2003 D e c i sion s O p inion s of the U nit e d S t at e s C our t of Appe al s for the Thir d C ir c uit

11-24-2003 

# C a rmon v . C omm S o c i al S ec ur it y P r e c e de n t i al or N on-P r e c e de n t i al : N on-P r e c e de n t i al D ocke t N o . 03-2539

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w Di g it al Re posit or y

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w Di g it al Re posit or y

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w . v i l l a no va . e du/thir dc ir c uit_2003/961 NOT PRE CEDENT IAL UNITED STATES COURT OF APPEALS FO R T HE TH IRD CIR CU IT

No. 03-2539

ANTONI O CARMON,

Appellant

v. JO AN NE B. B AR NH AR T, Co mm issione r of S ocial S ecurity

On A ppeal from the Un ited States District Co urt

for the Dis tri ct of New Jersey (Dist. Court No. 01-cv- 00624) District Judge: H on. Joseph A. G reenaw ay, Jr.

Submitte d Under Third Circ uit LAR 34.1(a)

November 19, 2003 Be for e: R EN DE LL , BA RR Y a nd C HE RT OF F, Circuit Judges (Fil ed: November 24, 2003)

OPI NION

CH ER TO FF , Circuit

Judge : Antonio Carmon appeals from an order of t he District Court

affirmi ng the deci sion1 “The la w and re gul at io ns g ove rn in g the d et er min at io n of di sa bi li tyar e the s ame for both di sabil ity

insurance benefit s and [suppl emental s ecurit y i ncome].” Greenspan v. Sha lala , 38 F.3d 232, 236 (5th Cir . 1994). We provide cit ations only to the regulations respecting disabil ityinsurance benefits. 2 of the Commissi oner of Socia l Securi ty denyi ng Carmon disabil ity insurance benefit s and supplementa l security

income under Title IIand Titl e XVI, respectively , of theSocial Security Act. Before us, a s before t he District Court , Carmon all eges that the Administr ative Law Judge (ALJ) erred i n determi ning that Carmon’s impai rments do not entitle him t o disabi lit

y benefi ts and suppl emental s ecurit y i ncome, and that the ALJ erred in dete rminin g that, d espite h is health prob lems, C armo n w as cap able o f return ing to work. The District Court exerci sed jurisdi ction pur suant t o 42 U.S.C. §§ 405(g) and 1383(c) 1 and en tered a final orde r affirming th e AL J’s opinion an d dismissing C armon ’s chall enge on March 31, 2003. We have j urisdi ction pur suant t o 28 U.S.C. § 1291 and will vacate the order of the District Court, remanding with directi ons to remand the cause to th e A LJ f or f urth er p roc eed ing s in c onf orm ity with this o pin ion

. I. Bec ause this op inion is not p reced ential, w e w ill recite on ly those fa cts relev ant to disposi tion. An tonio C armo n has HIV . On Ap ril 2, 199 6, Ca rmo n w ent to R ahw ay Ho spital in Rahway, New Jersey , si ck with what he thought was the flu. Carmon was admitted to the hospit al and spent

the better par

t of the following two months there. Carmon was treat ed2 Carmon’s T-helpe r ly mphocyte (CD4) count was below 200, an i ndication that

his “su scep tibility [to] opp ortun istic disea se [w a]s co nside rably incre ased ,” 20 C .F.R. P t. 404 , Sub pt. P, A pp. 1, ¶ 14.00 (D)(3 )(a)(iii), twic e w ithin on e year: a co unt o f 20 in October, 1996, and a count of 106 i n July , 1997. 3 by Dr. Kornicki, and was referred to an HIV specia lis t, Dr. Ruggeri-Weigel . Each doctor noted a host

of sy mptoms and possi ble cause s, and or dered a battery of test s. Among the sympt oms and possibl e causes were: pneumoniti s, febrile i llnes s, thrush, malnutri tion, diar rhe a, an d hi story o f H IV pos itive dise ase . The result s of the tests ordered byboth doctor s showed an absence of pneumocysi sti s carni i, or any ot her of a number of vi ral i ndicat ors. Indeed, by time of discharge, D r. Rugge ri-Weigel no ted that Carm on w as “feeling f ine” and d enied “fe ver, night s weats, di arrhea, or fati gue.” Although during hi s June 6, 1996 visi t with Carmon Dr. Kornickinoted weight gain of si xteen pounds, his outlook for Carmon was never as optimistic as that of D r. Rugge ri-Weigel. O n Oc tober 17, 19 96, we ll after discharge, D r. Ko rnicki w rote tha t Carm on’s lo ng-ter m p rogn osis w as “d ifficu lt to state” d ue to h is multi ple medicat

