UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLUMBIA
_______________________________
)
ELTON WILLIAMS, )
)
Plaintiff, )
)
v. )
) Civ. Action No. 14-972 (EGS)
)
CAROLYN W. COLVIN, )
Acting Commissioner of )
Social Security, )
)
Defendant. )
)
MEMORANDUM OPINION
Plaintiff Elton Williams (“Mr. Williams”) brings this
action for judicial review of the final decision of the
Commissioner of the Social Security Administration (“the
Commissioner”) denying his claims for Supplemental Security
Income Benefits. Pending before the Court are Mr. Williams’s
Motion for Judgment of Reversal and the Commissioner’s Motion
for Judgment of Affirmance. Docket Nos. 8, 9. Upon consideration
of the parties’ submissions, the administrative record, the
governing statutory and case law, and for the following reasons,
Mr. Williams’s Motion is GRANTED; the Commissioner’s Motion is
DENIED; and this action is remanded to the Commissioner for
further proceedings in accordance with this Memorandum Opinion.
I. BACKGROUND
A. Factual Background
Elton Williams, born October 18, 1955, is a veteran seeking
Supplemental Security Income (“SSI”) under Title XVI of the
Social Security Act, 42 U.S.C. § 301 et seq. (“the Act”). Mr.
Williams has a high school education and no past relevant work
experience. Administrative Record (“AR”) at 53-54. Mr. Williams
alleges that he is unable to work due to mental health issues
including auditory hallucinations. Id. at 62.
On April 29, 2011, Mr. Williams was admitted to the
Veteran’s Administration (“VA”) hospital in Washington, DC. AR
at 494. He reported symptoms consistent with depression and
auditory hallucinations instructing him to commit suicide. Id.
at 499. Mr. Williams was hospitalized at the VA until May 17,
2011. Id. at 538. Following his release, he was monitored by the
VA’s suicide prevention program. Id. at 557. Mr. Williams
subsequently reported to the VA for bi-weekly injections of
risperidone, a psychotropic medication, and to participate in
group counseling. Id. at 571, 589. The risperidone injections
helped reduce his auditory hallucinations to non-violent
whispers. Id. at 59-60, 571. On September 19, 2012, upon a
determination that he was no longer considered a high risk, Mr.
Williams was released from the suicide prevention program. Id.
at 619.
2
Mr. Williams lives with his niece in Southeast Washington,
DC. AR at 53, 60. His daily activities include preparing food
for himself, straitening up the house, and running small errands
for his niece. Id. at 60. Mr. Williams is unable to drive due to
poor vision, but is able to walk and use public transportation.
Id. at 60-61.
B. Procedural History
Mr. Williams filed for SSI benefits on February 2, 2011,
alleging disability due to mood swings, paranoia, and bipolar
disorder. 1 AR at 224. The Commissioner denied Mr. Williams’s
claims on August 19, 2011 and denied his request for
reconsideration on January 12, 2012. Id. at 95-97, 102-05. At
Mr. Williams’s request, an Administrative Law Judge (“ALJ”) held
a hearing on his application on April 22, 2013. AR at 49-71. On
April 26, 2013, the ALJ issued a decision finding that Mr.
Williams was not disabled at any time through the date of his
decision. Id. at 28. Mr. Williams’s request for Social Security
Appeals Council review was denied on March 20, 2014, at which
time the ALJ’s determination became the “final decision” of the
Commissioner for the purposes of judicial review. Id. at 1-5;
see also 42 U.S.C. § 405(g). This lawsuit followed.
1 Mr. Williams initially also filed for Disability Insurance
Benefits (“DIB”) pursuant to Title II of the Act, but
subsequently withdrew his request. AR at 12.
3
II. DISCUSSION
A. Standard of Review
Section 405(g) of the Social Security Act provides for
judicial review of “final decisions” of the Commissioner of
Social Security. 42 U.S.C. § 405(g). On review, the court must
uphold the Commissioner’s determination where it is “supported
by substantial evidence” and “not tainted by an error of law.”
