IN THE UNITED STATES DISTRICT COURT

FOR THE WESTERN DISTRICT OF PENNSYLVANIA

DAVID P. EGGLESTON, )

)

Plaintiff, ) Civil Action 05-84 Erie

v. )

)

JO ANNE B. BARNHART, )

COMMISSIONER OF SOCIAL )

SECURITY, )

Defendant. )

MEMORANDUM OPINION

McLAUGHLIN, SEAN J., District J.,

In this case, Plaintiff, David P. Eggleston seeks judicial review, pursuant to 42

U.S.C. §§ 405(g) and 1383(c)(3), of the final decision of the Commissioner of Social

Security denying his claims for disability insurance benefits (“DIB”) and supplemental

security income (“SSI”) under Titles II and XVI of the Social Security Act, 42 U.S.C.

§§ 401 et seq, and §§ 1381 et seq. Plaintiff filed applications for DIB and SSI on

November 3, 2002, alleging disability as of August 14, 2000 due to diabetes, high blood

pressure, and depression. (R. 76-78, 86, 191-92.) Plaintiff’s applications were denied

in a state agency decision dated April 15, 2003. (R. 60-63.) At Plaintiff’s request, an

Administrative Law Judge (ALJ) held a hearing on January 15, 2004, during which time

testimony was received from Plaintiff and a vocational expert. (R. 33-57.) On March 5,

2004 the ALJ rendered an adverse decision, finding that Plaintiff is not “disabled” within

the meaning of the Social Security Act. (R. 19-26) Upon the Appeals Council’s denial

of further review (R. 8-10), the ALJ’s decision became the “final decision” of the

Commissioner. Plaintiff then commenced this action on March 15, 2005.

Presently pending before this Court are cross-motions for summary judgment

filed by Plaintiff and the Commissioner. For the reasons that follow, we will deny both

motions and remand this case for further administrative proceedings.

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I. BACKGROUND

Plaintiff was forty-three years old at the time of the ALJ’s adverse decision. He

has a GED and no transferable work skills. Prior to the onset of his alleged disability,

he was employed as a general laborer for a lumbar company. (R. 37-38, 43-44, 79-81.) 

He was discharged from his job in 2001 after testing positive for marijuana and has not

worked since that time. (R. 44.) His treatment records reflect a history of diabetes,

hypertension, carpal tunnel syndrome, alcoholism, and depression. Most relevant for

purposes of this appeal, however, is the evidence concerning Plaintiff’s depression.

On February 13, 2003, Plaintiff underwent a clinical psychological disability

evaluation by Martin Meyer, Ph.D. (R. 131-38.) At the time of his evaluation, Plaintiff

reported experiencing mood swings about twice a week along with moderate to severe

depression that is “near constant.” He acknowledged that loss of financial capability,

health problems, and sexual problems were triggering factors for his lachrymosity and

social isolation. He admitted to frequent suicidal ideation and mild and occasional

anxiety relative to concerns about his finances. His thought assembly was confused

and he complained of short-term memory problems. Plaintiff also reported having an

extremely erratic appetite, very limited social interaction, infrequent episodes of intense

anger, easy loss of concentration and difficulty sleeping. Although he had not been

hospitalized for psychiatric evaluation, he had reportedly been receiving mental health

counseling with a therapist once per month relative to alcohol and depression. At the

time of his evaluation, Plaintiff had been taking Zyprexa and Lexapro and indicated that

he felt those drugs helped him “quite a bit.” Nevertheless, Plaintiff reported a poor

emotional status, noting that he had no money and depended on his wheelchair-bound

brother for everything. (R. 132.)

Dr. Meyer’s mental status exam indicates that Plaintiff appeared disheveled and

unkempt and failed to make eye contact during the interview. He was cooperative

about discussing his personal history and displayed no abnormal body movements. His

speech was mumbled and somewhat rambling and he displayed apathy and lethargy in

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his affect. However, Dr. Meyer found no evidence of disturbed thought process or

neural sensory distortion; rather, Plaintiff’s thought process was normal and relevant

and he showed coherent use of language. There was no blocking in expression of

thought, tangential thinking, flight of ideas, or loosening of associations. Response

latency was felt to be adequate. It was noted that Plaintiff admitted to suicidal ideation

and displayed excessive rumination about his family. He tended to obsess about his

worries and displayed somatic preoccupation. His statements tended to reflect feelings

of low self-esteem and worthlessness. There was no indication of a delusional thought

process and Dr. Meyer felt that Plaintiff likely had average intelligence and adequate

learning abilities. His fund of vocabulary knowledge was considered adequate. Plaintiff

reported attention problems and could not perform serial subtraction. He was fully alert

and oriented to time, place, person, and date. Although Plaintiff was reportedly

forgetful in the location or placement of objects, he was able to adequately recall

childhood experiences, recent events, and meaningful events occurring within the past

few months. He could recall seven digits forward and three digits backward. It was

noted that Plaintiff had difficulties with impulse control, as evidenced by his substance

abuse, suicidal tendencies, and eating disturbances. With respect to social judgment,

