Ramirez v. Comm Social Security ( 2004 )


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  •                                                                                                                            Opinions of the United
    2004 Decisions                                                                                                             States Court of Appeals
    for the Third Circuit
    6-18-2004
    Ramirez v. Comm Social Security
    Precedential or Non-Precedential: Precedential
    Docket No. 03-3313
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    Recommended Citation
    "Ramirez v. Comm Social Security" (2004). 2004 Decisions. Paper 545.
    http://digitalcommons.law.villanova.edu/thirdcircuit_2004/545
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    PRECEDENTIAL     Thomas D. Sutton (argued)
    Leventhal & Sutton
    UNITED STATES COURT OF                 One Oxford Valley
    APPEALS FOR THE THIRD CIRCUIT             Suite 317
    __________                      Langhorne, PA 19047
    No. 03-3313                Attorney for Appellant
    __________
    David F. Chermol (argued)
    Social Security Administration
    ELIZABETH RAMIREZ                OGC/Region III
    P.O. Box 41777
    Appellant,   Philadelphia, PA 19101
    v.
    Attorney for Appellee
    JOANNE B. BARNHART,
    Commissioner of Social Security                    __________
    Administration.
    OPINION
    __________                                __________
    On Appeal from the United States
    Garth, Circuit Judge:
    District Court for the
    Eastern District of Pennsylvania              Elizabeth Ramirez appeals from
    (Civil Action No. 02-cv-02696)       an Order of the United States District
    District Judge: Hon. Eduardo C. Robreno   Court for the Eastern District of
    __________                 Pennsylvania affirming the decision of
    the Commissioner of Social Security.
    Argued April 20, 2004           The Commissioner had denied Ramirez’s
    ___________                 claims for Supplemental Security Income
    (“SSI”) under Title XVI of the Social
    Security Act (the “Act”). 42 U.S.C.
    Before: SCIRICA, Chief Judge,           §§ 1381-1383(f). On appeal, Ramirez
    GARTH, and BRIGHT, * Circuit Judges       contends, as she did in the District Court,
    that the hypothetical question posed by
    (Opinion Filed June 18, 2004)      the Administrative Law Judge (“ALJ”) to
    the vocational expert failed to accurately
    convey all of Ramirez’s limitations, and
    that the Commissioner’s ensuing
    *
    Honorable Myron H. Bright, United    decision is, therefore, not supported by
    States Court of Appeals for the Eighth    substantial evidence. The District Court
    Circuit, sitting by designation.          affirmed the ALJ’s decision and Ramirez
    timely appealed to this Court. For the             varying degrees of success.
    reasons set forth below, we vacate the
    In December 1996, Ramirez
    District Court’s order and remand for
    stopped seeing Dr. Park. She did not
    further proceedings before the ALJ.
    resume mental health treatment until
    I.                             September 1998. At the request of her
    attorney, however, she underwent a
    A. Early Procedural History
    comprehensive psychological evaluation
    Ramirez is a 47-year-old divorced           by Dr. Craig Weiss in April 1997. Dr.
    mother of two children with no significant         Weiss concluded that Ramirez had an
    work experience. In August 1994, she               “Anxiety Disorder . . . with significant
    applied for disability insurance benefits          symptoms of depression, social phobia,
    and SSI under the Act, claiming that she           o b se ss iv e -c o m pu l s iv e , a n d m o o d
    was disabled by asthma, bad nerves and a           incongruent hallucinations.”
    thyroid condition. Six months later, she           (Administrative Record (“A.R.”) at 303.)
    began receiving mental health treatment            With respect to “functional limitations,”
    for an anxiety disorder.                           Dr. Weiss opined that Ramirez (1) had
    moderate restriction in activities of daily
    After the Commissioner denied
    living, (2) had marked to extreme
    Ramirez’s application initially and on
    difficulties in m aintain ing so cial
    reconsideration, she requested a hearing
    functioning, (3) experienced frequent
    before an ALJ. At Ramirez’s request, the
    deficiencies of concentration, and (4)
    ALJ dismissed Ramirez’s claim for
    continually experienced episodes of
    disability benefits.   The ALJ denied
    deterioration.
