Chambers v. Commissioner, Social Security Administration
Filing
18
OPINION AND ORDER. Signed on 07/10/2012 by Judge James A. Redden. (pvh)
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF OREGON
PATRICIA CHAMBERS,
Plaintiff,
6:11-CV- 06198 RE
OPINION AND ORDER
v.
MICHAEL J. ASTRUE,
Commissioner of Social Security,
Defendant.
REDDEN, Judge:
Plaintiff Patricia Chambers ("Chambers") brings this action to obtain judicial review of a
final decision of the Commissioner of the Social Security Administration ("Commissioner")
telminating her period of disability. For the reasons set fOlih below, the decision of the
Commissioner is reversed and this matter is remanded for further proceedings.
1 - OPINION AND ORDER
BACKGROUND
Born in 1956, Chambers has a college degree. She has worked as a sales clerk, a retail
store manager, and a waitress. She was found disabled as of February 2, 2002 because of a disc
herniation at L4-5 with grade 1 spondylosis and nerve root impingement.
On February 4, 2008,
it was detelmined that plaintiff was no longer disabled as of February 28, 2008. A hearing was
held before an Administrative Law Judge ("ALJ"). In a decision dated June
2, 2009, the ALJ
found Chambers no longer disabled. Chambers's request for review was denied, making the
ALJ's decision the final decision of the Commissioner. Chambers now seeks judicial review of
the Commissioner's decision.
ALJ's DECISION
The ALJ found Chambers had the medically detelminable severe impairments ofL4-SI
degenerative changes and post stU'gical changes as shown on bone scan and CT scan, with a
solidly healed fusion at L4-5, osteoporosis, fibromyalgia, major depression, anxiety, and a history
of polysubstance abuse. Tr. 26 ..
The ALJ determined that, as of February 28, 2008, Chambers retained the residual
functional capacity to perfOlm a limited range of light work, and is limited to simple, repetitive
tasks.
The ALJ found that Chambers was unable to perfOlm her past work, but retained the
ability to work as a small products assembler, an office helper, or a meter reader. Tr. 30-31.
The medical records acctU'ately set out Chambers's medical history as it relates to her
claim for benefits. The cou11 has carefully reviewed the extensive medical record, and the parties
2 - OPINION AND ORDER
are familiar with it. Accordingly, the details of those medical records will be set out below only
as they are relevant to the issues before the COUlt.
DISCUSSION
Chambers contends that the ALJ erred by: (1) failing to prove that plaintiff has
experienced medical improvement; (2) finding her not entirely credible; (3) improperly weighing
physician testimony; (4) improperly rejecting lay testimony; and (S) failing to show that she
retains the ability to perfotID other work. Because the first assettion is dispositive, the COUlt need
not address the latter issues.
I. Background
In the June 2009 decision, the ALJ asserts that plaintiff was found disabled under Title II
of the Social Security Act on October IS, 2002, with an onset date of Februaty 2, 2002. The ALJ
cites "Exhibit lA, page 14," but that exhibit is not in the administrative record. Tr. 22, 24. The
October 2002 decision is known as the comparison point decision, or "CPD."
The ALJ states that, at the time of the CPD, the plaintiff had the medically detetIDinable
severe impairments of "right-sided L4-S disc herniation complicated by LS-S 1 grade 1
spondylolisthesis with LS and SineI've root impingement based on MRI scan in Febtuaty 2002.
As of Februaty 2, 2002, the claimant was found disabled because of her inability to sustain even
sedentaty work from her extreme constant pain as a result of her lumbar spine impairment." Tr.
24.
The administrative transcript relating to plaintiff s prior favorable disability determination
is not in this administrative record.
3 - OPINION AND ORDER
On February 4, 2008, the Social Security Administration determined that plaintiffs
disability ceased as of February 28,2008. At plaintiffs request, a hearing was held on May 20,
2009, before a Disability Hearing Officer, who determined that plaintiff had experienced
"medical improvement" that rendered her no longer disabled within the meaning of the Act. Tr.
46-58. The Hearing Officer included a summaIY of evidence, much of which is not in the
administrative record before this court. Tr. 59.
A hearing was held on May 20,2009, and on June 2, 2009, the ALJ issued a decision
finding that plaintiff had experienced "medical improvement" that precluded disability.
A. Termination of Benefits Premised on a Finding of "Medical Improvement"
The Ninth Circuit has found that "once a Social Security benefits claimant has been found
to be disabled, "a presumption of continuing disability arises in [his or] her favor." Bellamy v.
