Ramirez v. Comm Social Security

• Court: Court of Appeals for the Third Circuit
• Decided: June 18, 2004
• Docket: 03-3313
• Status: Published

Opinion

Opinions of the United 2004 Decisions States Court of Appeals for the Third Circuit

6-18-2004

Ramirez v. Comm Social Security Precedential or Non-Precedential: Precedential

Docket No. 03-3313

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Recommended Citation "Ramirez v. Comm Social Security" (2004). 2004 Decisions. Paper 545. http://digitalcommons.law.villanova.edu/thirdcircuit_2004/545

This decision is brought to you for free and open access by the Opinions of the United States Court of Appeals for the Third Circuit at Villanova University School of Law Digital Repository. It has been accepted for inclusion in 2004 Decisions by an authorized administrator of Villanova University School of Law Digital Repository. For more information, please contact Benjamin.Carlson@law.villanova.edu. PRECEDENTIAL Thomas D. Sutton (argued) Leventhal & Sutton UNITED STATES COURT OF One Oxford Valley APPEALS FOR THE THIRD CIRCUIT Suite 317 __________ Langhorne, PA 19047

No. 03-3313 Attorney for Appellant __________ David F. Chermol (argued) Social Security Administration ELIZABETH RAMIREZ OGC/Region III P.O. Box 41777 Appellant, Philadelphia, PA 19101 v. Attorney for Appellee JOANNE B. BARNHART, Commissioner of Social Security __________ Administration. OPINION __________ __________

On Appeal from the United States Garth, Circuit Judge: District Court for the Eastern District of Pennsylvania Elizabeth Ramirez appeals from (Civil Action No. 02-cv-02696) an Order of the United States District District Judge: Hon. Eduardo C. Robreno Court for the Eastern District of __________ Pennsylvania affirming the decision of the Commissioner of Social Security. Argued April 20, 2004 The Commissioner had denied Ramirez’s ___________ claims for Supplemental Security Income (“SSI”) under Title XVI of the Social Security Act (the “Act”). 42 U.S.C. Before: SCIRICA, Chief Judge, §§ 1381-1383(f). On appeal, Ramirez GARTH, and BRIGHT, * Circuit Judges contends, as she did in the District Court, that the hypothetical question posed by (Opinion Filed June 18, 2004) the Administrative Law Judge (“ALJ”) to the vocational expert failed to accurately convey all of Ramirez’s limitations, and that the Commissioner’s ensuing * Honorable Myron H. Bright, United decision is, therefore, not supported by States Court of Appeals for the Eighth substantial evidence. The District Court Circuit, sitting by designation. affirmed the ALJ’s decision and Ramirez timely appealed to this Court. For the varying degrees of success. reasons set forth below, we vacate the In December 1996, Ramirez District Court’s order and remand for stopped seeing Dr. Park. She did not further proceedings before the ALJ. resume mental health treatment until I. September 1998. At the request of her attorney, however, she underwent a A. Early Procedural History comprehensive psychological evaluation Ramirez is a 47-year-old divorced by Dr. Craig Weiss in April 1997. Dr. mother of two children with no significant Weiss concluded that Ramirez had an work experience. In August 1994, she “Anxiety Disorder . . . with significant applied for disability insurance benefits symptoms of depression, social phobia, and SSI under the Act, claiming that she o b se ss iv e -c o m pu l s iv e , a n d m o o d was disabled by asthma, bad nerves and a incongruent hallucinations.” thyroid condition. Six months later, she (Administrative Record (“A.R.”) at 303.) began receiving mental health treatment With respect to “functional limitations,” for an anxiety disorder. Dr. Weiss opined that Ramirez (1) had moderate restriction in activities of daily After the Commissioner denied living, (2) had marked to extreme Ramirez’s application initially and on difficulties in m aintain ing so cial reconsideration, she requested a hearing functioning, (3) experienced frequent before an ALJ. At Ramirez’s request, the deficiencies of concentration, and (4) ALJ dismissed Ramirez’s claim for continually experienced episodes of disability benefits. The ALJ denied deterioration. Ramirez’s remaining claim for SSI, finding that Ramirez was not disabled by Almost two years earlier, in 1995, her physical or mental impairments. The Dr. Louis Poloni, a state agency SSA Appeals Council subsequently psychologist, had completed a Psychiatric vacated the ALJ’s decision and remanded Review Technique Form (“PRTF”) on with instructions to explain certain which he had also assessed Ramirez’s findings and take additional evidence on mental impairments in four broad areas of Ramirez’s mental impairments. mental functioning. Dr. Poloni concluded that Ramirez: (1) had no restriction in B. Ramirez’s M ental Health activities of daily living, (2) had slight Treatment/Evaluation diffic ulties in ma intainin g soc ial Ramirez first sought mental health functioning, (3) often experienced treatment in February 1995 from Dr. H.H. deficiencies of concentration, persistence, Park, who diagnosed her with generalized or pace, and (4) never experienced anxiety disorder with depression. Over the e p i s o d e s o f deterio r a t io n o r next twenty-two months, Dr. Park decompensation in work-like settings. prescribed various medications with Based on those findings, Dr. Poloni

