Robinson v. Colvin
ORDER GRANTING 19 Plaintiff's Motion for Judgment on the Pleadings, and DENYING 23 Defendant's Motion for Judgment on the Pleadings. The decision of the ALJ is reversed and this matter is remanded to the Commissioner for an awarded of benefits. Signed by US District Judge Terrence W. Boyle on 8/18/2014. (Fisher, M.)
IN THE UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF NORTH CAROLINA
CAROLYN W. COLVIN,
Acting Commissioner of Social Security,
This cause comes before the Court on cross-motions for judgment on the pleadings. A
hearing was held on these matters before the undersigned on July 29, 2014, at Elizabeth City,
North Carolina. For the reasons discussed below, the decision of the Commissioner is reversed.
Plaintiff brought this action under 42 U.S.C. §§ 405(g) and 1383(c)(3) for review of the
final decision of the Commissioner denying his claim for disability and disability insurance
benefits (DIB) pursuant to Title II of the Social Security Act. Plaintiff filed for DIB on May 5,
2009, alleging disability since March 6, 2009. After initial denials, a hearing was held before an
Administrative Law Judge (ALJ) who then issued an unfavorable ruling. The decision of the
ALJ became the final decision of the Commissioner when the Appeals Council denied plaintiffs
request for review. Plaintiff then timely sought review of the Commissioner's decision in this
Under the Social Security Act, 42 U.S.C. § 405(g), and 1383(c)(3), this Court's review of
the Commissioner's decision is limited to determining whether the decision, as a whole, is
supported by substantial evidence and whether the Commissioner employed the correct legal
standard. Richardson v. Perales, 402 U.S. 389, 401 (1971).
Substantial evidence is "such
relevant evidence as a reasonable mind might accept as adequate to support a conclusion."
Johnson v. Barnhart, 434 P.3d 650, 653 (4th Cir. 2005) (per curiam) (internal quotation and
An individual is considered disabled if he is unable "to engage in any substantial gainful
activity by reason of any medically determinable physical or mental impairment which can be
expected to result in death or which has lasted or can be expected to last for a continuous period
of not less than [twelve] months." 42 U.S.C. § 1382c(a)(3)(A). The Act further provides that an
individual "shall be determined to be under a disability only if his physical or mental impairment
or impairments are of such severity that he is not only unable to do his previous work but cannot,
considering his age, education, and work experience, engage in any other line of substantial
gainful work which exists in the national economy." 42 U.S.C. § 1382c(a)(3)(B).
Regulations issued by the Commissioner establish a five-step sequential evaluation
process to be followed in a disability case. 20 C.P.R. §§ 404.1520(a)(4), 416.920(a)(4). The
claimant bears the burden of proof at steps one through four, but the burden shifts to the
Commissioner at step five. See Bowen v. Yuckert, 482 U.S. 137, 146 n.5 (1987). If a decision
regarding disability can be made at any step of the process, however, the inquiry ceases. See 20
C.P.R.§§ 404.1520(a)(4), 416.920(a)(4).
At step one, if the Social Security Administration determines that the claimant is
currently engaged in substantial gainful activity, the claim is denied. If not, then step two asks
whether the claimant has a severe impairment or combination of impairments. If the claimant
has a severe impairment, it is compared at step three to those in the Listing of Impairments
("Listing") in 20 C.F.R. Pt. 404, Subpt. P, App. 1.
If the claimant's impairment meets or
medically equals a Listing, disability is conclusively presumed.
If not, at step four, the
claimant's residual functional capacity (RFC) is assessed to determine if the claimant can
perform his past relevant work. If so, the claim is denied. If the claimant cannot perform past
relevant work, then the burden shifts to the Commissioner at step five to show that the claimant,
based on his age, education, work experience, and RFC, can perform other substantial gainful
work. If the claimant cannot perform other work, then he is found to be disabled. See 20 C.F .R.
At step one, the ALJ determined that plaintiff met the insured status requirements and
had not engaged in substantial gainful activity since his alleged onset date. Plaintiffs obesity,
diabetes mellitus, sleep apnea, bilateral lower extremity fractures, degenerative joint disease of
the left knee, degenerative disc disease of the lumbar spine, and right foot degenerative disease
were considered severe impairments at step two but were not found alone or in combination to
meet or equal a Listing at step three. After finding plaintiffs statements not entirely credible, the
ALJ concluded that plaintiff could perform a greatly reduced range of light work. The ALJ
found that plaintiff could not return to his past relevant work, but that, considering plaintiffs
age, education, work experience, and RFC, there were other jobs that exist in significant numbers
in the national economy that plaintiff could perform. Thus, the ALJ determined that plaintiff
was not disabled as of the date of his opinion.