Dr. Meyer felt that Plaintiff showed “difficulty attributing meaning to the events of the

external environment in terms of appropriate behaviors and understanding the outcome

of their own behavior.” (R. 134.) It was felt that Plaintiff’s test judgment was

appropriate for his age, mental abilities and experiences. On the other hand, Dr. Meyer

felt that Plaintiff’s capacity to gain insight or learn from experience was poor. Dr.

Meyer’s diagnosis was as follows: AXIS 1: Adjustment Disorder with mixed Anxiety

and Depressed Mood, Cannabis Abuse, Nicotine Dependence; AXIS 2: No Diagnosis;

AXIS III: Diabetes, hypertension, visual acuity; AXIS IV: Significant Stressors: 

Occupational problems; AXIS V: GAF = 55-60. Dr. Meyer assigned Plaintiff a fair

prognosis in terms of higher level functioning and personality integration. (R. 134.)

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Dr. Meyer next rated Plaintiff’s abilities in various functional domains. (R. 135-

36.) Dr. Meyer felt that Plaintiff generally functioned “OK” in his activities of daily living,

with the exception of grooming and hygiene, where Plaintiff “lacked motivation.” (R.

135.) In terms of social functioning, Dr. Meyer felt that Plaintiff was “fair” in his ability to

get along with others, in his social maturity, and in his ability to interact with members of

the public. Dr. Meyer rated Plaintiff as “OK” in dealing with authority figures, co-workers

and peers. With respect to concentration and task persistence, Dr. Meyer rated Plaintiff

as “OK” in task completion and keeping to a schedule but he noted that, in terms of

maintaining a consistent pace, Plaintiff “fatigues easily.” In addition, Dr. Meyer felt

Plaintiff could handle only simple instructions and simple routines. (R. 136.) In terms of

making occupational adjustments, Dr. Meyer felt that Plaintiff had a “fair” ability to deal

with the public, use judgment, cope with work stresses, function independently, and

maintain attention and concentration. He rate Plaintiff as “good” with respect to

following work rules, relating to co-workers and interacting with supervisors. (R. 137.) 

As for understanding, remembering and carrying out job instructions, Dr. Meyer found

that Plaintiff had no useful ability in these areas when job instructions were complex

and only fair ability when the job instructions were detailed (but not complex). On the

other hand, Dr. Meyer felt that Plaintiff had good ability to understand, remember and

carry out simple job instructions. (R. 137.) Finally, with respect to making

personal/social adjustments, Dr. Meyer rated Plaintiff only “fair” in his ability to maintain

his personal appearance, behave in an emotionally stable manner, relate predictably in

social situations, and demonstrate reliability. (R. 138.)

Beginning in July of 2003, Plaintiff sought treatment from Jennifer Pasternak,

M.D., PhD at Stairways Behavioral Health. At his initial visit on July 3, 2003, Plaintiff

exhibited a dysphoric and constricted affect. Dr. Pasternak noted that Plaintiff

appeared distracted but it was not clear that he was “frankly disorganized.” Although he

had difficultly articulating his symptoms, Dr. Pasternak was not convinced that this was

actually psychotic disorganization. Dr. Pasternak assessed major depression,

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dysthymia, generalized anxiety disorder, alcohol and marijuana dependence in

remission, rule out Psychotic Disorder NOS. She continued Plaintiff on Seroquel to

help him sleep and proscribed a trial of Zoloft. (R. 184.)

On July 30, 2003, Plaintiff reported to Dr. Pasternak that he was still very

frustrated by the extent of his depression and had been unable to tolerate the Zoloft

that she prescribed. He could not identify much in life that would be enjoyable or that

would make him feel better. He did not make much eye contact but did appear

engaged during his mental status exam. He displayed significant negative cognitive

distortions but showed no evidence of psychosis other than perseveration in his

speech, which Dr. Pasternak felt might be mild disorganization. Dr. Pasternak

increased Plaintiff’s Seroquel dosage in an effort to increase the organization of his

thinking and improve his sleep. She planned to take him off Zoloft and restart him on

Lexapro based on his representation that he had felt much better on Lexapro. (R. 183.)

