Oliver Grier, Jr. v. Commissioner Social Security ( 2020 )

NOT PRECEDENTIAL
UNITED STATES COURT OF APPEALS
FOR THE THIRD CIRCUIT
_____________
No. 19-3898
_____________
OLIVER GRIER, JR.,
Appellant
v.
COMMISSIONER SOCIAL SECURITY
_____________________________________
On Appeal from the United States District Court for the
District of Delaware
(District Court No.: 1:18-cv-00386)
Magistrate Judge: Honorable Sherry R. Fallon
_____________________________________
Submitted under Third Circuit L.A.R. 34.1(a)
July 2, 2020
(Filed: August 27, 2020)
Before: GREENAWAY, JR., SHWARTZ and RENDELL, Circuit Judges.
O P I N I O N*
_________
RENDELL, Circuit Judge.
*
This disposition is not an opinion of the full Court and pursuant to I.O.P. 5.7 does not
constitute binding precedent.
Appellant Oliver Grier, Jr., challenges the District Court’s decision to affirm the
Administrative Law Judge’s (ALJ) denial of his application for supplemental security
income (SSI). Grier argues that the ALJ and the District Court failed to consider his need
for a supportive environment and improperly discounted the opinions of his treating
physicians. We agree that consideration of the impact of a supportive environment on
Grier’s ability to work was warranted, and we will therefore vacate and remand for
further proceedings.
I. Factual and Procedural Background
On August 27, 2013, Grier filed a claim for SSI and alleged disability on the basis
of mental impairments that caused him difficulty working around large numbers of
people. 1 At the time, he was 23 with limited education and past work experience. He
had been diagnosed with schizophrenia, among other psychological issues.
The state disability agency referred Grier for an in-person examination with a
psychologist, Kimberlyn R. Watson, Ph.D. Dr. Watson conducted the examination in
November 2013 and found no evidence of an active psychotic disorder, although she
diagnosed paranoid personality features, bipolar disorder, learning disability, and social
anxiety disorder all by history. She emphasized that Grier “seems to function well with
his current level of stressors” and noted that he has “a very structured life with limited
exposure to a wide range of individuals who are unknown to him.” Tr. 333. Overall, Dr.
1
Appellant had previously applied for SSI in 2012, but the SSA denied his claim at the
initial level of review without any further appeal.
2
Watson evaluated Grier’s Global Assessment of Functioning (GAF) score as 57,
indicating moderate symptoms or functioning difficulties.
Dr. Watson also completed an evaluation form concerning specific functional
areas. She assessed Grier as moderately impaired in relating to others and, with respect
to his daily living activities, mildly restricted when in his own space, but moderately
restricted when around crowds. Dr. Watson found a moderate limitation in coping with
the pressures of ordinary work and only mild limitations in understanding simple
instructions, carrying out instructions under ordinary supervision, performing routine or
repetitive tasks under ordinary supervision, and sustaining work performance and
attendance in a normal work setting.
Two non-examining specialists reviewed and agreed with Dr. Watson’s
conclusions. In January 2014, the state disability agency referred the case to Charlene
Tucker-Okine, Ph.D., who agreed that Grier was only mildly or moderately limited in
functional abilities relevant to work performance. After Grier sought reconsideration, the
state agency referred the case to Christopher King, Psy.D., who reviewed the file. On
August 13, 2014, Dr. King agreed that Grier was only mildly or moderately limited in
abilities relevant to sustained work performance. Both Dr. King and Dr. Tucker-Okine
determined, based on their review of Grier’s file, that he could “handle simple tasks in a
low contact environment.” Tr. 76, 89.
Twice in 2014, Grier was hospitalized when he stopped taking his medication and
engaged in substance abuse. On March 16 and 17, 2014, he was hospitalized after
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engaging in violent behavior and demonstrating paranoia. He was transferred to the
Delaware Psychiatric Center, where he improved after resuming medication and
treatment. He was discharged on April 22, 2014, with a GAF score of 55. His personal
discharge plan stated that he would rely on “family and friends[’] support” in his
recovery and that he felt “unsafe” in “big crowds.” Tr. 475. In October 2014, Grier was
again hospitalized after non-compliance with medication. He presented with auditory
hallucinations, paranoia, and agitation. After an 11-day stay at the Rockford Center,
during which he resumed medication and therapy, he was discharged with a GAF score
of 50.
