Goins v. Saul

MELISSA L. GOINS PLAINTIFF v. ANDREW SAUL,¹ Commissioner ofthe Social Security Administration DEFENDANT

CIVIL ACTION NO. 19-117-DLB

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF KENTUCKY CENTRAL DIVISION AT LEXINGTON

March 18, 2020

MEMORANDUM OPINION AND ORDER** ** ** ** **

Plaintiff brought this action pursuant to 42 U.S.C. § 405(g) to obtain judicial review of an administrative decision of the Commissioner of Social Security. The Court, having reviewed the record and the parties' dispositive motions, and for the reasons set forth herein, will affirm the Commissioner's decision.

I. FACTUAL AND PROCEDURAL BACKGROUND

On October 30, 2012, Plaintiff Melissa L. Goins filed for a period of disability and Disability Insurance Benefits ("DIB") under Title II, and Supplemental Security Income ("SSI") under Title XVI, alleging disability beginning on December 8, 2008. (Tr. 87). That application was denied initially on March 6, 2013 and was also denied upon reconsideration on June 20, 2013. Id. At Plaintiff's request, an administrative hearing was conducted, id., and on February 18, 2015, Administrative Law Judge ("ALJ") GregHolsclaw, found that Goins was not entitled to benefits.² Id. at 87-102. On April 13, 2015, Plaintiff filed a new application only seeking SSI, in which she alleged disability beginning January 1, 2009. Id. at 17. This application was also initially denied, and then denied again on reconsideration. Id. At Plaintiff's request, an administrative hearing was conducted on December 7, 2017 before ALJ Roger L. Reynolds. Id. at 17, 27. On May 2, 2018, ALJ Reynolds ruled that Goins was not disabled and, therefore, not entitled to benefits.³ Id. at 17-27. This decision became the final decision of the Commissioner on February 11, 2019 when the Appeals Council denied Plaintiff's request for review. Id. at 1-4.

Plaintiff filed the instant action on March 26, 2019, requesting judicial review of the Commissioner's 2018 ALJ decision. (Doc. # 1). The matter has culminated in cross-Motions for Summary Judgment, which are now ripe for adjudication. (Docs. # 14, 15 and 17).

II. DISCUSSION

A. Standard of Review

Judicial review of the Commissioner's decision is restricted to determining whether it is supported by substantial evidence and was made pursuant to proper legal standards. See Colvin v. Barnhart, 475 F.3d 727, 729 (6th Cir. 2007). "Substantial evidence" is defined as "more than a scintilla of evidence but less than a preponderance; it is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Cutlip v. Sec'y of Health & Human Servs., 25 F.3d 284, 286 (6th Cir. 1994).Courts are not to conduct a de novo review, resolve conflicts in the evidence, or make credibility determinations. Id. Rather, the Court must affirm the Commissioner's decision as long as it is supported by substantial evidence, even if the Court might have decided the case differently. Her v. Comm'r of Soc. Sec., 203 F.3d 388, 389-90 (6th Cir. 1999). If supported by substantial evidence, the Commissioner's findings must be affirmed, regardless of whether there is evidence favoring Plaintiff's side. Listenbee v. Sec'y of Health & Human Servs., 846 F.2d 345, 349 (6th Cir. 1988). Similarly, an administrative decision is not subject to reversal merely because substantial evidence would have supported the opposite conclusion. Smith v. Chater, 99 F.3d 780, 781-82 (6th Cir. 1996).

When a claimant files an application for benefits under the same title of the Social Security Act as a previously determined application, the principal of res judicata places limits on the evidence that an ALJ can review when evaluating the second application. In Drummond v. Comm'r of Soc. Sec., 126 F.3d 837 (6th Cir. 1997), the Sixth Circuit established that both claimants and the Commissioner are "bound by the principles of res judicata." Drummond, 126 F.3d at 841-42. According to Drummond, "[w]hen the Commissioner has made a final decision concerning a claimant's entitlement to benefits, the Commissioner is bound by this determination absent changed circumstances." Id. at 842 (citations omitted).

