UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF MICHIGAN

SOUTHERN DIVISION

COURTNEY LYNNE MEDINA,

Plaintiff, CIVIL ACTION NO. 15-cv-11895

v. DISTRICT JUDGE SEAN F. COX

COMMISSIONER OF MAGISTRATE JUDGE MONA K. MAJZOUB

SOCIAL SECURITY,

Defendant.

_____________________________/

REPORT AND RECOMMENDATION

Plaintiff Courtney Lynne Medina seeks judicial review of Defendant Commissioner of 

Social Security’s determination that she is not entitled to social security benefits for her mental 

impairments under 42 U.S.C. § 405(g). (Docket no. 1.) Before the Court are Plaintiff’s Motion 

for Summary Judgment (docket no. 14) and Defendant’s Motion for Summary Judgment (docket 

no. 17). The motions have been referred to the undersigned for a Report and Recommendation 

pursuant to 28 U.S.C. § 636(b)(1)(B). (Docket no. 3.) The Court has reviewed the pleadings, 

dispenses with a hearing pursuant to Eastern District of Michigan Local Rule 7.1(f)(2), and 

issues this Report and Recommendation. 

I. RECOMMENDATION

For the reasons that follow, it is recommended that the Court should GRANT Plaintiff’s 

Motion for Summary Judgment (docket no. 14) and DENY Defendant’s Motion for Summary 

Judgment (docket no. 17), and REVERSE and REMAND the decision of the Commissioner for 

an award of benefits.

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II. PROCEDURAL HISTORY

On August 14, 2009, an application for supplemental security income (SSI) was filed on 

behalf of the plaintiff, who was then a child under the age of 18. (Tr. 137-39, 147). The 

application alleged a disability beginning on September 1, 2005. (Id.) The Social Security 

Administration initially denied plaintiff’s claim on December 4, 2009, and plaintiff requested a 

de novo hearing. (Tr. 85, 94-96.) On February 9, 2011, plaintiff appeared with counsel and 

testified at the hearing before Administrative Law Judge (ALJ) Troy Patterson. (Tr. 38-51.) In a

March 18, 2011 decision, the ALJ found that plaintiff was not entitled to benefits because she 

was capable of performing a significant number of jobs in the national economy. (Tr. 9-31.) 

The Appeals Council declined to review the ALJ’s decision (Tr. 1-4), and plaintiff commenced 

an action for judicial review. In a judgment dated October 31, 2012, District Judge Sean F. Cox, 

adopting a report and recommendation (“R&R”) issued by Magistrate Judge Mark A. Randon, 

remanded the matter to the Commissioner for further proceedings as specified in the R&R. 

(Case No. 11-15272, Docket no. 15). Judge Cox specifically noted that the ALJ in the March 

2011 social security decision failed to give the plaintiff’s treating physician, K.J. Raval, M.D., 

“controlling weight” or explain why the opinion was not entitled to “controlling weight.” (Id.) 

By a February 26, 2013 order, the Appeals Council vacated the March 2011 decision and 

remanded the case for proceeding consistent with the District Court judgment. (Tr. 429-62). A

hearing was held and on August 20, 2013, ALJ Kevin J. Detherage issued a subsequent decision

also denying plaintiff’s claim for SSI. (Tr. 384-413). ALJ Detherage’s decision became the 

Agency’s final decision when the Appeal’s Council declined to assume jurisdiction. (Tr. 379-

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383). Plaintiff then commenced a second action in this Court (docket no. 1), and the parties have

filed cross motions for summary judgment. (Docket nos. 14, 17.) 

III. HEARING TESTIMONY AND MEDICAL EVIDENCE

Plaintiff (docket no. 14 at 1-11) and the ALJ (Tr. 392-402) each set out a detailed, factual 

recitation with regard to plaintiff’s medical record and the hearing testimony. Defendant, 

concurs with plaintiff’s recitation of the relevant facts to the extent they are consistent with the 

facts stated by the ALJ, which the Commissioner adopts. (Docket no. 17 at 6-7.) Having 

conducted an independent review of plaintiff’s medical record and the hearing transcript, the 

undersigned finds that there are no material inconsistencies among these recitations of the record. 