In addition to the foregoing records, the ALJ who assessed Grier’s SSI application
considered records from Grier’s treating psychiatrist at the time of the hearing, Lavinia
Park, MD; his former treating psychiatrist, Ralph Kaufman, MD; and his mental health
case manager, Carlos Mackell, MS. In a questionnaire completed at the request of the
state, Mackell emphasized Grier’s challenges with memory, concentration, and
completing tasks. Mackell also noted, however, that Grier could interact with others
positively and engage in various activities. Nonetheless, Mackell concluded that Grier
requires support from RHD staff or his parents, and that his condition “cause[s] him to
not be capable of working at this time.” Tr. 423. In other reports, Mackell noted that
Grier “relies heavily on his” family, and especially his mother, who “pay[s] his bills and
provide[s] him with money on a weekly basis”; relies on his family for transportation;
and “needs his family to advocate for him in some situations.” Tr. 550, 552. Mackell
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also observed that Grier had “[g]ood family suppor[t],” despite his hallucinations,
delusions, and isolation. Tr. 581.
Dr. Kaufman’s notes from around the same time—when he was Grier’s treating
psychiatrist—indicate some panic attacks, paranoia, and hallucinations, but his notes also
emphasize that, with medication, Grier steadily improved and engaged in certain
activities. Similarly, Dr. Kaufman’s notes from after Grier’s second hospitalization
indicate that he improved, was not exhibiting delusional symptoms or having racing
thoughts, and was able to spend time doing activities. On February 2, 2015, Dr. Kaufman
completed a Delaware Health and Social Services Medical Certification in which he
opined that Grier could not work at his usual occupation and would not be able to
perform any other work full time. Dr. Kaufman’s subsequent notes, however, indicate
that Grier’s delusional thinking was only occasional and “d[id] not appear to impact him
so much.” Tr. 592. The same records indicate that Grier increasingly left the house and
engaged in social activities with his family members.
Dr. Park offered similar assessments about Grier’s ability to work, although her
records also showed improvement. In March 2016, just after Dr. Park took over Grier’s
care from Dr. Kaufman, she submitted a medical summary in which she observed that
Grier had schizophrenia, could not work full-time, and required supervision. She noted,
however, that his condition had improved since his October 2014 hospitalization and that
his medication effectively managed auditory hallucinations, paranoia, and mood.
Records also indicate that Grier was increasingly active and social, including going out to
stores or gas stations with family and pushing himself to go out despite his ongoing
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anxiety. Dr. Park’s August 2016 notes specifically recount normal, logical thought
processes. Nonetheless, in a questionnaire around the same time, Dr. Park recorded that,
despite the use of medications, Grier continued to struggle with anxiety, panic attacks,
paranoia, and delusions. Dr. Park wrote that Grier had a poor ability to work in
proximity with others, deal with the public, or travel in unfamiliar places. She also found
that he had a serious limitation in his ability to maintain attention, maintain attendance,
be punctual, respond to changes appropriately, deal with normal work stress, set realistic
goals, maintain socially appropriate behavior, and use public transportation.
In October 2016, ALJ Jack Penca conducted a hearing and evaluated the record.
The ALJ heard from Grier, his mother, his attorney, and a vocational expert. He also
reviewed Dr. Watson’s November 2013 examination report, the reports from Dr. Tucker-
Okine and Dr. King, and the records from Grier’s hospitalizations and treatment through
2016.
The ALJ found that Grier had the severe impairment of schizophrenia but that the
impairment did not meet a mental listing for per se disability. The ALJ then assessed
Grier’s residual functional capacity (RFC) and determined that Grier could sustain work
in a job with “simple, unskilled tasks; no fast pace or strict production requirements;
occasional interaction with co-workers, with no teamwork or tandem tasks; and no
interaction with the public.” Tr. 24.
In reaching this conclusion, the ALJ afforded “great weight” to the opinions of the
Agency specialists, Dr. Watson, Dr. Tucker-Okine, and Dr. King, that Grier had no more
than mild or moderate limitations. Tr. 26. In the ALJ’s view, available records showed
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that Grier’s functionality remained equivalent to the functionality that the Agency
specialists found in their evaluations, so long as he complied with treatment. Although
the ALJ acknowledged that Grier had twice been hospitalized in 2014, he emphasized
that those episodes resulted from non-compliance with medication and that, since the
hospitalizations, Grier had demonstrated increased activity and independence, which
corroborated the conclusions of the Agency specialists.
