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holding that "the ALJ failed to provide `good reasons' for discrediting plaintiff's treating physicians' opinions" where his decision rejected two doctor's findings of disability and concluded "without citing any medical opinion, that despite the results of the MRI tests and EMG studies, there is no `muscle atrophy to suggest disuse of her extremities'"
Summary of this case from Banushi v. BarnhartOpinion
02 Civ. 7660.(SAS)
December 11, 2003
Carol S. Goldstein, Esq., Monroe, New York, For Plaintiff
Susan D. Baird, New York, New York, For Defendant
OPINION AND ORDER
I. INTRODUCTION
Angela Aronis brings this action under section 205(g) of the Social Security Act, 42 U.S.C. § 405 (g) (the "Act"), challenging the final decision of the Commissioner of Social Security ("Commissioner") denying her application for disability insurance benefits ("DIB") and supplemental security income ("SSI"). Plaintiff has moved and the Commissioner has cross-moved for judgment on the pleadings pursuant to Federal Rule of Civil Procedure 12(c).
II. BACKGROUND
A. Procedural History
Plaintiff filed an application for DIB and SSI benefits on October 27, 1998. See Plaintiff's Memorandum of Law in Support of Her Motion for Judgment on the Pleadings ("Pl. Mem.") at 2. In her application, plaintiff alleged that she was disabled and unable to work since October 3, 1998, due to an injury causing pain in her right arm, hip and shoulder. Tr. at 103. Her application was denied initially and on reconsideration. Id. at 2-3. Upon request, a hearing was conducted before an administrative law judge ("ALJ") on January 7, 2000. Id. at 28. On February 8, 2000, the ALJ issued a decision denying plaintiff's application for benefits.' Id. at 24. The ALJ's decision became the final decision of the Commissioner when the Appeals Council denied plaintiff's request for review on August 9, 2002. See Pl. Mem. at 3-4.
"Tr." refers to pages of the administrative record filed as part of the Commissioner's answer pursuant to 42 U.S.C. § 405(g).
B. Plaintiff's Personal History
Plaintiff was born in Greece on April 2, 1955, and was forty-four years old at the time of her administrative hearing. Tr. at 194. In 1967, she immigrated to the United States. Id. at 42. She has a seventh grade education, speaks both Greek and English, but reads and writes very little English. Id. at 41-42. Plaintiff lives with and is supported by her fiancee and her two adult children. Id. at 55, 113-14.
From September 1987 to October 1998, plaintiff worked as a waitress.Id. at 114. This work required constant standing, walking, stooping, kneeling, crouching, handling and writing. Id. at 104. Her job as a waitress also required frequent lifting of up to ten pounds, and occasional lifting of up to twenty pounds. Id. On October 3, 1998, while attending a conference at a Holiday Inn, plaintiff sustained trauma to her right elbow, lower back and neck when the chair she was sitting on collapsed beneath her.Id. at 168.
C. Summary of Medical Evidence
On the day of her injury, Dr. Shamir treated plaintiff at the emergency room at Westchester Square Medical Center. Id. at 132-39. He reported that plaintiff complained of right elbow pain and difficulty straightening her elbow. Id. at 138. An x-ray of the right elbow revealed no fracture, dislocation, or effusion. Id. at 136. The right shoulder and humerus were intact with the exception of the medial condyle of the humerus. Id. at 138. Range of motion and neurovascular functioning were normal. Id. Dr. Shamir diagnosed right elbow sprain. Id.
1. Treating Physicians
a. Dr. Joyce Goldenberg
Dr. Joyce Goldenberg, a physiatrist at Central Park Physical Medicine, treated plaintiff from October 1998 until March 1999. Id. at 140-45, 167-73. In a questionnaire sent by the Social Security Administration dated April 23, 1999," Dr. Goldenberg reported that plaintiff complained of neck pain radiating to the shoulders and arms, lower back pain radiating to the buttocks and thighs, and right elbow pain. Id. at 167. The report detailed limited range of movement in the cervical and lumbar spine; tenderness in the neck, scapular, and right elbow; and tenderness to palpation in the lower back along the lumbosacral and paraspinal muscles. Id. at 168.
