564 F.Supp.3d 261
E.D.N.Y2021Background:
- Plaintiff Isaac Kwasi Acheampong applied for DIB and SSI (filed Dec. 11, 2018) alleging disability from Oct. 15, 2016 due mainly to chronic low back pain, neck pain, diabetes, and related problems.
- ALJ held a hearing, found severe impairments (diabetes, hyperlipidemia, lumbar spine degeneration), and assessed an RFC for light work with limits (no ladders/ropes/scaffolds; occasional ramps/stairs; no unprotected heights or moving machinery).
- ALJ found consultative examiner Dr. Trimba and reviewing physician Dr. Feldman persuasive, but rejected treating physician Dr. Theresa Osei’s July 2019 Medical Source Statement (which limited standing/walking to <2 hours and imposed other significant restrictions).
- After the ALJ decision, claimant submitted additional Northwell records (Dr. Young) and Dec. 26, 2019 cervical and lumbar MRIs to the Appeals Council; the Council declined review, finding the new evidence would not change the outcome.
- The district court found the ALJ failed to explain consideration of the 2017 SSA factors (supportability and consistency) in discounting the treating opinion, improperly relied on conservative-treatment and other irrelevant grounds, and that the Appeals Council erred in rejecting the MRI/treatment records as immaterial — and therefore remanded for further proceedings.
Issues:
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ properly evaluated medical opinions under the 2017 rules (supportability/consistency) | ALLEGED failure to explain why treating opinion was unpersuasive and failure to address supportability/consistency | ALJ adequately weighed opinions; other medical opinions supported RFC | ALJ failed to articulate consideration of supportability and consistency for treating opinion; remand required |
| Whether Appeals Council erred in declining post‑decision MRI and treatment records | New MRI and Dr. Young records were material and predate ALJ decision; would likely change outcome | Evidence would not have altered ALJ’s decision | Appeals Council erred; records were material and must be considered on remand |
| Whether ALJ permissibly discounted treating opinion based on conservative treatment, noncompliance, and job application | Discounting for conservative treatment, diabetes noncompliance, and job application is improper and/or irrelevant | Such facts support discounting the treating opinion | Court: discounting for conservative treatment and job‑application activity was improper; diabetes noncompliance unrelated to musculoskeletal limits and should not have driven discounting |
| Whether ALJ’s RFC and step‑four finding are supported by substantial evidence | RFC not supported given treating opinion and new MRI/treatment records | RFC supported by consultative and reviewing opinions | RFC/step‑four unsupported given erroneous discounting and unconsidered material evidence; remand required |
Key Cases Cited
- Talavera v. Astrue, 697 F.3d 145 (2d Cir.) (standard of review and burden at SSA five‑step process)
- Selian v. Astrue, 708 F.3d 409 (2d Cir.) (definition of substantial evidence and reviewing the whole record)
- Richardson v. Perales, 402 U.S. 389 (U.S.) (substantial evidence standard in Social Security review)
- Burgess v. Astrue, 537 F.3d 117 (2d Cir.) (treating‑physician rule and limits on discounting where only conservative treatment offered)
- Clark v. Comm’r of Soc. Sec., 143 F.3d 115 (2d Cir.) (courts do not reweigh evidence; agency resolves conflicts)
- Cichocki v. Astrue, 729 F.3d 172 (2d Cir.) (finality of findings supported by substantial evidence)
- Barrett v. Berryhill, 906 F.3d 340 (5th Cir.) (observations of examining physicians are foundational in disability determinations)
- Perez v. Chater, 77 F.3d 41 (2d Cir.) (Appeals Council may consider new, material evidence that predates ALJ decision)
- Blash v. Comm’r of Soc. Sec. Admin., [citation="813 F. App'x 642"] (2d Cir.) (Appeals Council must review new and material evidence that could change the outcome)