United States District Court, E.D. North Carolina, Eastern Division
TERRENCE W. BOYLE UNITED STATES DISTRICT JUDGE.
matter is before the Court on the parties' cross-motions
for judgment on the pleadings. A hearing on the motions was
held before the undersigned on January 12, 2017, at Elizabeth
City, North Carolina. For the reasons detailed below, this
matter is remanded for further proceedings.
Jose Jones, protectively applied for disability insurance
benefits (DIB) under Title II of the Social Security Act on
August 27, 2013, alleging an onset date of October 13, 2012.
His claim was denied initially and upon reconsideration. A
hearing was held before an Administrative Law Judge (ALJ) on
May 28, 2015, in New Bern, North Carolina at which plaintiff
and his representative appeared in person and at which a
vocational expert appeared by telephone. The ALJ considered
plaintiffs claim de novo and issued an unfavorable
decision on July 16, 2015. The Appeals Council then denied
plaintiffs request for review and the ALJ's decision
became the final decision of the Commissioner. Plaintiff then
timely sought review in this Court.
social security claimant appeals a final decision of the
Commissioner, the Court's review is limited to the
determination of whether, based on the entire administrative
record, there is substantial evidence to support the
Commissioner's findings. 42 U.S.C. § 405(g);
Richardson v. Perales, 402 U.S. 389, 401 (1971).
Substantial evidence is defined as "evidence which a
reasoning mind would accept as sufficient to support a
particular conclusion." Shively v. Heckler, 739
F.2d 987, 989 (4th Cir. 1984) (quoting Laws v.
Celebrezze, 368 F.2d 640, 642 (4th Cir. 1966)). If the
Commissioner's decision is supported by such evidence, it
must be affirmed. Smith v. Chater, 99 F.3d 635, 638
(4th Cir. 1996).
a claimant disabled, an ALJ must conclude that the claimant
satisfies each of five steps. 20 C.F.R. §
404.1520(a)(4). First, a claimant must not be able to work in
a substantial gainful activity. Id. Second, a
claimant must have a severe physical or mental impairment or
combination of impairments. Id. Third, a
claimant's impairment(s) must be of sufficient duration
and must either meet or equal an impairment listed by the
regulations (Listing). Id. Fourth, a claimant must
not have the residual functional capacity (RFC) to meet the
demands of the claimant's past relevant work.
Id. Finally, the claimant must not be able to do any
other work, given the claimant's RFC, age, education, and
work experience. Id. The claimant bears the burden
of proof at steps one through four, but the burden shifts to
the Commissioner at step five. Bowen v. Yuckert, 482
U.S. 137, 146 n.5 (1987).
the ALJ found at step one that plaintiff met the insured
status requirements and had not engaged in substantial
gainful activity since his alleged onset date. Next, the ALJ
determined that plaintiffs osteoarthritis of the left knee
and shoulder, spine disorder of the lumbar spine, anxiety
(post-traumatic stress disorder (PTSD)), and affective
disorder were severe impairments. However, the ALJ found that
none of plaintiff s impairments or combination of impairments
met or equaled a Listing. The ALJ then found that plaintiff
had the RFC to perform medium work with additional exertional
and nonexertional limitations. The ALJ determined that
plaintiff was unable to perform any past relevant work, which
included work as an operator engineer, but found that,
considering plaintiffs age, education, work experience, and
RFC, there were jobs that exist in significant numbers in the
national economy that claimant could perform. These jobs
would include store laborer, automobile detailer, and kitchen
helper. Accordingly, the ALJ found that plaintiff was not
disabled as of the date of his decision.
argues that the ALJ erred by failing to properly consider
plaintiffs Veterans Affairs (VA) disability rating. As a
foundational matter, an ALJ is not bound by a disability
decision by another governmental agency, such as the VA. SSR
06-03p. However, the Fourth Circuit has noted that "both
the VA and Social Security programs serve the same
governmental purpose of providing benefits to persons unable
to work because of a serious disability" and, thus,
"in making a disability determination, the SSA must give
substantial weight to a VA disability rating." Bird
v. Comm 'r of SSA, 699, F.3d 337, 343 (4th Cir.
2012). The ALJ is relieved from this only when "the
record before the ALJ clearly demonstrates that such a
deviation is appropriate." Id.
the ALJ was aware plaintiffs VA disability determination
existed and referred to it in the decision, including that
plaintiff was given 100% disability rating for PTSD and
bipolar disorder. Tr. 22; 418. Despite knowing that the
decision existed, the ALJ gave the VA decision little weight
because the rating decision had not been submitted. Tr. 23.
The ALJ further noted that the VA uses disability criteria
which is "vastly different" from the Social
Security criteria and that, to the extent the VA decision was
based on the same medical evidence before the ALJ, it has
been considered as outlined in the ALJ's decision. Tr.
did not order and review the actual VA disability
determination. While the Court recognizes that the burden is
with the plaintiff in steps one through four of the
disability determination, "the ALJ has a duty to explore
all relevant facts and inquire into the issues necessary for
adequate development of the record, and cannot rely only on
the evidence submitted by the claimant when that evidence is
inadequate." Cook v. Heckler, 783 F.2d 1168,
1173 (4th Cir. 1986). Here, without reviewing the
determination, the ALJ had an insufficient basis for
assigning it little weight, nor could the ALJ determine that
deviation therefrom was appropriate. Additionally, the VA
determination was submitted post-hearing. Accordingly, the
Court finds that remand is appropriate for the ALJ to
consider and weigh the VA determination in accordance with
foregoing reasons, plaintiffs motion for judgment on the
pleadings is GRANTED [DE 12], defendant's motion for
judgment on the pleadings is DENIED [DE 14], and the matter
is REMANDED to the ...