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Barbara J. v. Saul

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

August 15, 2019

BARBARA J., [1] Plaintiff,
ANDREW M. SAUL, Commissioner of the Social Security Administration, Defendant.



         Plaintiff Barbara J. applied for disability insurance benefits (“DIB”) from the Social Security Administration (“SSA”) on June 29, 2015, alleging an onset date of June 14, 2013. [Filing No. 8-2 at 16.] Her application was initially denied on September 1, 2015, [Filing No. 8-4 at 7], and upon reconsideration on October 20, 2015, [Filing No. 8-4 at 17]. Administrative Law Judge Victoria A. Ferrer (the “ALJ”) conducted a hearing on December 1, 2017. [Filing No. 8-2 at 35-83.] The ALJ issued a decision on March 14, 2018, [Filing No. 8-2 at 13], concluding that Barbara J. was not entitled to receive DIB, [Filing No. 8-2 at 28.] The Appeals Council denied review on September 13, 2018. [Filing No. 8-2 at 2.] On November 2, 2018, Barbara J. timely filed this civil action asking the Court to review the denial of benefits according to 42 U.S.C. §§ 405(g) and 1383(c). [Filing No. 1.]


         “The Social Security Act authorizes payment of disability insurance benefits … to individuals with disabilities.” Barnhart v. Walton, 535 U.S. 212, 214 (2002). “The statutory definition of ‘disability' has two parts. First, it requires a certain kind of inability, namely, an inability to engage in any substantial gainful activity. Second, it requires an impairment, namely, a physical or mental impairment, which provides reason for the inability. The statute adds that the impairment must be one that has lasted or can be expected to last … not less than 12 months.” Id. at 217.

         When an applicant appeals an adverse benefits decision, this Court's role is limited to ensuring that the ALJ applied the correct legal standards and that substantial evidence exists for the ALJ's decision. Barnett v. Barnhart, 381 F.3d 664, 668 (7th Cir. 2004) (citation omitted). For the purpose of judicial review, “[s]ubstantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Id. (quotation omitted). Because the ALJ “is in the best position to determine the credibility of witnesses, ” Craft v. Astrue, 539 F.3d 668, 678 (7th Cir. 2008), this Court must accord the ALJ's credibility determination “considerable deference, ” overturning it only if it is “patently wrong.” Prochaska v. Barnhart, 454 F.3d 731, 738 (7th Cir. 2006) (quotations omitted).

         The ALJ must apply the five-step inquiry set forth in 20 C.F.R. § 404.1520(a)(4)(i)-(v), evaluating the following, in sequence:

(1) whether the claimant is currently [un]employed; (2) whether the claimant has a severe impairment; (3) whether the claimant's impairment meets or equals one of the impairments listed by the [Commissioner]; (4) whether the claimant can perform her past work; and (5) whether the claimant is capable of performing work in the national economy.

Clifford v. Apfel, 227 F.3d 863, 868 (7th Cir. 2000) (citations omitted) (alterations in original). “If a claimant satisfies steps one, two, and three, she will automatically be found disabled. If a claimant satisfies steps one and two, but not three, then she must satisfy step four. Once step four is satisfied, the burden shifts to the SSA to establish that the claimant is capable of performing work in the national economy.” Knight v. Chater, 55 F.3d 309, 313 (7th Cir. 1995).

         After Step Three, but before Step Four, the ALJ must determine a claimant's residual functional capacity (“RFC”) by evaluating “all limitations that arise from medically determinable impairments, even those that are not severe.” Villano v. Astrue, 556 F.3d 558, 563 (7th Cir. 2009). In doing so, the ALJ “may not dismiss a line of evidence contrary to the ruling.” Id. The ALJ uses the RFC at Step Four to determine whether the claimant can perform her own past relevant work and if not, at Step Five to determine whether the claimant can perform other work. See20 C.F.R. § 404.1520(iv), (v). The burden of proof is on the claimant for Steps One through Four; only at Step Five does the burden shift to the Commissioner. See Clifford, 227 F.3d at 868.

         If the ALJ committed no legal error and substantial evidence exists to support the ALJ's decision, the Court must affirm the denial of benefits. Barnett, 381 F.3d at 668. When an ALJ's decision is not supported by substantial evidence, a remand for further proceedings is typically the appropriate remedy. Briscoe ex rel. Taylor v. Barnhart, 425 F.3d 345, 355 (7th Cir. 2005). An award of benefits “is appropriate only where all factual issues have been resolved and the record can yield but one supportable conclusion.” Id. (citation omitted).


