Westberry v. Comm'r of Soc. Sec. Admin.

• Decision Date: 12 September 2022
• Docket Number: Civil Action 8:21-cv-03543-DCC-JDA
• Parties: Julianne Westberry, Plaintiff, v. Commissioner of Social Security Administration, Defendant.
• Court: U.S. District Court — District of South Carolina

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Julianne Westberry, Plaintiff, v. Commissioner of Social Security Administration, Defendant.

Civil Action No. 8:21-cv-03543-DCC-JDA

United States District Court, D. South Carolina, Anderson/Greenwood Division

September 12, 2022

REPORT AND RECOMMENDATION

Jacquelyn D. Austin United States Magistrate Judge

This matter is before the Court for a Report and Recommendation pursuant to Local Civil Rule 73.02(B)(2)(a), D.S.C., and 28 U.S.C. § 636(b)(1)(B).^[1] Plaintiff brought this action pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3) to obtain judicial review of a final decision of the Commissioner of Social Security (“the Commissioner”), denying Plaintiff's claim for disability insurance benefits (“DIB”) and supplemental security income (“SSI”).^[2]For the reasons set forth below, it is recommended that the decision of the Commissioner be reversed and remanded for administrative action consistent with this recommendation, pursuant to sentence four of 42 U.S.C. § 405(g).

PROCEDURAL HISTORY

In July 2014,^[3] Plaintiff filed applications for DIB and SSI, both alleging a disability onset date of June 19, 2014. [R. 203-13.] The claims were denied initially and upon reconsideration by the Social Security Administration (“the Administration”). [R. 130-134; 140-147]. Plaintiff requested a hearing before an administrative law judge (“ALJ”), and, on January 18, 2017, ALJ Ann G. Paschall conducted a de novo hearing on Plaintiff's claims. [R. 37-63.]

The ALJ issued a decision on March 17, 2017, finding Plaintiff was not disabled under the Social Security Act (“the Act”). [R. 18-31.] Plaintiff filed a request for a review of the ALJ's decision, which was denied by the Appeals Council. [R. 1-7.] Plaintiff commenced an action for judicial review in this Court at case number 8:18-cv-00462-DCC-JDA, and, on May 23, 2019, the Court remanded the case to the Commissioner for further proceedings pursuant to sentence four of 42 U.S.C. § 405(g). [Civil Action No. 8:18-cv-00462-DCC; Docs. 17, 21, 22.] On August 5 2019, pursuant to the Order of the Court, the Appeals Council remanded Plaintiff's case to ALJ Paschall^[4] [R. 764-68], who conducted a second hearing on Plaintiff's claims on February 3, 2020 [R. 663-94].

The ALJ issued a decision on March 31, 2020, finding Plaintiff not disabled under the Act. [R. 639-55.] At Step 1,^[5] the ALJ determined that Plaintiff met the insured status requirements of the Act through June 30, 2020, and had not engaged in substantial gainful activity since June 19, 2014, the alleged onset date. [R. 644, Findings 1 & 2.] At Step 2, the ALJ found Plaintiff had the following severe impairments degenerative joint disease of the bilateral hands, right shoulder impingement syndrome, left shoulder degenerative joint disease and impingement syndrome, right knee degenerative joint disease, left knee effusion, obesity depression, and anxiety. [R. 645, Finding 3.] At Step 3, the ALJ determined that Plaintiff did not have an impairment or combination of impairments that met or medically equaled the severity of an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. [R. 645, Finding 4.]

Before addressing Step 4, Plaintiff's ability to perform her past relevant work, the ALJ found Plaintiff retained the following residual functional capacity (?RFC”):

T]he claimant has the [RFC] to perform light work as defined in 20 CFR. 404.1567(b) and 416.967(b) except she is limited to frequent use of hand controls, bilaterally, frequent handling, fingering, and reaching overhead. She is also limited to no use of ladders; occasional stooping, crouching, and crawling; and no exposure to unprotected heights or dangerous moving machinery. She is limited to the performance of simple, routine tasks, and can perform low stress work with low stress defined as jobs with no team dependent or fast-paced production requirements and involving only simple, work-related decisions; she can tolerate public contact 10% of the workday or less; can tolerate occasional changes in the workplace and/or work methods; and can concentrate on, focus, and attend to work tasks for at least two hours at a time before needing a normal break of 15 minutes or, once per day, a 30-minute meal break.

[R. 647, Finding 5.] Based on this RFC, the ALJ determined at Step 4 that Plaintiff was unable to perform her past relevant work. [R. 653, Finding 6.] However, considering Plaintiff's age, education, work experience, RFC, and the testimony of the vocational expert (“VE”), the ALJ found that there were jobs that existed in significant numbers in the national economy that Plaintiff could perform. [R. 654, Finding 10.] Thus, on that basis, the ALJ determined that Plaintiff had not been under a disability as defined in the Act from June 19, 2014, through the date of the decision. [R. 655, Finding 11.]