    Ramirez’s remaining claim for SSI,
    finding that Ramirez was not disabled by                     Almost two years earlier, in 1995,
    her physical or mental impairments. The            Dr. Louis Poloni, a state agency
    SSA Appeals Council subsequently                   psychologist, had completed a Psychiatric
    vacated the ALJ’s decision and remanded            Review Technique Form (“PRTF”) on
    with instructions to explain certain               which he had also assessed Ramirez’s
    findings and take additional evidence on           mental impairments in four broad areas of
    Ramirez’s mental impairments.                      mental functioning. Dr. Poloni concluded
    that Ramirez: (1) had no restriction in
    B. Ramirez’s M ental Health
    activities of daily living, (2) had slight
    Treatment/Evaluation
    diffic ulties in ma intainin g soc ial
    Ramirez first sought mental health          functioning, (3) often experienced
    treatment in February 1995 from Dr. H.H.           deficiencies of concentration, persistence,
    Park, who diagnosed her with generalized           or pace, and (4) never experienced
    anxiety disorder with depression. Over the         e p i s o d e s o f deterio r a t io n o r
    next twenty-two months, Dr. Park                   decompensation in work-like settings.
    prescribed various medications with                Based on those findings, Dr. Poloni
    -2-
    concluded that Ramirez had a severe                    C. Procedural History After Remand
    anxiety disorder, but that Ramirez’s
    Following the remand by the SSA
    condition did not meet or equal any of the
    Appeals Council, the ALJ held a second
    mental impairments deemed by the SSA to
    hearing. The ALJ considered, among other
    be presumptively disabling. Consequently,
    things, all of the evidence described above
    Dr. Poloni proceeded to complete a Mental
    concerning Ramirez’s mental impairments.
    Residual Functional Capacity (“MRFC”)
    Near the conclusion of the second hearing
    form, which is meant to assess a claimant’s
    on remand, the ALJ posed the following
    ability to perform either the claimant’s
    hypothetical question to vocational expert
    previous work or other work in the
    Julie Stratton:
    national economy. Dr. Poloni determined
    that Ramirez could perform simple, routine                  I will begin by asking you to
    unskilled work.                                             assume that we’re talking
    about an individual of Ms.
    Ramirez’s mental functioning was
    Ramirez’s age, education
    also in 1998 assessed by Dr. Herman
    and prior work history. And
    Rudnick, a Board certified psychiatrist.
    I’d like you to further
    Dr. Rudnick concluded that Ramirez
    assume that this individual’s
    suffered from anxiety-related            and
    capable of performing a
    personality disorders. As to the four broad
    range of sedentary work.
    areas of mental functioning, Dr. Rudnick
    The wor k should be
    found that Ramirez (1) had only
    pe r f or me d in a we ll
    moderately limited daily activities, (2) had
    ventilated facility, with no
    moderately limited social functioning, (3)
    exposure to dust, fumes,
    often experienced deficiencies of
    pets, animals, chemicals, or
    concentration, persistence, or pace, (4) and
    temperature extremes. The
    did not experience any episodes of
    work should provide for
    deterioration or decompensation. Like Dr.
    occasional breaks, for the
    Poloni before him, Dr. Rudnick found that
    individual use of an inhaler
    Ramirez’s mental impairments did not
    or pump. The work should
    meet or equal the criteria of a listed
    involve simple one to two
    impairment. As to Ramirez’s residual
    step tasks. The work should
    functional capacity, Dr. Rudnick opined
    not require the individual
    that Ramirez could not perform complex
    during the course of
    or complicated work and would need to be
    performing the work to
    able to contact her home from work, but
    travel outside of th e
    that there was no need to limit Ramirez’s
    workplace. And . . . the
    interaction with the public or with co-
    work setting should provide
    workers.
    reasonable opportunity for
    the individual to make and
    -3-
    receive personal phone                         mentioned this particular limitation.
    calls. Within the boundaries
    Ramirez appealed the ALJ’s
    of these limitations, . . . are
    decision, but the Appeals Council declined
    there jobs in the regional or
    to grant review. Ramirez then challenged
    national economy that the
    the ALJ’s ruling in the United States
    individual could perform?
