United States District Court, S.D. Alabama, Southern Division
MARLON J. McGASTER, Plaintiff,
v.
ANDREW M. SAUL, Commissioner of Social Security, [1]Defendant.
MEMORANDUM OPINION AND ORDER
KATHERINE P. NELSON UNITED STATES MAGISTRATE JUDGE.
Plaintiff
Marlon J. McGaster brought this action under 42 U.S.C.
§§ 405(g) and 1383(c)(3) seeking judicial review of
a final decision of the Defendant Commissioner of Social
Security (“the Commissioner”) denying his
applications for a period of disability and disability
insurance benefits (“DIB”) under Title II of the
Social Security Act, 42 U.S.C. § 401, et seq.,
and for supplemental security income (“SSI”)
under Title XVI of the Social Security Act, 42 U.S.C. §
1381, et seq.[2] Upon consideration of the parties’
briefs (Docs. 13, 14) and those portions of the
administrative record (Doc. 12) (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, the Court finds that the
Commissioner’s final decision is due to be
REVERSED and REMANDED under
sentence four of § 405(g).[3]
I.
Background
McGaster
filed an application for a period of disability and DIB with
the Social Security Administration (“SSA”) on
October 7, 2015, and an application for SSI on November 17,
2015. After they were initially denied, McGaster requested a
hearing before an Administrative Law Judge
(“ALJ”) with the SSA’s Office of Disability
Adjudication and Review, which was held on February 22, 2017.
On August 9, 2017, the ALJ issued an unfavorable decision on
McGaster’s applications, finding him not disabled under
the Social Security Act and thus not entitled to benefits.
(See R. 10 – 24).
The
Commissioner’s decision on McGaster’s
applications became final when the Appeals Council for the
Office of Disability Adjudication and Review denied his
request for review of the ALJ’s decision on June 14,
2018. (R. 1 – 5). McGaster subsequently brought this
action under § 405(g) and § 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
Council.”).
II.
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)).
“Yet,
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.”).[4] “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.”).
However,
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. s
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. 1994).
In sum,
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. 2004).”).
Eligibility for DIB and SSI requires that the claimant be
disabled. 42 U.S.C. §§ 423(a)(1)(E),
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. §§ 423(d)(1)(A), 1382c(a)(3)(A).
Thornton v. Comm’r, Soc. Sec. Admin., 597
F.App’x 604, 609 (11th Cir. 2015) (per curiam)
(unpublished).[5]
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
experience.
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).[6]
“These
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).
If, in
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).
When
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).
III.
Summary of the ALJ’s Decision
At Step
One, the ALJ determined that McGaster met the applicable
insured status requirements through June 30, 2016, and that
he had not engaged in substantial gainful activity since the
alleged disability onset date of May 2, 2015.[7](R. 17). At Step
Two, the ALJ determined that McGaster had the following
severe impairments: degenerative disc disease of the cervical
spine with radiculopathy; lumbago; extruded disc of the
cervical spine with severe neuroforaminal stenosis and
indentation of the spinal cord; brachial neuritis; congenital
pes planus bilateral feet; chronic pain syndrome; and
scoliosis of the thoracic spine. (R. 17 – 18). At Step
Three, the ALJ found that McGaster did not have an impairment
or combination of impairments that met or equaled the
severity of a specified impairment in Appendix 1 of the
Listing of Impairments, 20 C.F.R. § 404, Subpt. P. (R.
18).
At Step
Four, [8] the ALJ determined that McGaster had the
residual functional capacity (RFC) “to perform less
than the full fange [sic] of sedentary work as defined in 20
CFR 404.1567(a) and 416.967(a)[, ]”[9] with the
following limitations: McGaster “can lift/carry up to
ten pounds occasionally[;] can sit for eight-hours in a
regular eight-hour workday[;] can stand/walk for two hours at
one time and a maximum of two hours per eight-hour workday[;]
can push/pull arm controls[;] is unable to climb ladders,
ropes, or scaffolds[;] is unable to crawl[;] cannot perform
overhead work[;] can reach in other directions
occasionally[;] cannot ...