Therefore, the undersigned will incorporate the factual recitations by reference. Additionally, 

the undersigned will include comments and citations to the record as necessary throughout this 

Report and Recommendation.

IV. ADMINISTRATIVE LAW JUDGE’S DETERMINATION

The ALJ initially determined that plaintiff was born on January 23, 1992 and was 

therefore in the “[a]dolescents (age 12) to attainment of age 18) age group on August 14, 2009, 

the date of her application.” (Tr. 392.) The ALJ found that Plaintiff had not engaged in 

substantial gainful activity since the application date, August 24, 2009. (Id.) Next, the ALJ 

concluded that before attaining age 18, plaintiff suffered from the following severe impairments: 

depression; mood disorder; bipolar disorder; post-traumatic stress syndrome; anxiety; borderline 

personality disorder; and oppositional defiant disorder. (Tr. 393.) The ALJ then found that 

before turning 18, plaintiff did not have an impairment or combination of impairments that met 

medically equaled the severity of an impairment listed in 20 C.F.R. Part 404, Subpart P, 

Appendix 1. (Id.) Because plaintiff did not have an impairment or combination of impairments 

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that met, medically equaled any listing or functionally equaled the listing, the ALJ determined 

that plaintiff was not disabled prior to attaining age 18. (20 C.F.R. § 416.924(a)) (Tr. 402.)

Next, the ALJ concluded that plaintiff has not developed any new impairment or 

impairments since attaining age 18. (Tr. 402.) Since age 18, the ALJ determined that the 

plaintiff continued to have a severe impairment or combination of impairments; however, during 

this same time period, plaintiff has not had an impairment or combination of impairments that 

meets or medically equals a listed impairment. (Id.) The ALJ then found that plaintiff had the 

following residual functional capacity (RFC):

Since attaining age 18, the claimant has had the residual functional capacity to 

perform a full range of work at all exertional levels but with the following nonexertional limitations: she can perform unskilled tasks. The claimant cannot 

perform production rate paced work. She can tolerate occasional routine work 

changes. The claimant can occasionally interact with the public, coworkers, and 

supervisors. She will be expected to be “off-task” 8% of the work period.

(Tr. 404.) The ALJ then determined that plaintiff had no relevant past work. (Tr. 408.) 

Subsequently, in reliance on the VE’s testimony, the ALJ determined that based on claimant’s 

age, education, work experience, and RFC, plaintiff was capable of performing a significant 

number of jobs in the national economy. (Id.) Therefore, the ALJ found that plaintiff was not 

disabled under the Social Security Act at any time from January 22, 2010, the date plaintiff 

turned 18, through the date of the decision. (Tr. 409.)

V. LAW AND ANALYSIS

A. Standard of Review

Pursuant to 42 U.S.C. § 405(g), this Court has jurisdiction to review the Commissioner’s 

final decisions. Judicial review of the Commissioner’s decisions is limited to determining 

whether his findings are supported by substantial evidence and whether he employed the proper 

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legal standards. See Richardson v. Perales, 402 U.S. 389, 401 (1971); Walters v. Comm’r, 127 

F.3d 525, 528 (6th Cir. 1997). Substantial evidence is more than a scintilla but less than a 

preponderance; it is “‘such relevant evidence as a reasonable mind might accept as adequate to 

support a conclusion.’” Richardson, 402 U.S. at 401 (quoting Consolidated Edison Co. v. NLRB, 

305 U.S. 197, 229 (1938)); Walters, 127 F.3d at 528. It is not the function of this Court to try 

cases de novo, resolve conflicts in the evidence, or decide questions of credibility. See Brainard 

v. Sec’y of Health and Human Servs., 889 F.2d 679, 681 (6th Cir. 1989); Garner v. Heckler, 745 

F.2d 383, 387 (6th Cir. 1984).