Dr. Goldenberg also reported that a magnetic resonance imaging test ("MRI") taken of the cervical spine on December 8, 1998, revealed a "[f]ocal epidural defect probably indicative of [an] osteophytic ridge or herniated disc" at the C5-6 level, with mild focal spinal cord compression to the right of midline. Id. at 169. The MRI also revealed a small central disc protrusion at disc level C4-5. Id. An electromyography ("EMG") study conducted on December 18, 1998, yielded abnormal results suggesting that plaintiff had cervical radiculopathy at disc level C4-C5 and lumbar radiculitis at L5-S1. Id. at 168.
Dr. Goldenberg diagnosed cervical sprain, lower back sprain, posttraumatic cervical radiculopathy at C4-5, posttraumatic lumbar radiculitis at L5-S1 level, and right elbow tendonitis. Id. at 167. She prescribed physical therapy two to three times a week and gave plaintiff an injection of Dexamethasone in her right elbow. Id. at 168. The questionnaire completed by Dr. Goldenberg contained a one-page residual functional capacity form. By checking off a series of boxes, Dr. Goldenberg indicated that plaintiff was limited to lifting and carrying less than ten pounds, standing and walking no more than two hours per day, sitting less than six hours per day, and pushing and pulling less than ten pounds of weight. Id. at 170.
By these criteria, plaintiff would be unable to perform even sedentary work and would therefore be considered totally disabled. See Perez v. Chater, 77 F.3d 41, 46 (2d Cir. 1996) ("Sedentary work . . . involves up to two hours of standing or walking and six hours of sitting in an eight-hour work day.") (citing Social Security Ruling 83-10).
b. Dr. Jeffrey S. Kaplan
Dr. Jeffrey S. Kaplan, an orthopedic surgeon, began treating plaintiff on October 7, 1998, for complaints of pain in the right elbow and lower back. Id. at 181. His notes indicate a total of nine visits with plaintiff from October 1998 through May 1999. Id. at 181-88, 198-99. On November 3, 1998, upon examination of plaintiff's right elbow, Dr. Kaplan reported limited supination and crepitus with motion. Id. at 181, 199. X-rays of the right elbow continued to be normal; however, a sonogram showed fluid where the tendon connects just above the radial head. Id. at 199.
On December 8, 1998, in addition to right elbow pain, plaintiff began experiencing numbness in her right hand. Id. Upon examination, Dr. Kaplan found a positive elbow flexion, as well as tenderness of the lateral epicondyle. Id. Dr. Kaplan prescribed a wrist splint and discontinued physical therapy. Id.
On May 16, 1999, Dr. Kaplan completed a medical questionnaire sent by the Social Security Administration, reporting a decreased range of motion in plaintiff's right elbow and lumbar spine. He further reported that plaintiff's past MRI and EMG results suggested cervical radiculopathy at the C4-C6 disc level. Id. at 176, 198. Dr. Kaplan diagnosed lumbar derangement, right elbow ligament injury, and cervical radiculopathy. Id. at 174. His prognosis on plaintiff's "ability to do work-related physical abilities," was reported as "limited." Id. at 176. However, at the end of the questionnaire, Dr. Kaplan checked a series of boxes indicating that plaintiff was totally disabled. Id. at 177. Specifically, Dr. Kaplan indicated that plaintiff could lift and carry no more than two pounds, stand or walk less than two hours per day, and sit less than six hours per day. Id. Furthermore, he reported that plaintiff had a limited ability to push and pull because of right elbow pain. Id.
c. Dr. Ely Finkelstein
Dr. Finkelstein, Dr. Kaplan's former associate whose specialty is pain management, examined plaintiff on December 16, 1999. Id. at 198. Upon examination, Dr. Finkelstein noted plaintiff's complaints of neck pain radiating to her right arm, numbness in her right hand, and lower back pain radiating to her right leg. Id. He found that plaintiff had positive straight leg raising on the right at seventy degrees. Id. Sensation and deep tendon reflexes were intact. Id. Motor testing of the right arm showed weakness of the right bicep and pronator. Id. Tinel's sign at the cubital and carpal tunnels was negative. Id. Symmetric strength of plaintiffs lower extremities was observed. Id. Dr. Finkelstein suggested an MRI, steroid injections, weight loss, and smoking cessation. Id.