-2- concluded that Ramirez had a severe C. Procedural History After Remand anxiety disorder, but that Ramirez’s Following the remand by the SSA condition did not meet or equal any of the Appeals Council, the ALJ held a second mental impairments deemed by the SSA to hearing. The ALJ considered, among other be presumptively disabling. Consequently, things, all of the evidence described above Dr. Poloni proceeded to complete a Mental concerning Ramirez’s mental impairments. Residual Functional Capacity (“MRFC”) Near the conclusion of the second hearing form, which is meant to assess a claimant’s on remand, the ALJ posed the following ability to perform either the claimant’s hypothetical question to vocational expert previous work or other work in the Julie Stratton: national economy. Dr. Poloni determined that Ramirez could perform simple, routine I will begin by asking you to unskilled work. assume that we’re talking about an individual of Ms. Ramirez’s mental functioning was Ramirez’s age, education also in 1998 assessed by Dr. Herman and prior work history. And Rudnick, a Board certified psychiatrist. I’d like you to further Dr. Rudnick concluded that Ramirez assume that this individual’s suffered from anxiety-related and capable of performing a personality disorders. As to the four broad range of sedentary work. areas of mental functioning, Dr. Rudnick The wor k should be found that Ramirez (1) had only pe r f or me d in a we ll moderately limited daily activities, (2) had ventilated facility, with no moderately limited social functioning, (3) exposure to dust, fumes, often experienced deficiencies of pets, animals, chemicals, or concentration, persistence, or pace, (4) and temperature extremes. The did not experience any episodes of work should provide for deterioration or decompensation. Like Dr. occasional breaks, for the Poloni before him, Dr. Rudnick found that individual use of an inhaler Ramirez’s mental impairments did not or pump. The work should meet or equal the criteria of a listed involve simple one to two impairment. As to Ramirez’s residual step tasks. The work should functional capacity, Dr. Rudnick opined not require the individual that Ramirez could not perform complex during the course of or complicated work and would need to be performing the work to able to contact her home from work, but travel outside of th e that there was no need to limit Ramirez’s workplace. And . . . the interaction with the public or with co- work setting should provide workers. reasonable opportunity for the individual to make and

