Harris v. Comm'r of Soc. Sec.
Harris v. Comm'r of Soc. Sec.
Opinion of the Court
The Court has reviewed the Report and Recommendation of United States Magistrate Judge Michael J. Newman (Doc. #14), to whom this case was referred pursuant to
Accordingly, it is hereby ORDERED that:
1. The Report and Recommendation (Doc. #14) is ADOPTED in full;
2. The Commissioner's non-disability determination is REVERSED;
3. This matter is REMANDED to the Commissioner under the Fourth Sentence of42 U.S.C. § 405 (g) for further proceedings; and
4. This case is terminated on the docket of this Court.
REPORT AND RECOMMENDATION
Michael J. Newman, United States Magistrate Judge *877This is a Social Security disability benefits appeal. At issue is whether the Administrative Law Judge ("ALJ") erred in finding Plaintiff not "disabled" and therefore unentitled to Supplemental Security Income ("SSI") and/or Disability Insurance Benefits ("DIB").
I.
A. Procedural History
Plaintiff filed for DIB and SSI alleging a disability onset date of April 24, 2014. PageID 53. Plaintiff claims disability as a result of a number of alleged impairments including, inter alia , degenerative joint disease and obesity. PageID 55.
After an initial denial of his applications, Plaintiff received a hearing before ALJ Gregory G. Kenyon on March 7, 2016. PageID 53. The ALJ issued a written decision on June 2, 2016 finding Plaintiff not disabled. PageID 53-64. Specifically, the ALJ found at Step Five that, based upon Plaintiff's residual functional capacity ("RFC") to perform a reduced range of sedentary work,
Thereafter, the Appeals Council denied Plaintiff's request for review, making the ALJ's non-disability finding the final administrative decision of the Commissioner. PageID 31-33. See Casey v. Sec'y of Health & Human Servs. ,
*878B. Evidence of Record
The evidence of record is adequately summarized in the ALJ's decision (PageID 53-64), Plaintiff's Statement of Errors (doc. 11), the Commissioner's memorandum in opposition (doc. 12), and Plaintiff's reply (doc. 13). The undersigned incorporates all of the foregoing and sets forth the facts relevant to this appeal herein.
II.
A. Standard of Review
The Court's inquiry on a Social Security appeal is to determine (1) whether the ALJ's non-disability finding is supported by substantial evidence, and (2) whether the ALJ employed the correct legal criteria.
Substantial evidence is "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales ,
The second judicial inquiry -- reviewing the correctness of the ALJ's legal analysis -- may result in reversal even if the ALJ's decision is supported by substantial evidence in the record. Rabbers v. Comm'r of Soc. Sec. ,
B. "Disability" Defined
To be eligible for disability benefits, a claimant must be under a "disability" as defined by the Social Security Act.
Administrative regulations require a five-step sequential evaluation for disability determinations.
1. Has the claimant engaged in substantial gainful activity?;
2. Does the claimant suffer from one or more severe impairments?;
3. Do the claimant's severe impairments, alone or in combination, meet or equal the criteria of an impairment set forth in the Commissioner's Listing of Impairments (the "Listings"), 20 C.F.R. Subpart P, Appendix 1?;
4. Considering the claimant's RFC, can he or she perform his or her past relevant work?; and
5. Assuming the claimant can no longer perform his or her past relevant *879work -- and also considering the claimant's age, education, past work experience, and RFC -- do significant numbers of other jobs exist in the national economy which the claimant can perform?
III.
On appeal, Plaintiff argues that the ALJ erred in: (1) addressing Listing § 1.02 (Major Dysfunction of a Joint(s) ); (2) considering and accounting for his obesity throughout the opinion; (3) establishing that a significant number of jobs would be available to Plaintiff despite his impairments; and (4) assessing his credibility. PageID 845. In addressing Plaintiff's first and second errors in tandem, the Court finds reversible error and would direct the ALJ to consider Plaintiff's remaining arguments on remand.
The Listing of Impairments "describes impairments the SSA considers to be severe enough to prevent an individual from doing any gainful activity, regardless of his or her age, education, or work experience." Rabbers ,
Listing § 1.02 provides as follows:
1.02 Major dysfunction of a joint(s) (due to any cause): Characterized by gross anatomical deformity (e.g. , subluxation, contracture, bony or fibrous ankylosis, instability) and chronic joint pain and stiffness with signs of limitation of motion or other abnormal motion of the affected joint(s), and findings on appropriate medically acceptable imaging of joint space narrowing, bony destruction, or ankylosis of the affected joint(s). With:
A. Involvement of one major peripheral weight-bearing joint (i.e. , hip, knee, or ankle), resulting in inability to ambulate effectively, as defined in 1.00B2b;
20 C.F.R. § Pt. 404, Subpt. P, App. 1.
At Step Three of his analysis, the ALJ held:
The claimant's musculoskeletal and mental impairments have been evaluated in the context of listings 1.02, 12.04, and 12.06. It is concluded that the claimant does not manifest clinical signs and findings that meet the specific criteria of any listings. In reaching this conclusion, the opinions of the state agency medical consultant have been considered.
