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Walton v. Berryhill

United States District Court, S.D. Indiana, Indianapolis Division

March 22, 2017

STEVEN M. WALTON, Plaintiff,
NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.

          Denise K. LaRue United States Magistrate Judge


         Plaintiff Steven M. Walton applied for disability benefits under the Social Security Act. The defendant Commissioner of Social Security denied his applications and Mr. Walton filed this suit for judicial review of those denials. The parties have briefed their positions and the matter is ready for decision. Upon the parties' consents, the assigned district judge referred this Cause to this magistrate judge to conduct all proceedings and to order entry of a final judgment. Notice, Consent, and Reference of a Civil Action to a Magistrate Judge [doc. 15]. This Entry explains the Court's reasons for ordering the separate judgment.


         Judicial review of the Commissioner's factual findings is deferential: courts must affirm if her findings are supported by substantial evidence in the record. 42 U.S.C. § 405(g); Skarbek v. Barnhart, 390 F.3d 500, 503 (7th Cir. 2004); Gudgel v. Barnhart, 345 F.3d 467, 470 (7th Cir. 2003). Substantial evidence is more than a scintilla, but less than a preponderance, of the evidence. Wood v. Thompson, 246 F.3d 1026, 1029 (7th Cir. 2001). If the evidence is sufficient for a reasonable person to conclude that it adequately supports the Commissioner's decision, then it is substantial evidence. Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971); Carradine v. Barnhart, 360 F.3d 751, 758 (7th Cir. 2004). This limited scope of judicial review derives from the principle that Congress has designated the Commissioner, not the courts, to make disability determinations:

In reviewing the decision of the ALJ [administrative law judge], we cannot engage in our own analysis of whether [the claimant] is severely impaired as defined by the SSA regulations. Nor may we reweigh evidence, resolve conflicts in the record, decide questions of credibility, or, in general, substitute our own judgment for that of the Commissioner. Our task is limited to determining whether the ALJ's factual findings are supported by substantial evidence.

Young v. Barnhart, 362 F.3d 995, 1001 (7th Cir. 2004). Carradine, 360 F.3d at 758. While review of the Commissioner's factual findings is deferential, review of her legal conclusions is de novo. Jones v. Astrue, 623 F.3d 1155, 1160 (7th Cir. 2010).

         The Social Security Act defines disability as the “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); 20 C.F.R. § 404.1505(a). 42 U.S.C. § 1382c(a)(3)(A); 20 C.F.R. § 416.905(a). A person will be determined to be disabled only if his 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 kind of substantial gainful work which exists in the national economy, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work.” 42 U.S.C. §§ 423(d)(2)(A) and 1382c(a)(3)(B). 20 C.F.R. §§ 404.1505, 404.1566, 416.905, and 416.966. The combined effect of all of an applicant's impairments shall be considered throughout the disability determination process. 42 U.S.C. §§ 423(d)(2)(B) and 1382c(a)(3)(G). 20 C.F.R. §§ 404.1523 and 416.923.

         The Social Security Administration has implemented these statutory standards in part by prescribing a “five-step sequential evaluation process” for determining disability. If disability status can be determined at any step in the sequence, an application will not be reviewed further. At the first step, if the applicant is currently engaged in substantial gainful activity, then he is not disabled. At the second step, if the applicant's impairments are not severe, then he is not disabled. A severe impairment is one that “significantly limits [a claimant's] physical or mental ability to do basic work activities.” Third, if the applicant's impairments, either singly or in combination, meet or medically equal the criteria of any of the conditions included in the Listing of Impairments, 20 C.F.R. Pt. 404, Subpt. P, Appendix 1, Part A, then the applicant is deemed disabled. The Listing of Impairments are medical conditions defined by criteria that the Social Security Administration has pre-determined are disabling. 20 C.F.R. ' 404.1525. If the applicant's impairments do not satisfy the criteria of a listing, then her residual functional capacity (“RFC”) will be determined for the purposes of the next two steps. RFC is an applicant's ability to do work on a regular and continuing basis despite his impairment-related physical and mental limitations and is categorized as sedentary, light, medium, or heavy, together with any additional non-exertional restrictions. At the fourth step, if the applicant has the RFC to perform his past relevant work, then he is not disabled. Fifth, considering the applicant's age, work experience, and education (which are not considered at step four), and his RFC, the Commissioner determines if he can perform any other work that exists in significant numbers in the national economy. 42 U.S.C. § 416.920(a)

         The burden rests on the applicant to prove satisfaction of steps one through four. The burden then shifts to the Commissioner at step five to establish that there are jobs that the applicant can perform in the national economy. Young v. Barnhart, 362 F.3d 995, 1000 (7th Cir. 2004). If an applicant has only exertional limitations that allow her to perform the full range of work at her assigned RFC level, then the Medical-Vocational Guidelines, 20 C.F.R. Part 404, Subpart P, Appendix 2 (the “grids”), may be used at step five to arrive at a disability determination. The grids are tables that correlate an applicant's age, work experience, education, and RFC with predetermined findings of disabled or not-disabled. If an applicant has non-exertional limitations or exertional limitations that limit the full range of employment opportunities at his assigned work level, then the grids may not be used to determine disability at that level. Instead, a vocational expert must testify regarding the numbers of jobs existing in the economy for a person with the applicant's particular vocational and medical characteristics. Lee v. Sullivan, 988 F.2d 789, 793 (7th Cir. 1993). The grids result, however, may be used as an advisory guideline in such cases.