The ALJ gave “no weight” to the opinions of Appellant’s treating physicians and
case manager. Tr. 27. He found their conclusions that Grier’s limitations would prevent
full-time work inconsistent with the record and the physicians’ notes. Based primarily on
the Agency physicians’ reports and the testimony of the vocational expert, the ALJ
concluded that Grier was not disabled from the date of his application through the date of
the decision. The Appeals Council denied a request for review.
Grier argued before the District Court that the ALJ erred in his assessment of the
opinions of the treating providers and in failing to consider Grier’s need for a structured
living environment. The Court found that both the ALJ’s evaluation of the treating
providers’ medical opinions and the ALJ’s finding that Grier could function outside a
structured living environment were supported by substantial evidence. Finding that
substantial evidence supported the ALJ’s determination regarding Grier’s RFC, the
District Court denied Grier’s motion for summary judgment and granted the
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Commissioner’s cross-motion for summary judgment. It then denied a motion to alter or
amend the judgment, and Grier now appeals. 2
II. Standard of Review
Like the District Court, we exercise plenary review over the ALJ’s legal
conclusions and review the factual findings for substantial evidence. 42 U.S.C. § 405(g);
Zirnsak v. Colvin, 777 F.3d 607, 610-11 (3d Cir. 2014). Substantial evidence is “such
relevant evidence as a reasonable mind might accept as adequate to support a
conclusion.” Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019) (citation omitted).
Although “we owe deference to [the ALJ’s] evaluation of the evidence, assessment of the
credibility of witnesses, and reconciliation of conflicting expert opinions,” remand is
necessary “where we cannot ascertain whether the ALJ truly considered competing
evidence, and whether a claimant’s conditions, individually and collectively, impacted”
his ability to work. Diaz v. Comm’r of Soc. Sec., 577 F.3d 500, 506 (3d Cir. 2009).
III. Discussion
Grier raises two issues on appeal. First, he contends that the ALJ did not
adequately evaluate the medical opinion evidence. Second, he argues that the ALJ failed
to consider his need for a supportive environment when formulating the RFC.
We need not address whether the ALJ erred in how it weighed the medical
evidence because we agree that the ALJ failed to consider Grier’s need for a structured
living environment. In addition to medical evidence, RFC assessments “must be based
2
The District Court had jurisdiction under 42 U.S.C. § 405(g). We have jurisdiction to
review the District Court’s decision pursuant to 28 U.S.C. § 1291.
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on all of the relevant evidence in the case record, such as . . . [n]eed for structured living
environment.” SSR 96-8P, 1996 WL 374184 (July 2, 1996). Failure to address crucial
facts, such as the need for a structured environment, may warrant remand. See Burnett v.
Comm’r of Soc. Sec. Admin., 220 F.3d 112, 121 (3d Cir. 2000). Here, the ALJ’s brief
discussion of Grier’s need for a structured environment was inadequate and overlooked
crucial evidence.
The government contends that the ALJ’s brief references to Grier’s environment
provided sufficient consideration of Grier’s need for a structured environment. We
disagree. The ALJ failed to discuss specific evidence pertaining to the significance of
Grier’s structured living environment. For instance, most of the activities to which the
ALJ pointed as evidence of Grier’s ability to engage in the community without support
were activities—swimming, yard work, exercise—that he only enjoyed when in the
company of close family or friends. Similarly, Dr. Watson’s evaluation, to which the
ALJ attributed “great weight,” Tr. 26, noted that Grier currently has “a very structured
life with limited exposure to a wide range of individuals who are unknown to him” and
that he “functions well within his current level of stressors” in such a structured
environment. Tr. 333. This evidence suggests that Grier’s success may be the result of
his current environment, which is quite structured and involves limited exposure to
unfamiliar individuals. Yet the ALJ did not consider this possibility.
The ALJ also emphasized Grier’s ability to function when compliant with
medication but did not examine whether Grier requires a supportive environment in order
to maintain compliance. Grier’s mother indicated that Grier requires regular reminders to
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take his medication, and Grier’s two hospitalizations due to noncompliance, both of
which occurred even when in a supportive environment, corroborate the view that
support may be essential to Grier maintaining medication compliance. The ALJ
acknowledged the hospitalizations and repeatedly qualified Grier’s stable condition as
dependent on medication compliance. But the ALJ never considered the need for a
structured environment to ensure such compliance. Because the ALJ failed to adequately
consider this important issue, we will remand to allow for consideration of Grier’s need
for a supportive environment.
IV. Conclusion
For the foregoing reasons, we will vacate the District Court’s order and remand for
further proceedings consistent with this opinion.
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