Federal Court Finds Disability, Reverses, and Orders Payment

September 30, 2011

Author: Louise M. Tarantino| Catherine M. Callery (Kate)

According to 2010 data from the Social Security Administration (SSA), only 4% of cases in federal district court are reversed for payment of benefits.  Getting an order of reversal, therefore, is understandably cause for joy and jubilation for plaintiff’s counsel.  A recent case from the N.D.N.Y. that was reversed for payment probably made Chris Cadin of Legal Services of Central New York one such very happy fellow.

In the case of Cook v. Astrue, 2011 WL 2490996 (N.D.N.Y. 2011), the Plaintiff applied for DIB and SSI in early 2005, alleging an inability to work since 2004 due to various mental and emotional impairments.  The Commissioner initially denied Plaintiff’s applications, and an Administrative Law Judge (ALJ) then issued a decision finding no disability.

In his decision, the ALJ found that the Plaintiff’s severe impairments, including major depression, social/generalized anxiety and obsessive compulsive disorder, did not meet or equal a listing; her post-traumatic stress syndrome (PTSD) was not severe.  The ALJ also found that the Plaintiff retained the residual functional capacity (RFC) to perform work at all levels of exertion.  But the ALJ also determined that due to her non-exertional mental impairments, the Plaintiff was limited to a low stress environment with no production pace requirements or supervisory duty, and only simple decision-making.

Further, the ALJ concluded that the Plaintiff should avoid crowds and the use of telephones.  The ALJ then determined that the Plaintiff could maintain time and attendance if all of these restrictions were observed.  As a result, the ALJ found that the Plaintiff could return to her past job as a library page.  In the alternative, considering her age, work experience and RFC, there existed jobs in the national economy that Plaintiff could perform. 

After the Appeals Council adopted the ALJ’s decision, Chris filed an action in the N.D.N.Y, advancing four chief arguments in support of her contention that the Commissioner’s decision should be reversed: 1) that the ALJ erred in finding that her PTSD was not a severe impairment; 2) that the ALJ’s RFC assessment was flawed; 3) that the ALJ erred by finding that she was capable of performing her past relevant work as a library page; and 4) that the ALJ’s hypotheticals presented to the vocational expert were flawed.

Magistrate Judge Bianchini found that the ALJ did not err with respect to Plaintiff’s PTSD.  Not only was there evidence to support such conclusion, but any error was harmless because the ALJ found other severe impairments and continued on with the sequential analysis.

Regarding the RFC assessment, the Magistrate found that the ALJ committed reversible error when he disregarded the testimony of Plaintiff’s treating psychiatrist as well as the testimony of her social worker/mental health coordinator in favor of the Plaintiff’s testimony.  Plaintiff’s social worker/mental health coordinator submitted a letter describing Plaintiff’s work at a transitional, vocational program for people with mental illness, noting that Plaintiff had numerous limitations in her ability to function in a normal work environment.  The social worker described how numerous attempts and various support measures failed to produce a successful transition into normal, competitive, remunerative work environments.  Similarly, Plaintiff’s psychiatrist found her to have marked limitations with regard to understanding, remembering and carrying out detailed instructions, as well as marked limitations in responding appropriately to work pressures and changes in a normal work setting.  These findings directly contradicted the ALJ’s findings. 

Despite the fact that the treating psychiatrist’s opinions were presumptively entitled to controlling weight, the ALJ decided to instead credit the Plaintiff’s self-reports of her abilities over this professional opinion of a treating source.  The ALJ accepted  Plaintiff’s testimony because he believed she had “no motivation” to overstate.  But the court here noted that Plaintiff was very nervous and anxious during the hearing and was also mentally ill.  She had a strong desire to please the ALJ by telling him what she believed he wanted to hear.  Further, most of her answers were equivocal until the ALJ prodded her for the answer he wanted to hear.  The ALJ’s discounting of the opinion of Plaintiff’s treating social worker in favor of Plaintiff’s statements also constituted reversible error for the same reasons.

The ALJ advanced two reasons to support his finding that the Plaintiff could perform her past relevant work as a library page:  1) Plaintiff’s own statements that she could go back to work, and 2) the testimony of the vocational expert (VE).  As noted above, the Court found that it was error for the ALJ to credit Plaintiff’s statements in light of the substantial amount of evidence that indicated her true, documented limitations were much more severe. 

The ALJ’s reliance on the testimony of the VE was misplaced because the hypothetical questions presented to the expert were flawed.  The hypothetical questions presumed that Plaintiff could maintain the time and attendance requirements customarily required by employers.  Based on this assumption, the VE concluded that Plaintiff could perform her past work. However, the assumption that she could maintain time and attendance was based almost entirely on Plaintiff’s own statements and did not accurately represent her true limitations.  Thus, the Court found, the testimony of the VE could not amount to substantial evidence.  The same flaw then undermined the ALJ’s 5 step analysis which he based on the same VE testimony.

The court found persuasive proof of disability in this case.  Plaintiff’s treating psychiatrist and social worker opined that she had numerous marked limitations.  The Magistrate found that substantial evidence existed in the record to indicate conclusively that the Plaintiff was disabled, in particular that she was unable to perform the nonexertional demands of competitive, remunerative employment on a full-time basis. In contrast, the evidence cited by the ALJ (primarily Plaintiff’s testimony) was suspect for the reasons stated above and was contradicted by credible and compelling reports from Plaintiff’s treating providers and her employer.  Accordingly, the court found proof of disability to be persuasive and concluded that a remand for further evidentiary proceedings would serve no purpose.  The Court remanded the case for calculation of benefits.

Congratulations to Chris Cadin for this significant victory. 

Thank you to Albany Law School intern Matthew Vassallo for this analysis.