Porter v. Colvin, 951 F. Supp. 2d 125, 129 (2013) (citing Smith
v. Bowen, 826 F.2d 1120, 1121 (D.C. Cir. 1987)). “Substantial
evidence” is “such relevant evidence as a reasonable mind might
accept as adequate to support a conclusion.” Brown v. Bowen, 794
F.2d 703, 705 (D.C. Cir. 1986) (quoting Richardson v. Perales,
402 U.S. 389, 401 (1971)).
“Even if supported by substantial evidence, however, the
court will not uphold the Commissioner’s findings if the
Commissioner reached them by applying an erroneous legal
standard.” Jackson v. Barnhart, 271 F. Supp. 2d 30, 33 (D.D.C.
2002); see also Coffman v. Bowen, 829 F.2d 514, 517 (4th Cir.
1987) (“A factual finding by the ALJ is not binding if it was
reached by means of an improper standard or misapplication of
the law.”). To determine whether the Commissioner’s decision is
free from legal error and supported by substantial evidence, the
court must “carefully scrutinize the entire record,” but “may
not reweigh the evidence and replace the [Commissioner’s]
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judgment regarding the weight of the evidence with its own.”
Jackson, 271 F. Supp. 2d 30, 34 (citing Davis v. Heckler, 556 F.
Supp. 1193, 1195 (D.D.C. 1983)).
B. Legal Framework
To qualify for Supplemental Security Income (“SSI”) under
Title XVI of the Act, the applicant must establish that he is
“disabled” as defined in the Act. 42 U.S.C. § 1382(a)(1).
“Disability” refers to the inability to “engage in any
substantial gainful activity by reason for any medically
determinable physical or mental impairment which . . . has
lasted or can be expected to last for a continuous period of not
less than twelve months.” 42 U.S.C. 1382c(a)(3)(A).
The Commissioner has established a five-step sequential
evaluation process for assessing a claimant’s alleged
disability. See 20 C.F.R. § 416.920. The claimant bears the
burden of proof during the first four steps. Id. First, the
claimant must demonstrate that he is not presently engaged in
“substantial gainful work.” 20 C.F.R. § 416.920(b). Second, a
claimant must show that he has a “severe impairment” that
“significantly limits [his] physical or mental ability to do
basic activities.” 20 C.F.R. § 416.920(c). Third, if the
claimant suffers from an impairment that meets or equals an
impairment listed in Appendix 1 to the Commissioner’s
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regulations, he is deemed disabled, and the inquiry ends. 20
C.F.R. § 416.920(d).
If the impairment is not one the regulations presume to be
disabling, however, then the evaluation continues to a fourth
step, which requires the claimant to show that he is incapable
of performing work that he has done in the past. 20 C.F.R. §
416.920(e). Once the claimant has carried his burden on the
first four steps, the burden shifts to the Commissioner on step
five to demonstrate that the claimant is able to perform “other
work” based on a consideration of his “residual functional
capacity” (“RFC”), age, education and past work experience. 20
C.F.R. § 416.920(f); see also Brown, 794 F.2d at 706; Davis v.
Astrue, 602 F. Supp. 2d 214, 217 (D.D.C. 2009).
C. The Commissioner’s Decision
In this case, the Commissioner, through the ALJ, applied
the five-step analysis and determined, first, that Mr. Williams
had not engaged in substantial gainful activity during the
relevant time period. AR at 14. Second, the ALJ found that Mr.
Williams had “severe impairments” within the meaning of the
regulations – specifically, an affective disorder,
schizophrenia, and visual disturbance. Id. at 14. At step 3 of
the analysis, the ALJ found that Mr. Williams’s impairments,
while severe, were not listed in Appendix 1, nor were they
“medically equal” to any of the presumptively disabling
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impairments. Id. at 15. At step 4, the ALJ determined that Mr.
Williams had no past relevant work experience. Id. at 27.
Finally, at step 5, upon consideration of his age,
education, work experience, and RFC, the ALJ concluded that Mr.
Williams could perform jobs that exist in significant numbers in
the national economy. Id. In determining Mr. Williams’s RFC, the
ALJ found that while Mr. Williams had the RFC to perform a full
range of work at all exertional levels, he possessed the
following “nonexertional limitations”: (1) Mr. Williams should
not work around dangerous conditions such as machinery or
unprotected heights; (2) Mr. Williams can perform tasks
requiring the ability to remember, understand, and carry out
simple instructions, but cannot perform complex tasks; (3) Mr.
Williams can tolerate only occasional contact with coworkers and
the general public; and (4) Mr. Williams’s limitations in
concentration and focus may cause him to be off task five
percent of the workday. Id. at 16. The ALJ concluded that Mr.
