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Laura M. v. Berryhill

United States District Court, W.D. Virginia, Roanoke Division

March 26, 2019

LAURA M., [1] Plaintiff,
v.
NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.

          MEMORANDUM OPINION

          Robert S. Ballou United States Magistrate Judge.

         Plaintiff Laura M. (“Laura”) filed this action challenging the final decision of the Commissioner of Social Security (“Commissioner”) finding her not disabled and therefore ineligible for supplemental security income (“SSI”) and disability insurance benefits (“DIB”) under the Social Security Act (“Act”). 42 U.S.C. §§ 401-433, 1381-1383f. Laura alleges that the Administrative Law Judge (“ALJ”) erred by: (1) failing to provide an adequate explanation regarding his consideration of the prior ALJ's decision in a prior benefits determination; (2) not evaluating the effects of Laura's morbid obesity on her RFC; (3) improperly evaluating the opinions of Laura's treating primary care physician; and (4) failing to properly determine Laura's mental RFC limitations.

         This case is before the Court by consent of the parties pursuant to 28 U.S.C. § 636(c)(1). (Dkt. 8.) The parties have fully briefed all issues and the case is ripe for decision. I conclude that the ALJ failed to properly account for Laura's moderate impairments in concentration, persistence, or pace, and thus substantial evidence does not support the ALJ's decision. Accordingly, I GRANT in part Laura's motion for summary judgment (Dkt. 15), [2] DENY the Commissioner's motion for summary judgment (Dkt. 16), and REVERSE AND REMAND this case for further administrative proceedings consistent with this opinion.

         STANDARD OF REVIEW

         This Court limits its review to a determination of whether substantial evidence exists to support the Commissioner's conclusion that Laura failed to demonstrate that she was disabled under the Act.[3] Mastro v. Apfel, 270 F.3d 171, 176 (4th Cir. 2001). “Substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion; it consists of more than a mere scintilla of evidence but may be somewhat less than a preponderance.” Craig v. Chater, 76 F.3d 585, 589 (4th Cir. 1996) (internal citations and alterations omitted). The final decision of the Commissioner will be affirmed where substantial evidence supports the decision. Hays v. Sullivan, 907 F.2d 1453, 1456 (4th Cir. 1990).

         However, remand is appropriate if the ALJ's analysis is so deficient that it “frustrate[s] meaningful review.” Mascio v. Colvin, 780 F.3d 632, 636 (4th Cir. 2015) (noting that “remand is necessary” because the court is “left to guess [at] how the ALJ arrived at his conclusions”); see also Monroe v. Colvin, 826 F.3d 176, 188 (4th Cir. 2016) (emphasizing that the ALJ must “build an accurate and logical bridge from the evidence to his conclusion” and holding that remand was appropriate when the ALJ failed to make “specific findings” about whether the claimant's limitations would cause him to experience his claimed symptoms during work and if so, how often) (citation omitted). In Mascio and Monroe, the Court of Appeals remanded because the ALJ failed to adequately explain how he arrived at conclusions regarding the claimant's RFC. Mascio, 780 F.3d at 636; Monroe, 826 F.3d at 189. Similarly, I find that remand is appropriate here because the ALJ's opinion leaves the Court to guess at how he reached his conclusions regarding Laura's mental RFC.

         CLAIM HISTORY

         This is Laura's second application for both DIB and SSI benefits. She previously filed for benefits on July 22, 2010. Ultimately, ALJ Frederick Johnson issued a decision on November 30, 2012, finding Laura not disabled. R. 88.

         Laura filed this application for DIB and SSI on March 27, 2014, claiming that her disability due to rheumatoid arthritis, fibromyalgia (all eighteen pressure points), anxiety, bipolar, panic attacks, depression, insomnia, borderline diabetes type II, herniated disc, and back and neck surgery began on September 1, 2014, [4] when she was forty-six years old. R. 37, 95, 105. Laura's date last insured was September 30, 2014; thus, she must show that her disability began on or before this date and existed for twelve continuous months to receive DIB. R. 95; 42 U.S.C. §§ 423(a)(1)(A), (c)(1)(B), (d)(1)(A); 20 C.F.R. §§ 404.101(a), 404.131(a). Additionally, to receive SSI, Laura must show that she has been disabled for at least twelve months prior to the date of filing her disability application. The state agency denied Laura's applications at the initial and reconsideration levels of administrative review. R. 95-114, 117-40. On February 9, 2017, ALJ John Dawkins held a hearing to consider Laura's claims for DIB and SSI. R. 33-63. Counsel represented Laura at the hearing, which included testimony from vocational expert John Newman. On April 20, 2017, the ALJ entered his decision analyzing Laura's claims under the familiar five-step process[5] and denying her claim for benefits. R. 15-26.

         The ALJ found that Laura had not engaged in substantial gainful activity since December 1, 2012, the alleged onset date. R. 18. The ALJ determined that Laura suffered from the severe impairments of morbid obesity; diabetes mellitus; degenerative joint disease of the knee; degenerative disc disease of the cervical and lumbar spine status post-discectomy; and post-traumatic stress disorder. Id. The ALJ found that Laura's alleged fibromyalgia was not a medically determinable impairment because the medical evidence did not establish a fibromyalgia diagnosis as required by SSR 12-1p. R. 18-19. The ALJ determined that all of Laura's impairments, either individually or in combination, did not meet or medically equal a listed impairment. R. 19-20. Specifically, the ALJ considered listings 1.02 (major dysfunction of a joint) and 1.04 (disorders of the spine). R. 19. The ALJ recognized that diabetes mellitus is not a listed impairment for adults, but determined that its effects, either alone or in combination with other impairments, did not meet or medically equal the criteria of a listing in affected body systems. Id. The ALJ considered listing 12.15 (trauma- and stressor-related disorders) for Laura's mental impairments. R. 19. The ALJ considered the “paragraph B” criteria regarding Laura's mental impairments and determined that they were not satisfied, finding that Laura had: mild limitation in understanding, remembering, or applying information; moderate limitation in interacting with others; moderate limitation in concentrating, persisting, or maintaining pace; and mild limitation in adapting or managing herself. R. 20. The ALJ likewise found that the “paragraph C” criteria were not satisfied. Id.

         The ALJ concluded that Laura retained the residual functional capacity (“RFC”) to perform light work. R. 21. Specifically, the ALJ found that Laura could occasionally crouch, stoop, balance, and climb ramps/stairs, and could never crawl, kneel, or climb ladders, ropes, or scaffolds. Id. She could not work around temperature extremes, humidity, noise, vibration, or hazards. Id. Laura would be limited to simple, routine tasks in a work environment with few day-to-day changes and no work with the general public. Id. The ALJ determined that Laura is unable to perform her past relevant work as a retail store owner, but that she could perform jobs that exist in significant numbers in the national economy, such as assembler, sorter, and packer. R. 24-26. Thus, the ALJ concluded that Laura was not disabled. R. 26. Laura appealed the ALJ's decision and the Appeals Council denied her request for review on July 19, 2017. R. 1-3.

         ANALYSIS

         Laura alleges that the ALJ erred by: (1) failing to provide an adequate explanation regarding his consideration of the prior ALJ's decision; (2) not evaluating the effects of Laura's morbid obesity on her RFC; (3) improperly evaluating the opinions of Laura's treating primary care physician; and (4) failing to properly determine Laura's mental RFC limitations.

         A. ...


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