Ricci v. Apfel

• Decision Date: 30 March 2001
• Docket Number: No. CIV. A. 00-2253.,CIV. A. 00-2253.
• Citation: 159 F.Supp.2d 12
• Parties: Ronald D. RICCI v. Kenneth S. APFEL, Commissioner of the Social Security Administration.
• Court: U.S. District Court — Eastern District of Pennsylvania

159 F.Supp.2d 12

Ronald D. RICCI v. Kenneth S. APFEL, Commissioner of the Social Security Administration.

No. CIV. A. 00-2253.

United States District Court, E.D. Pennsylvania.

March 30, 2001.

COPYRIGHT MATERIAL OMITTED

Robert Morris Cohen, Wyncote, PA, for Plaintiff.

Rafael Melendez, William B. Reeser, Office of Gen. Counsel, Philadelphia, PA, for Defendant.

MEMORANDUM AND ORDER

BECHTLE, District Judge.

Presently before the court are plaintiff Ronald D. Ricci's ("Plaintiff") and defendant Kenneth S. Apfel, Commissioner of the Social Security Administration's ("Commissioner") cross-motions for summary judgment, and the Report and Recommendation of United States Magistrate Judge Carol Sandra Moore Wells ("Magistrate Judge"). For the reasons set forth below, the court will grant the Commissioner's motion for summary judgment, and deny Plaintiff's motion.

I. BACKGROUND

This is a judicial review of the Commissioner's final decision denying Plaintiff's claim for Adult Child's Disability Insurance Benefits ("Disabled Child's Benefits") under Title II of the Social Security Act, 42 U.S.C. §§ 401-433 (the "Act"). At issue is whether substantial evidence supports the Commissioner's decision that Plaintiff was not disabled, as defined by the Act, prior to his twenty-second birthday. 20 C.F.R. 404.350(a).

Ronald D. Ricci was born on November 11, 1955. (R. 64.) On June 9, 1973, he graduated from St. Joseph's Preparatory School. (R. 165.) Plaintiff then completed three semesters at St. Joseph's University, withdrawing on September 2, 1975. (R. 166.) After leaving college, Plaintiff lived with his brother in Colorado for six months before returning to Pennsylvania. (R. 145.) Plaintiff returned to St. Joseph's University in 1984 and continued on a part-time basis through the summer of 1988. (R. 166-68.) Plaintiff has minimal work experience. Since 1974 or 1975, he has worked an hour or two each day in his mother's grocery store. (R. 84, 86 & 91.)

In November 1994, Plaintiff applied for, and was found eligible to receive, Supplemental Security Income ("SSI"). (R. 29; Pl.'s Mem. of Law in Supp. of Mot. for Summ. J. at 1.)

On November 6, 1995, Plaintiff applied for Disabled Child's Benefits under the Social Security Act based on his deceased father's employment record. (R. 64.) Plaintiff alleged that he was disabled since 1973.¹ (R. 80.) Plaintiff asserts that he suffers from schizophrenia, sacroilitis, and Crohn's disease. (R. 80.) However, the record shows that although Plaintiff is currently treated for other impairments, the only impairment that he alleges to have an onset date before 1977 is schizophrenia. See, e.g., Compl. ¶ 6; Pl.'s Mem. of Law in Supp. of Mot. for Summ. J. at 1 (stating that "[t]he thrust of the claim i[s] that the schizophrenia was disabling prior to claimant's 22nd birthday"); R. 146-47 (alleging onset of Crohn's disease in 1982).

Plaintiff's claim was denied initially and upon reconsideration. (R. 14, 67-69 & 72-73.) On April 6, 1998, an Administrative Law Judge ("ALJ") held a hearing on the claim. (R. 39-63.) Plaintiff attended the hearing. (R. 41.) He was accompanied by his attorney and by his brother, Lawrence R. Ricci, M.D., who testified on his behalf. Id.

On June 23, 1998, the ALJ determined that Plaintiff did not have a medically-determinable impairment that began prior to his twenty-second birthday. (R. 14-20.) On March 2, 2000, the Appeals Council declined Plaintiff's request to review the ALJ's decision. (R. 2-3.) Thus, the ALJ's decision became the final decision of the Commissioner. Plaintiff commenced this civil action challenging the ALJ's decision on May 2, 2000, and the parties filed cross motions for summary judgment.² The undersigned referred the matter to the Magistrate Judge for a report and recommendation pursuant to 28 U.S.C. § 636(b)(1)(B).