    District Court for the District of Eastern
    (A.R. at 457-58.) It is significant that              Pennsylvania, where Ramirez and the
    neither Dr. Weiss’s evaluation nor his                Commissioner filed cross-motions for
    conclusions found expression in the                   summary judgment. The District Court
    hypothetical.                                         referred the cross-motions to a Magistrate
    Judge for a Report and Recommendation.
    The purpose of the hypothetical was
    to assess Ramirez’s residual functional                      Although Ramirez made a number
    capacity.      Stratton responded that,               of claims, one of her primary arguments
    notwithstanding the limitations contained             was that the ALJ had failed to include in
    in the hypothetical, there were several jobs          her hypothetical the finding she had made
    in the local and national economy that the            on the PRTF that Ramirez often suffered
    hypothetical claimant could perform,                  deficiencies in concentration, persistence,
    including assembler, hand packer, and                 or pace. The Magistrate Judge rejected all
    production inspector.                                 of Ramirez’s arguments except for the
    PRTF argument, finding that it was “not
    The ALJ then issued a written
    clear whether a limitation in concentration,
    decision in which she determined that
    persistence or pace within the hypothetical
    Ramirez was not disabled and therefore
    . . . would have changed the vocational
    she again denied Ramirez’s application for
    expert’s response.” The Magistrate Judge
    SSI. In reaching her decision, the ALJ
    recommended that the District Court
    relied heavily on Stratton’s testimony.
    remand to the ALJ to allow for further
    The ALJ attached to her written                testimony by a vocational expert.
    decision a completed PRTF, as she was
    The Commissioner objected only to
    required to do under the then-existing
    the Magistrate Judge’s finding that the
    Social Security Regulations. In a section
    ALJ’s hypothetical was deficient. The
    of the PRTF entitled, “Functional
    District Court adopted those portions of
    Limitation and Degree of Limitation,” the
    the Magistrate’s Report to which no
    ALJ noted tha t Ramirez “often”
    objection was raised, but disapproved that
    experienced “deficiencies o f
    portion of the Magistrate Judge’s Report
    concentration, persistence, or pace
    which found the ALJ’s hypothetical to be
    resulting in a failure to complete tasks in a
    defective. The District Court explained
    timely manner (in work settings or
    that “the standards articulated by the Third
    elsewhere).” (Appendix at 93.) The
    Circuit do not mandate that the ALJ
    ALJ’s hypothetical, however, had not
    -4-
    articulate verbatim to the vocational expert                A. Administrative Framework
    the findings recorded on the PRTF form”
    Under the Act, a person who has a
    and proceeded to find that the limitations
    “disability” is entitled to SSI payments
    the ALJ had included in her hypothetical
    from the Social Security Administration
    “accurately reflect[ed] the evidence
    (“SSA”). The Act defines “disability” as
    contained in the record.” (Appendix at 20,
    the “inability to engage in any substantial
    23.) Accordingly, the District Court
    gainful activity by reason of any medically
    entered summary judgment for the
    determ inable physical or m enta l
    Commissioner.
    impairment which can be expected to
    Ramirez now appeals from the                    result in death or which has lasted or can
    District Court’s Order. Ramirez contends               be expected to last for a continuous period
    that (a) the ALJ’s hypothetical did not                of not less than 12 months.” 42 U.S.C.
    adequately incorporate the PRTF finding                § 423(d)(1)(A).        The definition is
    concerning Ramirez’s deficiencies in                   qualified, however, as follows:
    concentration, persistence, or pace; and (b)
    An individual shall be
    the ALJ improperly made adverse
    determined to be under a
    credibility findings.
