E. CLIFTON KNOWLES, Magistrate Judge.
This is a civil action filed pursuant to 42 U.S.C. § 405(g), to obtain judicial review of the final decision of the Commissioner of Social Security denying Plaintiff Disability Insurance Benefits ("DIB"), as provided under Title II of the Social Security Act ("the Act"). The case is currently pending on Plaintiff's "Motion for Judgment on the Pleading and Administrative Record." Docket No. 8. Defendant has filed a Response, arguing that the decision of the Commissioner was supported by substantial evidence and should be affirmed. Docket No. 10.
For the reasons stated below, the undersigned recommends that Plaintiff's "Motion for Judgment on the Pleading and Administrative Record" (Docket No. 8) be GRANTED, and that the decision of the Commissioner be REMANDED for further consideration of Plaintiff's mental impairments.
Plaintiff protectively filed his application for Disability Insurance Benefits ("DIB") on August 1, 2013, alleging that he had been disabled since March 21, 2013, due to "PTSD, Migraines, EBS, Knee Pain, Lower Back Pain, Raynauds, Shoulder Empingment [sic] Syndrome, TBI." See, e.g., Docket No. 6, Attachment ("TR"), pp. 13, 65, 79, 122-29, 183. Plaintiff's application was denied both initially (TR 65) and upon reconsideration (TR 79). Plaintiff subsequently requested (TR 88-89) and received (TR 32-51) a hearing. Plaintiff's hearing was conducted on July 28, 2014, by Administrative Law Judge ("ALJ") Michelle Thompson. TR 32-51. Plaintiff and vocational expert ("VE"), Chelsea Brown, appeared and testified, as did witness Kristen Burger. Id.
On August 11, 2014, the ALJ issued a decision unfavorable to Plaintiff, finding that Plaintiff was not disabled within the meaning of the Social Security Act and Regulations. TR 10-31. Specifically, the ALJ made the following findings of fact:
TR 15-28.
On August 28, 2014, Plaintiff timely filed a request for review of the hearing decision. TR 7. On November 7, 2014, the Appeals Council issued a letter declining to review the case (TR 1-5), thereby rendering the decision of the ALJ the final decision of the Commissioner. This civil action was thereafter timely filed, and the Court has jurisdiction. 42 U.S.C. § 405(g). If the Commissioner's findings are supported by substantial evidence, based upon the record as a whole, then these findings are conclusive. Id.
The parties and the ALJ have thoroughly summarized and discussed the medical and testimonial evidence of Record. Accordingly, the Court will discuss those matters only to the extent necessary to analyze the parties' arguments.
This Court's review of the Commissioner's decision is limited to the record made in the administrative hearing process. Jones v. Sec'y, Health & Human Servs., 945 F.2d 1365, 1369 (6th Cir. 1991). The purpose of this review is to determine (1) whether substantial evidence exists in the record to support the Commissioner's decision, and (2) whether any legal errors were committed in the process of reaching that decision. Landsaw v. Sec'y of Health & Human Servs., 803 F.2d 211, 213 (6th Cir. 1986).
"Substantial evidence" means "such relevant evidence as a reasonable mind would accept as adequate to support the conclusion." Her v. Comm'r of Soc. Sec., 203 F.3d 388, 389 (6th Cir. 1999) (citing Richardson v. Perales, 402 U.S. 389, 401 (1971)). "Substantial evidence" has been further quantified as "more than a mere scintilla of evidence, but less than a preponderance." Bell v. Comm'r of Soc. Sec., 105 F.3d 244, 245 (6th Cir. 1996) (citing Consol. Edison Co. v. N.L.R.B., 305 U.S. 197, 229, 59 S.Ct. 206, 216, 83 L.Ed. 126 (1938)).
