Opinion
Case No. 03-2657-JWL.
July 20, 2004
MEMORANDUM ORDER
Plaintiff Willie Mitchell brought this action pursuant to 42 U.S.C. § 405(g) seeking judicial review of the decision of defendant, the Commissioner of Social Security, to deny his application for disability insurance benefits under Title II of the Social Security Act. According to plaintiff, defendant erred in concluding that plaintiff's mental impairment did not meet the requirement of listing 12.05(B), inaccurately assessed plaintiff's residual functional capacity, and improperly determined that plaintiff could perform his past relevant work. As explained in more detail below, the court reverses and remands this case to the Commissioner for additional findings with respect to whether plaintiff meets the requirements of listing 12.05(B).
I. Procedural Background
On September 14, 2000, plaintiff filed his application for a period of disability and disability insurance benefits alleging pain in his back and shoulder. His application was denied both initially and upon reconsideration. At plaintiff's request, an administrative law judge ("ALJ") held a hearing on November 13, 2002, at which both plaintiff and his counsel were present. At the hearing, plaintiff testified that he suffered from impairments in addition to his back and shoulder pain, including diabetes and arthritis in his knees. Plaintiff also stated that he had been treated for depression in the past. Finally, the medical expert further testified that plaintiff had a history of a personality disorder with paranoia.
On July 16, 2003, the ALJ rendered a decision in which he determined that plaintiff was not under a "disability" as defined by the Social Security Act. After the ALJ's unfavorable decision, plaintiff requested review by the Appeals Council. The Appeals Council denied plaintiff's request for review on October 28, 2003, rendering the ALJ's decision the final decision of defendant.
II. Standard of Review
Judicial review under 42 U.S.C. § 405(g) is limited to whether defendant's decision is supported by substantial evidence in the record as a whole and whether defendant applied the correct legal standards. See White v. Massanari, 271 F.3d 1256, 1257 (10th Cir. 2001) (citing Castellano v. Sec'y of Health Human Servs., 26 F.3d 1027, 1029 (10th Cir. 1994)). The Tenth Circuit has defined "substantial evidence" as "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Id. (quoting Castellano, 26 F.3d at 1028). In the course of its review, the court may not reweigh the evidence or substitute its judgment for that of defendant. Id.
III. Relevant Framework for Analyzing Claim of Disability and the ALJ's Findings
"Disability" is defined in the Social Security Act as the "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment. . . ." Williams v. Bowen, 844 F.2d 748, 750 (10th Cir. 1988) (quoting 42 U.S.C. § 423(d)(1)(A), 1382c(a)(3)(A) (1982)). The Social Security Act further provides that an individual "shall be determined to be under a disability 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. . . ." Id. (quoting 42 U.S.C. § 423(d)(2)(A), 1382c(a)(3)(B) (1982 Supp. III 1985)).
The Social Security Administration has established a five-step sequential evaluation process for determining whether a claimant is disabled, see id. (citing 20 C.F.R. § 404.1520, 416.920 (1986)), and the ALJ in this case followed the five-step process. If a determination can be made at any of the steps that a claimant is or is not disabled, evaluation under a subsequent step is not necessary. Id. Step one determines whether the claimant is presently engaged in substantial gainful activity. Id. If he or she is, disability benefits are denied. Id. If he or she is not, the decision maker must proceed to the second step. Id. Here, the ALJ determined that plaintiff had not engaged in substantial gainful activity since his amended onset date of October 16, 2000 and, thus, the ALJ proceeded to the second step.
The second step of the evaluation process involves a determination of whether "the claimant has a medically severe impairment or combination of impairments." Id. (quoting Bowen v. Yuckert, 107 S.Ct. 2287, 2291 (1987)). This determination is governed by certain "severity regulations," is based on medical factors alone, and, consequently, does not include consideration of such vocational factors as age, education, and work experience. Id. (citing 20 C.F.R. § 404.1520(c), 416.920(c) (1986)). Pursuant to the severity regulations, the claimant must make a threshold showing that his or her medically determinable impairment or combination of impairments significantly limits his or her ability to do basic work activities. Id. at 750-51 (citing 20 C.F.R. § 404.1521(b), 416.921(b) (1986)). If the claimant is unable to show that his or her impairments would have more than a minimal effect on his or her ability to do basic work activities, the claimant is not eligible for disability benefits. Id. at 751. If, on the other hand, the claimant presents medical evidence and makes the de minimis showing of medical severity, the decision maker proceeds to step three. Id. The ALJ in this case concluded that plaintiff's impairments, including chronic pain syndrome in the mid-back, neck and shoulder, a personality disorder with paranoia, rheumatoid arthritis and herniated C5 and 6 discs, satisfied the severity requirement and, thus, the ALJ proceeded to step three.
