Nelson v. Saul

• Decision Date: 20 September 2019
• Docket Number: No. 2:18-CV-63 RLW,2:18-CV-63 RLW
• Citation: 413 F.Supp.3d 886
• Court: U.S. District Court — Eastern District of Missouri
• Parties: Talia S. NELSON, Plaintiff, v. Andrew M. SAUL, Commissioner of Social Security, Defendant.

413 F.Supp.3d 886

Talia S. NELSON, Plaintiff,

v.Andrew M. SAUL,¹ Commissioner of Social Security, Defendant.

No. 2:18-CV-63 RLW

United States District Court, E.D. Missouri, Northern Division.

Signed September 20, 2019

Vicki A. Dempsey, Dempsey and Dempsey, Hannibal, MO, for Plaintiff.

Nicholas P. Llewellyn, Office of U.S. Attorney, St. Louis, MO, for Defendant.

MEMORANDUM AND ORDER

RONNIE L. WHITE, UNITED STATES DISTRICT JUDGE

This is an action under 42 U.S.C. § 1383(c)(3) for judicial review of the Commissioner of Social Security's final decision denying plaintiff Talia S. Nelson's application for Supplemental Security Income ("SSI") under Title XVI of the Social Security Act ("the Act"). Because the Appeals Council denied Plaintiff's Request for Review, the decision by the Administrative Law Judge ("ALJ") is the final decision of the Commissioner. For the reasons set forth below, the Court reverses the decision of the Commissioner.

I. Procedural History

Plaintiff protectively filed an application for SSI on July 29, 2015. In the application, she alleged disability beginning August 24, 2007. Record ("R.") at 143. Plaintiff's claims were denied on October 1, 2015. R. 15. Plaintiff timely filed a request for a hearing before an ALJ on October 26, 2015. Id. On March 20, 2017, plaintiff moved to amend her alleged onset date to July 29, 2015. R. 159. On March 29, 2017, plaintiff testified at a hearing before the ALJ. R. 6. In a decision dated October 19, 2017, the ALJ concluded plaintiff was under a disability but also concluded that a substance use disorder was a contributing factor material to the determination of disability and determined that plaintiff was not disabled under the Act at any time from the date the application was filed through the date of decision. R. 15-26. On May 25, 2018, the Appeals Council denied plaintiff's request for review. R. 1-3. Accordingly, the Appeals Council found that plaintiff's reasons did not provide a basis for changing the ALJ's decision. R. 1. As a result, the ALJ's decision stands as the final decision of the Commissioner.

II. Legal Standard

A claimant for social security disability benefits must demonstrate that he or she suffers from a physical or mental disability

. The Social Security Act defines disability "as the inability to do 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." 20 C.F.R. § 404.1505(a).

Under the Social Security Act, the Commissioner has established a five-step process for determining whether a person is disabled. 20 C.F.R. §§ 416.920, 404.1520. "If a claimant fails to meet the criteria at any step in the evaluation of disability, the process ends and the claimant is determined to be not disabled." Goff v. Barnhart, 421 F.3d 785, 790 (8th Cir. 2005) (quoting Eichelberger v. Barnhart 390 F.3d 584, 590-91 (8th Cir. 2004) ). In this sequential analysis, the claimant first cannot be engaged in "substantial gainful activity" to qualify for disability benefits. 20 C.F.R. §§ 416.920(b), 404.1520(b). Second, the claimant must have a severe impairment. 20 C.F.R. §§ 416.920(c), 404.1520(c). The Social Security Act defines "severe impairment" as "any impairment or combination of impairments which significantly limits [claimant's] physical or mental ability to do basic work activities...." Id. " ‘The sequential evaluation process may be terminated at step two only when the claimant's impairment or combination of impairments would have no more than a minimal impact on [his or] her ability to work.’ " Page v. Astrue, 484 F.3d 1040, 1043 (8th Cir. 2007) (quoting Caviness v. Massanari, 250 F.3d 603, 605 (8th Cir. 2001) ).

Third, the ALJ must determine whether the claimant has an impairment which meets or equals one of the impairments listed in the Regulations. 20 C.F.R. §§ 416.920(d), 404.1520(d). If the claimant has one of, or the medical equivalent of, these impairments, then the claimant is per se disabled without consideration of the claimant's age, education, or work history. Id.

Fourth, the impairment must prevent the claimant from doing past relevant work. 20 C.F.R. §§ 416.920(f), 404.1520(f). The burden rests with the claimant at this fourth step to establish his or her Residual Functional Capacity ("RFC"). Steed v. Astrue, 524 F.3d 872, 874 n.3 (8th Cir. 2008) ("Through step four of this analysis, the claimant has the burden of showing that she is disabled."). The ALJ will review a claimant's RFC and the physical and mental demands of the work the claimant has done in the past. 20 C.F.R. § 404.1520(f).

