Opinion ID: 3012659
Heading Depth: 3
Heading Rank: 1

Heading: Combination of Impairm ents

Text: At Step Three of the sequential analysis, the ALJ must compare the claimant’s medical evidence to a list of impairments presumed severe enough to preclude any gainful work. 20 C.F.R. § 404.1520(d). We have explained that at the third step of analysis, “this Court requires the ALJ to set forth the reasons” for his or her decision. Burnett v. Comm’r of Soc. Sec. Admin., 220 F.3d 112, 118-119 (3d Cir. 2000) (citing Cotter v. 7 Harris, 642 F.2d 700, 704-05 (3d Cir. 1981)). 4 Our inquiry, however, does not end there. We do not merely check for a token recitation explaining the ALJ’s reasoning. The ALJ determined that Cadillac did not meet any of the listings or its equivalent, and proceeded to Step Four. Listing 1.05C of Appendix 1 to Subpart P of 20 C.F.R. § 404 details disorders of the spine. Listing 5.05F details impairments of the liver. The ALJ explained why she rejected a match between Cadillac’s medical evidence and the individual relevant listings. As to the back impairment, she observed, Cadillac’s own expert did not contend that he satisfied Listing 1.05C. The ALJ also explained that the evidence in the record did not establish the persistence of the chronically active nature of Cadillac’s hepatitis, as required by Listing 5.05F(3). With regard to both of these determinations, the ALJ’s decision is supported by substantial evidence. But the ALJ’s comparison of medical evidence to the listing of impairments should not have ended there, and the ALJ erred by not adequately considering the cumulative effect of Cadillac’s impairments. As the regulations explain, multiple impairments must 4 Cadillac excerpts conclusory statements from the ALJ’s decision and would have us fault that decision because the language is similar to that rejected in Burnett. But Burnett was not about magic words. In Burnett, we explained our concerns with conclusory statements: they are “beyond meaningful judicial review.” Burnett, 220 F.3d at 119. The single sentence we there condemned encapsulated the ALJ’s consideration of Step Three “in its entirety.” Burnett, 220 F.3d at 119 (emphasis added). In contrast, as the District Court correctly recognized, the ALJ’s Step Three determination regarding Cadillac does not come unadorned; the ALJ “subsequently devotes over three pages in her decision to analyzing and weighing the medical evidence presented by the parties.” A-7. Where, as here, the ALJ provides sufficient material to allow meaningful judicial review, Burnett is inapposite. 8 be considered in combination: If you have more than one impairment, and none of them meets or equals a listed impairment, we will review the symptoms, signs, and laboratory findings about your impairments to determine whether the combination of your impairments is medically equal to any listed impairment. 20 C.F.R. § 404.1526(a). See also 20 C.F.R. § 404.1523 (explaining that in assessing eligibility for benefits, the Commissioner “will consider the combined effect of all . . . impairments without regard to whether any such impairment, if considered separately, would be of sufficient severity”). The ALJ rejected Dr. Mylod’s assessment that the combination of Cadillac’s impairments satisfied Listing 1.05C, a decision, of course, that was within the ALJ’s discretion to make. See 20 C.F.R. § 404.1527 (“the final responsibility for deciding these issues [i.e., equalling and residual functional capacity] is reserved to the Commissioner”). That the decision rests with the ALJ does not, however, insulate it from review. The ALJ explained her logic in rejecting Dr. Mylod’s assessment of Cadillac’s impairments in combination. She found Dr. Mylod’s equating of Cadillac’s liver condition with the sensory loss requirements of Listing 1.05C as “a stretch.” The ALJ did not explain what she meant by this, but appeared to suggest that impairments in different categories cannot be used to satisfy the requirements of a specific listing. Consideration of a claimant’s impairments in combination, however, requires just that. See, e.g., Plummer, 186 F.3d at 435 (“the Commissioner shall consider the combined effect of all of Plummer’s impairments, physical and mental, in determining whether the claimant is 9 entitled to disability benefits”) (emphasis added); Burnam v. Schweiker, 682 F.2d 456, 458 (3d Cir. 1982) (“Because the administrative law judge failed to consider Burnam’s physical and mental condition as a whole, the Secretary’s decision is not supported by substantial evidence.”) (emphasis added); Beltran v. Barnhart, 2002 U.S. Dist. LEXIS 23953 (E.D. Pa. 2002) (“The ALJ concluded, based on the medical evidence, that Plaintiff had a combination of impairments, including a low back disorder, a uterine disorder, hepatitis C, and a combination of depression and anxiety.”) (emphasis added); Sudhop v. Secretary of Health & Human Servs., 580 F. Supp. 882, 884 (E.D. Pa. 1984) (considering plaintiff’s “migraine headaches and osteoarthritis of the spine” in combination) (emphasis added). The ALJ’s failure properly to consider Cadillac’s impairments in combination constitutes error.