Employee Benefits

In ERISA action challenging defendant’s calculation of plaintiff’s retirement benefit, Dist. Ct. erred in agreeing with plaintiff that appropriate offset to benefits owed under existing plan was actual amount that plaintiff had been receiving from different retirement plan, when plaintiff took early retirement from different employer. Relevant language in instant plan called for higher offset that was measured by what plaintiff would have received in pension benefits under prior employer’s pension plan had plaintiff began receiving payments at normal retirement date. Moreover, plaintiff’s interpretation would result in him receiving windfall, where amount he was receiving under prior plan from early retirement was actuarially identical to figure he would have received under same plan at normal retirement date.

Record failed to contain sufficient evidence to support ALJ’s denial of claimant’s application for Social Security disability benefits based on claimant’s asthma, chronic obstructive pulmonary disease (COPD), asbestosis and heel spur. While ALJ could properly find that claimant’s asthma did not meet disabling level under relevant regulations, ALJ failed to consider effect of claimant’s asthma on his COPD and/or discuss how claimant’s low pulmonary function test score affected his residual functional capacity to work. Moreover, while vocational expert found that claimant could perform certain jobs, record showed that: (1) said expert was unaware that claimant could not work in conditions that would expose him to temperature extremes or lung irritants; and (2) expert found that claimant was able to work in said prohibited conditions.

Record failed to contain sufficient evidence to support ALJ’s denial of claimant’s application for Social Security disability benefits based upon his back, joint and leg pain, his hypersomnia and obesity. ALJ could not simply disregard opinion of primary treating physician, who stated that claimant could only stand or sit for 1.5 hours per workday, and that claimant’s need to take frequent breaks during workday precluded him from full-time work. ALJ’s reasons for discounting treating physician’s opinion were not supported by record, and fact that claimant could perform some household chores did not translate into finding that claimant could do full-time work. Also, record failed to establish that claimant could maintain sufficient concentration to be able to perform simple, repetitive tasks for 6 out of 8 hours per workday.

Record failed to contain sufficient evidence to support ALJ’s denial of claimant’s application for Social Security disability benefits based on claimant’s severe pain associated with her back, neck and leg conditions, where ALJ made faulty credibility assessment of claimant’s testimony regarding her claims of severe pain. While state doctor opined that claimant could do light physical demand activities, including her prior work as yard driver for automobile factory, claimant testified that her pain arising out of her diagnosed radiculopathy and degenerative disc disease was debilitating. Moreover, ALJ failed to consider treating physician’s conclusion that claimant will always have neuropathic leg pain that would account for her pain becoming progressively worse. Fact that claimant was able to perform some household chores or could perform some tasks between long breaks did not correlate to finding that she could manage requirements of fulltime work. ALJ also improperly disregarded claimant’s long, steady work history, which would indicate that claimant was not malingerer.

Record failed to contain sufficient evidence to support ALJ’s denial of claimant’s application for Social Security disability benefits based on series of injuries to claimant’s leg, hip and ankle that caused claimant to experience severe pain that precluded him from working, even though ALJ adopted vocational expert’s opinion that claimant could do certain unskilled sedentary work. While certain medical records indicated that plaintiff had experienced improvement in condition of his leg and ankle, two physicians testified that plaintiff was still in severe pain at time of hearing, and plaintiff further indicated that he could walk only short distances. Ct. also criticized vocational expert for failing to identify precise jobs (or precise number of said jobs) that claimant could perform with his limitations.

Record failed to contain sufficient evidence to support ALJ’s denial of claimant’s application for SSI and disability insurance benefits based on claimant’s chronic back and hip problems, as well as her obesity and hypothyroidism. Although ALJ found that claimant was not credible, and that claimant was capable of performing light work while standing/walking for six hours per day, ALJ failed to adequately consider recent report from treating physician, who indicated that claimant had significant hip deformity and had need for total hip replacement. Moreover, ALJ failed to offer good reason for failing to credit treating physician’s opinion and improperly found that claimant’s need for hip replacement would not have affected her ability to stand/walk for 6-hour period, where no medical evidence supported such finding. Also, ALJ failed to properly evaluate claimant’s pain complaints and relied on improper ground (i.e., claimant’s failure to undergo invasive and expensive surgery) as reason to cast doubt on claimant’s credibility.

Record contained sufficient evidence to support ALJ’s denial of claimant’s application for Social Security disability benefits, even though claimant alleged that his shoulder impairment, diabetes and pancreatitis prevented him from working. While record showed that claimant had 10 pound lifting restriction in dominant arm and had limitations in standing and sitting, VE expert determined that claimant could perform certain retail jobs. Moreover, ALJ could discount contrary opinion of treating physician, where physician’s opinion did not square with claimant’s testimony regarding his daily activities, his routine and conservative medical treatment, as well as his earlier reports to physicians that he was experiencing only minimal pain. Fact that ALJ used agency’s “standard boilerplate” language when making credibility finding did not require remand, where ALJ actually justified credibility assessment based on evidence. Also, ALJ could look to claimant’s description of his daily activities in assessing credibility regarding severity of his impairments.