United States District Court, N.D. Iowa, Central Division
DONALD E. O'BRIEN, Senior District Judge.
This matter is before the Court pursuant to Penny Newsom's [hereinafter Ms. Newsom] application for Disability Insurance Benefits 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
Ms. Newsom was born on May 12, 1964, and was 48 years old at the time of the hearing before the Administrative Law Judge (ALJ). She lives in the Ft. Dodge, Iowa, area. Ms. Newsom has limited education. She dropped out of school in 10th grade, but received her GED in 1982. She also attended a cosmetology course in Kansas. Ms. Newsom worked a variety of jobs over the years, including for a cleaning service and an adult care facility.
Ms. Newsom claims disability based on a number of conditions, including hypertension, gastroesophageal reflux disease, diverticulitis, bilateral knee arthritis, obesity, bipolar disorder, panic disorder without agoraphobia, and substance abuse.
II. PROCEDURAL HISTORY
Ms. Newsom applied for disability insurance benefits and supplemental security income (SSI) under Titles II and XVI of the Social Security Act (Act), 42 U.S.C. §§ 401-434, 1381-1385, on November 4, 2010, and October 5, 2010, respectively, alleging an onset date of October 27, 2009. Plaintiff's claims were denied initially on February 16, 2011, and upon reconsideration on May 26, 2011. On October 26, 2012, following a hearing, the ALJ found that Ms. Newsom was not under a "disability" as defined in the Act. Ms. Newsom appealed the ALJ's decision to the Appeals Council, who denied her appeal on January 9, 2014. Ms. Newsom filed the present Social Security appeal on February 12, 2014.
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 has acquired sufficient quarters of coverage to remain insured through June 30, 2013. 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 impairment meets or medically equals 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 Ms. Newsom has not engaged in substantial gainful employment since October 27, 2009.
The ALJ stated that Ms. Newsom has the following combination of severe impairments: hypertension; gastroesophageal reflux disease; history of diverticulitis; bilateral knee arthritis; obesity; bipolar disorder; panic disorder without agoraphobia; and substance abuse (20 C.F.R. § 404.1520(c) and 416.920(c)).
However, the ALJ considered Ms. Newsom's impairments individually and combined and found that Ms. Newsom 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. 12.
The ALJ considered Ms. Newsom's mental impairments using the "paragraph B" criteria and the "paragraph C" criteria as set out in 20 C.F.R. Part 404, Subpart P, Appendix 1 (20 C.F.R. 416.920(d), 416.925 and 416.926), and determined that Ms. Newsom's mental impairments did not meet either set of requirements. Docket No. 7, Tr. 12-13.
The ALJ went on to consider residual functional capacity and concluded:
[a]fter careful consideration of the entire record, the undersigned finds the claimant has the residual functional capacity to perform light work as defined in 20 CFR 404.1567(b) and 416.967(b) involving lifting 20 pounds occasionally and 10 pounds frequently; standing and sitting 2 hours at a time for 6 hours in an 8 hour day; walking 2 blocks; never climbing ladders, ropes, or scaffolds; never working at heights; only occasionally climbing ramps and stairs; and only occasionally balancing, stooping, kneeling, crouching, crawling, and bending. The individual would be limited to simple, routine tasks.
Docket No. 7 Tr. 14.
The ALJ than considered the Plaintiff's credibility under the Polaski standard and stated:
[a]fter considering the evidence of record, the undersigned finds the claimant's medically determinable impairments could reasonably be expected to produce the alleged symptoms; however, the claimant's statements concerning the intensity, persistence, and limiting effects of these symptoms are not fully credible.
Docket No. 7, Tr. 17.
The ALJ found significant certain inconsistences in the record, stating:
[t]he record reflects the claimant made inconsistent statements regarding matters relevant to the issue of disability. For instance, the claimant testified she was capable of walking only about one-half block as she experienced difficulty with walking; yet, the claimant reported no difficulty with walking in a Functional Report. Examining sources observed normal gait and medical evidence of record revealed "good success" after knee injections. (Testimony, Exhibit 5E, and Exhibit 21F). At one point or another in the record, either in forms completed in connection with the application, in medical records, or in testimony, the claimant reported she was capable of caring for her personal needs; caring for two grandchildren; caring for a pet; driving; performing household chores such as dusting, vacuuming, and doing laundry; watching television; and playing on the computer. The activities are not limited to the extent one would expect, given the complaints of disabling symptoms and limitations.
Docket No. 7, Tr. 17. Similarly, the ALJ stated that he believed Ms. Newsom exaggerated her ...