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Chancey v. Berryhill

United States District Court, N.D. Alabama, Southern Division

August 31, 2017





         On April 16, 2013, the claimant, Janice Ward Chancey, protectively applied for supplemental social security income and disability insurance benefits because of her multiple sclerosis and affective mood disorder. The Commissioner denied the claims initially on July 18, 2013, because of lack of evidence. The claimant timely requested a hearing before an Administrative Law Judge, and that hearing took place on October 28, 2014. (R. 55, 109, 129).

         In a decision dated January 30, 2015, the ALJ found the claimant disabled under Title XVI and entitled to supplemental security income effective April 16, 2013. However, the ALJ found the claimant not disabled under Title II because she was not disabled prior to her last insured date of September 30, 2009. The claimant filed a timely request for a hearing before the Appeals Council on March 31, 2015. The Appeals Council denied the claimant's appeal because counsel's new evidence did not provide a basis for changing the ALJ's decision. Thus, the ALJ's decision became the final decision of the Commissioner on January 30, 2015.

         The claimant has exhausted her administrative remedies, and this court has jurisdiction pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3). For the reasons stated below, this court reverses the decision of the Commissioner and remands the case to the Commissioner for further proceedings. (R. 1-6, 14-16, 43).


         The claimant presents the following issue for review: whether the ALJ committed reversible error in failing to obtain a medical advisor at the hearing to establish the date of the plaintiff's onset of disability pursuant to SSR 83-20.


         The standard for reviewing the Commissioner's decision is limited. This court must affirm the Commissioner's decision if the Commissioner applied the correct legal standards and if the factual conclusions are supported by substantial evidence. See 42 U.S.C. § 405(g); Graham v. Apfel, 129 F.3d 1420, 1422 (11th Cir. 1997); Walker v. Bowen, 826 F.2d 996, 999 (11th Cir. 1987).

         “No . . . presumption of validity attaches to the [Commissioner's] legal claims.” Walker, 826 F.2d at 999. This court does not review the Commissioner's factual determinations de novo. The court will affirm those factual determinations that are supported by substantial evidence. “Substantial evidence” is “more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971).

         The court must keep in mind that opinions such as whether a claimant is disabled, the nature and extent of a claimant's residual functional capacity, and the application of vocational factors “are not medical opinions, . . . but are, instead, opinions on issues reserved to the Commissioner because they are administrative findings that are dispositive of a case; i.e., that would direct the determination or decision of disability.” 20 C.F.R. §§ 404.1527(d), 416.927(d). Whether the claimant meets the listing and is qualified for Social Security disability benefits is a question reserved for the ALJ, and the court “may not decide facts anew, reweigh the evidence, or substitute [its] judgment for that of the Commissioner.” Dyer v. Barnhart, 395 F.3d 1206, 1210 (11th Cir. 2005). Thus, even if the court were to disagree with the ALJ about the significance of certain facts, the court has no power to reverse that finding as long as substantial evidence in the record supports it.

         The court must “scrutinize the record in its entirety to determine the reasonableness of the [Commissioner]'s factual findings.” Walker, 826 F.2d at 999. A reviewing court must not look only to those parts of the record that support the decision of the ALJ, but also must view the record in its entirety and take account of evidence that detracts from the evidence relied on by the ALJ. Hillsman v. Bowen, 804 F.2d 1179, 1180 (11th Cir. 1986).


         Under 42 U.S.C. § 423(d)(1)(A), a person is entitled to disability benefits when the person cannot “engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A). To make this determination, the Commissioner employs a five-step, sequential evaluation process:

(1) Is the person presently unemployed?
(2) Is the person's impairment severe?
(3) Does the person's impairment meet or equal one of the specific impairments set forth in 20 C.F.R. Pt. 404, Subpt. P, App. 1?
(4) Is the person unable to perform his or her former occupation?
(5) Is the person unable to perform any other work within the economy?
An affirmative answer to any of the above questions leads either to the next question, or, on steps three and five, to a finding of disability. A negative answer to any question, other than step three, leads to a determination of “not disabled.”

McDaniel v. Bowen, 800 F.2d 1026, 1030 (11th Cir. 1986)[1]; 20 C.F.R. §§ 404.1520, 416.920.

         When an ALJ finds a claimant disabled, he must determine the onset date of that disability. Caces v. Comm'r, Soc. Sec. Admin., 560 Fed. App'x 936, 939 (11th Cir. 2014). The onset date must have a “legitimate medical basis.” See Titles II & XVI: Onset of Disability, SSR 83-20 (S.S.A. 1983). A claimant's disability onset must happen before the date the claimant was “last insured” to be entitled to disability benefits under Title II. The claimant's date last insured is the date that the claimant is eligible to receive Social Security Disability Insurance (SSDI) and depends on the date the claimant last worked. See 20 C.F.R. § 404.131.

         If the ALJ must “infer” the onset date, because the medical record pre-dating the date last insured is sparse, he “should call on the services of a medical advisor” at the hearing to help determine the onset date. See SSR 83-20; see also Caces, 560 F. App'x at 939. (citing March v. Massanari, 265 F.3d 1065 (11th Cir. 2001)) (if the medical evidence is inadequate or ambiguous, then the ALJ must infer the onset date and adhere to SSR 83-20). When an ALJ fails to consult a medical advisor as required by SSR ...

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