Ervolina v. Commissioner of Social Security

CourtDistrict Court, W.D. New York
DecidedMarch 22, 2021
Docket1:19-cv-01344
StatusUnknown

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

Bluebook
Ervolina v. Commissioner of Social Security, (W.D.N.Y. 2021).

Opinion

UNITED STATES DISTRICT COURT WESTERN DISTRICT OF NEW YORK

MICHAEL E.,1

Plaintiff,

v. 19-CV-1344-LJV DECISION & ORDER COMMISSIONER OF SOCIAL SECURITY,

Defendant.

On October 2, 2019, the plaintiff, Michael E. (“Michael”), brought this action under the Social Security Act. He seeks review of the determination by the Commissioner of Social Security (“Commissioner”) that he was not disabled. Docket Item 1. On May 20, 2020, Michael moved for judgment on the pleadings, Docket Item 16; on August 13, 2020, the Commissioner responded and cross-moved for judgment on the pleadings, Docket Item 19; and on September 3, 2020, Michael replied, Docket Item 20. For the reasons stated below, this Court grants Michael’s motion in part and denies the Commissioner’s cross-motion.2

1 To protect the privacy interests of social security litigants while maintaining public access to judicial records, this Court will identify any non-government party in cases filed under 42 U.S.C. § 405(g) only by first name and last initial. Standing Order, Identification of Non-government Parties in Social Security Opinions (W.D.N.Y. Nov. 18, 2020). 2 This Court assumes familiarity with the underlying facts, the procedural history, and the ALJ’s decision and will refer only to the facts necessary to explain its decision. STANDARD OF REVIEW

“The scope of review of a disability determination . . . involves two levels of inquiry.” Johnson v. Bowen, 817 F.2d 983, 985 (2d Cir. 1987). The court “must first decide whether [the Commissioner] applied the correct legal principles in making the determination.” Id. This includes ensuring “that the claimant has had a full hearing under the . . . regulations and in accordance with the beneficent purposes of the Social Security Act.” Moran v. Astrue, 569 F.3d 108, 112 (2d Cir. 2009) (quoting Cruz v. Sullivan, 912 F.2d 8, 11 (2d Cir. 1990)). Then, the court “decide[s] whether the determination is supported by ‘substantial evidence.’” Johnson, 817 F.2d at 985 (quoting 42 U.S.C. § 405(g)). “Substantial evidence” means “more than a mere scintilla.

It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting Consol. Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)). “Where there is a reasonable basis for doubt whether the [Administrative Law Judge (“ALJ”)] applied correct legal principles, application of the substantial evidence standard to uphold a finding of no disability creates an unacceptable risk that a claimant will be deprived of the right to have her disability determination made according to correct legal principles.” Johnson, 817 F.2d at 986.

DISCUSSION Michael argues that the ALJ erred in determining his residual functional capacity (“RFC”) by relying on her own lay judgment and not the judgment of a medical professional. Docket Item 16-1. This Court agrees that the ALJ erred and, because that error was to Michael’s prejudice, remands the matter to the Commissioner.

I. TREATING PHYSICIAN RULE When determining a claimant’s RFC, an ALJ must “weigh and evaluate” every medical opinion received. Wider v. Colvin, 245 F. Supp. 3d 381, 388 (E.D.N.Y. 2017) (citing 20 C.F.R. § 416.927(c)). That includes evidence from outside the disability period if that evidence relates to the relevant time frame. See, e.g., Hartfiel v. Apfel, 192 F. Supp. 2d 41, 44 (W.D.N.Y 2001) (considering treating physician’s diagnoses of disability that postdated insured status). An ALJ generally should give greater weight to the medical opinions of treating sources—physicians, psychologists, optometrists,

podiatrists, and qualified speech-language pathologists who have “ongoing treatment relationship[s]” with the claimant—because those medical professionals are in the best positions to provide “detailed, longitudinal picture[s] of [the claimant’s] medical impairments.” See 20 C.F.R. §§ 404.1527(a)(2), (c)(2); see also Genier v. Astrue, 298 F. App’x 105, 108 (2d Cir. 2008) (summary order). In fact, a treating physician’s opinion is entitled to controlling weight so long as it is “well-supported [sic] by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in [the claimant’s] case record.” 20 C.F.R. § 404.1527(c)(2). If an ALJ gives less-than-controlling weight to a treating source’s opinion, she must “explicitly consider, inter alia: (1) the frequency, length, nature, and extent of

treatment; (2) the amount of medical evidence supporting the opinion; (3) the consistency of the opinion with the remaining medical evidence; and[] (4) whether the physician is a specialist.” Greek v. Colvin, 802 F.3d 370, 375 (2d Cir. 2015) (quotations and alterations omitted). These are the so-called “Burgess factors” from Burgess v. Astrue, 537 F.3d 117 (2d Cir. 2008). Estrella v. Berryhill, 925 F.3d 90, 95 (2d Cir. 2019). “An ALJ’s failure to ‘explicitly’ apply the Burgess factors when assigning weight” to a treating source opinion “is a procedural error.” Id. at 96 (quoting Selian v. Astrue, 708 F.3d 409, 418 (2d Cir. 2013) (per curiam)).

The ALJ here discussed—but did not assign any specific weight to—the opinions of Michael’s treating physicians, Eugene J. Gosy, M.D., and Bernard Beaupin, M.D. See Docket Item 10 at 21-22. Therefore, this Court does not know whether the ALJ accepted their opinions; rejected part or all of their opinions; discounted part or all of their opinions; or did something else entirely. For that reason, the ALJ erred. See Wider, 245 F. Supp. 3d at 388 (“Under 20 C.F.R. § 416.927 ALJs are required to weigh and evaluate ‘every medical opinion.’”). Moreover, if the ALJ gave anything other than controlling weight to their opinions, she was required to “explicitly” discuss the Burgess factors before doing so and the failure to do that was an error as well. See Greek, 802

F.3d at 375. Indeed, it appears that is exactly what happened here. The ALJ said that “the persuasive value and relevance of [Dr. Gosy’s and Dr. Beaupin’s] opinions . . . must be carefully assessed because” those opinions were rendered in the context of Michael’s workers compensation claim. Docket Item 10 at 22. But despite purporting to “consider[ Dr. Gosy’s and Dr.

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Related

Burgess v. Astrue
537 F.3d 117 (Second Circuit, 2008)
Richardson v. Perales
402 U.S. 389 (Supreme Court, 1971)
Watkins v. Barnhart
350 F.3d 1297 (Tenth Circuit, 2003)
Selian v. Astrue
708 F.3d 409 (Second Circuit, 2013)
Tankisi v. Commissioner of Social Security
521 F. App'x 29 (Second Circuit, 2013)
Moran v. Astrue
569 F.3d 108 (Second Circuit, 2009)
Zabala v. Astrue
595 F.3d 402 (Second Circuit, 2010)
HARTFIEL v. Apfel
192 F. Supp. 2d 41 (W.D. New York, 2001)
Estrella v. Berryhill
925 F.3d 90 (Second Circuit, 2019)
Wider v. Colvin
245 F. Supp. 3d 381 (E.D. New York, 2017)
Greek v. Colvin
802 F.3d 370 (Second Circuit, 2015)
Genier v. Astrue
298 F. App'x 105 (Second Circuit, 2008)

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Bluebook (online)
Ervolina v. Commissioner of Social Security, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ervolina-v-commissioner-of-social-security-nywd-2021.