-3- receive personal phone mentioned this particular limitation. calls. Within the boundaries Ramirez appealed the ALJ’s of these limitations, . . . are decision, but the Appeals Council declined there jobs in the regional or to grant review. Ramirez then challenged national economy that the the ALJ’s ruling in the United States individual could perform? District Court for the District of Eastern (A.R. at 457-58.) It is significant that Pennsylvania, where Ramirez and the neither Dr. Weiss’s evaluation nor his Commissioner filed cross-motions for conclusions found expression in the summary judgment. The District Court hypothetical. referred the cross-motions to a Magistrate Judge for a Report and Recommendation. The purpose of the hypothetical was to assess Ramirez’s residual functional Although Ramirez made a number capacity. Stratton responded that, of claims, one of her primary arguments notwithstanding the limitations contained was that the ALJ had failed to include in in the hypothetical, there were several jobs her hypothetical the finding she had made in the local and national economy that the on the PRTF that Ramirez often suffered hypothetical claimant could perform, deficiencies in concentration, persistence, including assembler, hand packer, and or pace. The Magistrate Judge rejected all production inspector. of Ramirez’s arguments except for the PRTF argument, finding that it was “not The ALJ then issued a written clear whether a limitation in concentration, decision in which she determined that persistence or pace within the hypothetical Ramirez was not disabled and therefore . . . would have changed the vocational she again denied Ramirez’s application for expert’s response.” The Magistrate Judge SSI. In reaching her decision, the ALJ recommended that the District Court relied heavily on Stratton’s testimony. remand to the ALJ to allow for further The ALJ attached to her written testimony by a vocational expert. decision a completed PRTF, as she was The Commissioner objected only to required to do under the then-existing the Magistrate Judge’s finding that the Social Security Regulations. In a section ALJ’s hypothetical was deficient. The of the PRTF entitled, “Functional District Court adopted those portions of Limitation and Degree of Limitation,” the the Magistrate’s Report to which no ALJ noted tha t Ramirez “often” objection was raised, but disapproved that experienced “deficiencies o f portion of the Magistrate Judge’s Report concentration, persistence, or pace which found the ALJ’s hypothetical to be resulting in a failure to complete tasks in a defective. The District Court explained timely manner (in work settings or that “the standards articulated by the Third elsewhere).” (Appendix at 93.) The Circuit do not mandate that the ALJ ALJ’s hypothetical, however, had not

-4- articulate verbatim to the vocational expert A. Administrative Framework the findings recorded on the PRTF form” Under the Act, a person who has a and proceeded to find that the limitations “disability” is entitled to SSI payments the ALJ had included in her hypothetical from the Social Security Administration “accurately reflect[ed] the evidence (“SSA”). The Act defines “disability” as contained in the record.” (Appendix at 20, the “inability to engage in any substantial 23.) Accordingly, the District Court gainful activity by reason of any medically entered summary judgment for the determ inable physical or m enta l Commissioner. impairment which can be expected to Ramirez now appeals from the result in death or which has lasted or can District Court’s Order. Ramirez contends be expected to last for a continuous period that (a) the ALJ’s hypothetical did not of not less than 12 months.” 42 U.S.C. adequately incorporate the PRTF finding § 423(d)(1)(A). The definition is concerning Ramirez’s deficiencies in qualified, however, as follows: concentration, persistence, or pace; and (b) An individual shall be the ALJ improperly made adverse determined to be under a credibility findings. disability only if his physical II. or mental impairment or impairment are of such We have jurisdiction to hear this severity that he is not only appeal pursuant to 28 U.S.C. § 1291. We unable to do his previous may reverse the District Court’s grant of work but cannot, summary judgment to the Commissioner c o n s i d e r i n g h i s a g e, only if the ALJ’s findings were not educ ation, and work supported by “substantial evidence.” experience, engage in any Burns v. Barnhart, 312 F.3d 113, 118 (3d other kind of substantial Cir. 2002). If, however, an ALJ poses a gainful work which exists in hypothetical question to a vocational the national economy. expert that fails to reflect “all of a claimant’s impairments that are supported 42 U.S.C. § 423(d)(2)(A). A person by the record[,] . . . it cannot be considered seeking SSI may allege that they have substantial evidence.” Chrupcala v. disabling physical impairments, mental Heckler, 829 F.2d 1269, 1276 (3d Cir. impairments, or both. 1987). Acting pursuant to its rulemaking III. authority, the SSA has promulgated regulations establishing a five-step We consider first Ramirez’s sequential evaluation process to determine argument that the ALJ’s hypothetical was if a claimant has a disability. 20 C.F.R. § deficient. 404.1520 (2003). At step one, the SSA