Williams was capable of performing work as a janitor, stock
clerk, or packer. Id. at 26-27.
D. Mr. Williams’s Motion for Judgment of Reversal
Mr. Williams argues that the Commissioner’s determination
should be reversed due to an erroneous calculation of his RFC.
Pl.’s Mot. Judg. Rev., Docket No. 8-1 at 3. Mr. Williams alleges
that the ALJ failed to evaluate or consider the opinion of Dr.
7
Sud, one of Mr. Williams’s treating physicians, who concluded
that Mr. Williams was unable to handle stress as his psychotic
symptoms could quickly worsen when stressed. Id. at 6. Mr.
Williams also contends that the ALJ failed to explain how the
evidence supports his RFC assessment and that the ALJ improperly
relied on Mr. Williams’s Global Assessment of Functioning
(“GAF”) scores in determining that he was not disabled. Id. at
11. Each of Mr. Williams’s arguments will be addressed in turn.
1. The ALJ Erred in Not Considering the Opinion of
Dr. Sud
The D.C. Circuit has made clear that “[b]ecause a
claimant’s treating physicians have great familiarity with his
condition, their reports must be accorded substantial weight.”
Williams v. Shalala, 997 F.2d 1494, 1498 (D.C. Cir. 1993); see
also Gilliland v. Colvin, 67 F. Supp. 3d 308, 314 (D.D.C. 2014).
“A treating physician’s report is binding on the fact-finder
unless contradicted by substantial evidence.” Butler v.
Barnhart, 353 F.3d 992, 1003 (D.C. Cir. 2004). Thus, an “ALJ who
rejects the opinion of a treating physician must explain his or
her reasons for doing so.” Gilliand, 67 F.2d at 1498 (internal
citations and quotations omitted).
Here, Mr. Williams argues that the ALJ failed to consider,
let alone give substantial weight to, a form questionnaire
completed by Dr. Indu Sud on August 1, 2011. Pl.’s Mot. Judg.
8
Rev., Docket No. 8-1 at 6. 2 On the form, Dr. Sud diagnosed Mr.
Williams with “major depression with psychotic features.” Id. at
527. When asked to describe the effect of this diagnosis “on
[Mr. Williams’s] physical/mental ability to perform work-related
activities,” Dr. Sud indicated that Mr. Williams was “[u]nable
to handle stress, can have psychotic symptoms surface quickly
when stress” [sic]. Id. at 528. Mr. Williams argues that by
failing to mention or evaluate the opinion of one of his
treating physicians, the ALJ committed reversible error. Pl.’s
Mot. Judge. Rev., Docket No. 8-1 at 6. The Commissioner does not
dispute that Dr. Sud was one of Mr. Williams’s treating
physicians, nor does the Commissioner dispute that the ALJ
failed to mention or evaluate Dr. Sud’s August 1, 2011 opinion,
rather the Commissioner argues that this failure was harmless
error and does not warrant a remand of this case. Def.’s Mot.
Judg. Aff., Docket No. 9 at 11. The Commissioner argues that
there is no need to remand the case because the three potential
jobs identified for Mr. Williams during Step five of the ALJ’s
analysis – janitor, stock clerk, and packer – are all “low
stress” jobs. Id. at 13-14.
2 The form is a standard questionnaire prepared by the D.C.
Rehabilitation Services Administration: Disability Determination
Division. AR at 527-28.
9
The Commissioner’s argument is unavailing. “[S]tress is not
a characteristic of a job, but instead reflects an individual’s
subjective response to a particular situation.” Lancellotta v.
Sec. Health & Hum. Serv., 806 F.2d 284, 285 (1st Cir. 1986).
Indeed, “the use of the term ‘low stress’ is somewhat of a
misnomer because stress lies in the individual not in the job.”
Clifford v. Apfel, 227 F.3d 863, 868 n.2 (7th Cir. 2000). Social
Security Ruling 85-15 (“SSR 85-15”) states that a person’s
ability to cope with stress in the workplace is a “highly
individualized” condition that requires “thoroughness in
evaluation on an individualized basis” See SSR 85-15 at *5.
Moreover, any limitations created by a person’s response to
stress in the workplace “must be reflected in the RFC
assessment.” See SSR 85-15 at *6.
