Walters v. Saul

• Decision Date: 12 March 2020
• Docket Number: CASE NO. 1:18-cv-02287-CCC-GBC
• Parties: Steve WALTERS, Plaintiff, v. Andrew SAUL, Commissioner of Social Security, Defendant.
• Court: U.S. District Court — Middle District of Pennsylvania

452 F.Supp.3d 164

Steve WALTERS, Plaintiff,

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

CASE NO. 1:18-cv-02287-CCC-GBC

United States District Court, M.D. Pennsylvania.

Signed March 12, 2020

Stephen J. Hogg, Carlisle, PA, for Plaintiff.

Melissa A. Swauger, Shana Catherine Priore, United States Attorney's Office — Social Security, Harrisburg, PA, for Defendant.

REPORT AND RECOMMENDATION TO GRANT PLAINTIFF'S APPEAL AND TO REVERSE AND REMAND DECISION OF COMMISSIONER

GERALD B. COHN, UNITED STATES MAGISTRATE JUDGE

This matter is before the undersigned United States Magistrate Judge for a report and recommendation. Steve Walters ("Plaintiff") seeks judicial review of the Commissioner of the Social Security Administration's decision finding of not disabled. As set forth below, the undersigned recommends to GRANT Plaintiff's appeal and REVERSE and REMAND the Commissioner's decision in this case.

I. STANDARD OF REVIEW

To receive disability or supplemental security benefits under the Act, a claimant bears the burden to demonstrate an "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." 42 U.S.C. § 423(d)(1)(A) ; accord 42 U.S.C. § 1382c(a)(3)(A). The Act further provides that an individual:

shall be determined to be under a disability only if his physical or mental impairment

or impairments are of such severity that he 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, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work.

42 U.S.C. §§ 423(d)(2)(A), 1382c(a)(3)(B). Plaintiff must demonstrate the physical or mental impairment

"by medically acceptable clinical and laboratory diagnostic techniques." 42 U.S.C. §§ 423(d)(3), 1382c(a)(3)(D).

In cases involving a continuing disability review ("CDR"), entitlement to benefits will be reviewed periodically. 20 C.F.R. §§ 404.1594, 416.994. A claimant is no longer entitled to benefits where the medical condition improves to the extent that the claimant can engage in substantial gainful activity. Id. To determine whether there has been medical improvement, the ALJ must compare the medical severity of the current impairment(s) to the severity of the impairment(s) present at the time of the most favorable medical decision finding the claimant disabled. See 20 C.F.R. §§ 404.1594(b)(7), 416.994(b)(7). If an impairment is one subject to temporary remissions, such will not warrant a finding of medical improvement. 20 C.F.R. §§ 404.1594(c)(3)(iv), 416.994(c)(3)(iv).