II. LEGAL STANDARD

Judicial review of administrative decisions is limited. The court may not reweigh the evidence. The court determines only whether the Commissioner's decision is supported by substantial evidence. Monsour Med. Ctr. v. Heckler, 806 F.2d 1185, 1190-91 (3d Cir.1986) (citations omitted). Findings of fact made by an ALJ must be accepted as conclusive, provided that they are supported by substantial evidence. 42 U.S.C. § 405(g). Substantial evidence is "more than a mere scintilla." Monsour, 806 F.2d at 1190-91. It is "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Kangas v. Bowen, 823 F.2d 775, 777 (3d Cir.1987). Substantial evidence is "something less than the weight of the evidence, and the possibility of drawing two inconsistent conclusions from the evidence does not prevent an administrative agency's finding from being supported by substantial evidence." Consolo v. Federal Mar. Comm'n, 383 U.S. 607, 620, 86 S.Ct. 1018, 16 L.Ed.2d 131 (1966); Campbell v. Callahan, 57 Soc. Sec. Rep. Ser. 198 (available at 1998 WL 388374, at *2) (D.N.J.1998). In reviewing the ALJ decision, the court "need[s] from the ALJ not only an expression of the evidence s/he considered which supports the result, but also some indication of the evidence which was rejected." Cotter v. Harris, 642 F.2d 700, 705 (3d Cir.1981).

III. DISCUSSION

At issue in this case is whether substantial evidence supports the Commissioner's final decision that Plaintiff was not disabled, as defined by the Act, before November 11, 1977, his twenty-second birthday. 20 C.F.R. 404.350(a).³ The Commissioner contends that summary judgment should be granted in his favor because substantial evidence supports the ALJ's decision. Plaintiff contends that the ALJ erred in rejecting the testimony of several of Plaintiff's witnesses. Plaintiff also asserts that the ALJ erred by not consulting a medical advisor pursuant to Social Security Ruling 83-20, Titles II and XVI: Onset of Disability, 1983 WL 31249 (S.S.A.1983) ("SSR 83-20") to determine the onset date of Plaintiff's schizophrenia. (Pl.'s Mot. for Summ. J. ¶ 2(g).) In her Report and Recommendation dated March 15, 2001, the Magistrate Judge recommended that the matter be remanded so that the ALJ could employ a medical expert.⁴

Upon reviewing the record, the court finds that the Commissioner's decision that Plaintiff was not under a disability as defined in the Act by his twenty-second birthday is supported by substantial evidence. Further, as the medical evidence is not ambiguous, SSR 83-20 does not mandate a remand.

To receive disability insurance benefits, a claimant must show that 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.... [The impairment must be so severe that the claimant] is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy.

42 U.S.C. §§ 423(d)(1)(A) & (d)(2)(A); 20 C.F.R. § 404.1505(a).

An ALJ considering a claim for disability insurance benefits undertakes the five-step sequential evaluation set forth in 20 C.F.R. § 404.1520. Under Step One, if the claimant is working and the work constitutes substantial gainful activity, the ALJ must find that the claimant is not disabled regardless of medical condition, age, education or work experience. 20 C.F.R. § 404.1520(b). Under Step Two, the ALJ determines whether the claimant has a severe impairment which significantly limits his or her physical or mental ability to do basic work activity. Id. § 404.1520(c). Under Step Three, the ALJ must determine whether the claimant's impairment meets or equals the criteria for a listed impairment as set forth in 20 C.F.R. pt. 404, subpt. 4, Appendix 1. Id. § 404.1520(d). Under Step Four, if the ALJ finds that the claimant retains the residual functional capacity to perform past relevant work, the claimant will not be found to be disabled. Id. § 404.1520(e). Under Step Five, other factors, including the claimant's residual functional capacity, age, education and past work experience must be considered to determine if the claimant can perform other work in the national economy. Id. § 404.1520(f).

Plaintiff's claim was denied at Step Two because the ALJ concluded that Plaintiff was not disabled, as defined by the Act, before his twenty-second birthday. (R. 19-20.)

In order to receive Disabled Child's Benefits, Plaintiff must not only prove the existence of a disabling medical impairment, but must also establish that his impairment was of disabling severity prior to the expiration of his insured status. See, e.g., Walton v. Halter, 243 F.3d 703, 705 (3d Cir.2001) (citing 20 C.F.R. § 404.350); Brown v. Chater, 64 F.3d 669 (table) (available at 1995 WL 490275, at *2) (10th Cir. Aug. 16, 1995) (citations omitted); U.S. v. Thomas, No.94-6242, 1995 WL 722548, at *2 (E.D.Pa. Dec.4, 1995) (citations omitted); Martin v. Shalala, 927 F.Supp. 536, 540-41 (D.N.H.1995) (citing Deblois v. Sec'y of Health and Human Servs., 686 F.2d 76, 79 (1st Cir.1982)). Thus, Plaintiff must prove that he became disabled on or before November 11, 1977.

"Disability is not determined by the presence of impairments, but by the effect the impairments have on the individual's ability to perform substantial gainful activity." Thomas, 1995 WL 722548, at *5 (citing Moyer v. Shalala, 828 F.Supp. 354, 358 (E.D.Pa.1993) & Capoferri v. Harris, 501 F.Supp. 32, 36 (E.D.Pa.1980) aff'd 649 F.2d 858 (3d Cir.1981)); Brown, 1995 WL 490275, at *2 (stating that "presence of a condition or ailment, without accompanying evidence that the condition results in some functional limitation on the ability to do basic work activity, is insufficient to establish a disability"); Martin, 927 F.Supp. at 541 (stating that "it is insufficient for the claimant to...