Progress notes from August 29, 2003 indicate that Plaintiff was reportedly doing

better and was tolerating the Lexapro without difficulty. Dr. Pasternak noted that he

appeared much less distracted and better organized. His speech was coherent, but he

was preoccupied on that day with pain from an abscessed tooth. His affect continued

to be dysphoric and constrictive, but he had no suicidal ideations. Plaintiff was

continued on his medication regimen and was advised to continue with individual

therapy and attendance at the “mood and motivation group.” (R. 182.)

On November 20, 2003, Plaintiff reported that he was feeling a little bit better,

but he still did not feel like doing anything. He was feeling more lonely and alone since

his brother was spending a lot of time with his girlfriend. Although Plaintiff could not

identify much that he would like to do, he indicated definitely feeling less depressed. 

He was concerned about his fluctuating sugar levels and his tooth abscess. On mental

status exam, Plaintiff’s speech was moderately pressured but coherent. His affect,

though less dysphoric, was still constricted. He had no suicidal ideations. Dr.

Pasternak assessed major depression with some improvement, dysthymia, generalized

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anxiety disorder, alcohol and marijuana dependence in remission. She planned to

increase Plaintiff’s Lexapro to see whether the higher dose would target his depressive

symptoms and motivate him more effectively. She continued him on daily dosages of

Seroquel and strongly encouraged Plaintiff to participate in the mood and motivation

group, which she felt would give him the additional support and social interaction that

he was missing. (R. 181.)

On January 14, 2004, Dr. Pasternak completed a “Medical Source Statement of

[Plaintiff’s] Ability to Do Work-Related Activities” in light of his mental impairments. (R.

185-86.) Dr. Pasternak indicated that Plaintiff’s ability to understand, remember and

carry out instructions were affected by his poor concentration and lower energy level. 

She found that he suffered from “extreme” limitations in understanding, remembering,

and carrying out detailed instructions. When the instructions were short and simple, his

limitations in those areas were “marked.” She also found that he had marked limitation

in his ability to make judgments on simple work-related decisions. (R. 185.) Dr.

Pasternak further indicated limitations in Plaintiff’s ability to respond appropriately to

supervision, co-workers, and pressures in a work setting. She found extreme limitation

in Plaintiff’s ability to respond appropriately to work pressures in a usual setting. She

felt that Plaintiff possessed marked limitations in his ability to interact appropriately with

the public, supervisors, and co-workers. Plaintiff’s ability to respond appropriately to

changes in a routine work setting was also felt to be markedly limited. In support of

these findings, Dr. Pasternak cited Plaintiff’s inability to tolerate stress, noting that he

“becomes profoundly depressed and immobilized. Under significant stress can become

disorganized.” (R. 186.) Dr. Pasternak felt that Plaintiff could not manage benefits in

his own best interest. (Id.)

Also included in the record is a review completed on March 31, 2003, by Edward

Zuckerman, PhD, an expert for the state agency. Dr. Zuckerman opined that Plaintiff

would be moderately limited in terms of his ability to carry out detailed instructions and

maintain attention and concentration for extended periods. (R. 139.) Dr. Zuckerman

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also felt Plaintiff was moderately limited in his ability to respond appropriately to

changes in a work setting and in his ability to complete a normal workday and

workweek without interruptions from psychologically based symptoms and to perform at

a consistent pace without an unreasonable number and length of rest periods. (R.

140.) In all other respects, Dr. Zuckerman opined that Plaintiff would not be

significantly limited in the domains of understanding and memory, sustained

concentration and persistence, social interaction and adaptation. (R. 139-40.)

II. STANDARD OF REVIEW

The Court must affirm the determination of the Commissioner unless it is not

supported by substantial evidence. See 42 U.S.C. § 405(g). Substantial evidence does

not mean a large or considerable amount of evidence, but only “such relevant evidence

as a reasonable mind might accept as adequate to support a conclusion.” Pierce v.

