Jones v. Colvin
ORDER granting 12 Motion for Judgment on the Pleadings and denying 14 Motion for Summary Judgment. Signed by US District Judge Terrence W. Boyle on 3/1/2017. (Stouch, L.)
IN THE UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF NORTH CAROLINA
JOSE FALENCIA JONES,
NANCY A. BERRYHILL,
Acting Commissioner ofSocial Security,
This matter is before the Court on the parties' cross-motions for judgment on the
pleadings. A hearing on the motions was held before the undersigned on January 12, 2017, at
Elizabeth City, North Carolina. For the reasons detailed below, this matter is remanded for
Plaintiff, Jose Jones, protectively applied for disability insurance benefits (DIB) under
Title II of the Social Security Act on August 27, 2013, alleging an onset date of October 13,
2012. His claim was denied initially and upon reconsideration. A hearing was held before an
Administrative Law Judge (ALJ) on May 28, 2015, in New Bern, North Carolina at which
plaintiff and his representative appeared in person and at which a vocational expert appeared by
telephone. The ALJ considered plaintiffs claim de nova and issued an unfavorable decision on
July 16, 2015. The Appeals Council then denied plaintiffs request for review and the ALJ's
decision became the final decision of the Commissioner. Plaintiff then timely sought review in
When a social security claimant appeals a final decision of the Commissioner, the 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. Chafer, 99 F.3d 635, 638 (4th Cir. 1996).
To find a claimant disabled, an ALJ must conclude that the claimant satisfies each of five
steps. 20 C.F.R. § 404.1520(a)(4). First, a claimant must not be able to work in a substantial
gainful activity. Id Second, a claimant must have a severe physical or mental impairment or
combination of impairments. Id Third, a claimant's impairment(s) must be of sufficient duration
and must either meet or equal an impairment listed by the regulations (Listing). Id. Fourth, a
claimant must not have the residual functional capacity (RFC) to meet the demands of the
claimant's past relevant work. Id Finally, the claimant must not be able to do any other work,
given the claimant's RFC, age, education, and work experience. Id The claimant bears the
burden of proof at steps one through four, but the burden shifts to the Commissioner at step five.
Bowen v. Yuckert, 482 U.S. 137, 146 n.5 (1987).
Here, the ALJ found at step one that plaintiff met the insured status requirements and had
not engaged in substantial gainful activity since his alleged onset date. Next, the ALJ
determined that plaintiffs osteoarthritis of the left knee and shoulder, spine disorder of the
lumbar spine, anxiety (post-traumatic stress disorder (PTSD)), and affective disorder were severe
impairments. However, the ALJ found that none of plaintiffs impairments or combination of
impairments met or equaled a Listing. The ALJ then found that plaintiff had the RFC to perform
medium work with additional exertional and nonexertional limitations. The ALJ determined that
plaintiff was unable to perform any past relevant work, which included work as an operator
engineer, but found that, considering plaintiffs age, education, work experience, and RFC, there
were jobs that exist in significant numbers in the national economy that claimant could perform.
These jobs would include store laborer, automobile detailer, and kitchen helper. Accordingly, the
ALJ found that plaintiff was not disabled as of the date of his decision.
Plaintiff argues that the ALJ erred by failing to properly consider plaintiffs Veterans
Affairs (VA) disability rating. As a foundational matter, an ALJ is not bound by a disability
decision by another governmental agency, such as the VA. SSR 06-03p. However, the Fourth
Circuit has noted that "both the VA and Social Security programs serve the same governmental
purpose of providing benefits to persons unable to work because of a serious disability" and,
thus, "in making a disability determination, the SSA must give substantial weight to a VA
disability rating." Bird v. Comm 'r ofSSA, 699, F.3d 337, 343 (4th Cir. 2012). The ALJ is
relieved from this only when "the record before the ALJ clearly demonstrates that such a
deviation is appropriate." Id
Here, the ALJ was aware plaintiffs VA disability determination existed and referred to it
in the decision, including that plaintiff was given 100% disability rating for PTSD and bipolar
disorder. Tr. 22; 418. Despite knowing that the decision existed, the ALJ gave the VA decision
little weight because the rating decision had not been submitted. Tr. 23. The ALJ further noted
that the VA uses disability criteria which is "vastly different" from the Social Security criteria
and that, to the extent the VA decision was based on the same medical evidence before the ALJ,
it has been considered as outlined in the ALJ' s decision. Tr. 22.
The ALJ did not order and review the actual VA disability determination. While the
Court recognizes that the burden is with the plaintiff in steps one through four of the disability
determination, "the ALJ has a duty to explore all relevant facts and inquire into the issues
necessary for adequate development of the record, and cannot rely only on the evidence
submitted by the claimant when that evidence is inadequate." Cook v. Heckler, 783 F.2d 1168,
1173 (4th Cir. 1986). Here, without reviewing the determination, the ALJ had an insufficient
basis for assigning it little weight, nor could the ALJ determine that deviation therefrom was
appropriate. Additionally, the VA determination was submitted post-hearing. Accordingly, the
Court finds that remand is appropriate for the ALJ to consider and weigh the VA determination
in accordance with Bird.
For the foregoing reasons, plaintiffs motion for judgment on the pleadings is GRANTED
[DE 12], defendant's motion for judgment on the pleadings is DENIED [DE 14], and the matter
is REMANDED to the Commissioner for further proceedings consistent with this decision.
SO ORDERED, this_}__ day of.id:aaacy, 2017.
UNITED STATES DISTRICT JUDGE
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