         An application for benefits, together with any evidence submitted by the applicant and obtained by the agency, undergoes initial review by a state-agency disability examiner and a physician or other medical specialist. If the application is denied, the applicant may request reconsideration review, which is conducted by different disability and medical experts. If denied again, the applicant may request a hearing before an administrative law judge (“ALJ”).[1] An applicant who is dissatisfied with the decision of the ALJ may request the SSA's Appeals Council to review the decision. If the Appeals Council either affirms or declines to review the decision, then the applicant may file an action in district court for judicial review. 42 U.S.C. § 405(g). If the Appeals Council declines to review a decision, then the decision of the ALJ becomes the final decision of the Commissioner for judicial review.

         As they relate to this case, disability benefits are available through three programs under the Social Security Act. Disability-insurance benefits (“DIB”) are available to individuals who have become “insured” by working forty quarters and paying Social Security taxes. Supplemental-security income disability benefits (“SSI”) are available to individuals based on financial need. Finally, an unmarried dependent child over the age of eighteen years is entitled to receive child's disability insurance benefits based on the earnings record of an insured parent who is entitled to disability benefits if the child has a disability that began before he became twenty-two years old. 42 U.S.C. § 402(d)(1); 20 C.F.R. § 404.350.


         Mr. Walton's claims have taken a circuitous route to this point. On September 14, 2007 (protective filing date of August 24, 2007), [2] he filed two applications: one for DIB, based on his own earnings record, and one for SSI benefits. (R. 235, 241.) On January 7, 2008, he filed a third application, this one for child's insurance disability benefits based on his parents' earnings records. (R. 392.)[3] For his DIB claim, Mr. Walton declared an onset-of-disability date of December 30 or 31, 1990. (R. 241, 309, 342.) For his SSI claim, he declared on onset date of January 1, 1987. (R. 235.) Because his child-disability application is not in the record, the onset date that it might have contained is unknown. However, as noted above, eligibility for child benefits requires that the child's disability began before his twenty-second birthday. Mr. Walton became twenty-two years old on May 12, 1984.

         During the first hearing before an ALJ on his claims, Mr. Walton amended his onset date for his claims to January 10, 2008, and he and his counsel signed a motion to that effect. (R. 105-06, 274.) That date was chosen because it was the date of the first diagnosis in the record (as it was constituted at the time) by an acceptable medical source ― a psychiatrist or psychologist ― of a serious mental impairment[4] and because, at the time, earlier records of similar diagnoses rendered in the mid-1980s, when Mr. Walton was incarcerated, could not be obtained and were believed destroyed. (R. 103-13, 125-28.) The ALJ indicated that, if the missing prison medical records were found and submitted before she issued her decision, then she would consider them and not hold Mr. Walton to his amended date of onset and, if the records were submitted after her decision was issued, then he could appeal (presumably to the Appeals Council). (R. 107.) Apparently, Mr. Walton did not submit additional medical records before the ALJ issued her decision.

         The ALJ issued her decision on February 25, 2010. Initially, she dismissed Mr. Walton's DIB and child-disability claims because the amended onset date of January 10, 2008 rendered both claims moot: that date was long after both May 12, 1984, Mr. Walton's twenty-second birthday, and March 31, 1998, the last day that he was insured for DIB. (R. 145.) Proceeding on only Mr. Walton's claim for SSI benefits, the ALJ found, at step two of the sequential evaluation process, that Mr. Walton has the severe impairments of type II diabetes, obesity, and schizoaffective disorder, bipolar type. At step three, she found that his impairments meet the criteria of listing 12.03 (schizophrenic, paranoid, and other psychotic disorders). (R. 147.) She found that the paragraph A severity criteria of the listing are satisfied because Mr. Walton has medically documented persistence, either continuous or intermittent, of delusions or hallucinations and she found that the criteria of paragraph B are satisfied because his impairments result in marked restrictions in activities of daily living and marked difficulties in maintaining social functioning. Because the listing criteria are satisfied, she found that Mr. Walton was disabled on his amended onset date of January 10, 2008. (R. 148.)

         On April 28, 2010, about two months after the ALJ's decision was issued, Mr. Walton submitted a request to the ALJ to reopen the hearing and a request for the Appeals Council to review the ALJ's decision. (R. 215, 217.) His letter to the ALJ and his letter accompanying his request for review explained that, after the hearing, he obtained his prison psychiatric records for the period from November 1986 to November 1987, (R. 554-71), [5] and that these records proved that he met or equaled the criteria for listing 12.05C (“mental retardation, ” then; “intellectual disability, ” now) before his date last insured for DIB, on his own record, March 31, 1998. (R. 215, 218.)

         In both of his letters, Mr. Walton specifically described three of the prison medical records. First, the report of a psychiatrist's evaluation of Mr. Walton on November 7, 1986 noted that, in 1984 (no further identification of the date), Mr. Walton's IQ was tested at the Reception Diagnostic Center[6] and measured sixty-six, with a reading level at grade 3.5 and a math level at grade 2.3 grade. (R. 570.) The psychiatrist diagnosed him with acute paranoid disorder and mild mental retardation, prescribed Thorazine (which Mr. Walton refused), and recommended an emergency transfer to a psychology unit at another facility for treatment. (R. 570-71.) Mr. Walton was transferred the same day. Second, in the report of his psychological evaluation of Mr. Walton on November 18 and 19, 1986, a clinical psychologist at the transferee psychology unit diagnosed Mr. Walton with paranoid personality disorder and found it possible that he would decompensate into paranoid disorder and likely that he would reintegrate into anti-social personality. (R. 559.) Third, in the report of his mental-status evaluation of Mr. Walton before his release, a facility clinical psychologist wrote that Mr. Walton “seems at times to be borderline delusional in his relationship with others and at the very least confused about them.” (R. 555.) This psychologist found that Mr. Walton's attention span was impaired, he ...

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