Grimes v. Colvin
| Decision Date | 17 September 2014 |
| Docket Number | CIVIL ACTION NO. 13-472-RLB |
| Parties | RONALD LEE GRIMES v. CAROLYN W. COLVIN, ACTING COMMISSIONER OF THE SOCIAL SECURITY ADMINISTRATION |
| Court | U.S. District Court — Middle District of Louisiana |
Plaintiff, Ronald Lee Grimes (Plaintiff), seeks judicial review of a final decision of the Commissioner of the Social Security Administration (Commissioner) pursuant to 42 U.S.C. § 405(g) denying Plaintiff's application for supplemental security income benefits. (R. Doc. 1).1 Having found all of the procedural prerequisites met (Tr. 1-6), the Commissioner's determination is now ripe for review. See 42 U.S.C. § 405(g); 20 C.F.R. § 404.981 (). For the reasons given below, the Court ORDERS that the decision of the Commissioner is AFFIRMED and Plaintiff's appeal is DISMISSED with prejudice.
This Court's review of the Commissioner's decision is limited to an inquiry into whether there is substantial evidence to support the findings of the Commissioner and whether the correct legal standards were applied. 42 U.S.C. § 405(g); Richardson v. Perales, 402 U.S. 389, 401 (1971); Falco v. Shalala, 27 F.3d 160, 162 (5th Cir. 1994); Villa v. Sullivan, 895 F.2d 1019, 1021 (5th Cir. 1990). Substantial evidence has been defined as " " Richardson, 402 U.S. at 401 (quoting Consolidated Edison Co. of N.Y. v. N.L.R.B., 305 U.S. 197, 229 (1938) (). The Fifth Circuit has further held that substantial evidence "must do more than create a suspicion of the existence of the fact to be established, but no substantial evidence will be found only where there is a conspicuous absence of credible choices or no contrary medical evidence." Hames v. Heckler, 707 F.2d 162, 164 (5th Cir. 1983) (quotations omitted). Conflicts in the evidence are for the Commissioner "and not the courts to resolve." Selders v. Sullivan, 914 F.2d 614, 617 (5th Cir. 1990). The Court may not reweigh the evidence, try the case de novo, or substitute its own judgment for that of the Commissioner even if it finds that the evidence preponderates against the Commissioner's decision. See, e.g., Bowling v. Shalala, 36 F.3d 431, 434 (5th Cir. 1994) (); Hollis v. Bowen, 837 F.2d 1378, 1383 (5th Cir. 1988) (); Harrell v. Bowen, 862 F.2d 471, 475 (5th Cir. 1988) (same).
If the Commissioner's decision is supported by substantial evidence, then it is conclusive and must be upheld. Estate of Morris v. Shalala, 207 F.3d 744, 745 (5th Cir. 2000). If the Commissioner fails to apply the correct legal standards, or fails to provide a reviewing court with a sufficient basis to determine that the correct legal principles were followed, it is grounds for reversal. Bradley v. Bowen, 809 F.2d 1054, 1057 (5th Cir. 1987).
In determining disability, the Commissioner (through an ALJ) works through a five-step sequential evaluation process. See 20 C.F.R. § 404.1520(a)(4). The burden rests upon the claimant throughout the first four steps of this five-step process to prove disability. If the claimant is successful in sustaining his or her burden at each of the first four steps, the burden shifts to the Commissioner at step five. See Muse v. Sullivan, 925 F.2d 785, 789 (5th Cir. 1991) (). First, the claimant must prove he is not currently engaged in substantial gainful activity. 20 C.F.R. § 404.1520(b). Second, the claimant must prove his or her impairment is "severe" in that it "significantly limits your physical or mental ability to do basic work activities . . . ." 20 C.F.R. § 404.1520(c). At step three the ALJ must conclude the claimant is disabled if he proves that his or her impairments meet or are medically equivalent to one of the impairments contained in the Listing of Impairments. See 20 C.F.R. § 404.1520(d) (); 20 C.F.R. pt. 404, subpt. P, app. 1 (Listing of Impairments). Fourth, the claimant bears the burden of proving he is incapable of meeting the physical and mental demands of his or her past relevant work. 20 C.F.R. § 404.1520(f).
