Swan v. Comm., SSA

2013 DNH 046

• Court: District Court, D. New Hampshire
• Decided: March 28, 2013
• Docket: 11-CV-482-JD
• Status: Published

Opinion

Swan v . Comm., SSA 11-CV-482-JD 03/28/13 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE

Christopher Harold Swan

v. Civil N o . 11-cv-482-JD Opinion N o . 2013 DNH 046 Michael J. Astrue, Commissioner, Social Security Administration

O R D E R

Christopher Harold Swan seeks judicial review, pursuant to

42 U.S.C. § 405(g), of the decision of the Commissioner of the

Social Security Administration, denying his application for

disability insurance benefits under Title II and supplemental

security income under Title XVI. Swan contends that the

Administrative Law Judge (“ALJ”) erred in failing to find that

Swan met or equaled Listing 12.05C under 20 C.F.R. Part 4 0 4 ,

Subpart P, Appendix 1 . The Commissioner moves to affirm the

decision.

Background

Swan applied for social security disability insurance

benefits and supplemental security income on July 1 0 , 2007,

alleging a disability as of June 3 0 , 2007. The ALJ noted in his

decision that Swan’s “earnings record shows that [he] has acquired sufficient quarters of coverage to remain insured

through March 3 1 , 2012.” Swan claimed a disability due to mood

swings, depression, bipolar disorder, substance abuse, bleeding

ulcers, back problems, and neck and leg pain.

From 2007 through 2009, Swan saw Richard Young, ARNP, of

Health First Laconia several times for treatment of his back

pain. Nurse Young prescribed Swan flexeril and darvocet and

diagnosed him with chronic back and neck pain.

Throughout the same period, Swan saw various medical

practitioners for treatment of depression. He was prescribed

amitriptyline, wellbutrin, and lexapro. In October 2007, D r .

Michael Evans diagnosed Swan with alcohol dependence and a

history of depression. In November 2007, Judith McCarthy, ARNP,

gave a provisional diagnosis of a substance induced mood disorder

with depressive features.

In November 2007, D r . Craig Stenslie, a nonexamining state

agency medical consultant, completed a Psychiatric Review

Technique Form and a mental RFC assessment based upon a review of

the record evidence. D r . Stenslie opined that Swan was no more

than moderately limited in areas of understanding and memory,

sustaining concentration and persistence, social interaction, and

adaptation. D r . Stenslie did not review or give an opinion as to

Swan’s IQ score.

2 In June 2008, D r . S . Tyutyulkova, another nonexamining state

agency medical consultant, completed a medical source statement

of Swan’s mental ability to perform work-related activities. D r .

Tyutyulkova opined that Swan had no limitations with respect to

understanding and remembering simple instructions, carrying out

simple instructions, or making judgments on simple work-related

decisions. Like D r . Stenslie, D r . Tyutyulkova did not review or

give an opinion as to Swan’s IQ score.

In June 2009, D r . David Diamond, a psychologist, completed a

mental evaluation of Swan and administered a Wechsler Adult

Intelligence Scale Test. D r . Diamond reported that Swan achieved

a verbal IQ score of 6 6 , a performance IQ score of 6 7 , and a

full-scale IQ score of 6 3 . D r . Diamond opined that the test

results were a valid measure of Swan’s intellectual functioning.

A hearing before an ALJ was held on March 7 , 2011. 1 Swan

was represented by counsel and testified at the hearing. In

addition, an impartial medical expert, D r . Alfred Jonas, and a

vocational expert, Howard Steinberg, testified.

1 The ALJ initially held a hearing on March 1 , 2010, after which he denied Swan’s application for benefits. On July 1 3 , 2010, the Decision Review Board issued an order remanding the claims for a supplemental hearing. The supplemental hearing was held on March 7 , 2011, and the ALJ’s decision after that hearing is the subject of this order.

