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Doll v. Saul

United States District Court, W.D. North Carolina, Asheville Division

November 8, 2019

RACHEL DOLL, Plaintiff,
ANDREW M. SAUL, Commissioner of Social Security, Defendant.



         THIS MATTER is before the Court on the parties' opposing Motions for Summary Judgment. (Doc. Nos. 9, 10). The matter is ripe for review. Having carefully considered such motions and reviewed the pleadings, the court enters the following findings, conclusions, and Order.


         I. Administrative History

         Plaintiff brought this action, under 42 U.S.C. §§ 405(g) and 1383(c)(3), for review of defendant's final administrative decision denying her January 9, 2015, applications for a period of disability and disability insurance benefits (DIB) and supplemental security income (SSI) under Titles II & XVI of the Social Security Act (“the Act”).

         Plaintiff's DIB and SSI applications originally alleged disability onset of January 18, 2014, but were later amended at the hearing to June 1, 2014. (Tr. 11). The applications were denied initially on May 19, 2015, and, upon reconsideration, on September 3, 2015. (Id.). Plaintiff timely requested an administrative hearing, which was held on August 3, 2017. (Tr.107-145). An Administrative Law Judge (“ALJ”) decision denying benefits was made on January 18, 2018. (Tr. 11-28).

         Plaintiff's insured status for DIB benefits expired on December 31, 2019. (Tr. 14, Finding 1). Plaintiff appealed to defendant's Appeals Council (AC), which, on February 13, 2019, denied Plaintiff's request for review, thereby causing the ALJ's decision to become the "final decision" of the Commissioner. (Tr. 1-6). Plaintiff submitted additional medical evidence to the AC, but the evidence was not exhibited, because it was not relevant to the time period in question and/or did not show a reasonably probability it would change the outcome of the decision. (Tr. 2). Plaintiff now seeks judicial review of this decision pursuant to 42 U.S.C. § 405(g).

         II. Factual Background

         It appearing that the ALJ's findings of fact are supported by substantial evidence, the Court adopts and incorporates such findings herein as if fully set forth. Such findings are referenced in the substantive discussion which follows.

         III. Standard of Review

         The only issues on review are whether the Commissioner applied the correct legal standards and whether the Commissioner's decision is supported by substantial evidence. Richardson v. Perales, 402 U.S. 389, 390 (1971); Hays v. Sullivan, 907 F.2d 1453, 1456 (4th Cir. 1990). Review by a federal court is not de novo, Smith v. Schwieker, 795 F.2d 343, 345 (4th Cir. 1986); rather, inquiry is limited to whether there was “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Perales, 402 U.S. at 401 (internal citations omitted). Even if the Court were to find that a preponderance of the evidence weighed against the Commissioner's decision, the Commissioner's decision would have to be affirmed if it was supported by substantial evidence. Hays, 907 F.2d at 1456. The Fourth Circuit has explained substantial evidence review as follows:

the district court reviews the record to ensure that the ALJ's factual findings are supported by substantial evidence and that its legal findings are free of error. If the reviewing court decides that the ALJ's decision is not supported by substantial evidence, it may affirm, modify, or reverse the ALJ's ruling with or without remanding the cause for a rehearing. A necessary predicate to engaging in substantial evidence review is a record of the basis for the ALJ's ruling. The record should include a discussion of which evidence the ALJ found credible and why, and specific application of the pertinent legal requirements to the record evidence. If the reviewing court has no way of evaluating the basis for the ALJ's decision, then the proper course, except in rare circumstances, is to remand to the agency for additional investigation or explanation.

Radford v. Colvin, 734 F.3d 288, 295 (4th Cir. 2013) (internal citations and quotations omitted).

         I. Substantial Evidence

         A. Introduction

         The Court has read the transcript of Plaintiff's administrative hearing, closely read the decision of the ALJ, and reviewed the relevant exhibits contained in the extensive administrative record. The issue is not whether a court might have reached a different conclusion had it been presented with the same testimony and evidentiary materials, but whether the decision of the administrative law judge is supported by substantial evidence. For the following reasons, the Court finds that the ALJ's decision was supported by substantial evidence.

         B. Sequential Evaluation

         The Act defines “disability” as an 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)(2). To qualify for DIB under Title II of the Act, 42 U.S.C. §§ 416(i) and 423, an individual must meet the insured status requirements of these sections, be under retirement age, file an application for disability insurance benefits and a period of disability, and be under a “disability” as defined in the Act.

         Here, Plaintiff's date last insured (DLI) for DIB was December 31, 2019. (Tr. 14, Finding

         1). Therefore, she would have to prove she became disabled on or before the DLI.

         A five-step process, known as “sequential” review, is used by the Commissioner in determining whether a Social Security claimant is disabled. The Commissioner evaluates a disability claim pursuant to the following five-step analysis:

a. An individual who is working and engaging in substantial gainful activity will not be found to be “disabled” ...

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