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Culmer v. Berryhill

United States District Court, S.D. Texas, Houston Division

March 21, 2019

James A. Culmer, Plaintiff,
v.
Nancy A. Berryhill, Commissioner of the Social Security Administration, Defendant.

          MEMORANDUM AND RECOMMENDATION

          Christina A. Bryan United States Magistrate Judge.

         Plaintiff James A. Culmer filed this case under the Social Security Act, 42 U.S.C. §§ 405(g), for review of the Commissioner's final decision partially granting his request for social security disability insurance benefits. Culmer and the Commissioner filed cross-motions for summary judgment (Dkts. 7, 9). After considering the pleadings, the record, and the applicable law, the court recommends that the district court GRANT Culmer's motion, DENY the Commissioner's motion, and remand this case to the Commissioner for further proceedings consistent with this Memorandum and Recommendation.[1]

         I. Background

         1. Factual and Administrative History

         Culmer signed his application for social security disability insurance benefits on March 30, 2015 and the agency stamped the application as received on April 24, 2015. Dkt. 5-7 at 2-6. Culmer alleged the date of onset of his disability to be September 29, 2013, the date he stopped working. Dkt. 5-7 at 2. Culmer testified that he stopped working primarily due to back problems. Dkt.5-3 at 49. His claim for disability was denied by the agency on initial review and reconsideration. On January 31, 2017, an administrative law judge (ALJ) held a hearing at which Culmer and a vocational expert testified. No. medical advisor testified at the hearing. The ALJ issued a partially favorable decision on April 5, 2017, finding Culmer disabled as of April 24, 2015. Dkt. 5-3 at 15-28. The Appeals Council denied review on March 16, 2018, and the ALJ's decision became the final decision of the Commissioner.

         2. Standard for District Court Review of the Commissioner's Decision

         Section 405(g) of the Act governs the standard of review in social security disability cases. Waters v. Barnhart, 276 F.3d 716, 718 (5th Cir. 2002). Federal court review of the Commissioner's final decision to deny Social Security benefits is limited to two inquiries: (1) whether the Commissioner applied the proper legal standard; and (2) whether the Commissioner's decision is supported by substantial evidence. Copeland v. Colvin, 771 F.3d 920, 923 (5th Cir. 2014); Jones v. Apfel, 174 F.3d 692, 693 (5th Cir. 1999). With respect to all decisions other than conclusions of law, [2] “[i]f the Commissioner's findings are supported by substantial evidence, they are conclusive and must be affirmed.” Perez v. Barnhart, 415 F.3d 457, 461 (5th Cir. 2005). “Substantial evidence is ‘such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'” Greenspan v. Shalala, 38 F.3d 232, 236 (5th Cir. 1994) (quoting Richardson v. Perales, 402 U.S. 389, 401 (1971)).

         3. The ALJ's Decision

         The ALJ performed the standard 5-step sequential analysis, [3] finding in steps one and two that Culmer met the insured status requirements of the Social Security Act through March 31, 2019, did not engage in substantial gainful activity from his alleged onset date through the date of the ALJ's decision, and has severe impairments. Dkt. 5-3 at 17. He further found at step 3 that Culmer's heart condition met Listing 4.02 for chronic heart failure as of January 27, 2017, but not before. Id. at 20.

         At step four, the ALJ made separate findings and conclusions with respect to Culmer's residual functional capacity (RFC) for the periods before and after April 24, 2015. The ALJ found that prior to April 24, 2015, Culmer was capable of performing his past relevant work as a financial sales associate, and thus was not disabled. Id. at 26. However, the ALJ found that as of April 24, 2015, Culmer was not capable of performing his past relevant work, and considering his “age, education, work experience, and RFC, there are no jobs that exist in significant numbers in the national economy that [Culmer] can perform.” Id. at 27. Thus, the ALJ determined that as of April 24, 2015, Culmer was disabled within the meaning of the Act. Id. at 28.

         II. Analysis

         Culmer's point of error in this appeal centers on the ALJ's decision to infer April 24, 2015, rather than his alleged onset date of September 29, 2013, as the date he became disabled. Culmer argues that the ALJ's inference that April 24, 2015 is the date of onset of his disability is not supported by substantial evidence because his medical records do not establish that date and the ALJ did not consult a medical advisor as required by Social Security Ruling (SSR) 83-20, 1983 WL 31249 (1983). According to the Commissioner, the ALJ's decision is supported by substantial evidence because “objective medical evidence indicates that, until April 24, 2015, Plaintiff had some limitations, but not to a disabling degree.” Dkt. 10 at 5. The Commissioner contends that the ALJ was not required to consult a medical advisor to determine the onset date in this case “because there was a relatively complete medical chronology of Plaintiff's impairments.” Dkt. 11 at 3. The court concludes that Culmer's argument is correct and that the case should be remanded.

         1. Determining the Onset Date of Disability

         The onset date of disability is the first day an individual is disabled as defined in the Act and the regulations. The social security regulations establish that the onset date of a disability is a critical determination because “it may affect the period for which the individual can be paid and may even be determinative of whether the individual is entitled to or eligible for any benefits.” SSR 83-20, 1983 WL 31249 at *1. Accordingly, the Fifth Circuit has held “it is essential that the onset date ...


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