3 The ALJ issued a decision on April 5 , 2011, denying

benefits. The ALJ found that Swan had several severe

impairments, including degenerative disc disease of the lumbar

and cervical spine. The ALJ also found at Step Three, however,

that Swan did not have an impairment that would meet or equal any

of the impairments listed in 20 C.F.R. Part 4 0 4 , Subpart P,

Appendix 1 . In making that determination, the ALJ found that

Swan did meet all the criteria of Listing 12.05, which pertains to mental retardation.1

The ALJ found at Step Four that Swan had the residual

functional capacity to perform medium work involving simple,

repetitive tasks with light social demands and routine

interactions with public, supervisors, and peers. Based on the

residual functional capacity assessment, the ALJ found that Swan

could return to his past work as a groundskeeper or a

housekeeper. As a result, the ALJ concluded that Swan was not

disabled. The Appeals Council denied Swan’s request for review

1 The ALJ initially found that Swan’s impairments, including his alcohol abuse, met Listings 12.08 and 12.09 of 20 C.F.R. Part 404, Subpart P, Appendix 1 . The ALJ further found, however, that if Swan stopped his alcohol abuse, his impairments would not meet Listings 12.08 or 12.09. See Grogan v . Barnhart, 399 F.3d 1257, 1264 (10th Cir. 2005); Randall v . Astrue, 2011 WL 573603, at *1 (D. Mass. Feb. 1 5 , 2011). Swan challenges only the ALJ’s decision determination concerning Listing 12.05C. Therefore, the court will not address the ALJ’s findings as to Listings 12.08 or 12.09.

4 on September 1 3 , 2011, making the ALJ’s decision the final

decision of the Commissioner.

Standard of Review

In reviewing the final decision of the Commissioner in a

social security case, 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 3 1 , 35 (1st Cir. 1999). The court defers to the ALJ’s

factual findings as long as they are supported by substantial

evidence. § 405(g). “Substantial evidence is more than a

scintilla. It means such relevant evidence as a reasonable mind

might accept as adequate to support a conclusion.” Astralis

Condo. Ass’n v . Sec’y Dep’t of Housing & Urban Dev., 620 F.3d 6 2 ,

66 (1st Cir. 2010).

Discussion

Swan contends that the ALJ erred in finding that Swan’s

impairments did not meet or equal the impairment at Listing

12.05C. The Commissioner points to evidence supporting the ALJ’s

finding.

The ALJ follows a five-step sequential analysis for

determining whether a claimant is disabled. 20 C.F.R. § 404.1520

5 & § 416.920.2 At Step Three of the sequential analysis, the ALJ

compares the medical evidence of the claimant’s impairment “to a

list of impairments presumed severe enough to preclude any

gainful work.” Sullivan v . Zebley, 493 U.S. 5 2 1 , 525 (1990).

“If the claimant’s impairment matches or is ‘equal’ to one of the

listed impairments, he qualifies for benefits without further

inquiry.” Id.; § 404.1520(a)(4)(iii).

To match a listed impairment, the claimant’s medically

determinable impairment must satisfy all of the listed criteria.

20 C.F.R. § 404.1525(e). An impairment equals a listed

impairment if the impairment “is at least equal in severity and

duration to the criteria of any listed impairment.” §

404.1526(a). The claimant bears the burden of showing that he

has an impairment or combination of impairments that meets or

equals a listed impairment. Torres v . Sec’y of Health & Human

Servs., 870 F.2d 7 4 2 , 745 (1st Cir. 1989).

The ALJ found at Step Two that Swan had the following severe

impairments: degenerative disc disease of the lumbar spine and

2 The Social Security Administration promulgated regulations governing eligibility for disability insurance benefits at Part 404 and for supplemental security income at Part 416. Because the regulations are substantially the same, the court will cite only to the disability insurance benefits regulations. See McDonald v . Sec’y of Health & Human Servs., 795 F.2d 1118, 1120 n.1 (1st Cir. 1986).

6 the cervical spine, mild mental retardation, alcohol abuse,

depression, and anxiety. At Step Three, the ALJ found that

Swan’s impairments did not meet any of the listed impairments in

20 C.F.R. Part 4 0 4 , Subpart P, Appendix 1 , including Listing

12.05C.