In determining the existence of substantial evidence, the court must examine the 

administrative record as a whole. See Kirk v. Sec’y of Health and Human Servs., 667 F.2d 524, 

536 (6th Cir. 1981), cert. denied, 461 U.S. 957 (1983). If the Commissioner’s decision is 

supported by substantial evidence, it must be affirmed, even if the reviewing court would decide 

the matter differently, Kinsella v. Schweiker, 708 F.2d 1058, 1059 (6th Cir. 1983), and even if 

substantial evidence also supports the opposite conclusion. See Her v. Comm’r, 203 F.3d 388, 

389-90 (6th Cir. 1999); Mullen v. Bowen, 800 F.2d 535, 545 (6th Cir. 1986) (en banc) (noting 

that the substantial evidence standard “presupposes that there is a zone of choice within which 

the decisionmakers can go either way, without interference by the courts”). “But ‘[a]n ALJ’s 

failure to follow agency rules and regulations denotes a lack of substantial evidence, even where 

the conclusion of the ALJ may be justified based upon the record.’” Gayheart v. Comm’r of Soc. 

Sec., 710 F.3d 365, 374 (6th Cir. 2013) (quoting Cole v. Astrue, 661 F.3d 931, 937 (6th Cir. 

2011)).

B. Framework for Social Security Determinations

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Plaintiff’s Social Security disability determination was made in accordance with a fivestep sequential analysis.1

 In the first four steps, plaintiff was required to show that:

(1) Plaintiff was not presently engaged in substantial gainful employment; and

(2) Plaintiff suffered from a severe impairment; and

(3) The impairment met or was medically equal to a “listed impairment;” or

(4) Plaintiff did not have the residual functional capacity (RFC) to perform relevant 

past work.

See 20 C.F.R. § 404.1520(a)-(f). If plaintiff’s impairments prevented plaintiff from doing past 

work, the Commissioner, at step five, would consider plaintiff’s RFC, age, education, and past 

work experience to determine if plaintiff could perform other work. If not, plaintiff would be 

deemed disabled. See id. at § 404.1520(g). The Commissioner has the burden of proof only on 

“the fifth step, proving that there is work available in the economy that the claimant can 

perform.” Her, 203 F.3d at 391. To meet this burden, the Commissioner must make a finding 

“supported by substantial evidence that [the claimant] has the vocational qualifications to 

perform specific jobs.” Varley v. Sec’y of Health and Human Servs., 820 F.2d 777, 779 (6th Cir. 

1987). This “substantial evidence” may be in the form of vocational expert testimony in 

response to a hypothetical question, “but only ‘if the question accurately portrays [the 

claimant’s] individual physical and mental impairments.’” Id. (citations omitted). 

C. Analysis

The Social Security Act authorizes “two types of remand: (1) a post judgment remand in 

conjunction with a decision affirming, modifying, or reversing a decision of the [Commissioner] 

 1 The Social Security Administration has established a three-step sequential evaluation process to determine whether 

an individual under the age of 18 is disabled (20 CFR § 416.924(a)). At step one, the ALJ must determine whether 

the claimant is engaging in substantial gainful activity. At step two, the ALJ must determine whether the claimant 

has a medically determinable “severe” impairment or combination of impairments that is “severe.” And, at step 

three, the ALJ must determine whether the claimant has an impairment or combination of impairments that meets or 

medically equals the criteria of a listing, or that functionally equals the listings.

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(a sentence-four remand); and (2) a pre-judgment remand for consideration of new and material 

evidence that for good cause was not previously presented to the [Commissioner] (a sentence-six 

remand).” Faucher v. Sec’y of Health and Human Servs., 17 F.3d 171, 174 (6th Cir. 1994) 

(citing 42 U.S.C. § 405(g)). Under a sentence-four remand, the Court has the authority to “enter 

upon the pleadings and transcript of the record, a judgment affirming, denying, or reversing the 

decision of the [Commissioner], with or without remanding the cause for a hearing. 42 U.S.C. § 

405(g). Where there is insufficient support for the ALJ’s findings, “the appropriate remedy is 

reversal and a sentence-four remand for further consideration.” Morgan v. Astrue, 10-207, 2011 

WL 2292305, at *8 (E.D. Ky. June 8, 2011) (citing Faucher, 17 F.3d at 174). 

