Bagwell v. BarnhartBagwell v. Barnhart
MEMORANDUM AND ORDER
Pending before the Court are Plaintiff Julius Bagwell Jr.’s (“Bagwell”) and Defendant Jo Anne B. Barnhart’s (“Commissioner”) cross-motions for summary judgment. Bagwell appeals the determination of an Administrative Law Judge (“ALJ”) that he is not entitled to receive Title II disability insurance benefits or Title XVI supplemental security income benefits.
See
I. Background
Bagwell filed applications for disability insurance benefits and supplemental security income payments with the SSA on August 12, 1997, and April 25, 2000, respectively, alleging disability beginning on March 22,1994, as a result of degenerative disc disease 1 and asthma. 2 (R. 15, 184-186). After being denied benefits initially and on reconsideration, Bagwell requested an administrative hearing before an ALJ to review the decision. (R. 149). A hearing was held on November 20, 1998, in Bellaire, Texas, at which time the ALJ heard testimony from Bagwell and Laurie McQuade Johnson 3 (“Johnson”), a vocational expert (“VE”). (R. 29-64). In a decision dated, February 16, 1999, the ALJ denied Bagwell’s application for benefits. (R. 121-137). On March 17, 1999, Bagwell appealed the ALJ’s decision to the Appeals Council of the SSA’s Office of Hearings and Appeals. (R. 158). The Appeals Council, on June 15, 2001, remanded this case to an ALJ for further proceedings. (R. 169-170).
A second administrative hearing was held before an ALJ on February 6, 2002, in Bellaire, Texas, at which time the ALJ heard testimony from Bagwell, Ronald DeVere, M.D. (“Dr. DeVere”), a medical expert, and McQuade, a VE. (R. 65-118). In a decision dated March 1, 2002, the ALJ denied Bagwell’s application for benefits. (R. 15-23). In the decision, the ALJ found that Bagwell had severe medically determinable impairments of degenerative disc disease and asthma. (R. 22). The ALJ determined, however, that Bagwell’s impairments did not meet or medically equal one of the listed impairments in Appendix I, Subpart P, Regulation No. 4. (R. 22). The ALJ concluded that, although Bagwell could not perform his past relevant work as a truck driver, he could perform light work (ie., ticket taker, library page, and order caller), with certain limitations, and that these jobs exist in significant numbers in the national economy. (R. 23).
On March 15, 2002, Bagwell appealed the ALJ’s decision to the Appeals Council of the SSA’s Office of Hearings and Appeals. (R. 9). The Appeals Council, on October 18, 2002, declined to review the ALJ’s determination. (R. 7-8). This rendered the ALJ’s opinion the final decision of the Commissioner.
See Sims v. Apfel,
II. Analysis
A. Statutory Bases for Benefits
SSI benefits are authorized by Title XVI of the Act and are funded by general tax
When you file an application in the month that you meet all the other requirements for eligibility, the earliest month for which we can pay you benefits is the month following the month you filed the application. If you file an application after the month you first meet all the other requirements for eligibility, we cannot pay you for the month in which your application is filed or any months before that month.
Social Security disability insurance benefits are authorized by Title II of the Act and are funded by Social Security taxes.
See also
Social SECURITY Administration, Social Security Handbook:, § 2100. The disability insurance program provides income to individuals who are forced into involuntary, premature retirement, provided they are both
insured,
and
disabled,
regardless of indigence. A claimant for disability insurance can collect benefits for up to twelve months of disability prior to the filing of an application.
See
While these are separate and distinct programs, applicants seeking benefits under either statutory provision must prove “disability” within the meaning of the Act, which defines disability in virtually identical language for both programs.
See
B. Standard of Review
1. Summary Judgment
The court may grant summary judgment under
An issue of fact is “material” only if its resolution could affect the outcome of the case.
See Duplantis v. Shell Offshore, Inc.,
2. Administrative Determination
Judicial review of the Commissioner’s denial of disability benefits is limited to whether the final decision is supported by substantial evidence on the record as a whole and whether the proper legal standards were applied to evaluate the evidence.
See Masterson v. Barnhart,
When applying the substantial evidence standard on review, the court “scrutinize[s] the record to determine whether such evidence is present.”
