Howell v. SSA
Filing
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MEMORANDUM OPINION AND ORDER: (1) The decision of Commissioner is supported by substantial evidence and is hereby AFFIRMED; (2) Pla's pro se Motion for Summary Judgment (Doc. # 12 ) is hereby DENIED; (3) Commissioner's Motion for Summary Judgment (Doc. # 13 ) is hereby GRANTED; and (4) A Judgment affirming Commissioner's decision will be entered contemporaneously herewith. Signed by Judge David L. Bunning on 9/27/2013. (RCB)cc: COR, HOWELL
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF KENTUCKY
SOUTHERN DIVISION
AT PIKEVILLE
CIVIL ACTION NO. 12-2-DLB
WALKER HOWELL
vs.
PLAINTIFF
MEMORANDUM OPINION AND ORDER
MICHAEL J. ASTRUE, Commissioner
SOCIAL SECURITY ADMINISTRATION
DEFENDANT
*** *** *** ***
Plaintiff brings this pro se appeal pursuant to 42 U.S.C. § 405(g) to obtain judicial
review of the Social Security Administration’s decision to deny his claim for Title II Disability
Insurance Benefits.1 Having reviewed the record and the parties’ dispositive motions
(Docs. # 12, 13), the Court affirms the Commissioner’s decision.
I. FACTUAL BACKGROUND AND PROCEDURAL HISTORY
Plaintiff has sought benefits in one form or another from the Social Security
Administration for over twenty-seven years. His efforts have been successful at times while
futile at other times. He is currently appealing the Administration’s December 7, 2011
decision denying him Title II Disability Insurance Benefits (“DIB”). However, to fully
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In his motion for summary judgment, the Commissioner also addresses the Administration’s denial
of Plaintiff’s claim for Title XVI Supplemental Security Income (“SSI”). However, Plaintiff has quite clearly only
appealed the Administration’s decision to deny him Title II Disability Insurance Benefits. His Complaint states
that he “pray[s] the Court will make a new decision about [his] Title II Disability.” (Doc. # 1 at 6). Similarly,
his motion for summary judgment asks the Court to “grant a Summary Judgment in Plaintiff’s favor of his
(Howell) Title II Disability.” (Doc. # 12 at 1). Because Plaintiff is only seeking to appeal the Administration’s
finding on his Title II Disability Insurance Benefit claim, the Court will not consider his original claim for Title
XVI SSI benefits.
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understand the claims Plaintiff presents in this appeal, it is helpful to review Plaintiff’s
protracted history with the Social Security Administration (“SSA”).
On January 18, 1985, Plaintiff was working on a hillside when a tree fell and hit him
in his lower back. (Doc. # 1 at 1). Plaintiff was knocked unconscious. (Id.). He was
treated at a hospital in Pikeville, Kentucky for nine days after the injury, though the
treatment allegedly did not cure his injuries. He alleges that he still suffers disabling back
pain as a result of the accident, which continues to worsen.
As a result of his back injury, Plaintiff filed a claim for benefits2 with the SSA on
January 13, 1987, which was denied by an Administrative Law Judge (“ALJ”). (Doc. # 1
at 2). Plaintiff appealed that decision to the United States District Court for the Eastern
District of Kentucky.
The court remanded Plaintiffs claim to the ALJ for further
consideration. On remand, an ALJ conducted an evidentiary hearing and then denied the
claim on December 7, 1988. The United States District Court affirmed the ALJ’s decision
on November 3, 1989. (Doc. # 1 at 2).
Plaintiff filed a second application for DIB on February 7, 1990, primarily alleging that
he was disabled because of the back injury. (Doc. # 1-3 at 1); Howell v. Commissioner of
Social Sec., 37 F. App’x 765, 766 (6th Cir. 2002). This claim was denied by an ALJ on
June 17, 1991, but later remanded by the United States District Court for further
consideration. On September 8, 1992, while Plaintiff’s remanded claim for DIB was
pending, Plaintiff filed an application for Supplemental Security Income (“SSI”). An ALJ
considered the SSI application and the remanded DIB claim in tandem, denying both claims
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The type of benefits sought is unclear from the record.