The reviewing court does not substitute its findings of fact for those of the Commissioner if substantial evidence supports the Commissioner's findings and inferences. Garner v. Heckler, 745 F.2d 383, 387 (6th Cir. 1984). In fact, even if the evidence could also support a different conclusion, the decision of the Administrative Law Judge must stand if substantial evidence supports the conclusion reached. Her, 203 F.3d at 389 (citing Key v. Callahan, 109 F.3d 270, 273 (6th Cir. 1997)). If the Commissioner did not consider the record as a whole, however, the Commissioner's conclusion is undermined. Hurst v. Sec'y of Health & Human Servs., 753 F.2d 517, 519 (6th Cir. 1985) (citing Allen v. Califano, 613 F.2d 139, 145 (6
In reviewing the decisions of the Commissioner, courts look to four types of evidence: (1) objective medical findings regarding Plaintiff's condition; (2) diagnosis and opinions of medical experts; (3) subjective evidence of Plaintiff's condition; and (4) Plaintiff's age, education, and work experience. Miracle v. Celebrezze, 351 F.2d 361, 374 (6th Cir. 1965).
The claimant carries the ultimate burden to establish an entitlement to benefits by proving his or her "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 423(d)(1)(A). "Substantial gainful activity" not only includes previous work performed by Plaintiff, but also, considering Plaintiff's age, education, and work experience, any other relevant work that exists in the national economy in significant numbers regardless of whether such work exists in the immediate area in which Plaintiff lives, or whether a specific job vacancy exists, or whether Plaintiff would be hired if he or she applied. 42 U.S.C. § 423(d)(2)(A).
At the administrative level of review, the claimant's case is considered under a five-step sequential evaluation process as follows:
20 C.F.R. §§ 404.1520, 416.920 (footnote added). See also Moon v. Sullivan, 923 F.2d 1175, 1181 (6th Cir. 1990).
The Commissioner's burden at the fifth step of the evaluation process can be satisfied by relying on the medical-vocational guidelines, otherwise known as "the grid," but only if the claimant is not significantly limited by a nonexertional impairment, and then only when the claimant's characteristics identically match the characteristics of the applicable grid rule. Otherwise, the grid cannot be used to direct a conclusion, but only as a guide to the disability determination. Id. In such cases where the grid does not direct a conclusion as to the claimant's disability, the Commissioner must rebut the claimant's prima facie case by coming forward with particularized proof of the claimant's individual vocational qualifications to perform specific jobs, which is typically obtained through vocational expert testimony. See Varley v. Sec'y of Health & Human Servs., 820 F.2d 777, 779 (6th Cir. 1987).
In determining residual functional capacity for purposes of the analysis required at stages four and five above, the Commissioner is required to consider the combined effect of all the claimant's impairments: mental and physical, exertional and nonexertional, severe and nonsevere. See 42 U.S.C. § 423(d)(2)(B).
Plaintiff contends that the ALJ: (1) failed to find that Plaintiff's mental impairments met or medically equaled Listing 12.06; (2) improperly weighed the medical opinion evidence of record; (3) failed to discuss Plaintiff's impairments of traumatic brain injury ("TBI") and major depressive disorder; (4) improperly discounted Plaintiff's credibility; (5) failed to address the credibility of Plaintiff's wife, who testified at his hearing; (6) erroneously found that Plaintiff's "efforts to find work, attend Job Fairs, and attend online classes established that he was not disabled"; (7) ignored Plaintiff's medical history and complaints of headaches when determining his ability to function; (8) failed to consider Plaintiff's medication side effects; (9) failed to evaluate the evidence in the light most favorable to Plaintiff; (10) erroneously did not find that Plaintiff was disabled based on hypothetical question #3; (11) erroneously determined Plaintiff's RFC; and (12) failed to properly find that Plaintiff was disabled. Docket No. 9. Plaintiff additionally argues that there is "newly discovered material evidence of June 5, 2014, not known until September 18, 2014, unavailable at the hearing on August 11, 2014." Id. Accordingly, Plaintiff maintains that the Commissioner's decision should be reversed with an award of benefits, or in the alternative, remanded to "properly weigh the impact of TBI, Medical defects, and other severe impairments." Id.