Myers v. Apfel,
C. ALJ’s Determination
An ALJ must engage in a five-step inquiry to determine whether the claimant is capable of performing “substantial gainful activity,” or is, in fact, disabled:
1. An individual who is working and engaging in substantial gainful activity will not be found disabled regardless of the medical findings. See20 C.F.R. §§ 404.1520(b) , 416.920(b).
2. An individual who does not have a “severe impairment” will not be found to be disabled. See20 C.F.R. §§ 404.1520(c) , 416.920(c).
3. An individual who “meets or equals a listed impairment in Appendix 1”of the regulations will be considered disabled without consideration of vocational factors. See 20 C.F.R. §§ 404.1520(d) , 416.920(d).
4. If an individual is capable of performing the work he' has done in the past, a finding of “not disabled” must be made. See20 C.F.R. §§ 404.1520(e) , 416.920(e).
5. If an individual’s impairment precludes performance of his past work, then other factors, including age, education, past work experience, and residual functional capacity must be ■considered to determine if any work can be performed. See20 C.F.R. §§ 404.1520(f) , 416.920(f).
Newton v. Apfel,
The mere presence of an impairment does not necessarily establish a disability.
See Anthony v. Sullivan,
A medically determinable “physical or mental impairment” is an impairment that results from anatomical, physiological, or psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques.
See Hames v. Heckler,
In the case at bar, when addressing the first four steps, the ALJ determined:
1. The claimant met the disability insured status requirements of the Act on March 22, 1994, the alleged onset date of disability, and continued to meet them through December 31, 1996, but not thereafter.
2. The claimant has not engaged in substantial gainful activity during the relevant period under consideration.
3. The claimant has the following severe medically determinable impairments: degenerative disc disease and asthma.
4. The claimant’s impairments, singly or in combination, do not meet or equal in severity the medical criteria for any impairment described in the Listings.
5. The testimony concerning subjective symptoms and functional limitations is not wholly credible or supported by the evidence as a whole insofar as the claimant alleges an inability to perform all work activity including a limited range of light work.
6. The claimant retains the residual functional capacity for light work. The claimant can sit for 8 hours in a day, and stand and walk for 4 to 6 hours in a day. He can lift and carry 10 pounds occasionally and 20 pounds frequently. Although he can occasionally climb, balance, and bend, he cannot do any stooping or crawling. Due to his history of asthma, the claimant must work in a climate-controlled environment reasonably free of noxious fumes, dust, smoke, and lint.
7. The claimant cannot do his past relevant work as a truck driver.
(R. 22-23). As to the fifth step, the ALJ concluded:
8. The claimant’s vocational profile is that of a younger individual until [Date of Birth] 1997, when he became an individual closely approaching advanced age. The claimant has a high school education.
9. The claimant (considering age, education, skills, work history, and residual functional capacity) can perform the following occupations: ticket taker, library page, and order caller. Such jobs exist in a significant number in the regional and national economies.
10. Considering the claimant’s medical-vocational profile within the framework of Rules 202.21 and 202.14 of Appendix 2, a finding of “not disabled” is warranted.
11. The claimant was not under a “disability,” as defined in the Act, at any time through the date of this decision.
(R. 22-23).
This Court’s inquiry is limited to a determination of whether there is substantial evidence in the record to support the ALJ’s findings and whether the proper legal standards have been applied.
See Masterson,
D. Issues Presented
Bagwell contends that the decision of the ALJ is not supported by substantial evidence. Specifically, Bagwell claims that the ALJ erred by (1) setting his residual functional capacity at light work when the ALJ had adopted postural restrictions (ie., no stooping), which effectively precluded Bagwell from performing light and sedentary work because both require occasional stooping; and (2) failing to reconcile the VE’s testimony that someone with Bag-well’s limitations could perform the job of a library page with the description of that job contained in the Dictionary of Occupational Titles (“DOT”). 4
The Commissioner acknowledges that the ALJ found that Bagwell was unable to stoop; however, the Commissioner argues that the record supports a finding that Bagwell retained the ability to stoop on at least an occasional basis. Thus, the Commissioner argues he was capable of performing light work. The Commissioner also concedes that Bagwell is correct in pointing out that the DOT indicates that the job of library page requires frequent stooping. The Commissioner maintains that the remaining two jobs identified by the ALJ (ie., ticket taker and order caller) are unaffected by even a complete inability to stoop, as the DOT indicates that the need to stoop is “not present” in either of the job of ticket taker or the job of order caller.
