Gainous v. Saul

CourtDistrict Court, S.D. New York
DecidedOctober 18, 2021
Docket1:19-cv-10599-BCM
StatusUnknown

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

Bluebook
Gainous v. Saul, (S.D.N.Y. 2021).

Opinion

| USDC SDNY UNITED STATES DISTRICT COURT DOCUMENT SOUTHERN DISTRICT OF NEW YORK | ELECTRONICALLY FILED JOSHUA GAINOUS, DOC *—____—— DATE FILED: Plaintiff, 19-CV-10599 (BCM) Sana -against- OPINION AND ORDER COMMISSIONER OF SOCIAL SECURITY, Defendant. BARBARA MOSES, United States Magistrate Judge. Plaintiff Joshua Gainous filed this action pursuant to § 205(g) of the Social Security Act, 42 US.C. § 405(g), seeking judicial review of a final determination of the Commissioner of Social Security (Commissioner) denying his application for Supplemental Security Income (SSI). Now before me are the parties' cross-motions for judgment on the pleadings. For the reasons that follow, plaintiffs motion (Dkt. No. 16) will be granted, the Commissioner's motion (Dkt. No. 18) will be denied, and the case will be remanded for further proceedings. Background Plaintiff has a long history of mental health impairments and received SSI benefits as a child. See Certified Administrative Record (Dkt. No. 14) (hereinafter "R. __") at 130. When he attained age 18 on January 6, 2015, the Commissioner initiated an age 18 redetermination to review his eligibility for continued benefits. (R. 129.)! The Social Security Administration found that plaintiff was no longer disabled as of July 27, 2015. (R. 129-30.) On August 11, 2015, plaintiff

' An individual who receives SSI as a child must, upon attaining age 18, have his or her disability re-determined. 42 U.S.C. § 1382c(a)(3)(H)(iii); 20 C.F.R. § 416.987. The redetermination is governed by 20 C.F.R. § 416.920(c)-(h); that is, by the same multi-step process that applies to new adult disability applications except that the first step — determining whether the applicant engaged in "substantial gainful activity" — is not used for redetermining disability at age 18. See 20 C.F.R. § 416.987(b).

requested reconsideration of that determination (R. 142), but on March 11, 2016, after a disability hearing during which plaintiff "wept through most of the interview" and "appeared very depressed" (R. 151), reconsideration was denied. (R. 143, 154-55.) On April 13, 2016, plaintiff requested a hearing before an administrative law judge (ALJ)

(R. 161-64), and on April 11, 2018, plaintiff and a non-attorney representative appeared at a video hearing before ALJ Flor M. Suarez. (R. 58-106.) Board-certified psychiatrist Rita Clark, M.D., appearing as a medical expert (ME), also testified. (R. 97-101.) Dr. Clark opined that plaintiff met the criteria of Listing 12.05 (intellectual disorder).2 In so concluding, she relied, in part, on the results of a recent consultative examination in which plaintiff was assessed "with a very low IQ – a full scale IQ of 48," thus meeting the criteria of paragraph B(1) of Listing 12.05. (R. 99.) Additionally, Dr. Clark explained, plaintiff "has marked problem[s] in dealing with people because

2 See 20 C.F.R. Pt. 404, subpt. P, app'x 1 § 12.05. Listing 12.05 has two paragraphs, designated A and B, either of which will satisfy the Listing. Id. To meet the criteria of paragraph B of Listing 12.05, the claimant must have: 1. "Significantly subaverage general intellectual functioning evidenced by" either a "full scale (or comparable) IQ score of 70 or below on an individually administered standardized test of general intelligence" or a score of 71-75 accompanied by a verbal or performance IQ score of 70 or below; 2. "Significant deficits in adaptive functioning currently manifested by extreme limitation of one, or marked limitation of two" of the following areas of mental functioning: a. Understand, remember, or apply information; b. Interact with others; c. Concentrate, persist, or maintain pace; d. Adapt or manage oneself; and 3. "The evidence about [the claimant's] current intellectual and adaptive functioning and about the history of [his] disorder demonstrates or supports the conclusion that the disorder began prior to [his] attainment of age 22." Id. § 12.05(B)(1)-(3). See generally Bushey v. Berryhill, 739 F. App'x 668, 672 (2d Cir. 2018) (quoting Talavera v. Astrue, 697 F.3d 145, 152 (2d Cir. 2012)); Rivera v. Comm'r of the Soc. Sec. Admin., 2020 WL 8167136, at *19-20 (S.D.N.Y. Dec. 30, 2020), report and recommendation adopted sub nom. Rivera v. Comm'r of Soc. Sec. Admin., 2021 WL 134945 (S.D.N.Y. Jan. 14, 2021). he gets into fights and gets angry a lot of the time and [is] socially isolated and withdrawn and he certainly cannot adapt and manage himself," leading her to conclude that plaintiff had a "marked" limitation "in all criteria" under paragraph B(2) of Listing 12.05. (R. 100-01.)3 The ALJ thereupon concluded the hearing without calling a vocational expert (VE). (R. 101-02.) However, on July 17,

