United States District Court, D. Maryland
September 8, 2017, Plaintiff Natalie May Hamilton petitioned
this Court to review the Social Security Administration's
(“SSA's”) final decision to deny her claim
for Disability Insurance Benefits. (ECF No. 1). I have
considered the parties' cross-motions for summary
judgment, and Ms. Hamilton's reply. (ECF Nos. 16, 17,
18). I find that no hearing is necessary. See Loc.
R. 105.6 (D. Md. 2016). This Court must uphold the decision
of the SSA if it is supported by substantial evidence and if
the SSA employed proper legal standards. See 42
U.S.C. §§ 405(g), 1383(c)(3); Craig v.
Chater, 76 F.3d 585, 589 (4th Cir. 1996). Under that
standard, I will deny both motions, reverse the judgment of
the SSA, and remand the case to the SSA for further analysis
pursuant to sentence four of 42 U.S.C. § 405(g). This
letter explains my rationale.
Hamilton filed her claim for benefits in September, 2013,
alleging a disability onset date of June 13, 2013. (Tr.
208-09). Her claim was denied initially and on
reconsideration. (Tr. 120-30, 132-43). A hearing was held on
March 3, 2016, before an Administrative Law Judge
(“ALJ”). (Tr. 57-119). Following the hearing, the
ALJ determined that Ms. Hamilton was not disabled within the
meaning of the Social Security Act during the relevant time
frame. (Tr. 36-52). The Appeals Council (“AC”)
denied Ms. Hamilton's request for further review, (Tr.
16-21), so the ALJ's decision constitutes the final,
reviewable decision of the SSA.
found that Ms. Hamilton suffered from the severe impairments
of “[m]ajor depressive disorder, recurrent and
moderate; anxiety disorders; and borderline intellectual
functioning.” (Tr. 39). Despite these impairments, the
ALJ determined that Ms. Hamilton would retain the residual
functional capacity (“RFC”) to:
perform a full range of work at all exertional levels but
with the following nonexertional limitations: The claimant
can perform work that involves understanding, remembering,
and carrying out very short, simple instructions; can
interact appropriately with supervisors, co-workers, or peers
frequently; and can respond appropriately to changes in the
work setting frequently.
(Tr. 45). After considering the testimony of a vocational
expert (“VE”), the ALJ determined that Ms.
Hamilton could perform jobs existing in significant numbers
in the national economy. (Tr. 50-51). Therefore, the ALJ
concluded that she was not disabled. (Tr. 51-52).
Hamilton makes two primary arguments on appeal:
(1) that the ALJ's evaluation of Listing
12.05 (Intellectual Disorder) was defective; and (2) that the
ALJ's RFC assessment was flawed and runs afoul of the
Fourth Circuit's decision in Mascio v. Colvin,
780 F.3d 632, 638 (4th Cir. 2015). I agree, and I therefore
remand the case for further analysis.
in Mascio, the United States Court of Appeals for
the Fourth Circuit determined that remand was appropriate for
three distinct reasons, including, as pertinent to this case,
the inadequacy of the ALJ's evaluation of “moderate
difficulties” in concentration, persistence, or pace.
Id. At step three of the sequential evaluation, the
ALJ determines whether a claimant's impairments meet or
medically equal any of the impairments listed in 20 C.F.R.
Part 404, Subpart P, Appendix 1 (2016). Listings 12.00 et
seq. pertain to mental impairments. 20 C.F.R. Pt. 404,
Subpt. P, App. 1 § 12.00. The relevant listings therein
consist of: (1) a brief statement describing a subject
disorder; (2) “paragraph A criteria, ” which
consists of a set of medical findings; and (3)
“paragraph B criteria, ” which consists of a set
of impairment-related functional limitations. Id.
§ 12.00(A). If both the paragraph A criteria and the
paragraph B criteria are satisfied, the ALJ will determine
that the claimant meets the listed impairment. Id.
