United States District Court, Middle District of Pennsylvania
Christopher C. Conner, Chief Judge United States District Court.
The above-captioned action seeks review of a decision of the Commissioner of Social Security ("Commissioner") denying Plaintiff Terry Mortenson’s claim for social security disability insurance benefits and supplemental security income benefits. Under 42 U.S.C. § 405(g) and relevant case law, the court is generally limited to reviewing the administrative record to determine whether the decision is supported by substantial evidence.
Disability insurance benefits are paid to an individual if that individual is disabled and “insured, ” that is, the individual has worked long enough and paid social security taxes. The last date that a claimant meets the requirements of being insured is commonly referred to as the “date last insured.” It is undisputed that Mortenson met the insured status requirements of the Social Security Act through September 30, 2010. Tr. 15-16, 91, 93, 176 and 202. In order to establish entitlement to disability insurance benefits Mortenson was required to establish that he suffered from a disability on or before September 30, 2010. 42 U.S.C. §423(a)(1)(A), (c)(1)(B); 20 C.F.R. §404.131(a)(2008); see Matullo v. Bowen, 926 F.2d 240, 244 (3d Cir. 1990).
Supplemental security income is a federal income supplement program funded by general tax revenues (not social security taxes). It is designed to help aged, blind or other disabled individuals who have little or no income. Insured status is irrelevant in determining a claimant’s eligibility for supplemental security income benefits.
On June 29, 2010, Mortenson protectively filed an application for disability insurance benefits and an application for supplemental security income benefits. Tr. 14, 35, 37, 83-91, 93 and 176. On October 29, 2010, the Bureau of Disability Determination denied Mortenson’s applications. Tr. 38-45. On November 12, 2010, Mortenson filed a request for a hearing before an administrative law judge. Tr. 14 and 48-49. The request was granted and a hearing was held on September 27, 2011. Tr. 14 and 27-34. Mortenson did not appear at the hearing and was not represented by an attorney at the hearing but by a non-attorney representative. Id.
Mortenson in his applications for disability insurance benefits and supplemental security income benefits alleged that he became disabled on May 14, 2010. Tr. 14, 83, 87 and 175. Mortenson contends that he is unable to work because of left lower extremity deep venous thrombosis,  obesity, mild mental retardation, and headaches. Doc. 16, Plaintiff’s Brief, p. 2-3. He also claims that he suffers from depression and anxiety. Tr. 204.
Mortenson stated in documents filed with the Social Security Administration that he lives with his girlfriend; he has a “a lot of pain going down [his] leg;” he need reminders to take his medications; he fixes simple meals such as sandwiches and frozen dinners; he does laundry, mowing and cleaning house once a week; he shops in stores once a month; he no longer engages in his hobbies of “shooting pool, swimming and hanging out with friends” because of his disability; “at times” he needs someone to accompany him when he goes out; he has problems handling stress and changes in routine; and he worries all the time. Tr. 182-189. The non- attorney representative when asked by the administrative law judge if she had an opening statement responded as follows:
[I]t’s kind of hard with him not here, not being able to talk to him. I know he has the deep vein thrombosis. I haven’t got an update as to how it’s doing. But by the record, he did have headaches . . . dizziness. He was doing a heavy job of stone quarry work in which he was – it was very heavy work. He had a limited education. And we just believe, because of the clot in his leg, he’d only be able to do sedentary work. However, these jobs would – would be hard for him, also, because he did tell me that his leg swells if he sits and stands for long periods of time; and that he gets frequent headaches, needs frequent breaks.
On January 9, 2012, the administrative law judge issued a decision denying Mortenson’s applications. Tr. 14-26. The administrative law judge found that Mortenson failed to prove that he met the requirements of a listed impairment or suffered from work-preclusive functional limitations. Id. The administrative law judge concluded that Mortenson had the ability to engage in the full-range of unskilled, sedentary work. Id. The administrative law judge in setting Mortenson’s residual functional capacity at the full-range of unskilled, sedentary work found that Mortenson’s claims set forth in various documents regarding his functional limitations were not credible and were not supported by the objective medical evidence. Tr. 20.
The administrative law judge did not rely on the testimony of a vocational expert or identify specific jobs which Mortenson could perform on a full-time basis. Tr, 22-23. Instead, the administrative law judge utilized the Medical-Vocational Guidelines set forth at 20 C.F.R. pt. 404, subpt. P, app. 2.
Contained within the Social Security regulations is a grid or table which lists Rules 201.01 through 203.31 in the left hand column. The Social Security regulations provide that “where the findings of fact made with respect to a particular individual’s vocational factors and residual functional capacity coincide with all of the criteria of a particular rule, the rule directs a conclusion as to whether the individual is or is not disabled.” Rule 200.00. The Medical-Vocational Guidelines only cover sedentary, light and medium work. To utilize the Medical-Vocational Guidelines a claimant must be able to perform the full-range of a given level of work activity, i.e., sedentary, light or medium. If a claimant has any non-exertional limitations the Medical-Vocational Guidelines cannot be utilized to deny benefits. Jesurum v. Secretary of U.S. Dept. of Health & Human Services, 48 F.3d 114, 120 (3d Cir. 1995)(sit/stand option a nonexertional limitation); Scott v. Shalala, 30 F.3d 33, 35 (5th Cir. 1994)(same).
In the right hand column of the grid or table is set forth the “Decision” as to whether a claimant is “disabled” or “not disabled.” If all of the criteria of particular Rule are met “[t]he existence of jobs in the national economy is reflected in the ‘Decisions’ shown in the rules, i.e., in promulgating the rules, administrative notice has been taken of the numbers (sic) of unskilled jobs that exist throughout the national economy at the various functional levels. . . Thus, when all factors coincide with the criteria of a rule, the existence of such jobs is established.” Rule 200.00(b).
The administrative law judge concluded that based on his residual functional capacity, age, his education and his past work, Mortenson was not disabled because he could perform a significant number of unskilled, sedentary jobs in the national economy pursuant to Rule 201.24 of the Medical-Vocational Guidelines (grid). If all the criteria of Rule 201.24 are met then an individual is not disabled and there is no need to proceed to step five of the sequential evaluation process and determine based upon a vocational expert’s testimony that there are other jobs in the economy which the claimant’s can perform. In this case the administrative law judge made findings of fact which corresponded with all of the criteria of Rule 201.24 and found that Mortenson was not disabled.
On February 6, 2012, Mortenson filed a request for review with the Appeals Council. Tr. 9-12. On June 12, 2013, the Appeals Council concluded that there was no basis upon which to grant Mortenson’s request for review. Tr. 1-4. ...