2. Consulting Physicians
a. Dr. S. Imam
Dr. S. Imam, a state agency review physician, did not examine plaintiff, but reviewed her medical record and assessed her residual functional capacity on December 8, 1998. Id. at 159-66. Based on the medical record, Dr. Imam concluded that plaintiff could frequently lift and carry ten pounds, occasionally lift up to twenty pounds, and sit, stand or walk for about six hours in an eight hour workday. Id. at 160. He further concluded that plaintiff had a limited ability to push and pull her upper extremities. Dr. Imam diagnosed lower back pain and "status post arm injury." Id. at 159.
b. Dr. Mario Mancheno
Dr. Mario Mancheno, a consulting orthopedist, examined plaintiff on behalf of the Social Security Administration on June 1, 1999. Id. at 191-93. Dr. Mancheno reported that plaintiff had no difficulty rising from her chair, dressing or undressing, getting on or off the examining table, or lying down. Id. at 191. Plaintiff did have difficulty, however, with toe-heel walking. Id. Dr. Mancheno noted decreased range of motion in the right shoulder, cervical and lumbar spine, and full range of motion in the elbows, hands, hips, knees, and ankles. Id. at 192. Although slight rigidity in the right wrist was noted, full grip strength, gross and fine dexterity in the right hand were retained. Id. Examination of the back revealed tenderness along the spine and right shoulder on palpation and motion, and mild muscle guarding around the lower back. Id. No loss of lordosis, scoliosis, rigidity, or spasticity of the lower back was observed. Id. With regard to plaintiff's muscle power and tone, no signs of asymmetry, wasting or atrophy were found. Id. Plaintiff had full muscle power in both her upper and lower extremities. Id.
Dr. Mancheno diagnosed discogenic disorder of the spine and injury of the right elbow, wrist, and shoulder with possible torn ligaments. Id. at 193. He reported a "mild" impairment of plaintiff's ability to lift, carry, stand, sit, walk, push, and pull, without further specifying plaintiff's limitations. Id.
D. Other Evidence
At the hearing on January 7, 2000, plaintiff testified that she couldn't work because she had torn ligaments in her right elbow and a herniated disc in her neck. Id. at 45. She testified that she had a "shooting pain" in her elbow, neck, and hip, spreading down her right leg. Id. at 46. She claimed that she could not walk further than one block, stand for more than ten to fifteen minutes, and sit for more than fifteen to thirty minutes.Id. at 49. She further claimed that she could lift a one gallon bottle of milk, but only with her left hand. Id.
III. LEGAL STANDARD
In reviewing a denial of disability benefits, the Act provides that the "findings of the Commissioner of Social Security as to any fact, if supported by substantial evidence, shall be conclusive." 42 U.S.C. § 405(g); see also Green-Younger v. Barnhart, 335 F.3d 99, 105-06 (2d Cir. 2003). Substantial evidence in this context is "more than a mere scintilla. It `means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'" Rosa v. Callahan, 168 F.3d 72, 77 (2d Cir. 1999) (quoting Richardson v. Perales, 402 U.S. 389, 401 (1971)). As such, this Court's task is limited to determining whether the ALJ's decision is based upon substantial evidence in the record and the correct application of governing legal principles.See Rosa, 168 F.3d at 77.
In deciding disability claims, the ALJ must follow a five step process. See 20 C.F.R. § 404.1520, 416.920. First, the ALJ must consider whether the claimant is currently engaged in substantial gainful activity. Second, if she is not so engaged, the ALJ must determine whether the claimant has a "severe" impairment that significantly limits her physical or mental ability to do basic work activities. Third, if the claimant suffers from such a limitation, the ALJ must decide whether, based solely on the medical evidence, that limitation corresponds with one of the conditions listed in Appendix I of the regulations. If it does, the ALJ does not inquire into vocational factors such as age, education and work experience because the claimant is presumed to be disabled. Fourth, if the claimant does not have a listed impairment, the ALJ must determine whether the claimant has the residual capacity to perform her past relevant work despite her severe impairment. Finally, if the claimant satisfies her burden of showing that she has a severe impairment that prevents her from performing her past work, the burden then shifts to the Commissioner to prove that the claimant retains the residual functional capacity to perform alternative work which exists in the national economy. See Draegert v. Barnhart, 311 F.3d 468, 472 (2d Cir. 2002).
IV. DISCUSSION
Here, the ALJ determined that plaintiff had "not engaged in substantial gainful activity since her alleged onset of disability." Tr. at 20. The ALJ concluded that plaintiff had "severe musculoskeletal impairments" but that such impairments did not meet or equal the level of severity of any impairment in Appendix I. Id. at 23. In the fourth step, the ALJ found that plaintiff retained the residual functional capacity to perform her past relevant work as a waitress. Id. Without reaching the fifth step, the ALJ concluded that plaintiff was not disabled. Id.