Underwood, 487 U.S. 552, 564-65 (1988) (quoting Consolidated Edison Co. v. NLRB,

305 U.S. 197, 229 (1938)); see Richardson v. Parales, 402 U.S. 389, 401 (1971). It

has been defined as less than a preponderance of evidence but more than a mere

scintilla. See Richardson, 402 U.S. at 401; Jesurum v. Secretary of the United States

Dept. of Health and Human Servs., 48 F.3d 114, 117 (3d Cir. 1995).

III. DISCUSSION

A person is "disabled" within the meaning of the Social Security Act if he or she

is unable to "engage in any substantial gainful activity by reason of any medically

determinable physical or mental impairment which can be expected to result in death or

which has lasted or can be expected to last for a continuous period of not less than 12

months." 42 U.S.C. § 423(d)(1)(A). The Social Security Administration has established

a five-step evaluation process to determine when an individual meets this definition:

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First, the Commissioner considers whether the claimant is currently

engaged in substantial gainful activity. If he is not, then the

Commissioner considers in the second step whether the claimant

has a “severe impairment” that significantly limits his physical or

mental ability to perform basic work activities. If the claimant

suffers a severe impairment, the third inquiry is whether, based on

the medical evidence, the impairment meets the criteria of an

impairment listed in the “listing of impairments,” 20 C.F.R. pt. 404,

subpt. P, app. 1 (1999), which result in a presumption of disability,

or whether the claimant retains the capacity to work. If the

impairment does not meet the criteria for a listed impairment, then

the Commissioner assesses in the fourth step whether, despite the

severe impairment, the claimant has the residual functional

capacity to perform his past work. If the claimant cannot perform

his past work, then the final step is to determine whether there is

other work in the national economy that the claimant can perform. 

The claimant bears the burden of proof for steps one, two, and four

of this test. The Commissioner bears the burden of proof for the

last step.

Allen v. Barnhart, 417 F.3d 396, 401 n. 2 (3d Cir. 2005) (citing 20 C.F.R. § 404.15120

(1999) (internal citations omitted)).

In this case, the ALJ resolved the Plaintiff’s claim at the fifth step. In relevant

part, the ALJ determined that Plaintiff suffers from diabetes, depression, and anxiety,

which – although “severe” within the meaning of the Act – are not presumptively

disabling under the Commissioner’s regulations. The ALJ further found that Plaintiff’s

allegations regarding his own limitations were not totally credible and that Plaintiff

possesses the residual functional capacity (“RFC”) to perform a significant range of

work at the light exertional level, i.e. “work involving no more than simple, routine

repetitious tasks, with one- or two-step instructions, performed in a low-stress

environment, defined as work requiring few decisions; or more than occasional contact

with the public and co-workers.” (R. 25, finding 6.) Based on testimony from a

vocational expert, the ALJ found that Plaintiff’s residual functional capacity permits him

to engage in a significant number of jobs existing in the national economy, including

work as a janitor/cleaner or as a packager. The ALJ therefore concluded that Plaintiff is

not “disabled” within the meaning of the Social Security Act. 

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In this appeal, Plaintiff primarily challenges those portions of the ALJ’s analysis

and ruling which concern his mental impairments. He contends, in essence, that his

mental limitations preclude him from working and that the ALJ’s conclusion to the

contrary is unsupported by substantial evidence. Plaintiff’s chief criticism stems from

the ALJ’s alleged refusal to accord proper weight to Dr. Pasternak’s medical opinion. 

We agree that the ALJ’s analysis in this regard is fundamentally flawed such that the

Commissioner’s adverse ruling is not supported by substantial evidence in the record.

The Third Circuit and the Commissioner have established specific rules relative

to consideration of a treating source’s medical opinion:

A cardinal principle guiding disability eligibility determinations is that

the ALJ accord treating physicians' reports great weight, especially "when

their opinions reflect expert judgment based on a continuing observation

of the patient's condition over a prolonged period of time." Plummer, 186

F.3d at 429 (quoting Rocco v. Heckler, 826 F.2d 1348, 1350 (3d

Cir.1987)); see also Adorno v. Shalala, 40 F.3d 43, 47 (3d Cir.1994);

Jones, 954 F.2d at 128; Allen v. Bowen, 881 F.2d 37, 40-41 (3d Cir.1989);

Frankenfield v. Bowen, 861 F.2d 405, 408 (3d Cir.1988); Brewster, 786

F.2d at 585. Where ... the opinion of a treating physician conflicts with

that of a non-treating, non-examining physician, the ALJ may choose

whom to credit but "cannot reject evidence for no reason or for the wrong

reason." Plummer, 186 F.3d at 429 (citing Mason v. Shalala, 994 F.2d

1058, 1066 (3d Cir.1993)). The ALJ must consider the medical findings

that support a treating physician's opinion that the claimant is disabled. 

