United States District Court, M.D. Pennsylvania
JEFFREY C. ONCAY, Plaintiff,
CAROLYN W. COLVIN, ACTING COMMISSIONER OF SOCIAL SECURITY, Defendant.
GERALD B. COHN, Magistrate Judge.
The above-captioned action is one seeking review of a decision of the Commissioner of Social Security ("Commissioner") denying the application of Plaintiff Jeffrey C. Oncay disability insurance benefits ("DIB") under the Social Security Act, 42 U.S.C. §§401-433. (the "Act"). The Plaintiff has a previous denial of benefits by an administrative law judge ("ALJ") after a hearing dated May 4, 2010. Plaintiff did not pursue appeals or administrative remedies, and that decision addresses the same facts and issues in the present application. Consequently, the findings from the decision dated May 4, 2010 operate as res judicata to bar relitigation of those findings. The Plaintiff refiled on May 5, 2010. However, the evidence produced after May 5, 2010 is scarce, and indicates only mild to moderate abnormalities and conservative treatment. Although Plaintiff challenges the ALJ's listing analysis, credibility and RFC assessments, and assignment of weight to the medical opinions, the Court finds no merit to these objections. For the foregoing reasons, the Court will deny Plaintiff's appeal and affirm the decision of the Commissioner.
II. Procedural Background
On February 23, 2009, Plaintiff filed an application for DIB under Title II of the Act. (Tr. 54). Plaintiff filed a written request for a hearing, which was held on April 8, 2010. (Tr. 54). On May 4, 2010, an administrative law judge ("ALJ") issued a decision denying Plaintiff benefits. (Tr. 54).
The next day, May 5, 2010, Plaintiff filed the present application for DIB under Title II of the Act. (Tr. 101-104). On August 20, 2010, the Bureau of Disability Determination denied this application (Tr. 67-80), and Plaintiff filed a request for a hearing on August 26, 2010. (Tr. 84). On July 18, 2011, an ALJ held a hearing at which Plaintiff-who was represented by an attorney-and a vocational expert ("VE") appeared and testified. (Tr. 23-50). On August 24, 2011, the ALJ found that Plaintiff was not disabled and not entitled to benefits. (Tr. 9-22). On October 13, 2011, Plaintiff filed a request for review with the Appeals Council (Tr. 8), which the Appeals Council denied on May 21, 2013, thereby affirming the decision of the ALJ as the "final decision" of the Commissioner. (Tr. 1-7).
On August 5, 2013, Plaintiff filed the above-captioned action pursuant to 42 U.S.C. § 405(g) to appeal the decision of the Commissioner. (Doc. 1). On November 22, 2013, the Commissioner filed an answer and administrative transcript of proceedings. (Docs. 6, 7). On March 28, 2014, Plaintiff filed a brief in support of his appeal ("Pl. Brief"). (Doc. 20). On April 29, 2014, Defendant filed a brief in response ("Def. Brief"). (Doc. 21). On April 29, 2014, the Court referred this case to the undersigned Magistrate Judge. Both parties consented to the referral of this case for adjudication to the undersigned on July 29, 2014, and an order referring the case to the undersigned for adjudication was entered on July 29, 2014. (Doc. 28).
III. Standard of Review
When reviewing the denial of disability benefits, the Court must determine whether substantial evidence supports the denial. Johnson v. Commissioner of Social Sec. , 529 F.3d 198, 200 (3d Cir. 2008); Brown v. Bowen , 845 F.2d 1211, 1213 (3d Cir. 1988). Substantial evidence is a deferential standard of review. See Jones v. Barnhart , 364 F.3d 501, 503 (3d Cir. 2004). Substantial evidence "does not mean a large or considerable amount of evidence." Pierce v. Underwood , 487 U.S. 552, 564 (1988). Substantial evidence requires only "more than a mere scintilla" of evidence, Plummer v. Apfel , 186 F.3d 422, 427 (3d Cir. 1999), and may be less than a preponderance. Jones , 364 F.3d at 503. If a "reasonable mind might accept the relevant evidence as adequate" to support a conclusion reached by the Commissioner, then the Commissioner's determination is supported by substantial evidence. Monsour Med. Ctr. v. Heckler , 806 F.2d 1185, 1190 (3d Cir. 1986); Hartranft v. Apfel , 181 F.3d 358, 360 (3d Cir. 1999); Johnson , 529 F.3d at 200.
IV. Sequential Evaluation Process
To receive disability or supplemental security benefits, a claimant must demonstrate an "inability 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 12 months." 42 U.S.C. § 423(d)(1)(A); 42 U.S.C. § 1382c(a)(3)(A). The Act requires that a claimant for disability benefits show that he has a physical or mental impairment of such a 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 kind of substantial gainful work which exists in the national economy, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work.
