Thursday, November 10, 2011

social security disability - treating physician - clinical/home setting v. work setting

Callahan v. Astrue - ED Pa. - November 7, 2011

Over defendant's objection, the court affirmed the Magistrate Judge's Report and Recommendation recommending that plaintiff’s Request for Review be granted and the case be remanded to defendant for further proceedings pursuant to the fourth sentence of 42 U.S.C. § 405(g).

The disputes before the Court primarily concern plaintiff’s mental impairments, including her history of alcohol and drug dependency, bipolar disorder, and severe depression.

Evidence that a claimant is doing well in treatment does not contradict a treating physician’s opinion that she is unable to work. “[T]he work environment is completely different from home or a mental health clinic. [A treating physician’s] observation[] that [a patient] is ‘stable and well controlled with medication’ during treatment does not support the medical conclusion that [the patient] can return to work.” Morales, 225 F.3d at 319. For that reason, a treating physician’s opinion that an individual cannot work may “not be supplanted by an inference gleaned from treatment records reporting on [plaintiff] in an environment absent of the stresses that accompany the work setting.” Id.; see also Brownawell v. Comm’r of Soc. Sec., 554 F.3d 352, 356 (3d Cir. 2008) (reiterating “the distinction between a doctor’s notes for purposes of treatment and that doctor’s ultimate opinion on the claimant’s ability to work”); Nguyen v. Astrue, No. 06-3443, 2008 WL 200175, at *3 (E.D. Pa. Jan. 23, 2008) (holding that when an ALJ rejected a treating psychiatrist’s opinion based on clinical notes that the plaintiff was doing well on medication, the ALJ improperly “substitute[d] his clinical judgment for that of the treating psychiatrist”). The ALJ thus erred in rejecting the doctor's inability-to-work opinion on that basis.

Evidence that plaintiff sometimes performed domestic tasks such as caring for her children and doing chores does not contradict a doctor's opinion that she could not work. Defendant’s Objections omit plaintiff’s repeated statement that the domestic tasks occur only “on a good day[;] a lot of the time I’m unable to do these things so my friend or daughter drop my son off at daycare and I never get up.” This explanation by plaintiff is important. Plaintiff concedes that she might be able to sustain a full-time job for “a week or two” or even a month. However, “not too many bosses are willing to put up with [her]” when her bipolar disorder hits a “down stage.” The ALJ committed legal error when he refused to consider the doctor's opinion.