B consists of four broad functional areas: (1) activities of
daily living; (2) social functioning; (3) concentration,
persistence, or pace; and (4) episodes of decompensation. The
ALJ employs the “special technique” to rate a
claimant's degree of limitation in each area, based on
the extent to which the claimant's impairment
“interferes with [the claimant's] ability to
function independently, appropriately, effectively, and on a
sustained basis.” 20 C.F.R. § 404.1520a(c)(2)
(2016). The ALJ uses a five-point scale to rate a
claimant's degree of limitation in the first three areas:
none, mild, moderate, marked, or extreme. Id. §
404.1520a(c)(4). To satisfy paragraph B, a claimant must
exhibit either “marked” limitations in two of the
first three areas, or “marked” limitation in one
of the first three areas with repeated episodes of
decompensation. See, e.g., 20 C.F.R. Pt. 404, Subpt.
P, App. 1 § 12.02 (2016). Marked limitations “may
arise when several activities or functions are impaired, or
even when only one is impaired, as long as the degree of
limitation is such as to interfere seriously with [the
claimant's] ability to function.” Id.
functional area of “[c]oncentration, persistence, or
pace refers to the ability to sustain focused attention and
concentration sufficiently long to permit the timely and
appropriate completion of tasks commonly found in work
settings.” Id. § 12.00(C)(3). Social
Security regulations do not define marked limitations in
concentration, persistence, or pace “by a specific
number of tasks that [a claimant is] unable to
complete.” Id. The regulations, however, offer
little guidance on the meaning of “moderate”
Fourth Circuit remanded Mascio because the
hypothetical the ALJ posed to the VE-and the corresponding
RFC assessment-did not include any mental limitations other
than unskilled work, despite the fact that, at step three of
the sequential evaluation, the ALJ determined that the
claimant had moderate difficulties in maintaining
concentration, persistence, or pace. 780 F.3d at 637-38. The
Fourth Circuit specifically held that it “agree[s] with
other circuits that an ALJ does not account for a
claimant's limitations in concentration, persistence, and
pace by restricting the hypothetical question to simple,
routine tasks or unskilled work.” Id. at 638
(quoting Winschel v. Comm'r of Soc.
Sec., 631 F.3d 1176, 1180 (11th Cir. 2011)) (internal
quotation marks omitted). In so holding, the Fourth Circuit
emphasized the distinction between the ability to perform
simple tasks and the ability to stay on task, stating that
“[o]nly the latter limitation would account for a
claimant's limitation in concentration, persistence, or
pace.” Id. Although the Fourth Circuit noted
that the ALJ's error might have been cured by an
explanation as to why the claimant's moderate
difficulties in concentration, persistence, or pace did not
translate into a limitation in the claimant's RFC, it
held that absent such an explanation, remand was necessary.
instant case, the ALJ found that Ms. Hamilton had moderate
difficulties maintaining concentration, persistence, or pace.
(Tr. 43). The ALJ's analysis stated:
The claimant testified that her depression has caused
short-term memory problems and an inability to finish tasks.
She also testified to having learning issues. She stated she
was in “resource classes” at school, which
allowed time to do homework with help from teachers, and that
she failed ninth grade three times and was, consequently,
forced to leave the public school system. The claimant's
treatment records indicate GAF scores from 50 to 55,
suggesting moderate limitations in occupational functioning.
Although Ms. Woods, the claimant's therapist at Sheppard
Pratt Way Station, indicated marked limitations in
understanding even short and simple instructions, the
claimant's consultative examination report with Dr.
Burlingame showed an ability to follow 3-step instructions
and simple commands independently. The claimant's
cognitive ability was noted to have moderate (bordering on
marked) limitations based on the interrogatory answers of
consultative examiner Dr. Goff. However, Dr. Goff
specifically indicate [sic] that the claimant had moderate
limitations in understanding and carrying out complex
instructions but only mild limitations in simple ones. The
claimant's cognitive testing showed some deficits-Full
Scale IQ and Verbal scores of 70; however, her reading was on
[an] 8th grade level, spelling on an
11th grade level, and math at ¶ 5.7 grade
level. In the claimant's mental status examination with
Dr. Burlingame, the claimant had adequate concentration; she
could spell a word forwards and backwards and did serial
sevens with only one error. The claimant's memory test
was 3/3; she could follow a simple command, repeat a ...