Denise Cuffee v. Nancy Berryhill
680 F. App'x 156
| 4th Cir. | 2017Background
- Denise Cuffee suffered bilateral open tibial fractures from a 2008 gunshot and had corrective surgery; she applied for DIB and SSI twice (2009 and 2011/2012 filings).
- First application: ALJ Vest (2010) found Cuffee not disabled and assigned an RFC for a limited range of sedentary work; Appeals Council denied review and Cuffee did not seek judicial review.
- Second application: filed 2011 and amended alleged onset to September 26, 2012; ALJ Pianin (2013) found Cuffee not disabled and assigned a less restrictive RFC for a limited range of light work; Appeals Council denied review.
- District court adopted the magistrate judge’s R&R and affirmed the Commissioner; Cuffee appealed, arguing ALJ Pianin erred by not adopting the prior RFC.
- The Fourth Circuit reviewed whether substantial evidence supported the ALJ’s decision not to adopt the prior RFC, applying SSA Acquiescence Ruling AR 00-1(4) factors (changeable facts, time elapsed, new evidence).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ Pianin erred by declining to adopt ALJ Vest’s prior RFC | Cuffee: nerve damage is permanent, so prior RFC should carry weight; three-year gap too short to justify a more favorable RFC | Commissioner: substantial time elapsed since prior RFC and evidence shows functional improvement; RFC depends on functional limitations, not diagnosis | Court: Affirmed — substantial evidence supports ALJ’s departure from prior RFC |
| Proper weight to give older medical opinions and prior RFC under AR 00-1(4) | Cuffee: older treating surgeon’s opinion and prior RFC deserved controlling weight due to long-term treatment relationship | Commissioner: newer consultative exam plus evidence of functional gains support giving less weight to older opinion | Court: ALJ properly evaluated evidence, permissibly gave less weight to older opinion in light of intervening evidence |
Key Cases Cited
- Pearson v. Colvin, 810 F.3d 204 (4th Cir. 2015) (substantial-evidence standard for reviewing ALJ decisions)
- Bird v. Comm’r of Soc. Sec. Admin., 699 F.3d 337 (4th Cir. 2012) (review scope: defer to ALJ on credibility and weighing conflicts)
- Johnson v. Barnhart, 434 F.3d 650 (4th Cir. 2005) (definition of substantial evidence and appellate role)
- Hancock v. Astrue, 667 F.3d 470 (4th Cir. 2012) (substantial-evidence explanation)
- Craig v. Chater, 76 F.3d 585 (4th Cir. 1996) (ALJ credibility and fact-finding role)
- Lively v. Sec’y of HHS, 820 F.2d 1391 (4th Cir. 1987) (res judicata issues in SSA claims informing AR 00-1(4))
- Albright v. Comm’r of Soc. Sec. Admin., 174 F.3d 473 (4th Cir. 1999) (precedent on effect of prior SSA decisions)
- Gross v. Heckler, 785 F.2d 1163 (4th Cir. 1986) (disability depends on functional limitations, not diagnosis)
- Bowen v. Yuckert, 482 U.S. 137 (1987) (burden shifting under SSA sequential analysis)