Opinion ID: 1349375
Heading Depth: 2
Heading Rank: 2

Heading: Application of Wilson to the Facts of the Present Case

Text: The majority opinion rejects any application in the present case of the law set forth in Wilson regarding the need to reverse and remand when the Social Security Administration has violated its own regulation. It attempts to distinguish Wilson with the following arguments. First, the regulations are different: Because the opinion of the treating physician plays such a central and important role in a claimant's application for social security benefits, the reasons-giving requirement of § 404.1527(d)(2) serves its own independent and important function: as a safeguard to ensure[ ] that the ALJ applies the treating physician rule. Wilson, 378 F.3d at 544. We are unable to conclude that the same rationale applies in the context of an ALJ's failure to rate the B criteria. Majority Opinion, p. 656. I disagree. In my opinion, the ALJ's failure to rate the B criteria and include in the ALJ's decision specific findings as to the degree of limitation in each of the functional areas of the B criteria, as required by law in § 404.1520a, is just as important as the failure of an ALJ to include in his decision the reasons for the weight given the claimant's treating physician, as required by law in § 404.1527(d)(2). As noted, the Wilson court gave three reasons why enforcement of the regulation in that case was so important. 1. The regulation lets claimants understand the disposition of their cases. 2. The regulation ensures that the ALJ applies the treating physician rule. 3. The regulation permits meaningful review of the ALJ's application of the rule. Wilson, 378 F.3d at 544. Those reasons apply with equal, if not greater, force in the present case.
Section 404.1520a created a special technique which the regulation states in subsection (a), we must follow. The heart of that special technique is the requirement that the ALJ rate the degree of a claimant's limitations in four functional areas: daily living activities; social functioning; concentration, persistence or pace; and episodes of decompensation; and include the findings on each of these areas in the decision that is rendered. The court in Wilson pointed out that if a claimant knows that the claimant's physician has deemed him disabled, the claimant might be especially bewildered when told by an administrative bureaucracy that he is not. Wilson, 378 F.3d at 544. In the present case, it is just as likely, as it was in Wilson, that the claimant was aware that his treating physician, Dr. Fomunung, was of the opinion that claimant was disabled. Dr. Fomunung testified under oath that Rabbers was disabled as a result of his bipolar mental condition. The transcript of that testimony shows that Dr. Fomunung described Rabbers's condition in great detail, e.g., Rabbers was not able to function at work and even if he could make it to work, it's just trouble, (A.R. 257); he was not able to follow the demands of a work environment, follow rules and instructions, or get along with co-workers. (A.R.265). More importantly, in the context of this particular case, Dr. Fomunung testified regarding the B criteria. He found that with respect to Rabbers's Restriction of Activities of Daily Living, it would be mild. With respect to Rabbers's Difficulty in Maintaining Social Functioning, the limitation would be marked. With respect to Difficulties Maintaining Concentration, Persistence, or Pace, the limitation would be marked. With respect to Repeated Episodes of Decompensation, Dr. Fomunung found four or more. (A.R.266-67). The only thing that was needed to find Rabbers disabled under the applicable listing was at least two marked, or one marked and three or more episodes of decompensation. [2] The majority opinion is that the ALJ's procedural violation [of § 404.1520a] is neither as strong nor as personal as the ALJ's procedural violation of § 404.1527(d)(2), the regulation at issue in Wilson. Consequently, the majority thinks that a claimant will not be as `especially bewildered' or offended by the ALJ's failure to apply the law in the instant case as compared to the bewilderment and offense felt by a claimant when an ALJ fails to apply the law in a case involving § 404.1527(d)(2). Majority Opinion, p. 657. I seriously question whether a court of appeals' opinion regarding the degree of bewilderment or offense a claimant may suffer as a result of an ALJ's unlawful conduct is a valid measurement of how that conduct should be treated by the court. I believe that any violation of the law by an ALJ that affects a claimant, who expects the ALJ to apply the law properly and fairly, is very serious and should not be subject to how bewildered or offended the claimant may or may not be as a result of that violation.