1. Residual Functional Capacity
Under the Act, a person is considered disabled:
only if his physical or mental impairment or impairments are of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work.
Moreover, under certain circumstances, the ALJ’s application of the medical-vocational guidelines set forth in Appendix 2 of Subpart P of the Regulations, also referred to as the grids, without testimony from a vocational expert, is sufficient to assess whether a claimant is able to work or is disabled under the Act.
See Heckler v. Campbell,
These guidelines relieve the Secretary of the need to rely on vocational experts by establishing through rulemaking the types and numbers of jobs that exist in the national economy. They consist of a matrix of the four factors identified by Congress — physical ability, age, education, and work experience — and set forth rules that identify whether jobs requiring specific combinations of these factors exist in significant numbers in the national economy. Where a claimant’s qualifications correspond to the job requirements identified by a rule, the guidelines direct a conclusion as to whether work exists that the claimant could perform. If such work exists, the claimant is not considered disabled.
Id.
at 461-62,
Each of these four factors is divided into defined categories. A person’s ability to perform physical tasks, for example, is categorized according to the physical exertion requirements necessary to perform varying classes of jobs — i.e., whether a claimant can perform sedentary, light, medium, heavy, or very heavy work.20 C.F.R. § 404.1567 . Each of these work categories is defined in terms of the physical demands it places on a worker, such as the weight of objects he must lift and whether extensive movement or use of arm and leg controls is required. Ibid.
Id.
at 462 n. 3,
Under the regulations, impairments can be either exertional or nonexertional.
See Sykes v. Apfel,
In evaluating RFC, the Fifth Circuit has looked to SSA rulings (“SSR”). The Social Security Administration’s rulings are not binding on this Court, but they may be consulted when the statute at issue provides little guidance.
5
See Myers,
First, SSR 96-8p provides that a residual functional capacity (RFC) “is an assessment of an individual’s ability to do sustained work-related physical and mental activities in a work setting on a regular and continuing basis.” “A ‘regular and continuing basis’ means 8 hours a day, for 5 days a week, or an equivalent work schedule.” “The RFC assessment is a function-by-function assessment based upon all of the relevant evidence of an individual’s ability to do work-related activities.” “However, without the initial function-by-function assessment of the individual’s physical and mental capacities, it may not be possible to determine whether the individual is able to do past relevant work....” RFC involves both exertional and nonexertional factors. Exertional capacity involves seven strength demands: sitting, standing, walking, lifting, carrying, pushing, and pulling. “Each function must be considered separately.” “In assessing RFC, the adjudicator must discuss the individual’s ability to perform sustained work activities in an ordinary work setting on a regular and continuing basis....” The RFC assessment must include a resolution of any inconsistencies in the evidence.
Id.
(quoting 61 Fed.Reg. 34474-01 (July 2, 1996)). The court also noted that SSR 96-9p defines exertional capacity as the aforementioned seven strength demands and requires that the individual’s capacity to do them on a regular continuing basis be stated.
See id.
Thus, to determine that an applicant can do a given type of work, the ALJ must find that the applicant can meet the job’s exertional and nonexertional requirements on a sustained basis and can maintain regular employment.
See Watson,
When a claimant suffers only ex-ertional impairments and an ALJ’s findings of residual functional capacity, age, education, and previous work experience coincide with the grids, the Commissioner may rely exclusively on the medical-voca
In the case at bar, there are voluminous medical records detailing treatment Bagwell has received for back pain and asthma symptoms. (R. 458, 487-489). In her decision, the ALJ described the pertinent records that substantiate Bag-well’s severe medically determinable impairments of degenerative disc disease and asthma. (R. 16-21). Because the parties’ dispute is not centered around the medical records, there is no need for the Court to reiterate these records.
