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Lisaf v. Saul

United States District Court, W.D. Virginia

September 23, 2019

Charlottesville Division LISAF., [1] Plaintiff,
ANDREW M. SAUL, Commissioner of Social Security, Defendant.[2]


          Joel C. Hoppe, United States Magistrate Judge

         Plaintiff Lisa F. asks the Court to review the Commissioner of Social Security's final decision denying her claim for supplemental security income ("SSI") under Title XVI of the Social Security Act (the "Act"), 42 U.S.C. §§ 1381-1383f. The case is before me by the parties' consent under 28 U.S.C. § 636(c). ECF No. 13. Having considered the administrative record, the parties' briefs, and the applicable law, I cannot find that substantial evidence supports the Commissioner's final decision. Accordingly, the decision will be reversed, and the case remanded under the fourth sentence of 42 U.S.C. § 405(g).

         I. Standard of Review

         The Social Security Act authorizes this Court to review the Commissioner's final decision that a person is not entitled to disability benefits. 42 U.S.C. §§ 405(g), 1383(c)(3); see Hines v. Barnhart, 453 F.3d 559, 561 (4th Cir. 2006). The Court's role, however, is limited-it may not "reweigh conflicting evidence, make credibility determinations, or substitute [its] judgment" for that of agency officials. Hancock v. Astrue, 667 F.3d 470, 472 (4th Cir. 2012). Instead, a court reviewing the merits of the Commissioner's final decision asks only whether the Administrative Law Judge ("ALJ") applied the correct legal standards and whether substantial evidence supports the ALJ's factual findings. Meyer v. Astrue, 662 F.3d 700, 704 (4th Cir. 2011); see Riley v. Apfel, 88 F.Supp.2d 572, 576 (W.D. Va. 2000) (citing Melkonyan v. Sullivan, 501 U.S. 89 (1991)).

         "Substantial evidence" means "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401 (1971). It is "more than a mere scintilla" of evidence, id, but not necessarily "a large or considerable amount of evidence," Pierce v. Underwood, 487 U.S. 552, 565 (1988). Substantial evidence review considers the entire record, and not just the evidence cited by the ALJ. See Universal Camera Corp. v. NLRB, 340 U.S. 474, 487-89 (1951); Gordon v. Schweiker, 725 F.2d 231, 236 (4th Cir. 1984). Ultimately, this Court must affirm the ALJ's factual findings if "conflicting evidence allows reasonable minds to differ as to whether a claimant is disabled." Johnson v. Barnhart, 434 F.3d 650, 653 (4th Cir. 2005) (per curiam). However, "[a] factual finding by the ALJ is not binding if it was reached by means of an improper standard or misapplication of the law." Coffman v. Bowen, 829 F.2d 514, 517 (4th Cir. 1987).

         A person is "disabled" within the meaning of the Act if he or she is unable 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." 42 U.S.C. § 1382c(a)(3)(A). Social Security ALJs follow a five-step process to determine whether a claimant is disabled. The ALJ asks, in sequence, whether the claimant (1) is working; (2) has a severe impairment that satisfies the Act's duration requirement; (3) has an impairment that meets or equals an impairment listed in the Act's regulations; (4) can return to his or her past relevant work based on his or her residual functional capacity; and, if not (5) whether he or she can perform other work. See Heckler v. Campbell, 461 U.S. 458, 460-62 (1983); Lewis v. Berryhill, 858 F.3d 858, 861 (4th Cir. 2017); 20 C.F.R. § 416.920(a)(4).[3] The claimant bears the burden of proof through step four. Lewis, 858 F.3d at 861. At step five, the burden shifts to the agency to prove that the claimant is not disabled. See id.

         II. Procedural History

         In December 2014, Lisa filed for SSI alleging that she was disabled by degenerative disc and joint disease, chronic back pain, and arthritis, among other medical conditions. See Administrative Record ("R.") 15, 67-68, 173-76, ECF No. 11. Lisa was forty-six years old, or a "younger person" under the regulations, when she allegedly became disabled in June 2014. See R. 24, 67; 20 C.F.R. § 416.963(c). Disability Determination Services ("DDS"), the state agency, denied her claim initially in June 2015, R. 66-79, and upon reconsideration that September, R. 80-94. In December 2016, Lisa appeared with a non-attorney representative and testified at an administrative hearing before ALJ Susan Smith. R. 31-57. A vocational expert ("VE") also testified at this hearing. R. 53-56.

         ALJ Smith issued an unfavorable decision on March 13, 2017. R. 15-26. Lisa had the following "severe impairments: hip joint dysfunction status post replacement; carpal tunnel syndrome and tendinitis; degenerative disc disease of the cervical and lumbar spine; chronic obstructive pulmonary disease (COPD); and arthritis." R. 17. These impairments did not meet or medically equal any listed impairment. R. 19. ALJ Smith then evaluated Lisa's residual functional capacity ("RFC") and found that she could perform "sedentary work"[4] with additional restrictions:

[Occasionally climb ramps and stairs, stoop, kneel, and balance; never crouch and crawl; never climb ladders, ropes, and scaffolds; should avoid concentrated exposure to hazards including dangerous moving machinery, uneven terrain, and unprotected heights; should avoid concentrated exposure to fumes, odors, dusts, gases, and poor ventilation; and frequently use hands bilaterally for fingering and handling.

