United States District Court, N.D. Iowa, Western Division
DONALD E. O'BRIEN, Senior Judge.
This matter is before the Court pursuant to Ismael Soria's [hereinafter Mr. Soria] application for disability insurance benefits under Title II of the Social Security Act ("Act"), 42 U.S.C. §§ 401 et seq. The parties appeared for a hearing on August 21, 2013. During the hearing, the Court requested supplemental briefs, which the parties filed shortly thereafter. After considering the parties' arguments, the Court took the matter under advisement and now enters the following.
I. FACTUAL BACKGROUND
Mr. Soria was born on December 21, 1974. He lives in Storm Lake, Iowa. At the time of the hearing, he was 37 years old. He has a fifth grade education and is a native Spanish speaker. (There was some testimony that Mr. Soria went to school intermittently in later grades, but did not complete them.) Mr. Soria cannot read English, and only speaks limited English. He is married and has four children.
Mr. Soria has a varied work history. His first jobs were doing basic farm labor. After that, he began working in packing houses and meat packing plants. He spent much of his adult life working at the Tyson meat packing plant in Storm Lake, Iowa. While working at Tyson, Mr. Soria hurt his back and that back injury is the basis for his present disability complaint. Mr. Soria first had back surgery in 2007. After returning to Tyson, he did light work but was eventually laid off. Since being laid off in 2009, Mr. Soria has made some attempts to learn English and find other work.
Mr. Soria claims disability based on back pain, high blood pressure and depression.
II. PROCEDURAL HISTORY
Mr. Soria filed his application for disability benefits on October 14, 2009. Mr. Soria alleged he became disabled on September 28, 2009. At the time Mr. Soria became disabled, he was 34 years old. The Social Security Administration denied Mr. Soria's application on December 2, 2009, and upon reconsideration March 22, 2010. On August 16, 2011, Mr. Soria appeared for telephonic hearing before an Administrative Law Judge (ALJ). Because of issues related to the telephone based interpreter, the hearing was continued. On November 29, 2011, Mr. Soria appeared for an in person hearing in Sioux Falls, South Dakota. Administrative Law Judge (ALJ) Robert Maxwell heard Mr. Soria's claim and denied it on December 12, 2011. Mr. Soria appealed to the Appeals Council, who denied his claim on December 5, 2012. Mr. Soria filed the present Complaint on February 7, 2013.
The ALJ set out the issue presently before the Court:
The issue is whether the claimant is disabled under sections 216(i) and 223(d) of the Social Security Act. Disability is defined as the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment or combination of impairments that can be expected to result in death or that has lasted or can be expected to last for a continuous period of not less than 12 months. There is an additional issue whether the insured status requirements of sections 216(i) and 223 of the Social Security Act are met. The claimant's earnings record shows that the claimant has acquired sufficient quarters of coverage to remain insured through December 31, 2014. Thus, the claimant must establish disability on or before that date in order to be entitled to a period of disability and disability insurance benefits.
Docket No. 5, Tr. 10.
Under the authority of the Social Security Act, the Social Security Administration has established a five-step sequential evaluation process for determining whether an individual is disabled and entitled to benefits. 20 C.F.R. § 404.1520. The five successive steps are: (1) determination of whether a plaintiff is engaged in "substantial gainful activity, " (2) determination of whether a plaintiff has a "severe medically determinable physical or medical impairment" that lasts for at least 12 months, (3) determination of whether a plaintiff's impairment or combination of impairments meets or medically equals the criteria of a listed impairment, (4) determination of whether a plaintiff's Residual Functional Capacity (RFC) indicates an incapacity to perform the requirements of their past relevant work, and (5) determination of whether, given a plaintiff's RFC, age, education and work experience, a plaintiff can "make an adjustment to other work." 20 C.F.R. § 404.1520(4)(i-v).
At step one, if a plaintiff is engaged in "substantial gainful activity" within the claimed period of disability, there is no disability during that time. 20 C.F.R. § 404.1520(a)(4)(I). At step 2, if a plaintiff does not have a "severe medically determinable physical or mental impairment" that lasts at least 12 months, there is no disability. 20 C.F.R. § 404.1520(a)(4)(ii). At step 3, if a plaintiff's impairments meet or medically equal the criteria of an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1, and last at least 12 months, a plaintiff is deemed disabled. 20 C.F.R. § 404.1520(e). Before proceeding to step 4 and 5, the ALJ must determine a plaintiff's Residual Functional Capacity [RFC]. RFC is the "most" a person "can still do" despite their limitations. 20 C.F.R. § 404.1545(a)(1). The RFC an ALJ assigns a plaintiff has been referred to as the "most important issue in a disability case...." Malloy v. Astrue , 604 F.Supp.2d 1247, 1250 (S.D. Iowa 2009) (citing McCoy v. Schweiker , 683 F.2d 1138, 1147 (8th Cir. 1982)(en banc)). When determining RFC, the ALJ must consider all of the relevant evidence and all of the Plaintiff's impairments, even those which are not deemed severe, as well as limitations which result from symptoms, such as pain. 20 C.F.R. § 404.1545(a)(2) and (3). An ALJ "may not simply draw his own inferences about a plaintiff's functional ability from medical reports." Strongson v. Barnhart , 361 F.3d 1066, 1070 (8th Cir. 2004).
