.
Dr. Pelletier, a clinical psychologist, completed an “APTD Medical Eligibility
Review Summary” form on September 20, 2019, for purposes of Clark’s application
to the New Hampshire Department of Health and Human Services for the APTD
(Aid to the Permanently and Totally Disabled Program).5 Dr. Pelletier noted that
Clark had impairments due to bipolar I disorder, cannabis use disorder, ADHD, and
excoriation disorder. He found that Clark had moderate limitations in some aspects
of sustaining concentration and persistence, social interaction, and adaptation. He
also found that Clark was not capable of basic unskilled work in a competitive labor
market, which made him eligible for the ADTP.
E. Marie Macedonia, Psy.D
Dr. Macedonia, who was one of Clark’s providers at the Greater Nashua
Mental Health Center, completed a “Mental Impairment – Medical Source
Statement” form on October 23, 2020. She indicated on the form that Clark would
be limited at least one third of the time or most of the time in completing daily
activities, concentrating, completing tasks, tolerating stress in a work environment,
maintaining attendance, accepting instructions and criticism, working with others,
adapting appropriately to changes in the work setting, performing at a consistent
pace, and adhering to standards of neatness and cleanliness. Dr. Macedonia wrote
that when Clark was not properly medicated he had had episodes of mania that
5 See www.nhcarepath.dhhs.nh.gov/partner-resources/documents/cb- 177b.pdf (last visited May 3, 2023).
9 lasted for weeks. She further explained that every manic episode was triggered by
work-related stress and that although medication has helped Clark was still
struggling. She expected that he would be absent more than four days per month
from work.
F. Marilou Patalinjug Tyner, M.D.
Dr. Tyner, who is a psychiatrist, also treated Clark at the Greater Nashua
Mental Health Center and completed a “Mental Impairment – Medical Source
Statement” on November 12, 2020. Dr. Tyner noted diagnoses of bipolar disorder I
and ADHD. In the area used for identifying signs and symptoms, Dr. Tyner wrote
that the symptoms she checked had been observed “without medication.” Doc. no.
4-13 at 1112. For functional limitations, Dr. Tyner found that Clark would be
limited at least a third of the time or most of the time in completing daily activities,
concentrating, tolerating work stresses, maintaining attendance, accepting
instructions and criticism, working with others, adapting appropriately to changes
in the work setting, completing a normal work day and week, performing at a
consistent pace, and adhering to standards of neatness and cleanliness.
In addition, Dr. Tyner wrote that Clark had had long periods of
decomposition in the past and that he would be absent from work about four days
per month. Dr. Tyner explained that work stress had caused Clark to experience
mania or depression that required periods of inpatient psychiatric treatment. She
further wrote that “even with adherence to meds, mood lability manifest. ADHD
further compromises ability to sustain work.” Doc. no. 4-13 at 1114.
10 G. Danielle Zimmerman
Danielle Zimmerman, who was Clark’s case manager at the Greater Nashua
Mental Health Center, completed a “Mental Impairment – Medical Source
Statement” form on January 14, 2021. Before assessing Clark’s limitations,
Zimmerman explained that Clark becomes fatigued when the stress in his life
increases, which requires him to reschedule appointments. She wrote that he needs
“significant supports to regulate his symptoms and diagnosis [and] needs frequent
reminders to attend weekly appts. and oftentimes still forgets during these periods
of stress.” Doc. no. 4-27 at 1461. She also wrote that Clark’s medication caused him
to be lethargic for five days after each monthly injection.
Zimmerman checked the following signs and symptoms: generalized
persistent anxiety, mood disturbance, difficulty thinking or concentrating, change in
personality, and emotional withdrawal or isolation. She found that he would be
limited for at least a third of the time in completing daily activities, maintaining
social functioning, understanding and remembering, completing tasks, tolerating
work stresses, and maintaining attendance. Zimmerman explained that at times
Clark was “unable to function during high periods of stress in his life” and that he
would “often isolate and disengage with any and all supports until the stressful
situations or periods pass.” Id. at 1465.
