United States District Court, S.D. Alabama, Southern Division
YASHICA C. JONES, Plaintiff,
NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.
MEMORANDUM OPINION AND ORDER
KATHERINE P. NELSON UNITED STATES MAGISTRATE JUDGE
Yashica C. Jones brought this action under 42 U.S.C. §
1383(c)(3) seeking judicial review of a final decision of the
Defendant Commissioner of Social Security (“the
Commissioner”) denying her application for supplemental
security income (“SSI”) under Title XVI of the
Social Security Act, 42 U.S.C. § 1381, et seq.
Upon consideration of the parties' briefs (Docs. 17, 21)
and those portions of the administrative record (Doc. 16)
(hereinafter cited as “(R. [page number(s) in
lower-right corner of transcript])”) relevant to the
issues raised, and with the benefit of oral argument held May
17, 2018, the Court finds that the Commissioner's final
decision is due to be REVERSED and
REMANDED to the Commissioner under sentence
four of § 405(g) (applicable to SSI claims under §
1383(c)(3)) for further administrative
February 27, 2014, Jones filed an application for SSI with
the Social Security Administration (“SSA”),
alleging disability beginning May 16, 2007. After her
application was initially denied, Jones requested a hearing
before an Administrative Law Judge (“ALJ”) with
the SSA's Office of Disability Adjudication and Review.
Hearings were held with an ALJ on October 23, 2015, and June
3, 2016. On September 29, 2016, the ALJ issued an unfavorable
decision on Jones's application, finding her not disabled
under the Social Security Act and thus not entitled to
benefits. (See R. 14 - 29).
Commissioner's decision on Jones's application became
final when the Appeals Council for the Office of Disability
Adjudication and Review denied Jones's request for review
of the ALJ's decision on August 24, 2017. (R. 1 - 5).
Jones subsequently filed this action under § 1383(c)(3)
for judicial review of the Commissioner's final decision.
See 42 U.S.C. § 1383(c)(3) (“The final
determination of the Commissioner of Social Security after a
hearing [for SSI benefits] shall be subject to judicial
review as provided in section 405(g) of this title to the
same extent as the Commissioner's final determinations
under section 405 of this title.”); 42 U.S.C. §
405(g) (“Any individual, after any final decision of
the Commissioner of Social Security made after a hearing to
which he was a party, irrespective of the amount in
controversy, may obtain a review of such decision by a civil
action commenced within sixty days after the mailing to him
of notice of such decision or within such further time as the
Commissioner of Social Security may allow.”);
Ingram v. Comm'r of Soc. Sec. Admin., 496 F.3d
1253, 1262 (11th Cir. 2007) (“The settled law of this
Circuit is that a court may review, under sentence four of
section 405(g), a denial of review by the Appeals
Standards of Review
“In Social Security appeals, [the Court] must determine
whether the Commissioner's decision is ‘
“supported by substantial evidence and based on proper
legal standards. Substantial evidence is more than a
scintilla and is such relevant evidence as a reasonable
person would accept as adequate to support a
conclusion.”' ” Winschel v. Comm'r of
Soc. Sec., 631 F.3d 1176, 1178 (11th Cir. 2011) (quoting
Crawford v. Comm'r of Soc. Sec., 363 F.3d 1155,
1158 (11th Cir. 2004) (per curiam) (internal citation
omitted) (quoting Lewis v. Callahan, 125 F.3d 1436,
1439 (11th Cir. 1997))). However, the Court “
‘may not decide the facts anew, reweigh the evidence,
or substitute our judgment for that of the
[Commissioner].' ” Id. (quoting
Phillips v. Barnhart, 357 F.3d 1232, 1240 n.8 (11th
Cir. 2004) (alteration in original) (quoting Bloodsworth
v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983))).
“ ‘Even if the evidence preponderates against the
[Commissioner]'s factual findings, [the Court] must
affirm if the decision reached is supported by substantial
evidence.' ” Ingram, 496 F.3d at 1260
(quoting Martin v. Sullivan, 894 F.2d 1520, 1529
(11th Cir. 1990)).
within this narrowly circumscribed role, [courts] do not act
as automatons. [The Court] must scrutinize the record as a
whole to determine if the decision reached is reasonable and
supported by substantial evidence[.]”