R. 19. The limitation to sedentary work ruled out Lisa's return to her past jobs as a waitress and certified nursing assistant. R. 24; see R. 53-54. Finally, based on this RFC finding and the VE's testimony, ALJ Smith concluded at step five that Lisa was not disabled because she could perform three sedentary occupations (order clerk; inspector, sorter, and tester; materials packer and sealer) that offered a significant number of jobs in the national economy. R. 25; see R. 54. The Appeals Council denied Lisa's request for review, R. 1-3, and this appeal followed.

         III. Discussion

         Lisa argues that ALJ Smith did not give "good reasons" for discounting a treating physician's medical opinion that, because of her severe lumbar and hip pain, Lisa "cannot lift, bend, stoop," or walk more than one hundred feet and frequently needs to change positions. Pl's Br. 5-6 (citing R. 436), ECF No. 15. This opinion conflicted with ALJ Smith's RFC findings that Lisa could frequently lift ten pounds, occasionally stoop (i.e., bend at the waist), and sit for about six hours and stand/walk for about two hours during a normal eight-hour workday. See R. 19, 23-24, 75-76; 20 C.F.R. § 416.967(a); SSR 96-9p, 1996 WL 374185, at *3, *8. It also bolstered Lisa's testimony that she must "shift positions to help alleviate her overall pain," R. 20 (citing R. 48-49, 52), which ALJ Smith did not include in her RFC finding.


         A claimant's RFC is her "maximum remaining ability to do sustained work activities in an ordinary work setting" for eight hours a day, five days a week despite her medical impairments and symptoms.[5] SSR 96-8p, 1996 WL 374184, at *2 (July 2, 1996) (emphasis omitted). It is a factual finding "made by the [ALJ] based on all the relevant evidence in the case record," Felton-Miller v. Astrue, 459 Fed.Appx. 226, 230-31 (4th Cir. 2011), and it should reflect specific, credibly established "restrictions caused by medical impairments and their related symptoms," including pain, that affect the claimant's "capacity to do work-related physical and mental activities," SSR 96-8p, 1996 WL 374184, at *1, *2. See Mascio, 780 F.3d at 637-40; Reece v. Colvin, 7:14cv428, 2016 WL 658999, at *6-7 (W.D. Va. Jan. 25, 2016), adopted by 2016 WL 649889 (W.D. Va. Feb. 17, 2016). The ALJ has broad (but not unbounded) discretion to determine whether an alleged limitation is supported by or consistent with other relevant evidence in the claimant's record. See Perry v. Colvin, No. 2:15cvl 145, 2016 WL 1183155, at *5 (S.D. W.Va. Mar. 28, 2016) (citing Oppenheim v. Finch, 495 F.2d 396, 397 (4th Cir. 1974)). Generally, a reviewing court will affirm the ALJ's RFC findings when it is clear that she considered all the relevant evidence under the correct legal standards, see Brown v. Comm 'r of Soc. Sec. Admin., 873 F.3d 251, 268-72 (4th Cir. 2017), and she built an "accurate and logical bridge from that evidence to h[er] conclusion[s]," Woods v. Berryhill, 888 F.3d 686, 694 (4th Cir. 2018) (quotation marks and brackets omitted). See Thomas v. Berryhill, 916F.3d307, 311-12 (4th Cir. 2019); Patterson v. Comm 'r of Soc. Sec, 846 F.3d 656, 662 (4th Cir. 2017).

         A. Summary

         Lisa provided the following information in her testimony at the administrative hearing and her submissions to the state agency. Lisa stopped working as a certified nursing assistant around June 2014 because she "couldn't lift the patients" and "walking was becoming ridiculously painful." R. 37. She had a total hip replacement on the right in January 2015, followed by a total hip replacement on the left in April 2016. R. 39-40. Her chronic pain was "even worse" after the second surgery, but her doctors said the prosthetic joints "look[ed] good." R. 41. Lisa usually used a walker or a crutch, R. 42-43, on the "very rare[]" occasions when she went out into the community, R. 72 (June 2015). See also R. 216. She could "get dressed, shower, and take care of morning" activities, but she did "everything slower" than she used to. R. 71 (June 2015); see also R. 211 (Jan. 2015). She needed "help bending over to get [her] shoes and socks on." R. 71; see also R. 215. Lisa could prepare microwave meals, but her mother did "mostly all" of the cooking, cleaning, and shopping. R. 214-16. When Lisa did go grocery shopping "once a month" she used a motorized cart to get around the store and someone went with her to get things off the shelves. R. 216.

         By December 2016, Lisa's chronic back and hip pain was "pretty much" uncontrolled. R. 43. Sometimes she used "marijuana or methadone," R. 52-53, to supplement the four prescription pain medications she took every day, R. 258. Trigger point injections "sometimes" dulled her back pain "a little bit," but only for "a few days" after each treatment. R. 44. Lisa spent most days lying in bed with her legs elevated, R. 43, or switching between sitting, standing, and lying down, R. 213-15 (June 2015). See also R. 48-49, 52 (Dec. 2016); R. 71 ("[M]ust alternate between sitting and standing because of pain."). She could sit for about 30 minutes before needing to reposition herself or get up and take "a few steps around." R. 48; see also R. 52, 71, 86, 211, 213. She could stand for about 10 minutes and walk at most 70 feet, but only if she had a crutch or walker for support. R. 48-49; see also R. 71-72 ("Cannot walk very far because of pain. . . . [U]ses a walker [that] was prescribed."); R. 219 (uses prescription walker when "pain gets very severe"). She was not sure if she could lift or carry something weighing between five and ten pounds. R. 50; see R. 72. ...

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