The Sixth Circuit, however, recently clarified that courts have overread Drummond. See Earley v. Comm'r of Soc. Sec., 893 F.3d 929, 934 (6th Cir. 2018). The Circuit explained that res judicata only applies if an applicant files a subsequent application for the same period of disability. Id. at 933 ("[R]es judicata only 'foreclose[s] successive litigation of the very same claim.'" (second alteration in original) (quoting New Hampshirev. Maine, 532 U.S. 742, 749 (2001))); see also id. ("If an individual . . . files a second application for the same period of time finally rejected by the first application and offers no cognizable explanation for revisiting the first decision, res judicata would bar the second application."). Drummond's holding was based on the "principles of res judicata . . . [f]inality, efficiency, and the consistent treatment of like cases." Id. (emphasis added) (citing Drummond, 126 F.3d at 841-43). "Drummond was never intended to preclude an ALJ 'from giving a fresh look to a new application containing new evidence . . . that covers a new period of disability.'" Warren v. Saul, No. 6:18-cv-225-HRW, 2019 WL 3253964, at *2 (E.D. Ky. July 19, 2019) (alteration in original) (quoting Earley, 893 F.3d at 931). It was also not supposed to prevent an ALJ from only "revisiting [an] earlier finding . . . [when the claimant] offered new and material evidence of a changed condition." Id. (first alteration in original) (quoting Earley, 893 F.3d at 931). However, "it is fair for an administrative law judge to take the view that, absent new and additional evidence, the first administrative law judge's findings are a legitimate, albeit not binding, consideration in reviewing a second application." Earley, 893 F.3d at 933.

Thus, under the guidance of Earley, when an ALJ encounters a successive application from the same applicant that covers a new period of disability, the ALJ "honors [the res judicata principles] by considering what an earlier judge found with respect to a later application and by considering that earlier record." Earley, 893 F.3d at 933 (citing Drummond, 126 F.3d at 842; Albright v. Comm'r of Soc. Sec., 174 F.3d 473, 478 (4th Cir. 1999)). In other words, the subsequent ALJ should make determinations based on a "fresh look" at the "new evidence . . . while being mindful of past rulings and the record in prior proceedings." Earley, 893 F.3d at 931. A fresh look requires the ALJ to considerthe new evidence and make his or her own determinations about a claimant's limitations. See, e.g., Sadler v. Comm'r of Soc. Sec., No. 18-11689, 2019 WL 4892419, at *6 (E.D. Mich. Aug. 16, 2019), adopted by Sadler v. Saul, No. 18-11689, 2019 WL 462703 (E.D. Mich. Sept. 24, 2019) (The ALJ gave a fresh look at the evidence when he "reviewed the new evidence thoroughly to make his own determination at step two" which included adding two new severe impairments not included in the prior ALJ's decision; he also gave a fresh look by "review[ing] treatment records dating back to 2009, and thoroughly discuss[ing] the medical evidence from just before the first ALJ's determination through 2017, well after the date last insured . . . to determine plaintiff's RFC."); Cornett v. Berryhill, 6:18-cv-044-JMH, 2019 WL 691776, at *3 n.2 (E.D. Ky. Feb. 19, 2019) ("[H]ere, the ALJ determined that new evidence provided for different findings than those previously made. Thus, the ALJ's decision here does not run afoul of Earley." (internal citation omitted)).

B. The ALJ's Determination

To determine disability, the ALJ conducts a five-step analysis. Step One considers whether the claimant has engaged in substantial gainful activity; Step Two, whether any of the claimant's impairments, alone or in combination, are "severe"; Step Three, whether the impairments meet or equal a listing in the Listing of Impairments; Step Four, whether the claimant can still perform her past relevant work; and Step Five, whether a significant number of other jobs exist in the national economy that the claimant can perform. Walters v. Comm'r of Soc. Sec., 127 F.3d 525, 529 (6th Cir. 1997) (citing 20 C.F.R. § 404.1520). The burden of proof rests with the claimant on Steps One through Four. Jones v. Comm'r of Soc. Sec., 336 F.3d 469, 474 (6th Cir. 2003). As to the last step, the burden of proofshifts to the Commissioner to identify "jobs in the economy that accommodate the claimant's residual functional capacity." Id. The ALJ's determination becomes the final decision of the Commissioner if the Appeals Council denies review, as it did in this case. See Thacker v. Berryhill, No. 7:16-cv-114, 2017 WL 653546, at *1 (E.D. Ky. Feb. 16, 2017); (Tr. 1-4).

Here, the ALJ applied Drummond,⁴ 126 F.3d 837, and the five-step sequential evaluation process to conclude that Goins is not disabled; the ALJ found that the record contained no new or material evidence as to the unadjudicated period that justified altering the findings from the 2015 ALJ decision. See (Tr. 17-27). At Step One, the ALJ found that Goins has not engaged in substantial gainful activity since April 13, 2015, the date of her application. Id. at 20. At Step Two, the ALJ determined that Goins has the following severe impairments:

insulin dependent diabetes mellitus[;] hypothyroidism[;] cervical and lumbar spine degenerative disc disease with disc protrusions at C3-4 and L2-3, status post lumbar laminectomy; COPD with continued nicotine abuse; alcohol and marijuana/"serenity" abuse, allegedly in remission; history of seizures vs[.] TIA vs. migraine headaches; status post left rotator cuff repair; history of shingles of the left eye; obesity; major depressive disorder; generalized anxiety disorder with PTSD features; paranoid schizophrenia, rule out substance induced mood disorder; angina; mild hearing loss; and hypertension.

Id. At...