Smith v. Colvin
17 F. Supp. 3d 260
W.D.N.Y.2014Background
- Plaintiff Lisa Smith (born 1972) applied for Social Security Disability Insurance in 2010, alleging disability from depression, anxiety, and PTSD with onset in 2008.
- ALJ John P. Costello held a hearing (Aug. 29, 2011) and denied benefits (Sept. 8, 2011), finding severe mental impairments but not meeting Listings 12.04/12.06 and assigning an RFC for work at all exertional levels with low-stress, no public contact, and occasional coworker contact.
- ALJ gave "great weight" to consultative psychologist Adele Jones, Ph.D., and a state agency reviewer, but afforded little or no weight to some treating-source notes (e.g., PA Mesiti) and failed to discuss substantial treatment records from Dr. Andrew Wurl, a psychology intern.
- Appeals Council denied review, and Smith sued under 42 U.S.C. § 405(g). Both parties moved for judgment on the pleadings; plaintiff sought remand for improper evaluation of medical opinions.
- District Court found the ALJ failed to properly consider/treat the treating-source evidence and did not give "good reasons" under 20 C.F.R. § 416.927(c) for discounting treating reports, warranting remand for further proceedings.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ properly weighed medical opinions (treating vs. consultative) in RFC | ALJ failed to address and weigh substantial treating-source records (Dr. Wurl) and gave insufficient reasons for discounting them | ALJ's reliance on consultative and state-agency opinions was supported by substantial evidence | Court: ALJ misapplied regulations by failing to give "good reasons" for not crediting treating-source evidence; remand ordered |
| Whether ALJ’s assessment satisfied treating-source rules under 20 C.F.R. § 416.927 | Smith: treating evidence required specific consideration of § 416.927(c) factors | Commissioner: ALJ permissibly relied on examining and state consultants as substantial evidence | Court: Failure to apply § 416.927(c) and to discuss treating records is reversible error |
| Whether consultative opinions alone constituted substantial evidence to deny benefits | Smith: consultative opinion insufficient when treating records show more limiting impairments | Commissioner: examining and state-review opinions can constitute substantial evidence if consistent with record | Court: Because ALJ ignored/failed to evaluate treating records, consultative opinions cannot stand as adequate basis without proper analysis |
| Remedy — remand v. direct award | Smith sought remand for further development and reweighing of evidence | Commissioner sought affirmance | Court: Remanded to Commissioner for further proceedings consistent with opinion |
Key Cases Cited
- Consolidated Edison Co. v. NLRB, 305 U.S. 197 (describes substantial-evidence standard)
- Richardson v. Perales, 402 U.S. 389 (substantial-evidence review of administrative findings)
- Tejada v. Apfel, 167 F.3d 770 (2d Cir. 1999) (scope of judicial review and substantial evidence)
- Halloran v. Barnhart, 362 F.3d 28 (2d Cir. 2004) (treating physician rule and requirement to give good reasons)
- Veino v. Barnhart, 312 F.3d 578 (2d Cir. 2002) (deference to Commissioner on evidentiary conflicts)
- Schaal v. Apfel, 134 F.3d 496 (2d Cir. 1998) (treating physician rule; "good reasons" requirement)
- Snell v. Apfel, 177 F.3d 128 (2d Cir. 1999) (failure to provide good reasons for discounting treating opinion is grounds for remand)