Plaintiff asserts that this matter should be reversed for an award of benefits under

sentence four because (1) the ALJ committed reversible error by failing to give “great and 

controlling weight” to plaintiff’s treating psychiatrist which would have eliminated all gainful 

employment on plaintiff’s adult disability claim; (2) the ALJ failed to comply with the Remand 

order of this Court requiring the ALJ to give controlling weight to the medical restrictions and 

opinions of the treating physician, or give “good reasons” for rejecting that opinion; and (3) 

plaintiff was, and remains, totally and permanently disabled and is therefore entitled to an award 

of benefits under the Social Security Act. (Docket no. 14 at 1-2.) 

1. The Treating Physician Rule

In her first argument, plaintiff challenges the weight the ALJ gives to her treating 

psychiatrist, Dr. Kaushik Raval, who has been treating plaintiff for her mental health issues, 

including hallucinations, significant paranoia, suicidal behavior, and isolating behaviors. On 

September 16, 2010, a doctor’s note from Dr. Raval indicated that plaintiff is “significantly ill 

and therefore she will not be able to work until she feels better.” (Tr. 374). When asked to be 

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more specific, on January 6, 2011, Dr. Raval completed a medical source statement in which he 

opined that plaintiff was “markedly limited” or had no useful ability to: 

(1) Remember locations and work-like procedures.

(2) Understand and remember very short and simple 

instructions.

(3) Understand and remember detailed instructions.

(4) Carry out detailed instructions.

(5) Maintain attention and concentration for extended periods 

of time.

(6) Perform activities within a schedule, maintain regular 

attendance, and be punctual within customary tolerances.

(7) Sustain an ordinary routine without special supervision.

(8) Work in coordination with or proximity to others without 

being distracted by them.

(9) Complete a normal workday and work week without 

interruption from psychologically based symptoms and to 

perform at a consistent past without an unreasonable 

number and length of rest periods. 

(10) Accept instructions and respond appropriately to criticism 

from supervisors.

(11) Get along with co-workers or peers without distracting 

them or exhibiting behavioral extremes.

(Tr. 376-78). Dr. Raval also opined that plaintiff was moderately limited, or that plaintiff’s 

ability was “seriously limited, but not precluded” in her ability to respond appropriately to 

changes in the work setting, and to set realistic goals or make plans independently of others. (Tr. 

378). On July 18, 2011, Dr. Raval again noted his belief that plaintiff was unable to work due to 

“severe depression and anxiety.” (Tr. 564). At this time, Dr. Raval also noted that plaintiff was 

experiencing visual and auditory hallucinations. (Id.)

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An ALJ must give a treating physician’s opinion complete deference if it is supported by 

clinical and laboratory diagnostic evidence and it is not inconsistent with the other substantial 

evidence in the record. 20 C.F.R. §§ 404.1527(c)(2), 416.927(c)(2). When an ALJ determines 

that a treating source’s medical opinion is not controlling, he must determine how much weight 

to assign that opinion in light of several factors: (1) length of the treatment relationship and the 

frequency of examination; (2) nature and extent of the treatment relationship; (3) supportability 

of the opinion; (4) consistency of the opinion with the record as a whole; (5) specialization of the 

treating source; and (6) other factors. 20 C.F.R. §§ 404.1527(c)(2)-(6), 416.927(c)(2)-(6).

 There is no per se rule that requires an articulation of each of the six regulatory factors listed 

in 20 C.F.R. §§ 404.1527(c)(2)-(6), 416.927(c)(2)-(6). Norris v. Comm’r of Soc. Sec., No. 11-

CV-11974, 2012 WL 3584664, at *5 (E.D. Mich. Aug. 20, 2012) (citing Tilley v. Comm’r of Soc. 

Sec., 394 F. App’x 216, 222 (6th Cir. 2010)). An ALJ’s failure to discuss the requisite factors 

may constitute harmless error (1) if “a treating source's opinion is so patently deficient that the 

Commissioner could not possibly credit it;” (2) “if the Commissioner adopts the opinion of the 

treating source or makes findings consistent with the opinion;” or (3) “where the Commissioner 

has met the goal of [§ 1527(c)]—the provision of the procedural safeguard of reasons—even 

though she has not complied with the terms of the regulation.” Nelson v. Comm’r of Soc. Sec., 

195 F. App’x 462, 470 (6th Cir. 2006) (quoting Wilson v. Comm’r of Soc. Sec., 378 F.3d 541, 

547 (6th Cir. 2004)).

