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Woods v. Berryhill

United States Court of Appeals, Fourth Circuit

April 26, 2018

BILLIE J. WOODS, Plaintiff - Appellant,
v.
NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant-Appellee.

          Argued: March 20, 2018

          Appeal from the United States District Court for the Western District of North Carolina, at Asheville. Max O. Cogburn, Jr., District Judge. (1:16-cv-00058-MOC-DLH)

         ARGUED:

          Charlotte W. Hall, CHARLES T. HALL LAW FIRM, P.C., Raleigh, North Carolina, for Appellant.

          Leo Rufino Montenegro, SOCIAL SECURITY ADMINISTRATION, Baltimore, Maryland, for Appellee.

         ON BRIEF:

          Leah F. Golshani, Special Assistant United States Attorney, SOCIAL SECURITY ADMINISTRATION, Baltimore, Maryland; Jill Westmoreland Rose, United States Attorney, Gill Beck, Assistant United States Attorney, OFFICE OF THE UNITED STATES ATTORNEY, Charlotte, North Carolina, for Appellee.

          Before MOTZ, TRAXLER, and DIAZ, Circuit Judges.

          DIANA GRIBBON, MOTZ, CIRCUIT JUDGE.

         Billie Jean Woods appeals the Social Security Administration's denial of her application for disability insurance benefits. Because we conclude that the Administrative Law Judge erred by not according adequate weight to a prior disability determination by the North Carolina Department of Health and Human Services, we vacate and remand.

         I.

         Before turning to the facts of this case, we set forth the framework that an Administrative Law Judge ("ALJ") must use to determine a claimant's eligibility for Social Security disability insurance benefits.

         "Disability" means "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). To determine whether an individual is disabled, ALJs use the "five-step sequential evaluation process" outlined in the Social Security Administration's ("SSA") regulations. 20 C.F.R. § 404.1520(a)(4). "[T]he ALJ asks at step one whether the claimant has been working; at step two, whether the claimant's medical impairments meet the regulations' severity and duration requirements; at step three, whether the medical impairments meet or equal an impairment listed in the regulations . . . ." Mascio v. Colvin, 780 F.3d 632, 634 (4th Cir. 2015); see 20 C.F.R. § 404.1520(a)(4). If the ALJ cannot make a conclusive determination at the end of the third step, the ALJ must then determine the claimant's residual function capacity, meaning the most a claimant can still do despite "all of the claimant's medically determinable impairments of which the ALJ is aware, including those not labeled severe at step two." Mascio, 780 F.3d at 635 (brackets and internal quotation marks omitted); see 20 C.F.R. §§ 404.1520(a)(4); 404.1545(a). Only once the ALJ has identified the claimant's "functional limitations or restrictions" and assessed the claimant's "work-related abilities on a function-by-function basis" may the ALJ express the claimant's residual function capacity "in terms of the exertional levels of work, sedentary, light, medium, heavy, and very heavy." SSR 96-8p, 61 Fed. Reg. 34, 474, 34, 475 (July 2, 1996); see 20 C.F.R. § 404.1567 (defining exertional levels).

         After the ALJ determines the claimant's residual function capacity, the ALJ proceeds to step four, where the claimant must show that she cannot perform her past work. 20 C.F.R. § 404.1520(a)(4). If the claimant makes that showing, the burden shifts to the SSA to prove at step five that the claimant is capable of performing other work, in light of her residual function capacity, age, education, and work experience, that "exists in significant numbers in the national economy." Id. §§ 404.1560(c); 404.1520(c). If the SSA satisfies that burden, the ALJ will find the claimant not disabled and deny her application for benefits. See id. § 404.1520(a)(4).

         II.

         A.

         In the years leading up to her alleged disability onset date, Woods held various production and manufacturing jobs that required her to lift up to 50 pounds and to walk, stand, and crouch for seven hours or more per day. In 2010, Woods began exhibiting symptoms consistent with inflammatory arthritis, osteoarthritis, and fibromyalgia. She also began complaining of persistent pain that limited her ability to perform her job. Her symptoms progressed over the next three years, and in April 2013, Woods stopped working. The next month, Woods applied for Social Security disability insurance benefits.

         The SSA initially denied her application and her petition for reconsideration. Woods then requested a hearing before an ALJ.

         Before the ALJ, Woods presented medical records from Dr. Aasheim (her primary care physician), Dr. de Wit (her rheumatologist through January 2013), and a prior decision by the North Carolina Department of Health and Human Services ("NCDHHS") that found that Woods was disabled and entitled to Medicaid benefits. The ALJ also reviewed the opinions of Drs. Burgess and Pardoll, who conducted consultative examinations at NCDHHS's request, and Dr. Clayton, the state agency medical consultant who reviewed Woods's medical record but did not treat or examine her in person. In addition, Woods submitted disability questionnaires and testified before the ALJ.

         We briefly summarize the relevant evidence from each source.

• Beginning in 2010, Drs. de Wit and Aasheim documented various symptoms consistent with inflammatory arthritis, osteoarthritis, and fibromyalgia. In early 2013, both doctors concluded that because of her condition, Woods "should not do heavy manual labor" as required by her current job. In November 2013, Dr. Aasheim concluded that Woods could occasionally lift up to ten pounds but frequently could not lift any weight, she could stand one of eight hours, could sit one of ...

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