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in a March 23, 1994 decision. However, that decision was also remanded “for further
consideration of [Plaintiff’s] alleged mental impairments and the different time frames that
were covered by his [DIB and SSI] claims.” Howell, 37 F. App’x at 766.
Upon remand, the ALJ found that Plaintiff was capable of performing a limited range
of light work, and that there were a significant number of available jobs that he could
perform. Id. The ALJ therefore concluded that Plaintiff was not disabled and denied his
claim for SSI and DIB. Id. On appeal, the district court affirmed the ALJ’s decision
concerning DIB, but remanded the case for an award of SSI benefits for a period beginning
on June 30, 1997. Id. In doing so, the district court concluded that Plaintiff was medically
disabled as of June 30, 1997. The district court’s decision was affirmed by the Sixth Circuit
Court of Appeals on June 19, 2002, Howell, 37 F. App’x at 767, and the Supreme Court
denied certiorari on June 13, 2003, Howell v. Barnhart, 537 U.S. 1124 (2003).
Based on the district court’s decision, Plaintiff was entitled to receive SSI benefits
beginning on June 30, 1997. Plaintiff apparently assumed he would be awarded past-due
benefits up to the present day—sometime in early 2000. However, after considering the
district court’s decision, the SSA only provided Plaintiff with SSI benefits through
September 1999 because, starting in October 1999, his wife’s income exceeded the
maximum amount to remain eligible for benefits.
After being advised that he would only receive SSI benefits through September
1999, Plaintiff filed a third claim for benefits on February 15, 2006. (Doc. # 1-2 at 4).
Plaintiff alleged a disability onset date of June 30, 1997—the date the district court
previously determined as his disability onset date. The SSA construed the claim as one
for SSI, and denied the claim because Plaintiff and his wife had excess resources. (Doc.
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# 1-3).
Plaintiff subsequently filed a request for a hearing before an ALJ, which was
conducted on May 10, 2007. (Id.). On July 17, 2007, the ALJ issued a decision construing
Plaintiff’s February 15, 2006 claim for SSI benefits as a request for reinstatement of
benefits awarded “[u]nder the application for Supplemental Security Income filed February
7, 1990.” (Doc. # 1-3 at 7). So construed, the ALJ reinstated Plaintiff’s SSI benefits
beginning September 31, 2004. (Id.).
Plaintiff appealed the ALJ’s favorable decision to the SSA’s Appeals Council,
apparently because the ALJ failed to consider whether he was entitled to Title II DIB. (Tr.
15). The Appeals Council found a number of errors in the ALJ’s decision. First, the
Appeals Council found that the ALJ should have considered whether Plaintiff was entitled
to Title II DIB, which he failed to do. Second, the Appeals Council found it was unclear
whether Plaintiff even intended to appeal the original denial of his SSI claim. If he did not
intend to appeal the denial of SSI benefits, the Council suggested that the ALJ improperly
awarded SSI benefits on appeal. Finally, even if Plaintiff intended to appeal the denial of
SSI benefits, the Council held that the ALJ erred as a matter of law in reinstating those
benefits. As a result, the Appeals Council instructed the ALJ on remand to consider (1)
whether Plaintiff intended to have the ALJ consider the Administration’s initial denial of SSI
benefits and (2) whether Plaintiff was entitled to SSI or Title II DIB.
On March 16, 2011, ALJ Charlie Paul Andrus issued his decision from the Appeals
Council’s remand. After conferring with Plaintiff at an October 12, 2010 hearing, ALJ
Andrus concluded that Plaintiff did not intend to appeal the Administration’s initial denial of
his SSI claim. Additionally, the ALJ held that Plaintiff was not entitled to Title II DIB
because he was not insured at the time of his alleged disability onset date. Therefore, ALJ
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Andrus denied Plaintiff’s application for both Title II DIB and SSI.
Thereafter, Plaintiff appealed ALJ Andrus’ unfavorable decision to the SSA Appeals
Council. Plaintiff also submitted additional evidence for the Council’s consideration,
including a letter he drafted and medical reports from Doctors Ira B. Potter and Duane
Densler. (Tr. 8). On December 7, 2011, the Appeals Council notified Plaintiff that it found
no reason under its rules to review ALJ Andrus’ decision, making the ALJ’s decision the
final decision of the Commissioner.