 The Commissioner requires its ALJs to “always give good reasons in [their] notice of 

determination or decision for the weight [they] give [a] treating source’s opinion.” 20 C.F.R. §§ 

404.1527(c)(2), 416.927(c)(2). Those good reasons must be “supported by the evidence in the 

case record, and must be sufficiently specific to make clear to any subsequent reviewers the 

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weight the adjudicator gave to the treating source’s medical opinion and the reasons for that 

weight.” Wilson, 378 F.3d at 544 (quoting SSR 96-2p, 1996 WL 374188, at *5 (1996)). The 

district court should not hesitate to remand when the Commissioner has failed to identify the 

weight assigned to a treating physician’s opinion and provide good reasons for that weight. See 

Cole v. Astrue, 661 F.3d 931, 939 (6th Cir. 2011) (“This Court has made clear that ‘[w]e do not 

hesitate to remand when the Commissioner has not provided ‘good reasons’ for the weight given 

to a treating physician's opinion and we will continue remanding when we encounter opinions 

from ALJ's that do not comprehensively set forth the reasons for the weight assigned to a treating 

physician's opinion.”) (citing Hensley v. Astrue, 573 F.3d 263, 267 (6th Cir. 2009)).

Here, the ALJ dedicated two pages of his opinion attempting to support his conclusion 

that Dr. Raval’s opinions were not consistent with the overall record and were therefore not 

entitled to controlling weight. (Tr. 406-407). In terms of Factors One (length and frequency of 

treatment) and Two (nature and extent of the treatment relationship), the ALJ found that plaintiff 

engaged in treatment with Dr. Raval in 2010 and that she saw him for medication reviews every 

few months. At the hearing, plaintiff testified that she was still seeing Dr. Raval, therefore, the 

ALJ concluded that plaintiff and Dr. Raval had established a treating relationship. The parties do 

not contest that a treating relationship was formed.

The ALJ, however, concluded that Dr. Raval’s opinions were not entitled to “controlling” 

weight because they did not satisfy the criteria of Factor 3 (supporting evidence); Factor 4 

(consistency); and Factor 5 (area of specialty). (Tr. 406.) With respect to his conclusions on 

these factors, the ALJ opined:

On September 16, 2010, Dr. Raval provided a report in which he 

opined that the claimant was “significantly ill” and would “not be 

able to work” “until she feels better” (11F and 14E). I gave this 

opinion little weight for the following reasons:

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The term “significantly ill” was too vague to be helpful. It likely 

meant the claimant was not well physically or mentally. However, 

the term did not work to preclude all activities. I needed more 

specific terms in order to decide if the claimant was capable of 

other work. I needed to know how “significant” the claimant’s 

limitations were. I needed to know what Dr. Raval meant by “ill.”

Without more, these terms were not very helpful and given little 

weight.

Dr. Raval added that the claimant was “not able to work.” This was 

a conclusion about the claimant’s ability to work. Dr. Raval was 

not qualified to make decisions reserved to the Commissioner. 

Moreover, Dr. Raval was not a vocational expert. Opinions 

regarding the existing work that an individual with the claimant’s 

limitations could perform were outside of Dr. Raval’s area of 

expertise. For these reasons, I gave this portion of Dr. Raval’s 

opinion little weight.

Dr. Raval added that the claimant would be able to work “when 

she felt better.” Given the evidence that the claimant was able to 

go to college, this likely meant that the claimant’s condition was 

expected to improve and she would be able to work in the future. 

However, the term “when” was too vague. It also appeared that if

the claimant were to say she could work, Dr. Raval would agree. 

The opinion appeared to be made by proxy. It appeared that if the 

claimant were to say that she felt better and could work, Dr. Raval 

would agree. For these reasons, I gave this portion of Dr. Raval’s 

opinion little weight.

