United States District Court, N.D. Iowa, Western Division
JAMIE W. DRAPER, Plaintiff,
CAROLYN W. COLVIN, Commissioner of Social Security, Defendant.
DONALD E. O'BRIEN, Senior District Judge.
This matter is before the Court pursuant to Jamie Draper's [hereinafter Mr. Draper] application for disability insurance benefits under Title II of the Social Security Act ("Act"), 42 U.S.C. §§ 401 et seq. After considering the parties' arguments, the Court took the matter under advisement and now enters the following.
I. FACTUAL BACKGROUND
Mr. Draper, 35 years old at the time of the ALJ hearing, alleges disability arising out injuries he suffered during a motor vehicle accident. Mr. Draper was rear-ended while driving down the interstate in a blizzard, and he suffered various injuries to his neck and head. Since the accident, Mr. Draper lives with his mother.
Mr. Draper has a high school degree. After graduating from high school, Mr. Draper had a number of manual labor type jobs; including, as a commercial glass installer, a painter, and general construction work. His final job prior to his alleged onset date was working retail at the construction supply store, Home Depot. He was gainfully employed at all times prior to the accident.
II. PROCEDURAL HISTORY
Mr. Draper protectively filed an application for disability insurance benefits under Title II of the Social Security Act ("Act"), 42 U.S.C. §§ 401 et seq. (Tr. 72, 74, 163-69) on August 24, 2010. His claim was denied initially and upon reconsideration. Mr. Draper appealed, and a hearing was held before an ALJ. On May 21, 2012, the ALJ denied Mr. Draper's claim. Mr. Draper appealed to the Appeals Council, who denied his claim on April 23, 2013. Mr. Draper filed the present Complaint on June 21, 2013. Docket No. 1.
The ALJ set out the issue presently before the Court:
[t]he 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. 7, Tr. 9.
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) abrogated on other grounds by Higgins v. Apfel , 222 F.3d 504, 505 (8th Cir. 2000)). When determining the 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. Draper had not engaged in substantial gainful employment since January 1, 2010. The ALJ stated that Mr. Draper has severe impairments including status post cervical and lumbar spine fusion surgeries, affective disorder, and anxiety disorder. However, the ALJ found that Mr. Draper 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). Although the claimant has impairments considered severe, the undersigned finds these impairments were not attended, singly or in combination with any other impairment, with the specific clinical signs and diagnostic findings required to meet or equal the requirements of any listed impairment. Moreover, no physician has opined that the claimant equals a listed impairment alone or in combination.
Docket No. 7, Tr. 12.
The ALJ went on to consider residual functional capacity and concluded:
[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). The undersigned has considered all of the claimant's impairments, singly and in combination, and finds that they do not meet or medically equal any of the listings found in 20 CFR Part 404, Subpart P, Appendix 1.
Docket No. 7 Tr. 12.
The ALJ considered Mr. Draper's neck/back problems and stated:
[t]he undersigned has evaluated the claimant's back and neck conditions under the section 1.00 listings for musculoskeletal impairments, but concludes that none of the listings are met. The record does not document medical findings that are equivalent in severity and duration to any of the listed findings, and the claimant's impairments therefore do not medically equal a listing under this section. The undersigned gave particular consideration to listing 1.04 in evaluating the claimant's back and neck disorders. The "paragraph A" criteria of listing 1.04 are not met because the record does not demonstrate evidence of nerve root compression characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss (atrophy with associated muscle weakness) accompanied by sensory or reflex loss, and positive straight-leg raising. ...