Rubin v. O'Malley
116 F.4th 145
2d Cir.2024Background
- Michelle Rubin, suffering from major depressive disorder, applied for Social Security Disability Insurance (SSDI) benefits, alleging disability onset in February 2018 and last insured date December 31, 2019.
- Rubin's claim was denied by an Administrative Law Judge (ALJ), who found she was not disabled under the Social Security Act.
- The ALJ based her decision largely on Rubin’s ability to perform certain daily activities, operate a small business for a time, and the results of routine mental status exams, rather than fully crediting the treating psychiatrist and therapy notes.
- Rubin provided consistent medical and nonmedical evidence (from therapists, psychiatrist Dr. Paul, and family/friends) documenting severe functional limitations and inability to adapt to changes.
- Two state agency psychologists found insufficient evidence to adjudicate the claim (as Rubin missed a consultative exam, possibly due to notification issues) and did not contradict Dr. Paul's opinion.
- The district court affirmed the SSA’s benefits denial, but the Second Circuit vacated the district court’s judgment and remanded for further proceedings.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ’s no-disability finding was supported by substantial evidence | No substantial evidence; only Dr. Paul offered a substantive medical opinion (supporting disability); contrary evidence lacking | The ALJ could base decision on overall record, including daily activities and mental exams, not just medical opinion | ALJ’s decision was not supported by substantial evidence, especially at step three |
| Whether ALJ properly evaluated medical opinions under new regulations | ALJ failed to properly consider supportability and consistency of Dr. Paul’s opinion and overlooked entire treatment team context | ALJ’s partial rejection of Dr. Paul justified by Rubin's activities and Dr. Paul’s normal MSE notes | Court found the ALJ misinterpreted/misconstrued the medical and lay evidence |
| Whether Rubin met criteria for Listing 12.04 (paragraph C) | Rubin satisfied both C(1) (ongoing treatment) and C(2) (marginal adjustment/minimal adaptation) based on consistent clinical and lay evidence | No evidence of minimal capacity to adapt to changes; activities showed more capacity than alleged | ALJ’s conclusion not backed by record; Rubin satisfied Listing 12.04(C) criteria |
| Remedy: direct award or remand | Court should find Rubin disabled and order benefits | Remand for further agency proceedings due to incomplete record (Missed consultative exam) | Remand for further proceedings, including examination |
Key Cases Cited
- Estrella v. Berryhill, 925 F.3d 90 (2d Cir. 2019) (standard of review for ALJ's disability decisions; requirement to consider medical opinion evidence)
- Cichocki v. Astrue, 729 F.3d 172 (2d Cir. 2013) (plenary review of administrative record for substantial evidence)
- Selian v. Astrue, 708 F.3d 409 (2d Cir. 2013) (requirement for ALJ to consider contradictory evidence)
- Berry v. Schweiker, 675 F.2d 464 (2d Cir. 1982) (upholding ALJ decision only if supported by substantial evidence in the record)