-5- will find that a claimant is not disabled 416.960(c). Unlike some of the earlier unless he demonstrates that he is not stages in the evaluation process, the working at a “substantial gainful activity.” burden of proof at step five is on the 20 C.F.R. §§ 404.1520(b), 416.920(b). At agency. Here, Ramirez was found able to step two, the SSA will find no disability perform other jobs. unless the claimant shows that he has a B. Evaluating Mental Impairments “severe impairment,” defined as “any impairment or combination of impairments In 1985, the SSA issued revised which significantly limits [the claimant’s] regulations to evaluate individuals who physical or mental ability to do basic work claimed to be disabled as a result of a activities.” 20 C.F.R. §§ 404.1520(c), mental impairment. 20 C.F.R. § 416.920a 416.920(c). If the claimant successfully (1999). The revised regulations demonstrates that he has a severe implemented a new technique that required impairment, the SSA determines at step the SSA to evaluate a claimant’s mental three whether the impairment is on a list of impairments in four broad areas of impairments presumed severe enough by functioning: (1) activities of daily living, the SSA to render one disabled; if so, the (2) social functioning, (3) concentration, claimant qualifies. 20 C.F.R. §§ persistence, or pace, and (4) deterioration 404.1520(d), 416.920(d). If, however, the or decompensation in work or work-like claimant’s impairment is not on the list, settings. 20 C.F.R. § 416.920a (1999). the inquiry proceeds to step four and the The third functional area—which is of the SSA assesses whether the claimant has the most concern in this appeal—was rated on “residual functional capacity” to perform a five point scale of never, seldom, often, his previous work. Unless he shows that frequent, and constant. 20 C.F.R. § he cannot, he is determined not to be 416.920a(b)(3) (1999). disabled.1 If the claimant survives step Under the revised regulations, the four, the fifth step requires the SSA to adjudicator applied the new technique by consider “vocation al factors” (the completing a form known as the claimant’s age, education, and past work Psychiatric Review Technique Form experience) and to determine whether the (PRTF). 20 C.F.R. § 416.920a(d) (1999). claimant is capable of performing other Based on the adjudicator’s findings on the jobs existing in significant numbers in the PRTF with respect to these four areas of national economy. 20 C.F.R. §§ functioning, he would determine at step 404.1520(f), 404.1560(c), 416.920(f), two of the sequential evaluation process if the claimant had a “severe mental impairment.” 20 C.F.R. § 416.920a(c)(1) 1 Residual functional capacity is (1999). If so, the adjudicator would defined as “what a [claimant] can still do proceed to the third step and determine if despite his limitations.” 20 C.F.R. § the claimant’s impairment met or equaled 416.945(a).

-6- one of the impairments found on the list of evaluation process requires impairments presumed severe enough to a more detailed assessment render a person disabled. 20 C.F.R. by itemizin g var ious § 416.920a(c)(2) (1999). functions contained in the broad categories found in In 1996, the SSA issued Social paragraphs B and C of the Security Ruling 96-8p “[t]o state the adult mental disorders [SSA]’s policies and policy interpretations listings in 12.00 of the regarding the assessment of residual Listing of Impairments, and functional capacity (RFC) in initial claims summarized on the PRTF. for disability benefits under [the Act].” Ruling 96-8p discussed the PRTF and the SSR 96-8p (July 2, 1996). role it plays in the five-step analysis: C. The ALJ’s Hypothetical Did Not The psychiatric review Adequately Convey Ramirez’s technique described in 20 Limitations CFR 404.1520a and As we have previously noted, the 416.920a and summarized ALJ who reviewed Ramirez’s application on the Psychiatric Review noted on the PRTF that Ramirez “often” Technique Form (PRTF) suffers from “deficiencies of requires adjudicators to concentration, persistence, or pace assess an ind ividua l’s resulting in a failure to complete tasks in a limitations and restrictions timely manner (in work settings or from a mental impairment(s) elsewhere).” (Appendix at 93.) Ramirez in categories identified in argues on appeal that the ALJ erred by not the “paragraph B” and including this limitation in the hypothetical “paragraph C” criteria of the that she posed to the vocational expert. As adult mental disorders we explain below, we agree with Ramirez listings. The adjudicator and hold that the hypothetical did not must remember that the accurately convey all of Ramirez’s limitations identified in the impairments, and the limitations they “paragraph B” and cause, and therefore the ALJ’s decision is “paragraph C” criteria are not supported by substantial evidence.2 not an RFC assessment but are used to rate the severity of mental impairment(s) at 2 The Commissioner frames the issue steps 2 and 3 of the on appeal as whether a hypothetical s e q u e n t ia l e v a l u a t i o n question to a vocational expert in a process. The mental RFC Social Security disability case must assessment used at steps 4 include a verbatim recitation of the and 5 of the sequential findings listed on a Psychiatric Review

