United States District Court, M.D. Pennsylvania
above-captioned action is one seeking review of a decision of
the Acting Commissioner of Social Security
(“Commissioner”), denying Plaintiff John
Ragen's application for Social Security Disability
Insurance Benefits (“DIB”) and Supplemental
Security Income (“SSI”) under Title II and Title
XVI. For the reasons set forth below, we will vacate the
decision of the Commissioner and remand the case to the
Commissioner for further proceedings.
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 Ragen
met the insured status requirements of the Social Security
Act through December 31, 2013. (Tr. 25).
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
applied protectively for DIB on May 20, 2013 and SSI on May
3, 2013, alleging disability for both claims beginning
February 7, 2013. (Tr. 23). Ragen's date last insured for
purposes of his DIB claim is December 31, 2013. (Tr. 25, 46).
His claims were initially denied on August 21, 2013. (Tr. 23,
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 September 5, 2014. (Tr. 23, 44-90). At the hearing,
Ragen was represented by counsel, and a Vocational Expert
testified. (Tr. 44-90). On December 11, 2014, the ALJ issued
a decision denying Ragen's applications. (Tr. 127-43).
Ragen's request for a review with the Appeals Council was
denied on May 5, 2016. (Tr. 1-6). Thus, the ALJ's
decision stood as the final decision of the Commissioner.
filed a complaint in this Court on July 11, 2016. (Doc. 1).
The Commissioner filed an answer on September 16, 2016. (Doc.
13). After supporting and opposing briefs were submitted
(Docs. 15 and 16), the appeal became ripe for disposition.
was born on June 25, 1971 (Tr. 37), has a limited education,
and is able to communicate in English. (Tr. 37). In the past,
Ragen worked as a stock person, industrial cleaner,
loader/unloader, packager and cleaner/janitor. (Tr. 36, 37).
Ragen has not engaged in substantial gainful activity since
the alleged onset date of February 7, 2013. (Tr. 25).
found Ragen to have the following severe impairments:
coronary artery disease, history of myocardial infarction,
hypertension, bipolar disorder, anxiety disorder, and
cannabis abuse. (Tr. 25).
Standard of Review
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)). The Commisioner must indicate which evidence
was accepted, which evidence was rejected, and the reasons
for rejecting certain evidence. Johnson v. Comm'r of
Soc. Sec., 529 F.3d 198, 203 (3d Cir. 2008). Therefore,
a court reviewing the decision of the Commissioner must
scrutinize the record as a whole. Gilliland, 786
F.2d at 183 (citing Smith v. Califano, 637 F.2d 968,
970 (3d Cir. 1981)).
Sequential Evaluation Process
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 the burden of demonstrating
an inability to return to her past relevant work. Adorno
v. Shalala, 40 F.3d 43, 46 (3d Cir. 1994).
If the claimant is unable to resume her former occupation,
the evaluation moves to the final step. At this stage, the
burden of production shifts to the Commissioner, who must
demonstrate the claimant is capable of performing other
available work in order to deny a claim of disability. 20
C.F.R. § 404.1520(f). The ALJ must show there are other
jobs existing in significant numbers in the national economy
which the claimant can perform, consistent with her medical
impairments, age, education, past work experience, and
residual functional capacity. The ALJ must analyze the
cumulative effect of all the claimant's impairments in
determining whether she is capable of performing work and is
not disabled. See ...