If the claimant is successful at all four of the preceding steps then the burden shifts to the Commissioner to prove, considering the claimant's residual functional capacity, age, education and past work experience, that he or she is capable of performing other work. 20 C.F.R §404.1520(g)(1). If the Commissioner proves other work exists which the claimant can perform, the claimant is given the chance to prove that he or she cannot, in fact, perform that work. Muse, 925 F.2d at 789.
Here, after considering the administrative record, the ALJ made the following determinations:
3. Plaintiff's impairments did not meet or medically equal a listing, in particular one of the musculoskeletal listings of section 1.00.
4. Plaintiff had the residual functional capacity (RFC) to perform medium work except that he could lift and carry 50 pounds occasionally and 25 pounds frequently; stand, walk and sit for 6 hours in an 8 hour workday; and aside from his lifting and carrying restrictions, he could push and pull without limitation.
Due to "postural limitations based on seizure precautions," Plaintiff could occasionally climb ramps, climb stairs, crouch and crawl; never climb ladders, ropes of scaffolds; frequently stoop; and balance and kneel without limitation.
Plaintiff was also instructed to avoid exposure to "hazards," including "machinery and heights."
5. Plaintiff had no past relevant work.
6. Plaintiff was an individual of advanced age (58) on September 6, 2011, the day he filed his application for benefits.
7. Plaintiff had at least a high school education and was able to communicate in English.
8. Because Plaintiff did not have any past relevant work, the transferability of job skills was immaterial.
(Tr. 13-19).
The ALJ found Plaintiff was not disabled under Rule 203.14 of the Medical Vocational Guidelines and that he had the residual functional capacity to perform medium work with certain non-exertional limitations. The ALJ also found that Plaintiff did not alternatively qualify for benefits under the "Worn-Out-Worker" Rule. See 20 C.F.R. 416.962(b). On appeal, Plaintiff claims the ALJ's credibility assessment, and ultimately his RFC finding, are not supported by substantial evidence because the ALJ improperly rejected his alleged pain and limitations. (R. Doc. 12 at 3-5). Plaintiff likewise claims that the ALJ erred in adopting the opinion and RFC assessment of non-examining consultative physician, Maria Pons. (R. Doc. 9 at 10). Finally, Plaintiff claims the ALJ improperly rejected his claim that he qualified for benefits under the Worn-Out-Worker Rule by not applying the correct legal standard and failing to develop the record on this issue. (R. Doc. 9 at 5-7); (R. Doc. 12 at 2-3).
Plaintiff testified that his impairments caused constant and increasing pain; prevented him from lifting more than 20 pounds safely, lifting 5 pounds overheard, or frequently stooping or bending; and required him to alternate between sitting, standing and lying down throughout the day. (Tr. 27, 29, 30, 38, 39, 40). If these limitations were accepted, Plaintiff would be precluded from performing medium work.2 The ALJ, however, found Plaintiff's pain and limitations were not as severe as alleged because: (1) there were minimal medical records, asPlaintiff failed to obtain regular treatment; (2) the medical records that did exist showed normal functioning; and (3) Plaintiff's testimony was inconsistent with his own statements and the medical evidence in the record. (Tr. 17).
Plaintiff first claims his lack of medical treatment was an improper basis for the ALJ to discredit the alleged severity of Plaintiff's symptoms. According to Plaintiff, his lack of medical treatment was justified by his inability to afford and obtain treatment. (Tr. 27-28, 40-41, 157, 180) (Plaintiff claimed he was unable to afford medical treatment, obtain care without a "family doctor," or easily get to Earl K. Long, a local charity hospital.). Nonetheless, Plaintiff suggests the ALJ dismissed his explanation based solely on "unfounded facts regarding plaintiff's social life"— specifically, Plaintiff's consumption of alcohol, tobacco and marijuana. (R. Doc. 12 at 5).
Social Security Ruling 96-7P prevents an ALJ from drawing any inferences "about an individual's symptoms and their functional effects from a failure to seek or pursue regular medical treatment without first considering any explanations that the individual may provide, or other information in the case record, that may explain infrequent or irregular medical visits or failure to seek medical treatment." SSR 96-7P, 1996 WL 374186, at *7 (July...
To continue reading
Request your trial