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Gilbert v. Berryhill

United States District Court, N.D. Texas, Dallas Division

January 23, 2018

TONYA GILBERT, Plaintiff,
v.
NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.

          FINDINGS, CONCLUSIONS, AND RECOMMENDATION OF THE UNITED STATES MAGISTRATE JUDGE

          DAVID L. HORAN UNITED STATES MAGISTRATE JUDGE

         Plaintiff Tonya Gilbert seeks judicial review of a final adverse decision of the Commissioner of Social Security under 42 U.S.C. § 405(g). For the reasons explained below, the hearing decision should be reversed.

         Background

         Ms. Gilbert alleges that she is disabled due to a variety of ailments including diabetes, back pain, depression and anxiety. After her application for disability insurance benefits was denied initially and on reconsideration, Ms. Gilbert requested a hearing before an administrative law judge (“ALJ”). That hearing was held on January 29, 2015. See Dkt. No. 10 (Administrative Record (“Tr.”)) at 49-85 (Hearing Transcript). At the time of the hearing, Ms. Gilbert was 51 years old. She has a tenth grade education and past work experience as a cashier-checker. Ms. Gilbert has not engaged in substantial gainful activity since January 1, 2010.

         The ALJ found that Ms. Gilbert was not disabled and therefore not entitled to disability benefits. See Tr. at 21-32 (ALJ's Decision). Although the medical evidence established that Ms. Gilbert suffered from status post left knee replacement, degenerative disc disease, obesity, affective disorder, anxiety disorder and diabetes, the ALJ concluded that the severity of those impairments did not meet or equal any impairment listed in the social security regulations. The ALJ further determined that Ms. Gilbert had the residual functional capacity to perform a limited range of light work but could not return to her past relevant employment. Relying on a vocational expert's testimony, the ALJ found that Ms. Gilbert was capable of working as an assembler, laundry folder and price marker - jobs that exist in significant numbers in the national economy. Given her age, education, and exertional capacity for light work, the ALJ determined that Ms. Gilbert was not disabled under the Medical-Vocational Guidelines.

         Ms. Gilbert appealed that decision to the Appeals Council. The Council affirmed. Ms. Gilbert then filed this action in federal district court. Ms. Gilbert contends that the hearing decision is not supported by substantial evidence and results from reversible legal error. More particularly, Ms. Gilbert argues that (1) the ALJ erred by assigning significant weight to the opinion of the examining psychologist but failing to include all of the limitations that the examining psychologist found or explaining why he did not include them and (2) the ALJ failed to provide good, specific, and supported reasons for giving “less weight” to the opinion of the consultive examiner, who found extreme physical limitations.

         The undersigned concludes that the hearing decision should be reversed and this case remanded to the Commissioner of Social Security for further proceedings consistent with these findings and conclusions.

         Legal Standards

         Judicial review in social security cases is limited to determining whether the Commissioner's decision is supported by substantial evidence on the record as a whole and whether Commissioner applied the proper legal standards to evaluate the evidence. See 42 U.S.C. § 405(g); Copeland v. Colvin, 771 F.3d 920, 923 (5th Cir. 2014); Ripley v. Chater, 67 F.3d 552, 555 (5th Cir. 1995). Substantial evidence is “more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971); accord Copeland, 771 F.3d at 923. The Commissioner, rather than the courts, must resolve conflicts in the evidence, including weighing conflicting testimony and determining witnesses' credibility, and the Court does not try the issues de novo. See Martinez v. Chater, 64 F.3d 172, 174 (5th Cir. 1995); Greenspan v. Shalala, 38 F.3d 232, 237 (5th Cir. 1994). This Court may not reweigh the evidence or substitute its judgment for the Commissioner's but must scrutinize the entire record to ascertain whether substantial evidence supports the hearing decision. See Copeland, 771 F.3d at 923; Hollis v. Bowen, 837 F.2d 1378, 1383 (5th Cir. 1988). The Court “may affirm only on the grounds that the Commissioner stated for [the] decision.” Copeland, 771 F.3d at 923.

         “In order to qualify for disability insurance benefits or [supplemental security income], a claimant must suffer from a disability.” Id. (citing 42 U.S.C. § 423(d)(1)(A)). A disabled worker is entitled to monthly social security benefits if certain conditions are met. See 42 U.S.C. § 423(a). The Act defines “disability” as the inability to engage in substantial gainful activity by reason of any medically determinable physical or mental impairment that can be expected to result in death or last for a continued period of 12 months. See Id. § 423(d)(1)(A); see also Copeland, 771 F.3d at 923; Cook v. Heckler, 750 F.2d 391, 393 (5th Cir. 1985).

         “In evaluating a disability claim, the Commissioner conducts a five-step sequential analysis to determine whether (1) the claimant is presently working; (2) the claimant has a severe impairment; (3) the impairment meets or equals an impairment listed in appendix 1 of the social security regulations; (4) the impairment prevents the claimant from doing past relevant work; and (5) the impairment prevents the claimant from doing any other substantial gainful activity.” Audler v. Astrue, 501 F.3d 446, 447-48 (5th Cir. 2007).

         The claimant bears the initial burden of establishing a disability through the first four steps of the analysis; on the fifth, the burden shifts to the Commissioner to show that there is other substantial work in the national economy that the claimant can perform. See Copeland, 771 F.3d at 923; Audler, 501 F.3d at 448. A finding that the claimant is disabled or not disabled at any point in the five-step review is conclusive and terminates the analysis. See Copeland, 771 F.3d at 923; Lovelace v. Bowen, 813 F.2d 55, 58 (5th Cir. 1987).

         In reviewing the propriety of a decision that a claimant is not disabled, the Court's function is to ascertain whether the record as a whole contains substantial evidence to support the Commissioner's final decision. The Court weighs four elements to determine whether there is substantial evidence of disability: (1) objective medical facts; (2) diagnoses and opinions of treating and examining physicians; (3) subjective evidence of pain and disability; and (4) the claimant's age, education, and work history. See Martinez, 64 F.3d at 174.

         The ALJ has a duty to fully and fairly develop the facts relating to a claim for disability benefits. See Ripley, 67 F.3d at 557. If the ALJ does not satisfy this duty, the resulting decision is not substantially justified. See Id. However, the Court does not hold the ALJ to procedural perfection and will reverse the ALJ's decision as not supported by substantial evidence where the claimant shows that the ALJ failed to fulfill the duty to adequately develop the record only if that failure prejudiced Ms. Gilbert, see Jones v. Astrue, 691 F.3d 730, 733 (5th Cir. 2012) - that is, only if Ms. Gilbert's substantial rights have been affected, see Audler, 501 F.3d at 448. ‚ÄúPrejudice can be established by showing that additional evidence would have been produced if the ALJ had fully developed the record, and that the additional evidence might have led to a different ...


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