11 IV. Administrative Proceedings
The ALJ held a telephonic hearing on January 28, 2021. Clark was
represented by counsel and testified at the hearing. A vocational expert also
testified.
The ALJ posed this hypothetical question to the expert: a person who should
avoid social interaction with the general public, avoid tandem tasks and teamwork
with coworkers, who requires a low stress job with only one or two step tasks with
only minor changes in the routine, and who can only have brief and superficial
social interaction with a supervisor. The vocational expert identified several jobs
that met that hypothetical. When the ALJ added that the individual would be
absent one or more times per month or would come in late or need to leave early
weekly, the vocational expert testified that would preclude all jobs. If the person
would be off task more than 15% of the day, that too would preclude all jobs.
In the decision denying Clark’s application for benefits, the ALJ found that
Clark had a residual functional capacity to do all work as long as he avoided social
interaction with the general public, avoided tandem tasks and teamwork with
coworkers, was limited to brief and superficial social interaction with supervisors,
and was limited to working in a low stress environment with only one or two step
tasks and with only routine changes in the work routine. Based on that functional
capacity and the vocational expert’s testimony, the ALJ found that Clark could do
jobs as an industrial cleaner, a change house attendant, and a sweeper cleaner. The
ALJ concluded that Clark was not disabled. The Appeals Council denied Clark’s
12 request for review on July 21, 2022, making the ALJ’s decision the final decision of
the Acting Commissioner.
DISCUSSION
In support of his motion to reverse the Acting Commissioner’s decision, Clark
contends that the ALJ’s residual functional capacity assessment is not supported by
substantial evidence. He argues that the ALJ erred by accepting the state agency
consultants’ opinions and failing to incorporate limitations based on the opinions of
his treating sources and the examining state agency physician, Dr. Robbins. The
Acting Commissioner moves to affirm, arguing that the ALJ properly assessed the
medical opinions and that substantial evidence supports the ALJ’s residual
functional capacity assessment. For the reasons that follow, the decision is reversed
and the case is remanded for further proceedings.
I. Opinions Based on Incomplete Record
Clark contends that the ALJ erred in relying on the opinions provided by
state agency consultants Drs. Warren and Stenslie because they were issued before
significant additional evidence was available in the record. Specifically, Clark
states that Drs. Warren and Stenslie did not review treatment records from the
Greater Nashua Mental Health Center in later 2020 and early 2021 and
assessments done by Case Manager Zimmerman, treating psychiatrist Dr. Tyner,
13 treating psychologist Dr. Macedonia, and clinical psychologist Dr. Pelletier.6 The
Acting Commissioner contends that the ALJ properly relied on the consultants’
opinions to make the residual functional capacity assessment.
An opinion provided by a state agency reviewing consultant cannot provide
substantial evidence to support an ALJ's residual functional capacity assessment if
the opinion was based on a significantly incomplete record. Kimball, 2022 WL
2702819, at *7 (citing Giandomenico v. U.S. Soc. Sec. Admin., 2017 WL 5484657, at
*4 (D.N.H. Nov. 15. 2017)); see also Provencal v. Kijakazi, 2022 DNH 147, 2022 WL
17324286, at *3 (D.N.H. Nov. 29, 2022). “The reviewed record is significantly
incomplete if records added or generated after the review ‘would materially change
the basis for assessing the claimant's limitations.’” Provencal, 2022 WL 17324286,
at *3 (quoting Kimball, 2022 WL 2702819, at *9). In other words, review of a
partial record cannot provide substantial evidence to support a residual functional
capacity assessment “if later evidence supports the claimant’s limitations.” Randy
M. v. Kijakazi, 2021 WL 4551141, at *6 (D.R.I. Oct. 5, 2021).
“[I]t is the ALJ’s burden to determine and explain whether missing evidence
is material.” Motuzas v. Saul, 565 F. Supp. 3d 174, 189 (D.N.H. 2021). The ALJ
does not carry that burden by providing only a conclusory statement as to
materiality and the content of the new evidence. Id.; see also Gorman v. Saul, 2020
WL 502938, at *3 (D.N.H. Jan. 31, 2020). Instead, the ALJ must explain why new
6 Clark also cites the assessment done in 2015 by Dr. Vogel, but that
assessment predates Clark’s onset date by several years.
