United States District Court, E.D. North Carolina, Western Division
TERRENCE W. BOYLE CHIEF UNITED STATES DISTRICT JUDGE
cause comes before the Court on cross-motions for judgment on
the pleadings. A hearing was held on the motions before the
undersigned on April 25, 2019, at Edenton, North Carolina.
For the reasons that follow, the decision of the Commissioner
brought this action under 42 U.S.C. §§ 405(g) and
1383(c)(3) for. review of the final decision of the
Commissioner denying his claim for disability insurance
benefits (DIB) and supplemental security income (SSI)
pursuant to Titles II and XVI of the Social Security Act.
Plaintiff applied for DIB on February 12, 2010 alleging an
onset date of July 7, 2009; plaintiff subsequently applied
for SSI and the claims were considered together in the
decision currently on review. After initial denials, an
Administrative Law Judge (ALJ) issued an unfavorable
decision, which was subsequently remanded by the Appeals
Council for further consideration. The ALJ issued a second
decision finding plaintiff not disabled. The ALJ's
decision became the decision of the Commissioner when the
Appeals Council denied plaintiffs request for review, and
plaintiff filed suit in this Court. SeeDixonv.
Colvin, No. 5:14-CV-516-D(E.D.N.C). Defendant requested
a voluntary remand, which the Court allowed, reversing the
Commissioner's decision under sentence four of 42 U.S.C.
§ 405(g) and remanding to the Commissioner for further
proceedings. No. 5:15-CV-516-D (May 19, 2015 E.D.N.C).
remand, a new hearing was held before an ALJ,  who again issued
an unfavorable ruling. The Appeals Council denied plaintiffs
request for review, and plaintiff timely sought review of the
Commissioner's decision in this Court.
the Social Security Act, 42 U.S.C. §§ 405(g), and
1383(c)(3), this Court's review of the Commissioner's
decision is limited to determining whether the decision, as a
whole, is supported by substantial evidence and whether the
Commissioner employed the correct legal standard.
Richardson v. Perales, 402 U.S. 389, 401 (1971).
Substantial evidence is "suchrelevant evidence as a
reasonable mind might accept as adequate to support a
conclusion." Johnson v. Barnhart, 434 F.3d 650,
653 (4th Cir. 2005) (per curiam) (internal quotation and
individual is considered disabled if he is unable "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
[twelve] months." 42 U.S.C. § l382c(a)(3)(A). The
Act further provides that an individual "shall be
determined to be under a disability only if his physical or
mental impairment or impairments are of such severity that he
is not only unable to do his previous work but cannot,
considering his age, education, and work experience, engage
in any other line of substantial gainful work which exists in
the national economy." 42 U.S.C. § l382c(a)(3)(B).
issued by the Commissioner establish a five-step sequential
evaluation process to be followed in a disability case. 20
C.F.R. §§ 404.1520(a)(4), 416.920(a)(4). The
claimant bears the burden of proof at steps one through four,
but the burden shifts to the Commissioner at step five.
See Bowen v. Yuckert, 482 U.S. 137, 146 n.5 (1987).
If a decision regarding disability can be made at any step of
the process the inquiry ceases. See 20 C.F.R.
§§ 404.1520(a)(4), 416.920(a)(4).
one, if the Social Security Administration determines that
the claimant is currently engaged in substantial gainful
activity, the claim is denied. If not, then step two asks
whether the claimant has a severe impairment or combination
of impairments. If the claimant has a severe impairment, it
is compared at step three to those in the Listing of
Impairments ("Listing") in 20 C.F.R. Pt. 404,
Subpt. P, App. 1. If the claimant's impairment meets or
medically equals a Listing, disability is conclusively
presumed. If not, at step four, the claimant's residual
functional capacity (RFC) is assessed to determine if the
claimant can perform his past relevant work. If so, the claim
is denied. If the claimant cannot perform past relevant work,
then the burden shifts to the Commissioner at step five to
show that the claimant, based on his age, education, work
experience, and RFC, can perform other substantial gainful
work. If the claimant cannot perform other work, then he is
found to be disabled. See 20 C.F.R. §
step one, the ALJ found tnat plaintiff met the insured status
requirements through r September 30, 2012, and that
he had not engaged in substantial gainful activity since his
alleged onset date. The ALJ found plaintiffs degenerative
disc disorder of the lumbar and cervical spine,
post-laminectomy syndrome, lumbosacral neuritis/radiculitis,
sacroiliitis, headaches/migraines, chronic pain syndrome,
coronary artery disease, hypertension, anxiety disorder,
major depressive disorder, and panic attacks to be severe
impairments at step two, but found that plaintiff did not
have an impairment or combination of impairments which met or
equaled a Listing at step three. The ALJ found that plaintiff
could perform a reduced range of sedentary work with a number
of exertional and nonexertional limitations. The ALJ found
that plaintiff could not return to his past relevant work as
a construction worker or deliverer but that, considering
plaintiffs age, education, work experience, and RFC,
plaintiff could perform jobs which existed in significant
numbers in the national economy, specifically surveillance
system monitor and sorter. Thus, the ALJ found that plaintiff
was not disabled from July 7, 2009, through the date of his
decision. Tr. 1809-1827.
was determined to be disabled by the North Carolina
Department of Health and Human Services (NCDHHS) and thus
qualified for Medicaid on October 13, 2011. The NCDHHS found
that plaintiffs ability to work at all exertional levels was
compromised due to his need to alternate between sitting and
standing, determining that the range of work plaintiff might
perform was so narrowed by his limitations that a finding of
disabled was appropriate. Tr. 1824-25; Tr. 388. The ALJ gave
the NCDHHS opinion limited weight, finding it not completely
consistent with the overall record evidence.
disability determination by the NCDHHS (or other state
Medicaid agency) is generally entitled to substantial weight,
and an ALJ must adequately justify a decision to deviate from
that agency's determination. Woods v. Berryhill,
888 F.3d 686, 693 (4th Cir. 2018). Here, the ALJ's
cursory explanation that the NCDHHS decision was not
completely consistent with the record evidence was
insufficient and would normally require remand. However, the
record and the posture of the case support a determination
that the plaintiff is disabled and that remand for a fourth
¶ ALJ decision is unwarranted.
of less than sedentary work, particularly where, as here,
there are twelve categories of additional limitations
imposed, "reflects very serious limitations" and
"is expected to be relatively rare." SSR 96-9p. In
formulating plaintiffs restrictive RFC, the ALJ discounted
the opinions of plaintiffs treating pain management
physician, Dr. Idrissi. Dr. Idrissi opined that plaintiff
would be unable to work a full-time work schedule at any
level of exertion. See e.g., Tr. 1781; 1073. This
opinion was based on, inter alia, plaintiff s need
to alternate between sitting and standing at will, with the
need to walk every five minutes as well as the need for
unscheduled breaks. Tr. 1779. Although ...