See Adorno, 40 F.3d at 48. In choosing to reject the treating physician's

assessment, an ALJ may not make "speculative inferences from medical

reports" and may reject "a treating physician's opinion outright only on the

basis of contradictory medical evidence" and not due to his or her own

credibility judgments, speculation or lay opinion. Plummer, 186 F.3d at

429; Frankenfield v. Bowen, 861 F.2d 405, 408 (3d Cir.1988); Kent, 710

F.2d at 115.

Morales v. Apfel, 225 F.3d 310, 317-18 (3d Cir. 2000).

In this case, the ALJ declined to give Dr. Pasternak’s opinion controlling weight

because the ALJ felt it was: (i) not supported by Dr. Pasternak’s treatment records, (ii)

inconsistent with the Plaintiff’s daily activities, and (iii) inconsistent with the medical

opinion of Dr. Meyer. Instead, the ALJ credited Dr. Meyer’s medical assessment on the

grounds that Dr. Meyer’s opinion was supported by his own findings, by evidence of the

Plaintiff’s daily activities, and by the opinion of the state agency expert. Plaintiff

contends, and we agree, that the ALJ’s analysis is unsupportable to the extent he found

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 Plaintiff has appended to his brief a sample copy of the 7-page medical

assessment form generated by the state Bureau of Disability Determination. (See

Attachment A to Pl.’s Br. in Supp. of Pl.’s Mot. for Summ. Judg. [Doc. 8].) Pages 6 and

7 of this sample form appear to be identical to the form submitted by Dr. Meyer. The

relevant definitions explaining the rating system appear on page 5 of the form, which is

not included within the administrative record. However, Plaintiff presumes (and the

Commissioner has not disputed) that the same form, in its entirety, would have been

mailed by the state agency to Dr. Meyer and, therefore, Dr. Meyer would have had the

benefit of the page 5 definitions in making his assessment.

10

Dr. Meyer’s opinion consistent with the state agency expert and materially inconsistent

with Dr. Pasternak’s assessment.

We begin by noting that Dr. Meyer’s medical assessment of Plaintiff’s ability to

do work-related activities required him to rate Plaintiff in several subcategories

supposedly reflective of Plaintiff’s ability to make occupational, performance, and

personal/social adjustments, among other things. As Plaintiff observes (and the

Commissioner does not seem to dispute), it appears that Dr. Meyer partly completed

his assessment on a standard agency form (Form H56993 CEMD) sent to him by the

Commonwealth Bureau of Disability Determination. This form required Dr. Meyer to

rate Plaintiff’s abilities as being either “unlimited or very good,” “good,” “fair” or “poor or

none” in each of the relevant subcategories. (See R. 137-38.) 

Although only pages 6 and 7 of the form were submitted by Dr. Meyer, Plaintiff points

out that page 5 of the standardized form defines the rating system as follows1:

Unlimited or Very Good - Ability to function in this area is more than

satisfactory.

Good - Ability to function in this area is limited but satisfactory.

Fair - Ability to function in this area is seriously limited, but not precluded.

Poor or None - No useful ability to function in this area.

(See Pl.’s Br. in Supp. of Mot. for Summ. Judg. [Doc. 8] at Attachment A, p. 5.) 

Significantly, Dr. Meyer rated Plaintiff as only “fair,” – i.e., displaying “serious

limitation” – in ten out of fifteen categories indicated on Form H56993 CEMD. Many of

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 Plaintiff infers that, if a “good” rating means that the claimant’s ability to

function is “limited but satisfactory,” and if a “poor/none” rating means that the claimant

has “no useful ability to function,” then a “fair” rating must indicate some level of ability

that is less than satisfactory. The Commissioner does not dispute this inference, nor do

we find any logical basis for doing so.

11

these “fair” ratings are consistent with (or, at least, not inconsistent with) Dr.

