Gourley v. Colvin

• Decision Date: 31 May 2016
• Docket Number: Case No. 6:15-cv-00812-SI
• Parties: JAMES M. GOURLEY, JR., Plaintiff, v. CAROLYN W. COLVIN, Commissioner of Social Security Defendant.
• Court: U.S. District Court — District of Oregon

JAMES M. GOURLEY, JR., Plaintiff, v. CAROLYN W. COLVIN, Commissioner of Social Security Defendant.

Case No. 6:15-cv-00812-SI

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF OREGON

May 31, 2016

OPINION AND ORDER

George J. Wall, 1336 East Burnside Street, Suite 130, Portland, Oregon 97214. Of Attorneys for Plaintiff.

Billy J. Williams, United States Attorney, and Janice E. Hebert, Assistant United States Attorney, UNITED STATES ATTORNEY'S OFFICE, District of Oregon, 1000 Southwest Third Avenue, Suite 600, Portland, Oregon, 97204-2902; Thomas M. Elsberry, Special Assistant United States Attorney, OFFICE OF THE GENERAL COUNSEL, SOCIAL SECURITY ADMINISTRATION, 701 Fifth Avenue, Suite 2900 M/S 221A, Seattle, Washington 98104-7075. Of Attorneys for Defendant.

Michael H. Simon, District Judge.

James M. Gourley, Jr. ("Plaintiff") applied for Disability Insurance Benefits ("DIB") and Supplemental Security Income ("SSI"). The final decision of the Commissioner of the Social Security Administration ("Commissioner") held that Plaintiff's disability began March 22, 2010, which was after Plaintiff's date last insured. Thus, the Comissioner denied Plaintiff's application for DIB and granted his application for SSI beginning March 22, 2010. Plaintiff seeks review of this final decision by the Commissioner, arguing that Plaintiff became disabled beginning on March 31, 2008, before his date last insured and that he is thus entitled to DIB and SSI beginning on that earlier date. For the following reasons, the Commissioner's decision is REVERSED.

STANDARD OF REVIEW

The district court must affirm the Commissioner's decision if it is based on the proper legal standards and the findings are supported by substantial evidence. 42 U.S.C. § 405(g); see also Hammock v. Bowen, 879 F.2d 498, 501 (9th Cir. 1989). "Substantial evidence" means "more than a mere scintilla but less than a preponderance." Bray v. Comm'r of Soc. Sec. Admin., 554 F.3d 1219, 1222 (9th Cir. 2009) (quoting Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995)). It means "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Id. (quoting Andrews, 53 F.3d at 1039).

Where the evidence is susceptible to more than one rational interpretation, the Commissioner's conclusion must be upheld. Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005). Variable interpretations of the evidence are insignificant if the Commissioner's interpretation is a rational reading of the record, and this Court may not substitute its judgment for that of the Commissioner. See Batson v. Comm'r of Soc. Sec. Admin., 359 F.3d 1190, 1193, 1196 (9th Cir. 2004). "[A] reviewing court must consider the entire record as a whole and may not affirm simply by isolating a specific quantum of supporting evidence." Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007) (quoting Robbins v. Soc. Sec. Admin., 466 F.3d 880, 882 (9th Cir. 2006) (quotation marks omitted)). A reviewing court, however, may not affirm the Commissioner on a ground upon which the Commissioner did not rely. Id.; see also Bray, 554 F.3d at 1226.

BACKGROUND

A. Plaintiff's Application

Plaintiff was a world-ranked competitive wrestler in college. AR 32. He suffered wrestling injuries to his knees, neck, and shoulder, which created chronic problems. AR 600. Plaintiff filed an application for DIB on April 28, 2009, and later filed an application for both DIB and SSI on March 22, 2010, initially alleging disability as of September 5, 2007, and later amending the alleged onset date to October 31, 2008. AR 22, 156. Plaintiff was 27 years old on the latter alleged disability onset date. AR 109. Plaintiff is classified as a "younger individual" under the regulations, with more than a high school education. AR 70. Plaintiff alleges disability due to bulged discs, disc fusion, chronic pain in the neck, lower back, and right shoulder, chronic exhaustion, depression, tingling and burning in the upper and lower extremities, and migraine headaches. AR 49, 109, 129. The Commissioner denied Plaintiff's application initially and upon reconsideration, and Plaintiff requested a hearing before an Administrative Law Judge ("ALJ"). AR 156, 179, 184, 191, 195.

After a video hearing was held on July 3, 2012, an ALJ, in a decision dated July 18, 2012, found Plaintiff not disabled. AR 153-173. The Appeals Council reviewed the matter and remanded the case for further proceedings with several special instructions, including further consideration of lay witness testimony, Plaintiff's right shoulder impairment, maximum residual functional capacity, and subjective complaints. AR 175-177. After a second hearing was held on September 16, 2014, another ALJ found Plaintiff disabled as of his amended alleged onset date, October 31, 2008. AR 22, 63.

