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Ross v. Colvin

United States District Court, M.D. Pennsylvania

March 10, 2015

CAROLYN W. COLVIN, Acting Commissioner of Social Security Defendant



This is an action brought under Section 205(g) of the Social Security Act, 42 U.S.C. § 405(g), seeking judicial review of the final decision of the Commissioner of Social Security ("Commissioner") denying the Plaintiff's claim for a period of Disability Insurance Benefits under Title II of the Social Security Act. This matter has been referred to the undersigned Magistrate Judge for the preparation of a report and recommended disposition pursuant to the provisions of 28 U.S.C. §636(b) and Rule 72(b) of the Federal Rules of Civil Procedure. For the reasons stated herein, it is recommended that the decision of the Commissioner be AFFIRMED.


On February 17, 2012, Plaintiff Sandra Ann Ross protectively filed an application for a period of disability and disability insurance benefits under Title II of the Social Security Act due to a heart attack and unstable blood pressure beginning March 21, 2011. (Admin Tr. 143; Doc. 9-6 p. 9). Ross's claim was denied initially on May 9, 2012, and denied on reconsideration on July 6, 2012. Ross requested, and was granted, an opportunity to have her claim re-evaluated during an administrative hearing. On October 16, 2013, Ross, assisted by counsel, appeared and testified during an administrative hearing before Administrative Law Judge ("ALJ") B.T. Amos in St. Petersburg, Florida.

During her hearing, Ross testified that she lived with her husband in a house. (Admin Tr. 36; Doc. 9-2 p. 37). She also reported that she last worked as a registered nurse case manager in the insurance industry for approximately four months, until she had a heart attack in March 2011. Id. Prior to transitioning to the insurance industry, Ross worked as a case manager for a brain injury company for about one year, which she characterized as a similar type of work. (Admin Tr. 37; Doc. 9-2 p. 38). In a work history report, however, Ross reported that her work at the brain injury company required her to lift up to one hundred pounds, though she did not lift more than ten pounds on a frequent basis, whereas she only lifted objects weighing less than ten pounds as a nurse practitioner case manager. (Admin Tr. 153-54; Doc. 9-6 pp. 19-20).

Ross reported that she cannot return to work because she cannot focus, stay on task, or concentrate, and because she experiences chronic fatigue therefore must take mid-day naps. (Admin Tr. 38; Doc. 9-2 p. 39). Additionally, Ross asserted that she has anxiety (related to her heart condition), heart palpitations (due to her anxiety), shortness of breath on exertion, dizziness, neuropathy in her hands (right more often than left). Id. She also experiences "occasional" chest pain and "more than occasional" swelling in her feet. She reported that when her feet swell she must sit down and elevate her feet above her heart level. Id. Ross reported that she has difficulty using her right (dominant) had due to neuropathy, and constantly drops items. (Admin Tr. 38-39; Doc. 9-2 pp. 39-40). In a cardiac questionnaire, Ross reported that she could walk one to two blocks before stopping due to shortness of breath, climb 12 steps before she develops a rapid heartbeat, is unable to lift more than fifteen pounds, and cannot lift objects of any weight above her head. (Admin Tr. 137-38; Doc. 9-6 pp. 3-4). As far as her daily activities, Ross testified that she can do all "basic daily living" activities like cooking, cleaning, and laundry. (Admin Tr. 166-67; Doc. 9-6 pp. 32-33).

On December 3, 2013, the ALJ denied Ross's claim in a written decision. (Admin Tr. 20-28; Doc. 9-2 pp. 21-29). Thereafter, Ross requested review of her claim by the Appeals Council. On March 27, 2014, her request for review was denied. (Admin Tr. 1-3; Doc. 9-2 pp. 2-4).

At some point between the Appeals Counsel's decision to deny review, and her initiation of this action, Ross - formerly a Florida resident - relocated to the Middle District of Pennsylvania. She currently resides within the Middle District of Pennsylvania. She then initiated this action by filing a Complaint in this Court on May 22, 2014.[1] (Doc. 1). Ross alleges that the conclusions and findings of fact made by the Commissioner are not supported by substantial evidence, are contrary to the law and applicable regulations, and urges us to reverse the Commissioner's decision without remand, or in the alternative remand this matter for a new administrative hearing. On July 25, 2014, the Commissioner filed her Answer to Ross's complaint, in which she contends that the decision denying Ross's application for disability insurance benefits is correct and in accordance with the law and applicable regulations. (Doc. 8). Together with her answer, the Commissioner filed a complete copy of the administrative record. (Doc. 9).

Having been fully briefed by the parties, this appeal is now ripe for resolution. (Doc. 10; Doc. 16).


Resolution of the instant social security appeal involves an informed consideration of the respective roles of two adjudicators - the ALJ and this Court. At the outset, it is the responsibility of the ALJ in the first instance to determine whether a claimant has met the statutory prerequisites for entitlement to benefits.

To receive benefits under the Social Security Act by reason of disability, 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. §405(g); see also 20 C.F.R. §404.1505(a). To satisfy this requirement, a claimant must have a severe physical or mental impairment that makes it impossible to do his or her previous work or any other substantial gainful activity that exists in the national economy. 42 U.S.C. §405(g); 20 C.F.R. §404.1505(a). To receive benefits under Title II of the Social Security Act, a claimant must show that he or she contributed to the insurance program, is under retirement age, and became disabled prior to the date on which he or she was last insured. 42 U.S.C. § 423(a); 20 C.F.R. § 404.131(a).

