Probst v. Berryhill
Probst v. Berryhill
Opinion of the Court
In this action, plaintiff Lisa Probst ("plaintiff" or, in context, "claimant") challenges the final decision of defendant Acting Commissioner of Social Security Nancy Berryhill ("Commissioner") denying her application for a period of disability and disability insurance benefits ("DIB") on the grounds that she is not disabled. The case is before the court on the parties' motions for judgment on the pleadings. D.E. 14, 16. Both filed memoranda in support of their respective motions (D.E. 15, 17) and plaintiff filed a reply (D.E. 18). With the consent of the parties, the case was reassigned to the undersigned magistrate judge for disposition pursuant to
BACKGROUND
I. CASE HISTORY
Plaintiff filed an application for DIB on 26 March 2014, alleging a disability onset date of 17 February 2014. Transcript of Proceedings ("Tr.") 12. The application was denied initially and upon reconsideration, and a request for a hearing was timely filed. Tr. 12. On 27 March 2017, a hearing was held before an administrative law judge ("ALJ") at which plaintiff, who was represented by counsel, testified. Tr. 24-53. On 1 May 2017, the ALJ issued a decision denying plaintiff's application. Tr. 12-19.
Plaintiff timely requested review by the Appeals Council, and on 16 February 2018, the Appeals Council denied the request for review. Tr. 1-5. At that time, the ALJ's *580decision became the final decision of the Commissioner.
II. STANDARDS FOR DISABILITY
The Social Security Act ("Act") defines disability as the "inability 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."
The disability regulations under the Act ("Regulations") provide a five-step analysis that the ALJ must follow when determining whether a claimant is disabled:
To summarize, the ALJ asks at step one whether the claimant has been working; at step two, whether the claimant's medical impairments meet the [R]egulations' severity and duration requirements; at step three, whether the medical impairments meet or equal an impairment listed in the [R]egulations; at step four, whether the claimant can perform her past work given the limitations caused by her medical impairments; and at step five, whether the claimant can perform other work.
The first four steps create a series of hurdles for claimants to meet. If the ALJ finds that the claimant has been working (step one) or that the claimant's medical impairments do not meet the severity and duration requirements of the [R]egulations (step two), the process ends with a finding of "not disabled." At step three, the ALJ either finds that the claimant is disabled because her impairments match a listed impairment [i.e. , a listing in 20 C.F.R. pt. 404, subpt. P, app. 1 ("the Listings") ] or continues the analysis. The ALJ cannot deny benefits at this step. If the first three steps do not lead to a conclusive determination, the ALJ then assesses the claimant's residual functional capacity ["RFC"], which is "the most" the claimant "can still do despite" physical and mental limitations that affect her ability to work. [ 20 C.F.R.] § 416.945(a)(1)[2 ] To make this assessment, the ALJ must "consider all of [the claimant's] medically determinable impairments of which [the ALJ is] aware," including those not labeled severe at step two.Id. § 416.945(a)(2).[3 ]
*581The ALJ then moves on to step four, where the ALJ can find the claimant not disabled because she is able to perform her past work. Or, if the exertion required for the claimant's past work exceeds her [RFC], the ALJ goes on to step five.
At step five, the burden shifts to the Commissioner to prove, by a preponderance of the evidence, that the claimant can perform other work that "exists in significant numbers in the national economy," considering the claimant's [RFC], age, education, and work experience.Id. §§ 416.920(a)(4)(v); 416.960(c)(2); 416.1429.[4 ] The Commissioner typically offers this evidence through the testimony of a vocational expert responding to a hypothetical that incorporates the claimant's limitations. If the Commissioner meets her burden, the ALJ finds the claimant not disabled and denies the application for benefits.
Mascio v. Colvin ,
III. ALJ'S FINDINGS
Plaintiff was 39 years old on the alleged onset date, 42 years old on the date of the hearing, and 43 years old on the date of issuance of the ALJ's decision. See, e.g. , Tr. 18 ¶ 7; 29. The ALJ found that she had at least a high school education (Tr. 18 ¶ 8) and past relevant work as a data entry clerk (Tr. 17 ¶ 6).
Applying the five-step analysis of
The ALJ next determined that plaintiff had the RFC to perform a limited range of sedentary work as follows:
After careful consideration of the entire record, the undersigned finds that the claimant has the [RFC] to perform sedentary work as defined in 20 CFR 404.1567(a),[5 ] except she may use an assisted devices for prolonged ambulation and walking on uneven terrain. The claimant can climb ramps and stairs occasionally, never climb ladders, ropes, or scaffolds, balance occasionally, stoop occasionally, kneel occasionally, crouch occasionally, and crawl occasionally. The claimant can never work at unprotected heights or with moving mechanical parts.
Tr. 15 ¶ 5.
Based on his determination of plaintiff's RFC, the ALJ found at step four that plaintiff was unable to perform her past relevant work. Tr. 17 ¶ 6. At step five, the ALJ found that there were jobs existing in significant numbers in the national economy that plaintiff could perform, including jobs in the occupations of order clerk, charge account clerk, and document preparer. Tr. 18-19 ¶ 10. The ALJ therefore *582concluded that plaintiff was not disabled from the alleged disability onset date, 17 February 2014, through the date of his decision, 1 May 2017. Tr. 19 ¶ 11.