In light of this individualized inquiry, the Commissioner
cannot simply declare post hoc that the potential work
identified by the ALJ would be low stress for Mr. Williams. 3 The
Commissioner’s own policy statement indicates that a person’s
ability to handle stress must be evaluated individually and
3 Further, Dr. Sud’s opinion did not state that Mr. Williams
could tolerate low stress work, it stated that Mr. Williams was
“unable to handle stress.” AR at 258. Thus, limiting Mr.
Williams to “low stress” work does not sufficiently address the
limitation identified by Dr. Sud.
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reflected specifically in the individual’s RFC assessment. SSR
85-15 at *5, *6.
When confronted with Dr. Sud’s opinion indicating that Mr.
Williams was “unable to handle stress,” the ALJ had two options:
(1) reject Dr. Sud’s opinion and provide an explanation for that
rejection, or (2) accept Dr. Sud’s opinion and conduct an
individualized assessment on how stress affects Mr. Williams’s
ability to work. The ALJ did neither. 4 Accordingly, the ALJ’s
decision must be vacated and remanded for further consideration
of Dr. Sud’s opinion in regard to Mr. Williams’s ability to
handle stress.
2. The ALJ’s Decision Fails to Explain How His RFC
Assessment is Supported by the Evidence
Next, Mr. Williams argues that the ALJ’s decision fails to
provide a “narrative discussion setting forth how the evidence
supported each conclusion, citing specific medical facts and
nonmedical evidence.” Pl.’s Mot. Judg. Rev., Docket No 8-1 at
4 Alternatively, the Commissioner argues that the ALJ’s failure
to consider Dr. Sud’s August 11, 2011 opinion was harmless
because the ALJ considered Dr. Sud’s treatment notes from
September 22, 2011. Def.’s Mot. Judg. Aff., Docket No. 9 at 11-
12. The Commissioner notes that “[a]part from Dr. Sud’s notation
concerning [Mr. Williams’s] ability to handle stress,” the two
documents from Dr. Sud are nearly identical. The Commissioner’s
concession swallows her argument – the two documents are
different in that only the August opinion provides Dr. Sud’s
opinion on Mr. Williams’s ability to handle stress. Compare AR
527-28 with AR 570-74. Accordingly, the case must be remanded to
allow the ALJ to consider Dr. Sud’s August opinion.
11
10. Specifically, Mr. Williams argues the ALJ did not explain
his basis for the following findings: (1) that Mr. Williams
needed to avoid dangerous conditions; (2) that Mr. Williams was
limited in tasks requiring the ability to understand, remember,
and carry out simple tasks; (3) that Mr. Williams could only
tolerate occasional contact with coworkers, supervisors, and the
general public; and (4) that Mr. Williams would be off-task for
about five percent of the day. Id. The Commissioner counters
that the evidence supports the ALJ’s conclusion, and that while
“the ALJ ideally might have provided additional explanation for
the functional restrictions he found,” any error was harmless.
Def.’s Mot. Judg. Aff., Docket 9 at 16.
Social Security Ruling 96-8p (“SSR 96-8p”) requires that
the ALJ’s narrative discussion of the claimant’s RFC,
contain a thorough discussion and analysis
of the objective medical and other evidence,
including the individual’s complaints of
pain and other symptoms and the
adjudicator’s personal observations, if
appropriate; a resolution of any
inconsistencies in the evaluation as a
whole; and a logical explanation of the
effects of the symptoms, . . . on the
individual’s ability to work.
SSR 96-8p at *7 (emphasis added). It is insufficient for the ALJ
to merely list the claimant’s medical history and then
conclusively state the claimant’s RFC; the ALJ must “build an
accurate and logical bridge from the evidence to [his]
12
conclusion so that, as a reviewing court, we may assess the
validity of the agency’s ultimate findings and afford a claimant
meaningful judicial review.” Lane-Rauth v. Barnhart, 437 F.
Supp. 2d 63, 67 (D.D.C. 2006) (quoting Scott v. Barnhart, 297
F.3d 589, 595 (7th Cir. 2002)).
Here, the ALJ’s decision fails to build that logical
bridge. While the ALJ finds four non-exertional limitations on
Mr. Williams’s RFC and follows those findings with a thorough
recitation of Mr. Williams’s testimony and a summary of his
medical history, the ALJ fails to indicate how the evidence
recited supports each of his findings. Without that “logical
bridge” between the evidence and the ALJ’s conclusion, the Court
cannot determine whether the ALJ’s conclusion is supported by
substantial evidence. Lanue-Rauth, 437 F. Supp. 2d at 68
(“Although the court defers to the ALJ’s determination of facts
based on substantial evidence, the court is unable to understand
the ALJ’s route to his conclusions from the ruling in its
current form”).