    disability only if his physical
    II.                                      or mental impairment or
    impairment are of such
    We have jurisdiction to hear this
    severity that he is not only
    appeal pursuant to 
    28 U.S.C. § 1291
    . We
    unable to do his previous
    may reverse the District Court’s grant of
    work           but     cannot,
    summary judgment to the Commissioner
    c o n s i d e r i n g h i s a g e,
    only if the ALJ’s findings were not
    educ ation, and work
    supported by “substantial evidence.”
    experience, engage in any
    Burns v. Barnhart, 
    312 F.3d 113
    , 118 (3d
    other kind of substantial
    Cir. 2002). If, however, an ALJ poses a
    gainful work which exists in
    hypothetical question to a vocational
    the national economy.
    expert that fails to reflect “all of a
    claimant’s impairments that are supported              
    42 U.S.C. § 423
    (d)(2)(A). A person
    by the record[,] . . . it cannot be considered         seeking SSI may allege that they have
    substantial evidence.”          Chrupcala v.           disabling physical impairments, mental
    Heckler, 
    829 F.2d 1269
    , 1276 (3d Cir.                  impairments, or both.
    1987).
    Acting pursuant to its rulemaking
    III.                              authority, the SSA has promulgated
    regulations establishing a five-step
    We consider first Ramirez’s
    sequential evaluation process to determine
    argument that the ALJ’s hypothetical was
    if a claimant has a disability. 20 C.F.R. §
    deficient.
    404.1520 (2003). At step one, the SSA
    -5-
    will find that a claimant is not disabled            416.960(c). Unlike some of the earlier
    unless he demonstrates that he is not                stages in the evaluation process, the
    working at a “substantial gainful activity.”         burden of proof at step five is on the
    
    20 C.F.R. §§ 404.1520
    (b), 416.920(b). At             agency. Here, Ramirez was found able to
    step two, the SSA will find no disability            perform other jobs.
    unless the claimant shows that he has a
    B. Evaluating Mental Impairments
    “severe impairment,” defined as “any
    impairment or combination of impairments                    In 1985, the SSA issued revised
    which significantly limits [the claimant’s]          regulations to evaluate individuals who
    physical or mental ability to do basic work          claimed to be disabled as a result of a
    activities.” 
    20 C.F.R. §§ 404.1520
    (c),               mental impairment. 
    20 C.F.R. § 416
    .920a
    416.920(c). If the claimant successfully             (1999).       The revised regulations
    demonstrates that he has a severe                    implemented a new technique that required
    impairment, the SSA determines at step               the SSA to evaluate a claimant’s mental
    three whether the impairment is on a list of         impairments in four broad areas of
    impairments presumed severe enough by                functioning: (1) activities of daily living,
    the SSA to render one disabled; if so, the           (2) social functioning, (3) concentration,
    claimant qualifies.        20 C.F.R. §§              persistence, or pace, and (4) deterioration
    404.1520(d), 416.920(d). If, however, the            or decompensation in work or work-like
    claimant’s impairment is not on the list,            settings. 
    20 C.F.R. § 416
    .920a (1999).
    the inquiry proceeds to step four and the            The third functional area—which is of the
    SSA assesses whether the claimant has the            most concern in this appeal—was rated on
    “residual functional capacity” to perform            a five point scale of never, seldom, often,
    his previous work. Unless he shows that              frequent, and constant. 20 C.F.R. §
    he cannot, he is determined not to be                416.920a(b)(3) (1999).
    disabled.1 If the claimant survives step
    Under the revised regulations, the
    four, the fifth step requires the SSA to
    adjudicator applied the new technique by
    consider “vocation al factors” (the
    completing a form known as the
    claimant’s age, education, and past work
    Psychiatric Review Technique Form
    experience) and to determine whether the
    (PRTF). 
    20 C.F.R. § 416
    .920a(d) (1999).
    claimant is capable of performing other
    Based on the adjudicator’s findings on the
    jobs existing in significant numbers in the
    PRTF with respect to these four areas of
    national economy.          20 C.F.R. §§
    functioning, he would determine at step
    404.1520(f), 404.1560(c), 416.920(f),
    two of the sequential evaluation process if
    the claimant had a “severe mental
    impairment.” 