14 records and materials do not show any material change in the claimant’s
limitations. Motuzas, 565 F. Supp. 3d at 189-90.
In this case, the ALJ acknowledged that Drs. Warren and Stenslie did not
review Clark’s complete records. The ALJ stated that “they did not consider all of
the impairments of the claimant, including ADHD and anxiety.”7 Doc. no. 4-2 at 25.
The ALJ then stated that he found “the evidence reflects similar, although not the
same, mild to moderate functional limitations, with restriction from interaction
with the general public, and reduced interaction with coworkers and supervisors.”
Id. With that explanation, the ALJ apparently intended to convey that the
additional evidence was not material because, based on the ALJ’s lay interpretation
of the subsequent treatment notes and opinions the additional impairments can be
addressed by the cited restrictions.
The ALJ did not identify the other impairments, in addition to ADHD and
anxiety, that were diagnosed in the subsequent medical records, nor did he cite any
opinion that found only mild to moderate limitations with the addition of the
restrictions he articulated. The ALJ also did not explain how he determined that
7 The ALJ is mistaken that Dr. Stenslie did not have an opportunity to assess
impairments based on ADHD and anxiety. Dr. Robbins diagnosed both ADHD and anxiety, along with other impairments, in the medical statement that Dr. Stenslie reviewed for purposes of his opinion. Dr. Stenslie quoted Dr. Robbins’s diagnosis in his review of Clark’s records but did not include all of the impairments in his own diagnosis and did not explain why his diagnosis was different. Dr. Stenslie also did not address Dr. Robbins’s comments about the effects a manic episode would have on Clark’s ability to function. It appears that Dr. Stenslie may have overlooked the additional impairments that Dr. Robbins found and the additional functional limitations.
15 those restrictions (restrictions from interaction with the general public and reduced
interaction with coworkers) would accommodate Clark’s functional impairments
due to ADHD and anxiety or any other impairments. The ALJ stated that the more
recent treatment notes were consistent with no more than moderate functional
limitations and an ability to work in a low stress environment because the
treatment notes showed “improvement in symptoms and stability and treatment,
and mostly normal mental status exams, with intact memory, judgment and
insight.” Id.
The cited treatment records, however, document variations in Clark’s mental
health and functioning during the period with some improvement noted but also
increased symptoms of depression, anxiety, and isolation at other appointments.
Dr. Macedonia wrote that proper medication had provided some relief for Clark’s
symptoms, that his decomposition episodes of mania were triggered by work, and
that despite proper medication, Clark was still struggling. Importantly, Clark’s
treating sources, his case manager, his psychiatrist, and his psychologist, all
provided opinions that Clark’s ability to function was significantly restricted by his
impairments, including ADHD and anxiety, and that he would be absent from work
a significant amount of time. Drs. Warren and Stenslie did not have the benefit of
those opinions.
The ALJ’s brief, conclusory, and somewhat inaccurate explanation of the
record is not sufficient to carry the ALJ’s burden to show that the new parts of the
treatment record were not material. Instead, the opinions provided by Clark’s
16 treating sources document more limited functional ability and support his
limitations.
The ALJ found the treating source opinions unpersuasive for a variety of
reasons, including the use of a check-off form. Drs. Warren and Stenslie, however,
each used a “Psychiatric Review Technique” form. For purposes of the functional
capacity assessment, they provided only two-or-three-word answers, such as
“Moderately limited” and “Not significantly limited.” The forms used by the
treating sources are no more abbreviated and, in contrast, the treating sources
wrote narrative explanations in some parts of the form. Therefore, that basis for
finding the opinions unpersuasive lacks support in the record.
