Simpson v. Colvin
ORDER GRANTING 13 Plaintiff's Motion for Judgment on the Pleadings, and DENYING 14 Defendant's Motion for Judgment on the Pleadings. The decision of the Commissioner is reversed and this matter is remanded for an award of benefits. Signed by US District Judge Terrence W. Boyle on 11/17/2014. (Fisher, M.)
IN THE UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF NORTH CAROLINA
Acting Commissioner of Social Security,
This matter is before the Court on the parties' cross-motions for judgment on the
pleadings. [DE 13 & 14]. A hearing on this matter was held in Elizabeth City, North Carolina on
November 12, 2014 at 10:00 a.m. For the reasons discussed below, plaintiffs motion is
GRANTED, defendant's motion is DENIED, and, accordingly, the judgment of the
Commissioner is REVERSED.
Plaintiff applied for disability insurance benefits and supplemental security income
("SSI"), based on disability, under Titles II and XVI of the Social Security Act, 42 U.S.C. §§
401-433 and 1381-83d, respectively on September 24, 2010. Plaintiff alleged an onset date of
December 15, 2008. Plaintiffs date last insured ("DLI") was September 30, 2010. Ultimately a
hearing was held before an Administrative Law Judge ("ALJ"), who determined that plaintiff
was disabled as of December 10, 2010, but not before that date. [Tr. 32]. The ALJ's decision
finding plaintiff disable after her DLI therefore operated as a denial of her Title II claim, but an
approval of her Title XVI claim. The Appeals Council declined to review the ALJ' s decision
thereby making it the Commissioner's final decision for the purposes of judicial review. Plaintiff
then commenced the instant action for judicial review pursuant to 42 U.S.C. §§ 405(g),
Plaintiff was 54 years old at the time of her filing for benefits. She completed the 1Oth
grade and last worked on December 15, 2008. [Tr. 43, 235]. Plaintiffs past relevant work was as
a nurse aide, a nurse assistant, and certified medical technician. Plaintiff suffers from depression,
anxiety, panic attacks, diabetes, and left shoulder pain.
When a social security claimant appeals a final decision of the Commissioner, the district
court's review is limited to the determination of whether, based on the entire administrative
record, there is substantial evidence to support the Commissioner's findings. 42 U.S.C. § 405(g);
Richardson v. Perales, 402 U.S. 389, 401 (1971). Substantial evidence is defined as "evidence
which a reasoning mind would accept as sufficient to support a particular conclusion." Shively v.
Heckler, 739 F.2d 987, 989 (4th Cir. 1984)(quoting Laws v. Celebrezze, 368 F.2d 640, 642 (4th
Cir. 1966)). If the Commissioner's decision is supported by such evidence, it must be affirmed.
Smith v. Chater, 99 F.3d 635,638 (4th Cir. 1996).
In making a disability determination, the ALJ engages in a five-step evaluation process.
20 C.F.R. § 404.1520; see Johnson v. Barnhart, 434 F.3d 650 (4th Cir. 2005). The analysis
requires the ALJ to consider the following enumerated factors sequentially. At step one, if the
claimant is currently engaged in substantial gainful activity, the claim is denied. At step two, the
claim is denied if the claimant does not have a severe impairment or combination of impairments
significantly limiting him or her from performing basic work activities. At step three, the
claimant's impairment is compared to those in the Listing of Impairments. See 20 C.F.R. Part
404, Subpart P, App. 1. If the impairment is listed in the Listing of Impairments or if it is
equivalent to a listed impairment, disability is conclusively presumed. However, if the claimant's
impairment does not meet or equal a listed impairment then, at step four, the claimant's residual
functional capacity ("RFC") is assessed to determine whether plaintiff can perform his past work
despite his impairments. If the claimant cannot perform past relevant work, the analysis moves
on to step five: establishing whether the claimant, based on his age, work experience, and RFC
can perform other substantial gainful work. The burden of proof is on the claimant for the first
four steps of this inquiry, but shifts to the Commissioner at the fifth step. Pass v. Chafer, 65 F.3d
1200, 1203 (4th Cir. 1995).
Here, the plaintiff alleges that the ALJ erred by not finding her disabled as of, at the
latest, her DLI, September 30, 2010. The ALJ found that plaintiff met Listing 12.06 as of
December 10, 2010. [Tr. 31]. Prior to December 10, 2010, the ALJ found that plaintiff did not
meet a listing, had an RFC of medium, could not return to her past relevant work, and could have
performed jobs found in significant numbers in the national economy. [Tr. 25-31]. Plaintiff
alleges that nothing in her condition changed during the 71 days between her alleged onset date
and the date as of which the ALJ found her disabled. Therefore, plaintiff argues that she should
have been found disabled as of September 30, 2010 and the ALJ's decision finding otherwise is
not supported by substantial evidence. The Court agrees.
Plaintiff argues and the evidence demonstrates that her condition, which the ALJ found
severe enough to meet Listing 12.06 as of December 10, 2010, was triggered by two traumatic
experiences suffered by plaintiff. The first was when she lost guardianship of the foster children
she was caring for at the time in 2003. The second incident involved a physical attack at her
workplace in 2008 which resulted in plaintiff suffering wounds. Plaintiff suggests that because
her condition was trigger induced and no traumatic incidents happened between September 30
and December 10 that the logical inference here is that her condition was unchanged between
those dates and therefore the ALJ should have found her disabled as of her DLI. The Court
agrees and finds that the relative lack of medical evidence pointing to her disability before
September 30, 2010 is overcome by the strong logical inference at work here. Although the ALJ
cites medical records supporting her disability in the interim period between September 30, and
December 10, a review of his opinion makes clear that his opinion was not contingent upon an
event happing during that time period to trigger plaintiffs condition. The evidence in the record
from medical records and lay witness testimony supports a finding that plaintiff was disabled
under the Act by September 30, 2010. [Tr. 323, 433-34, 73]. Accordingly, the Court finds that
the ALJ' s opinion was not supported by substantial evidence.
This Court finds that Ms. Simpson was disabled under Listing 12.06 as of September 30,
2010. Because this date was on her date last insured, this Court reverses the decision of the
Commissioner and awards benefits to Ms. Simpson. Reversal without remand is appropriate
where, as here, the record does not contain substantial evidence to support a decision denying
disability, and reopening the record for more evidence would serve no purpose. Coffman v.
Bowen, 829 F.2d 514, 519 (4th Cir. 1987).
For the foregoing reasons, the plaintiffs motion for judgment on the pleadings is
GRANTED, and the decision of the Commissioner is REVERSED. The decision of whether to
reverse and remand for benefits or reverse and remand for a new hearing is one which "lies
within the sound discretion of the district court." Edwards v, Bowen, 672 F.Supp. 230, 236
(E.D.N.C. 1987). Accordingly, this case is REMANDED for an award of benefits consistent with
This _j_Jday ofNovember, 2014.
T RENCE W. BOYLE
UNITED STATES DISTRICT
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