    20 C.F.R. § 416
    .920a(c)(1)
    1
    Residual functional capacity is                 (1999). If so, the adjudicator would
    defined as “what a [claimant] can still do           proceed to the third step and determine if
    despite his limitations.” 20 C.F.R. §                the claimant’s impairment met or equaled
    416.945(a).
    -6-
    one of the impairments found on the list of                  evaluation process requires
    impairments presumed severe enough to                        a more detailed assessment
    render a person disabled. 20 C.F.R.                          by itemizin g var ious
    § 416.920a(c)(2) (1999).                                     functions contained in the
    broad categories found in
    In 1996, the SSA issued Social
    paragraphs B and C of the
    Security Ruling 96-8p “[t]o state the
    adult mental disorders
    [SSA]’s policies and policy interpretations
    listings in 12.00 of the
    regarding the assessment of residual
    Listing of Impairments, and
    functional capacity (RFC) in initial claims
    summarized on the PRTF.
    for disability benefits under [the Act].”
    Ruling 96-8p discussed the PRTF and the               SSR 96-8p (July 2, 1996).
    role it plays in the five-step analysis:
    C. The ALJ’s Hypothetical Did Not
    The psychiatric review                              Adequately Convey Ramirez’s
    technique described in 20                                   Limitations
    CFR 404.1520a and
    As we have previously noted, the
    416.920a and summarized
    ALJ who reviewed Ramirez’s application
    on the Psychiatric Review
    noted on the PRTF that Ramirez “often”
    Technique Form (PRTF)
    suffers from “deficiencies of
    requires adjudicators to
    concentration, persistence, or pace
    assess an ind ividua l’s
    resulting in a failure to complete tasks in a
    limitations and restrictions
    timely manner (in work settings or
    from a mental impairment(s)
    elsewhere).” (Appendix at 93.) Ramirez
    in categories identified in
    argues on appeal that the ALJ erred by not
    the “paragraph B” and
    including this limitation in the hypothetical
    “paragraph C” criteria of the
    that she posed to the vocational expert. As
    adult mental disorders
    we explain below, we agree with Ramirez
    listings. The adjudicator
    and hold that the hypothetical did not
    must remember that the
    accurately convey all of Ramirez’s
    limitations identified in the
    impairments, and the limitations they
    “paragraph B” and
    cause, and therefore the ALJ’s decision is
    “paragraph C” criteria are
    not supported by substantial evidence.2
    not an RFC assessment but
    are used to rate the severity
    of mental impairment(s) at                        2
    The Commissioner frames the issue
    steps 2 and 3 of the
    on appeal as whether a hypothetical
    s e q u e n t ia l e v a l u a t i o n
    question to a vocational expert in a
    process. The mental RFC
    Social Security disability case must
    assessment used at steps 4
    include a verbatim recitation of the
    and 5 of the sequential
    findings listed on a Psychiatric Review
    -7-
    We have not previously decided the           claimant argued that the vocational
    precise issue of whether certain findings           expert’s testimony did not provide
    on a PRTF must be included in an ALJ’s              substantial evidence because the ALJ’s
    hypothetical. We have, however, stated in           hypothetical questions regarding the
    the clearest of terms that an ALJ’s                 claimant’s residual functional capacity
    hypothetical must include all of a                  failed to incorporate the claimant’s
    claimant’s impairments. For example, in             borderline intellectual functioning. The
    Chrupcala v. Heckler, 
    829 F.2d 1269
    ,                Commissioner argued there, as it does
    1276 (3d Cir. 1987), the claimant argued            here, that the ALJ’s use of “simple
    that the vocational expert’s opinion was            repetitive one, two-step tasks” in the
    deficient because it failed to account for          hypothetical was sufficiently descriptive to
    all of the claimant’s impairments. We               encompass the findings concerning the
    agreed, noting that the ALJ’s hypothetical          claimant’s limited intellectual functioning.
    question “did not reflect the fact of               We disagreed, however, explaining that
    constant and severe pain which [the                 the reference to simple tasks did not
    claimant] testified to and which we have            “specifically convey” the claimant’s
    explained was supported by objective                intellectual limitations and that “greater
    medical findings in the record.” 
