Bagwell v. Barnhart

• Decision Date: 08 March 2004
• Docket Number: No. CIV.A.H-02-4443.,CIV.A.H-02-4443.
• Citation: 338 F.Supp.2d 723
• Parties: Julius BAGWELL, Jr., Plaintiff, v. Jo Anne B. BARNHART, Commissioner of the Social Security Administration, Defendant.
• Court: U.S. District Court — Southern District of Texas

338 F.Supp.2d 723

Julius BAGWELL, Jr., Plaintiff, v. Jo Anne B. BARNHART, Commissioner of the Social Security Administration, Defendant.

No. CIV.A.H-02-4443.

United States District Court, S.D. Texas, Houston Division.

March 8, 2004.

Victor N. Makris, Attorney at Law, Bellaire, TX, for Julius Bagwell, Plaintiff.

Cheryl Latrice Chapman, Office of the General Counsel, Social Security Admin., Dallas, TX, for Jo Anne B. Barnhart, Defendant.

MEMORANDUM AND ORDER

BOTLEY, United States Magistrate Judge.

Pending before the Court are Plaintiff Julius Bagwell Jr.'s ("Bagwell") and Defendant Jo Anne B. Barnhart's ("Commissioner") cross-motions for summary judgment. Bagwell appeals the determination of an Administrative Law Judge ("ALJ") that he is not entitled to receive Title II disability insurance benefits or Title XVI supplemental security income benefits. See 42 U.S.C. §§ 416(i), 423, 1382c(a)(3)(A). Having reviewed the pending motions, the submissions of the parties, the pleadings, the administrative record and the applicable law, this Court is of the opinion that Bagwell's Motion for Summary Judgment (Docket Entry No. 11) should be granted, the Commissioner's Motion for Summary Judgment (Docket Entry No. 14) should be denied, the ALJ's decision denying benefits be reversed, and the case be remanded pursuant to sentence four to the Social Security Administration ("SSA") for further proceedings.

I. Background

Bagwell filed applications for disability insurance benefits and supplemental security income payments with the SSA on August 12, 1997, and April 25, 2000, respectively, alleging disability beginning on March 22, 1994, as a result of degenerative disc disease¹ and asthma.² (R. 15, 184-186). After being denied benefits initially and on reconsideration, Bagwell requested an administrative hearing before an ALJ to review the decision. (R. 149). A hearing was held on November 20, 1998, in Bellaire, Texas, at which time the ALJ heard testimony from Bagwell and Laurie McQuade Johnson³ ("Johnson"), a vocational expert ("VE"). (R. 29-64). In a decision dated, February 16, 1999, the ALJ denied Bagwell's application for benefits. (R. 121-137). On March 17, 1999, Bagwell appealed the ALJ's decision to the Appeals Council of the SSA's Office of Hearings and Appeals. (R. 158). The Appeals Council, on June 15, 2001, remanded this case to an ALJ for further proceedings. (R. 169-170).

A second administrative hearing was held before an ALJ on February 6, 2002, in Bellaire, Texas, at which time the ALJ heard testimony from Bagwell, Ronald DeVere, M.D. ("Dr. DeVere"), a medical expert, and McQuade, a VE. (R. 65-118). In a decision dated March 1, 2002, the ALJ denied Bagwell's application for benefits. (R. 15-23). In the decision, the ALJ found that Bagwell had severe medically determinable impairments of degenerative disc disease and asthma. (R. 22). The ALJ determined, however, that Bagwell's impairments did not meet or medically equal one of the listed impairments in Appendix I, Subpart P, Regulation No. 4. (R. 22). The ALJ concluded that, although Bagwell could not perform his past relevant work as a truck driver, he could perform light work (i.e., ticket taker, library page, and order caller), with certain limitations, and that these jobs exist in significant numbers in the national economy. (R. 23).

On March 15, 2002, Bagwell appealed the ALJ's decision to the Appeals Council of the SSA's Office of Hearings and Appeals. (R. 9). The Appeals Council, on October 18, 2002, declined to review the ALJ's determination. (R. 7-8). This rendered the ALJ's opinion the final decision of the Commissioner. See Sims v. Apfel, 530 U.S. 103, 107, 120 S.Ct. 2080, 147 L.Ed.2d 80 (2000). Bagwell filed the instant action on November 26, 2002, contesting the Commissioner's denial of his claim for benefits.

