Summary
stating that "in determining medical equivalency under step three, the ALJ must adequately explain his comparative evaluation of the applicant's impairment to the listed impairment"
Summary of this case from Emeonye v. AstrueOpinion
No. C-01-01770 BZ
December 23, 2002
ORDER GRANTING PLAINTIFF'S MOTION FOR SUMMARY JUDGMENT AND DENYING DEFENDANT'S CROSS-MOTION FOR SUMMARY JUDGMENT
Plaintiff Cecilia Galaspi-Bey appeals from a final decision by the Commissioner of Social Security (Commissioner) affirming the decision of an Administrative Law Judge (ALJ) denying her request for disability benefits due to carpal tunnel syndrome for the closed period from March 12, 1995 through February 28, 1998. The ALJ found that Ms. Galaspi-Bey was not disabled and therefore not eligible for social security income under 42 U.S.C. § 1602 and 1614(a)(3) because, although she was not capable of performing her past relevant work, during the period at issue she was able to perform medium exertion work in jobs which did not involve repetitive or sustained flexion/extension of the wrists, and that these jobs were present in the national and local economy in sufficient numbers. (Tr. at 19-22.)
The Social Security Administration Appeals Council declined to review the ALJ's decision. (Tr. at 4-5.) Ms. Galaspi-Bey timely requested judicial review pursuant to 42 U.S.C. § 405(g), and requests in her motion for summary judgment that the ALJ's decision be overturned and the case be remanded to the Commissioner for further proceedings. The parties consented to the jurisdiction of a United States Magistrate Judge in accordance with the provisions of 28 U.S.C. § 636. Defendant filed a cross-motion for summary judgment. This matter is deemed submitted on the briefs and the transcript of the administrative record.
This court has the "power to enter, upon the pleadings and transcript of the record, a judgement affirming, modifying, or reversing the decision of the Secretary, with or without remanding the case for a rehearing." 42 U.S.C. § 405(g). The Commissioner's decision to deny benefits will be disturbed only if it is not supported by substantial evidence or is based on legal error. Id.; Smolen v. Chater, 80 F.3d 1273, 1279 (9th Cir. 1996); Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995). Substantial evidence means more than a mere scintilla, but less than a preponderance. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. Id. As a result of the limited scope of the review, the ALJ's decision will be upheld where the evidence is conflicting or inconclusive. Allen v. Secretary of Health Human Servs., 726 F.2d 1470, 1473 (9th Cir. 1984).
Following the standard five step process for evaluating Ms. Galaspi-Bey's claim, the ALJ found at step one that Ms. Galaspi-Bey did not engage in substantial gainful activity from March 12, 1995 to March 1997, (Tr. at 21), and that she did engage in substantial gainful activity "for most months" from March 1997 through February 1998. (Tr. at 15, 21.) At step two, the ALJ found that Ms. Galaspi-Bey's bilateral carpal tunnel syndrome and ulnar nerve neuropathy constituted a severe impairment. Id. At step three, the ALJ found that Ms. Galaspi-Bey's impairment did not meet or equal any impairment set out in the Listing of Impairments. (Tr. at 16, 21.) At step four, the ALJ found that Ms. Galaspi-Bey was unable to perform her past relevant work as a medical assistant or chiropractic assistant. (Tr. at 19, 21.) At the fifth and final step, the ALJ found that Ms. Galaspi-Bey was not disabled because she could perform certain types of work at the medium exertional level which preclude repetitive or sustained wrist flexion/extension, encompassing a variety of jobs that exist in significant numbers in the national economy. (Tr. at 20-21.) In addition, the ALJ found that Ms. Galaspi-Bey's testimony concerning the pain she experienced and its impact on her ability to work was not fully credible or reliable. (Tr. at 18-19, 22.)
See 20 C.F.R. § 416.920.
The Commissioner has acknowledged certain impairments to be so severe as to preclude substantial gainful activity. These impairments are set out in the Listing of Impairments, 20 C.F.R. Part 404, Subpt. P, App. 1. A claimant whose impairment or combination of impairments meets or equals the "Listings" is presumptively disabled.
Ms. Galaspi-Bey raises two objections to these findings, alleging that the ALJ: (1) failed to correctly analyze the medical equivalence of Ms. Galaspi-Bey's impairment to the impairments in the Listing, and (2) erred in not finding Ms. Galaspi-Bey's testimony fully credible or reliable.