Pasternak’s findings that Plaintiff’s ability to function in certain areas is “markedly”

limited – i.e. “seriously” or “severely” limited, although not completely precluded. (See

R. 185.) For example, both Dr. Meyer and Dr. Pasternak felt that Plaintiff had serious

limitations in dealing with the public. Both evaluators found Plaintiff to be serious

limited in his use of judgment. Dr. Meyer’s finding that Plaintiff would have serious

limitations in his ability to behave in an emotionally stable manner, relate predictably,

and demonstrate reliability correspond loosely with Dr. Pasternak’s finding that Plaintiff

has marked limitations in his ability to respond appropriately to changes in a routine

work setting. (R. 137-38.) Dr. Meyer also indicated a “fair” rating – i.e., serious

limitations – in Plaintiff’s ability to function independently, maintain attention and

concentration, maintain his personal appearance, and deal with work stresses. 

Plaintiff points out that, under the definition section of Form H56993 CEMD,

a”fair” rating by Dr. Meyer suggests a level of performance that is less than

satisfactory.2 Thus, these “fair” ratings by Dr. Meyer are significant in assessing

Plaintiff’s residual functional capacity because, as the Administration’s own regulations

make clear:

The basic mental demands of competitive, remunerative, unskilled

work include the abilities (on a sustained basis) to understand,

carry out, and remember simple instructions; to respond

appropriately to supervision, coworkers, and usual work situations;

and to deal with changes in a routine work setting. A substantial

loss of ability to meet any of these basic work-related activities

would severely limit the potential occupational base. This, in turn,

would justify a finding of disability because even favorable age,

education, or work experience will not offset such a severely limited

occupational base.

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 We note that part of the difficulty in being able to meaningfully analyze medical

evidence stems from the fact that, as in this case, physicians and psychologists often

use differing forms in rating a claimant’s residual functional abilities. It would seem that

both the Administration and the courts would be greatly assisted in their review of

medical evidence if the same forms were used consistently among different evaluators.

12

Social Security Ruling 85-15, 1985 WL 56857 at *4 (1985) (emphasis supplied). While

it remains a possibility that the ALJ construed Dr. Meyer’s “fair” ratings under a

definition different from the one supplied on the standardized form, the record provides

no evidence or guidance in this regard, nor does it suggest any rationale on the ALJ’s

part for doing so. 

In support of his conclusion that Dr. Pasternak’s opinion was inconsistent with

that of Dr. Meyer, the ALJ cited the fact that Dr. Meyer found Plaintiff’s thought process

to be in tact, whereas Dr. Pasternak found evidence of disorganization. The ALJ also

noted that Dr. Meyer rated Plaintiff’s ability to deal with simple job instructions as

“good,” whereas Dr. Pasternak indicated marked limitations in this area. However,

these discrepancies alone do not translate into fundamentally inconsistent medical

opinions, especially when one considers the various areas in which Dr. Meyer rated

Plaintiff’s ability as only fair, i.e. less than satisfactory.3

As further support for his rejection of Dr. Pasternak’s findings, the ALJ reasoned

that Dr. Meyer’s evaluation (in contrast, apparently, to Dr. Pasternak’s) was “consistent

with his findings and with the claimant’s daily activities.” However, the ALJ provided no

analysis or reasoning as to how or why he felt Dr. Meyer’s evaluation was more

internally consistent than Dr. Pasternak’s. Furthermore, while it is true that Dr. Meyer

rated Plaintiff favorably (i.e. “ok”) in most activities of daily living (see R. 135), it does

not follow that Dr. Meyer’s opinion materially contradicted Dr. Pasternak in this regard. 

Dr. Pasternak did not formally assess Plaintiff’s abilities to engage in activities of daily

living. Perhaps more significant, a claimant’s ability to function in activities of daily living

does not necessarily translate into an ability to work. See Smith v. Califano, 637 F.2d

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968, 971-72 (3d Cir. 1981) (sporadic or transitory activity does not disprove disability). 

As our circuit court of appeals has reminded us, for the mentally impaired, “the work

environment is completely different from home or a mental health clinic.” Morales v.

Apfel, 225 F.3d 310, 319 (3d Cir. 2000). 

Nor is it as evident as the ALJ suggested that Dr. Meyer’s conclusions are

consistent with the conclusions of Dr. Zuckerman, the state agency expert. It does

appear that both Dr. Meyer and Dr. Zuckerman rated Plaintiff favorably in terms of his

ability to understand, remember and carry out simple job instructions, his ability to

maintain a schedule, and his ability to deal with authority figures and co-workers. 

