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Curtis v. Commissioner of Social Security

United States District Court, W.D. Tennessee, Eastern Division

April 26, 2017




         Plaintiff Kathy Ann Curtis filed this action to obtain judicial review of Defendant Commissioner's final decision denying her application for disability insurance benefits under Title II of the Social Security Act (“Act”). Plaintiff's application was denied initially and upon reconsideration by the Social Security Administration. Plaintiff requested a hearing before an administrative law judge (“ALJ”), which was held on March 10, 2009. On April 21, 2009, the ALJ issued a decision, finding that Plaintiff was not entitled to benefits. The Appeals Council granted Plaintiff's request for review, and a second hearing was held on December 8, 2010. The ALJ again issued an unfavorable decision on June 7, 2011. The Appeals Council denied Plaintiff's request for review, and, thus, the decision of the ALJ became the Commissioner's final decision. For the reasons set forth below, the decision of the Commissioner is REVERSED, and the action is REMANDED for additional testimony pursuant to sentence four of 42 U.S.C. § 405(g).

         Under 42 U.S.C. § 405(g), a claimant may obtain judicial review of any final decision made by the Commissioner after a hearing to which he was a party. “The court shall have the power to enter, upon the pleadings and transcript of the record, a judgment affirming, modifying, or reversing the decision of the Commissioner of Social Security, with or without remanding the cause for a rehearing.”[1] The court's review is limited to determining whether there is substantial evidence to support the Commissioner's decision, [2] and whether the correct legal standards were applied.[3]

         Substantial evidence is “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.”[4] It is “more than a mere scintilla of evidence, but less than a preponderance.”[5] The Commissioner, not the Court, is charged with the duty to weigh the evidence, to make credibility determinations and resolve material conflicts in the testimony, and to decide the case accordingly.[6] When substantial evidence supports the Commissioner's determination, it is conclusive, even if substantial evidence also supports the opposite conclusion.[7] “[W]hen there is not substantial evidence to support one of the ALJ's factual findings and his decision therefore must be reversed, the appropriate remedy is not to award benefits. The case can be remanded under sentence four of 42 U.S.C. § 405(g) for further consideration.”[8]

         The Court may immediately award Plaintiff benefits “only if all essential factual issues have been resolved and the record adequately establishes a plaintiff's entitlement to benefits.”[9]“A judicial award of benefits is proper only where the proof of disability is overwhelming or where the proof of disability is strong and evidence to the contrary is lacking.”[10] These factors are not present in this case, and, therefore, an immediate award of benefits is not appropriate. However, a remand pursuant to sentence four of § 405(g) is appropriate because all essential issues have not been resolved.

         Plaintiff was born on May 5, 1956; she was fifty four years and eleven months old on March 31, 2011, her date last insured. Plaintiff has at least a high school education, is able to communicate in English, and has past relevant work experience as a scaler and inspector.

         The ALJ enumerated the following findings: (1) Plaintiff met the insured status requirements on March 31, 2011; (2) Plaintiff has not engaged in substantial gainful activity since the alleged onset date; (3) Plaintiff has the following severe impairments: fibromyalgia, osteoarthritis, degenerative disc disease, peripheral neuropathy, a prolapsed mitral valve, and depression; but she does not have impairments, either alone or in combination, that meet or equal the requirements of any listed impairment contained in 20 C.F.R. pt. 404, subpt. P, app. 1 of the listing of impairments; (4) Plaintiff retains the residual functional capacity to lift and or carry twenty pounds occasionally and ten pounds frequently; stand, walk, and/or sit six hours in an eight-hour workday; and do work involving no greater than simple job instructions; (5) Plaintiff is unable to perform her past relevant work; (6) transferability of job skills is not material to the determination of disability because using the Medical-Vocational Rules (“the Grids”) as a framework supports a finding that Plaintiff is not disabled whether or not she has transferable job skills; (7) considering Plaintiff's age, education, work experience, and residual functional capacity, there are jobs that exist in significant numbers in the national economy that Plaintiff can perform; (8) Plaintiff was not under a disability as defined in the Act at any time through the date of this decision.[11]