PageID 56.
In determining whether a Plaintiff met or equalled a listing, "the ALJ needed to actually evaluate the evidence, compare it to Section [1.02] of the Listing, and give an explained conclusion, in order to facilitate meaningful judicial review. Without it, it is impossible to say that the ALJ's decision at Step Three was *880supported by substantial evidence." Reynolds v. Comm'r of Soc. Sec. ,
The ALJ's error is particularly troublesome in this case because Plaintiff's obesity is a complicating factor which the ALJ must "consider ... in combination with other impairments, at all stages of the sequential evaluation." Shilo v. Comm'r of Soc. Sec. ,
The ALJ's failure to provide a full discussion at Step Three may be harmless error where his findings at Step Four provide a sufficient basis for the Court to determine that no reasonable administrative fact finder would have resolved the matter differently. Malone v. Comm'r of Soc. Sec. ,
Most significantly, the record includes evidence that he walked with a limp after his 2000 car accident, PageID 591; a 2012 x-ray image of the right knee showing post-operative changes, moderate osteoarthritis, and findings suggestive of lateral subluxation of the patellofemoral joint, PageID 582; a 2014 x-ray imaging of Plaintiff's right and left knee showing moderate to severe degenerative changes, PageID 631-32; and evidence of surgery in August 2015 to remove screws from his leg, which did not alleviate his pain and necessitated the use of an ambulatory device at that time, PageID 716-19. Plaintiff also has a BMI of 61.4, which is well over the cut-off of 40 for Level III Extreme Obesity and the gravity of which was highlighted by all of the physicians in the record. See Shilo , 600 Fed. Appx. at 962 (finding a BMI of 53.7 to be "disturbing" in light of the cut-off for Level III obesity ). Julia Ann Boyd, M.D., Plaintiff's treating physician, noted that he was morbidly obese. PageID 508. Damian Danopulos, M.D, a state agency consulting physician, opined that "Plaintiff's ability to do any work-related activities is affected and restricted from the combination of his unusual morbid obesity plus his right knee moderate arthritic changes and right upper leg arthralgias." PageID 576. The opinions of both state agency reviewing physicians also documented Plaintiff's "severe obesity." PageID 128, 173.
Finally, the undersigned notes that in determining Plaintiff's RFC, the ALJ relied on three state agency physicians, Maria Congbalay, M.D., Elaine Lewis, M.D., and Damian Danopulos, M.D., PageID 60, who formed opinions concerning Plaintiff's disability status without first conducting a full and complete review of the record. Kelly ex rel. Hollowell v. Comm'r of Soc. Sec. ,
Based on the foregoing, the ALJ's conclusion -- that Plaintiff did not meet or equal Listing § 1.02(A) -- is deemed unsupported by substantial evidence. Accordingly, the ALJ's non-disability finding should be reversed.
IV.
When the ALJ's non-disability determination is unsupported by substantial evidence, the Court must determine *882whether to remand the matter for rehearing or to award benefits. Generally, benefits may be awarded immediately "if all essential factual issues have been resolved and the record adequately establishes a plaintiff's entitlement to benefits." Faucher v. Sec'y of Health & Human Servs. ,
V.
IT IS THEREFORE RECOMMENDED THAT: (1) the Commissioner's non-disability finding be found unsupported by substantial evidence, and REVERSED ; (2) this matter be REMANDED to the Commissioner under the Fourth Sentence of
Date: January 4, 2019
Attached hereto is a NOTICE to the parties regarding objections to this Report and Recommendation.
"The Commissioner's regulations governing the evaluation of disability for DIB and SSI are identical ... and are found at
Hereafter, citations to the electronically-filed record will refer only to the PageID number.
Sedentary work "involves lifting no more than 10 pounds at a time and occasionally lifting or carrying articles like docket files, ledgers, and small tools. Although a sedentary job is defined as one which involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties."
The opinion given by Dr. Danopulos was authored in 2012 and the ALJ acknowledged that his opinion was not based on a complete review of Plaintiff's medical records. PageID 60.
Reference
- Full Case Name
- William HARRIS v. COMMISSIONER OF SOCIAL SECURITY
- Cited By
- 2 cases
- Status
- Published