THOMAS B. SMITH, Magistrate Judge.
Plaintiff brings this action pursuant to the Social Security Act, as amended, 42 U.S.C. § 405(g), to obtain judicial review of a final decision of Defendant, the Commissioner of the Social Security Administration denying his claim for a period of disability and Disability Insurance Benefits. After due consideration, the Commissioner's final decision is
On February 11, 2014, Plaintiff protectively filed an application for Disability Insurance Benefits alleging disability commencing on August 16, 2010, later amended to April 17, 2013, due to back pain, high blood pressure, migraine headaches, "lung problem," "kidney problem," and depression (Tr. 24, 124, 276-84, 293, 339). His claims were denied initially and on reconsideration and Plaintiff requested and received a hearing before an administrative law judge ("ALJ") (Tr. 181-87, 189-97, 40-75, 198-99). On November 29, 2016, the ALJ found Plaintiff not disabled and issued an unfavorable decision (Tr. 21-39). On August 25, 2017, the Appeals Council denied Plaintiff's request for review (Tr. 1-3). Accordingly, the ALJ's decision became the Commissioner's final decision. This appeal timely followed (Doc. 1).
When determining whether an individual is disabled, the ALJ must follow the five-step sequential evaluation process established by the Commissioner and published in 20 C.F.R. §§ 404.1520(a)(4) and 416.920(a)(4). Specifically, the ALJ must determine whether the claimant (1) is currently employed; (2) has a severe impairment; (3) has an impairment or combination of impairments that meets or medically equals an impairment listed at 20 C.F.R. Part 404, Subpart P, Appendix 1; (4) can perform past relevant work; and (5) retains the ability to perform any work in the national economy.
Here, the ALJ performed the required five-step sequential analysis. At step one, the ALJ found that Plaintiff had not engaged in substantial gainful activity during the period from his alleged onset date of April 17, 2013, through his date last insured of December 31, 2015 (Tr. 26). At step two, the ALJ determined that Plaintiff had the severe impairments of: degenerative disc disease, diabetes mellitus, obesity, and migraines (20 CFR 404.1520(c)) (Tr. 26). At step three, the ALJ concluded that Plaintiff did not have an impairment or combination of impairments that met or medically equaled the severity of one of the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1 (Tr. 27). Next, the ALJ found that Plaintiff retained the residual functional capacity ("RFC") to:
(Tr. 28).
At step four, the ALJ determined that Plaintiff was unable to perform any past relevant work (Tr. 31).
The scope of the Court's review is limited to determining whether the ALJ applied the correct legal standards and whether the ALJ's findings are supported by substantial evidence.
When the Commissioner's decision is supported by substantial evidence the district court will affirm even if the reviewer would have reached a contrary result as finder of fact, and even if the reviewer finds that the preponderance of the evidence is against the Commissioner's decision.
Plaintiff contends that the Commissioner failed to properly consider his Veterans Affairs disability rating of 100 percent and overlooked the opinion of examining doctor Sangeeta P. Duggal, M.D.
Plaintiff served in the United States Navy from 1987-1993 (Tr. 964). He testified that the VA assigned him a 100% disability rating due to his headaches, depressive disorder, mental conditions, radiculopathy of the bilateral lower extremity, residuals of herniated nucleus pulpous, status post-surgery, and hypothyroidism (Tr. 67; Doc. 21 at 14). The ALJ considered Plaintiff's statement but gave the VA rating decision "only partial weight because the VA applies different disability standards, and VA medical records reflect that the claimant would be capable of performing sedentary work as he has good extremity strength, able to ambulate effectively, and able to sit without difficulty (Exhibits B7F, B8F, B10F, and B12F)." (Tr. 30). Plaintiff contends that this was error because the ALJ's analysis was cursory and the scant reasoning provided is not supported by substantial evidence. The Commissioner argues that the record does not contain a disability rating and it is unclear if one even exists (Doc. 21 at 17-18). Even if the rating does exist, the Commissioner argues that it is not binding here and the ALJ adequately considered it and gave reasons supported by substantial evidence.
A VA determination that a claimant is disabled is not a medical opinion from a treating source or an acceptable source and is not entitled to controlling weight or special consideration on that basis.
The administrative record does not contain a paper purporting to be a combined VA disability rating decision for Plaintiff. Instead, the administrative record includes what appears to be an Ebenefits printout from the VA website of a table of rated disabilities in various percentages (Tr. 294-95).
The Commissioner states that none of the treatment records reflect that Plaintiff was disabled or had received a disability rating. This is true. There are, however, numerous notations in Plaintiff's VA records to "Aid & Attendance (verified)" and receipt of a "non service connected pension" in the amount of $1,400. (
Next, the Commissioner argues that, by referencing the computer printout, the ALJ fully and properly considered the VA disability rating, and the absence of a formal VA disability decision and rationale doesn't matter. The Court cannot agree. The printout lists various impairments under the heading "Disability," including, among other impairments, a 50% rating for depressive disorder, a 10% rating for headaches and a 10% rating for hypothyroidism (Tr. 295). Depression and headaches (and, to some extent, hypothyroidism) are non-exertional impairments. Yet, the ALJ discounted the VA decision, based, in part, on a finding as to Plaintiff's exertional capacity (Tr. 30 — "The undersigned gives this decision only partial weight because the VA applies different disability standards, and VA medical records reflect that the claimant would be capable of performing sedentary work as he has good extremity strength, able to ambulate effectively, and able to sit without difficulty."). The ALJ's reasoning does not provide a basis for discounting Plaintiff's rating with respect to his non-exertional impairments, especially where, as here, the ALJ found Plaintiff's migraine impairment to be severe at step two. The sole remaining basis articulated by the ALJ is that the VA applies different disability standards. This alone is not enough to discredit a 100% disability rating.
Given the great weight normally accorded to VA disability ratings and the importance of this evidence to Plaintiff's claim, the Court finds that the evidentiary gaps regarding the VA rating and the ALJ's analysis compels remand for further record development and findings on this issue. While the ALJ may ultimately reach the same conclusion with respect to the weight to be given the rating, he must do so by application of the correct legal standard.
Plaintiff argues that the ALJ erred by failing to discuss and weigh Dr. Duggal's opinion (Tr. 1120). The Commissioner concedes the error,
(1) The Commissioner's final decision is
(2) The Clerk is directed to enter judgment and
(3) Plaintiff is advised that the deadline to file a motion for attorney's fees pursuant to 42 U.S.C. § 406(b) shall be thirty (30) days after Plaintiff receives notice from the Social Security Administration of the amount of past due benefits awarded.
(4) Plaintiff is directed that upon receipt of such notice, he shall promptly email Mr. Rudy and the OGC attorney who prepared the Commissioner's brief to advise that the notice has been received.