Fifth, the severe impairment must prevent the claimant from doing any other work. 20 C.F.R. §§ 416.920(g), 404.1520(g). At this fifth step of the sequential analysis, the Commissioner has the burden of production to show evidence of other jobs in the national economy that can be performed by a person with the claimant's RFC. Steed, 524 F.3d at 874 n.3. If the claimant meets these standards, the ALJ will find the claimant to be disabled. "The ultimate burden of persuasion to prove disability, however, remains with the claimant." Young v. Apfel, 221 F.3d 1065, 1069 n.5 (8th Cir. 2000). See also Harris v. Barnhart, 356 F.3d 926, 931 n.2 (8th Cir. 2004) (citing 68 Fed. Reg. 51153, 51155 (Aug. 26, 2003) ); Stormo v. Barnhart, 377 F.3d 801, 806 (8th Cir. 2004) ("The burden of persuasion to prove disability and to demonstrate RFC remains on the claimant, even when the burden of production shifts to the Commissioner at step five."). Even if a court finds there is a preponderance of the evidence against the ALJ's decision, the decision must be affirmed if it is supported by substantial evidence. Clark v. Heckler, 733 F.2d 65, 68 (8th Cir. 1984). "Substantial evidence is less than a preponderance but is enough that a reasonable mind would find it adequate to support the Commissioner's conclusion." Krogmeier v. Barnhart, 294 F.3d 1019, 1022 (8th Cir. 2002). See also Cox v. Astrue, 495 F.3d 614, 617 (8th Cir. 2007).

It is not the district court's role to re-weigh the evidence or review the factual record de novo. Cox, 495 F.3d at 617. Instead, the district court must determine whether the quantity and quality of evidence is such that a reasonable mind might find it adequate to support the ALJ's conclusion. Davis v. Apfel, 239 F.3d 962, 966 (8th Cir. 2001) (citing McKinney v. Apfel, 228 F.3d 860, 863 (8th Cir. 2000) ). Weighing the evidence is a function for the ALJ, who is the fact-finder. Masterson v. Barnhart, 363 F.3d 731, 736 (8th Cir. 2004). Thus, an administrative decision that is supported by substantial evidence is not subject to reversal because substantial evidence may also support an opposite conclusion or because the reviewing court would have decided differently. Krogmeier, 294 F.3d at 1022.

To determine whether the Commissioner's final decision is supported by substantial evidence, the court must review the administrative record as a whole and consider:

(1) Findings of credibility made by the ALJ;

(2) The education, background, work history, and age of the claimant;

(3) The medical evidence given by the claimant's treating physicians;

(4) The subjective complaints of pain and description of the claimant's physical activity and impairment;

(5) The corroboration by third parties of the claimant's physical impairment;

(6) The testimony of vocational experts based upon proper hypothetical questions which fairly set forth the claimant's physical impairment; and

(7) The testimony of consulting physicians.

Brand v. Sec'y of Dep't of Health, Educ. & Welfare, 623 F.2d 523, 527 (8th Cir. 1980).

Additional analysis is necessary when an ALJ finds that a claimant is disabled but there is medical evidence of substance abuse or alcoholism in the record. 20 C.F.R. § 416.935(a). Where there is such evidence, the ALJ is required to determine if the substance abuse is a material contributing factor to the claimant's disability, with the "key factor" in the analysis being whether the ALJ "would still find [the claimant] disabled if [she] stopped using drugs or alcohol." 20 C.F.R. § 416.935(b)(1). The ALJ must determine which of the claimant's disabling limitations, physical or mental, would remain if the claimant stopped using substances or alcohol, and then determine whether any or all of the remaining limitations would be disabling. 20 C.F.R. § 416.935(b)(2). If the ALJ finds a claimant's remaining limitations would not be disabling, the substance abuse is a material contributing factor to the claimant's disability and the ALJ must conclude the claimant is not disabled. 42 U.S.C. § 1382c(a)(3)(J) ; 20 C.F.R. § 416.935(b)(2)(i). In contrast, if the ALJ finds the remaining limitations would be disabling by themselves, the substance abuse is not material and the ALJ must conclude the claimant is disabled. 20 C.F.R. § 416.935(b)(2)(ii).

III. Administrative Decision

In the decision in this case, the ALJ found at step one that plaintiff had not engaged in substantial gainful activity since July 29, 2015, the application date. R. 18; see 20 C.F.R. § 416.971. At step two, the ALJ found that plaintiff had severe impairments of mental disorders variously diagnosed as a major depressive disorder

, a panic disorder, a borderline personality disorder, a post-traumatic stress disorder, and a poly substance abuse disorder. The ALJ found plaintiff's psoriasis was non-severe, and her migraine headaches were not a medically determinable impairment due to a lack of objective evidence. R. 18; see 20 C.F.R. § 416.920(c). At step three, the ALJ determined that plaintiff's impairments including the substance use disorder met the medical criteria of section 12.04, presumptively disabling impairments listed in 20 C.F.R. Part 404, Subpart P, Appendix 1 (the "Listings"). R.18; see 20 C.F.R § 416.920(d). The ALJ found that...