United States District Court, D. South Carolina
Richard Mark Gergel, United States District Judge
has brought this action pursuant to 42 U.S.C. §§
405(g) and 1383(c)(3) seeking judicial review of the final
decision of the Commissioner of Social Security denying her
claim for Disability Insurance Benefits ("DIB") and
Supplemental Security Income ("SSI"). In accordance
with 28 U.S.C. § 636(b) and Local Civil Rule 73.02 DSC,
this matter was referred to a United States Magistrate Judge
for pre-trial handling. The Magistrate Judge issued a Report
and Recommendation ("R & R") on June 2, 2017,
recommending that the Commissioner's decision be
affirmed. (Dkt. No. 19). Plaintiff filed objections to the R
& R and the Commissioner filed a response. (Dkt. No. 21,
22). As explained below, the Court reverses the decision of
the Commissioner and remands the matter to the agency for
further action consistent with this order.
Magistrate Judge makes only a recommendation to this Court.
The recommendation has no presumptive weight, and the
responsibility to make a final determination remains with the
Court. Mathews v. Weber, 423 U.S. 261 (1976). The
Court is charged with making a de novo determination
of those portions of the Report and Recommendation to which
specific objection is made. The Court may accept, reject, or
modify, in whole or in part, the recommendation of the
Magistrate Judge. 28 U.S.C. § 636(b)(1).
role of the federal judiciary in the administrative scheme
established by the Social Security Act is a limited one. The
Act provides that the "findings of the Commissioner of
Social Security as to any fact, if supported by substantial
evidence, shall be conclusive." 42 U.S.C. § 405(g).
"Substantial evidence has been defined innumerable times
as more than a scintilla, but less than preponderance."
Thomas v. Celebrezze, 331 F.2d 541, 543 (4th Cir.
1964). This standard precludes de novo review of the
factual circumstances that substitutes the Court's
findings of fact for those of the Commissioner. Vitek v.
Finch, 438 F.2d 1157 (4th Cir. 1971). Although the
federal court's review role is a limited one, "it
does not follow, however, that the findings of the
administrative agency are to be mechanically accepted. The
statutorily granted right of review contemplates more than an
uncritical rubber stamping of the administrative
action." Flack v. Cohen, 413 F.2d 278, 279 (4th
Cir. 1969). Further, the Commissioner's findings of fact
are not binding if they were based upon the application of an
improper legal standard. Coffman v. Bowen, 829 F.2d
514, 519 (4th Cir. 1987).
the regulations of the Social Security Administration, the
Commissioner is obligated to consider all medical evidence
and the opinions of all medical sources, including treating
physicians. 20 C.F.R. § 404.1527(b). This includes the
duty to "evaluate every medical opinion we
receive." Id. § 404.1527(c). Under what is
commonly referred to as Treating Physician Rule, the
Commissioner is required to give special consideration to the
opinions of treating physicians of the claimant, based on the
view that "these sources are likely to be the medical
professionals most able to provide a detailed, longitudinal
picture of [the claimant's] medical impairment(s) and may
bring a unique perspective to the medical evidence that
cannot be obtained from objective medical findings alone or
from reports of individual examinations, such as consultative
examinations or brief hospitalizations." Id.
§ 404.1527(c)(2). Under some circumstances, the opinions
of the treating physicians are to be accorded controlling
weight. Even where the opinions of the treating physicians of
the claimant are not accorded controlling weight, the
Commissioner is obligated to weigh those opinions in light of
a broad range of factors, including the examining
relationship, the treatment relationship, length of
treatment, nature and extent of the treatment relationship,
supportability of the opinions in the medical record,
consistency, and whether the treating physician was a
specialist. Id., §§ 404.1527(c)(1)-(5).
The Commissioner is obligated to weigh the findings and
opinions of treating physicians and to give "good
reasons" in the written decision for the weight given to
a treating source's opinions. SSR 96-2P, 61 Fed. Reg.