ions and viral l oad. 2 Dr. Kornickialso expressed that “the like lihood of [Carmon] doing anyconstricti ve work [was] probabl y ext remelypoor.” I t is undisput ed that C arm on h as n ot w ork ed s ince Ap ril 15 , 199 6. On Au gus t 2 7, 199 6, Carmon ap pl ie d f ordi sabi li ty

in su ra nc e b en ef

it s. On September 20, 1996, Carmon appli ed for suppl emental s ecurit y i ncome for the period3 In connection with hi s socia l security clai ms, Carmon met with a phy sici an from the Ne w Jersey D epartmen t of Lab or, Dr. Aru na S. Patel, on M ay 13, 1997. A lthough D r. Patel ne ver treated Carmon and met wit h him onlyonce, Dr. Patel c onducted a thorough physical examin ation. Of sign ificance, D r. Patel observed that Carm on “look ed very healthy” and ne eded li ttl e or no assi stance during the e xaminati on, for example, getting onto the e xaminati on table or dress ing himsel f. The result s of the tests r un at Rahway Hospit al and those conducte d by Dr. Patel were a lso review ed by state physicians, who drew c onclusions with respe ct to Carm on’s w or k c ap ac ity.

4 The Co mm issione r has p rom ulgate d a fiv e-step proc ess of evalu ating d isability ben efit c laim s. See sec tion II, infra

. 4 beginning Apri l 15, 1996. 3 Carmon’s appli cati ons were denied, both ini tial ly and on reconsi derati on, so Carmon exer cised hi s right to de novo consider ation by an ALJ. After a heari ng on May 6, 1998, the ALJ issue d an opinion. The ALJ first de termine d that Carmon had proven he was not gai nfully employe d, that he had an i mpairment, and that his i mpairment was seve re. 4 But the ALJ determined that Carmon’s medicalconditi on was not equival ent to anything on the Soci al Securi ty Administr ation l ist of ail ments that

are s uff icien tly seve re to justif y a pre sum ptio n in fav or o f be nef it-en titling disa bility. The ALJ further determined that Carmon ret ained the capacit y t o perform “l ight work” pursuant

to 20 C.F.R. § 404.1567. Under t his defi niti on, the ALJ found that Ca rmo n w as c apa ble o f lifti ng 1 0 po und s fre que ntly an d up to 2 0 po und s oc cas ion ally. Id. The A LJ con cluded tha t Carmo n wa s therefore ab le to return to his past releva nt work as a hospi tal f

ood servi ce employ ee, which Carmon’s file s characterize d as requi ring frequent lift ing of items up to 20 pounds. Having determined that Carmon was not entitled to disability benefits, the ALJ d id not proce ed further.5

Carmon sought revi ew of the ALJ’s decis ion by the Appeals Counci l, but the Appeals Council determi ned that there were no grounds for s uch revie w. After exhausti ng these admi nist rati ve remedies , Carmon fil ed the pre sent act ion in t he United Sta tes D istrict Co urt f or th e D istrict of N ew Jers ey on Feb rua ry 7, 20 01. B ef or e th e D ist ric t C ou rt, a s b ef or e u s, C ar m on co nt en de d t ha t th e A LJ er re d b y: (1) fai ling to explai n why Carmon’s i mpairments , al one or in combi nation, did not meet the cri teri a of paragraphs 14.08( D)(2)(b) , 14.08( M) or 14.08(N) of the lis t of presumpti velydisabl ing impai rments cont ained i n the Socia l Securi ty regulat ions; (2) rejec ting a t

reati ng physi cian’s medical opi nion in fa vor of that of a non-treati ng physi cian; (3) det ermining t hat Carmon had a res idual f unctiona l capaci ty suffici ent for him to perfo rm h is past re levan t wo rk; and (4) rejec ting C armo n’s su bjectiv e com plaints with out su fficien t analysis. T he D istrict Co urt aff irmed the A LJ’s d ecision on all grounds. This ti mely appeal fol lowed. II. Alt hou gh w e ha ve p lena ry revi ew of a ll leg al iss ues , see Krystoforski v. Chater , 55 F.3d 857, 858 ( 3d Cir. 1995) , our fac tual review is l imit ed to whether substant ial e vidence supports the ALJ’s det ermination. Subs tanti al evi dence is “ less t han a preponder ance of the evi dence but more t han a mere sci ntil la. ” Jesurum v. Sec’y of the U nited States D ep’t of Health & H uman Servs. , 48 F.3d 114, 117 (3d Cir. 1995) (quoting Richardson v. Perales , 402 U .S. 389 , 401 ( 197 1)). “‘It m eans such releva nt evid ence as a rea sona ble6

mind might acc ept as ade quate. ’” Plummer v. Apfel , 186 F.3d 422, 427 (3d Cir. 1999) (quoti ng Ve ntura v . Shala la , 55 F.3d 900, 901 (3d Cir. 1995)). Overall, the subst antia l evid enc e sta nda rd is a def eren tial sta nda rd o f rev iew

