United States District Court, D. Rhode Island
J. McConnell, Jr. United States District Judge.
Ida Buonanno is in her 60's and previously worked as a
products assembler and city clerk for 32 continuous years,
Ms. Buonanno seeks judicial review of the final
administrative decision of the Commissioner of Social
Security denying her claim for Social Security Disability
Insurance Benefits. The Administrative Law Judge
("ALJ") determined at step 2 of the sequential
evaluation process that, while Ms. Buonanno had medically
determinable impairments by way of back and hand pain,
hypertension, major depressive disorder, and generalized
anxiety disorder, none of these impairments, singularly or in
combination, were "severe impairments" qualifying
her for benefits. The Appeals Council denied review, and Ms.
Buonanno now appeals to this Court for relief. Because this
Court finds that the ALJ erred in failing to develop the
record, the Court reverses the ALJ's ruling and remands
for further consideration.
Buonanno completed high school in Italy. Tr. at 26-27. She
had worked as an assembler for twenty-five years, and then in
the City of Providence Clerk's office. Tr. at 27-28. She
took care of her sick husband until his death three years
prior. Tr. at 38. Her husband had been verbally and
physically abusive to her. Tr. at 39.
in 2008, Ms. Buonanno could no longer work becaxise of back
pain and mental health issues. Tr. at 35. In January 2009,
Ms. Buonanno, after complaining of weakness and fatigue,
chest pains, and right arm numbness, treated with Stephen M.
Scott, M.D., an internist. Tr. at 262. Dr. Scott diagnosed
Ms. Buonanno with anxiety disorder. Id. She latter
presented to Dr. Scott with constant low back pain. Tr. at
260. Dr. Scott prescribed Flexeril and Tramadol and sent her
for x-rays of her lumbosacral spine, which showed narrowing
of the posterior aspect of the disc space between L5 and SI,
indicating early degenerative arthritis. Tr. at 260, 264. Ms.
Buonanno returned to Dr. Scott in 2010 because of depression
and physical and verbal abusive from her husband. Tr. at 258.
He noted that Ms. Buonanno had "left for weeks but
returned as she has no money, " Id. Dr. Scott
also noted that Ms. Buonanno's "depression was
getting worse" and that she was "ill-appearing,
" and therefore he diagnosed her with generalized
anxiety and major depressive disorder. Id. Ms.
Buonanno again presented to Dr. Scott feeling depressed with
some suicidal thoughts. Tr. at 256. She demonstrated a flat
affect and reported that she was worried about violence from
her spouse. Id. Dr. Scott again diagnosed Ms.
Buonanno with generalized anxiety and major depressive
Buonanno then saw Walter A. Hollinger, M.D., an internist at
St, Joseph's Health Services, in November 2013 and again
in July 2014, explaining she had increased depression,
headache, dizziness, and decreased appetite. Tr. at 317-24.
She reported not getting much effect from one of her
medications-Citalopram. Tr. at 318. She was experiencing
insomnia and not getting the full effect from the medication
Fluoxetine for her depression. Tr. at 322.
fall of 2014, Ms. Buonanno went to Giulio G. Diamante, M.D.,
an ophthalmologist, reporting progressive blurred vision in
both eyes. Tr. at 332, 335. On examination, Dr. Diamante
found that Ms. Buonanno had blepharitis, inferior corneal
thinning consistent with keratoconus, and cataracts in both
eyes. Id. Dr. Diamante noted she might have
lenticular astigmatism, reducing her net perception of
astigmatism in each eye. Id. He also noted that,
with standard cataract surgery, her astigmatism might be more
pronounced. Tr. at 335.
January 2015 ALJ hearing, Ms. Buonanno testified that she was
depressed and always stayed home. Tr. at 31-32. She had
memory problems, difficulty concentrating, and felt
worthless. Tr. at 32. She would break up tasks into smaller
tasks in order to complete them. Tr. at 41. Ms. Buonanno
testified that her friends helped her with household chores.
Tr. at 40, She can sit, stand, and walk for twenty minutes at
a time. Tr. at 32. She sleeps only one to two hours a night,
despite taking medication. Tr. at 33. Ms. Buonanno sometimes
went to dinner or shopping with friends but did not really go
out socially much. Tr. at 35.
Buonanno stopped going to treatment because she lost her
health insurance after she left work due to her disability.
Tr. at 39-40.
medical expert John Pella, M.D., after reviewing the
evidence, testified as follows:
This is a somewhat limited record medically. [Prior to the
date last insured, ] the claimant had systemic hypertension
requiring treatment but no end organ damage. References to
low back pain in April of . She did have plane [sic]
films of the lumbosacral spine which revealed mild
degenerative disc disease at ¶ 5 and SI. No more
detailed studies such as MRI and [there is] little
descriptive [sic] with regard to any neurological complaints
or impairment. References to general anxiety disorder, a
depressive disorder as well, on treatment. Borderline obesity
through that period. BMI value anywhere from 27 to 33. No
basis for the complaints of sciatica in the record. No basis
for complaint of the arm pain in the record. No basis for the
cognitive effects in the record. She has one episode of
atypical chest pain not pursued. And the recent record
suggests vision problems which may extend back into that
period but are not - we have no examination at that period to
. . . make that determination.
Tr. at 43-44.
addition, a Vocational Expert testified that Ms.
Buonanno's past work as a small product assembler was
light and unskilled, and her work as a clerk was light and
semi-skilled. Tr. at 45.
denied Ms. Buonanno's claim at the second step of the
evaluation process, finding that she does not have a severe
disability. In large part, the ALJ ...