As mentioned earlier in finding #9, on January 6, 2011, Dr. Raval 

completed a residual functional capacity assessment in which he 

opined that the claimant was “markedly” limited in several areas of 

mental function (11F). I gave this opinion little weight. The term 

“marked” is a term of art used in the “B criteria” to determine if

the claimant’s conditions meet or equal the criteria of listed 

impairments in finding #9. However, the term “marked” is too 

vague to be helpful in finding #10. As a term of art, it means “more 

than moderate” hut “less than extreme.” The term does not connote 

specific limitations. It does not preclude mental functional abilities.

Moreover, as mentioned earlier, the claimant’s conditions 

presented “less than marked” limitations. Specifically, the claimant 

was able to take online classes, attend church, go shopping, etc. 

(Feb-Apr 2011, 11F and 14F).

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In July 2011, Dr. Raval opined that the claimant was “unable to 

work” due to “depression and anxiety.” In the next sentence, he 

adds, “she does take online classes now.” As mentioned earlier, the 

conclusion about if a person is able to work is reserved to the 

Commissioner. In addition, Dr. Raval failed to specify why he 

thought the claimant was disabled by depression and anxiety. He 

likely meant that these would limit the claimant’s ability to 

accomplish her daily activities, ability to socialize, concentrate, 

persist, etc. However, he failed to say how extensive the 

limitations were. Without more information, I was unable to give 

this opinion much weight. Moreover, as mentioned in his own 

opinion, Dr. Raval knew that the claimant was mentally able to 

take classes at the time the opinion was assigned. The opinion also 

appeared to be inconsistent with Dr. Raval’s progress notes that 

revealed improvement when the claimant was compliant with 

treatment. For these reasons, I gave this opinion little weight.

(Tr. 406-07) (emphasis in original.)

The undersigned has reviewed the ALJ’s opinion and agrees with plaintiff that the ALJ 

has failed to offer sufficiently good reasons as required by 20 C.F.R. §§ 404.1527(c)(2), 

416.927(c)(2) when he discounted Dr. Raval’s opinion and assigned it “little weight.”2

 While 

the ALJ is under no obligation to discuss every factor in discounting a treating source’s opinion, 

the ALJ here did not articulate sufficiently good reasons to support the weight given. The 

primary problem with the ALJ’s analysis is his treatment of Dr. Raval’s January 6, 2011 RFC 

assessment. In this assessment, Dr. Raval concluded that plaintiff was “markedly” limited in 

eleven (11) separate mental functional areas. (Tr. 376-78.) Dr. Raval also concluded that 

plaintiff had moderate limitations in two mental functional areas. (Tr. 378.) The ALJ gave this 

opinion “little weight” because, according to the ALJ, the word “marked” does not connote 

specific limitations, or preclude mental functional abilities. (Tr. 407.) Rather, the term is too 

vague to be helpful. (Id.) However, as noted by plaintiff, the medical assessment that Dr. Raval 

 2 The undersigned is aware that a treating source is not able to make a determination on an issue that is reserved to 

the Commissioner (e.g., the ultimate decision on whether plaintiff is able to work), and concludes that the ALJ acted 

reasonably when he discounted Dr. Raval’s opinions to the extent he opined in that manner. See Warner v. Comm’r 

of Soc. Sec., 375 F.3d 387, 390 (6th Cir. 2004); see also 20 C.F.R. § 416.927(d). 

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completed in January 2011 specifically defines “markedly limited” as meaning: “no useful 

ability to function in this area.” (Tr. 376.) Moreover, “moderately limited” was defined as the 

“ability to function in this area is seriously limited, but not precluded.” (Id.) Further, the mental 

functional assessment that Dr. Raval completed is divided into three separate and detailed areas: 

(1) understanding and memory; (2) sustained concentration and persistence; and (3) social 

interaction – thereby, lending additional categorical detail. (Tr. 376-78.) The undersigned 

concludes that the medical assessment provides sufficiently detailed information for an ALJ to 

determine whether an individual is precluded in a mental functional area. Particularly when, as 

here, a treating source in the area of psychiatry is completing the assessment. See 20 C.F.R. § 

416.927(c)(5) (“[w]e generally give more weight to the opinion of a specialist about medical 

issues related to his or her area of specialty than to the opinion of a source who is not a 

specialist.”). The Commissioner argues that plaintiff was able to take on-line classes, attend 

church, and go shopping; however, this court has consistently held that minimal activities are 

hardly consistent with eight hours’ worth of typical work activities. Rogers v. Comm’r of Soc. 