. See Schaudeck v. Comm’r of Soc. Sec. Admin. , 181 F.3d 429, 431 (3d Cir. 199 9). A claimant i s enti tled to disabi lit y i nsurance bene fits if he or s he can prove an “inab ility to engag e in an y substan tial gainf ul activ ity by reason o f any m edica lly determi nable phy sicalor mental impairment which can be expect ed to res ult i n death or which has las ted or can be expected to last for a continuous period of not l ess than 12 months.” 42 U.S. C. § 423(d)( 1)(A). A cl aimant i s conside red unable to engage i n any substant ial gainful a ctivi ty “onlyif his physi cal or ment al impai rments are of such severi ty that he is not

only unable t o do his pre vious work but c annot, considering his age, education , and w ork exp erience, enga ge in any other kind of substan tial gainful wo rk wh ich ex ists in the n ationa l econ om y . . . .” 42 U.S .C. § 4 23 (d )(2)(A ); see also Farg noli v. Ma ssanari , 247 F.3d 34, 39 (3d Cir. 2001 ). The Social Security Administration has promulgated a five-step evaluation process for use bythe Commissione r of the Soci al Securi ty Administr ation i n determi ning wh ethe r an ind ivid ual is disa bled

. See 20 C .F.R. § 404 .1520 ; see also Plummer , 186 F.3d at 428 . The proc ess req uires th e Co mm issione r to seq uentia lly determ ine the follow ing: (1) Wh ether the claima nt is currently engaging in s ubstantial gainfu l activity. If so, the claiman t is not eligible for disability benefits. 20 C.F.R . § 404.152 0(b).7

(2) Whether t

he clai mant is s uffering f rom a severe i mpairment. If not, the claimant is not eligible fo r disability benefits. 20 C.F.R. § 4 04.1520 (c). (3) W hethe r the ev idenc e estab lishes th at the c laima nt suf fers f rom any ailm ent in a list of a ilmen ts presu med seriou s eno ugh to prec lude g ainfu l wo rk. If so , the claim ant is automati call y el igibl e for dis abili ty benefit s. I f not, t he Commissioner proceeds to t he

nex t step . 20 C .F.R . § 40 4.15 20( d). (4) W hethe r the cla iman t retains th e “resid ual fu nction al cap acity” to pe rform his pas t rele van t wo rk. If so, th e cla ima nt is n ot eli gib le fo r disa bility be nef its. 20 C.F .R. § 404 .152 0(e ). (5) Wh ether— given the c laimant’s me dical impairm ents, age, educ ation, past wo rk experie nce, and “residualfuncti onal capaci ty ”—jobs exist i n signi ficant numbers in t

he nationa l economy that t he clai mant can perform. If so, the cl aimant i s not el igibl e for ben efits . 20 C .F.R . § 40 4.15 20( f). The claimant

bears the burden of proof at the f irst four st eps, and t

he Co mm issio ner bea rs the bur den at the fifth

. See Farg noli , 247 F.3 d at 3 9. The ALJ determined that Carmon had proven he was not gainful ly employe d and that hi s impairment was severe. Therefore, steps 1 and 2 are not at is sue. At s tep 3, how ever, th e A LJ d eterm ined th at Ca rmo n’s m edica l cond ition w as no t equiv alent to anything on th e list of p resum ptively disa bling a ilmen ts. The AL J’s ana lysis, in its entirety , states:5 We note that what the ALJ justifie d in one curs ory paragraph required more than sev en p age s of den se b rief ing by the Go ver nm ent to but tress . 8 [Carmon] has no impai rment which [si c] meets t he criteria of

any of t he listed imp airm ents des crib ed in Ap pen dix 1 of the R egu latio ns (2 0 C .F.R ., Part 404, Subpart P, Appendix 1). No treati ng or examini ng phyi sici an has mentioned fi ndings equi valent in severity

to the c riteria of

any l ist ed impairme nt. Specifially, the undersigned evaluated the claimant’s H IV infection under t

he requirements of l isting 14.08 ( Id.) . Although t he clai mant does have some symptoms of HIV, his condi tion fails to meet or med ically equa l the req uirem ents o f this listed impa irmen t. Carm on ch alleng es that d eterm ination , conte ndin g that h is con dition f alls w ithin (or is equivalen t to) paragraph s 14.08(D )(2)(b), 14.08(M ) or 14.08(N ), and that the A LJ’s dete rmin ation is im per mis sibly co nclu sory. We are troubl ed by t

he ALJ’s summary de termination. 5 We have repeatedl y st ated that we ar e unable t o conduct our s ubstantial e vidence r eview if the ALJ fails to identi fy the e vid enc e he or sh e reje cts a nd t he r eas on f or its rejec tion