-7- We have not previously decided the claimant argued that the vocational precise issue of whether certain findings expert’s testimony did not provide on a PRTF must be included in an ALJ’s substantial evidence because the ALJ’s hypothetical. We have, however, stated in hypothetical questions regarding the the clearest of terms that an ALJ’s claimant’s residual functional capacity hypothetical must include all of a failed to incorporate the claimant’s claimant’s impairments. For example, in borderline intellectual functioning. The Chrupcala v. Heckler, 829 F.2d 1269, Commissioner argued there, as it does 1276 (3d Cir. 1987), the claimant argued here, that the ALJ’s use of “simple that the vocational expert’s opinion was repetitive one, two-step tasks” in the deficient because it failed to account for hypothetical was sufficiently descriptive to all of the claimant’s impairments. We encompass the findings concerning the agreed, noting that the ALJ’s hypothetical claimant’s limited intellectual functioning. question “did not reflect the fact of We disagreed, however, explaining that constant and severe pain which [the the reference to simple tasks did not claimant] testified to and which we have “specifically convey” the claimant’s explained was supported by objective intellectual limitations and that “greater medical findings in the record.” Id. We specificity” was required. Id. at 123. explained that “[a] hypothetical question Although we have not previously must reflect all of a claimant’s held whether findings on a PRTF about a impairments that are supported by the claimant’s concentration, persistence, or record; otherwise the question is deficient pace must be included in an ALJ’s and the expert’s answer to it cannot be hypothetical, some of our sister Circuits considered substantial evidence. Id. have dealt with this issue. For example, in (citing Podedworny v. Harris, 745 F.2d Howard v. Massanari, 255 F.3d 577 (8th 210 (3d Cir. 1984) and Wallace v. Cir. 2001), the claimant argued on appeal Secretary, 722 F.2d 1150 (3d Cir. 1983)) that the ALJ had failed to convey in his (emphasis added). hypothetical the finding that the claimant We recently reaffirmed this often suffered from deficiencies in principle in Burns v. Barnhart, 312 F.3d concentration, persistence, or pace. Id. at 113, 122 (3d Cir. 2002). There, the 581. The ALJ had, however, asked the vocational expert to assume that the claimant would be capable of performing Technique Form (PRTF). However, simple, routine, repetitive tasks. Id. The Ramirez does not claim that the findings Eighth Circuit Court of Appeals held that must be included verbatim in the the hypothetical “adequately capture[d]” hypothetical; rather, Ramirez contends the claimant’s deficiencies, in part because that all of a claimant’s limitations must the state psychologist who had made the be adequately conveyed in the finding also prepared a “functional hypothetical.