Sec'y ofHealth & Human Servs., 755 F.2d 1380, 1381 (9th Cir. 1985) (citing }viurray v. Heckler,
722 F.2d 499,500 (9 th Cir. 1983); accord Parra v. Astrue, 481 F.3d 742, 748 (9th Cir. 2007). The
Commissioner notes, however, that this presumption of continuing disability was specifically
rejected in the 1984 Amendments to the Social Security Act. 42 U.S.C. § 423(f)(l)("Any
detennination made under this section shall be made on the basis of the weight of the
evidence .... , without any initial inference as to the presence or absence of disability being drawn
from the fact that the [claimant] has previously been detennined to be disabled").
A claimant's entitlement to Disability Insurance Benefits and Supplemental Security
Income is subject to periodic review. 20 C.F.R. §§ 404.1594(a) (regarding DIB determinations),
416.994(a) (regarding SSI determinations).
4 - OPINION AND ORDER
A claimant's benefits may be tenninated where the Commissioner produces substantial
evidence that: "(A) there has been any medical improvement in the individual's impairment or
combination of impairments (other than medical improvement which is not related to the
individual's ability to work), and (B) the individual is now able to engage in substantial gainful
activity." 42 U.S.c. § 423(f)(1). The regulations applicable to both DIB and SSI define
"medical improvement" as follows:
Medical improvement is any decrease in the medical severity of
your impai11llent(s) which was present at the time of the most
recent favorable medical decision that you were disabled or continued to be disabled. A detelmination that there has been a
decrease in medical severity must be based on changes (improvement)
in the symptoms, signs andlor laboratory findings associated with
your impairment(s) ....
20 C.F.R. § 404.1594(b)(I); accord 20 C.F.R. § 416.994(b)(1). A reviewing cOUli will not set
aside a decision to terminate benefits unless the determination is based on legal error or is not
suppOlied by substantial evidence in the record as a whole. Allen v. Heckler, 749 F.2d 577, 579
(9th Cir. 1984).
The Commissioner determines whether a claimant continues to be entitled to DIB or SSI
under two similar multi-step tests. In a DIB case, the Commissioner employs an eight-step test.
20 C.F.R. § 404.1594(f)(1)-(8). In an SSI case, there is a seven-step test. 20 C.F.R. §
4l6.994(b)(5)(1)-(vii). These tests are substantially similar.
At step three of the DIB test the Commissioner detelmines whether there has been
"medical improvement" as defined in the regulations. The regulations provide that, for the
purposes of determining whether medical improvement has occUlTed, the Commissioner "will
compare the current medical severity of that impairment(s) which was present at the time ofthe
5 - OPINION AND ORDER
most recent favorable medical decision that you were disabled ... to the medical severity of that
impahment(s) at that time." 20 C.F.R. § 404. 1594(b)(7).
Plaintiff contends that the ALJ failed to meet the burden of producing evidence of
medical improvement because he did not produce any medical records regarding plaintiff s
medical condition at the time she was found to be eligible for benefits.
The Ninth Circuit COUlt of Appeals has not, apparently, addressed this issue. However,
other Circuits have, concluding that in assessing medical improvement the AU must evaluate
not only the CUlTent medical evidence, but also the medical evidence upon which the disability
was established. See Byron v. Heckler, 742 F.2d 1232, 1236 (loth Cir. 1984)(per curiam);
Vaughn v. Heckler, 727 F.2d 1040 (lIth Cir. 1984); Veino v. Barnhart, 312 F.3d 578 (2nd Cir.
2002).
I find the reasoning of the Second Circuit persuasive. The Veino court noted that the ALJ
and the Commissioner had received and submitted to the cOUlt substantial medical evidence as to
the claimant's CUlTent impahments, but the record before the COUlt contained no medical
evidence as to the claimant's condition at the time ofthe CPD. The Second Circuit concluded
that, "[i]n the absence of the early medical records, the administrative record lacks a foundation
for a reasoned assessment of whether there is substantial evidence to SUppOlt the Commissioner's
finding that [the claimant's recent] condition represents an 'improvement.'" Veino, 312 F.3d at
587. The Veino COUlt found that without any of the original medical evidence in the record
before the court, it could not make a reasoned detelmination as to whether the summmy provided
by the ALI andlor Hearings Officer is accurate or adequate.
6 - OPINION AND ORDER
The Commissioner argues that any enol' in failing to compare the cunent medical reports
with the medical evidence at the CPD is hannless. However, this cOUli, and the claimant, should
not be asked to rely on the two sentence summary of the CPD medical evidence provided by the
ALJ.
CONCLUSION
For these reasons, the ALJ's decision that Chambers's experienced medical improvement
is not sUPPOlied by substantial evidence. The decision of the Commissioner is reversed and this
case is remanded pursuant to sentence four of 42 U.S.C. § 405(g) for further proceedings
consistent with this opinion and order.
IT IS SO ORDERED.
Dated this jttClay of July, 2012.
J11
U~~
7 - OPINION AND ORDER
A.
DEN
States Dlstnct Judge
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