The ALJ's decision in this instance is not supported by substantial evidence. An ALJ
makes an RFC assessment based on all of the relevant medical and other evidence. 20 C.F.R. §
When formulating plaintiffs RFC, the ALJ relied on the opmwn of Dr.
Caviness, a state agency consultative physician, noting that he included additional postural
limitations in light of plaintiffs testimony. Tr. 23. Dr. Caviness' opinion that plaintiff could
perform light work was not, however, without qualification. Tr. 322. Dr. Caviness opined that
plaintiff could perform light work assuming that plaintiffs left leg, which was currently in the
treatment and recovery phase after he fell at work, continued to heal. !d.; Tr. 297-99. The
record reflects that this continuing healing and improvement did not occur.
Moreover, Dr. Caviness' opinion was given prior to plaintiffs motor vehicle accident in January
2010, in which he sustained fractures to his right tibia and fibula requiring surgery. Tr. 342-43.
After he had healed from his surgery, the record reflects that plaintiff continued to experience
pain in his legs and difficulty ambulating in 2010 and 2011. Tr. 427; 625-28; 618-23; 633. The
ALJ did not address this contrary evidence when formulating his RFC.
The vocational expert in this matter has testified that if plaintiff needed to adjust his
position every thirty minutes as testified to by plaintiff, there would be no jobs in the nation
economy that plaintiff could perform. Tr. 51. Though the ALJ rejected plaintiffs statements
regarding his need to change positions and his continued difficulty with ambulation, plaintiffs
treating physician, Dr. Barsanti, gave an opinion in December 2011 1 regarding permanent work
restrictions which included the following: no prolonged sitting, no repetitive motion, no
lifting/carrying over five pounds, and no pushing or pulling with legs. Tr. 634. Dr. Barsanti's
opinion further noted that plaintiff would be required to be able to change positions as needed
This evidence was submitted after the ALJ' s decision but was presented to the appeals council
and is thus appropriately considered here. Wilkins v. Sec y, Dep 't of Health & Human Servs., 953
F.2d 93, 96 (4th Cir. 1991) (en bane).
while working. The opinion of a treating physician must be given controlling weight if it is not
inconsistent with substantial evidence in the record and may be disregarded only if there is
persuasive contradictory evidence.
Coffman v. Bowen, 829 F.2d 514, 517 (4th Cir. 1987);
Mitchell v. Schweiker, 699 F.2d 185 (4th Cir. 1983). Even if a treating physician's opinion is not
entitled to controlling weight, it still may be entitled to the greatest of weight. SSR 96-2p. Dr.
Barsanti's opinion is not inconsistent with the record evidence and serves to bolster plaintiffs
credibility regarding his limitations.
Because the record clearly demonstrates that plaintiff
continued to have difficulty ambulating and that he would need to change positions more
frequently than provided for by the ALI's RFC finding, the Court finds the ALJ's decision not to
be supported by substantial evidence.
Reversal for Award of Benefits
The decision of whether to reverse and remand for benefits or reverse and remand for a
new hearing is one that "lies within the sound discretion of the district court." Edwards v.
Bowen, 672 F. Supp. 230, 237 (E.D.N.C. 1987); see also Evans v. Heckler, 734 F.2d 1012, 1015
(4th Cir. 1984). When "[o]n the state ofthe record, [plaintiffs] entitlement to benefits is wholly
established," reversal for award of benefits rather than remand is appropriate. Crider v. Harris,
624 F.2d 15, 17 (4th Cir. 1980). The Fourth Circuit has held that it is appropriate for a federal
court to "reverse without remanding where the record does not contain substantial evidence to
support a decision denying coverage under the correct legal standard and when reopening the
record for more evidence would serve no purpose." Breeden v. Weinberger, 493 F.2d 1002,
1012 (4th Cir. 1974). Remand, rather than reversal, is required when the ALJ fails to explain his
reasoning and there is ambivalence in the medical record, precluding a court from "meaningful
review." Radford v. Colvin, 734 F.3d 288, 296 (4th Cir. 2013).
The Court in its discretion finds that reversal and remand for an award of benefits is
appropriate in this instance as the ALJ has clearly explained the basis for his decision and the
record before this Court properly supports a finding that the Acting Commissioner has failed to
satisfy her burden to show that plaintiff can perform work in the national economy. In light of
the vocational expert's testimony, there is no benefit to be gained from remanding this matter for
further consideration and reversal is appropriate.
For the foregoing reasons, plaintiff's motion for judgment on the pleadings [DE 19] is
GRANTED and defendant's motion for judgment on the pleadings [DE 23] is DENIED. The
decision of the ALJ is REVERSED and this matter is REMANDED to the Acting Commissioner
for an award of benefits.
SO ORDERED, this
_j__f_ day of August, 2014.
T RRENCE W. BOYLE
UNITED STATES DISTRI
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