Listing 12.05C, which pertains to mental retardation, has

three requirements: (1) the claimant developed deficits in

adaptive functioning prior to age 2 2 ; (2) “[a] valid verbal,

performance, or full scale IQ of 60 through 7 0 ; and” (3) “a

physical or other mental impairment imposing an additional and

significant work-related limitation of function.” The ALJ found

that Swan had met the first factor, but not the second or third.3

Swan contends that his impairments meet all the criteria for

Listing 12.05C.

A. Third Prong of Listing 12.05C

Swan argues that he met the third prong of Listing 12.05C

because the ALJ found in Step Two that Swan’s degenerative disc

disease would be a severe impairment even if Swan stopped his

alcohol abuse. Swan argues that a finding of a severe impairment

3 With regard to the first factor, the ALJ noted that “the record documents a history of difficulties with intellectual functioning as early as high school when [Swan] required an IEP and special education services.” Admin. Rec. at 1 9 .

7 at Step Two requires a finding that he had a physical impairment

imposing an additional and significant work-related limitation of

function for Listing 12.05C purposes.

The Commissioner appears to concede that the ALJ’s finding

at Step Two that Swan’s degenerative disc disease would be a

severe impairment requires a finding that Swan’s impairment meets

the third prong of Listing 12.05C. See Def. Mot. at 8 (“Here,

although the ALJ found that in the absence of substance abuse,

Plaintiff had a severe impairment of degenerative disc disease of

the lumbar and cervical spine, he reasonably found that Plaintiff

did not meet listing 12.05C because he did not have a valid

verbal, performance, or full scale IQ score of 60 through 7 0 . ” ) .

Even if the Commissioner had not conceded this point, case law is

clear that a Step Two finding of a severe impairment satisfies

the significant limitations standard of Listing 12.05C. See

Nieves v . Sec’y of Health & Human Servs., 775 F.2d 1 2 , 13-14 (1st

Cir. 1985) (“Because claimant’s impairment was found to be

severe, a fortiori it satisfies the significant limitations

standard [of 12.05C].”); see also Santos v . Astrue, 2012 WL

1109285, at *6 n.4 (D. Mass. Mar. 3 0 , 2012). Therefore, the

ALJ’s determination that Swan did not meet the third factor of

12.05C is not supported by substantial evidence.

8 B. Second Prong of Listing 12.05C Swan argues that he met the second prong of Listing 12.05C

because D r . Diamond assessed Swan’s IQ score at 6 3 , and D r . Jonas

testified that the score was valid. The Commissioner argues that

the ALJ’s determination that Swan’s IQ score was invalid and

inconsistent with the record is supported by substantial

evidence.

In discussing Swan’s IQ score, the ALJ wrote:

I note that [Swan] did undergo testing of his intellectual function with David Diamond, MD in June 2009. Although D r . Diamond assessed his full scale IQ at only a 6 3 , I find that the results of his examination were not valid because the claimant testified that he drank beer the night before. The IQ of 63 is also not consistent with the remainder of the record which shows the claimant is able to go hiking, fishing, and camping, and having previous jobs at the semi-skilled level, with jobs at the unskilled level.

Admin. Rec. at 19 (internal citations omitted).

The record shows that Swan drank one beer the night before

his IQ test and that both D r . Diamond, who administered the test,

and D r . Jonas, the independent medical examiner, opined that the test result was valid.4 There is nothing in the record to

4 At the hearing, D r . Jonas testified that if Swan had just had one beer the night before the IQ test, “then that would not have interfered with his testing, so I think we should accept these IQ’s and, therefore, get him into 12.05.” Admin. Rec. at 9 6 . D r . Jonas further noted that D r . Diamond did not suggest that the scores were invalid. Id.

9 support the ALJ’s determination that Swan’s limited alcohol

consumption the night before the IQ test should invalidate his

score. Therefore, the ALJ erred in disregarding Swan’s IQ score

on that basis. See Nieves, 775 F.2d at 14 (Appeals Council erred

in disregarding claimant’s IQ score when there was no medical

evidence as to why the score was invalid); cf Wilkinson v .

