MAX O. COGBURN, JR., District Judge.
Plaintiff filed an application on February 18, 2013, for disability and disability insurance benefits under title II and supplemental security income ("SSI") payments under title XVI, alleging disability since September 10, 2010. (Tr. 104). After her application was denied initially on June 17, 2013 and on reconsideration on January 9, 2014, plaintiff appeared and testified at an administrative hearing on November 30, 2015, and amended the alleged onset date to December 1, 2011. (Tr. 104, 146-64). On January 13, 2016, Administrative Law Judge ("ALJ") Ann G. Paschall issued a decision denying benefits. (Tr. 8-26). On July 29, 2017, the Appeals Council denied plaintiff's request for review, rendering the ALJ's decision the final decision of the Commissioner. (Tr. 1-4). Plaintiff proceeded to file the instant action, seeking judicial review of the Commissioner's decision pursuant to 42 U.S.C. § 405(g).
The court adopts and incorporates the ALJ's factual findings herein as if fully set forth. Such findings are referenced in the substantive discussion which follows.
The only issues on review are whether the Commissioner applied the correct legal standards and whether the Commissioner's decision is supported by substantial evidence.
Even if the undersigned were to find that a preponderance of the evidence weighed against the Commissioner's decision, the Commissioner's decision would have to be affirmed if supported by substantial evidence.
The court has read the transcript of plaintiff's administrative hearing, closely read the decision of the ALJ, and reviewed the relevant exhibits contained in the extensive administrative record. The issue is not whether the court might have reached a different conclusion had it been presented with the same testimony and evidentiary materials, but whether the decision of the administrative law judge is supported by substantial evidence. Here, the court finds that the ALJ's decision was not supported by substantial evidence, and it will thus be reversed and remanded.
A five-step process, known as "sequential" review, is used by the Commissioner in determining whether a Social Security claimant is disabled. The Commissioner evaluates a disability claim under Title XVI pursuant to the following five-step analysis:
20 C.F.R. § 416.920(a)-(f). The burden of proof and production during the first four steps of the inquiry rests on the claimant.
At step one of the sequential evaluation, the ALJ found that plaintiff has not engaged in substantial gainful activity ("SGA") since December 1, 2011, the amended alleged onset date. (Tr. 106). At step two, the ALJ found that plaintiff has the following severe impairments: bipolar disorder; PTSD; lumbar degenerative disc disease; asthma; fibromyalgia; and obesity.
Then, before step four, the ALJ found that plaintiff had the RFC to perform light work, with the following limitations: no use of ladders but occasional use of stairs; can frequently balance, stoop, crouch, kneel, and crawl; no exposure to dangerous machinery or unprotected heights; and occasional exposure to respiratory irritants, extreme heat, and humidity; limited to simple, routine tasks and instructions in jobs with public contact 10% of the time or less. (Tr. 108-12).
At step four, the ALJ found that plaintiff's RFC prevents plaintiff from performing any past relevant work, as plaintiff lacked past relevant work to consider. (Tr. 112). At step five, the ALJ found that there are jobs that exist in significant numbers in the national economy that plaintiff can perform, including small part assembler, inspector hand packager, and electronic worker. (Tr. 112-13). As a result, the ALJ concluded that plaintiff is not disabled within the meaning of the Act. (Tr. 114).
The court has closely read plaintiff's memorandum (#12) in support of her Motion for Summary Judgment (#11). Plaintiff argues that the Appeals Council neglected to consider a favorable Medicaid ruling by a state officer, that the ALJ improperly considered medical opinion evidence, and that the ALJ improperly relied on testimony from a vocational expert ("VE"). The court will consider each allegation in turn.
First, plaintiff argues that the Appeals Council failed to properly consider Hearing Officer Richard Stewart's Medicaid ruling in plaintiff's favor. In doing so, plaintiff argues that the Appeals Council's decision was incomplete, as "[t]he disability determination of a state administrative agency is entitled to consideration in a SSA disability proceeding."
Here, the court disagrees with plaintiff for one simple reason: the Appeals Council did consider the ruling in question. In their decision declining to review plaintiff's claim, the Appeals Council specifically noted that plaintiff had "submitted evidence from State of North Carolina Department of Health and Human Services dated February 15, 2017" but that such evidence "does not relate to the period at issue" and thus "does not affect the decision about whether you were disabled beginning on or before January 13, 2016." (Tr. 2). That evidence is the favorable Medicaid decision plaintiff argues the Appeals Council did not consider. As the record explicitly shows that the Appeals Council did, in fact, consider that decision, the court finds no basis for remand on this issue.
Plaintiff first argues that the ALJ improperly evaluated medical opinion evidence in the record. Specifically, plaintiff contends that the ALJ ignored elements of Dr. Mary H. Berg's opinion that contradict the ALJ's findings on plaintiff's RFC, especially plaintiff's personal history and social, personal, and occupational limitations as set out by Dr. Berg.
Here, the court does not agree that the ALJ improperly evaluated Dr. Berg's testimony. Plaintiff offers no case law in support of her contention that the ALJ improperly evaluated Dr. Berg's testimony, and instead suggests that the court take a de novo look at Dr. Berg's testimony and compare it to the ALJ's findings to find for remand. Such a request is improper, as this court must not "re-weigh conflicting evidence, make credibility determinations, or substitute [its] judgment" for that of the ALJ's.
Instead, the issue is whether the ALJ adequately explained her reasoning for her decision and whether that decision was supported by substantial evidence. Patterson v. Comm'r of Soc.
Finally, plaintiff argues that the ALJ improperly relied on testimony from the VE in this matter. Specifically, plaintiff claims that the ALJ's hypotheticals posed to the VE failed to account for plaintiff's limitations in concentration, persistence, and pace by merely limiting to plaintiff to simple, routine work. In such a situation, plaintiff contends that precedent from the Fourth Circuit Court of Appeals requires remand.
Here, the court agrees. The ALJ found that plaintiff has moderate difficulties with concentration, persistence, and pace, and limited plaintiff to simple, routine tasks and instructions with minimal public contact. (Tr. 107-08). While the addition of minimal public contact technically distinguishes plaintiff from the claimant in
The court notes that it is entirely possible that hypotheticals updated to account for plaintiff's moderate difficulties with concentration, persistence, and pace would lead to a similar result as the ALJ reached here. However, it is not the court's place to say so.
The undersigned has carefully reviewed the decision of the ALJ, the transcript of proceedings, plaintiff's complaint, the cross Motions for Summary Judgment, and accompanying memoranda. Review of the entire record reveals that the decision of the ALJ was not supported by substantial evidence.