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Andrew W. v. Saul

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

September 30, 2019

ANDREW W., Plaintiff,
ANDREW M. SAUL, Commissioner of Social Security, Defendant.[1]



         Plaintiff Andrew W.[2] asks the Court to review the Commissioner of Social Security's final decision denying his claim for disability insurance benefits (“DIB”) under Title II of the Social Security Act (the “Act”), 42 U.S.C. §§ 401-434. The case is before me by the parties' consent under 28 U.S.C. § 636(c). ECF Nos. 8, 9. Having considered the administrative record, the parties' briefs and oral arguments, 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); see also 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. § 423(d)(1)(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. § 404.1520(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 August 2014, Andrew filed for DIB alleging that he had been disabled since February 15, 2013, because of “unpredictable” physical pain and psychiatric disorders including anxiety, depression, attention deficit disorder, osmophobia, and obsessive-compulsive disorder. See Administrative Record (“R.”) 18, 88, 177-80, ECF No. 12. He later amended his alleged onset date (“AOD”) to March 1, 2011, the same date he was in a serious car accident. R. 47. Andrew was thirty years old, or a “younger person” under the regulations, on that date. R. 20, 34; 20 C.F.R. § 404.1563(c). Disability Determination Services (“DDS”), the state agency, denied his claim initially in January 2015, R. 88-101, and upon reconsideration that July, R. 102-16. In September 2016, Andrew appeared with counsel and testified at an administrative hearing before ALJ Mark O'Hara. R. 41-87. A vocational expert (“VE”) also testified at this hearing. R. 74-85.

         ALJ O'Hara issued an unfavorable decision on January 9, 2017. R. 18-36. He found that Andrew had performed work activity since March 2011, but not “at the substantial gainful activity” level. R. 20. Andrew met the Act's insured-status requirements through March 31, 2014.[4] Id. At step two, ALJ O'Hara found that Andrew “had the following questionably severe impairments” during the relevant time: “anxiety and affective disorders, multiple fractures status-post [the] March 1, 2011 motor vehicle accident with right ankle pain, and myofascial neck and back pain.” Id. All other “medical conditions found in the record, alone or in combination, ” were either non-severe or not medically determinable. R. 21. Andrew's severe impairments did not meet or medically equal the relevant listings. R. 21-23 (citing 20 C.F.R. pt. 404, subpt. P, app. 1 §§ 1.02, 1.06, 12.04, 12.06 (2016)).

         ALJ O'Hara then evaluated Andrew's residual functional capacity (“RFC”) as it existed before March 31, 2014. R. 23-34. Physically, Andrew could have performed medium work[5] that involved “occasional[ly] climbing ladders/ropes/scaffolds, balancing without limitation, ” and doing other postural activities “no more than frequently.” R. 24. Mentally, Andrew “retained the concentration, persistence, and pace to perform simple repetitive tasks that [did] not require working with the public” and involved “working with things” more than people. Id. The limitation to simple work ruled out Andrew's return to his past relevant work as an engineer. R. 34; see R. 35-36, 80-82. Finally, based on this RFC finding and the VE's testimony, ALJ O'Hara concluded at step five that Andrew was not disabled between March 1, 2011, and March 31, 2014, because he could have performed several unskilled occupations (e.g., janitor/cleaner, order picker, office helper, laundry aide) that offered a significant number of jobs in Virginia and nationwide. R. 35-36; see R. 82-85. The Appeals Council denied Andrew's request for review, R. 1-3, and this appeal followed.

         III. Discussion

         Andrew's sole argument on appeal challenges ALJ O'Hara's finding that Andrew's severe anxiety and affective disorders did not meet Listing 12.06. See Pl.'s Br. 2, 5-11, ECF No. 14. The Listings are examples of medical conditions that “ordinarily prevent a person from working” in any capacity. Sullivan v. Zebley, 493 U.S. 521, 533 (1990) (quotation marks omitted). If a claimant's severe impairment(s) “satisfies all of the criteria of [the corresponding] listing, including any relevant criteria in the introduction, ” 20 C.F.R. § 404.1525(c)(3) (emphasis added), then the claimant is “entitled to a conclusive presumption” that he or she is disabled, Radford v. Colvin, 734 F.3d 288, 291 (4th Cir. 2013) (citing Bowen v. City of New York, 476 U.S. 467, 471 (1986)). See Zebley, 493 U.S. at 530 (“An impairment that manifests only some of those criteria, no matter how severely, does not qualify.”). To make this determination, the ALJ must identify the relevant listed impairment(s) and “compare[] each of the listed criteria” to the evidence in the claimant's record. Cook v. Heckler, 783 F.2d 1168, 1173 (4th Cir. 1986).

         ALJ O'Hara considered whether Andrew's mental impairments met Listing 12.06, “Anxiety-related disorders.”[6] R. 20-23, 27-34. That listing is broken into three “paragraphs, ” or parts, 20 C.F.R. pt. 404, subpt. P, app. 1 § 12.06(A)-(C) (2016), and in this case Andrew had to “present[] evidence of both parts A and B” to prevail, McCartney v. Apfel, 28 Fed.Appx. 277, 279 (4th Cir. 2002). See Def.'s Br. 10 n.7, ECF No. 16. Part A required “medically documented findings” that Andrew exhibited at least one of five listed “persistent” or “recurrent” psychiatric disorders and accompanying symptoms.[7] 20 C.F.R. pt. 404, subpt. P, app. 1 § 12.06(A)(1)-(5). Part B required evidence that the impairment caused “marked” limitations in at least two of three broad functional areas: activities of daily living; social functioning; and concentration, persistence, or pace. Id. § 12.06(B)(1)-(3). A “marked” limitation means “more than moderate but less than extreme” difficulty in a functional area. Id. § 12.00(C). Andrew could have had a “marked limitation . . . when several activities or functions [were] impaired, or even when one [was] impaired, so long as the degree of limitation . . . interfere[d] seriously with [his] ability to function independently, appropriately, effectively, and on a sustained basis.” Id. In making this determination, ALJ O'Hara was required to “consider all relevant evidence in [the] case record, ” id. § 12.00(D), including medical opinions, findings on mental-status exams, Andrew's subjective statements, information about unsuccessful work attempts, id. § 12.00(D)(1)-(5), and, importantly, any descriptions of Andrew's “typical reaction” to stress, id. § 12.00(D)(11).

         Andrew argues that the medical evidence of record shows he had “at least marked limitation” in social functioning and maintaining concentration, persistence, or pace. See Pl.'s Br. 6. That question-whether Andrew was disabled during the relevant time-is for the Commissioner to decide. The fundamental question before the Court is whether the ALJ's conclusion that Andrew was “not disabled is supported by substantial evidence and was reached based upon a correct application of the relevant law.” Craig v. Chater, 76 F.3d 585, 589 (4th Cir. 1996). On that issue, Andrew points to specific medical records dated between February 2013 and July 2016 that he believes the ALJ misinterpreted. See Pl.'s Br. ...

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