The term ""residual functional capacity" is defined as follows: "Your impairment(s), and any related symptoms, such as pain, may cause physical and mental limitations that affect what you can do in a work setting. Your residual functional capacity is the most you can still do despite your limitations." 20 Q.F.R. §§ 404.1545(a), 416.945(a).
Plaintiff argues that the ALJ misapplied the treating physician rule by failing to accord controlling weight to the opinions of her treating physicians. She further contends that the ALJ did not properly credit her subjective complaints of pain in determining that she was able to perform her past relevant work as a waitress.
A. The Treating Physician Rule
The regulations require an ALJ to give a treating physician's opinion on the nature and severity of a claimant's impairments controlling weight when it is "well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in the record." 20 C.F.R. § 404.1527 (d)(2), 416.927(d)(2). When a treating physician's opinion is not given controlling weight, the ALJ must apply a series of factors in determining the weight to give such an opinion. See id. These factors include: (1) the frequency of examination and the length, nature, and extent of the treatment relationship; (2) the evidence in support of the opinion; (3) the opinion's consistency with the record as a whole; and (4) whether the opinion is from a specialist. See id. "Failure to provide `good reasons' for not crediting the opinion of a claimant's treating physician is a ground for remand." Snell v. Apfel, 177 F.3d 128, 133 (2d Cir. 1999).
Here, both Dr. Goldenberg and Dr. Kaplan completed medical questionnaires reporting plaintiff's history of pain, the results of their medical tests, and their diagnoses of, inter alia, cervical radiculopathy. At the end of these questionnaires, both physicians checked a series of boxes indicating that plaintiff was incapable of performing even sedentary work. Although "[a] treating physician's statement that the claimant is disabled cannot itself be determinative,"Snell, 177 F.3d at 133, the Commissioner is required to explain the weight it gives to such opinions.
Sedentary work is the least rigorous of the five categories of work which include "very heavy, heavy, medium, light, and sedentary." 20 C.F.R. § 404.1567, 416.967, Generally, sedentary work involves "up to two hours of standing or walking and six hours of sitting in an eight-hour work day." Curry v. Apfel, 209 F.3d 117, 122 (2d Cir. 2000). Sedentary work also involves "lifting no more than 10 pounds at a time and occasionally lifting or carrying articles like docket files, ledgers, and small tools." Id. (quoting 20 C.F.R. § 404.1567(a)).
In rejecting those opinions, the ALJ provided two reasons. First, the ALJ concluded that the treating physicians' opinions were not "well-supported by objective medical evidence," because of the lack of clinical evidence in support of those opinions. Tr. at 21. Second, the ALJ found that their findings of total disability were "contradicted" by Dr. Mancheno's conclusion that plaintiff was subject only to "mild exertional limitations." Id. at 22.
The ALJ failed to provide "good reasons" for discrediting plaintiff's treating physicians' opinions. First, in rejecting Dr. Goldenberg's and Dr. Kaplan's findings of disability, the ALJ stated, without citing any medical opinion, that despite the results of the MRI tests and EMG studies, there is no "muscle atrophy to suggest disuse of her extremities." However, in so finding, the ALJ made an improper medical determination and impermissibly substituted his lay opinion for that of the treating physicians. See Rosa, 168 F.3d at 78-79 ("[T]he ALJ cannot arbitrarily substitute his own opinion for competent medical opinion.");see also Balsamo v. Chater, 142 F.3d 75, 80-81 (2d Cir. 1998) (finding it improper for ALJ to conclude that absence of muscle atrophy precluded disability).