Sentence four of § 405(g) states as follows:
The court shall have power to enter, upon the pleadings and transcript of the record, a judgment affirming, modifying, or reversing the decision of the Commissioner of Social Security, with or without remanding the cause for a rehearing.
42 U.S.C. §§ 405(g), 1383(c)(3).
"In cases where there is an adequate record, the Secretary's decision denying benefits can be reversed and benefits awarded if the decision is clearly erroneous, proof of disability is overwhelming, or proof of disability is strong and evidence to the contrary is lacking." Mowery v. Heckler, 771 F.2d 966, 973 (6th Cir. 1985). Furthermore, a court can reverse the decision and immediately award benefits if all essential factual issues have been resolved and the record adequately establishes a plaintiff's entitlement to benefits. Faucher v. Sec'y of Health & Human Servs., 17 F.3d 171, 176 (6th Cir. 1994). See also Newkirk v. Shalala, 25 F.3d 316, 318 (6th Cir. 1994).
As an initial matter, the ALJ's decision is not "clearly erroneous"; proof of disability is not "overwhelming" or "strong [with] evidence to the contrary [] lacking"; "all essential factual issues" have not been resolved; and the record does not adequately establish Plaintiff's entitlement to benefits. Accordingly, reversal with an award of benefits is not warranted.
As set forth above, Plaintiff argues numerous grounds for remand, many of which relate to the ALJ's consideration of Plaintiff's mental impairments. See Docket No. 9. The ALJ in the instant action thoroughly considered Plaintiff's mental impairments and evidence, including, inter alia, the function report, headache questionnaire, and pain questionnaire completed by Plaintiff's wife; Plaintiff's mental health treatment records, including his GAF scores, diagnoses, and medications; Plaintiff's 2013 reports of taking online classes, going to job fairs, applying for jobs, and interviewing for jobs; Plaintiff's report that he planned to stay home with his autistic son while his wife completed school; Plaintiff's mental examinations, as well as his VA compensation and pension examination; Plaintiff's VA disability ratings; and the opinions of the State agency psychological consultants. See TR 16-28, citing Exhibits 1A, 3A, 4D, 6E, 8E, 11E, 1F, 3F, 4F, 5F, 8F.
The ALJ further acknowledged that Plaintiff had dropped out of school; that Plaintiff had been hospitalized between February 16, 2014 and February 25, 2014
The ALJ also recounted the testimony of both Plaintiff and his wife, stating in part as follows:
TR 24-25.
After thoroughly reviewing the evidence in its entirety, however, the ALJ determined that Plaintiff's mental impairments were not disabling. TR 13-28. In so doing, the ALJ acknowledged that Plaintiff's symptoms had worsened in 2014, but noted that the evidence prior to February 2014 demonstrated that "it is possible that the claimant's symptoms can improve with treatment." TR 25 (emphasis added). Ultimately, the ALJ opined, "Therefore, there is no evidence to suggest that the claimant's current mental state can be expected to last for a continuous period of twelve months." Id.
As the ALJ acknowledged, the evidence establishes that Plaintiff's symptoms had worsened between at least February and June 2014. Plaintiff's hearing was held in July 2014, and the ALJ issued her decision in August 2014. The ALJ's determination that "there [was] no evidence to suggest that the claimant's current mental state can be expected to last for a continuous period of twelve months" was purely speculative and based on her belief that "it is possible that the claimant's symptoms can improve with treatment." Accordingly, the undersigned recommends that this action be REMANDED to determine whether Plaintiff's worsened symptoms have met the continuous twelve-month durational requirement, and if so, whether those worsened symptoms meet or medically equal a listing level severity.
For the reasons discussed above, the undersigned recommends that Plaintiff's "Motion for Judgment on the Pleading and Administrative Record" (Docket No. 8) be GRANTED, and that the decision of the Commissioner be REMANDED for further evaluation of Plaintiff's mental impairments.