Dr. DeVere, the medical expert at the second administrative hearing, reviewed Bagwell’s medical records and testified that Bagwell’s asthma had been stable since 1996, requiring only routine visits to the doctor. (R. 94, 661). Moreover, a 1998 pulmonary function study showed only a very mild obstruction. (R. 94-95, 467). According to Dr. DeVere, Bagwell did not meet the requirements of Listing 3.03, which addresses asthma, because he neither had asthma attacks occurring at least once every two months and requiring physician intervention, nor did he have the required level of pulmonary decomposition. (R. 94-97).
With respect to Bagwell’s lower back pain, Dr. DeVere testified that Bagwell failed to meet Listing 1.05(C), 6 which addresses lumbar radiculopathy, because he did not have motor or reflex loss. (R. 97-98, 102-103, 662). Bagwell’s motor strength had been repeatedly described as 5/5, which was normal. (R. 20, 487-489, 662).
In determining Bagwell’s RFC, the ALJ relied upon John Anigbogu’s, M.D. (“Dr.Anigbogu”), medical assessment of Bagwell’s abilities to do work-related activities. (R. 661-666). Dr. Anigbogu opined that Bagwell could lift and carry from 30 to 40 pounds occasionally, and 25 pounds frequently. (R. 665). He stated that Bag-well could stand and walk for about 2 hours in an 8-hour day. (R. 665). Bag-well’s ability to sit was not affected. (R. 665). Dr. Anigbogu further stated that Bagwell could occasionally climb, and balance but never stoop, crouch, kneel, or crawl. (R. 666). The ALJ concluded that “based solely on the objective medical evidence of record, it appears that the claimant retains the residual functional capacity for a limited range of light work as specified by Dr. Anigbogu.” (R. 19). Thus, in his decision, the ALJ made the following
The Administrative Law Judge finds that the claimant’s impairments do not preclude him from engaging in light work. The claimant can sit for 8 hours in a day, and stand and walk for 4 to 6 hours in a day. He can lift and carry 10 pounds occasionally and 20 pounds frequently. Although he can occasionally climb, balance, and bend, he cannot do any stooping or crawling. Due to his history of asthma, the claimant must work in a climate-controlled environment reasonably free of noxious fumes, dust, smoke and lint.
******
The claimant retains the residual functional capacity for light work. The claimant can sit for 8 hours in a day, and stand and walk for 4 to 6 hours in a day. He can lift and carry 10 pounds occasionally and 20 pounds frequently. Although he can occasionally climb, balance, and bend, he cannot do any stooping or crawling. Due to his history of asthma, the claimant must work in a climate-controlled environment reasonably free of noxious fumes, dust, smoke and lint.
(R. 20, 23) (emphasis added).
The ALJ’s RFC finding is internally inconsistent to the extent she states Bagwell can “occasionally ... bend” but “cannot do any stooping.” (R. 20, 23). It is unclear what distinction the ALJ intended between the ability to bend and stoop. A review of the social security regulations and rulings does not bear out a distinction between the two terms. Indeed, SSR 83-14 defines “stooping” as “bending the body downward and forward by bending the spine at the waist.”
[s]tooping, kneeling, crouching, and crawling are progressively more strenuous forms of bending parts of the body, with crawling as a form of locomotion involving bending. Some stooping (bending the body downward and forward by bending the spine at the waist) is required to do almost any kind of work, particularly when objects below the waist are involved. If a person can stoop occasionally (from very little up to one-third of the time) in order to lift objects, the sedentary and light occupational base is virtually intact.
Similarly, the ALJ fails to provide reasoning as to how Bagwell could perform light work when he is precluded from stooping. The physical exertional requirements for light work are as follows:
Light work involves lifting no more than 20 pounds at a time with frequent lifting or carrying of objects weighing up to 10 pounds. Even though the weight lifted may be very little, a job is in this category when it requires a good deal of walking or standing, or when it involves sitting most of the time with some pushing and pulling of arm or leg controls. To be considered capable of performing a full or wide range of light work, you must have the ability to do substantially all of these activities. If someone can do light work, we determine that he or she can also do sedentary work, unless there are additional limiting factors such as a loss of fine dexterity or inability to sit for long periods of time.