II. ANALYSIS
Plaintiff appeals the Commissioner’s decision to deny his claim for disability
insurance benefits, though his grounds for doing so are unclear. He appears to generally
argue that the Commissioner’s December 7, 2011 decision is not supported by substantial
evidence. However, he also advances twenty five arguments that appear to challenge
aspects of his two previous claims.3 To the extent that those arguments are relevant to his
most recent claim for DIB and the Commissioner’s December 7, 2011 decision, the Court
will consider them as part of its substantial evidence review.
A.
The “Substantial Evidence” Standard of Review
The Court’s review of ALJ Andrus’ decision is limited to determining whether it is
supported by substantial evidence and was made pursuant to proper legal standards.
Gayheart v. Comm’r of Soc. Sec., 710 F.3d 365, 374 (6th Cir. 2013). “Substantial evidence
is ‘such relevant evidence as a reasonable mind might accept as adequate to support a
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For example, regarding his first claim for benefits, he challenges the evidence relied upon by the
medical examiner and the ALJ’s finding that he was not precluded from all types of work. Regarding his
second claim for benefits, he challenges, inter alia, the ALJ’s reliance on medical opinions that were not
supported by “detailed assessments” and hypothetical questions posed to the vocational expert. The Court
cannot reconsider issues decided in Plaintiff’s previous claims.
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conclusion.’” Id. (quoting Heston v. Comm’r of Soc. Sec., 245 F.3d 528, 534 (6th Cir.
2001)). If the decision is supported by substantial evidence, it must be affirmed even if this
Court would have arrived at a different result. Kinsella v. Schweiker, 708 F.2d 1058, 1059
(6th Cir. 1983).
B.
ALJ Andrus’ decision to deny Plaintiff’s claim for disability insurance
benefits is supported by substantial evidence
To be eligible for disability insurance benefits, “an individual must establish that he
became ‘disabled’ prior to expiration of his insured status.” Moon v. Sullivan, 923 F.2d
1175, 1182 (6th Cir. 1990) (emphasis added) (citing 42 U.S.C. § 423(a) and (c)). Plaintiff
has failed to establish this temporal requirement. Plaintiff was last insured on December
31, 1990. In his most recent application for DIB, he alleged a disability onset date of June
30, 1997. Because this alleged onset date is nearly seven years after Plaintiff was last
insured, Plaintiff cannot show that he was “disabled prior to expiration of his insured status.”
See Moon, 923 F.2d at 1182.
Although Plaintiff alleged a disability onset date of June 30, 1997, each of the
arguments presented in his motion for summary judgment suggest that he believes he was
disabled as of January 18, 1985. If that were the case, Plaintiff would have been insured
on the date he became disabled and, thus, entitled to disability benefits. However,
Plaintiff’s attempt to convince the Court that he was disabled on January 18, 1985 ignores
the force of res judicata.
Res judicata is a principle that applies to social security claimants. Drummond v.
Comm’r of Soc. Sec., 126 F.3d 837, 841 (6th Cir. 1997). It “prescribes that ‘a final
judgment on the merits of an action precludes the parties or their privies from relitigating
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issues that were or could have been raised in that action.” Id. For res judicata to apply, four
elements must be present:
(1) a final decision on the merits by a court of competent jurisdiction; (2) a
subsequent action between the same parties or their “privies”; (3) an issue
in the subsequent action which was litigated or which should have been
litigated in the prior action; and (4) an identity of the cause of action.
Bragg v. Flint Bd. of Educ., 570 F.3d 775, 776 (6th Cir. 2009).
