Opinion
CIVIL ACTION NO. 3:00CV131-B-A
May 11, 2001.
MEMORANDUM OPINION
This case involves an application pursuant to 42 U.S.C. § 405(g) for judicial review of the decision of the Commissioner of Social Security denying the application of plaintiff William T. Jones for period of disability (POD) and disability insurance benefits (DIB) under Title II, as well as supplemental security income (SSI) benefits under Title XVI. The district court's jurisdiction over plaintiff's claim rests upon 28 U.S.C. § 1331. In accordance with the provisions of 28 U.S.C. § 636(c), both parties have consented to have a magistrate judge conduct all the proceedings in this case, therefore the undersigned has the authority to issue this opinion and the accompanying final judgment.
Plaintiff was born on March 14, 1947. He graduated from high school and attended junior college and a university, although he obtained a degree from neither. His employment experience includes work as a machine operator, a hospital floor technician, and a factory water management operations worker. Plaintiff filed his application for benefits on May 21, 1997, alleging a disability onset date of March 22, 1997. Plaintiff's request for benefits was denied at the initial and reconsideration stages, and plaintiff sought timely review from an administrative law judge (ALJ). Plaintiff alleged that he is disabled due to lower back pain. In an opinion dated December 19, 1998, the ALJ denied the request for benefits. Plaintiff unsuccessfully sought review from the Appeals Council, and he timely filed suit in this court. The case is now ripe for review.
Pursuant to the Social Security Act, insurance benefits can be paid to persons who have contributed to the program and who suffer a physical or mental disability. See Loza v. Apfel, No. 98-50892, 2000 WL 966719 (5th Cir. July 13, 2000) (citing 42 U.S.C. § 423(a)(1)(D)). "`Disability' is defined as the `inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months . . . .'" Id. (quoting 42 U.S.C. § 423(a)(1)(D)).
In determining disability, the Commissioner, through the ALJ, works through a five-step sequential evaluation process. The burden rests upon the plaintiff throughout the first four steps of this five-step process to prove disability, and if the plaintiff is successful in sustaining his burden at each of the first four levels then the burden shifts to the Commissioner at step five. First, plaintiff must prove he is not currently engaged in substantial gainful activity. Second, the plaintiff must prove his impairment is "severe" in that it "significantly limits his physical or mental ability to do basic work activities . . . ." At step three the ALJ must conclude the plaintiff is disabled if he proves that his impairments meet or are medically equivalent to one of the impairments listed at 20 C.F.R. Part 404, Subpart P, App. 1, §§ 1.00-114.02 (1998). Fourth, the plaintiff bears the burden of proving he is incapable of meeting the physical and mental demands of his past relevant work. If the plaintiff is successful at all four of the preceding steps, the burden shifts to the Commissioner to prove, considering plaintiff's residual functional capacity, age, education and past work experience, that he is capable of performing other work. If the Commissioner proves other work exists which the plaintiff can perform, the plaintiff is given the chance to prove that he cannot, in fact, perform that work.
See 20 C.F.R. § 404.1520, 416.920 (2000).
Muse v. Sullivan, 925 F.2d 785, 789 (5th Cir. 1991).
20 C.F.R. § 404.1520(b), 416.920(b) (2000).
20 C.F.R. § 404.1520(b), 416.920(c) (2000).
20 C.F.R. § 404.1520(d), 416.920(d) (2000). If a claimant's impairment meets certain criteria, that claimant's impairments are "severe enough to prevent a person from doing any gainful activity." 20 C.F.R. § 404.1525, 416.925 (2000).
20 C.F.R. § 404.1520(e), 416.920(e) (2000).
20 C.F.R. § 404.1520(f)(1), 416.920(f)(1) (2000).
Muse, 925 F.2d at 789.
Plaintiff contends the instant case requires remand because the ALJ's finding at Step 4 of the sequential evaluation process, that plaintiff retains the residual functional capacity to return to his past relevant work, is not based upon substantial evidence and is based upon the application of an erroneous standard of law. Indeed, the court considers on appeal whether the Commissioner's final decision is supported by substantial evidence, and whether the Commissioner used the correct legal standard. Muse v. Sullivan, 925 F.2d 785, 789 (5th Cir. 1991); Villa v. Sullivan, 895 F.2d 1019, 1021 (5th Cir. 1990). "To be substantial, evidence must be relevant and sufficient for a reasonable mind to accept it as adequate to support a conclusion; it must be more than a scintilla but it need not be a preponderance . . . ." Anderson v. Sullivan, 887 F.2d 630, 633 (5th Cir. 1989) (citation omitted). "If supported by substantial evidence, the decision of the [Commissioner] is conclusive and must be affirmed." Paul v. Shalala, 29 F.3d 208, 210 (5th Cir. 1994) (citing Richardson v. Perales, 402 U.S. 389, 390, 28 L.Ed.2d 842 (1971)).