II. Analysis

A. Statutory Bases for Benefits

SSI benefits are authorized by Title XVI of the Act and are funded by general tax revenues. See SOCIAL SECURITY ADMINISTRATION, SOCIAL SECURITY HANDBOOK, § 2100 (14th ed.2001). The SSI Program is a general public assistance measure providing an additional resource to the aged, blind, and disabled to assure that their income does not fall below the poverty line. See 20 C.F.R. § 416.110. Eligibility for SSI is based upon proof of indigence and disability. See 42 U.S.C. §§ 1382(a), 1382c(a)(3)(A)-(C). A claimant applying to the SSI program cannot receive payment for any period of disability predating the month in which he applies for benefits, no matter how long he has actually been disabled. See Brown v. Apfel, 192 F.3d 492, 495 n. 1 (5th Cir.1999); see also 20 C.F.R. § 416.335. The applicable regulation provides:

When you file an application in the month that you meet all the other requirements for eligibility, the earliest month for which we can pay you benefits is the month following the month you filed the application. If you file an application after the month you first meet all the other requirements for eligibility, we cannot pay you for the month in which your application is filed or any months before that month.

20 C.F.R. § 416.335. Thus, the month following an application, here, September 1997, fixes the earliest date from which benefits can be paid. Eligibility for SSI payments, however, is not dependent on insured status. See 42 U.S.C. § 1382(a).

Social Security disability insurance benefits are authorized by Title II of the Act and are funded by Social Security taxes. See also SOCIAL SECURITY ADMINISTRATION, SOCIAL SECURITY HANDBOOK, § 2100. The disability insurance program provides income to individuals who are forced into involuntary, premature retirement, provided they are both insured and disabled, regardless of indigence. A claimant for disability insurance can collect benefits for up to twelve months of disability prior to the filing of an application. See 20 C.F.R. §§ 404.131, 404.315; see also Perkins v. Chater, 107 F.3d 1290, 1295 (7th Cir.1997). For purposes of Title II disability benefits, Bagwell was last insured on December 31, 1996. (R. 193). Consequently, to be eligible for disability benefits, Bagwell must prove that he was disabled prior to that date.

While these are separate and distinct programs, applicants seeking benefits under either statutory provision must prove "disability" within the meaning of the Act, which defines disability in virtually identical language for both programs. See 42 U.S.C. §§ 423(d), 1382c(a)(3), 1382c(a)(3)(G); 20 C.F.R. §§ 404.1505(a), 416.905(a). Under both provisions, disability is defined as the inability 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. See 42 U.S.C. §§ 423(d)(1)(A), 1382c(3)(A). Moreover, the law and regulations governing the determination of disability are the same for both disability insurance benefits and SSI. See Greenspan v. Shalala, 38 F.3d 232, 236 (5th Cir.1994), cert. denied, 514 U.S. 1120, 115 S.Ct. 1984, 131 L.Ed.2d 871 (1995).

B. Standard of Review

1. Summary Judgment

The court may grant summary judgment under Fed. R. Civ. P. 56(c) when the moving party is entitled to judgment as a matter of law because there is no genuine issue as to any material fact. The burden of proof, however, rests with the movant to show that there is no evidence to support the nonmoving party's case. If a reasonable jury could return a verdict for the nonmoving party, then a motion for summary judgment cannot be granted because there exists a genuine issue of fact. See Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986).

An issue of fact is "material" only if its resolution could affect the outcome of the case. See Duplantis v. Shell Offshore, Inc., 948 F.2d 187, 189 (5th Cir.1991). When deciding whether to grant a motion for summary judgment, the court shall draw all justifiable inferences in favor of the nonmoving party, and deny the motion if there is some evidence to support the nonmoving party's position. See McAllister v. Resolution Trust Corp., 201 F.3d 570, 574 (5th Cir.2000). If there are no issues of material fact, the court shall review any questions of law de novo. See Merritt-Campbell, Inc. v. RxP Prods., Inc., 164 F.3d 957, 961 (5th Cir.1999). Once the movant properly supports the motion, the burden shifts to the nonmoving party, who must present specific and supported material facts, of significant probative value, to preclude summary judgment. See Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586, 106 S.Ct. 1348, 89 L.Ed.2d 538 (1986); International Ass'n of Machinists & Aerospace Workers, AFL-CIO v. Compania Mexicana de Aviacion, S.A. de C.V., 199 F.3d 796, 798 (5th Cir.2000).

2. Administrative Determination

Judicial review of the Commissioner's denial of disability benefits is limited to whether the final decision is supported by substantial evidence on the record as a whole and whether the proper legal standards were applied to evaluate the evidence. See Masterson v. Barnhart, 309 F.3d 267, 272 (5th Cir.2002). "Substantial evidence" means that the evidence must be enough to allow a reasonable mind to support the Commissioner's decision; it must be more than a mere scintilla and less than a preponderance. See Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971); Masterson, 309 F.3d at 272; Brown, 192 F.3d at 496.

When applying the substantial evidence standard on review, the court "scrutinize[s] the record to determine whether such evidence is present." Myers v. Apfel, 238 F.3d 617, 619 (5th Cir.2001) (citations omitted). If the Commissioner's findings are supported by substantial evidence, they are conclusive and must be affirmed. See Watson v. Barnhart, 288 F.3d 212, 215 (5th Cir.2002). Alternatively,...