2018, the ALJ held a supplemental hearing, at which plaintiff again appeared and testified, as did VE Gerald D. Belchick. (R. 1099-1140.) The ALJ's Decision On September 4, 2018, the ALJ issued an unfavorable decision (Decision) (R. 17-27) concluding, again, that plaintiff's disability ended on July 27, 2015. (R. 17.) At step two of the analysis mandated by 20 C.F.R. § 416.920(c)-(h), the ALJ found that plaintiff's learning disability, depression, anxiety disorder, post-traumatic stress disorder (PTSD) and asthma were "severe" impairments. (R. 19.) However, at step three, the ALJ found that none of them, individually or in combination, met or equaled the severity of any Listing. (R. 20-21.) At this step, the ALJ considered Listings 12.04 (depressive disorders), 12.06 (anxiety disorders), 12.11

(neurodevelopmental disorders), and 12.15 (trauma- and stressor-related disorders), but did not expressly discuss Listing 12.05. Nor did she discuss Listing 12.10 (autism spectrum disorders), although plaintiff was diagnosed with autism at age 14 and his special education plan in high school was based in part on that diagnosis. (R. 22, 24, 386-96, 405-09.) As to the Listings she did discuss, the ALJ found that plaintiff did not satisfy the applicable paragraph B criteria; that is, the requirement that the impairments "result in at least one extreme

3 Since plaintiff was under the age of 22 at the time of the hearing, paragraph B(3) of Listing 12.05 was not in issue. or two marked limitations" among the four broad areas of functioning assessed. (R. 20.)4 Specifically, the ALJ found that plaintiff had moderate limitations in understanding, remembering, or applying information (id.); mild limitations in interacting with others (id.); moderate limitations in concentrating, persisting, or maintaining pace (R. 21); and moderate limitations in adapting or

managing himself. (Id.) The ALJ concluded that "[b]ecause the Claimant's mental impairments do not cause at least two 'marked' limitations or one 'extreme' limitation, the 'paragraph B' criteria are not satisfied." (Id.) She also found that the paragraph C criteria applicable to Listings 12.04, 12.06, and 12.15 were not satisfied, because "the evidence fails to establish that that there have been changes or increased demands that have led to the exacerbation of symptoms and signs, and deterioration of functioning." (Id.)5 Before proceeding to step four, the ALJ found plaintiff had the residual functional capacity (RFC) to perform medium work, as defined in 20 C.F.R.

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Related

Burgess v. Astrue
537 F.3d 117 (Second Circuit, 2008)
Talavera v. Comm’r of Social Security
697 F.3d 145 (Second Circuit, 2012)
Selian v. Astrue
708 F.3d 409 (Second Circuit, 2013)
Mejia v. Barnhart
261 F. Supp. 2d 142 (E.D. New York, 2003)
Estrella v. Berryhill
925 F.3d 90 (Second Circuit, 2019)
Sweet v. Astrue
32 F. Supp. 3d 303 (N.D. New York, 2012)
Harris v. Colvin
149 F. Supp. 3d 435 (W.D. New York, 2016)
Greek v. Colvin
802 F.3d 370 (Second Circuit, 2015)

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Bluebook (online)
Gainous v. Saul, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gainous-v-saul-nysd-2021.