IV. STANDARD OF REVIEW
Under
The court may not substitute its judgment for that of the Commissioner as long as the decision is supported by substantial evidence. Hunter v. Sullivan ,
Before a court can determine whether a decision is supported by substantial evidence, it must ascertain whether the Commissioner has considered all relevant evidence and sufficiently explained the weight given to probative evidence. See Sterling Smokeless Coal Co. v. Akers ,
DISCUSSION
I. OVERVIEW OF PLAINTIFF'S CONTENTIONS
Plaintiff contends that this case should be remanded for a new hearing on the grounds that the ALJ erred in failing to conduct a function-by-function analysis and because at the time his decision was issued, the ALJ's appointment did not comply with the Appointments Clause of the United States Constitution. Because the issue of the ALJ's appointment is dispositive of this appeal, the court's analysis will focus on it.
II. NON-COMPLIANCE WITH THE APPOINTMENTS CLAUSE
The Appointments Clause of the Constitution requires the President to "appoint Ambassadors, other public Ministers and Consuls, Judges of the Supreme Court, and all other Officers of the United States." U.S. Const. art. II, § 2, cl. 2. It further provides that "Congress may by Law vest the Appointment of such inferior Officers, as they think proper, in the President alone, in the Courts of Law, or in the heads of Departments."
The Supreme Court in *583Lucia v. Sec. & Exch. Comm'n , --- U.S. ----,
The Court went on to conclude that " 'one who makes a timely challenge to the constitutional validity of the appointment of an officer who adjudicates his case' is entitled to relief."
Here, plaintiff contends that the ALJ who heard plaintiff's case was subject to the Appointments Clause, but was not appointed by the President, courts of law, or the Commissioner, as required, at the time the decision was issued on 1 May 2017. The Commissioner does not dispute this contention for purposes of this appeal. See Cmm'r's Mem. 6 n.2. In fact, following issuance of the Lucia decision, the Social Security Administration addressed the issue of challenges to its ALJ appointments by the Commissioner's express ratification of the appointments. See Soc. Sec. Ruling 19-1p; Titles II and XVI: Effect of the Decision in Lucia v. Securities and Exchange Commission (SEC) On Cases Pending at the Appeals Council ,
Nonetheless, the Commissioner still opposes any relief for plaintiff based on violation of the Appointments Clause. She does so on the grounds that plaintiff has forfeited any claim concerning the ALJ's appointment by not presenting it at the administrative level.
The Fourth Circuit has not addressed the question of whether issue exhaustion at the administrative level in a Social Security case is required in order to preserve the matters for review by a federal court. However, the majority of lower court decisions, within the Fourth Circuit and beyond, addressing this question have held that Lucia directs a finding that a plaintiff who fails to raise a challenge pursuant to the Appointments Clause at the administrative level is precluded from doing so later on judicial review. See, e.g., Burgin v. Berryhill , No. 1:17-CV-346-FDW,
*584Stewart v. Berryhill , No 5:18-CV-85-RJ,
Courts relying on Lucia to find waiver in the Social Security context seemingly read the decision to create a baseline requirement that a claim arising under the Appointments Clause will only be timely when a party raises it at the administrative level, as the plaintiff did in Lucia .
The Supreme Court's decision in Sims v. Apfel ,
As to the non-adversarial nature of Social Security proceedings, the Supreme Court stated:
The differences between courts and agencies are nowhere more pronounced than in Social Security proceedings. Although "[m]any agency systems of adjudication are based to a significant extent on the judicial model of decisionmaking," 2 K. Davis & R. Pierce, Administrative Law Treatise § 9.10, p. 103 (3d ed. 1994), the SSA is "[p]erhaps the best example of an agency" that is not, B. Schwartz, Administrative Law 469-470 (4th ed. 1994). Seeid. , at 470 ("The most important of [the SSA's modifications of the judicial model] is the replacement of normal adversary procedure by ... the 'investigatory model' " (quoting Friendly, Some Kind of Hearing,123 U. Pa. L. Rev. 1267 , 1290 (1975) ) ). Social Security proceedings are inquisitorial rather than adversarial. It is the ALJ's duty to investigate the facts and develop the arguments both for and against granting benefits, see Richardson v. Perales ,402 U.S. 389 , 400-401,91 S.Ct. 1420 ,28 L.Ed.2d 842 (1971), and the Council's review is similarly broad. The Commissioner has no representative before the ALJ to oppose the claim for benefits, and we have found no indication that he opposes claimants before the Council.
Id. at 110-11,
Importantly, though, for purposes of the instant analysis, the question of whether a claimant is required to exhaust issues before the ALJ at the hearing level was specifically not before or addressed by the Court in Sims .
