Debra Miller v. Commissioner Social Security
20-3642
| 3rd Cir. | Jul 26, 2021Background
- Debra Miller applied for Disability Insurance Benefits (DIB), alleging disability beginning June 13, 2013; her date last insured was December 31, 2016.
- She claimed disabling fibromyalgia and rheumatoid arthritis and submitted treating-physician statements from Dr. Natalie Dubchak (rheumatologist) and Dr. Edward Lentz (PCP).
- Initial ALJ decision denied benefits; Appeals Council remanded because the ALJ had mistakenly relied on medical records belonging to a different person and directed reassessment of Miller’s RFC.
- On remand, after a new hearing and excluding the wrong-person exhibits, the ALJ again denied benefits, finding Miller incapable of past work but able to perform other sedentary jobs.
- The District Court affirmed the ALJ; Miller appealed to the Third Circuit, which also affirmed, finding substantial evidence supported the RFC and other aspects of the decision.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Weight accorded to treating physicians' opinions | ALJ should have given controlling weight to treating-physicians (Drs. Dubchak, Lentz) and not relied on the ALJ’s own view | ALJ permissibly gave only partial weight because opinions relied on events after the date last insured and conflicted with other record evidence | Held: ALJ properly gave partial weight; substantial evidence supports RFC determination |
| ALJ’s evaluation of Miller’s and spouse’s symptom testimony and daily activities | ALJ improperly discounted testimony about fibromyalgia/RA and overstated functional abilities based on limited household activities | ALJ reasonably rejected some testimony as inconsistent with treatment records, objective findings, improvement with medication, and non-exertional daily activities | Held: Court affirmed ALJ’s credibility assessment as supported by substantial evidence |
| Duty to develop/supplement the record | ALJ failed to supplement gaps in medical evidence and should have obtained additional records/expert review | No showing of gaps requiring supplementation; ALJ may determine RFC without outside expert for each fact | Held: No duty to supplement here; record was adequate for RFC finding |
| Compliance with Appeals Council remand directive | Remand required a materially different RFC; 2019 RFC is nearly identical to 2017 RFC, so ALJ failed to follow directive | ALJ complied: requested new evidence, held a new hearing, excluded wrong-person exhibits, and issued an RFC supported by current record | Held: ALJ complied with remand and decision was supported by substantial evidence |
Key Cases Cited
- Biestek v. Berryhill, 139 S. Ct. 1148 (2019) (defines "substantial evidence" standard in SSA review)
- Chandler v. Comm’r of Soc. Sec., 667 F.3d 356 (3d Cir. 2011) (ALJ may make RFC findings without outside medical expert for every issue)
- Zirnsak v. Colvin, 777 F.3d 607 (3d Cir. 2014) (medical opinions about periods outside the insured period have limited relevance)
- Brown v. Astrue, 649 F.3d 193 (3d Cir. 2011) (treating physician opinion does not bind the ALJ on functional capacity)
- Plummer v. Apfel, 186 F.3d 422 (3d Cir. 1999) (ALJ must weigh medical opinions against other record evidence)
- Schaudeck v. Comm’r of SSA, 181 F.3d 429 (3d Cir. 1999) (ALJ must state reasons for rejecting claimant testimony)
- Smith v. Califano, 637 F.2d 968 (3d Cir. 1981) (sporadic activity does not necessarily disprove disability)