Nugent v. Berryhill
1:15-cv-00111
W.D.N.Y.Sep 14, 2017Background
- Plaintiff John L. Nugent, Jr. applied for Disability Insurance Benefits (DIB) with an alleged onset of March 26, 2008; his insured status ended December 31, 2009.
- ALJ held a hearing May 15, 2013 and found plaintiff not disabled, concluding plaintiff retained the RFC for limited light work but could not perform past relevant work; Appeals Council denied review.
- The ALJ gave little weight to the only medical opinion assessing functional capacity (Dr. John Ring, Jr., June 4, 2008), because it predated plaintiff’s arthroscopy.
- No other medical opinion was obtained to assess RFC for the insured period; treating physicians had provided workers’ compensation opinions but the ALJ did not recontact them or obtain a consultative or retrospective opinion.
- District court found that rejecting Dr. Ring’s opinion created an evidentiary gap the ALJ was required to fill and remanded for further development; credibility issue not reached on merits.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ’s RFC finding was supported by substantial evidence | ALJ improperly rejected Dr. Ring’s opinion leaving an evidentiary void; ALJ should have developed record or obtained retrospective/consultative opinion | ALJ permissibly discounted Dr. Ring as stale; treating physician’s statement (Dr. Smith) indicated possible return to work so no further development needed | Remanded: ALJ permissibly discounted Dr. Ring, but failure to obtain other medical opinions created an evidentiary gap requiring remand to develop record |
| Whether the ALJ had a duty to recontact treating sources or obtain consultative exam | Nugent: ALJ had affirmative duty to develop complete medical history and recontact or order consultative exam when record inadequate | Commissioner: no further development necessary given existing records and Dr. Smith’s note | Held for Nugent: ALJ failed to satisfy duty to fill evidentiary gap; should have recontacted treating sources or obtained retrospective/consultative opinions |
| Whether plaintiff’s testimony alone establishes RFC for light work | Nugent: testimony that he could perform “light duty” in 2009 supports ability to work | Commissioner: claimant’s testimony shows willingness and belief he could work; supports ALJ’s RFC | Rejected: Court held claimant’s lay statements were vague, tentative, and not equivalent to regulatory definitions; insufficient to fill evidentiary gap |
| Whether error was harmless | Nugent: error prejudicial because no medical basis for RFC | Commissioner: plaintiff failed to show resulting harm | Court: Error not harmless; remand required for further proceedings |
Key Cases Cited
- Green-Younger v. Barnhart, 335 F.3d 99 (2d Cir.) (standard for district court review of ALJ factual findings)
- Shaw v. Chater, 221 F.3d 126 (2d Cir.) (definition of substantial evidence)
- Balsamo v. Chater, 142 F.3d 75 (2d Cir.) (ALJ cannot substitute own medical judgment for physician opinion)
- Lisa v. Sec’y of Dep’t of Health & Human Servs., 940 F.2d 40 (2d Cir.) (post-application evidence may bear on condition during insured period)
- Camille v. Colvin, 104 F. Supp. 3d 329 (W.D.N.Y.) (opinions rendered before intervening treatment may be stale)
- Weed Covey v. Colvin, 96 F. Supp. 3d 14 (W.D.N.Y.) (ALJ’s affirmative duty to develop record)
- Filocomo v. Chater, 944 F. Supp. 165 (E.D.N.Y.) (ALJ should not perform own medical evaluations in absence of expert opinion)
- Campbell v. Astrue, 596 F. Supp. 2d 446 (D. Conn.) (retrospective treating physician diagnosis can be entitled to weight when uncontradicted)