Hughes v. Berryhill
Filing
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ORDER AND OPINION REVERSING COMMISSIONERS FINAL DECISION DENYING BENEFITS AND REMANDING FOR FURTHER PROCEEDINGS. Signed on 12/24/2018 by District Judge Ortrie D. Smith. (Kitsmiller, Julia)
IN THE UNITED STATES DISTRICT COURT FOR THE
WESTERN DISTRICT OF MISSOURI
SOUTHERN DIVISION
ISAAC HUGHES,
Plaintiff,
vs.
NANCY A. BERRYHILL,
Acting Commissioner of Social Security,
Defendant.
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Case No. 18-03097-CV-S-ODS
ORDER AND OPINION REVERSING COMMISSIONER’S FINAL DECISION
DENYING BENEFITS AND REMANDING FOR FURTHER PROCEEDINGS
Pending is Plaintiff’s appeal of the Commissioner of Social Security=s final
decision denying his application for supplemental security income. As set forth below,
the Commissioner’s decision is reversed and remanded for further proceedings.
(1)
The record establishes Plaintiff has a history of substance and alcohol
use. As set forth by the Administrative Law Judge (“ALJ”), “[i]f it is found that the
claimant is disabled and there is medical evidence of a substance use disorders [sic],
the undersigned must determine if the substance use disorders [sic] is a contributing
factor material to the determination of disability.” R. at 17. “In making this
determination, the [ALJ] must evaluate the extent to which the claimant’s mental and
physical limitations would remain if the claimant stopped the substance use.” Id.; see
also 20 C.F.R. §§ 404.1535(b)(1), 416.935(b)(1).
The “key factor” the ALJ examines when making this determination is “whether
[the ALJ] would still find [the claimant] disabled if [the claimant] stopped using drugs or
alcohol.” Id. § 416.935(b)(1). The ALJ evaluates which of the claimant’s “current
physical and mental limitations...would remain if [the claimant] stopped using drugs or
alcohol,” and the ALJ then determines whether any or all of the claimant’s remaining
limitations are disabling. Id. § 406.935(b)(2). If the remaining limitations are not
disabling, the drug addiction or alcoholism is considered a contributing factor material to
the termination of disability, and “the claimant’s application must be denied.”
Brueggemann v. Barnhart, 348 F.3d 689, 693 (8th Cir. 2003) (citing 42 U.S.C. §
423(d)(2)(C) and 20 C.F.R § 404.1535). “If the ALJ is unable to determine whether
substance use disorders are a contributing factor material to the claimant's otherwiseacknowledged disability, the claimant's burden has been met and an award of benefits
must follow.” Id.
The ALJ determined Plaintiff had the following severe impairments: attentiondeficit hyperactivity disorder; an affective disorder (diagnosed as depression, major
depressive disorder, substance-induced mood disorder, bipolar disorder, and
schizoaffective disorder – bipolar type); an anxiety disorder (diagnosed as generalized
anxiety disorder and anxiety); post-traumatic stress disorder; and polysubstance abuse
disorder. R. at 17-18. The ALJ concluded Plaintiff’s mental impairments, including the
substance use disorders, met Listing 12.04. R. at 18-20. However, if Plaintiff stopped
using substances, the ALJ found Plaintiff would not be disabled. R. at 21-24.
The Court concludes the ALJ’s finding (that Plaintiff’s substance use is material
to the finding of disability) is not supported by substantial evidence in the record. The
record contains evidence that Plaintiff, even when abstaining from substances,
continued to have significant limitations. Furthermore, the ALJ, when determining
Plaintiff’s impairments are marked to extreme, cited to portions of the record during
which Plaintiff was sober. Then, when supporting his conclusion that Plaintiff’s
substance use is material and he is not disabled, the ALJ cited to several of the same
records. Compare R. at 19-20 with R. at 21-22. As such, this Court cannot determine
with certainty why the ALJ found Plaintiff met the requirements of Listing 12.04, and why
the ALJ also concluded Plaintiff’s substance use was material to the finding of disability.
See Pettit v. Apfel, 218 F.3d 901, 903-04 (8th Cir. 2000) (remanding the matter, and
directing the ALJ to “address more specifically” the claimant’s claim that he is disabled,
but also recognizing the claimant has the burden of showing his alcoholism is not
material to his disability).
Upon remand, the ALJ must further develop the record with regard to whether
Plaintiff’s substance use is a contributing factor material to the determination of
disability. To the extent the ALJ concludes Plaintiff’s substance use is material to the
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determination of disability, that conclusion must be based upon Plaintiff’s impairments
absent substance use, and must be supported by substantial evidence in the record.
(2)
The ALJ gave “less than substantial weight” to the opinion of Plaintiff’s
treating psychiatrist, Dr. Gunda. R. at 24. The ALJ discounted Dr. Gunda’s opinion
because “it is unclear whether his opinion regarding the claimant’s abilities takes into
consideration the claimant’s significant use of illicit substances, and thus provides little
insight into his abilities if the substance use [was] stopped.” Id. But the Medical Source
Statement specifies it contains Dr. Gunda’s “professional opinion of the claimant’s
limitations. If drug addiction and/or alcohol is a diagnosis, this statement sets forth
the limitation remaining if the claimant stopped doing drugs and/or alcohol.” R. at
1000 (emphasis added).
Generally, a treating physician’s opinion is given more weight than other sources
in a disability proceeding. 20 C.F.R. § 404.1527(c)(2). A treating physician’s opinion
may be disregarded if it is unsupported by clinical or other data or is contrary to the
weight of the remaining evidence in the record. See Pena v. Chater, 76 F.3d 906, 908
(8th Cir. 1996). Ultimately, the ALJ must “give good reasons” to explain the weight
given the treating physician’s opinion. 20 C.F.R. § 404.1527(c)(2). Upon remand, the
ALJ must provide good reasons, supported by evidence in the record, explaining the
weight afforded Dr. Gunda’s opinions.
IT IS SO ORDERED.
/s/ Ortrie D. Smith
ORTRIE D. SMITH, SENIOR JUDGE
UNITED STATES DISTRICT COURT
DATE: December 24, 2018
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