42 U.S.C. § 423(d)(2)(A); 42 U.S.C. § 1382c(a)(3)(B).
The Commissioner uses a five-step evaluation process to determine if a person is eligible for disability benefits. See 20 C.F.R. § 404.1520; see also Plummer , 186 F.3d at 428. If the Commissioner finds that a Plaintiff is disabled or not disabled at any point in the sequence, review does not proceed. See 20 C.F.R. § 404.1520. The Commissioner must sequentially determine: (1) whether the claimant is engaged in substantial gainful activity; (2) whether the claimant has a severe impairment; (3) whether the claimant's impairment meets or equals a listed impairment from 20 C.F.R. Part 404, Subpart P, Appendix 1; (4) whether the claimant's impairment prevents the claimant from doing past relevant work; and (5) whether the claimant's impairment prevents the claimant from doing any other work. See 20 C.F.R. §§ 404.1520, 416.920. Before moving on to step four in this process, the ALJ must also determine Plaintiff's residual functional capacity ("RFC"). 20 C.F.R. §§ 404.1520(e), 416.920(e).
The disability determination involves shifting burdens of proof. The claimant bears the burden of proof at steps one through four. If the claimant satisfies this burden, then the Commissioner must show at step five that jobs exist in the national economy that a person with the claimant's abilities, age, education, and work experience can perform. Mason v. Shalala , 994 F.2d 1058, 1064 (3d Cir. 1993). The ultimate burden of proving disability within the meaning of the Act lies with the claimant. See 42 U.S.C. § 423(d)(5)(A); 20 C.F.R. § 416.912(a).
V. Res Judicata The ALJ invoked res judicata to bar reconsideration of evidence and issues from prior to May 4, 2010, the date of the prior ALJ decision. (Tr. 17). Plaintiff asserts that the ALJ improperly invoked res judicata because there was "no discussion of, or ruling on, or evidence supporting the finding of res judicata." (Pl. Brief at 4).
However, the Court finds that the application of res judicata was proper. First, the Court generally lacks jurisdiction to review a denial on res judicata grounds. As the Third Circuit has explained:
In Sanders, the Supreme Court declared that § 405(g)
clearly limits judicial review to a particular type of agency action, a "final decision of the Secretary made after a hearing." But a petition to reopen a prior final decision may be denied without a hearing as provided in § 205(b), 42 U.S.C. § 405(b) (1970 ed., Supp. V).... Indeed, the opportunity to reopen final decisions and any hearing convened to determine the propriety of such action are afforded by the Secretary's regulations and not by the Social Security Act. Moreover, an interpretation that would allow a claimant judicial review simply by filing-and being denied-a petition to reopen his claim would frustrate the congressional purpose, plainly evidenced in § 205(g), to impose a 60-day limitation upon judicial review of the Secretary's final decision on the initial claim for benefits. 20 CFR § 404.951 (1976). Congress' determination so to limit judicial review to the original decision denying benefits is a policy choice obviously designed to forestall repetitive or belated litigation of stale eligibility claims. Our duty, of course, is to respect that choice.
430 U.S. at 108 , 97 S.Ct. at 986. Similarly, the courts of appeals of several circuits have held that dismissals of "new" claims that effectively repeat previously denied claims and which are therefore held by the Secretary to be res judicata are not reviewable. Davis v. Schweiker, 665 F.2d 934 (9th Cir.1982); Ellis v. Schweiker, 662 F.2d 419 (5th Cir.1981); Bagby v. Harris, 650 F.2d 836 (6th Cir.), cert. denied, 454 U.S. 1087 , 102 S.Ct. 647, 70 L.Ed.2d 623 (1981); Andrews v. Harris, 635 F.2d 1362 (8th Cir.1980) (per curiam); Rios v. Secretary of Health, Education and Welfare, 614 F.2d 25 (1st Cir.1980). We agree that Sanders and § 405(g) require this conclusion.
The magistrate reviewing the claim examined the allegations and determined that, inasmuch as Stauffer conceded that the same claim was involved in his second filing, res judicata was properly applied.
Stauffer v. Califano , 693 F.2d 306, 307 (3d Cir. 1982) (quoting Califano v. Sanders , 430 U.S. 99, 108, 97 S.Ct. 980, 986, 51 L.Ed.2d 192 (1977)). Here, Plaintiff has not conceded that the same claims are involved in both applications. However, a review of the record shows that the claims are the same, and thus res judicata was properly applied.
Res judicata applies when:
1. There has been a previous determination or decision under the same subpart with respect to the same party.
2. The previous determination or decision was based on the same facts and on the same issue(s).
3. The previous determination or decision has become final by either administrative or judicial action. I-3-3-9. Admin. Res Judicata, HALLEX I-3-3-9 (S.S.A Sept. 8, 2005) (citing 20 C.F.R. § 404.957(c)(1)); Tobak v. Apfel , 195 F.3d 183, 185-88 (3d Cir. 1999); Rogerson ...