United States District Court, M.D. Alabama, Northern Division
MEMORANDUM OPINION AND ORDER
STEPHEN M. DOYLE UNITED STATES MAGISTRATE JUDGE.
Annette
Williams Moss (“Plaintiff”) applied for
disability insurance benefits under Title II of the Social
Security Act (“the Act”) alleging a disability
date of December 31, 2012. (R. 75, 205). The application was
denied initially. (R. 90-91). A hearing was held before the
Administrative Law Judge (“ALJ”) on October 5,
2016. (R. 39-73). The ALJ rendered an unfavorable decision on
November 25, 2016. (R. 22-34). The Appeals Council denied
Plaintiff's request for review. (R. 1-4). As a result,
the ALJ's decision became the final decision of the
Commissioner of Social Security (“Commissioner”).
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 concludes that the Commissioner's
decision is to be REVERSED AND REMANDED.
I.
STANDARD OF REVIEW
The
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
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)).
If the
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).
The
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
1053).
II.
STATUTORY AND REGULATORY FRAMEWORK
The
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 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 that 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
12 months.
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).
The
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).
(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. ...