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Spoljaric v. Berryhill

United States District Court, M.D. Pennsylvania

July 16, 2018

JERRY SPOLJARIC, Plaintiff
v.
NANCY BERRYHILL, Acting Commissioner of Social Security, Defendant

          MEMORANDUM

          MALACHY E. MANNION UNITED STATES DISTRICT JUDGE.

         The above-captioned action is one seeking review of the decision of the Acting Commissioner of Social Security (“Commissioner”), denying plaintiff Jerry Spoljaric's application for Social Security Disability Insurance Benefits (“DIB”) under Title II of the Social Security Act, 42 U.S.C. §§401-433. The court has jurisdiction pursuant to 42 U.S.C. §405(g). Currently before the court is plaintiff's appeal of the decision, (Doc. 1), which has been briefed by the parties. For the reasons set forth below, plaintiff's appeal will be GRANTED and the Commissioner's decision will be VACATED. The court will REMAND this case to the Commissioner for further proceedings.

         I. BACKGROUND[1]

         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 plaintiff meets the insured status requirements of the Social Security Act through March 31, 2014. (Tr. 19).[2] In order to establish entitlement to disability insurance benefits, plaintiff 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).

         Plaintiff was born May 25, 1966, and was 47 years old on the his date of last insured. He was a younger individual when the Administrative Law Judge (“ALJ”) rendered his decision in this case. Plaintiff has a high school education. His past relevant work was as a doorman. Plaintiff alleges that on June 1, 2008, after a motor vehicle accident in April 2008, he became disabled and was unable to work. Thus, the relevant time period is June 1, 2008 through March 31, 2014.

         Plaintiff filed a claim for DIB on November 15, 2013. He alleged that he was disabled due to severe back pain, left rotator cuff problems, and herniated discs. The agency denied plaintiff's application on January 29, 2014. Plaintiff filed a request for a hearing before an ALJ, which was held on June 4, 2015.

         The ALJ issued a decision on July 16, 2015. The ALJ found that plaintiff was not disabled within the meaning of the Social Security Act from June 1, 2008, through the date of his decision. Plaintiff filed a request for review.

         On December 13, 2016, the Appeals Council denied plaintiff's request for review, making the ALJ's decision the final decision of the Commissioner. Since plaintiff exhausted his administrative remedies, he initiated the present action on February 9, 2017, appealing the final decision of the Commissioner. (Doc. 1).

         Plaintiff appeals the ALJ's determination on two grounds: 1.Whether the ALJ erred in his Residual Functional Capacity (“RFC”) assessment, i.e., substantial evidence does not support the ALJ's RFC assessment, since he afforded inadequate weight to the opinion of plaintiff's treating physician, Dr. Poonia; and 2. Whether the ALJ erred in his evaluation of Dr. Goldenberg's functional assessment and whether the ALJ failed to properly explain his reason for discounting it.

         II. STANDARD OF REVIEW

         When reviewing the denial of disability benefits, the court must determine whether the denial is supported by substantial evidence. Brown v. Bowen, 845 F.2d 1211, 1213 (3d Cir. 1988); Johnson v. Commissioner of Social Sec., 529 F.3d 198, 200 (3d Cir. 2008). 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 (1988); Hartranft v. Apfel, 181 F.3d 358, 360. (3d Cir. 1999), Johnson, 529 F.3d at 200. It is less than a preponderance of the evidence but more than a mere scintilla. Richardson v. Perales, 402 U.S. 389, 401 (1971).

         To receive disability benefits, the plaintiff 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. §432(d)(1)(A). Furthermore,

[a]n individual shall be determined to be under a disability 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, 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. For purposes of the preceding sentence (with respect to any individual), ‘work which exists in the national economy' means work which exists in significant numbers either in the region where such individual lives or in several regions of the country.

42 U.S.C. §423(d)(2)(A).

         III. DISABILITY 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 v. Apfel,186 F.3d 422, 427 (3d Cir. 1999) (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 ...


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