Plaintiff requested Appeals Council review of the ALJ's decision but the Council declined review. [R. 633-38.] Plaintiff filed this action for judicial review on October 28, 2021. [Doc. 1.]

THE PARTIES' POSITIONS

Plaintiff argues that this Court should reverse the decision and remand this case for further proceedings. [Doc. 10.] In particular, Plaintiff argues the ALJ failed to properly evaluate two of the medical opinions offered in her case. [Id. at 29-34.]^[6]

The Commissioner, on the other hand, contends that substantial evidence supports the ALJ's decision. [Doc. 11.] The Commissioner argues the ALJ provided “extensive explanation” as to why he gave little weight to the medical opinions Plaintiff identifies in her brief. [Id. at 8-15.]

STANDARD OF REVIEW

The Commissioner's findings of fact are conclusive if supported by substantial evidence. 42 U.S.C. § 405(g). Substantial evidence is more than a scintilla-i.e., the evidence must do more than merely create a suspicion of the existence of a fact and must include such relevant evidence as a reasonable person would accept as adequate to support the conclusion. See Richardson v. Perales, 402 U.S 389, 401 (1971); Laws v. Celebrezze, 368 F.2d 640, 642 (4th Cir. 1966) (“Substantial evidence, it has been held, is evidence which a reasoning mind would accept as sufficient to support a particular conclusion. It consists of more than a mere scintilla of evidence but may be somewhat less than a preponderance. If there is evidence to justify a refusal to direct a verdict were the case before a jury, then there is ‘substantial evidence.'”).

Where conflicting evidence “allows reasonable minds to differ as to whether a claimant is disabled, the responsibility for that decision falls on the [Commissioner] (or the [Commissioner's] designate, the ALJ),” not on the reviewing court. Craig v. Chater, 76 F.3d 585, 589 (4th Cir. 1996); see also Edwards v. Sullivan, 937 F.2d 580, 584 n.3 (11th Cir. 1991) (stating that where the Commissioner's decision is supported by substantial evidence, the court will affirm, even if the reviewer would have reached a contrary result as finder of fact and even if the reviewer finds that the evidence preponderates against the Commissioner's decision). Thus, it is not within the province of a reviewing court to determine the weight of the evidence, nor is it the court's function to substitute its judgment for that of the Commissioner so long as the decision is supported by substantial evidence. See Bird v. Comm'r, 699 F.3d 337, 340 (4th Cir. 2012); Laws, 368 F.2d at 642; Snyder v. Ribicoff, 307 F.2d 518, 520 (4th Cir. 1962).

The reviewing court will reverse the Commissioner's decision on plenary review, however, if the decision applies incorrect law or fails to provide the court with sufficient reasoning to determine that the Commissioner properly applied the law. Myers v. Califano, 611 F.2d 980, 982 (4th Cir. 1980); see also Keeton v. Dep't of Health & Human Servs., 21 F.3d 1064, 1066 (11th Cir. 1994). Where the Commissioner's decision “is in clear disregard of the overwhelming weight of the evidence, Congress has empowered the courts to modify or reverse the [Commissioner's] decision ‘with or without remanding the cause for a rehearing.'” Vitek v. Finch, 438 F.2d 1157, 1158 (4th Cir. 1971) (quoting 42 U.S.C. § 405(g)). Remand is unnecessary where “the record does not contain substantial evidence to support a decision denying coverage under the correct legal standard and when reopening the record for more evidence would serve no purpose.” Breeden v. Weinberger, 493 F.2d 1002, 1012 (4th Cir. 1974).

The court may remand a case to the Commissioner for a rehearing under sentence four or sentence six of 42 U.S.C. § 405(g). Sargent v. Sullivan, 941 F.2d 1207 (4th Cir. 1991) (unpublished table decision). To remand under sentence four, the reviewing court must find either that the Commissioner's decision is not supported by substantial evidence or that the Commissioner incorrectly applied the law relevant to the disability claim. See, e.g., Jackson v Chater, 99 F.3d 1086, 1090-91 (11th Cir. 1996) (holding remand was appropriate where the ALJ failed to develop a full and fair record of the claimant's residual functional capacity); Brenem v. Harris, 621 F.2d 688, 690-91 (5th Cir. 1980) (holding remand was appropriate where record was insufficient to affirm but was also insufficient for court to find the claimant disabled). Where the court cannot discern the basis for the Commissioner's decision, a remand under sentence four is usually the proper course to allow the Commissioner to explain the basis for the decision or for additional investigation. See Radford v. Comm'r, 734 F.3d 288, 295 (4th Cir. 2013);see also Smith v. Heckler, 782 F.2d 1176, 1181-82 (4th Cir. 1986) (remanding case where decision of ALJ contained “a gap in its reasoning” because ALJ did not say he was discounting testimony or why); ...