-8- capacity assessment” in which he mentioned that the claimant’s borderline concluded that the claimant could “sustain intelligence seriously limited, but did not sufficient concentration and attention to preclude him from , understanding, perform at least simple, repetitive, and remembering, and carrying out detailed routine cognitive activity without severe instructions. Id. at 544. On appeal, the restriction of function.” Id. at 582. But Seventh Circuit stated that it saw “nothing see Newton v. Chater, 92 F.3d 688 (8th in the hypothetical that takes into account Cir. 1996), infra. the ALJ’s own earlier observation . . . that [the claimant] suffered from frequent The Sixth Circuit Court of Appeals deficiencies of concentration, persistence, reached a similar outcome in Smith v. or pace.” Id. The court acknowledged Halter, 307 F.3d 377 (6th Cir. 2001). In that there might be an explanation for the Smith, the ALJ also found that the omission, but it explained that it had “no claimant often suffered from deficiencies way of knowing that.” Id. Accordingly, it in concentration, persistence, or pace. In remanded the case for further proceedings. his hypothetical, the ALJ instructed the vocational expert to assume the claimant In Newton v. Chater, 92 F.3d 688 had mental impairments limiting him to (8th Cir. 1996), the court found that a jobs that were routine and low stress, and hypothetical was defective because it did not involve intense interpersonal failed to adequately convey the claimant’s confrontations, high quotas, unprotected deficiencies in concentration, persistence, heights, or operation of dangerous or pace. The ALJ’s hypothetical had machinery. Id. at 378. On appeal, the described a person with a minimal ability Sixth Circuit concluded that the ALJ to read and write, a borderline range of “went beyond” the simple findings intelligence, a ninth or tenth grade included in the PRTF and determined that education, an inability to perform highly the claimant’s concentration problems skilled or technical work, a capacity for were minimal or negligible, and then simple jobs, and a demonstrated ability to “translated [the claimant’s] condition into control his drinking problem. Id. at 694. the only concrete restrictions available to The Commissioner argued that the him . . . and duly incorporated them into deficiencies of concentration, persistence his hypothetical . . . .” Id. at 379. or pace did not have to be included in the hypothetical because the ALJ had limited Other Courts of Appeal (or in one the hypothetical to simple jobs and two case a different panel of the same Circuit) medical professionals had testified that the have been less forgiving. For example, in c la im a n t ’ s d e f i c ie n c i e s d id n o t Kasarsky v. Barnhart, 335 F.3d 539 (7th significantly limit his abilities to follow Cir. 2003), the ALJ noted on the PRTF short and simple instructions and make that the claimant frequently suffered from simple work-related decisions. Id. at 695. deficiencies in concentration, persistence, The court disagreed, noting that the or pace. In his hypothetical, the ALJ

-9- vocational expert had testified on cross- We are not satisfied that these e x a m i n a t io n that the cla iman t’s limitations take into account the ALJ’s concentration and persistence deficiencies own observation (both in her opinion and related to basic work habits needed to in the PRTF) that Ramirez often suffered maintain employment. Thus, the court from deficiencies in concentration, remanded for further proceedings. persistence, or pace. The first several limitations that the ALJ included in her Turning to the instant appeal, the hypothetical pertain to Ramirez’s physical ALJ asked vocational expert Stratton to impairments and therefore have no bearing assume a hypothetical individual with on her mental impairments. The only Ramirez’s background and the following limitations that relate to Ramirez’s mental limitations: sedentary work in a well- impairments are the limitations to simple ventilated environment, with no exposure tasks, the restriction on travel, and the to dust, fumes, pets, animals, chemicals, or phone privileges. temperature extremes; occasional breaks necessary for the use of an inhaler or These limitations do not adequately pump; no more than simple one- or two- convey all of Ramirez’s limitations. The step tasks; no travel outside the workplace; Commissioner contends that the limitation and a reasonable opportunity to receive to one to two step tasks is sufficient, but and make personal telephone calls.3 we agree with the Magistrate Judge that a “a requirement that a job be limited to one to two step tasks, as was stated in the 3 We repeat the text of the hypothetical relied upon by the ALJ, does hypothetical which was presented to not adequately encompass a finding that Stratton, the vocational expert: [Ramirez] ‘often’ has ‘deficiencies in concentration, persistence, or pace, as was I will begin by asking you to assume that noted by the ALJ both in her decision and we’re talking about an individual of Ms. on the PRTF attached to the decision.” Ramirez’s age, education and prior work history. And I’d like you to further assume that this individual’s capable of of performing the work to travel outside performing a range of sedentary work. of the workplace. And . . . the work The work should be performed in a well setting should provide reasonable ventilated facility, with no exposure to opportunity for the individual to make dust, fumes, pets, animals, chemicals, or and receive personal phone calls. Within temperature extremes. The work should the boundaries of these limitations, . . . provide for occasional breaks, for the are there jobs in the regional or national individual use of an inhaler or pump. economy that the individual could The work should involve simple one to perform? two step tasks. The work should not require the individual during the course (A.R. at 457-58.)