At step 4, if, given a plaintiff's RFC, a plaintiff can still perform their past relevant work, there is no disability. 20 C.F.R. § 404.1520(a)(4)(iv). At step 5, if, given a plaintiff's RFC, age, education, and work experience, a plaintiff can make an adjustment to other work, there is no disability. 20 C.F.R. §§ 404.1520(a)(4)(v) and 416.920(a)(4)(v). This step requires the ALJ to provide "evidence" that a plaintiff could perform "other work [that] exists in significant numbers in the national economy." 20 C.F.R. § 404.1560(c)(2). In other words, at step 5, the burden of proof shifts from a plaintiff to the Commissioner of the S.S.A. Basinger v. Heckler , 725 F.2d 1166, 1168 (8th Cir. 1984). The ALJ generally calls a Vocational Expert (VE) to aid in determining whether this burden can be met.
In this case, the ALJ applied the appropriate methodology and found that Mr. Soria had not engaged in substantial gainful employment since September 28, 2009. The ALJ stated that Mr. Soria suffers from the degenerative disc disease and status post lumbar fusion. However, the ALJ found that Mr. Soria did not suffer from a disability as contemplated by the Social Security Code. Specifically, the ALJ stated:
[t]he claimant does not have an impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR 404.1520(d), 404.1525 and 404.1526). There are no medical opinions within the record that conclude that any of the claimant's impairments, alone or in combination, medically equals one of the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1. Moreover, the undersigned concludes that the evidence of record does not support a conclusion that any of the claimant's impairments, alone or in combination, meets one of the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1. The claimant carries the burden to establish that his or her impairment satisfies the requirements of a listed impairment ( Johnson v. Barnhart , 390 F.3d 1067, 1070 (8th Cir. 2004)). However, the undersigned has examined all of the impairments listed in 20 CFR Part 404, Subpart P, Appendix 1, and specifically considered Listing 1.04, and concludes that the record does not support that the criteria of this listing are satisfied.
The claimant's back impairment does not meet Listing 1.04 because there is no indication that the impairment has resulted in compromise of a nerve root or spinal cord with either: evidence of nerve root compression, characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss accompanied by sensory or reflex loss, and positive straight leg raising test (sitting and supine); spinal arachnoiditis; or lumbar spinal stenosis resulting in pseudoclaudication manifested by chronic nonradicular pain and weakness and resulting in inability to ambulate effectively. Specifically, the claimant's nerve root compression has not resulted in neuroanatomic distribution of pain (Exhibit 4F). It has resulted in limitation of motion of the spine (Exhibit 7F, p. 3), but there has been no sensory or reflex loss. Similarly, there is no indication or allegation that the claimant has spinal arachnoidits or has developed pseudoclaudication. Thus, Listing 1.04 is not met.
Docket No. 5, Tr. 14.
The ALJ went on to consider residual functional capacity and concluded:
[a]fter careful consideration of the entire record, the undersigned finds that the claimant has the residual functional capacity to perform less than the full range of light work as defined in 20 CFR 404.1567(b). Specifically, the claimant can lift and/or carry 20 pounds occasionally and 10 pounds frequently; stand/walk for about 6 hours in an 8-hour day with normal breaks and sit for about 6 hours in an 8-hour day with normal breaks. He could occasionally balance, stoop, kneel, crouch, crawl, and climb stairs/ramps, but never climb ladders/ropes/scaffolds.
Docket No. 5, Tr. 14. The ALJ than considered the plaintiff's credibility under the Polaski standard and stated:
[t]he claimant reported that due to his back impairment, he has significant pain in his legs and back. He also reports that he experiences dizziness and seeing "stars" or "lights, " possibly as a consequence of his pain medication. He states he can walk for 5 minutes and has only limited ability to perform all other exertional and postural activities. He alleges the need to change positions frequently. After careful consideration of the evidence, the undersigned finds that the claimant's medically determinable impairments could reasonably be expected to cause the alleged symptoms; however, the claimant's statements concerning the intensity, persistence and limiting effects of these symptoms are not credible to the extent they are inconsistent with the above residual functional capacity assessment.
Docket No. 5, Tr. 15.
The ALJ found significant Mr. Soria's medical history, stating:
[t]he objective medical evidence is one factor that the undersigned has considered. The claimant is diagnosed with degenerative disc disease and is status post a lumbar fusion performed in July 2007, two years prior to the alleged onset date (Exhibit 1F). Since the alleged onset date, physical examination has indicated limited forward flexion, positive straight leg raise, spinal tenderness, and muscle spasms (Exhibit 16F, p. 1; 15F, p. 2-3; 4F, p. 3; 7F, p.3). However, these exams have also consistently revealed intact sensation, normal strength, and normal reflexes. Furthermore, x-rays have consistently shown a solid, intact fusion (Exhibit 4F). The claimant's treating neurosurgeon, Jonathan Fuller, M.D., has ...