    Id.
     We             specificity” was required. Id. at 123.
    explained that “[a] hypothetical question
    Although we have not previously
    must reflect all of a claimant’s
    held whether findings on a PRTF about a
    impairments that are supported by the
    claimant’s concentration, persistence, or
    record; otherwise the question is deficient
    pace must be included in an ALJ’s
    and the expert’s answer to it cannot be
    hypothetical, some of our sister Circuits
    considered substantial evidence.        Id.
    have dealt with this issue. For example, in
    (citing Podedworny v. Harris, 745 F.2d
    Howard v. Massanari, 
    255 F.3d 577
     (8th
    210 (3d Cir. 1984) and Wallace v.
    Cir. 2001), the claimant argued on appeal
    Secretary, 
    722 F.2d 1150
     (3d Cir. 1983))
    that the ALJ had failed to convey in his
    (emphasis added).
    hypothetical the finding that the claimant
    We recently reaffirmed this                  often suffered from deficiencies in
    principle in Burns v. Barnhart, 312 F.3d            concentration, persistence, or pace. Id. at
    113, 122 (3d Cir. 2002). There, the                 581. The ALJ had, however, asked the
    vocational expert to assume that the
    claimant would be capable of performing
    Technique Form (PRTF). However,                     simple, routine, repetitive tasks. Id. The
    Ramirez does not claim that the findings            Eighth Circuit Court of Appeals held that
    must be included verbatim in the                    the hypothetical “adequately capture[d]”
    hypothetical; rather, Ramirez contends              the claimant’s deficiencies, in part because
    that all of a claimant’s limitations must           the state psychologist who had made the
    be adequately conveyed in the                       finding also prepared a “functional
    hypothetical.
    -8-
    capacity assessment” in which he                    mentioned that the claimant’s borderline
    concluded that the claimant could “sustain          intelligence seriously limited, but did not
    sufficient concentration and attention to           preclude him from , understanding,
    perform at least simple, repetitive, and            remembering, and carrying out detailed
    routine cognitive activity without severe           instructions. Id. at 544. On appeal, the
    restriction of function.” Id. at 582. But           Seventh Circuit stated that it saw “nothing
    see Newton v. Chater, 
    92 F.3d 688
     (8th              in the hypothetical that takes into account
    Cir. 1996), infra.                                  the ALJ’s own earlier observation . . . that
    [the claimant] suffered from frequent
    The Sixth Circuit Court of Appeals
    deficiencies of concentration, persistence,
    reached a similar outcome in Smith v.
    or pace.” 
    Id.
     The court acknowledged
    Halter, 
    307 F.3d 377
     (6th Cir. 2001). In
    that there might be an explanation for the
    Smith, the ALJ also found that the
    omission, but it explained that it had “no
    claimant often suffered from deficiencies
    way of knowing that.” 
    Id.
     Accordingly, it
    in concentration, persistence, or pace. In
    remanded the case for further proceedings.
    his hypothetical, the ALJ instructed the
    vocational expert to assume the claimant                     In Newton v. Chater, 
    92 F.3d 688
    had mental impairments limiting him to              (8th Cir. 1996), the court found that a
    jobs that were routine and low stress, and          hypothetical was defective because it
    did not involve intense interpersonal               failed to adequately convey the claimant’s
    confrontations, high quotas, unprotected            deficiencies in concentration, persistence,
    heights, or operation of dangerous                  or pace. The ALJ’s hypothetical had
    machinery. Id. at 378. On appeal, the               described a person with a minimal ability
    Sixth Circuit concluded that the ALJ                to read and write, a borderline range of
    “went beyond” the simple findings                   intelligence, a ninth or tenth grade
    included in the PRTF and determined that            education, an inability to perform highly
    the claimant’s concentration problems               skilled or technical work, a capacity for
    were minimal or negligible, and then                simple jobs, and a demonstrated ability to
    “translated [the claimant’s] condition into         control his drinking problem. Id. at 694.