Plaintiff argues that the ALJ failed to properly assess plaintiff's physical abilities. In order for the ALJ's assessment of plaintiff's residual functional capacity to be sustained, there must be substantial evidence of each physical requirement listed in the regulations. 3 Social Security Law and Practice § 43:14 (Timothy E. Travers et al. eds., 1999) (citing Marks v. Apfel, 13 F. Supp.2d 319 (N.D.N.Y. 1998)). An ALJ is not qualified to interpret raw medical data in functional terms, and if an ALJ reaches conclusions as to a claimant's physical exertional capacity without a physician's assessment then the ALJ's decision is not supported by substantial evidence. Perez v. Secretary of Health and Human Services, 958 F.2d 445, 446 (1st Cir. 1991) (citations omitted); see Richardson v. Perales, 402 U.S. 389, 408 (1971) (upholding the use of testimony from vocational expert because the ALJ is a layman). Furthermore, the lack of affirmative evidence supporting the ALJ's findings as to claimant's residual functional capacity may require remand for further development of the record. 3 Social Security Law and Practice § 43:14 (Timothy E. Travers et al. eds., 1999).
En route to determining that plaintiff could return to his past relevant work as a floor technician or machine operator, the ALJ determined that plaintiff retained the residual functional capacity to "perform the exertional demands of medium work, or work which requires maximum lifting of 50 pounds and frequent lifting of up to 25 pounds." (R. at 18). Indeed, SSA regulations list the ability to lift a maximum of fifty pounds and twenty-five pounds frequently as physical requirements of possessing the ability to work at the medium exertional level. 20 C.F.R. § 404.1567(c), 416.967(c) (2000). However, a thorough review of the administrative record reveals no affirmative evidence or physician's assessment supporting the ALJ's finding.
The record contains a total of four reports from physicians. The first, by Dr. Thomas J. McDonald, is dated November 10, 1988 and details plaintiff's recovery from back surgery performed in 1986. (R. at 110). Although Dr. McDonald found that plaintiff could return to work, he made no assessment as to plaintiff's ability to lift various levels of weight. Moreover, Dr. McDonald saw plaintiff over nine years before plaintiff's alleged onset date of March 22, 1997, and the ALJ made no explicit reference to Dr. McDonald's report in his opinion. (R. at 14-20).
The second medical report was completed by Dr. William Bell after examining plaintiff on July 12, 1997. (R. at 115-117). Dr. Bell noted that plaintiff could get on and off the exam table without difficulty and was able to dress himself. Dr. Bell noted no evidence of atrophy of any major muscle groups and noted that plaintiff's sensory was intact. During the examination, plaintiff refused to engage in heel walking or toe walking, saying that doing so would hurt. (R. at 116). Dr. Bell concluded that plaintiff had lower extremity motor and neurological functioning without any significant impairment or abnormal findings and that plaintiff could handle objects without difficulty. (R. at 117). Dr. Bell made no objective findings concerning the effect of plaintiff's back pain on the amount of weight he could lift.
Dr. John P. Vaughn, a psychologist, completed a mental evaluation of plaintiff after examining him on April 21, 1998. Not surprisingly, the mental evaluation makes no assessment of plaintiff's ability to lift. The final medical report is the only actual functional assessment completed by a physician in the record. Dr. Eugene M. Murphy, III found that plaintiff could only occasionally lift ten pounds, with no frequent lifting. (R. at 132).
After reviewing the medical evidence of record, the court finds no affirmative evidence to support the ALJ's finding that plaintiff retains the ability to lift a maximum of fifty pounds and twenty-five pounds frequently. The ALJ did explain his reasons for not crediting the evidence that plaintiff was incapable of lifting enough to work at the medium level. However, as detailed above, there must be affirmative evidence supporting the ALJ's findings on each physical requirement listed in the regulations, and there is no physician's residual functional capacity assessment to support the ALJ's findings. Accordingly, the case sub judice will be remanded to the Commissioner for further development of the medical record and a redetermination of the claim. A final judgment will issue this day in accordance with this memorandum opinion.
FINAL JUDGMENT
In accordance with the memorandum opinion issued this day, It is, hereby,
ORDERED:
That the decision of the Commissioner is reversed, and this case is remanded to the Commissioner for further proceedings.
SO ORDERED AND ADJUDGED.