However, Dr. Meyer felt Plaintiff had only fair ability (i.e., less than satisfactory ability) to

deal with the public and “get along with others,” to use judgment, to function

independently, to maintain attention and concentration, to maintain personal

appearance, and to behave in an emotionally stable manner. These findings contradict

Dr. Zuckerman’s opinion that Plaintiff had no significant limitations or, at most, only

moderate limitations, in these areas. The ALJ reasoned that the opinion of the state

agency expert was entitled to significant weight under SSR 96-6p because it was

“consistent with the objective medical evidence.” (R. 23.) However, the ALJ’s

reasoning in this regard consists of no more than a blanket assertion without any further

evaluation or analysis. (And, as Plaintiff points out, the state agency expert did not

have the benefit of Dr. Pasternak’s treatment notes or functional assessment at the

time he rendered his opinion.) 

The foregoing problems would be a sufficient basis, in this Court’s view, for

vacating the Commissioner’s final decision; however, we find that a few additional

comments are pertinent. We note that the ALJ discounted Dr. Pasternak’s medical

assessment partly on the theory that she supposedly failed to cite specific limitations or

her treatment notes in support of her functional assessment. However, a review of Dr.

Pasternak’s functional assessment shows that she specifically cited Plaintiff’s poor

concentration and decreased energy level as findings supporting her opinion that

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 Interestingly, Dr. Meyer’s medical assessment of Plaintiff’s ability to do workrelated activities required him to rate Plaintiff’s abilities to make occupational,

performance and personal/social adjustments and further instructed him to “[d]escribe

any limitations and include the medical/clinical findings that support this assessment.” 

(R. 137-38.) The ALJ purported to credit Dr. Meyer’s findings, notwithstanding the fact

that the areas on the form calling for a description of limitations and/or medical/clinical

findings is left blank. (Id.)

14

Plaintiff had impaired ability to understand, remember, and carry out instructions. (R.

185.) In support of her conclusion that Plaintiff has impaired ability to respond

appropriately to supervision/co-workers and work pressures in a work setting, Dr.

Pasternak noted that Plaintiff is “‘unable to tolerate stress- becomes profoundly

depressed and immobilized. Under significant stress can become disorganized.” (R.

186.)4 Thus, the record belies the ALJ’s assertion that Dr. Pasternak failed to cite any

specific limitations in support of her medical assessment. Moreover, Dr. Pasternak’s

failure to specifically cite her treatment records does not necessarily undermine the

validity of her opinion. As Plaintiff points out, a medical source’s treatment notes

necessarily reflect the provider’s assessment of the patient’s progress at a given point

in time, whereas the medical source statement completed by Dr. Pasternak in January

2004 asked Dr. Pasternak to evaluate Plaintiff’s “ability to do work-related activities on a

sustained basis.” (R. 185 (emphasis supplied).) The factors cited by Dr. Pasternak in

support of her January 2004 evaluation – Plaintiff’s poor concentration, low energy, and

inability to tolerate stress – are not necessarily inconsistent with her diagnosis or the

observations she recorded in her treatment notes.

The ALJ also cited the fact that Dr. Pasternak’s treatment notes did not record

hospitalizations or other episodes of decompensation that would illustrate, to the ALJ’s

satisfaction, the disabling impact of Plaintiff’s stress. However, the Plaintiff need not

have experienced extreme episodes of decompensation in order to be considered

“disabled.” See Smith v. Califano, 637 F.2d 968, 971 (3d Cir. 1981) (“Disability does

not mean that a claimant must vegetate in a dark room excluded from all forms of

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human and social activity.”). Furthermore, under the circumstances of this case, it is

not surprising that the record is devoid of episodes of Plaintiff’s decompensation in a

work-like setting. That is because the evidence in this case suggests that the Plaintiff’s

depression became more severe after (and perhaps, because of) the termination of his

employment and, since that time, he has led a life marked by social isolation and

removed from the realities of a work-like setting. In fact, Dr. Meyer, whom the ALJ

purports to credit, suggests in his report that Plaintiff’s lack of employment and resulting

dire financial circumstances are among the factors triggering Plaintiff’s depression and

anxiety. Dr. Meyer notes, for example, that Plaintiff’s “[d]epressive episodes initiated in

August, 2001 with loss of employment and have been moderate to severe and near

constant. The claimant indicates lachrymosity and isolation from others with

circumstantial triggers involving loss of financial capability, health problems, and sexual

problems.” (R. 132.) (See also id.(“Anxiety is mild and occasional with worries of

finances. Obsessive thoughts involved the latter as well as general rumination.”)) Dr.

Meyer’s Axis IV diagnosis indicates that Plaintiff’s “occupational problems” are a

significant stressor. (R. 134.)

