Wilson v. Comm’r of Soc. Sec. (M.D. Fla. Mar. 9, 2018) (Decision by Magistrate Judge Irick)

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Included: Joint Memorandum and Decision

Issues Briefed:

  1. 1)  Whether the ALJ erred in according “lesser weight” to the opinion of Dr. Owens, and the “greatest weight” to the opinion of Dr. Goldman.

  2. 2)  Whether the ALJ’s credibility finding was based on substantial evidence.

  3. 3)  Whether Ms. Wilson was prejudiced by an invalid waiver of counsel.

  4. 4)  Whether the proper remedy is reversal or remand.

In Wilson, a case that was pending for 16 years and included one prior court remand, two Appeals Council remands and four hearings, the claimant proceeded pro se following the first court remand and obtained two partially favorable decisions. The sole period at issue was from June 13, 2003 through January 1, 2007. Slip op at 18. The court reversed and remanded for further proceedings. Id.

The court first found that the ALJ “did not articulate any specific reasons supporting his credibility determination, and failed to tie any of those medical records to any of Claimant’s testimony concerning her disabling pain and functional limitations.” Id. at 10. As the ALJ “failed to clearly articulate any specific reasons supporting his credibility determination,” it was “unclear what the ALJ relied on in reaching his credibility determination,” which “frustrates the Court’s ability to conduct a meaningful review.” Id. The Court found this failure was “significant” because the claimant’s limitations, if credited, would contradict the ALJ’s RFC determination. Id. at 11. Thus, the Court held that ALJ’s decision was not supported by substantial evidence. Id.

The court further found that the ALJ erred in only discussing the claimant’s testimony at the fourth hearing, as the record included transcripts of the three prior hearings where she “testified to extensive pain and limitations . . . each of which was temporally more proximal to the interim time periodatissueinthefourthhearing.”Id.at12. “Infact,Claimant’stestimonyatthesecondhearing was on January 14, 2008, just two weeks after the end of the interim period at issue,” and her testimony was inconsistent with the ALJ’s light work finding. Id. Thus, the Court held “this case must also be reversed so the ALJ may consider Claimant’s testimony at the first, second, and third hearings contained within the record in this case.” Id.

The court went on to address the two reasons cited by the ALJ for concluding that the claimant was not disabled during the interim period – the claimant’s treatment regimen and her move from Florida to Virginia and back. Id. at 13. “Even if the Court were to consider both of the foregoing rationales as the ALJ’s stated basis for discrediting Claimant’s testimony, the Court finds that the ALJ’s decision is still unsupported by substantial evidence.” Id. First, the “Court cannot simply assume that the move required physical action by the Claimant that somehow belied disability” and “[t]o say that such a move is evidence of a lack of disability is completely baseless . . . .” Id.

Second, the ALJ’s finding regarding the “alleged conservative nature of the medical treatment and alleged rejection of a surgical option . . . ignores a significant portion of the record evidence as it relates to the interim period.” Id. at 14. As the court elaborated:

Here, there was consistent record evidence that Claimant was unable to afford treatment during the interim period at issue, including Claimant’s testimony at the first, second, and third hearings, as well as her two letters to the Appeals Council. . . . The conservative nature of Claimant’s treatment – including her alleged non- compliance with a surgical recommendation – was the primary reason even arguably articulated by the ALJ to support the credibility decision in this case. Indeed, setting aside the boilerplate language concerning the medical evidence of record and Claimant’s interstate move with her husband so he could find work, it was the sole basis for the ALJ’s credibility decision. That credibility determination, supported as it was by an evaluation of the nature of Claimant’s treatment, is inextricably intertwined with Claimant’s financial ability to obtain treatment. Thus, the Court finds that it was error for the ALJ to fail to determine, or even consider, the record evidence that the conservative nature of Claimant’s treatment – and her alleged non- compliance with a surgical recommendation – during the interim period was due to Claimant’s inability to afford other treatment.

Id. at 15.

Finally, the Court noted that the Commissioner found the claimant disabled from September 2001 to June 13, 2003 and again beginning January 1, 2007, but during the “three-and-a-half interim period from June 13, 2003 to December 31, 2006, the Commissioner deemed Claimant to not be disabled, and found her testimony to not be credible.” Id. at 16. However, the “ALJ failed to address Claimant’s testimony and statements that she could not afford medical treatment during this interim time period.” Id. Accordingly, the Court found that the ALJ’s credibility determination was not supported by substantial evidence. Id.

The court also commented that the “errors identified above were compounded by Claimant’s lack of counsel or a representative assisting her” and directed that, on remand, the ALJ shall:

  1. (1)  allow Claimant an opportunity to have a representative assist her, and to obtain a clear waiver on the record if Claimant does not have such a representative;

  2. (2)  consider all of the hearing transcripts and medical opinions contained within the record including those supporting a disability finding prior to June 13, 2003;

  1. (3)  consider Claimant’s ability to afford treatment during the interim period at issue; and

  2. (4)  in the event the ALJ concludes that Claimant was not disabled during the interim

    period in question, then the ALJ must identify the evidence that supports his or her finding that Claimant’s condition improved after June 12, 2003.

Id. at 16-17.