United States District Court, M.D. Alabama, Eastern Division
MEMORANDUM OPINION AND ORDER
WALLACE CAPEL, JR. CHIEF UNITED STATES MAGISTRATE JUDGE
April 17, 2014, James Wilson applied for Supplemental
Security Income (SSI) and disability insurance benefits under
Title II of the Social Security Act alleging a disability
date of November 19, 2013. (R. 168-178). His application was
denied on August 20, 2014. (R. 94). Wilson timely filed a
request for hearing before the Administrative Law Judge
(“ALJ”). (R. 106). Following a hearing, the ALJ
rendered an unfavorable decision on April 29, 2016. (R. 9).
The Appeals Council denied Plaintiff's request for
review. (R. 1-7). As a result, the ALJ's decision became
the final decision of the Commissioner of Social Security.
Id. Judicial review proceeds pursuant to 42 U.S.C.
§ 405(g), and 28 U.S.C. § 636(c). After careful
scrutiny of the record and briefs, for reasons herein
explained, the Court REVERSES AND REMANDS
the Commissioner's decision.
NATURE OF THECASE
seeks judicial review of the Commissioner's decision
denying his application for disability insurance benefits and
social security income. United States District Courts may
conduct limited review of such decisions to determine whether
they comply with applicable law and are supported by
substantial evidence. 42 U.S.C. § 405. The Court may
affirm, reverse and remand with instructions, or reverse and
render a judgment. Id.
STANDARD OF REVIEW
Court's review of the Commissioner's decision is a
limited one. The Court's sole function is to determine
whether the ALJ's opinion is supported by substantial
evidence and whether the proper legal standards were applied.
See Jones v. Apfel, 190 F.3d 1224, 1228 (11th Cir.
1999); Bloodsworth v. Heckler, 703 F.2d 1233, 1239
(11th Cir. 1983). “The Social Security Act mandates
that ‘findings of the Secretary as to any fact, if
supported by substantial evidence, shall be
conclusive.'” Foote v. Chater, 67 F.3d
1553, 1560 (11th Cir. 1995) (quoting 42 U.S.C. §
405(g)). Thus, this Court must find the Commissioner's
decision conclusive if it is supported by substantial
evidence. Graham v. Apfel, 129 F.3d 1420, 1422 (11th
Cir. 1997). Substantial evidence is more than a
scintilla-i.e., the evidence must do more than merely create
a suspicion of the existence of a fact, and must include such
relevant evidence as a reasonable person would accept as
adequate to support the conclusion. Lewis v.
Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997) (citing
Richardson v. Perales, 402 U.S. 389, 401 (1971));
Foote, 67 F.3d at 1560 (citing Walden v.
Schweiker, 672 F.2d 835, 838 (11th Cir. 1982)).
Commissioner's decision is supported by substantial
evidence, the district court will affirm, even if the court
would have reached a contrary result as finder of fact, and
even if the evidence preponderates against the
Commissioner's findings. Ellison v. Barnhart,
355 F.3d 1272, 1275 (11th Cir. 2003); Edwards v.
Sullivan, 937 F.2d 580, 584 n.3 (11th Cir. 1991)
(quoting MacGregor v. Bowen, 786 F.2d 1050, 1053
(11th Cir. 1986)). The Court must view the evidence as a
whole, taking into account evidence favorable as well as
unfavorable to the decision. Foote, 67 F.3d at 1560
(citing Chester v. Bowen, 792 F.2d 129, 131 (11th
Cir. 1986). The Court “may not decide facts anew,
reweigh the evidence, or substitute [its] judgment for that
of the [Commissioner], ” but rather it “must
defer to the Commissioner's decision if it is supported
by substantial evidence.” Miles v. Chater, 84
F.3d 1397, 1400 (11th Cir. 1997) (quoting
Bloodsworth, 703 F.2d at 1239).
Court will also reverse a Commissioner's decision on
plenary review if the decision applies incorrect law, or if
the decision fails to provide the district court with
sufficient reasoning to determine that the Commissioner
properly applied the law. Keeton v. Dep't of Health
and Human Servs., 21 F.3d 1064, 1066 (11th Cir. 1994)
(citing Cornelius v. Sullivan, 936 F.2d 1143, 1145
(11th Cir. 1991)). There is no presumption that the
Commissioner's conclusions of law are valid.
Id.; Brown v. Sullivan, 921 F.2d 1233, 1236
(11th Cir. 1991) (quoting MacGregor, 786 F.2d at
STATUTORY AND REGULATORY FRAMEWORK
Social Security Act's general disability insurance
benefits program (“DIB”) provides income to
individuals who are forced into involuntary, premature
retirement, provided they are both insured and disabled,
regardless of indigence. See 42 U.S.C. §
423(a). The Social Security Act's Supplemental Security
Income (“SSI”) is a separate and distinct
program. SSI is a general public assistance measure providing
an additional resource to the aged, blind, and disabled to
assure that their income does not fall below the poverty
line. Eligibility for SSI is based upon proof of indigence
and disability. See 42 U.S.C. §§ 1382(a),
1382c(a)(3)(A)-(C). However, despite the fact they are
separate programs, the law and regulations governing a claim
for DIB and a claim for SSI are identical; therefore, claims
for DIB and SSI are treated identically for the purpose of
determining whether a claimant is disabled. Patterson v.
Bowen, 799 F.2d 1455, 1456 n.1 (11th Cir. 1986).
Applicants under DIB and SSI must prove
“disability” within the meaning of the Social
Security Act, which defines disability in virtually identical
language for both programs. See 42 U.S.C.
§§ 423(d), 1382c(a)(3), 1382c(a)(3)(G); 20 C.F.R.
§§ 404.1505(a), 416.905(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
42 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A). A
“physical or mental impairment” is one resulting
from anatomical, physiological, or psychological
abnormalities which are demonstrable by medically acceptable
clinical and laboratory diagnostic techniques. 42 U.S.C.
§§ 423(d)(3), 1382c(a)(3)(D).
Commissioner of Social Security employs a five-step,
sequential evaluation process to determine whether a claimant
is entitled to benefits. See 20 C.F.R. §§
404.1520, 416.920 (2010). The five steps are as follows:
(1) Is the person presently unemployed?
(2) Is the person's impairment(s) severe?
(3) Does the person's impairment(s) meet or equal one of
the specific impairments set forth in 20 C.F.R. Pt. ...