United States District Court, S.D. West Virginia, Huntington
L. Tinsley, United States Magistrate Judge.
before this Court is Plaintiff's Brief in Support of
Judgment On the Pleadings (ECF No. 11) and Defendant's
Brief in Support of Defendant's Decision (ECF No. 14).
This is an action seeking review of the final decision of the
Commissioner of Social Security denying the Plaintiff's
application for Disability Insurance Benefits (DIB) under
Title II and Supplemental Security Income (SSI) under Title
XVI of the Social Security Act.
Teresa Lynn Stearns, filed applications for DIB and SSI on
January 18, 2013. Claimant alleged disability beginning May
1, 2009. The applications were denied initially on June 6,
2013, and upon reconsideration on October 9, 2013. Claimant
filed a request for hearing on November 20. 2013. A video
hearing was held on February 4, 2015. Claimant appeared in
Huntington, West Virginia, and the Administrative Law Judge
presided over the hearing from St. Louis, Missouri. The
Administrative Law Judge (ALJ) denied Claimant's
applications on February 9, 2015 (Tr. at 9-19). The Appeals
Council denied Claimant's request for review on May 24,
2016 (Tr. at 1-3). Subsequently, Claimant brought the present
action seeking judicial review of the administrative decision
pursuant to 42 U.S.C. § 405(g).
42 U.S.C. § 423(d)(5), a claimant for disability has the
burden of proving a disability. See Blalock v.
Richardson, 483 F.2d 773, 774 (4th Cir. 1972). A
disability is defined as the "inability to engage in any
substantial gainful activity by reason of any medically
determinable impairment which can be expected to last for a
continuous period of not less than 12 months . . . ." 42
U.S.C. § 423(d)(1)(A).
Social Security Regulations establish a "sequential
evaluation" for the adjudication of disability claims.
20 C.F.R. § 404.1520 (2016). If an individual is found
"not disabled" at any step, further inquiry is
unnecessary. Id. § 404.1520(a). The first
inquiry under the sequence is whether a claimant is currently
engaged in substantial gainful employment. Id.
§ 404.1520(b). If the claimant is not, the second
inquiry is whether claimant suffers from a severe impairment.
Id. § 404.1520(c). If a severe impairment is
present, the third inquiry is whether such impairment meets
or equals any of the impairments listed in Appendix 1 to
Subpart P of the Administrative Regulations No. 4.
Id. § 404.1520(d). If it does, the claimant is
found disabled and awarded benefits. Id. If it does
not, the fourth inquiry is whether the claimant's
impairments prevent the performance of past relevant work.
Id. § 404.1520(e). By satisfying inquiry four,
the claimant establishes a prima facie case of
disability. Hall v. Harris, 658 F.2d 260, 264 (4th
Cir. 1981). The burden then shifts to the Commissioner,
McLain v. Schweiker, 715 F.2d 866, 868-69 (4th Cir.
1983), and leads to the fifth and final inquiry: whether the
claimant is able to perform other forms of substantial
gainful activity, considering claimant's remaining
physical and mental capacities and claimant's age,
education and prior work experience. 20 C.F.R. §
404.1520(f) (2016). The Commissioner must show two things:
(1) that the claimant, considering claimant's age,
education, work experience, skills and physical shortcomings,
has the capacity to perform an alternative job, and (2) that
this specific job exists in the national economy.
McLamore v. Weinberger, 538 F.2d 572, 574 (4th Cir.
claimant alleges a mental impairment, the Social Security
Administration “ must follow a special technique at
every level in the administrative review process.” 20
C.F.R. §§ 404.1520a(a) and 416.920a(a). First, the
SSA evaluates the claimant's pertinent symptoms, signs
and laboratory findings to determine whether the claimant has
a medically determinable mental impairment and documents its
findings if the claimant is determined to have such an
impairment. Second, the SSA rates and documents the degree of
functional limitation resulting from the impairment according
to criteria as specified in 20 C.F.R. §§
404.1520a(c) and 416.920a(c). Those sections provide as
(c) Rating the degree of functional limitation.
(1) Assessment of functional limitations is a complex and
highly individualized process that requires us to consider
multiple issues and all relevant evidence to obtain a
longitudinal picture of your overall degree of functional
limitation. We will consider all relevant and available
clinical signs and laboratory findings, the effects of your
symptoms, and how your functioning may be affected by factors
including, but not limited to, chronic mental disorders,
structured settings, medication and other treatment.