On January 29, 2015, 57 days after the second ALJ's decision, the Appeals Council notified Plaintiff that it would review that decision on its own motion. AR 18, 282. On March 26, 2015, the Appeals Council vacated the ALJ's decision and issued a partially favorable decision, finding Plaintiff disabled as of March 22, 2010. AR 1-13. Specifically, the Appeals Council found Plaintiff's subjective testimony not credible to the extent that it related to the period before March 22, 2010, and that Plaintiff's migraines were not a severe impairment until July 2010. AR 7-8, 10. Because the Appeals Council determined that Plaintiff was not disabled until March 22, 2010, he was not disabled on or before December 31, 2009, his date last insured. Thus, the Appeals Council found that Plaintiff is not entitled to DIB and is entitled only to SSI beginning March 22, 2010. AR 13. Plaintiff now seeks review in this Court of the Appeals Council's decision, which is a final, reviewable decision by the Commissioner.

B. The Sequential Analysis

A claimant is disabled if he or she is unable to "engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment 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 Regulations set out a five-step sequential process for determining whether an applicant is disabled within the meaning of the Social Security Act." Keyser v. Comm'r Soc. Sec. Admin., 648 F.3d 721, 724 (9th Cir. 2011); see also 20 C.F.R. §§ 404.1520 (DIB), 416.920 (SSI); Bowen v. Yuckert, 482 U.S. 137, 140 (1987). Each step is potentially dispositive. 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4). The five-step sequential process asks the following series of questions:

1. Is the claimant performing "substantial gainful activity?" 20 C.F.R. §§ 404.1520(a)(4)(i), 416.920(a)(4)(i). This activity is work involving significant mental or physical duties done or intended to be done for pay or profit. 20 C.F.R. §§ 404.1510, 416.910. If the claimant is performing such work, she is not disabled within the meaning of the Act. 20 C.F.R. §§ 404.1520(a)(4)(i), 416.920(a)(4)(i). If the claimant is not performing substantial gainful activity, the analysis proceeds to step two.

2. Is the claimant's impairment "severe" under the Commissioner's regulations? 20 C.F.R. §§ 404.1520(a)(4)(ii), 416.920(a)(4)(ii). An impairment or combination of impairments is "severe" if it significantly limits the claimant's physical or mental ability to do basic work activities. 20 C.F.R. §§ 404.1521(a), 416.921(a). Unless expected to result in death, this impairment must have lasted or be expected to last for a continuous period of at least 12 months. 20 C.F.R. §§ 404.1509, 416.909. If the claimant does not have a severe impairment, the analysis ends. 20 C.F.R. §§ 404.1520(a)(4)(ii), 416.920(a)(4)(ii). If the claimant has a severe impairment, the analysis proceeds to step three.

3. Does the claimant's severe impairment "meet or equal" one or more of the impairments listed in 20 C.F.R. Part 404, Subpart P, Appendix 1? If so, then the claimant is disabled. 20 C.F.R. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii). If the impairment does not meet or equal one or more of the listed impairments, the analysis continues. At that point, the ALJ must evaluate medical and other relevant evidence to assess and determine the claimant's "residual functional capacity" ("RFC"). This is an assessment of work-related activities that the claimant may still perform on a regular and continuing basis, despite any limitations imposed by his or her impairments. 20 C.F.R. §§ 404.1520(e), 404.1545(b)-(c), 416.920(e), 416.945(b)-(c). After the ALJ determines the claimant's RFC, the analysis proceeds to step four.

4. Can the claimant perform his or her "past relevant work" with this RFC assessment? If so, then the claimant is not disabled. 20 C.F.R. §§ 404.1520(a)(4)(iv), 416.920(a)(4)(iv). If the claimant cannot perform his or her past relevant work, the analysis proceeds to step five.

5. Considering the claimant's RFC and age, education, and work experience, is the claimant able to make an adjustment to other work that exists in significant numbers in the national economy? If so, then the claimant is not disabled. 20 C.F.R. §§ 404.1520(a)(4)(v), 416.920(a)(4)(v), 404.1560(c), 416.960(c). If the claimant cannot perform such work, he or she is disabled. Id.

See also Bustamante v. Massanari, 262 F.3d 949, 954 (9th Cir. 2001).

The claimant bears the burden of proof at steps one through four. Id. at 953; see also Tackett v. Apfel, 180 F.3d 1094, 1098 (9th Cir. 1999); Yuckert, 482 U.S. at 140-41. The Commissioner bears the burden of proof at step five. Tackett, 180 F.3d at 1100. At step five, the Commissioner must show that the claimant can perform other work that exists in significant numbers in the national economy, "taking into consideration the claimant's residual functional capacity, age, education, and work experience." Id.; see also 20 C.F.R. §§ 404.1566, 416.966 (describing "work which exists in the national economy"). If the Commissioner fails to meet...