In the instant case, the ALJ made a statement at the outset of the hearing about its nature and consequences, essentially establishing the ground rules for the hearing. The ALJ began by telling plaintiff that "[t]his is just an informal fact-finding process." Tr. 27. He went on to say:
The way I explain it to people, it's no worse than if you and me were just sitting in your living room talking about your life. This isn't Law and Order. This isn't some kind of show that you're watching where every one is getting cross-examined. It's real low key, no big deal.
Tr. 28. The ALJ's statement certainly indicates the non-adversarial nature of the hearing. But it goes well beyond that in its benign characterization of the proceeding. The ALJ equates the hearing to a casual conversation in plaintiff's home with no legal consequences at all. The ALJ's statement thereby reinforces the propriety of not applying the exhaustion requirement in this case.
Even if the exhaustion requirement were deemed to apply, the principles espoused in Freytag v. Cmm'r of Internal Revenue ,
The Supreme Court's reasoning in Freytag applies equally in this case. The challenge here to the ALJ's appointment is neither frivolous nor disingenuous and goes to the validity of the proceeding itself. Therefore, even if issue exhaustion were deemed to apply, the court would have the discretion to consider the Appointments Clause issue. See Cirko o/b/o Cirko v. Berryhill , No. 1:17-CV-680,
*587The court finds that this is one of the "rare cases" contemplated by Freytag in which it should exercise its discretion to find that no waiver occurred, again, assuming the exhaustion requirement applied. The ALJ's statement to plaintiff about the nature and significance of the hearing he was about to conduct helps establish this case as among the "rare ones" and bolsters the appropriateness of finding that she did not waive her Appointments Clause claim. While it is not unusual for an ALJ to make an opening statement at a hearing, particularly to help put the claimant at ease, the statement by the ALJ here was extreme and starkly atypical in its characterization of the hearing as a benign proceeding devoid of legal consequence-that is, akin to a casual conversation in plaintiff's home about her life. The statement effectively encouraged plaintiff not to be vigilant in protecting her rights and interests during the hearing. The court declines to indulge in the presumption-which would be to the ALJ's and Commissioner's benefit-that plaintiff's counsel's handling of the hearing and the Appointments Clause claim in particular were not affected by the ALJ's statement. Under the specific circumstances presented, it would be manifestly unfair to find waiver by plaintiff of her Appointments Clause claim.
In sum, the court concludes that the exhaustion requirement did not apply to plaintiff's Appointments Clause claim pursuant to Sims based on the non-adversarial nature of the Social Security disability process. Alternatively, if the exhaustion requirement is deemed to apply, the court exercises its discretion under Freytag to find that no waiver occurred.
Turning then to the merits of plaintiff's Appointments Clause claim, the court, in accordance with the uncontested contention of plaintiff, concludes that the ALJ who decided plaintiff's case was appointed in violation of the Appointments Clause. Particularly in light of the Social Security Administration having since corrected the appointment process, remand for a new hearing before a different ALJ is the appropriate remedy for this violation. See Lucia ,
The court emphasizes that the issue presented by plaintiff's Appointments Clause claim is overwhelmingly a legal one and that the claim is not a matter that falls within the scope of an ALJ's usual fact-finding duties, if it is within the scope of an ALJ's authority at all. See infra n. 6. Therefore, nothing in this Order shall be interpreted as excusing a claimant from the burden of presenting evidence and otherwise showing at the administrative level that he or she is disabled pursuant to the Regulations and other applicable provisions of law. See, e.g. ,
*588adopted sub nom. Cooke v. Berryhill ,
CONCLUSION
For the foregoing reasons, IT IS ORDERED that plaintiff's motion (D.E. 14) for judgment on the pleadings be ALLOWED, the Commissioner's motion (D.E. 16) for judgment on the pleadings be DENIED, and this case be REMANDED to the Commissioner pursuant to sentence four of
The versions of the regulations and Social Security Rulings cited by the undersigned herein are those applicable to this appeal of the ALJ's decision.
See also
See also
See also
This regulation describes sedentary work as "involv[ing] lifting no more than 10 pounds at a time and occasionally lifting or carrying articles like docket files, ledgers, and small tools."
Lucia was decided on 21 June 2018, after the administrative proceedings in this case had been completed and this appeal had been filed. Given the other grounds upon which it resolves plaintiff's Appointments Clause claim, it need not address whether this chronology bears on the timeliness of plaintiff's assertion of her claim. Similarly, the court need not rule on plaintiff's argument that assertion of her Appointments Clause claim before the ALJ would have been futile, and her non-assertion of it therefore did not affect its waiver, by virtue of the Commissioner's own issuance of an Emergency Message EM-18003 (30 Jan. 2018) providing that ALJs lack the authority to rule on Appointments Clause claims and instructing them not to do so. See also EM-18003 REV (26 Dec. 2018) (replacing EM-18003); EM-18003 REV 2 (6 Feb. 2019) (replacing EM-18003 REV).
Social Security regulations do provide that objections to issues to be decided at the hearing should be identified "at the earliest possible opportunity,"
Reference
- Full Case Name
- Lisa PROBST v. Nancy BERRYHILL, Acting Commissioner of Social Security
- Cited By
- 5 cases
- Status
- Published