(2) We will rate the degree of your functional limitation
based on the extent to which your impairment(s) interferes
with your ability to function independently, appropriately,
effectively, and on a sustained basis. Thus, we will consider
such factors as the quality and level of your overall
functional performance, any episodic limitations, the amount
of supervision or assistance you require, and the settings in
which you are able to function. See 12.00C through 12.00H of
the Listing of Impairments in appendix 1 to this subpart for
more information about the factors we consider when we rate
the degree of your functional limitation.
(3) We have identified four broad functional areas in which
we will rate the degree of your functional limitation:
Activities of daily living; social functioning;
concentration, persistence, or pace; and episodes of
decompensation. See 12.00C of the Listings of Impairments.
(4) When we rate the degree of limitation in the first three
functional areas (activities of daily living, social
functioning; and concentration, persistence, or pace), we
will use the following five-point scale: None, mild,
moderate, marked, and extreme. When we rate the degree of
limitation in the fourth functional area (episodes of
decompensation), we will use the following four-point scale:
None, one or two, three, four or more. The last point on each
scale represents a degree of limitation that is incompatible
with the ability to do any gainful activity.
after rating the degree of functional limitation from the
claimant's impairment(s), the SSA determines their
severity. A rating of “none” or
“mild” in the first three functional areas
(activities of daily living, social functioning; and
concentration, persistence, or pace) and “none”
in the fourth (episodes of decompensation) will yield a
finding that the impairment(s) is/are not severe unless
evidence indicates more than minimal limitation in the
claimant's ability to do basic work activities. 20 C.F.R.
§§ 404.1520a(d)(1) and 416.920a(d)(1). Fourth, if
the claimant's impairment(s) is/are deemed severe, the
SSA compares the medical findings about the severe
impairment(s) and the rating and degree and functional
limitation to the criteria of the appropriate listed mental
disorder to determine if the severe impairment(s) meet or are
equal to a listed mental disorder. 20 C.F.R. §§
404.1520a(d)(2) and 416.920a(d)(2). Finally, if the SSA finds
that the claimant has a severe mental impairment(s) which
neither meets nor equals a listed mental disorder, the SSA
assesses the Claimant's residual functional capacity. 20
C.F.R. §§ 404.1520a(d)(3) and 416.920a(d)(3). The
Regulation further specifies how the findings and conclusion
reached in applying the technique must be documented at the
ALJ and Appeals Council levels as follows:
At the administrative law judge hearing and the Appeals
Council levels, the written decision issued by the
administrative law judge and the Appeals Council must
incorporate the pertinent findings and conclusions based on
the technique. The decision must show the significant
history, including examination and laboratory findings, and
the functional limitations that were considered in reaching a
conclusion about the severity of the mental impairment(s).
The decision must include a specific finding as to the degree
of limitation in each of the functional areas described in
paragraph (c) of this section.
20 C.F.R. §§404.1520a(e)(2) and 416.920a(e)(2).
particular case, the ALJ determined that Claimant satisfied
the first inquiry because she has not engaged in substantial
gainful activity since the amended alleged onset date of
January 1, 2011, and meets the insured status requirements
through December 31, 2016 (Tr. at 12). Under the second
inquiry, the ALJ found that Claimant suffers from the severe
impairments: diffuse degenerative changes of the lumbar
spine, bipolar disorder NOS, generalized anxiety disorder,
panic disorder and polysubstance dependence that is in
remission. (Id.) At the third inquiry, the ALJ
concluded that Claimant did not have an impairment or
combination of impairments that met or medically equaled the
level of severity of any listing in Appendix 1 (Tr. at 13).
The ALJ then found that Claimant has a residual functional
capacity to perform a range of work at the light exertional
level (Tr. at 15). The ALJ found Claimant would have the
following limitations: Claimant cannot climb ladders, ropes
or scaffolds and can only occasionally climb ramps or stairs,
stoop, kneel, crouch or crawl. She is further limited to
simple, routine tasks that do not involve interaction with
the general public and only occasional interaction with
coworkers. (Id.) The ALJ found that Claimant is
unable to perform any past relevant work (Tr. at 18). The ALJ