. See Walton v. Halter , 243 F.3d 70 3, 710 (3d Cir. 2001 ). Our prece dent requires m uch m ore than a m ere conclu sory state me nt th at the claim ant’ s co ndi tion s are not fou nd i n th e listin gs. See Burnett v. Comm’r of Soc. Sec. , 220 F .3d 11 2, 121 (3d C ir. 2000 ); Co tter v. H arris , 642 F.2d 700, 705 (3d Cir. 1981). The re ason is not merelya desire to make the ALJ jump through additio nal “h oop s.” Su bstan tial evide nce re view is all but im poss ible w ithout a n ade quate ind icatio n of wh at the AL J co nsid ered , wh at he or sh e reje cted , and wh y. Cotter , 642 F.3d at 705- 6. But we need not determine whether a remand is ne cessary here to cl arify the pro cess b y which the A LJ re ache d his ste p 3 d eterm ination , beca use re man d is6 Carmon’s fil ings act ually state that

the heavi est obj ect he was expected to li ft was 20 p oun ds, an d that h e w as ex pecte d to lift u p to 2 5 po und s freq uently. Th is inconsi stencyis due t o the choi ces with which Carmon was presented on t he form he completed. The two responses can be harmonize d by concluding that Carmon’s pri or relevant work required him to lift no more than 20 po unds, but required him to do so fr eq ue nt ly. 9 unq ues tion ably n ece ssar y with resp ect to the A LJ’ s step 4 de term inati on. The AL J deter mine d that C armo n w as cap able o f “ligh t wo rk,” as th at term is defined by40 C.F.R. § 404. 1567(b). The definit ion of “l ight work” pr ovides t hat an emp loyee be aske d to lift u p to 2 0 po und s, but frequent lifti ng is restri cted to items 10 pounds or les s. 40 C.F. R. § 404.1567(b) . The ALJ also expl icitly looked to and credited Carmon’s descripti on of his duties at his past relevant work as a hospi tal f ood servi ce worker. Carmon’s fili ngs make clear that a s a hospit al food service worker he was frequ ently expected t o lift cartons of juic e and milk weighi ng up to 20 pounds

. 6 The AL J’s resid ual ca pacity de termin ation u nder step 4 , theref ore, is at o dds w ith his det ermi nation that Carmon was capable of r esu ming his pas t r el evan t work: t he ALJ would send Carmon back to do frequ ently that whic h the ALJ alre ady determined Carmon could only

do occa siona lly – lift 20 pou nds. T he de finition of “m edium wo rk” w ould seem more appropri ate t o fit Carmon’s past relevant work as it

provides that t

he employ ee be asked to l ift up to 25 p oun ds fre quen tly , and mo re th an th at inf req uen tly. 40 C .F.R . § 404 .1567 (c). W e can not sq uare th e resp onsib ilities of C armo n’s pa st releva nt w ork w ith the ALJ’s det ermination of his resi dual capaci ty , give n the C.F. R.’s defi niti ons of li ght7 Carm on als o cha llenge s the A LJ’s s tep 4 d eterm ination as: (1) im perm issibly

conc lusory; (2) im perm issibly base d on the fin ding s of a non -exam ining p hysician d espite contradi ctoryfindings of an examining phy sici an; and (3) impermiss ibly dismis sive of Carm on’s s ubjec tive symp toms (e.g., pain , fatigu e, etc.). W e dec line to re ach th e me rits of the se ch alleng es in ligh t of ou r determ ination that a re man d is ne cessa ry, but reiterate our recommendati on that t he ALJ reconsider

all ba ses for hi s prior

opinion. 10 and medium work. 7 A remand is necess ary to clarifyhow the ALJ determined t hat Ca rmo n w as a ble to retu rn to his p ast re leva nt w ork , in lig ht o f his resid ual c apa city. W e also st ronglyadvise t

he ALJ to take note of our holdi ngs in Cotter , Bu rnett and th eir progeny , and t o consider not res tri cting a

revis ed opinion to clari fication of step 4. III. For th e reaso ns state d abo ve, w e vac ate the Distric t Cou rt’s orde r and rema nd w ith instruc tions to rema nd to the C om missio ner fo r add itional p rocee ding s con sistent w ith this opinion.

/s/ Michael Chertof

f, Circ uit J udge