The regulations require the ALJ to "compare the symptoms, signs, and laboratory findings" about the applicant's impairment with the medical criteria of the Listed Impairments, in order to determine if the "medical findings are at least equal in severity and duration to the listed findings." 20 C.F.R § 404.1526 (2002). In his decision, the ALJ stated that he considered Ms. Galaspi-Bey's impairments in the context of section 1.01 et seq. of the Listings (musculoskeletal impairments). (Tr. at 16.) Without any discussion of how he compared Ms. Galaspi-Bey's medical evidence to the criteria in section 1.01 et seq. of the Listings, the ALJ referred to his step four discussion of residual functional capacity and concluded that since he found Ms. Galaspi-Bey to have residual functional capacity, her impairment was therefore not medically equivalent to a musculoskeletal impairment under the Listings. Id. Citing 20 C.F.R. § 404.1525(a), which states that the Listing of Impairments is intended to describe impairments which prevent a person from doing any gainful activity, the ALJ reasoned that if Ms. Galaspi-Bey has some residual functional capacity, then she is able to perform at least some gainful activity and her impairment cannot be equivalent to a Listed Impairment. Setting aside the fact that it does not necessarily follow that any finding of residual functional capacity will allow a person to engage in gainful activity, the regulations unequivocally state that a decision on medical equivalence must be based on "medical evidence only." 20 C.F.R. § 404.1526 (2002). By comparison, a finding of residual functional capacity is based on "all of the relevant evidence," including observations by family, friends, the applicant, and other persons of any important limitations, such as pain. 20 C.F.R. § 404.1545 (2002). In this case, the ALJ's finding of Ms. Galaspi-Bey's residual functional capacity is premised in part upon his assessment of non medical evidence, including Ms. Galaspi-Bey's testimony as to the pain she experienced and her daily live activities during the period at issue. The ALJ erred in making a finding of medical equivalence based not on "medical evidence only", but based on a finding of residual functional capacity, which rested in part on non-medical evidence.
The ALJ seems to have been especially troubled by the fact that the claimant did not take medication during her pregnancy. Tr. 18-19.
Additionally, the regulations require a step four analysis of residual functional capacity only after a step three finding that the applicant's impairment does not meet or equal an impairment under the Listings. See 20 C.F.R. § 416.920. To conclude that Ms. Galaspi-Bey's residual functional capacity under step four prevents a finding of medical equivalence under step three creates a circular reasoning which bypasses the logical five-step process required by the regulations.
Defendant argues that Ruff v. Sullivan holds that residual functional capacity must be considered in an analysis of medical equivalency. Ruff v. Sullivan, 907 F.2d 915, 919 (9th Cir. 1990). Ruff holds only that if the Secretary has concluded that a surviving spouse does not have a Listed Impairment, the Secretary must also consider whether the surviving spouse is nonetheless disabled because her lack of residual functional capacity is the medical equivalent of a Listed Impairment. Ruff does not hold that the presence of some functional capacity obviates the need for an equivalence analysis based on medical evidence, and this is not a survivor's claim under 42 U.S.C. § 402(e).
Even if it were proper to use the ALJ's finding of residual functional capacity as evidence of no medical equivalency under step three, the ALJ's discussion of that finding does not support a finding of no medical equivalency. The discussion makes no mention of section 1.01 et seq. of the Listings, and does not compare the medical evidence in the record to the criteria in the Listings. (Tr. at 17-19) Defendant contends that the ALJ has no obligation to specify in detail why "any" section of the Listings has not been satisfied, citing Gonzales v. Sullivan, 914 F.2d 1197, 1200-01 (9th Cir. 1990). However, the court in Gonzales stated "it is unnecessary to require the Secretary, as a matter of law, to state why a claimant failed to satisfy every different section of the Listings." Id. (emphasis added). Here, the ALJ provided no explanation beyond the finding of residual functional capacity to demonstrate how he reached a finding of no medical equivalency. This contravenes the Ninth Circuit holding that, in determining medical equivalence under step three, the ALJ must adequately explain his comparative evaluation of the applicant's impairment to the listed impairment. Marcia v. Sullivan, 900 F.2d 172, 176 (9th Cir. 1990).
For example, had the ALJ compared Ms. Galaspi-Bey's medical record to the criteria of section 1.02 of the Listings (active rheumatoid arthritis and other inflammatory arthritis), he might have found that her impairments were medically equivalent to active rheumatoid arthritis. For example, the record contains medical evidence indicating a history of persistent joint pain and some tingling involving both of Ms. Galaspi-Bey's wrists and hands (see Tr. at 146, 217), and objective medical evidence consisting of nerve conduction and electromyopathy on January 16, 1996, an MRI on November 22, 1996 and an x-ray examination on January 23, 1997. See Tr. at 144-145, 162, 201. In addition, the record contains evidence of therapy prescribed for Ms. Galaspi-Bey, including wrist splints (Tr. at 139), physical therapy (Tr. at 162), medication (Tr. at 172, 185), and recommendations for surgery (Tr. at 141, 174). At least one of the medications prescribed for Ms. Galaspi-Bey, Naprosyn, is one prescribed for rheumatoid arthritis. See Medical Economics Co., Physicians' Desk Reference (1996). This issue, however, was not raised by plaintiff or briefed by either party, so I need not reach it.
For the reasons given above, I find that the ALJ committed legal error in his medical equivalency analysis.6 IT IS THEREFORE ORDERED that the plaintiff's motion for summary judgment is GRANTED and the case REMANDED to the Commisioner for further proceedings. Defendant's cross-motion for summary judgment is DENIED.