The Social Security regulations provide an ALJ with an eight-step inquiry designed to evaluate whether a claimant remains disabled. 20 C.F.R. §§ 404.1594(f), 416.994(f). The claimant bears the burden of proof through the first seven steps. Thus, the claimant must " ‘introduce evidence that his or her condition remains essentially the same as it was at the time of the earlier determination.’ " Hagans v. Commissioner of Soc. Sec., 694 F.3d 287, 308 (3d Cir. 2012), quoting, Early v. Heckler, 743 F.2d 1002, 1007 (3d Cir. 1984). The Commissioner bears the burden at the eighth step to "present evidence that there has been sufficient improvement in the [claimant's] condition to allow the [claimant] to undertake gainful activity." Hagans, 694 F.3d at 308, quoting, Early, 743 F.2d 1002, 1007 (3d Cir. 1984) (internal quotation marks omitted). At step one, the ALJ determines whether the claimant is engaged in substantial gainful activity above the residual functional capacity. If so, then the disability has ended. 20 C.F.R. §§ 404.1594(f)(1), 416.994(f)(1). At step two, the ALJ assesses whether the claimant has an impairment or combination of impairments which meets or equals the severity of an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. If so, then the disability continues. 20 C.F.R. §§ 404.1594(f)(2), 416.994(f)(2). At step three, the ALJ considers whether there has been medical improvement as defined in paragraph (b)(1). 20 C.F.R. §§ 404.1594(f)(3), 416.994(f)(3). The second example for section (b)(1) explains "[a]lthough [the claimant's] impairment is subject to temporary remission and exacerbations, the improvement that has occurred has been sustained long enough to permit a finding of medical improvement." 20 C.F.R. § 404.1594 (b)(1). Section (c)(3)(iv) states that temporary remissions "will not warrant a finding of medical improvement." 20 C.F.R. §§ 404.1594(c)(3)(iv), 416.994(c)(3)(iv). If medical improvement is shown, the analysis continues to step four and if there has been no medical improvement, the it continues to step five. 20 C.F.R. §§ 404.1594(f)(3), 416.994(f)(3). At step four, the ALJ determines whether the medical improvement found in step three relates to the claimant's ability to do work. If so, the analysis continues at step six. If not, the analysis proceeds to step five. 20 C.F.R. §§ 404.1594(f)(4), 416.994(f)(4). At step five, the ALJ considers whether one of two sets of exceptions to medical improvements apply. 20 C.F.R. § 404.1594(f)(5). The first exception provides that claimant should no longer be considered disabled where (1) substantial evidence shows that the claimant is the beneficiary of advances in medical or vocational therapy or technology related to the claimant's ability to work; (2) substantial evidence shows that the claimant has undergone vocational therapy related to the claimant's ability to work; (3) substantial evidence shows that based on new or improved diagnostic or evaluative techniques the claimant's impairments are not as disabling as considered at the time of the most recent favorable decision; (4) substantial evidence demonstrates that any prior disability was in error; or (5) the claimant is currently engaging in substantial gainful activity. 20 C.F.R. §§ 404.1594(d)(1)-(5), 416.994(d)(1)-(5). The second exception applies when: (2) the prior decision was fraudulently obtained; (2) the claimant does not cooperate; (3) the claimant cannot be found; or (4) the claimant fails to follow the prescribed treatment that would be expected to restore ability to engage in substantial gainful activity. If none of the exceptions apply, then the disability benefits continue. 20 C.F.R. §§ 404.1594(e)(1)-(4), 416.994(e)(1)-(4). If, however, one of the first exceptions apply, analysis continues at step six. 20 C.F.R. §§ 404.1594(f)(5), 416.994(f)(5). If one of the second exceptions apply, benefits will end. 20 C.F.R. §§ 404.1594(f)(5), 416.994(f)(5). At step six, the ALJ considers whether the claimant's impairment(s) are severe. 20 C.F.R. § 404.1594(f)(6). If the claimant's "current impairments in combination do not significantly limit [his / her] physical or mental abilities to do basic work activities," then those impairments will be deemed to be "not severe." Id. However, where a significant limitation is found, then the analysis proceeds to the next step. Id. At the seventh step, the ALJ will consider the claimant's current ability to perform past relevant work. 20 C.F.R. § 404.1594(f)(7). An ability to perform past relevant work precludes benefits. If the claimant cannot perform past relevant work, the analysis proceeds to the last step. At step eight, the ALJ evaluates the claimant's ability to perform other work in the national economy, considering the claimant's RFC, age, education and past work experience. 20 C.F.R. § 404.1594(f)(8).

In reviewing a decision of the Commissioner, the Court is limited to determining whether the Commissioner has applied the correct legal standards and whether the decision is supported by substantial evidence. See e.g., 42 U.S.C. § 405(g) ("court shall review only the question of conformity with such regulations and the validity of such regulations"); Johnson v. Commissioner of Social Sec., 529 F.3d 198, 200 (3d Cir. 2008) ; Sanfilippo v. Barnhart, 325 F.3d 391, 393 (3d Cir. 2003) (plenary review of legal questions in social security cases). Substantial evidence "does not mean a large or considerable amount of evidence, but rather ‘such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.’ " Pierce v. Underwood, 487 U.S. 552, 565, 108 S.Ct. 2541, 101 L.Ed.2d 490 (1988) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229, 59 S.Ct. 206, 83 L.Ed. 126 (1938) ); accord Biestek v. Berryhill, ––– U.S. ––––, 139 S. Ct. 1148, 1154, 203 L. Ed. 2d 504 (2019). The Court's review is based on the record, and the Court will "meticulously examine the record as a whole, including anything that may undercut or detract from the ALJ's findings in order to determine if the substantiality test has been met." Id. Substantial evidence is a deferential standard of review. See Jones v. Barnhart, 364 F.3d 501, 503 (3d Cir. 2004). Substantial evidence "does not mean a large or considerable amount of evidence, but rather ‘such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.’ " Pierce v. Underwood, 487 U.S. 552, 565, 108 S.Ct. 2541, 101 L.Ed.2d 490 (1988) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229, 59 S.Ct. 206, 83 L.Ed. 126 (1938) ). Substantial evidence is "less than a preponderance" and "more than a mere scintilla." Jesurum v. Sec'y of U.S. Dep't of Health & Human Servs., 48 F.3d 114, 117 (3d Cir. 1995) (citing Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971) ).

The Court may neither re-weigh the evidence nor substitute its judgment for that of the factfinder. Rutherford v. Barnhart, 399 F.3d 546, 552 (3d Cir. 2005). The Court will not set the...