34490, 34492, 1996 WL 374185 (July 2, 1996). Further, all
medical opinions must be weighed under the standards of the
Treating Physician Rules, including non-treating and
non-examining physicians. §§ 404.1527(c),
evaluating a claim of disability under the Social Security
Act, the Commissioner is obligated to determine the
claimant's severe and non-severe impairments and assess
whether, despite any such combination of impairments, the
claimant retains the residual functional capacity to perform
sustained work on a regular and continuous basis. The lowest
level of functional capacity for sustained work is sedentary
work. Such work generally requires the capacity to sit 6
hours in an 8 hour workday, to stand up to 2 hours in an
eight hour day, and to lift no more than 10 pounds at a time.
SSR 96-9P, 1996 WL 374185 (July 2, 1996).
important to note at the outset the profound work-related
limitations the Administrative Law Judge ("ALJ")
concluded were present in this claim for disability benefits.
The ALJ determined that Plaintiff retained the residual
functional capacity ("RFC") for less than the full
range of sedentary work. Tr. 19-22. The Commissioner
recognizes that a RFC of less than the full range of
sedentary work "reflects very serious limitations
resulting from an individual's medical
impairments(s)" and is "expected to be relatively
rare." SSR 96-9P, 1996 WL 374185, at * 1. This level of
function is the lowest level possible without a claimant
being found disabled under the Social Security Act. This
"rare" determination was reached by the ALJ only
after providing "little weight" to the opinions of
Plaintiff s primary treating physician, Dr. Jeff Kramer, and
making findings regarding Plaintiffs capacity to sit during a
normal work day and Dr. Kramer's treatment notes which
are not supported by substantial evidence in the record.
concluded that Plaintiff suffered from multiple severe
impairments, including lupus, depression and anxiety. The
Commissioner recognizes that lupus is "a chronic
inflammatory disease that can affect any organ or body
system" and can result in severe fatigue, malaise,
anemia, mood disorders, anxiety, inflammatory arthritis, and
severe pain. 20 CFR Pt. 404, Subpt. P, App. 1, Listing
14.02(1)(a). A lupus patient's condition can be
"highly variable" and requires a careful,
individualized assessment. Id. In light of these
potential signs and symptoms, lupus can have a profound and
disabling affect on a individual's capacity to sustain
work 8 hours a day, 5 days a week.
Court sets forth below significant deficiencies in the
ALJ's decision in this matter, each which independently
require reversal and remand.
The ALJ's finding that Dr. Kramer's opinions are
inconsistent with the doctor's treatment notes is not
supported by substantial evidence in the record.
support of the ALJ's conclusion that the opinions of
Plaintiff s primary care physician, Dr. Kramer were entitled
to "little weight, " the ALJ found that opinions
Dr. Kramer provided in response to a February 2014
questionnaire were "inconsistent with [his] treatment
notes." Tr. 21. By way of background, Dr. Kramer, an
internal medicine physician, was intimately involved in the
management of Plaintiff s complicated medical problems during
the entire period in question in this appeal. Over the period
extending from October 1, 2012 until May 13, 2014, Dr. Kramer
examined and treated Plaintiff on at least nine occasions,
more than any other medical provider. Plaintiff was also
treated for her lupus during this period by a rheumatologist,
Dr. William Edwards. Notably, Dr. Edwards declined to provide
a disability assessment for Plaintiff, explaining that this
was an area in which he deferred to other providers. Tr. 334.
Dr. Kramer thereafter completed a detailed functional
assessment of Plaintiff s capacity to work, considering all
of her multiple impairments, and the opinions offered in this
assessment were the ones in which the ALJ accorded
"little weight" because they were allegedly
inconsistent with his treatment notes.
responses to the February 2014 questionnaire, Dr. Kramer
documented that as a result of her lupus Plaintiff suffered
from non-erosive arthritis, anemia, severe fatigue, severe
joint pain, malaise, mood disorders, and inflammatory
arthritis. Tr. 343-344. He opined that she could sit no more
than 15 minutes at a time and stand no more than 5 minutes at
a time. Tr. 345. He indicated that she could not sit or
stand/walk as much as 2 hours in an 8 hour day. Id.
He further indicated she would need frequent breaks
throughout the day and was incapable of even low stress work,
explaining that this was because of "severe pain from