-10- (Appendix at 72.) M ost importantly, this may have concluded that the deficiency in limitation does not take into account pace was so minimal or negligible that, deficiencies in pace. Many employers even though Ramirez “often” suffered require a certain output level from their from this deficiency, it would not limit her employees over a given amount of time, ability to perform simple tasks under a and an individual with deficiencies in pace production quota. The record, however, might be able to perform simple tasks, but would seem to suggest otherwise. At the not over an extended period of time. If second hearing, Dr. Rudnick—upon whose Ramirez often suffers deficiencies in pace testimony the ALJ relied—was asked the and this had been included in the following question: “What happens to hypothetical, vocational expert Stratton [Ramirez’s] ability to handle pace, for may have changed her answer as to example, in a work situation, where there’s whether there were jobs in the local or a certain amount of work that has to be national economy that Ramirez could done in an eight hours or two hours or perform. In fact, the vocational expert whatever segment?” (A.R. at 451.) testified that each of the jobs suitable for Although the ALJ briefly interceded Ramirez (assembler, packer, and inspector) before Dr. Rudnick could answer, Dr. would have daily production quotas and Rudick eventually replied that Ramirez’s that Ramirez would have to maintain a ability to maintain a full-time job certain degree of pace to maintain those depended primarily on “the proximity to jobs. where her children would be” because Ramirez’s anxiety-disorder is in large part This omission from the hypothetical attributable to her “need to feel that she runs afoul of our directive in Chrupcala has to be reasonably protective of her that a “hypothetical question posed to a children.” While this might lead a neutral vocational expert ‘must reflect all of a observer to conclude that Ramirez’s clamant’s impairments,” Chrupcala, 829 deficiencies in pace could be overcome by F.2d at 1276, as well as our statement in finding a job close to her children, the ALJ Burns that “great specificity” is required did not include this limitation in her when an ALJ incorporates a claimant’s hypothetical. Instead, the ALJ provided mental or physical limitations into a only for a reasonable number of personal hypothetical. Burns, 312 F.3d at 122. phone calls. If this accommodation would Indeed, the SSA’s own ruling requires a not remedy Ramirez’s deficiency in “more detailed assessment” of the concentration and pace, the vocational claimant’s mental limitations at step five expert might have given a different answer of the disability analysis. See SSR 96-8p to the hypothetical. (July 2, 1996). Relying on Social Security Ruling Of course, there may be a valid 96-8p, which we reproduced in part earlier explanation for this omission from the in this opinion, the Commissioner ALJ’s hypothetical. For example, the ALJ

-11- contends that the “PRTF does not For the foregoing reasons, we will document specific functional limitations vacate the Order of the District Court and for RFC purposes, bur rather assesses remand to the District Court so that it can functional loss from a claimant’s mental in turn remand to the Commissioner for impairments only with respect to broad further proceedings consistent with this areas of functioning.” In other words, the Opinion. Commissioner argues that the PRTF findings are relevant only in steps two and three of the sequential evaluation process, before any assessment of a claimant’s residual functional capacity is made. We cannot concur in the Commissioner’s evaluation of the PRTF findings. While SSR 96-8p does state that the PRTF findings are “not an RFC assessment” and that step four requires a “more detailed assessment,” it does not follow that the findings on the PRTF play no role in steps four and five, and SSR 96- 8p contains no such prohibition. In conclusion, we hold that the ALJ’s hypothetical did not adequately capture and recite all of Ramirez’s mental impairments and the limitations caused by those impairments. In reaching that holding, one factor we cannot ignore is that the burden shifts to the Commissioner at step five to prove that the claimant can perform a job that exists in the national economy. See Burns, 312 F.3d at 119 (“At the final step—step five—the burden shifts to the Commissioner to show that the claimant can perform ‘other work.’”). IV. We have considered Ramirez’s remaining arguments and, after reviewing the record, are persuaded that they are without merit. V.