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Wells v. Commissioner of Social Security

November 25, 2009


The opinion of the court was delivered by: Mitchell M.J.


On July 1, 2009, Daniel Garrett Wells, by his counsel, filed a complaint pursuant to Section 205(g) of the Social Security Act, as amended, 42 U.S.C. §405(g) for review of the Commissioner's final determination disallowing his claim for Supplemental Security Income benefits under Sections 1614 and 1631 of the Act, as amended, 42 U.S.C. §1381 cf. For the reasons set forth below, the cross motions for summary judgment (Docket Nos. 11 and 13) will be dismissed without prejudice and the matter will be remanded to the Commissioner for further evaluation and consideration.

The instant application for Supplemental Security Income Benefits was filed on August 7, 2007 (R.103-106). On November 27, 2007, benefits were denied (R.81-95), and on January 16, 2008 the plaintiff requested a hearing (R.59-61). Pursuant to that request a hearing was held on October 27, 2008 (R.12-44). In a decision filed on January 26, 2009, an Administrative Law Judge denied benefits (R.66-79). The plaintiff requested reconsideration of that determination and on May 28, 2009, the Appeals Council affirmed the prior determination (R.1-3). The instant complaint was filed on July 1, 2009.

In reviewing an administrative determination of the Commissioner, the question before any court is whether there is substantial evidence in the agency record to support the findings of the Commissioner that the plaintiff failed to sustain his/her burden of demonstrating that he/she was disabled within the meaning of the Social Security Act. Richardson v. Perales, 402 U.S. 389 (1971); Adorno v. Shalala, 40 F.3d 43 (3d Cir. 1994).

It is provided in 42 U.S.C. Section 405(g) that:

The court shall have power to enter, upon the pleadings and transcript of the record, a judgment affirming, modifying, or reversing the decision of the Commissioner of Social Security, with or without remanding the cause for a rehearing. The findings of the Commissioner of Social Security as to any fact, if supported by substantial evidence, shall be conclusive....

Substantial evidence is "'more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.' Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)." Richardson v. Perales, supra., at page 401; Plummer v. Apfel, 186 F.3d 422 (3d Cir. 1999).

The purpose of the Supplemental Security Income Program is to provide additional income to persons of limited resources who are aged, blind or disabled persons. 42 U.S.C. §1381; Chalmers v. Shalala, 23 F. 3d 752 (3d Cir. 1994). To be eligible for such benefits, an individual's income must not exceed a certain established maximum and he/she must fulfill certain eligibility requirements.

As set forth in 20 C.F.R. § 416.905(a) disability is defined as: the inability to do 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 12 months. In addition, a person will be considered disabled if he/she is (a) ... permanently and totally disabled as defined under a State plan approved under title XIV or XVI of the Social Security Act, as in effect for October 1972; (b) ... received aid under the State plan ... for the month of December 1973 and for at least one month prior to July 1973; and (c) ... continue[s] to be disabled as defined under the State plan.

20 C.F.R. § 416.907.

A physical or mental impairment is defined in 20 C.F.R. §416.908 as an: impairment [which] result[s] from anatomical, physiological, or psychological abnormalities which [are demonstrated] by medically acceptable clinical and laboratory diagnostic techniques.

For purposes of determining whether or not the plaintiff met the eligibility requirements, certain evidence was considered by the Commissioner.

At the hearing held on October 27, 2008 (R.12-44), the plaintiff appeared with counsel (R. 14) and testified that he was born on September 13, 1966 (R.16); that he earned an associate's degree in air conditioning and refrigeration (R.16) and that he worked at Wal-Mart for a few months in 2005 (R.18).

In addition he testified that he cannot be around people (R.18); that he has difficulty concentrating (R.21,33,35); that he has severe arthritis and has to lay down three or four times a day due to pain (R.22,26,28); that he experiences daily depression (R.34); that he has a "demon" chasing him and he also sees dots (R.21); that he takes medication for pain, arthritis and his mental condition (R.20); that he can ...

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