U.S. District Court for the Western District of NY says plaintiff

Daily Record (Rochester, NY), Jul 28, 2005 by Helen Nguyen

Concluding the administrative law judge (ALJ) made several errors when evaluating the plaintiff's claim for disability benefits, the U.S. District Court for the Western District of New York ruled the plaintiff was entitled to disability benefits.

In Colleen Orr v. Commissioner of Social Security, Judge David G. Larimer noted the case had already been previously remanded to the ALJ due to errors, that it has been over five years since the plaintiff first applied for benefits and there was sufficient evidence in the record to support the plaintiff's entitlement to benefits. Therefore, the judge determined an additional hearing was unnecessary and the case should be remanded for the sole purpose of calculating benefits.

Plaintiff's Disability Claim

In May 2000, the plaintiff, Colleen Orr, applied for disability insurance benefits and Supplemental Security Income. She claimed she could not work because of back and left shoulder pain, anxiety and depression.

Orr was over 40 years old when she applied for benefits. Her past work included positions as a nurse's aid, cashier and delicatessen manager. In December 1998, she stopped working after she injured her left shoulder. Despite undergoing surgery, she continued to experience shoulder pain and decreased motion.

Orr also has a history of anxiety, depression, obesity and alcohol dependence.

ALJ's Decisions

In October 2001, the ALJ denied disability benefits to Orr based on his finding that she was not disabled. Specifically, the ALJ determined Orr had the residual functional capacity to perform sedentary work.

Upon review of the ALJ's decision, the district court determined the case needed to be remanded for further proceedings. The court directed the ALJ to obtain updated treatment records, conduct a new hearing, obtain the testimony of a vocational expert and consider all of Orr's impairments including her obesity. In addition, the Appeals Council of the Social Security Administration directed the ALJ to provide citations to the medical evidence in the record to support his assessment of Orr's residual functional capacity and to cite specific jobs she could perform if he determined she was not disabled.

After conducting a second hearing, the ALJ in November 2003 ruled for a second time that Orr was not disabled. The ALJ, however, failed to correct many of the errors from his first evaluation of Orr's claim. As a result, the commissioner of social security requested the case be remanded for further proceedings.

Orr opposed the commissioner's motion, arguing she was entitled to disability benefits. She asserted the case should be remanded for the immediate calculation and payment of benefits.

Court's Discussion

After reviewing the ALJ's decision, the district court determined Orr was entitled to disability benefits.

The court found the ALJ failed to correctly weigh the opinions of Orr's treating physician. Specifically, the ALJ failed to explain why he rejected the opinions of Orr's doctor who stated Orr could never stoop, bend, lift, carry or pull and that she was limited in walking, climbing, standing, sitting and working at a high rate of speed.

By doing so, he 'arbitrarily substitute[d] his own judgment for competent medical opinion,' and 'set his own expertise against that of a physician who [submitted an opinion to or] testified before him, wrote Judge Larimer, referring to Balsamo v. Chater, 142 F3d 75, 81 (Second Cir. 1998) (citing McBrayer v. Sec. of Health and Human Servs., 712 F2d 795, 799 (Second Cir. 1983)).

The court also found the ALJ failed to consider the effect Orr's obesity, anxiety and depression had on her ability to work. In particular, a vocational expert testified that Orr's mental limitations prevented her from being employed.

The medical evidence, including the opinions of the commissioner's medical experts, indicates that plaintiff is moderately limited in at least seven categories of work-related mental activities, including the ability to understand and remember detailed instructions, the ability to make judgments on simple work related decisions, the ability to interact appropriately with supervisors and co-workers, and to respond appropriately to work pressures or changes in routine, explained the court. These limitations can significantly erode the occupational base for the full range of sedentary work....

Lastly, the court found the ALJ failed to properly evaluate Orr's alcohol dependence. Orr's doctor opined that Orr would continue to suffer from severe mental disorders even if she abstained from alcohol. In particular, there was medical evidence that her anxiety increased when she stopped self-medicating with alcohol.

Overall, the court found there was sufficient evidence that Orr was disabled.

When the court considers all of the relevant evidence and applies the proper legal standards, substantial evidence exists that plaintiff is disabled within the meaning of the [Social Security Act], wrote Judge Larimer.

Therefore, the judge determined a new hearing was not necessary, pointing out that it has been more than five years since Orr first applied for disability benefits.