BILLIE J. WOODS, Plaintiff - Appellant,
NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant-Appellee.
Argued: March 20, 2018
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)
Charlotte W. Hall, CHARLES T. HALL LAW FIRM, P.C., Raleigh,
North Carolina, for Appellant.
Rufino Montenegro, SOCIAL SECURITY ADMINISTRATION, Baltimore,
Maryland, for Appellee.
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.
MOTZ, TRAXLER, and DIAZ, Circuit Judges.
GRIBBON, MOTZ, CIRCUIT JUDGE.
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.
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.
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
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. §
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.
initially denied her application and her petition for
reconsideration. Woods then requested a hearing before an
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.
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 ...