Sec., 486 F.3d 234, 248–49 (6th Cir. 2007) (finding that the plaintiff’s daily functions, including 

her ability to drive, clean her apartment, care for two dogs, do laundry, read, do stretching 

exercises, and watch the news, were not “comparable to typical work activities” and did not 

justify the ALJ’s discrediting her testimony). 

Plaintiff’s argument that Dr. Raval did not provide an underlying basis for his functional 

assessment is belied by detailed treatment records that document issues of plaintiff’s severe 

paranoia, as well as visual and auditory hallucinations.3 (Tr. 372, 373, 375, 562, 563, 566, 568, 

570, 572, 576.) Due to the difficulty in controlling plaintiff’s psychological symptoms, on 

 3

 Some of the records cited are from after the date of Dr. Raval’s January 2011 assessment, but the undersigned 

includes them to provide additional support that plaintiff’s mental functional limitations have persisted. 

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multiple occasions, the record also reflects that Dr. Raval increased or changed plaintiff’s 

medication protocol. (Tr. 248, 270, 370, 373, 375, 566, 568.) Plaintiff’s argument is also 

bolstered by the fact that it does not appear that the ALJ considered plaintiff’s medical records as 

a whole as supporting Dr. Raval’s RFC assessment. Specifically, plaintiff has had several 

hospital admissions that note severe anxiety, together with cutting behavior, suicidal thoughts 

and ideation. (Tr. 219, 231, 553.) Also, several other physicians have noted symptoms that track

Dr. Raval’s conclusions. (Tr. 241, 214, 215, 248, 251.) The undersigned further notes that there 

are no countervailing or contradictory medical opinions in the record to which the ALJ pointed 

in support of his almost wholesale rejection of the treating physician’s opinions. See Kalmbach 

v. Comm'r of Soc. Sec., 409 F. App’x 852, 862 (6th Cir. 2011).

For the above-stated reasons, the ALJ in the instant matter did not provide the necessary

good reasons for discounting Dr. Raval’s opinion; as such, the weight the ALJ assigned to Dr. 

Raval’s opinion is not supported by substantial evidence. 

2. The Remand Order

In his second argument, Plaintiff asserts that defendant failed to properly comply with the 

prior remand order of this court requiring defendant to: (1) apply the four factors outlined in 20 

CFR 404.1527; (2) indicate with sufficient specificity the weight he gave to Dr. Raval’s opinion, 

and (3) indicate with sufficient specificity the reasons for that weight. (Tr. 489, 492.) Because 

the undersigned has already concluded that the ALJ failed to give the requisite good reasons for 

discounting the opinion of Dr. Raval, there is no need for further analysis.

3. The Proper Remedy

Last, plaintiff asserts that because she was, and remains, totally and permanently 

disabled, she is entitled to an award of benefits under the Social Security Act. Plaintiff has 

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already had two administrative hearings, two Appeals Council actions, and now two district 

court reviews in this matter. At both administrative hearings, vocational expert testimony was 

entered into the record. When asked to consider functional restrictions consistent with those 

outlined in Dr. Raval’s mental health assessment, including time off-task due to psychological 

reasons, absences from work, the inability to work in coordination with or in proximity to coworkers or the general public, the need for special supervision, or because of emotional 

distractions being consistently slower than the average worker, both vocational experts testified 

that each of those factors would preclude all employment. Plaintiff contends that the proof of

her disability is strong and that there is no significant evidence to contradict the findings of her 

treating physician, Dr. Raval. As such, plaintiff says that pursuant to Mowrey v. Heckler, 771 

F.2d 966, 973 (6th Cir. 1985), a remand for further evaluation is not necessary and a reversal for 

an award of benefits is appropriate here. The Commissioner argues that if error exists, a new 

hearing is the appropriate remedy, as the standard set forth in Kalambach v. Comm’r v. Soc. Sec., 

409 Fed. App’x 852, 865 (6th Cir. 2011) has not been met. Indeed, the court has authority to 

affirm, modify or reverse the Commissioner’s decision with or without remanding the cause for 

rehearing. Id. (citing 42 U.S.C. § 405(g); Melkonyan v. Sullivan, 501 U.S. 89, 100, 111 S. Ct. 