The Commissioner seeks to save the ALJ’s decision by
pointing to evidence that may have supported each of the ALJ’s
findings. Def.’s Mot. Judg. Aff., Docket 9 at 15. For instance,
for the ALJ’s first finding, the Commissioner’s motion explains:
The ALJ’s conclusion that Plaintiff needed
to avoid dangerous conditions was supported
by Plaintiff’s report that he was unable to
13
drive due to his poor vision (and,
therefore, logically would be unable to
perform other hazardous activities or deal
with other hazardous conditions).
Id. However, this explanation never appears in the ALJ’s
opinion. A reviewing court “may not accept appellate counsel’s
post hoc rationalizations for agency action.” Burlington Truck
Lines, Inc. v. United States, 371 U.S. 156, 168 (1962); Snell v.
Apfel, 116 F.3d 128, 134 (2d Cir. 1999). Accordingly, the
Commissioner’s attempt to build a logical bridge post hoc is
insufficient.
Finally, the Commissioner argues that
[a]lthough the ALJ ideally might have
provided additional explanation for the
functional restrictions that he found,
procedural perfection in the administrative
proceedings is not required, and the Court
should not vacate the judgment of the agency
unless the substantial rights of a party
have been affected.
Def.’s Mot. Judg. Aff., Docket No. 9 at 16. The Commissioner
argues there are no grounds to remand the ALJ’s decision because
Mr. Williams “does not point out any limitations that he
believes the ALJ omitted from his RFC findings.” Id. at 14.
Procedural perfection is not required, but in this case,
Mr. Williams has identified a limitation the ALJ failed to
consider, namely, Mr. Williams’s inability to handle stress.
Accordingly, the ALJ’s failure to set forth a narrative
discussion connecting the evidence to the limitations found was
14
not harmless error. On remand, the ALJ must provide his own
explanation of how the evidence supports each of his findings.
3. The ALJ’s Use of Mr. Williams’s GAF Scores Was
Permissible
Finally, Mr. Williams argues that the ALJ erroneously
relied on his Global Assessment of Functioning (“GAF”) scores in
determining that he was not disabled. Pl.s’ Mot. Judg. Rev.,
Docket No. 8-1 at 11. The Commissioner replies that Mr.
Williams’s GAF scores were properly considered in conjunction
with the rest of the evidence. Def.’s Mot. Judg. Aff., Docket
No. 9 at 17-18.
The GAF score is a “subjective determination that
represents the clinician’s judgment of the individual’s overall
level of functioning.” Jones v. Astrue, 619 F.3d 963, 973 (8th
Cir. 2010). The Commissioner has declined to endorse the GAF
scale for “use in the Social Security and SSI disability
programs,” and has indicated that GAF scores have no “direct
correlation to the severity requirements of the mental disorders
listings.” See Wind v. Barnhart, 133 F. App’x 684, 692 n.5 (11th
Cir. 2005) (citing 65 Fed. Reg. 50746, 50764-65 (Aug. 21,
2000)). While an individual’s GAF score is never dispositive of
disability, an ALJ may consider a claimant’s GAF scores as
relevant evidence of the claimant’s general functional
15
abilities. Graham v. Astrue, 385 F. App’x 704, 706 (9th Cir.
2010).
It was permissible for the ALJ to consider Mr. Williams’s
GAF scores in conjunction with the rest of the evidence. Rather
than relying on the GAF scores alone, the ALJ included Mr.
Williams’s GAF scores as part of the discussion of his medical
history. This alone is not grounds for remand. In light of the
errors noted above, however, it is nonetheless necessary to
remand this action to the ALJ for further proceedings.
III. CONCLUSION
For the foregoing reasons, Mr. Williams’s motion for
judgment of reversal is GRANTED; the Commissioner’s motion for
judgment of affirmance is DENIED; and the matter is remanded to
the Social Security Administration for further proceedings
consistent with this Memorandum Opinion. A separate order
accompanies this Memorandum Opinion.
Signed: Emmet G. Sullivan
United States District Judge
September 30, 2015.
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