Finally, 96-9p, addressing postural limitations, explains that
[a] complete inability to stoop would significantly erode the unskilled sedentary occupational base and a finding that the individual is disabled would usually apply, but restriction to occasional stooping should, by itself, only minimally erode the unskilled occupational base of sedentary work. Consultation with a vocational resource may be particularly useful for cases where the individual is limited to less than occasional stooping.
The Commissioner contends that, despite the ALJ’s conclusion that Bagwell cannot stoop, the record supports the Commissioner’s contention that Bagwell retained the ability to stoop on at least an occasional basis.
See
Docket Entry No. 13. While this argument may be factually correct, the ALJ did not articulate this view in her decision.
See Securities & Exch. Comm’n v. Chenery Corp.,
In sum, the ALJ failed to reconcile the inconsistencies in her RFC finding that Bagwell could occasionally bend but never stoop. The judiciary can scarcely perform its assigned review function without some indication of the ALJ’s reasoning on such crucial particulars. As such, substantial evidence does not support the ALJ’s determination that Bagwell is capable of performing light work.
2. Improper Reliance on Testimony of Vocational Expert
a. Incomplete Hypothetical
At the hearing, the ALJ failed to formulate a hypothetical question for the VE that encompassed all of Bagwell’s recognized limitations. The ALJ posed the following question to the VE:
Q: Okay. Let’s see — my next hypothetical question is going to be an individual who could sit for eight hours.Stand and walk for approximately four to six hours — but at least two hours and can lift 25 pounds frequently, 40 paid (sic) — 40 pounds occasionally. And, can bend on an occasional basis. And, occasionally claim and balance. Again, I’m going to use as a precaution the climate controlled environment. Would — obviously the past work does not — is not viable. Is there other unskilled work that would fit the criteria I gave you?
A: That hypothetical ma’am is most closely associated with the performance of light work. So, work at the light, unskilled level that is administratively noticed would be available.
Q: All right. In existence — now, can you give me some examples?
A: Certainly. This is the point of reference that base exists between 150 and 250,000 in the local, regional economy. And, examples of work that satisfy your hypothetical may include a ticket taker, library page [phonetic], order caller — [INAUDIBLE] representative sampling.
Q: Okay.
A: And, that base is eroded by approximately 30 percent because of your requirements to—
Q: Atmospheres?
A: —yes.
(R. 113-114). The hypothetical incorrectly advised the VE that Bagwell can “bend on an occasional basis” and failed to inform the VE that Bagwell cannot stoop.
A hypothetical question to a VE is deemed defective and in error unless (1) the assumptions reasonably incorporate all of the disabilities recognized by the ALJ, and (2) the claimant is afforded the opportunity to correct deficiencies in the ALJ’s question.
See Boyd,
The ALJ has a duty to develop the facts fully and fairly relating to an applicant’s claim for disability benefits. If the ALJ does not satisfy her duty, her decision is not substantially justified.
See Boyd,
b. Conflict Between VE’s Testimony and the Dictionary of Occupational Titles
Bagwell argues that the ALJ erred by relying on VE testimony regarding other work that Bagwell could perform, contending that the YE’s testimony was in conflict with the DOT and, thereby, in violation of SSR 00-4p. Specifically, the VE testified that three jobs were within Bagwell’s functional capacity — ticket taker, library page, and order caller. As set forth above, the ALJ concluded that Bag-well could never stoop. (R. 20, 23). Bag-well correctly points out that the job of library page, as described in the DOT, requires frequent stooping and kneeling. See Dictionary of Occupational Titles, § 249.687-014 PAGE (4th ed.1991). Thus, the job of library page has nonexertional requirements outside of Bagwell’s RFC. Despite such a patent inconsistency, the ALJ neither recognizes or seeks to reconcile the conflict between the VE’s testimony and the DOT.
At step five, the burden shifts to the ALJ to prove that other work exists in significant numbers in the national economy that the claimant can perform.
