United States District Court, M.D. Alabama, Southern Division
MEMORANDUM OPINION
WALLACE CAPEL, JR. CHIEF UNITED STATES MAGISTRATE JUDGE
I.
INTRODUCTION
Kenneth
Moore (“Moore” or “Plaintiff”) filed
a Title II application for a period of disability and
disability insurance benefits and a Title XVI for
supplemental security income on August 25, 2015, alleging
disability beginning on February 15, 2014. R. 10, 160-69. The
application was denied at the initial administrative level.
R. 107-16. Plaintiff then requested and received a hearing
before an Administrative Law Judge (“ALJ”) on
August 16, 2017. R. 50, 117-22. Following the hearing, the
ALJ issued an unfavorable decision, and the Appeals Council
denied Plaintiff's request for review on March 12, 2018.
R. 1-3, 7-9. The ALJ's decision consequently became the
final decision of the Commissioner of Social Security
(“Commissioner”).[2] See Chester v. Bowen,
792 F.2d 129, 131 (11th Cir. 1986). The case is now before
the court for review of that decision under 42 U.S.C. §
405(g). Pursuant to 28 U.S.C. § 636(c), both parties
have consented to the conduct of all proceedings and entry of
a final judgment by the undersigned United States Magistrate
Judge. Pl.'s Consent to Jurisdiction (Doc. 10);
Gov't's Consent to Jurisdiction (Doc. 9). After
careful scrutiny of the record and the parties' briefs,
and for the reasons herein explained, the Court REVERSES the
Commissioner's decision and REMANDS the matter with
instructions to the ALJ for a proper evaluation under the
three-part pain standard as it applies to the Plaintiff.
II.
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
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 (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).
III.
STATUTORY AND REGULATORY FRAMEWORK
The
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
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. 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 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 ...