All of the foregoing observations lead us to conclude that the ALJ misconstrued

the evidence and/or viewed it selectively, in deciding to discount Dr. Pasternak’s

findings. Thus, we cannot say that the ALJ’s hypothetical to the vocational expert

incorporates all material limitations as reflected in the record. 

In addition, however, we note our agreement with Plaintiff’s argument that the

ALJ engaged in speculation to the extent that he determined Plaintiff’s limitations in

dealing with stress would be adequately accommodated by jobs requiring “few

decisions.” (See ALJ’s RFC finding no. 6, R. 25.) For one, it should be reiterated that

Dr. Meyer, whom the ALJ purported to credit, indicated that Plaintiff has only “fair”

ability to deal with work stresses, which (as we’ve seen) apparently translates into

serious limitations and less-than-satisfactory ability. More to the point, however, it is by

no means clear that job-related stress is defined principally by the number of decisions

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that an individual must make on the job. As the Administration itself has observed, for

the mentally impaired, the very requirement of breaking a highly rigid routine or lifestyle

may produce stress:

Individuals with mental disorders often adopt a highly

restricted and/or inflexible lifestyle within which they appear to

function well. ...The reaction to the demands of work (stress) is

highly individualized, and mental illness is characterized by adverse

responses to seemingly trivial circumstances. The mentally

impaired may cease to function effectively when facing such

demands as getting to work regularly, having their performance

supervised, and remaining in the workplace for a full day. A person

may become panicked and develop palpitations, shortness of

breath, or feel faint while riding in an elevator; another may

experience terror and begin to hallucinate when approached by a

stranger asking a question. Thus, the mentally impaired may have

difficulty meeting the requirements of even so-called "low-stress"

jobs.

Because the response to the demands of work is highly

individualized, the skill level of a position is not necessarily related

to the difficulty an individual will have in meeting the demands of

the job. A claimant's condition may make performance of an

unskilled job as difficult as an objectively more demanding job. for

example, a busboy need only clear dishes from tables. But an

individual with a severe mental disorder may find unmanageable

the demands of making sure that he removes all the dishes, does

not drop them, and gets the table cleared promptly for the waiter or

waitress. Similarly, an individual who cannot tolerate being

supervised may not be able to work even in the absence of close

supervision; the knowledge that one's work is being judged and

evaluated, even when the supervision is remote or indirect, can be

intolerable for some mentally impaired persons. Any

impairment-related limitations created by an individual's response

to demands of work, however, must be reflected in the RFC

assessment.

SSR 85-15 (emphasis supplied).

Because of the deficiencies in the ALJ’s analysis, this Court is not satisfied that

all of Plaintiff’s relevant impairment-related limitations were adequately reflected in the

ALJ’s hypothetical question to the vocational expert. Accordingly, we cannot say that

the ALJ’s adverse ruling is supported by substantial evidence. See Ramirez v.

Barnhart, 372 F.3d 546, 550 (3d Cir. 2004) (“If ... an ALJ poses a hypothetical question

to a vocational expert that fails to reflect ‘all of the claimant’s impairments that are

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supported by the record(,) ... it cannot be considered substantial evidence.’”) (quoting

Chrupcala v. Heckler, 829 F.2d 1269, 1276 (3d Cir. 1987)).

IV. CONCLUSION

Based upon the foregoing reasons, we will vacate the Commissioner’s final

decision and remand the matter for further administrative proceedings consistent with

this memorandum opinion. An appropriate order follows.

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IN THE UNITED STATES DISTRICT COURT

FOR THE WESTERN DISTRICT OF PENNSYLVANIA

DAVID P. EGGLESTON, )

)

Plaintiff, ) Civil Action 05-84 Erie

v. )

)

JO ANNE B. BARNHART, )

COMMISSIONER OF SOCIAL )

SECURITY, )

Defendant. )

O R D E R

AND NOW, to wit, this 30th day of September, 2005, for the reasons set forth in

the accompanying Memorandum Opinion,

IT IS HEREBY ORDERED that Plaintiff’s motion [Doc. No. 7] for summary

judgment is DENIED and the Defendant’s motion [Doc. No. 9] for summary judgment is

DENIED. 

IT IS FURTHER ORDERED that the final decision of the Commissioner in the

above-captioned matter is hereby VACATED and the matter is REMANDED for further

administrative proceedings consistent with this Memorandum Opinion and Order.

 s/ Sean J. McLaughlin

United States District Judge

cm: All counsel of record.

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