See
Occupational evidence provided by a VE ... generally should be consistent with the occupational information supplied by the DOT. When there is an apparent unresolved conflict between VE ... evidence and the DOT, the adjudicator must elicit a reasonable explanation for the conflict before relying on the VE ... evidence to support a determination or decision about whether the claimant is disabled. At the hearings level, as part of the adjudicator’s duty to fully develop the record, the adjudicator will inquire, on the record, as to whether or not there is such consistency. Neither the DOT nor the VE ... evidence automatically “trumps” when there is a conflict. The adjudicator must resolve the conflict by determining if the explanation given by the VE ... is reasonable and provides a basis for relying on the VE ... testimony rather than on the DOT information.
SSR 00-4p,
When the conflict between the VE’s testimony and the DOT is implied or indirect, the Fifth Circuit has held that an ALJ may rely on a VE’s testimony “provided that the record reflects an adequate basis for doing so.” See
Carey,
Here, the VE’s testimony that an individual with Bagwell’s functional capacity could perform the job of library page is in direct conflict with the DOT job description of library page as requiring frequent stooping. Neither the VE nor the ALJ recognized or discussed the conflict between the VE’s testimony and the DOT. Likewise, neither the VE nor the ALJ articulated plausible reasons for finding the VE’s testimony more credible under the circumstances. Independent review of the administrative record discloses no substantial evidence that Bagwell can perform jobs, such as a library page, requiring frequent stooping. While the other two jobs suggested by the VE do not require frequent stooping, the VE’s testimony does not distinguish as to each job whether work exists in significant numbers in the national economy for the particular job. (R. 114). Thus, there is insufficient evidence demonstrating that, absent the library page job, work that Bagwell could perform exists in significant numbers in the national economy. Consequently, the Commissioner did not carry her burden at Step five of the sequential evaluation process to show by substantial evidence that Bagwell is capable of performing gainful employment that exists in substantial numbers in the national economy. Therefore, remand is appropriate.
III. Conclusion
Accordingly, Bagwell’s Motion for Summary Judgment is GRANTED, the Commissioner’s Motion for Summary Judgment is DENIED, and the case is REVERSED and REMANDED, pursuant to “sentence four” of Section 205(g) of the Social Security Act,
FINAL JUDGMENT
In accordance with the Memorandum and Order issued this day, it is hereby
ORDERED that Plaintiff Julius Bag-well, Jr.’s Motion for Summary Judgment (Docket Entry No. 11) is GRANTED. Further, it is
ORDERED that the Defendant Jo Anne B. Barnhart’s, Commissioner of the Social Security Administration (“Commissioner”), Motion for Summary Judgment (Docket Entry No. 14) is DENIED. It is finally
ORDERED that this case is REVERSED AND REMANDED to the Commissioner, pursuant to “sentence four” of the Social Security Act,
This is a FINAL JUDGMENT.
Notes
. "Degenerative disease” is a disease characterized by the progressive impairment óf the function of an organ or organs and not attributable to some cause such as an infection or a metabolic defect. See Gould's Medical Dictionary 363 (4th ed.1979).
. "Asthma” refers to recurrent attacks of paroxysmal dyspnea, with airway inflammation and wheezing due to spasmodic contraction of the bronchi. See Dorland’s Illustrated Medical Dictionary 163 (29th ed.2000).
.The VE's name is "McQuade-Johnson” or "McQuade,” instead of "McClay” as reflected in the first administrative hearing transcript. (R. 30, 56, 65, 156).
. The Dictionary of Occupational Titles, published by the United States Department of Labor, is a comprehensive listing of job titles in the United States. It provides detailed descriptions of requirements for each job, including assessments of exertional level and reasoning ability necessary for satisfactory performance of the work.
. While SSRs do not have the force of law or properly promulgated notice and comment regulations, the agency makes SSR “binding on all components of the Social Security Administration.”
See
. The ALJ also found that Bagwell did not meet or equal Listing 1.04, which became effective February 19, 2002, because he did not have motor loss accompanied by sensory or reflex loss. (R. 18-19). Moreover, there was no evidence that he was unable to ambulate ineffectively. (R. 19).
. To the extent the Commissioner appears to question the propriety of the ALJ's findings, the proper vehicle to rectify flawed findings is through a request for remand under sentence four.