Bloodsworth, 703 F.2d at 1239 (citations and
quotation omitted). See also Owens v. Heckler, 748
F.2d 1511, 1516 (11th Cir. 1984) (per curiam) (“We are
neither to conduct a de novo proceeding, nor to rubber stamp
the administrative decisions that come before us. Rather, our
function is to ensure that the decision was based on a
reasonable and consistently applied standard, and was
carefully considered in light of all the relevant
facts.”). “In determining whether substantial
evidence exists, [a court] must…tak[e] into account
evidence favorable as well as unfavorable to the
[Commissioner's] decision.” Chester v.
Bowen, 792 F.2d 129, 131 (11th Cir. 1986). See also
McCruter v. Bowen, 791 F.2d 1544, 1548 (11th Cir. 1986)
(“We are constrained to conclude that the
administrative agency here…reached the result that it
did by focusing upon one aspect of the evidence and ignoring
other parts of the record. In such circumstances we cannot
properly find that the administrative decision is supported
by substantial evidence. It is not enough to discover a piece
of evidence which supports that decision, but to disregard
other contrary evidence. The review must take into account
and evaluate the record as a whole.”).
the “substantial evidence” “standard of
review applies only to findings of fact. No similar
presumption of validity attaches to the [Commissioner]'s
conclusions of law, including determination of the proper
standards to be applied in reviewing claims.”
MacGregor v. Bowen, 786 F.2d 1050, 1053 (11th Cir.
1986) (quotation omitted). Accord, e.g., Wiggins
v. Schweiker, 679 F.2d 1387, 1389 (11th Cir. 1982)
(“Our standard of review for appeals from the
administrative denials of Social Security benefits dictates
that ‘(t)he findings of the Secretary as to any fact,
if supported by substantial evidence, shall be conclusive
....' 42 U.S.C.A. Â§ 405(g) … As is plain from the
statutory language, this deferential standard of review is
applicable only to findings of fact made by the Secretary,
and it is well established that no similar presumption of
validity attaches to the Secretary's conclusions of law,
including determination of the proper standards to be applied
in reviewing claims.” (some quotation marks omitted)).
This Court “conduct[s] ‘an exacting
examination' of these factors.” Miles v.
Chater, 84 F.3d 1397, 1400 (11th Cir. 1996) (per curiam)
(quoting Martin v. Sullivan, 894 F.2d 1520, 1529
(11th Cir. 1990)). “‘The [Commissioner]'s
failure to apply the correct law or to provide the reviewing
court with sufficient reasoning for determining that the
proper legal analysis has been conducted mandates
reversal.'” Ingram, 496 F.3d at 1260
(quoting Cornelius v. Sullivan, 936 F.2d 1143,
1145-46 (11th Cir. 1991)). Accord Keeton v. Dep't of
Health & Human Servs., 21 F.3d 1064, 1066 (11th Cir.
courts “review the Commissioner's factual findings
with deference and the Commissioner's legal conclusions
with close scrutiny.” Doughty v. Apfel, 245
F.3d 1274, 1278 (11th Cir. 2001). See also Moore v.
Barnhart, 405 F.3d 1208, 1211 (11th Cir. 2005) (per
curiam) (“In Social Security appeals, we review de
novo the legal principles upon which the
Commissioner's decision is based. Chester v.
Bowen, 792 F.2d 129, 131 (11th Cir. 1986). However, we
review the resulting decision only to determine whether it is
supported by substantial evidence. Crawford v. Comm'r
of Soc. Sec., 363 F.3d 1155, 1158-59 (11th Cir.
Eligibility for…SSI requires that the claimant be
disabled. 42 U.S.C. §…1382(a)(1)-(2). A claimant
is disabled if she is unable “to engage in any
substantial gainful activity by reason of a medically
determinable physical or mental impairment ... which has
lasted or can be expected to last for a continuous period of
not less than 12 months.” 42 U.S.C.
