Hofman v. Commissioner of Social Security
6:18-cv-06382
| W.D.N.Y. | Jun 13, 2019Background
- Marion Hofman filed a January 20, 2015 SSI application alleging disability from January 1, 2008, after a 2007 car accident; an earlier SSI award in 2009 for cervical/back impairments was terminated after his 2012–2015 incarceration.
- The 2015 application was denied; an ALJ issued a decision on April 14, 2017 finding severe cervical and lumbar degenerative disc disease but an RFC for limited light work, and the Appeals Council denied review.
- The ALJ found non-severe other conditions (asthma, hypertension, hepatitis C, history of polysubstance abuse) and concluded Hofman could perform several light or sedentary jobs per the vocational expert, so he was not disabled.
- Hofman challenged the 2015 decision in federal court, arguing (1) the 2009 disability finding as to his cervical/spinal condition should have collateral or estoppel effect on the 2015 claim, and (2) the ALJ improperly weighed medical opinions (treating sources and consultative examiner) and failed to reconcile inconsistencies with the RFC.
- The magistrate judge concluded the 2009 ALJ’s disability finding for Hofman’s cervical condition was binding under 20 C.F.R. § 416.1450(f) absent new and material evidence of improvement, granted Hofman’s motion in part, vacated the Commissioner’s decision, and remanded for further proceedings limited to the cervical condition.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Collateral estoppel / estoppel effect of 2009 disability finding | The 2009 finding of disability for spinal impairments should carry forward to the 2015 application | Different timeframe and different claimed impairments in 2015 mean res judicata/estoppel does not apply | Court held the 2009 cervical disability finding must be given collateral effect absent new/material evidence of improvement; granted relief on this ground |
| Treating physician opinions weight (pre-Mar 2017 rule) | ALJ improperly discounted treating sources (Drs. Bavibidila, Lurie) with conclusory reasons | ALJ permissibly discounted opinions as inconsistent with record, showing effective treatment, opiate-seeking behavior, and noncompliance | Court found issue largely mooted by remand on estoppel ground but directed ALJ on remand to reconsider post-2009 treating opinions if relevant |
| State agency / consultative examiner (Dr. Toor) vs. RFC | ALJ failed to reconcile Dr. Toor’s moderate-to-marked limitations with RFC finding allowing light work | ALJ gave Dr. Toor "some weight" and found opinions based on isolated exams and otherwise consistent with record | Court held reconciliation moot as to cervical condition given estoppel result but noted ALJ’s weight assignment was unclear and should be revisited on remand if necessary |
| Vocational expert hypotheticals and absences/off-task limits | Certain limitations (e.g., off-task >10% or absences >2 days/month, sitting/standing restrictions) preclude competitive full-time work | VE testimony supported that with the ALJ’s RFC, there are jobs available | Court relied on VE testimony for broader RFC but remanded because the cervical disability finding must be incorporated into the analysis, which could change VE outcomes |
Key Cases Cited
- Richardson v. Perales, 402 U.S. 389 (U.S. 1971) (definition of "substantial evidence")
- Berry v. Schweiker, 675 F.2d 464 (2d Cir. 1982) (plaintiff’s burden at step four and burden shift at step five)
- Halloran v. Barnhart, 362 F.3d 28 (2d Cir. 2004) (ALJ must give good reasons for weight given to treating source opinions)
- Clark v. Comm'r of Soc. Sec., 143 F.3d 115 (2d Cir. 1998) (discussion of treating physician rule)
- Stubbs-Danielson v. Astrue, 539 F.3d 1169 (9th Cir. 2008) (incarceration suspends/terminates SSI benefits under regulatory provisions)
- Curry v. Apfel, 209 F.3d 117 (2d Cir. 2000) (sentence-four remand authority)