[Tonya L.] v. Kijakazi, No. 22-CV-61236, 2023 WL 2562649 (S.D. Fla. Feb. 28, 2023)

[Tonya L.] v. Kijakazi, No. 22-CV-61236, 2023 WL 2562649 (S.D. Fla. Feb. 28, 2023), report and recommendation adopted, No. 22-61236-CIV, 2023 WL 2560903 (S.D. Fla. Mar. 17, 2023) (R&R by U.S. Magistrate Judge Jared M. Strauss, adopted by Chief U.S. District Judge Cecilia M. Altonaga)

Briefs for purchase:

• Plaintiff’s Motion for Summary Judgment
• Plaintiff’s Reply Brief
• Report and Recommendation
• Order Adopting Report & Recommendation 

Topics addressed:

• Establishing onset date 

• RFC - assistive device

• RFC - required findings

• RFC - ALJ must build an accurate and logical bridge from the evidence to his conclusion

• ALJ decision - misstatement of evidence

• Subjective symptoms - ALJ must consider reasons for not seeking treatment 

• Medical opinions (new law) - persuasiveness

• Post hoc justification
  

Rulings addressed:

• Social Security Ruling 83-10

• Social Security Ruling 96-8p

• Social Security Ruling 16-3p

• Social Security Ruling 18-01p
  

Issues briefed:

1)  The ALJ failed to comply with 20 C.F.R. §§ 404.1520b, 416.920b in evaluating the report of Dr. Adam, a consultative physician.

2) The ALJ’s RFC assessment for the period from the alleged onset date of March 23, 2018, to August 3, 2020, the established onset date, is not supported by substantial evidence.

3) The ALJ’s stated reasons for discrediting Plaintiff’s testimony for the period prior to August 3, 2020, are not based on substantial evidence.

Court decision:
The Report and Recommendation, which was adopted in full by the district court, noted the Commissioner did not dispute that the ALJ failed to address the persuasiveness, consistency, or supportability of the CE’s opinion, and instead, disputes the CE provided any medical opinion at all. 2023 WL 2562649 at *5. The court looked to the definition of “medical opinion” in 20 C.F.R. §§ 404.1513(a)(2), 416.913(a)(2), and agreed that the CE’s findings that Plaintiff had reduced strength, difficulty getting on and off the table and with postural movements, walked with a cane, and had reduced range of motion do not qualify as medical opinions. Id. However, the CE’s statement that Plaintiff’s cane is medically necessary to walk both short and long distances directly addresses a restriction in the ability to walk, which is a physical demand of work activities and qualifies as a medical opinion; thus, the ALJ erred by failing to assess it in accordance with the regulations governing the evaluation of medical opinions. Id.

The court agreed that the RFC of light work between the alleged onset date (AOD) of March 23, 2018, and the established onset date (EOD) of August 3, 2020, and sedentary work as of the EOD, was not supported by substantial evidence. Id. at *7. “To ensure that meaningful review is possible, an ALJ’s RFC analysis must contain ‘three components: (1) evidence, (2) logical explanation, and (3) conclusion’” and contain “a narrative discussion describing how the evidence supports each conclusion” and the ALJ must “‘build an accurate and logical bridge from the evidence to his or her conclusion.’” Id. at *6. (citing Thomas v. Berryhill, 916 F.3d 307, 311 (4th Cir. 2019)).

The court found the ALJ’s apparent agreement with the State agency consultants that insufficient evidence existed to assess RFC prior to the September 30, 2018, date last insured, but in the same sentence, then seemed to say that she could still find there was enough evidence to limit Plaintiff to light work during that period “does not add up.” Id. at *7. “Moreover, if there was in fact enough evidence to assess the level of work Plaintiff could perform (light, sedentary, etc.), the ALJ does not explain why that evidence only limited Plaintiff to light work and not sedentary work. The absence of a logical explanation frustrates meaningful review.” Id.

The court further found unclear from the ALJ’s decision why the mere introduction of the consultative examination of August 3, 2020, and the August 2020 scans became enough to reduce Plaintiff to sedentary work when the seemingly serious MRIs of Plaintiff’s knee from early 2018 combined with Plaintiff’s allegations and the other evidence, including that Plaintiff already was using a cane at the August 3, 2020, examination, were not enough. Id. While noting the ALJ’s determination may ultimately be reasonable, “the absence of a logical explanation impedes the Court’s ability to ascertain whether the ALJ’s RFC determination is supported by substantial evidence.” Id.

The R&R notes that discussion of Plaintiff’s subjective symptom argument was not made because that argument largely turns on the outcome of her argument regarding the ALJ’s RFC assessment, which was found deficient. Id.at*8,nt.4.  Since an ALJ will need to reassess RFC on remand, the subjective symptom inquiry will need to be conducted again given that it is part and parcel of the RFC assessment. Id.