Lausell v. Commissioner of Social Security
1:19-cv-02016
S.D.N.Y.Mar 1, 2021Background
- Jessica Lausell filed for Disability Insurance Benefits and SSI in August 2015; ALJ George M. Gaffaney denied benefits in a May 9, 2018 decision, and the Appeals Council denied review. The district court granted Lausell judgment and remanded for further proceedings.
- Medically, Lausell has severe left-knee degenerative joint disease (right total knee arthroplasty in 2015), bilateral hip trochanteric bursitis, sacroiliac dysfunction and vestibular symptoms; she has a long history of pain treatment (repeated cortisone injections) and uses a wheeled chair and a cane.
- A consultative examiner (Dr. Long) noted the cane “appears to be medically necessary”; treating notes document cane use for ambulation but do not clearly specify whether the cane is required while standing.
- The ALJ found several severe impairments, assessed an RFC for light work with a sit/stand option (sit 6 hrs/stand 2 hrs), included “use of a cane to ambulate,” and concluded jobs exist in the national economy.
- At the hearing the Vocational Expert testified that requiring a cane while standing would be work‑preclusive, but requiring a cane only for ambulation would not; the ALJ did not clarify whether Lausell needs the cane while standing.
- The district court vacated and remanded: it held the ALJ failed to develop the record regarding cane use and failed to apply required credibility analysis; the court declined to resolve the Appointments Clause challenge as moot on remand.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ adequately developed record on cane use | Lausell testified she uses a cane “all the time”; medical notes show cane medically necessary; ALJ should have clarified whether cane is required while standing | Commissioner points to mixed notes (e.g., uses cane mostly at home) and consultative language suggesting cane improves gait, arguing record supports ALJ’s RFC | Court: Remand; ambiguity about whether cane is required while standing is outcome‑determinative (per VE); ALJ must develop record and elicit clarification/VE testimony |
| Whether ALJ properly evaluated claimant credibility of pain/limitations | ALJ ignored longitudinal, corroborating treatment (left knee worsening, repeated injections, vertigo) and didn’t apply the regulatory seven‑factor credibility analysis | Commissioner: ALJ’s RFC and findings track testimony and consultative opinions showing ability to perform restricted work with sit/stand option | Court: Remand; ALJ failed to apply required credibility analysis and must reassess symptom testimony under 20 C.F.R. §§ 404.1529/416.929(c)(3) |
| Weight afforded to Dr. Beauvais’s opinion (treating status) | Lausell: ALJ should have treated Beauvais as part of Montefiore team or at least investigated basis for his restrictions | Commissioner: Beauvais’s form is unsupported, unsigned in places, devoid of findings or treatment records; ALJ permissibly gave it little weight | Court: Affirmed ALJ’s decision to give little weight — form lacked supporting clinical findings and evidence of a treating relationship |
| Appointments Clause (ALJ’s appointment) | Lausell raised Lucia‑based challenge; seeks relief if ALJ was unconstitutionally appointed | Commissioner: Challenge was not raised administratively and is waived/exhaustion required | Court: Declined to decide; remand for further proceedings renders the constitutional issue effectively moot and guidance from higher courts was forthcoming |
Key Cases Cited
- Burgess v. Astrue, 537 F.3d 117 (2d Cir. 2008) (standards for treating‑physician controlling weight and required ALJ reasons)
- Lamay v. Comm’r of Soc. Sec., 562 F.3d 503 (2d Cir. 2009) (ALJ’s affirmative duty to develop the administrative record)
- Rosa v. Callahan, 168 F.3d 72 (2d Cir. 1999) (remand appropriate where gaps in the administrative record prevent meaningful review)
- Selian v. Astrue, 708 F.3d 409 (2d Cir. 2013) (consultative examiners’ one‑time opinions should not be heavily relied on over treating sources)
- Greek v. Colvin, 802 F.3d 370 (2d Cir. 2015) (failure to apply treating‑physician rule can be reversible error)
- Butts v. Barnhart, 388 F.3d 377 (2d Cir. 2004) (remand for calculation of benefits vs. further proceedings; standards for remand)
- Poupore v. Astrue, 566 F.3d 303 (2d Cir. 2009) (burden of proof shifts to Commissioner at step five of the sequential evaluation)
- Moran v. Astrue, 569 F.3d 108 (2d Cir. 2009) (substantial‑evidence standard and scope of judicial review)