In making this determination at the administrative level, the ALJ follows a five-step sequential evaluation process. 20 C.F.R. §404.1520(a). Under this framework, the ALJ 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; (4) whether the claimant is able to do his or her past relevant work; and (5) whether the claimant is able to do any other work, considering his or her age, education, work experience and residual functional capacity ("RFC"). 20 C.F.R. §404.1520. Between steps three and four, the ALJ must also assess a claimant's Residual Functional Capacity ("RFC"). RFC is defined as "that which an individual is still able to do despite the limitations caused by his or her impairment(s)." Burnett v. Comm'r of Soc. Sec., 220 F.3d 112, 121 (3d Cir. 2000) (citations omitted); see also 20 C.F.R. §404.1545. In making this assessment, the ALJ considers all of the claimant's medically determinable impairments, including any non-severe impairments identified by the ALJ at step two of his or her analysis. 20 C.F.R. §404.1545(a)(2).

At steps one through four, the claimant bears the initial burden of demonstrating the existence of a medically determinable impairment that prevents him or her in engaging in any of his or her past relevant work. 42 U.S.C. §423(d)(5); 20 C.F.R. §404.1512; Mason v. Shalala, 994 F.2d 1058, 1064 (3d Cir. 1993). Once this burden has been met by the claimant, it shifts to the Commissioner at step five to show that jobs exist in significant number in the national economy that the claimant could perform that are consistent with the claimant's age, education, work experience and RFC. 20 C.F.R. §404.1512(f); Mason, 994 F.2d at 1064.

Once a final decision is issued by the Commissioner, and that decision is appealed to this Court, this Court's review of the Commissioner's final decision is limited to determining whether the findings of the final decision maker - the ALJ in this case - are supported by substantial evidence in the record. See 42 U.S.C. § 405(g)(sentence five); Johnson v. Comm'r of Soc. Sec., 529 F.3d 198, 200(3d Cir. 2008); Ficca v. Astrue, 901 F.Supp.2d 533, 536(M.D.Pa. 2012). Substantial evidence "does not mean a large or considerable amount of evidence, but rather such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Pierce v. Underwood, 487 U.S. 552, 565 (1988). Substantial evidence is less than a preponderance of the evidence but more than a mere scintilla. Richardson v. Perales, 402 U.S. 389, 401 (1971). A single piece of evidence is not substantial evidence if the ALJ ignores countervailing evidence or fails to resolve a conflict created by the evidence. Mason, 994 F.2d at 1064. But in an adequately developed factual record, substantial evidence may be "something less than the weight of the evidence, and the possibility of drawing two inconsistent conclusions from the evidence does not prevent [the ALJ's decision] from being supported by substantial evidence." Consolo v. Fed. Maritime Comm'n, 383 U.S. 607, 620 (1966). "In determining if the Commissioner's decision is supported by substantial evidence the court must scrutinize the record as a whole." Leslie v. Barnhart, 304 F.Supp.2d 623, 627 (M.D.Pa. 2003). The question before this Court, therefore, is not whether Ross is disabled, but whether the Commissioner's finding that she is not disabled is supported by substantial evidence and was reached based upon a correct application of the relevant law. See Arnold v. Colvin, No. 3:12-CV-02417, 2014 WL 940205, at *1 (M.D.Pa. Mar. 11, 2014)("[I]t has been held that an ALJ's errors of law denote a lack of substantial evidence.")(alterations omitted); Burton v. Schweiker, 512 F.Supp. 913, 914 (W.D.Pa. 1981)("The Secretary's determination as to the status of a claim requires the correct application of the law to the facts."); see also Wright v. Sullivan, 900 F.2d 675, 678 (3d Cir. 1990)(noting that the scope of review on legal matters is plenary); Ficca, 901 F.Supp.2d at 536 ("[T]he court has plenary review of all legal issues....").


In his decision, the ALJ found that Ross meets the insured status requirements of Title II of the Social Security Act through December 31, 2016, and proceeded through steps one though four of the five step sequential evaluation process. At step one, the ALJ found that Ross has not engaged in any substantial gainful activity since March 21, 2011, her alleged onset date. (Admin Tr. 21; Doc. 9-2 p. 22). At step two, the ALJ found that Ross had the medically determinable severe impairments of coronary artery disease with a history of percutaneous coronary intervention and stent, hypertension, hyperintensive cardiovascular disease, hyperlipidemia, obesity, and chronic stable angina. Id. The ALJ found that Ross's alleged impairments of anxiety and neuropathy were not medically determinable due to a lack of objective evidence. Id. At step three, the ALJ found that Ross did not have an impairment, or combination of medically determinable impairments, that met or equaled the severity of one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. (Admin Tr. 23; Doc. 9-2 p. 24).

Before proceeding to step four, the ALJ evaluated Ross's residual functional capacity based upon his review of all the relevant evidence in the record, which included treatment notes, hospital records, Ross's statements, and medical opinions by treating medical sources cardiologist Dr. Vimesh Mithani and primary care physician Dr. Halima ...

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