Second, "even if the clinical findings were inadequate, it was the ALJ's duty to seek additional information from the treating physician[s]sua sponte." Schaal v. Apfel, 134 F.3d 496, 505 (2d Cir. 1998); see also Rosa, 168 F.3d at 79 (stating that an ALJ "cannot reject a treating physician's diagnosis without first attempting to fill any clear gaps in the administrative record"); Clark v. Commissioner of Soc. Sec., 143 F.3d 115, 118 (2d Cir. 1998) (explaining that a treating physician's failure to include support for his findings does not necessarily mean that such support does not exist). Here, given the conclusory nature of Dr. Goldenberg's and Dr. Kaplan's findings of disability — as indicated by a series of checked boxes — the ALJ should have sought additional explanation from the treating physicians in support of their diagnoses of total disability. See Perez, 77 F.3d at 47 ("[T]he ALJ generally has an affirmative obligation to develop the administrative record. This duty exists even when the claimant is represented by counsel."). Third, the opinions of the treating physicians were not so inconsistent with other substantial evidence as to warrant the ALJ's complete disregard of those opinions. The ALJ cited Dr. Mancheno's conclusion that plaintiff was subject to "mild exertional limitations" as inconsistent with the conclusions reached by the treating physicians. Tr. at 22. However, a physician's use of the term "mild," without more, does not "permit the ALJ . . . to make the necessary inference that [plaintiff] can perform the exertional requirements of sedentary work." Curry, 209 F.3d at 123. Where the sole inconsistency cited by the ALJ goes not to the existence of exertional limitations, but rather to the degree of those limitations, the ALJ should not, without more, completely discount the opinions of the treating physicians.
The inadequacy of a checklist to support a finding of disability is further demonstrated by Dr. Kaplan's inconsistent conclusions reported in the questionnaire he completed. On one page, Dr. Kaplan concluded that plaintiff's ability to perform "work-related physical activities" was "limited." Tr. at 176. On the following page, however, Dr. Kaplan checked the series of boxes indicating that plaintiff was totally disabled and completely unable to work. Id. at 177. The ALJ did not address this inconsistency. See Schaal, 134 F.3d at 504 ("It is for the SSA, and not this court, to weigh the conflicting evidence in the record.").
The ALJ might consider the need to obtain narrative reports from the treating physicians describing in more detail how and in what degree their clinical findings and diagnoses affect plaintiff's ability to perform various work-related activities.
Finally, the ALJ failed to consider all of the relevant factors discussed above in his decision not to accord any weight, much less controlling weight, to the treating physicians' opinions. While the reasons advanced by the ALJ relate to the second and third factors — i.e., the evidence in support of the opinions and the consistency of the opinions with the record as a whole — the first and fourth factors were apparently not considered at all.
B. Plaintiff's Subjective Symptoms of Pain
In evaluating the severity of an impairment, the ALJ must consider a claimant's subjective symptoms including complaints of pain. See 20 C.F.R. § 404.1529, 416.929. "The ALJ has discretion to evaluate the credibility of a claimant and to arrive at an independent judgment, in light of medical findings and other evidence, regarding the true extent of the pain alleged by the claimant." Marcus, 615 F.2d at 27. In so doing, the ALJ must set forth his reasons for discounting a plaintiff's subjective complaints with "sufficient specificity to enable [the district court] to decide whether the determination is supported by substantial evidence." Miller v. Barnhart, No. 02 Civ. 2777, 2003 WL 749374, at *7 (S.D.N.Y. Mar. 4, 2003). If the ALJ's decision to ignore plaintiff's subjective complaints of pain is supported by substantial evidence, then this Court must uphold that determination. See id. (citingAponte v. Secretary, Dep't of Health and Human Servs., 728 F.2d 588, 591 (2d Cir. 1984)).
In Marcus v. Califano, 615 F.2d 23, 27 (2d Cir. 1979), the Second Circuit stated that ""subjective pain may serve as the basis for establishing disability, even if such pain is unaccompanied by positive clinical findings or other `objective' medical evidence." (emphasis in original). This statement was subsequently limited to "cases where the claimant had been determined to be suffering from an impairment whose existence was established by medical findings." Gallagher v. Schweiker, 697 F.2d 82, 84 (2d Cir. 1983) ("The pain need not be corroborated by objective medical findings, but some impairment [e.g., osteoporosis, arthritis] must be medically ascertained."). Thus, Marcus does not "signal any departure from the statutory requirement that a disability claimant must prove physical or mental impairment by `medically acceptable clinical and laboratory techniques.'" Id.
At the January 7, 2000 hearing, plaintiff testified that she had "shooting pain" in her elbow, neck, and hip, spreading down her right leg. She also testified that she could not walk further than one block, stand for more than ten to fifteen minutes, and sit for more than fifteen to thirty minutes. She further stated that she could not lift anything heavier than a one gallon bottle of milk, and that she could only do that by using her left hand.