Astrue, 2008 WL 1925133, at *4-*5 (D.R.I. Apr. 3 0 , 2008)

(affirming ALJ’s decision which invalidated claimant’s IQ score

because numerous other medical practitioners opined that the IQ

scores were inconsistent with the claimant’s medical records,

history, and evaluations).

The ALJ’s determination that Swan’s IQ score was invalid

because of his physical activities or work history was also not

supported by substantial evidence. “The fact that an individual

lives and functions independently, is able to work, and has

attended schooling (even beyond high school) have been held in

several cases to be facts which are not inconsistent with mild

mental retardation.” Gross v . Astrue, 2012 WL 2449900, at *10

(D. Kan. June 2 6 , 2012) (citing Markle v . Barnhart, 324 F.3d 182

(3rd Cir. 2003)); see also Nieves, 775 F.2d at 1 4 . “Listing

12.05C accommodates such activities, and anticipates that a

mildly mentally retarded individual will be able to perform all

of these activities . . . unless or until he develops another

10 severe mental or physical impairment.” Gross, 2012 WL 2449900,

at * 1 0 . As discussed above, the medical evidence in the record

regarding Swan’s IQ test supports the validity of Swan’s reported

score.5 “[An] ALJ [is] not at liberty to ignore medical evidence

or substitute his own views for uncontroverted medical opinion.”

Nguyen, 172 F.3d at 35. 6

The Commissioner argues that D r . Stenslie and D r .

Tyutyulkova opined that Swan did not have a medically

determinable impairment of mental retardation. Neither doctor,

however, gave an opinion as to Swan’s IQ score and, therefore,

their opinions do not bear on whether Swan meets the second

factor of Listing 12.05C. See Hewes v . Astrue, 2011 WL 4501050,

5 Other than the opinions of D r . Diamond and D r . Jonas, the only evidence in the record concerning Swan’s IQ score is a mental impairment questionnaire by D r . Christine Runyan. In response to the question, “Does [Swan] have a low IQ or reduced intellectual functioning,” D r . Runyan wrote that she was “[u]nable to answer.” She added, “Suspect relatively low IQ but not meeting criteria for MR.” That opinion does not contradict Swan’s reported IQ score. 6 The Commissioner points to D r . Jonas’s testimony that there was no “good basis” for finding that Swan met the criteria of Listing 12.05C. The basis for that opinion, however, was that Swan did not have a “separate and impairing problem” and, therefore, did not meet the third prong of 12.05C. As discussed above, the Commissioner’s finding at Step Two that Swan had a severe impairment satisfies the third prong of 12.05C. Therefore, that part of D r . Jonas’s testimony is irrelevant to the court’s determination.

11 at *4 (D. M e . Sept. 2 7 , 2011) (“The existence or non existence of

a diagnosis of mental retardation is not an element of the

[12.05C] analysis.”) (internal quotation marks and citation

omitted). Regardless, neither doctor’s opinion was mentioned by

the ALJ in his determination that Swan’s IQ score was invalid,

and the Commissioner cannot provide a post-hoc rationale for the

ALJ’s erroneous findings. See Van Blarcom v . Astrue, 2011 WL

2118643, at *4 (D.N.H. May 2 5 , 2011); Larlee v . Astrue, 694 F.

Supp. 2d 8 0 , 84 (D. Mass. 2010).

Accordingly, the ALJ’s determination that Swan did not meet

the criteria of Listing 12.05C is not supported by substantial

evidence in the record.

Conclusion

For the foregoing reasons, the applicant’s motion to reverse

(document n o . 8 ) is granted. The Commissioner’s motion to affirm

(document n o . 10) is denied.

12 Under sentence four of § 405(g), the case is reversed and

remanded for further proceedings. The clerk of court shall enter

judgment accordingly and close the case.

SO ORDERED.

V J Joseph A. DiClerico, Jr.~ Jr. United States District Judge

March 28, 2013

cc: Robert J. Rabuck, Esquire D. Lance Tillinghast, Esquire