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Grimes v. Saul

United States District Court, E.D. North Carolina, Western Division

July 26, 2019

ANDREW M. SAUL, Commissioner of Social Security Administration, [1] Defendant.



         This matter is before the court on the parties' cross motions for judgment on the pleadings pursuant to Rule 12(c) of the Federal Rules of Civil Procedure. Tarsha Lashawn Grimes (“Plaintiff”) filed this action pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3) seeking judicial review of the denial of her applications for a period of disability and disability insurance benefits (“DIB”) and supplemental security income (“SSI”). The time for filing responsive briefs has expired, and the pending motions are ripe for adjudication. The court has carefully reviewed the administrative record and the motions and memoranda submitted by the parties. For the reasons set forth below, the undersigned recommends that Plaintiff's Motion for Judgment on the Pleadings [DE #21] be granted, Defendant's Motion for Judgment on the Pleadings [DE #25] be denied, and the case be remanded to the Commissioner pursuant to sentence four of 42 U.S.C. § 405(g) for further proceedings.


         On December 2, 2013, Plaintiff filed applications for DIB and SSI, with an alleged onset date of August 22, 2012. (R. 178-79, 213.) The applications were denied initially and upon reconsideration, and a request for hearing was filed. (R. 178-79, 214-15, 292, 337.) Following an administrative hearing, Administrative Law Judge (“ALJ”) Anne-Marie A. Ofori-Acquaah issued an unfavorable ruling on March 8, 2016. (R. 145-76, 271-80.) On February 6, 2017, the Appeals Council granted Plaintiff's request for review, vacated the hearing decision, and remanded the case to the ALJ to consider Plaintiff's severe impairments and to review new and material medical records. (R. 289-90.) Subsequently, an administrative hearing was held before the ALJ on July 5, 2017, with the ALJ issuing an unfavorable ruling on December 18, 2017. (R. 93-108, 117-44.) Plaintiff now seeks judicial review of the final administrative decision pursuant to 42 U.S.C. §§ 405 and 1383(c)(3).


         I. Standard of Review

         The scope of judicial review of a final agency decision denying disability benefits is limited to determining whether substantial evidence supports the Commissioner's factual findings and whether the decision was reached through the application of the correct legal standards. See Coffman v. Bowen, 829 F.2d 514, 517 (4th Cir. 1987). Substantial evidence is “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion; [i]t consists of more than a mere scintilla of evidence but may be somewhat less than a preponderance.” Craig v. Chater, 76 F.3d 585, 589 (4th Cir. 1996) (quoting Richardson v. Perales, 402 U.S. 389, 401 (1971), and Laws v. Celebrezze, 368 F.2d 640, 642 (4th Cir. 1966)) (citations omitted) (alteration in original). “In reviewing for substantial evidence, [the court should not] undertake to re-weigh conflicting evidence, make credibility determinations, or substitute [its] judgment for that of the [Commissioner].” Mastro v. Apfel, 270 F.3d 171, 176 (4th Cir. 2001) (quoting Craig, 76 F.3d at 589) (first and second alterations in original). Rather, in conducting the “substantial evidence” inquiry, the court determines whether the Commissioner has considered all relevant evidence and sufficiently explained the weight accorded to the evidence. Sterling Smokeless Coal Co. v. Akers, 131 F.3d 438, 439-40 (4th Cir. 1997).

         II. Disability Determination

         In making a disability determination, the Commissioner utilizes a five-step evaluation process. The Commissioner asks, sequentially, whether the claimant: (1) is engaged in substantial gainful activity; (2) has a severe impairment; (3) has an impairment that meets or equals the requirements of an impairment listed in 20 C.F.R. Part 404, Subpart P, App. 1; (4) can perform the requirements of past work; and, if not, (5) based on the claimant's age, work experience, and residual functional capacity can adjust to other work that exists in significant numbers in the national economy. See 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4); Albright v. Comm'r of Soc. Sec. Admin., 174 F.3d 473, 475 n.2 (4th Cir. 1999). The burden of proof and production during the first four steps of the inquiry rests on the claimant. Pass v. Chater, 65 F.3d 1200, 1203 (4th. Cir. 1995). At the fifth step, the burden shifts to the Commissioner to show that other work exists in the national economy that the claimant can perform. Id. In making this determination, the ALJ must decide “whether the claimant is able to perform other work considering both [the claimant's RFC] and [the claimant's] vocational capabilities (age, education, and past work experience) to adjust to a new job.” Hall v. Harris, 658 F.2d 260, 264 (4th Cir. 1981) “If the Commissioner meets [this] burden, the ALJ finds the claimant not disabled and denies the application for benefits.” Mascio v. Colvin, 780 F.3d 632, 634-35 (4th Cir. 2015).

         III. ALJ's Findings

         As a preliminary matter, the ALJ found Plaintiff meets the insured status requirements of the Social Security Act (“the Act”) through December 31, 2017. (R. 95.) Applying the five-step, sequential evaluation process, the ALJ found Plaintiff “not disabled” as defined in the Act. At step one, the ALJ found Plaintiff had not engaged in substantial gainful employment since August 22, 2012, the alleged onset date. (R. 96.) Next, the ALJ determined Plaintiff had the following severe impairments: “fibromyalgia, diabetes mellitus, peripheral neuropathy, essential hypertension, asthma, hidradentis, obesity, degenerative disc disease, right shoulder adhesive capsulitis, and disorder of the muscle, ligament, and fascia.” (Id.) The ALJ found Plaintiff's history of breast cancer, gastroesophageal reflux disease, and anemia to be non-severe impairments as they had either resolved or were medically managed with conservative treatment. (Id.)

         At step three, the ALJ concluded that Plaintiff's impairments were not severe enough, either individually or in combination, to meet or medically equal one of the listed impairments in 20 C.F.R. Part 404, Subpart P, App. 1. (R. 32.) The ALJ analyzed Listings 1.02 (major dysfunction of a joint), 1.04 (spine disorders), 11.14 (peripheral neuropathy), and 12.04 (depressive, bipolar and related disorders). (R. 18.) Although there is no specific listing for fibromyalgia, obesity, diabetes mellitus, and hypertension, the ALJ evaluated the impairment under the listings for other body systems and found that the requirements were not met. (R. 97-98.)

         Prior to proceeding to step four, the ALJ assessed Plaintiff's residual functional capacity (“RFC”) and found that Plaintiff had

the residual functional capacity to perform light work as defined in 20 CFR 404.1567(b) and 416.967(b) except the claimant can lift and/or carry 20 pounds occasionally and 10 pounds frequently. She can sit, stand, and/or walk for 6 hours in an 8-hour workday. Additionally, the claimant can push/pull as much as she can lift/carry. She can also frequently reach overhead to the left and/or right. Moreover, the claimant can handle items frequently with the left and/or right hand, as well as perform occasional fingering with the left and/or right hand. The claimant can climb ramps and stairs frequently, but never climb ladders, ropes, or scaffolds. She can also occasionally balance, stoop, kneel, crouch, and crawl. Furthermore, the claimant can never work at unprotected heights, but can work around moving mechanical ...

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