Nieves, Jr v. Commissioner of Social Security

Background

Oswaldo Nieves, Jr. sought judicial review under Section 205(g) of the Social Security Act of the Commissioner’s denial of his application for Disability Insurance Benefits. He alleged disability beginning January 18, 2018. Before that date, he had worked as a New York City police officer and had suffered back injuries, including a 2015 injury that led to an L4-5 microdiscectomy and laminectomy. Medical records described continuing lower-back and leg pain, disc herniations and protrusions, limited movement, weakness, and varying examination results.

Administrative Law Judge Martha Bower found that Nieves had severe lumbar degenerative disc disease and chronic pain syndrome, but that he did not have an impairment meeting the listed requirements for disability. The Administrative Law Judge determined that Nieves had the residual functional capacity—the most he could still do despite his impairments—to perform light work with occasional postural activities. She found that he could not return to his police-officer work but could perform other jobs identified by a vocational expert, including driver, parking-lot attendant, cashier, telephone order clerk, assembler, and inspector. The Appeals Council denied review, making the Administrative Law Judge’s decision the Commissioner’s final decision.

Parties’ Motions

The parties filed cross-motions for judgment on the pleadings under Federal Rule of Civil Procedure 12(c). Nieves sought reversal and either an award of benefits or a new hearing. The Commissioner sought judgment upholding the administrative decision.

Court’s Analysis

The court held that the Administrative Law Judge did not properly evaluate the medical-opinion evidence under the regulations applicable to Nieves’s claim. The Administrative Law Judge found persuasive the opinion of H. Miller, M.D., a non-examining agency consultant who concluded that Nieves could perform light work with postural restrictions. But the explanation largely stated that Dr. Miller was qualified and had reviewed treatment evidence. It did not adequately address the required factors of supportability—how well the opinion was supported by medical findings and explanations—and consistency—how well it fit the entire record.

The court also found that the error was not harmless. Dr. Miller had not examined Nieves and had not reviewed more recent medical records. In addition, the Administrative Law Judge’s decision referred to nonexistent record exhibits and described the diagnostic imaging as mild, moderate, or unremarkable, even though the record included findings such as disc herniations, disc protrusions, and narrowing in the spine. The court further found misleading the repeated description of Nieves’s treatment as conservative because he had undergone spinal surgery, received steroid injections and physical therapy, and had a treating physician recommend further neurosurgical intervention.

Because these errors required remand, the court did not decide Nieves’s additional arguments. The court nevertheless provided guidance for further proceedings. It stated that the Administrative Law Judge should explain the step-three analysis concerning Listing 1.04(A) in light of evidence that appeared to address many of that listing’s requirements. The Administrative Law Judge should also address Nieves’s testimony that his medications caused drowsiness and concentration problems, as well as his testimony that he needed to lie down during the day.

Disposition

Judge Sarah L. Cave granted Nieves’s motion for judgment on the pleadings, denied the Commissioner’s cross-motion, and remanded the matter for further proceedings. The Clerk was directed to close the motions and the case. The court did not award Disability Insurance Benefits or hold that Nieves was disabled.