         Barbara J. was 53 years of age at the time she alleged her disability began. [Filing No. 8-5 at 2.] She has completed one year of college with specialized training as a medical assistant and previously worked as a bus driver, cook, gate worker, and meat wrapper. [Filing No. 8-6 at 22.][2]

         The ALJ followed the five-step sequential evaluation set forth by the Social Security Administration in 20 C.F.R. § 404.1520(a)(4) and ultimately concluded that Barbara J. was not disabled. Specifically, the ALJ found as follows:

• Barbara J. last met the insured status requirements of the Social Security Act on June 30, 2014 (the date last insured or “DLI”).[3] [Filing No. 8-2 at 19.]
• At Step One, she had not engaged in substantial gainful activity[4] since June 14, 2013, the alleged onset date. [Filing No. 8-2 at 19.]
• At Step Two, Barbara J. “had the following severe impairments: Asthma/COPD; Right Knee Degenerative Joint Disease; Right Rotator Cuff Tear.” [Filing No. 8-2 at 19 (citation omitted).]
• At Step Three, she did not have an impairment or combination of impairments that met or medically equaled the severity of one of the listed impairments. [Filing No. 8-2 at 21.]
• After Step Three but before Step Four, Barbara J. had the RFC “to perform medium work as defined in 20 CFR 404.1567(c) except: [t]he claimant could frequently stoop; [t]he claimant should avoid concentrated exposure to pulmonary irritants.” [Filing No. 8-2 at 21.]
• At Step Four, relying on the testimony of the vocational expert (“VE”) considering Barbara J.'s RFC, she was capable of performing her past relevant work as a gate guard, short order cook, and hand packager. [Filing No. 8-2 at 27-28.]


         Barbara J. asserts that the ALJ erred in the following respects: (1) the ALJ's RFC finding was not supported by substantial evidence and included a unilateral rejection of the disabling opinions of both state agency consultants and Barbara J.'s treating physician; and (2) the ALJ's subjective symptom evaluation was patently wrong. The Court will address the issues as necessary to resolve the appeal.

         A. Supplemental Security Income

         The Court begins by addressing a procedural issue concerning Barbara J.'s application for supplemental security income (“SSI”). The administrative record before the Court indicates that at the time of her DIB application on June 29, 2015, Barbara J. also filed an application for SSI. [Filing No. 8-5 at 11.] The SSI application was described as “abbreviated, ” [Filing No. 8-5 at 10], and Barbara J. reported significant spousal income that was ongoing at the time of the application, [Filing No. 8-5 at 17]. The SSA's initial and reconsideration notices referred only to Barbara J.'s claim for DIB. [Filing No. 8-4 at 7; Filing No. 8-4 at 17.] Likewise, the SSA's internal determination transmittal forms referred only to her claim for DIB. [Filing No. 8-3 at 10; Filing No. 8-3 at 20.] Furthermore, the disability determination explanation forms only reference a claim for DIB. [Filing No. 8-3 at 2; Filing No. 8-3 at 11.] However, the corresponding state agency consultant reviews contained in those explanations ambiguously reflected a “current evaluation” of Barbara J.'s RFC with the initial determination, [Filing No. 8-3 at 5], despite the fact Barbara J.'s DLI had expired more than a year before the determination, [see Filing No. 8-3 at 7 (initial review dated August 12, 2015); see also Filing No. 8-5 at 43 (certified earnings record indicating a “06/14” DLI, referring to June 30, 2014)], and then an RFC assessment limited to the period ending with Barbara J.'s DLI along with the reconsideration determination, [Filing No. 8-3 at 15]. On November 5, 2015, Barbara J. appealed the reconsideration determination by requesting a hearing. [Filing No. 8-2 at 88.] The hearing notice sent to Barbara J. explained that the hearing concerned a June 29, 2015, application for DIB, as well as a November 5, 2015, application for SSI. [Filing No. 8-4 at 68.]

         During the hearing, the ALJ stated that the SSI application “wasn't filed until April 27, 2017.” [Filing No. 8-2 at 36.] She explained that because there was no overlapping period covering the SSI application and the DIB claim-with an expired DLI on June 30, 2014-and there had not been an initial determination by the SSA with the SSI claim, she was going to “return the SSI application” and the hearing would only concern the DIB application. [Filing No. 8-2 at 35-37; see20 C.F.R. § 416.335 (SSI is not compensable before the application date); see also supra note 3 (Barbara J.'s DLI is June 30, 2014).] Likewise, the ALJ's written decision addressed the SSI issue and reiterated what she had explained during the hearing, that the separate claims did not share a common issue. [Filing No. 8-2 at 16.] Accordingly, the ALJ explained that the SSI claim was “being remanded to the state agency for an initial determination, as was explained to the claimant and her representative during the hearing.” [Filing No. 8-2 at 16.]

         Barbara J. asserts along with her judicial review appeal that “such a remand never happened and the Title XVI application [for SSI] was sent along with the ALJ's unfavorable decision to the Appeals Council for Review.” [Filing No. 14 at 19.] Barbara J. attached a screenshot of her attorney's firm's case management system indicating that on April 17, 2018, a staff member for her attorney's firm spoke with an employee of the SSA and was informed that no claim was currently being reviewed by the disability determination service for an initial determination and both claims were currently with the Appeals Council. [See Filing No. 14-1.] Barbara J. contends that “[b]ecause the Appeals Council elected not to review the disposition, the ALJ's unfavorable decision should serve as the final disposition on both Plaintiff's Title II [for DIB] and Title XVI claims.” [Filing No. 14 at 19.] Based on her conclusion that the ALJ's decision ...

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