    the only concrete restrictions available to         The Commissioner argued that the
    him . . . and duly incorporated them into           deficiencies of concentration, persistence
    his hypothetical . . . .” Id. at 379.               or pace did not have to be included in the
    hypothetical because the ALJ had limited
    Other Courts of Appeal (or in one
    the hypothetical to simple jobs and two
    case a different panel of the same Circuit)
    medical professionals had testified that the
    have been less forgiving. For example, in
    c la im a n t ’ s d e f i c ie n c i e s d id n o t
    Kasarsky v. Barnhart, 
    335 F.3d 539
     (7th
    significantly limit his abilities to follow
    Cir. 2003), the ALJ noted on the PRTF
    short and simple instructions and make
    that the claimant frequently suffered from
    simple work-related decisions. Id. at 695.
    deficiencies in concentration, persistence,
    The court disagreed, noting that the
    or pace. In his hypothetical, the ALJ
    -9-
    vocational expert had testified on cross-                     We are not satisfied that these
    e x a m i n a t io n that the cla iman t’s            limitations take into account the ALJ’s
    concentration and persistence deficiencies            own observation (both in her opinion and
    related to basic work habits needed to                in the PRTF) that Ramirez often suffered
    maintain employment. Thus, the court                  from deficiencies in concentration,
    remanded for further proceedings.                     persistence, or pace. The first several
    limitations that the ALJ included in her
    Turning to the instant appeal, the
    hypothetical pertain to Ramirez’s physical
    ALJ asked vocational expert Stratton to
    impairments and therefore have no bearing
    assume a hypothetical individual with
    on her mental impairments. The only
    Ramirez’s background and the following
    limitations that relate to Ramirez’s mental
    limitations: sedentary work in a well-
    impairments are the limitations to simple
    ventilated environment, with no exposure
    tasks, the restriction on travel, and the
    to dust, fumes, pets, animals, chemicals, or
    phone privileges.
    temperature extremes; occasional breaks
    necessary for the use of an inhaler or                       These limitations do not adequately
    pump; no more than simple one- or two-                convey all of Ramirez’s limitations. The
    step tasks; no travel outside the workplace;          Commissioner contends that the limitation
    and a reasonable opportunity to receive               to one to two step tasks is sufficient, but
    and make personal telephone calls.3                   we agree with the Magistrate Judge that a
    “a requirement that a job be limited to one
    to two step tasks, as was stated in the
    3
    We repeat the text of the                        hypothetical relied upon by the ALJ, does
    hypothetical which was presented to                   not adequately encompass a finding that
    Stratton, the vocational expert:                      [Ramirez] ‘often’ has ‘deficiencies in
    concentration, persistence, or pace, as was
    I will begin by asking you to assume that             noted by the ALJ both in her decision and
    we’re talking about an individual of Ms.              on the PRTF attached to the decision.”
    Ramirez’s age, education and prior work
    history. And I’d like you to further
    assume that this individual’s capable of              of performing the work to travel outside
    performing a range of sedentary work.                 of the workplace. And . . . the work
    The work should be performed in a well                setting should provide reasonable
    ventilated facility, with no exposure to              opportunity for the individual to make
    dust, fumes, pets, animals, chemicals, or             and receive personal phone calls. Within
    temperature extremes. The work should                 the boundaries of these limitations, . . .
    provide for occasional breaks, for the                are there jobs in the regional or national
    individual use of an inhaler or pump.                 economy that the individual could
    The work should involve simple one to                 perform?
    two step tasks. The work should not
    require the individual during the course              (A.R. at 457-58.)