         The Social Security Act defines disability as the inability to engage in substantial gainful activity.[12] The claimant bears the ultimate burden of establishing an entitlement to benefits.[13]The initial burden of going forward is on the claimant to show that he is disabled from engaging in his former employment; the burden of going forward then shifts to the Commissioner to demonstrate the existence of available employment compatible with the claimant's disability and background.[14]

         The Commissioner conducts the following, five-step analysis to determine if an individual is disabled within the meaning of the Act:

         1. An individual who is engaging in substantial gainful activity will not be found to be disabled regardless of medical findings.

         2. An individual who does not have a severe impairment will not be found to be disabled.

         3. A finding of disability will be made without consideration of vocational factors, if an individual is not working and is suffering from a severe impairment which meets the duration requirement and which meets or equals a listed impairment in Appendix 1 to Subpart P of the regulations.

         4. An individual who can perform work that she has done in the past will not be found to be disabled.

         5. If an individual cannot perform his or her past work, other factors including age, education, past work experience and residual functional capacity must be considered to determine if other work can be performed.[15]

         Further review is not necessary if it is determined that an individual is not disabled at any point in this sequential analysis.[16] Here, the sequential analysis proceeded to the fifth step with a finding that, although Plaintiff cannot perform her past relevant work, there is a substantial number of jobs that exist in the national economy that she can perform.

         Plaintiff argues that the ALJ's finding that she retains the residual functional capacity to perform work other than her past relevant work is not supported by substantial evidence because the ALJ failed to properly apply the Grids, Medical-Vocational Guidelines of Appendix 2 to Subpart P of 20 CFR part 404, Subpart P. Plaintiff also contends that the ALJ's residual functional capacity assessment for a full range of light work is not supported by substantial evidence because he did not properly weigh the medical evidence in the record. The Court finds Plaintiff's arguments to be persuasive; a remand is in order because the ALJ failed to correctly assess the medical evidence in the record.

         Plaintiff argues that the ALJ should have assigned controlling weight to the opinion of her treating physician, Mohammed Yousef, M.D. The regulations require that, if the opinion of the claimant's treating physician is ‘“well-supported by medically acceptable clinical and laboratory diagnostic techniques' and [is] ‘not inconsistent with the other substantial evidence in [the] case record, '” it must be given “controlling weight.”[17] “If the opinion of a treating source is not accorded controlling weight, an ALJ must apply certain factors - namely, the length of the treatment relationship and the frequency of examination, the nature and extent of the treatment relationship, supportability of the opinion, consistency of the opinion with the record as a whole, and the specialization of the treating source - in determining what weight to give the opinion.”[18]Even if the treating physician's opinion is not given controlling weight, “there remains a presumption, albeit a rebuttable one, that the opinion of a treating physician is entitled to great deference.”[19]

         If the treating physician's opinion is not given controlling weight, the ALJ is required to provide “good reasons” for discounting it and that rationale must be supported by the evidence in the record and “must be sufficiently specific to make clear to any subsequent reviewers the weight the adjudicator gave to the treating source's medical opinion and the reasons for that weight.”[20]

         In the present case, the ALJ acknowledged that Dr. Yousef had opined that Plaintiff was disabled and could not “hold down gainful employment” because of her fibromyalgia, shoulder pain, hypertension, and generalized anxiety disorder, but the ALJ rejected that opinion as going to the ultimate issue of qualifying for disability benefits, which is an issue reserved for the Commissioner.[21] According to the ALJ, Dr. Yousef “did not give specific functional limitations, but rather, noted that the claimant was precluded from performing nearly every physical and mental activity.”[22] Despite noting that some of Dr. Yousef's records were illegible, the ALJ determined that the records “did not contain significant objective clinical findings based upon ...

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