2157, 115 L. Ed. 2d 78 (1991)).

In considering what remedy is appropriate, the undersigned is mindful that “when there is 

not substantial evidence to support one of the ALJ’s factual findings and his decision therefore 

must be reversed, the appropriate remedy is not to award benefits. The case can be remanded 

under sentence four of 42 U.S.C. § 405(g) for further consideration.” Faucher v. Sec’y of Health 

& Human Servs., 17 F.3d 171, 175-76 (6th Cir. 1994). It is appropriate to remand for an award 

of benefits only when “all essential factual issues have been resolved and the record adequately 

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establishes a plaintiff’s entitlement to benefits.” Faucher, 17 F.3d at 176; Newkirk v. Shalala, 25 

F.3d 316, 318 (6th Cir. 1994). This entitlement is established if “the decision is clearly 

erroneous, proof of di[s]ability is overwhelming, or proof of disability is strong and evidence to 

the contrary is lacking.” Mowery v. Heckler, 771 F.2d 966, 973 (6th Cir. 1985).

After considering Dr. Raval’s records and opinions, plaintiff’s own testimony regarding

her mental condition, together with additional record evidence of hospitalizations and severe 

mental psychosis, the undersigned concludes that there exists strong evidence that plaintiff’s 

combined impairments meet or exceed a listed impairment under the Social Security regulations. 

As noted above, two vocational experts have testified that accepting Dr. Raval’s limitations 

would preclude all competitive work. And, there effectively is no competing medical evidence, 

which makes any denial of benefits on remand in this case unsupportable by substantial 

evidence. As such, the appropriate procedure upon remand is to reverse the decision of the 

Commissioner and award benefits to the plaintiff. 

VI. CONCLUSION

For the reasons stated herein, the Court should GRANT Plaintiff’s Motion for Summary 

Judgment (docket no. 14) and DENY Defendant’s Motion for Summary Judgment (docket no. 

17), and REVERSE and REMAND the decision of the Commissioner for an award of benefits.

REVIEW OF REPORT AND RECOMMENDATION

Either party to this action may object to and seek review of this Report and 

Recommendation, but must act within fourteen (14) days of service of a copy hereof as provided 

for in 28 U.S.C. § 636(b)(1) and E.D. Mich. LR 72.1(d)(2). Failure to file specific objections 

constitutes a waiver of any further right of appeal. Thomas v. Arn, 474 U.S. 140 (1985); Howard 

v. Sec’y of Health and Human Servs., 932 F.2d 505 (6th Cir. 1991); United States v. Walters, 638 

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F.2d 947 (6th Cir. 1981). Filing objections which raise some issues but fail to raise others with 

specificity will not preserve all objections that a party might have to this Report and 

Recommendation. Willis v. Sec’y of Health and Human Servs., 931 F.2d 390, 401 (6th Cir. 

1991); Smith v. Detroit Fed’n of Teachers Local 231, 829 F.2d 1370, 1373 (6th Cir. 1987). 

Pursuant to Rule 72.1(d)(2) of the Local Rules of the United States District Court for the Eastern 

District of Michigan, a copy of any objection must be served upon this Magistrate Judge.

Within fourteen (14) days of service of any objecting party’s timely filed objections, the 

opposing party may file a response. The response shall be not more than five (5) pages in length 

unless by motion and order such page limit is extended by the Court. The response shall address 

specifically, and in the same order raised, each issue contained within the objections.

Dated: July 7, 2016 s/ Mona K. Majzoub 

MONA K. MAJZOUB

UNITED STATES MAGISTRATE JUDGE

PROOF OF SERVICE

I hereby certify that a copy of this Report and Recommendation was served upon counsel 

of record on this date.

Dated: July 7, 2016 s/ Marlena Williams 

Acting in the absence of Lisa Bartlett

Case Manager

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