In discounting plaintiff's testimony as "overstated," the ALJ considered the fact that plaintiff had a pending lawsuit against the Holiday Inn as a "possibility that secondary gains are contributing to her complaints." Tr. at 23. However, the existence of a pending lawsuit alone does not constitute the type of substantial evidence needed to discount a plaintiff's subjective complaints of pain. Here, the ALJ did not address any of the factors relevant to an assessment of plaintiff's subjective complaints of pain. On remand, the ALJ should fully address his reasons for rejecting plaintiff's subjective complaints of pain.
Factors relevant to a claimant's subjective complaints of pain include:
(1) The claimant's daily activities;
(2) The location, duration, frequency, and intensity of the claimant's pain;
(3) Precipitating and aggravating factors;
(4) The type, dosage, effectiveness, and side effects of any medication taken to alleviate pain or other symptoms;
(5) Treatment, other than medication, received for relief of pain;
(6) Any measures used to relieve pain (e.g., lying flat on one's back, standing for 15 to 20 minutes every hour, sleeping on a board); and
(7) Any other factors relevant to a claimant's functional limitations and restrictions due to pain.See 20 C.F.R. § 404.1529(c)(3), 416.929(c)(3).
In his Decision, the ALJ stated that he considered "the claimant's own testimony regarding her symptoms and limitations." Tr. at 22. However, other than the lack of recent treatment, the ALJ does not provide any reasons for rejecting plaintiff's complaints of pain.
C. Remand for the Calculation of Benefits
Where application of the correct legal standard does not lead to one inescapable conclusion, a remand for further administrative proceedings is appropriate. See Schaal,' 134 F.3d at 504. In contrast, where the record contains "persuasive proof of disability, and a remand for further evidentiary proceedings would serve no purpose," the appropriate disposition is to remand solely for calculation of benefits. See Parker v. Harris, 626 F.2d 225, 235 (2d Cir. 1980). ("This remedy becomes especially appropriate where a claimant has already endured a substantial amount of time since first applying for benefits.") (citing Carroll, 705 F.2d at 644; Balsamo, 142 F.3d at 82).
While this Court is mindful of the substantial amount of time plaintiff's administrative proceedings have already taken, without unequivocal evidence in the record to support a finding of disability, delay alone is insufficient to justify a remand solely for the calculation of benefits. See Bush v. Shalala, 94 F.3d 40, 46 (2d Cir. 1996). Because there is conflicting medical evidence regarding the level of plaintiff's disability, a remand solely for the calculation of benefits is not warranted here.
V. CONCLUSION
In sum, the Commissioner committed a number of errors in concluding that plaintiff is not disabled including: (1) inadequate explanation of why the ALJ did not give the treating physicians' opinions controlling weight; (2) failure to more fully develop the record with regard to the opinions of the treating physicians; and (3) failure to adequately explain why the ALJ completely discounted plaintiff's subjective complaints of pain. I therefore cannot conclude that the Commissioner's finding of no disability is supported by "substantial evidence."
Given these errors, this matter is remanded for further administrative proceedings. A remand for further administrative proceedings is especially appropriate here because "an erroneous step four determination has precluded any analysis under step five." See Williams v. Apfel, 204 F.3d 48, 50 (2d Cir. 2000); Harman v. Apfel, 211 F.3d 1172, 1179-80 (9th Cir. 2000) (remanding for further proceedings because "there was no testimony from the vocational expert that the limitations found by the [treating physician] would render [plaintiff] unable to engage in any work").
On remand, the Commissioner should request detailed explanations from Dr. Goldenberg and Dr. Kaplan describing plaintiff's physical limitations and how they affect her ability to perform various work-related activities. Clearly, further findings on the extent of plaintiff's limitations, including a reevaluation of her subjective complaints of pain, would enable the ALJ to make a well-reasoned decision based on a more fully developed record. See Rosa, 168 F.3d at 82-83 (finding remand for further development of the evidence appropriate where there are gaps in the administrative record or where the ALJ has applied an improper legal standard) (citing Pratts v. Chater, 94 F.3d 34, 39 (2d Cir. 1996)).
For the foregoing reasons, the Commissioner's decision is reversed and the matter is remanded pursuant to sentence four of section 405(g) of Title 42 of the United States Code for further proceedings consistent with this Opinion, including a rehearing if deemed necessary by the Commissioner. Due to the extraordinary amount of time that has already passed, the Commissioner is urged to complete administrative proceedings and issue a final determination as expeditiously as possible, preferably within ninety days of the date of this Opinion and Order. The Clerk of the Court is directed to close this case.