Plaintiff’s attempt to have the Court reconsider his disability onset date is clearly
precluded by res judicata. On appeal of the Administration’s denial of his second claim for
benefits, Judge Wix Unthank found that Plaintiff became disabled on June 30, 1997. See
Howell v. Comm’r of Soc. Sec., 37 F. App’x 765, 766 (6th Cir. 2001); Howell v. Comm’r of
Soc. Sec., Case No. 7:00-cv-86-GWU (E.D. Ky. Sept. 16, 2005) (Docs. # 13, 14). That
decision was later affirmed by the Sixth Circuit Court of Appeals. Howell, 37 F. App’x at
767. Plaintiff wishes to re-litigate that very issue in this appeal. Because each of the four
elements of res judicata are met, Plaintiff is precluded from challenging his previouslydetermined disability onset date.
The preclusive effect of Judge Unthank’s decision may be avoided, though, if a
limited exception to res judicata applies. In reviewing a subsequent claim for benefits, an
ALJ may revisit a claimant’s condition during the previously-considered time period if the
claimant presents new and material evidence relevant to that time period. See Bailey v.
Astrue, No. 10-262-DLB, 2011 WL 4478943, at *3 (E.D. Ky. Sept. 26, 2011) (citing 20
C.F.R. §§ 404.988, 416.1488-1489; Brewster v. Barnhart, 145 F. App’x 542, 546 (6th Cir.
2005); Wheeler v. Sec. of Health & Human Serv., No. 85-1757, 1986 WL 16116, at *1 (6th
Cir. Aug. 8, 1986)). Here, Plaintiff is asking the Court to consider evidence that was
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submitted along with his previous claims. There is no indication that Plaintiff presented new
evidence to ALJ Andrus during his third claim for benefits that would suggest he was
disabled prior to June 30, 1997. In fact, it does not appear that Plaintiff presented any
medical records to ALJ Andrus at all. Instead, he presented two medical records to the
Appeals Council along with his request to review ALJ Andrus’ unfavorable decision. Even
if the Appeals Council could have considered those records, they say nothing about his
condition prior to June 30, 1987. The first set of records contains the results of an MRI
performed on October 15, 2009; the second set of records contains notes from physical
examinations performed on January 12, 2010 and September 28, 2010. (Tr. 22-27).
Because these records do not speak to Plaintiff’s condition during the time period
considered in his second claim for benefits, ALJ Andrus was not permitted to find that
Plaintiff was disabled before the date determined by Judge Unthank.
At best, the records Plaintiff provided to the Appeals Council might have shown that
he was disabled some time in 2009 or 2010. But even if that were true, Plaintiff would still
not be entitled to DIB. As previously stated, in order to receive DIB, Plaintiff must
demonstrate that he was insured on the date he became disabled. Plaintiff was last
insured on December 31, 1990, nearly nineteen years before the time period addressed
by the medical records submitted to the Appeals Council. As such, the records do nothing
to show that Plaintiff was either disabled before June 30, 1997, or entitled to benefits at any
point thereafter.
III. CONCLUSION
In the end, Plaintiff must be clear on what this appeal is and what it is not. This
appeal is an opportunity for Plaintiff to challenge ALJ Andrus’ March 16, 2011 decision to
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deny his claim for DIB and SSI. However, this appeal is not an opportunity for Plaintiff to
challenge every alleged mistake that occurred over the past twenty-seven years that he
has dealt with the Social Security Administration. Plaintiff’s previous claims for disability
benefits were finally adjudicated by the United States District Court and the Sixth Circuit
Court of Appeals. This Court cannot revisit issues litigated in those cases on Plaintiff’s
present appeal. Instead, this Court can only consider whether ALJ Andrus’ March 16, 2011
decision–which became final on December 7, 2011–is supported by substantial evidence.
As previously explained, the Court does find that ALJ Andrus decision to deny Plaintiff’s
claim for disability insurance benefits is supported by substantial evidence. Accordingly,
IT IS ORDERED as follows:
(1)
The decision of the Commissioner is supported by substantial evidence and
is hereby AFFIRMED;
(2)
Plaintiff’s pro se Motion for Summary Judgment (Doc. # 12) is hereby
DENIED;
(3)
The Commissioner’s Motion for Summary Judgment (Doc. # 13) is hereby
GRANTED; and
(4)
A Judgment affirming the Commissioner’s decision will be entered
contemporaneously herewith.
This 27th day of September, 2013.
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