Ted Herod, associate at Kelley Drye, partnered with Seton Hall University School of Law’s Center for Social Justice (the “CSJ”) to represent a client who was denied disability benefits for nearly two decades. Our client was severely injured on a job site in 2003. His injuries caused severe impairments to his back, neck, left shoulder, left hand, and left wrist. He applied for disability benefits with the Social Security Administration (the “SSA”) in 2004. While his case slowly churned through the system, our client relied on minimal worker’s compensation and the support of his daughter for nearly two decades.
By the time the Second Circuit appointed Professor Jon Romberg of the CSJ to the case, our client’s journey included four hearings with administrative law judges, two reversals from the SSA Commissioner, and a reversal from the Southern District of New York. Nevertheless, each ensuing ALJ decision would—through different and, at times, contradictory rationales—reach the same conclusion: finding at least one job in the national economy wherein the client could allegedly work despite his severe impairments.
The most recent—and now vacated—ALJ decision disregarded the opinion of the client’s treating physician. The ALJ assigned little weight to the opinion of the treating physician—a board certified orthopedic surgeon specializing in the hands, wrists, and upper extremities—due, in part, to an allegedly conflicting report from the client’s hip specialist who was reviewing him for possible hip replacement surgery. The client was not seeing the hip surgeon for his back, neck, shoulder, hand, or wrist injuries.
In oral argument before the Second Circuit, Ted and Jon argued that the ALJ failed to properly apply the treating physician rule—a rule that requires the ALJ to attribute weight to a treating physician over that of a consultative examiner or justify failing to do so through a multifactor test. They further argued that a cursory system review by a hip specialist for the express purpose of diagnosing acute, aggravated hip pain, did not constitute substantial evidence contradicting the opinion of the established, treating physician of the client’s back, neck, shoulder, hand, and wrist.
The Second Circuit vacated the SSA’s denial of benefits. The court “express[ed] uncertainty as to the ALJ’s relatively cursory conclusion,” given that the two doctors’ “findings appear to have addressed different areas of concern.” Ultimately, the Second Circuit found that the ALJ failed to apply the appropriate legal standard in analyzing our client’s treating physician’s opinions, and thus, improperly assigned “little weight” to the treating physician’s assessment. The Second Circuit vacated the District Court’s judgment and remanded the case to the SSA.