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

REPORT AND RECOMMENDATION OF MAGISTRATE JUDGE

JACQUELYN D. AUSTIN, UNITED STATES MAGISTRATE JUDGE.

This matter is before the Court for a Report and Recommendation pursuant to Local Rule 73.02(B)(2)(a), D.S.C., and Title 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 claims 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).

2

PROCEDURAL HISTORY

In January 2013, Plaintiff filed applications for DIB and SSI, alleging disability beginning January 8, 2012. [R. 165-79.] The claims were denied initially and on reconsideration by the Social Security Administration (“the Administration”). [R. 71-86, 89-110.] Plaintiff requested a hearing before an administrative law judge (“ALJ”), and on October 8, 2014, ALJ Carl B. Watson conducted a de novo hearing on Plaintiff's claims. [R. 32-67.]

The ALJ issued a decision on November 21, 2014, finding Plaintiff not disabled. [R. 14-31.] Plaintiff requested Appeals Council review of the ALJ's decision, but the Council declined. [R. 1-4.] This Court subsequently reversed the Commissioner's decision and remanded the case for further administrative action. [R. 511-12, 514-49.] O n remand on August 14, 2019, ALJ Watson once again held a hearing. [R. 388-410.] The ALJ then issued a second decision on March 30, 2020, again finding Plaintiff not disabled. [R. 354-86.]

At Step 1, ^[3] the ALJ found Plaintiff met the insured status requirements of the Act through June 30, 2016, and had not engaged in substantial gainful activity since January 8, 2012, the alleged onset date. [R. 360, Findings 1 & 2.] At Step 2, the ALJ found Plaintiff had the following severe impairments: degenerative disc disease, status post hernia repair, status post right knee meniscus tear repair with chondromalacia, low IQ, dyslexia, and depression. [R. 360, Finding 3.] The ALJ also found Plaintiff had non-severe impairments of history of cervical cancer in remission, marijuana abuse, and anxiety. [R. 360.] At Step

3

3, the ALJ found 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. 360, 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”):

[Plaintiff] has the [RFC] to perform less than the full range of light work as defined in 20 CFR 404.1567(b) and 416.967(b) except that she can only occasionally push and pull with the right leg. [S]he cannot climb ladders, ropes, or scaffolds She can occasionally climb ramps and stairs, as well as occasionally kneel, crouch, and crawl. [She] must avoid working at unprotected heights; and she is limited to simple routine, repetitive tasks in an environment where changes are infrequent and are introduced gradually and where she is not required to read at more than a 3^rd grade level

[R. 365, Finding 5 (footnote omitted)^[4].] At Step 4, the ALJ noted Plaintiff had no past relevant work. [R. 376, Finding 6.] However, based on Plaintiff's age, education, work experience, RFC, and the testimony of a vocational expert (“VE”), the ALJ determined that there were jobs that existed in significant numbers in the national economy that Plaintiff could perform. [R. 376, Finding 10.] On this basis, the ALJ found Plaintiff had not been under a disability as defined by the Act from January 8, 2012, through the date of the decision. [R. 377, Finding 11.]

THE PARTIES' POSITIONS

Plaintiff contends the ALJ's decision is not supported by substantial evidence because the ALJ failed to assess the combined effect of her multiple impairments [Doc. 15

4

at 16-18]; he improperly evaluated her subjective complaints [id. at 18-20]; and he improperly discounted the opinion evidence of record [id. at 21-22]. The Commissioner, on the other hand, contends the ALJ's decision is supported by substantial evidence and should be affirmed. [Doc. 16.]

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).

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).

5

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). 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

6

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); Gordon v. Schweiker, 725 F.2d 231, 235 (4th Cir. 1984) (remanding case where neither the ALJ nor the Appeals Council indicated the weight given to relevant evidence). On remand under sentence four, the ALJ should review the case on a complete record, including any new material evidence. See Smith, 782 F.2d at 1182 (“The [Commissioner] and the claimant may produce further evidence on remand.”). After a remand under sentence four, the court enters a final and immediately appealable judgment and then loses jurisdiction. Sargent, 941 F.2d 1207.

In contrast, sentence six provides:

The court may . . . at any time order additional evidence to be taken before the Commissioner of Social Security, but only upon a showing that there is new evidence which is material and that there is good cause for the failure to incorporate such evidence into the record in a prior proceeding

42 U.S.C. § 405(g). A reviewing court may remand a case to the Commissioner on the basis of new evidence only if four prerequisites are met: (1) the evidence is relevant to the determination of disability at the time the application was first filed; (2) the evidence is material to the extent that the Commissioner's decision might reasonably have been different had the new evidence been before him; (3) there is good cause for the claimant's failure to submit the evidence when the claim was before the Commissioner; and (4) the claimant made at...