United States District Court, W.D. Virginia, Roanoke Division
GLEN E. CONRAD, Chief District Judge
The plaintiff, David A. Plunkett, filed this action challenging the final decision of the Commissioner of Social Security denying plaintiffs claim for a period of disability and disability insurance benefits under the Social Security Act, as amended, 42 U.S.C. §§ 416(i) and 423. Plaintiff also challenges the date of disability onset established by the Commissioner for purposes of plaintiff's application for supplemental security income benefits under 42 U.S.C. § 1381 et seq. Jurisdiction of this court is pursuant to 42 U.S.C. § 405(g) and 42 U.S.C. § 1383(c)(3).
This court's review is limited to a determination as to whether there is substantial evidence to support the Commissioner's final decision that plaintiff was not under a disability at any time prior to the termination of his insured status, and that he did not become disabled, within the meaning of the Act, until April 10, 2012. If such substantial evidence exists, the final decision of the Commissioner must be affirmed. Laws v. Celebrezze , 368 F.2d 640 (4th Cir. 1966). Stated briefly, substantial evidence has been defined as such relevant evidence, considering the record as a whole, as might be found adequate to support a conclusion by a reasonable mind. Richardson v. Perales , 402 U.S. 389, 400 (1971).
David A. Plunkett was born on June 22, 1957 and eventually completed his high school education. He also finished two years in college. Plaintiff has worked as a general laborer, carpenter, painter, and maintenance man in an apartment complex. He last worked on a regular basis in 2009. On August 3, 2009, Mr. Plunkett filed applications for disability insurance benefits and supplemental security income benefits. Plaintiff alleged that he became disabled for all forms of substantial gainful employment on May 1, 2009, due to pain in his back and lower extremities, ruptured tendon, and nerve grafts. Mr. Plunkett now maintains that he has remained disabled to the present time. As to his application for disability insurance benefits, the record reveals that plaintiff met the insured status requirements of the Act through the fourth quarter of 2009, but not thereafter. See gen., 42 U.S.C. §§ 416(i) and 423(a). Consequently, plaintiff is entitled to disability insurance benefits only if he has established that he became disabled for all forms of substantial gainful employment on or before December 31, 2009. See generally, 42 U.S.C. § 423(a).
Mr. Plunkett's claims were denied upon initial consideration and reconsideration. He then requested and received a de novo hearing and review before an Administrative Law Judge. In an opinion dated April 10, 2012, the Law Judge also ruled that Mr. Plunkett is not disabled. The Law Judge found that plaintiff suffers from several severe impairments including history of varicose and spider veins of the lower extremities; diabetes 2 controlled with medication; arthritis; degenerative disc disease; degenerative joint disease; hypertension; and chronic obstructive pulmonary disease. Because of these impairments, the Law Judge determined that plaintiff is disabled for all of his past relevant work roles. However, the Law Judge found that plaintiff retains sufficient functional capacity to perform a limited range of light work activity. The Law Judge assessed Mr. Plunkett's residual functional capacity as follows:
After careful consideration of the entire record, the undersigned finds that the claimant has the residual functional capacity to perform light work as defined in 20 C.F.R. 404.1567(b) and 416.967(b) except the claimant can never crawl or climb ladders, ropes, and scaffolds, and the claimant can no more than occasionally kneel, crouch, stoop, balance, or climb stairs or ramps. The claimant must avoid even moderate exposure to dust, fumes, odors, chemicals and gases and even moderate exposure to hazards.
(TR 37). Given such a residual functional capacity, and after considering plaintiffs age, education, and prior work experience, as well as testimony from a vocational expert, the Law Judge determined that Mr. Plunkett retained sufficient functional capacity for several specific light work roles at all relevant times. Accordingly, the Law Judge ultimately concluded that Mr. Plunkett is not disabled, and that he is not entitled to benefits under either federal program. See generally, 20 C.F.R. §§ 404.1520(g) and 416.920(g).
Mr. Plunkett sought review of the Administrative Law Judge's rulings by the Social Security Administration's Appeals Council. The Appeals Council rendered its decision on June 25, 2013. Stated succinctly, the Appeals Council adopted the Law Judge's findings and conclusions as regards plaintiffs application for disability insurance benefits. However, the Appeals Council held that plaintiff became disabled for purposes of his application for supplemental security income benefits as of April 10, 2012. The Appeals Council noted that, under the findings of the Administrative Law Judge, including residual functional capacity for no more than light exertion, the medical vocational guidelines direct a determination of disabled as of June 21, 2012, the day before plaintiffs fifty-fifth birthday. See 20 C.F.R. § 416.969 and Rule 202.06 of Appendix 2 to Subpart P of the Administrative Regulations, Part 404. Noting that "the age categories will not be applied mechanically in a borderline age situation when the individual is within a few days to a few months of attaining an older age category and application of the older age category will result in a finding of disabled, " see 20 C.F.R. § 416.963(b), the Appeals Council assumed, for purposes of the guidelines, that Mr. Plunkett became disabled on April 10, 2012, the date of the Law Judge's hearing decision. Challenging the denial of his application for disability insurance benefits, and the onset date established for purposes of his claim for supplemental security income benefits, Mr. Plunkett has now appealed to this court.
While plaintiff may be disabled for certain forms of employment, the crucial factual determination is whether plaintiff is disabled for all forms of substantial gainful employment. See 42 U.S.C. §§ 423(d)(2) and 1382c(a). There are four elements of proof which must be considered in making such an analysis. These elements are summarized as follows: (1) objective medical facts and clinical findings; (2) the opinions and conclusions oftreating physicians; (3) subjective evidence of physical manifestations of impairments, as described through a claimant's testimony; and (4) the claimant's education, vocational history, residual skills, and age. Vitek v. Finch , 438 F.2d 1157, 1159-60 (4th Cir. 1971); Underwood v. Ribicoff , 298 F.2d 850, 851 (4th Cir. 1962).
While the court believes that this is a very close case, the court is constrained to conclude that the Commissioner's final decision is supported by substantial evidence. Mr. Plunkett suffers from poor circulation in his lower extremities, degenerative arthritis in his back and in multiple joints, diabetes, hypertension, and chronic obstructive pulmonary disease. The medical record confirms that plaintiff's diabetes and hypertension are subject to reasonable medical control. Plaintiff's chronic obstructive pulmonary disease is severe, and results in environmental restrictions. Nevertheless, the medical record supports the Law Judge's finding that plaintiff's breathing problems do not prevent performance of lighter levels of exertion. However, Mr. Plunkett's degenerative arthritis and circulatory problems substantially limit his capacity for work activity. If these problems were so severe as to prevent performance of anything more than sedentary levels of exertion as of the date of alleged disability onset, the medical vocational guidelines would have directed a determination of disabled in Mr. Plunkett's case. See Rule 201.14 of Appendix 2 to Subpart P of the Administrative Regulations Part 404. Thus, the critical issue on appeal is whether there is substantial evidence to support the Law Judge's determination, as adopted by the Appeals Council, that Mr. Plunkett retained sufficient functional capacity for a limited range of light work activity at all relevant times.
Shortly after Mr. Plunkett filed his application for benefits, the state disability agency referred plaintiff for consultative examination by Dr. William H. Humphries. Dr. Humphries is a board certified emergency medicine specialist. Dr. Humphries completed a medical examination on October 29, 2009. Based on his physical findings, Dr. Humphries listed diagnoses and impressions as follows:
1. Hypertension, mild.
2. DJD, mild in both hands, and moderate in both ...