    -10-
    (Appendix at 72.) M ost importantly, this             may have concluded that the deficiency in
    limitation does not take into account                 pace was so minimal or negligible that,
    deficiencies in pace. Many employers                  even though Ramirez “often” suffered
    require a certain output level from their             from this deficiency, it would not limit her
    employees over a given amount of time,                ability to perform simple tasks under a
    and an individual with deficiencies in pace           production quota. The record, however,
    might be able to perform simple tasks, but            would seem to suggest otherwise. At the
    not over an extended period of time. If               second hearing, Dr. Rudnick—upon whose
    Ramirez often suffers deficiencies in pace            testimony the ALJ relied—was asked the
    and this had been included in the                     following question: “What happens to
    hypothetical, vocational expert Stratton              [Ramirez’s] ability to handle pace, for
    may have changed her answer as to                     example, in a work situation, where there’s
    whether there were jobs in the local or               a certain amount of work that has to be
    national economy that Ramirez could                   done in an eight hours or two hours or
    perform. In fact, the vocational expert               whatever segment?”          (A.R. at 451.)
    testified that each of the jobs suitable for          Although the ALJ briefly interceded
    Ramirez (assembler, packer, and inspector)            before Dr. Rudnick could answer, Dr.
    would have daily production quotas and                Rudick eventually replied that Ramirez’s
    that Ramirez would have to maintain a                 ability to maintain a full-time job
    certain degree of pace to maintain those              depended primarily on “the proximity to
    jobs.                                                 where her children would be” because
    Ramirez’s anxiety-disorder is in large part
    This omission from the hypothetical
    attributable to her “need to feel that she
    runs afoul of our directive in Chrupcala
    has to be reasonably protective of her
    that a “hypothetical question posed to a
    children.” While this might lead a neutral
    vocational expert ‘must reflect all of a
    observer to conclude that Ramirez’s
    clamant’s impairments,” Chrupcala, 829
    deficiencies in pace could be overcome by
    F.2d at 1276, as well as our statement in
    finding a job close to her children, the ALJ
    Burns that “great specificity” is required
    did not include this limitation in her
    when an ALJ incorporates a claimant’s
    hypothetical. Instead, the ALJ provided
    mental or physical limitations into a
    only for a reasonable number of personal
    hypothetical. Burns, 
    312 F.3d at 122
    .
    phone calls. If this accommodation would
    Indeed, the SSA’s own ruling requires a
    not remedy Ramirez’s deficiency in
    “more detailed assessment” of the
    concentration and pace, the vocational
    claimant’s mental limitations at step five
    expert might have given a different answer
    of the disability analysis. See SSR 96-8p
    to the hypothetical.
    (July 2, 1996).
    Relying on Social Security Ruling
    Of course, there may be a valid
    96-8p, which we reproduced in part earlier
    explanation for this omission from the
    in this opinion, the Commissioner
    ALJ’s hypothetical. For example, the ALJ
    -11-
    contends that the “PRTF does not                     For the foregoing reasons, we will
    document specific functional limitations      vacate the Order of the District Court and
    for RFC purposes, bur rather assesses         remand to the District Court so that it can
    functional loss from a claimant’s mental      in turn remand to the Commissioner for
    impairments only with respect to broad        further proceedings consistent with this
    areas of functioning.” In other words, the    Opinion.
    Commissioner argues that the PRTF
    findings are relevant only in steps two and
    three of the sequential evaluation process,
    before any assessment of a claimant’s
    residual functional capacity is made.
    We cannot concur in the
    Commissioner’s evaluation of the PRTF
    findings. While SSR 96-8p does state that
    the PRTF findings are “not an RFC
    assessment” and that step four requires a
    “more detailed assessment,” it does not
    follow that the findings on the PRTF play
    no role in steps four and five, and SSR 96-
    8p contains no such prohibition.
    In conclusion, we hold that the
    ALJ’s hypothetical did not adequately
    capture and recite all of Ramirez’s mental
    impairments and the limitations caused by
    those impairments.        In reaching that
    holding, one factor we cannot ignore is
    that the burden shifts to the Commissioner
    at step five to prove that the claimant can
    perform a job that exists in the national
    economy. See Burns, 
    312 F.3d at 119
     (“At
    the final step—step five—the burden shifts
    to the Commissioner to show that the
    claimant can perform ‘other work.’”).
    IV.
    We have considered Ramirez’s
    remaining arguments and, after reviewing
    the record, are persuaded that they are
    without merit.
    V.