The ALJ noted that the treating sources did not record side effects caused by
Clark’s medications. Although not addressed specifically, that reference apparently
suggests that Clark was not experiencing fatigue from medication that would cause
absences from work. To the extent the ALJ intended to counter the findings about
absenteeism in the opinions, that point is made tangentially at best and does not
support the finding of no absenteeism.
The ALJ stated that it was unclear whether Dr. Macedonia’s opinion was
addressing limitations with or without medication, but he did not request
clarification. Contrary to the ALJ’s assessment, Dr. Macedonia clearly indicated
that she answered questions about decomposition in the context of Clark not being
medicated and explained the effect medication has had. Therefore, Dr. Macedonia’s
opinion was not unclear.
17 The ALJ stated as to each opinion that the severity of functional limitations
found was not consistent with the treatment records. As is discussed above, the
treatment records do not document the consistent improvement and normal results
that the ALJ describes. Given the differences in the opinions and the complex
record, this case would seem to have been an appropriate opportunity for an
independent expert medical opinion. See 20 C.F.R. § 404.1513a(b)(2).
In the absence of an adequate explanation, the ALJ erred in relying on the
opinions provided by Drs. Warren and Stenslie that were not based on a complete
record.
II. Residual Functional Capacity Assessment
A claimant’s residual functional capacity is the most a clamant can do despite
the functional limitations caused by his impairments. 20 C.F.R. § 404.1545(a)(1).
Based on his assessment of the record, including the opinion evidence, the ALJ
found that Clark could
perform a full range of work at all exertional levels but with the following nonexertional limitations: the claimant should avoid social interaction with the general public; should avoid tandem tasks and team work with coworkers; is limited to brief and superficial social interaction with supervisors; and is limited to working in a low stress environment (defined as performing only simple 1-2 step tasks with only minor changes in work the work routine).
Doc. no. 4-2 at 21. The ALJ used that assessment in questioning the vocational
expert about jobs that would be available for Clark to do. When the ALJ added that
the claimant would be absent from work more than once per month, would come in
18 late or leave early once each week, or would be off task more than 15% of the work
day, the vocational expert answered that those restrictions would preclude all jobs.
Because Drs. Warren and Stenslie did not review the more recent treatment
records and opinions, their opinions cannot provide substantial evidence to support
the ALJ’s residual functional capacity assessment. Dr. Tyner, Dr. Macedonia, and
Case Manager Zimmerman all found that Clark’s ability to function was
significantly more limited than the ALJ’s residual functional capacity assessment.
Further, they found that Clark would regularly be absent from work, which would
preclude the jobs the vocational expert testified to.
Because substantial evidence is lacking to support the residual functional
capacity assessment, the hypothetical question posed to the vocational expert did
not accurately reflect Clark’s limitations. “For a vocational expert’s opinion to
constitute substantial evidence, the testimony regarding an individual’s ability to
perform jobs in the national economy must come in response to a hypothetical
question that accurately describes the claimant’s impairments.” Conrad v. Kijakazi,
21-cv-10788-IT, 2023 WL 2743306, at *13 (D. Mass. Mar. 31, 2023) (citing Arocho v.
Sec’y of Health & Human Servs., 670 F.2d 374, 375 (1st Cir. 1982)). Therefore,
substantial evidence is lacking to support the ALJ’s finding that Clark was not
disabled based on the vocational expert’s testimony.
19 CONCLUSION
For the foregoing reasons, the claimant’s motion to reverse and remand (doc.
no. 5) is granted. The Acting Commissioner’s motion to affirm (doc. no. 8) is denied.
The Acting Commissioner’s decision is reversed and remanded for further
administrative proceedings pursuant to Sentence Four of § 405(g). The clerk of
court shall enter judgment accordingly and close the case.
SO ORDERED.
______________________________ Landya B. McCafferty United States District Judge May 10, 2023
cc: Counsel of record.