United States District Court, N.D. Iowa, Western Division
DONALD E. O'BRIEN, Senior District Judge.
This matter is before the Court pursuant to Timothy Sundling's [hereinafter Mr. Sundling's] application for Disability Insurance Benefits ("DIB") under Title II of the Social Security Act ("Act"), and Supplemental Security Income ("SSI") benefits under Title XVI of the Act. After considering the parties' arguments, the Court took the matter under advisement and now enters the following.
I. FACTUAL BACKGROUND
Mr. Sundling, a resident of Sioux City, was born September 1, 1973, and was 38 years old at the time of hearing before the Administrative Law Judge (ALJ). He lives with his wife. He has a son, although his parental rights to that child have been terminated. He has a high school education. He has experience as a "construction worker II, " "construction worker, " "industrial-truck operator, " "machine feeder, " and a "telephone solicitor." He has worked off and on at these various construction type jobs throughout his adult life.
Mr. Sundling suffers from the medically diagnosed impairments of bipolar affective disorder, post-traumatic stress disorder, adjustment disorder with mixed anxiety and depression, cannabis abuse in remission and polysubstance abuse in remission. Additional medically diagnosed impairments that the ALJ determined to be non-severe are asthma, back pain, arthralgia and myalgia. However, the primary basis of Mr. Sundling's alleged disability is his mental health issues.
II. PROCEDURAL HISTORY
Mr. Sundling filed his application on February 4, 2010, alleging an onset date of July 1, 2009. The Social Security Administration denied Mr. Sundling's application on April 13, 2010, and upon reconsideration, July 23, 2010. On March 15, 2012, Mr. Sundling appeared for a telephonic hearing before the ALJ. The ALJ denied Mr. Sundling's claim on March 29, 2012. Mr. Sundling appealed to the Appeals Council, who denied his claim on April 30, 2013. Mr. Sundling filed the present Complaint on June 14, 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), 223(d), and 1614(a)(3)(A) 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. With respect to the claim for a period of disability and disability insurance benefits, 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 the claimant acquired sufficient quarters of coverage to remain insured through March 31, 2010. 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. 12.
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 lasts 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 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. Sundling had engaged in substantial gainful employment from May 15, 2009, to July 10, 2009. However, the ALJ went on to find that there have been continuous 12-month periods since the alleged onset date during which Mr. Sundling did not engage in substantial gainful employment.
The ALJ stated that Mr. Sundling has severe impairments including bipolar affective disorder, post-traumatic stress disorder (PTSD); adjustment disorder with mixed anxiety and depression; cannabis abuse, in remission; and polysubstance dependence, in remission.
However, the ALJ found that Mr. Sundling 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, 404.1526, 416.920(d), 416.925, and 416.926).
Docket No. 7, Tr. 15.
The ALJ considered Mr. Sundling's mental impairments using the "paragraph B" criteria and the "paragraph C" criteria as set out in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR 416.920(d), 416.925 and 416.926), regarding mental impairments, and determined that Mr. Sundling's mental impairment did not meet either set of requirements. Docket No. 7, Tr. 15-16. In doing so, the ALJ gave great weight to the opinion of the medical consultant, Dr. Hutchinson.
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 a full range of work at all exertional levels but he has nonexertional limitations due to his mental impairments. The claimant is limited to simple tasks of 1, 2, or 3 steps and needs reminders to perform work tasks 10% of the time. He can maintain concentration and attention span 90% of the time, and he is able to have contact with the public and co-workers 75% of the time. In making this finding, the undersigned has considered all symptoms and the extent to which these symptoms can reasonably be accepted as consistent with the objective medical evidence and other evidence, based on the requirements of 20 CFR 404.1529 and ...