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Kopinetz v. Colvin

United States District Court, M.D. Pennsylvania

February 23, 2017

JOHN JAY KOPINETZ, Plaintiff,
v.
CAROLYN W. COLVIN, Acting Commissioner of Social Security Defendant.

          MEMORANDUM

          Matthew W. Brann United States District Judge

         The above-captioned action is one seeking review of a decision of the Acting Commissioner of Social Security (“Commissioner”)[1], denying Plaintiff John Jay Kopinetz's (“Kopinetz”) application for Social Security Disability Insurance Benefits (“DIB”) and Supplemental Security Income (“SSI”) under Title II and Title XVI, respectively. For the reasons set forth below, the Court will affirm the Commissioner's denial of DIB, but vacate and remand the Commissioner's denial of SSI.

         I. Background

         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 Kopinetz met the insured status requirements of the Social Security Act through March 31, 2010. (Tr. 17).[2] In order to establish entitlement to disability insurance benefits, Kopinetz was required to establish that he suffered from a disability on or before that date. 42 U.S.C. § 423(a)(1)(A), (c)(1)(B); 20 C.F.R. § 404.131(a); see Matullo v. Bowen, 926 F.2d 240, 244 (3d Cir. 1990).

         SSI 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.

         Kopinetz applied protectively for DIB on May 24, 2013 and SSI on June 30, 2013, alleging disability beginning May 12, 2009. (Tr. 14, 124-134). His claims were initially denied on August 27, 2013 (Tr. 98, 99). Kopinetz requested a hearing before the Administrative Law Judge (“ALJ”) Office of Disability and Adjudication and Review of the Social Security Administration, and one was held on August 6, 2014. (Tr. 33, 109-111). At the hearing, Kopinetz was represented by counsel, and a vocational expert testified. (Tr. 33-67). On September 22, 2014, the ALJ issued a decision denying Kopinetz's application. (Tr. 11-32). Kopinetz filed a request for review with the Appeals Council, which was denied. (Tr. 1-10). Thus, the ALJ's decision stood as the final decision of the Commissioner.

         Kopinetz filed a complaint in this Court on June 6, 2016. (Doc. 1). The Commissioner filed an answer on August 8, 2016. (Doc. 8). After supporting and opposing briefs were submitted (Docs. 10 and 11), the appeal[3] became ripe for disposition.

         Kopinetz was born on November 26, 1965, has at least a high school education, and is able to communicate in English. (Tr. 27). In the past, Kopinetz worked as a pastry chef and bakery manager. (Tr. 26). Kopinetz has not engaged in substantial gainful activity since the alleged onset date of disability, May 12, 2009. (Tr. 17).

         Kopinetz has the following severe impairments: osteoarthritis, degenerative disc disease, obesity, narcotic addiction/abuse and, as of June 2014, anxiety and major depressive disorder. (Tr. 17).

         II. Standard of Review

         When considering a social security appeal, the Court has plenary review of all legal issues decided by the Commissioner. See Poulos v. Comm'r of Soc. Sec., 474 F.3d 88, 91 (3d Cir. 2007); Johnson v. Comm'r of Soc. Sec., 529 F.3d 198, 200 (3d Cir. 2008). However, our review of the Commissioner's findings of fact pursuant to 42 U.S.C. § 405(g) is to determine whether those findings are supported by “substantial evidence.” Id. The factual findings of the Commissioner, “if supported by substantial evidence, shall be conclusive . . . .” 42 U.S.C. § 405(g). “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.” Johnson, 529 F.3d at 200 (3d Cir. 2008) (quoting Hartranft v. Apfel, 181 F.3d 358, 360 (3d Cir. 1999)) (internal quotations and citations omitted). Substantial evidence has been described as more than a mere scintilla of evidence but less than a preponderance. Brown v. Bowen, 845 F.2d 1211, 1213 (3d Cir. 1988). “It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Plummer v. Apfel, 186 F.3d 422, 427 (3d Cir. 1999) (citing Ventura v. Shalala, 55 F.3d 900, 901 (3d Cir. 1995)) (quoting Richardson v. Perales, 402 U.S. 389, 401 (1971) (internal citations omitted)). The United States Court of Appeals for the Third Circuit has stated,

[O]ur decisions make clear that determination of the existence vel non of substantial evidence is not merely a quantitative exercise. A single piece of evidence will not satisfy the substantiality test if the [Commissioner] ignores, or fails to resolve, a conflict created by countervailing evidence. Nor is evidence substantial if it is overwhelmed by other evidence - particularly certain types of evidence (e.g., that offered by treating physicians) - or if it really constitutes not evidence but mere conclusion.

Morales v. Apfel, 225 F.3d 310, 317 (3d Cir. 2000) (citing Kent v. Schweiker, 710 F.2d 110, 114 (3d Cir. 1983); Gilliland v. Heckler, 786 F.2d 178, 183 (3d Cir. 1986)). Therefore, a court reviewing the decision of the Commissioner must scrutinize the record as a whole. Id. (citing Smith v. Califano, 637 F.2d 968, 970 (3d Cir. 1981)).

         III. Sequential Evaluation Process

         The plaintiff must establish that there is some “medically determinable basis for an impairment that prevents him from engaging in any substantial gainful activity for a statutory twelve-month period.” Fargnoli v. Massanari, 247 F.3d 34, 38-39 (3d Cir. 2001) (quoting Plummer, 186 F.3d at 427) (internal quotations omitted). “A claimant is considered unable to engage in any substantial gainful activity ‘only if his physical or mental impairment or impairments are of such 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 . . . .'” Fargnoli, 247 F.3d at 39 (quoting 42 U.S.C. § 423(d)(2)(A)). The Commissioner follows a five-step inquiry pursuant to 20 C.F.R. § 404.1520 to determine whether the claimant is disabled. In Plummer, the Third Circuit set out the five-steps:

In step one, the Commissioner must determine whether the claimant is currently engaging in substantial gainful activity. 20 C.F.R. § [404.]1520(a). If a claimant is found to be engaged in substantial activity, the disability claim will be denied. Bowen v. Yuckert, 482 U.S. 137, 140 (1987) . . . . In step two, the Commissioner must determine whether the claimant is suffering from a severe impairment. 20 C.F.R. § 404.1520(c). If the claimant fails to show that her impairments are “severe, ” she is ineligible for disability benefits.
In step three, the Commissioner compares the medical evidence of the claimant's impairment to a list of impairments presumed severe enough to preclude any gainful work. 20 C.F.R. § 404.1520(d). If a claimant does not suffer from a listed impairment or its equivalent, the analysis proceeds to steps four and five. Step four requires the ALJ to consider whether the claimant retains the residual functional capacityto perform her past relevant work. 20 C.F.R. § 404.1520(d). The claimant bears ...

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