218 F. Supp. 3d 249
S.D.N.Y.2016Background
- Plaintiff Constance Craig applied for DIB and SSI (alleged onset Jan 1, 2011); ALJ Dorf denied benefits in March 2013 and the Appeals Council declined review, rendering the ALJ decision final.
- Medical record shows long‑term psychiatric treatment with Dr. Faiq Hameedi (treating psychiatrist, monthly since ~2006), neurologic complaints (sensory polyneuropathy from diabetes noted by Dr. Joel Cohen), and consultative exams by Drs. Alexander (psychiatric) and Pelczar‑Wissner (internal medicine).
- Hameedi submitted treating wellness reports stating Craig was unable to work for at least 12 months; those treating records themselves are absent from the administrative record.
- ALJ found diabetes a severe impairment but characterized Craig’s mood disorder as nonsevere, gave little weight to Hameedi, great weight to consultative examiners, found Craig capable of light, simple repetitive work (e.g., home health aide), and discounted some of Craig’s subjective complaints.
- Plaintiff sought judicial review arguing (1) Appeals Council improperly declined to consider post‑decision MRIs, (2) ALJ erred in discounting treating opinions (Hameedi, and insufficient analysis of Cohen), and (3) ALJ failed to account for obesity/medication side effects; district court remanded primarily for failure to give good reasons for discounting the treating psychiatrist and for failure to develop the record.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Appeals Council erred by not considering MRIs submitted after ALJ decision | Craig: MRIs (Mar–Apr 2013) were new, material, and bore on prior complaints (back pain); should have been considered on remand | Commissioner: MRIs post‑date ALJ decision and concern a later time; would not change outcome | Court did not decide on merits; ordered ALJ on remand to consider the MRIs as part of a fully developed record |
| Whether ALJ erred in assigning "little weight" to treating psychiatrist Dr. Hameedi | Craig: Hameedi is a long‑term treating psychiatrist whose opinion (unable to work ≥12 months) merited controlling or at least well‑explained weight | Commissioner: ALJ permissibly discounted treating opinion as inconsistent with consultative opinions and because disability is an issue reserved to the Commissioner | Court: ALJ failed to give the required "good reasons"—did not analyze Halloran factors (treatment frequency, support in record, specialization) or explain inconsistencies; remand required for proper evaluation and explanation |
| Whether ALJ satisfied duty to develop the record (treating records) | Craig: ALJ failed to obtain treating psychiatrist records and thus relied on an incomplete record | Commissioner: ALJ need only seek additional evidence where gaps are obvious; argued Appeals Council/record justified decision | Court: Absence of Hameedi’s treatment records was an obvious gap, especially for mental impairment; ALJ had affirmative duty to obtain them—remand required to develop records and solicit treating physician opinions if needed |
| Whether ALJ considered treating neurologist Dr. Cohen and other medical opinions properly | Craig: ALJ failed to state what weight, if any, was given to Dr. Cohen’s findings and should have solicited an opinion if none present | Commissioner: ALJ referenced Cohen and relied on consultative examiners; no further action necessary | Court: On remand ALJ should determine whether Cohen’s letter is a medical opinion and, if so, assign and explain weight or obtain a treating opinion; failure to do so supports remand |
Key Cases Cited
- Selian v. Astrue, 708 F.3d 409 (2d Cir. 2013) (standard for substantial evidence review and duty to fill obvious gaps in the record)
- Butts v. Barnhart, 388 F.3d 377 (2d Cir. 2004) (substantial evidence standard and remand where record gaps make further findings necessary)
- Mongeur v. Heckler, 722 F.2d 1033 (2d Cir. 1983) (reviewing court must consider entire record, including conflicting evidence)
- Brault v. Social Sec. Admin., 683 F.3d 443 (2d Cir. 2012) (deferential substantial‑evidence standard and limits on overturning ALJ factfindings)
- Halloran v. Barnhart, 362 F.3d 28 (2d Cir. 2004) (treating physician rule and factors for weighing treating opinions)
- Schaal v. Apfel, 134 F.3d 496 (2d Cir. 1998) (ALJ’s duty to seek clarification from treating sources when clinical findings are inadequate)
- Snell v. Apfel, 177 F.3d 128 (2d Cir. 1999) (treating physician’s disability statement not dispositive; requirement to explain reasons for discounting treating opinions)