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Ray v. Berryhill

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

February 12, 2018





         On September 4, 2013, the claimant, Pamela Michelle Ray, applied for a period of disability and disability insurance benefits under Title II, alleging that she became disabled on January 1, 2007, because of reflex sympathetic dystrophy, high blood pressure, poor reading comprehension skills, depression, high cholesterol, and low thyroid levels. (R. 183-89, 204, 244). After the Commissioner initially denied benefits to the claimant, she filed a timely request for a hearing; the Administrative Law Judge held a hearing on June 4, 2015. (R. 33-57).

         In her decision dated August 5, 2015, the ALJ found that the claimant had no disability prior to September 30, 2011, her date last insured. (R. 21-32). The Appeals Council denied the claimant's request for review on December 16, 2016. (R 1-6). Consequently, the ALJ's decision became the final decision of the Commissioner of the Social Security Administration. 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 and REMANDS the decision of the Commissioner.


         Whether the ALJ erred as a matter of law in failing to consider Listing 12.05 (C) regarding the claimant's Full Scale IQ score of 61.


         The standard for reviewing the Commissioner's decision is limited. This court must affirm the Commissioner's decision if she applied the correct legal standard and if substantial evidence supports her factual conclusions. 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 [ALJ's] legal conclusions, including determination of the proper standards to be applied in evaluating claims.” Walker, 826 F.2d at 999. This court does not review the ALJ's factual determinations de novo and will affirm those factual determinations 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, 402 (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 a Listing and is entitled to 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 [ALJ]'s factual findings.” Walker, 826 F.2d at 999. A reviewing court must not only look 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 is unable to “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 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); 20 C.F.R. §§ 404.1520, 416.920.

         To establish eligibility for disability insurance benefits, the claimant must demonstrate that she was disabled on or before her date last insured. Moore v. Barnhart, 405 F.3d 1208, 1211 (11th Cir. 2005). Evidence that post-dates a claimant's date last insured “‘may be relevant and properly considered if it bears upon the severity of the claimaint's condition before the expiration of his or her insured status.'” Dye v. Colvin, No. 6:15-cv-00237-VEH, 2016 WL 3997245 *6 (N.D. Ala. July 26, 2016) (quoting Ward v. Astrue, No. 3:00-cv-1137-J-HTS, 2008 WL 1994978, at *4 (M.D. Fla. May 8, 2008)) (emphasis omitted). The ALJ must adequately explain whether medical records dated after the date last insured have any bearing on the claimant's condition prior to her date last insured for the court to conduct a “meaningful review.” See Fitzgibbon v. Comm'r of Soc. Sec., No. 8:15-cv-706-T-JSS, 2017 WL ...

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