Thornton v. Comm'r, Soc. Sec. Admin., 597
Fed.Appx. 604, 609 (11th Cir. 2015) (per curiam)
The Social Security Regulations outline a five-step,
sequential evaluation process used to determine whether a
claimant is disabled: (1) whether the claimant is currently
engaged in substantial gainful activity; (2) whether the
claimant has a severe impairment or combination of
impairments; (3) whether the impairment meets or equals the
severity of the specified impairments in the Listing of
Impairments; (4) based on a residual functional capacity
(“RFC”) assessment, whether the claimant can
perform any of his or her past relevant work despite the
impairment; and (5) whether there are significant numbers of
jobs in the national economy that the claimant can perform
given the claimant's RFC, age, education, and work
Winschel, 631 F.3d at 1178 (citing 20 C.F.R.
§§ 404.1520(a)(4)(i)-(v), 416.920(a)(4)(i)-(v);
Phillips, 357 F.3d at 1237-39).
regulations place a very heavy burden on the claimant to
demonstrate both a qualifying disability and an inability to
perform past relevant work.” Moore, 405 F.3d
at 1211 (citing Spencer v. Heckler, 765 F.2d 1090,
1093 (11th Cir. 1985)). “In determining whether the
claimant has satisfied this initial burden, the examiner must
consider four factors: (1) objective medical facts or
clinical findings; (2) the diagnoses of examining physicians;
(3) evidence of pain; and (4) the claimant's age,
education, and work history.” Jones v. Bowen,
810 F.2d 1001, 1005 (11th Cir. 1986) (per curiam) (citing
Tieniber v. Heckler, 720 F.2d 1251, 1253 (11th Cir.
1983) (per curiam)). “These factors must be considered
both singly and in combination. Presence or absence of a
single factor is not, in itself, conclusive.”
Bloodsworth, 703 F.2d at 1240 (citations omitted).
Steps One through Four of the five-step evaluation, a
claimant proves that he or she has a qualifying disability
and cannot do his or her past relevant work, it then becomes
the Commissioner's burden, at Step Five, to prove that
the claimant is capable-given his or her age, education, and
work history-of engaging in another kind of substantial
gainful employment that exists in the national economy.
Jones v. Apfel, 190 F.3d 1224, 1228 (11th Cir.
1999); Sryock v. Heckler, 764 F.2d 834, 836 (11th
Cir. 1985). Finally, although the “claimant bears the
burden of demonstrating the inability to return to [his or]
her past relevant work, the Commissioner of Social Security
has an obligation to develop a full and fair record.”
Shnorr v. Bowen, 816 F.2d 578, 581 (11th Cir. 1987).
See also Ellison v. Barnhart, 355 F.3d 1272, 1276
(11th Cir. 2003) (per curiam) (“It is well-established
that the ALJ has a basic duty to develop a full and fair
record. Nevertheless, the claimant bears the burden of
proving that he is disabled, and, consequently, he is
responsible for producing evidence in support of his
claim.” (citations omitted)). “This is an onerous
task, as the ALJ must scrupulously and conscientiously probe
into, inquire of, and explore for all relevant facts. In
determining whether a claimant is disabled, the ALJ must
consider the evidence as a whole.” Henry v.
Comm'r of Soc. Sec., 802 F.3d 1264, 1267 (11th Cir.
2015) (per curiam) (citation and quotation omitted).
the ALJ denies benefits and the Appeals Council denies review
of that decision, the Court “review[s] the ALJ's
decision as the Commissioner's final decision.”
Doughty, 245 F.3d at 1278. But “when a
claimant properly presents new evidence to the Appeals
Council, a reviewing court must consider whether that new
evidence renders the denial of benefits erroneous.”
Ingram, 496 F.3d at 1262. Nevertheless, “when
the [Appeals Council] has denied review, [the Court] will
look only to the evidence actually presented to the ALJ in
determining whether the ALJ's decision is supported by
substantial evidence.” Falge v. Apfel, 150
F.3d 1320, 1323 (11th Cir. 1998). If the applicant attacks
only the ALJ's decision, the Court may not consider
evidence that was presented to the Appeals Council but not to
the ALJ. See Id. at 1324.
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