In step three, the ALJ "determines whether the impairment is equivalent to one of a number of listed impairments that the Secretary acknowledges are so severe as to preclude substantial gainful activity." Id. (citing 20 C.F.R. § 404.1520(d), 416.920(d) (1986); Bowen v. Yuckert, 107 S.Ct. at 2291). If the impairment is listed and thus conclusively presumed to be disabling, the claimant is entitled to benefits. Id. If not, the evaluation proceeds to the fourth step, where the claimant must show that the "impairment prevents [the claimant] from performing work he has performed in the past." Id. (citing 20 C.F.R. § 404.1520(e), 416.920(e) (1986); Bowen v. Yuckert, 107 S.Ct. at 2291). If the claimant is able to perform his or her previous work, the claimant is not disabled. Id. With respect to the third step of the process in this case, the ALJ determined that plaintiff's impairments were not listed or medically equivalent to those listed in the relevant regulations. At the fourth step, the ALJ concluded that plaintiff would be able to perform his past relevant work as a small equipment operator and, thus, determined that plaintiff was not disabled.
IV. Discussion
In his motion, plaintiff contends that the ALJ made three errors in reaching his decision — he erroneously concluded at step three that plaintiff's mental impairment did not meet listing 12.05(B); he inaccurately assessed plaintiff's residual functional capacity; and he improperly concluded at step four that plaintiff could perform his past relevant work. For the reasons to follow, the court reverses and remands for additional, explicit findings at step three. Thus, the court declines to discuss at any length plaintiff's remaining arguments. The court notes, however, that the record contains substantial evidence to support the ALJ's assessment of plaintiff's residual functional capacity with respect to plaintiff's physical limitations. Depending upon the nature of the ALJ's findings on remand with respect to plaintiff's mental limitations, the ALJ may deem it necessary to reevaluate the effect, if any, of any mental limitations on plaintiff's residual functional capacity. Finally, while the court does not conclude that the ALJ made any errors at step four (the court simply need not decide the issue), the ALJ should consider developing the record regarding the specific physical demands of plaintiff's previous work.
According to plaintiff, the ALJ in this case erroneously concluded that plaintiff's mental impairment did not meet the requirements of listing 12.05(B). Section 12.05 of the listed impairments applies to mental retardation and states as follows:
Mental retardation refers to significantly subaverage general intellectual functioning with deficits in adaptive functioning initially manifested during the developmental period; i.e., the evidence demonstrates or supports onset of the impairment before age 22.
The required level of severity for this disorder is met when the requirements in A, B, C, or D are satisfied.See 20 C.F.R. § 404, Subpart P, App. 1. Subsection (B), in turn, requires a "valid verbal, performance, or full scale IQ of 59 or less." If plaintiff's impairment meets 12.05(B) of the listings, plaintiff has satisfied his burden of proving his disability. See 20 C.F.R. § 416.920(d) (stating that if impairment is listed, then claimant must be found disabled without regard to her age, education, or work experience); Williams v. Bowen, 844 F.2d 748, 751 (10th Cir. 1988) (explaining that listed impairments are "conclusively presumed to be disabling"); Weakley v. Heckler, 795 F.2d 64, 65 (10th Cir. 1986) (noting that claimant met burden of proving disability where impairment met listings).
In this case, plaintiff received a post-hearing consultative psychological exam, including a WAIS-III test. The results of that test indicate that plaintiff had a verbal IQ of 52, a performance IQ of 54 and a full scale IQ of 49. Plaintiff, then, has satisfied the requirements of subsection (B). Nonetheless, the ALJ concluded that his impairment did not meet the requirements of the listing because the evidence did not demonstrate that plaintiff's alleged mental retardation had an onset during the developmental period ( i.e., before age 22). As the ALJ explained, the evidence demonstrated that plaintiff had engaged in substantial work activity from 1983 through October 2000 and that the work was classified as semi-skilled. The ALJ further noted that there were minimal treatment records for any mental impairment and that plaintiff's testimony did not suggest a mental impairment reaching the level of mental retardation. For example, plaintiff testified that he had a driver's license and that he took the written test on his own. Plaintiff's disability report further indicates that plaintiff completed the twelfth grade (he testified at the hearing, however, that he completed the ninth grade) and that he did not require special education classes. Finally, plaintiff did not allege any disabling mental limitations in his application for benefits and no treating or examining physician (aside from Dr. Mouille, who administered the WAIS-III test and saw plaintiff on only one occasion) indicated that plaintiff had such severe mental limitations.
Plaintiff argues that a person's IQ score is presumed to remain stable throughout his or her life and, thus, plaintiff's IQ score is sufficient evidence that plaintiff's mental deficiencies had an onset during the developmental period. While the Tenth Circuit has yet to address the issue of whether mental deficits such as those exhibited by plaintiff are presumed to have manifested themselves in the developmental period, the Circuit has at least noted that the circuit courts have liberally construed 12.05's early manifestation requirement, under which a claimant "is not required to affirmatively prove that he was mentally retarded prior to reaching the age of twenty two so long as there was no evidence that claimant's IQ had changed." See McKown v. Shalala, 1993 WL 335788, at *3 (10th Cir. Aug. 26, 1993). Indeed, several circuit courts have adopted the presumption urged by plaintiff. See, e.g., Muncy v. Apfel, 247 F.3d 728, 734 (8th Cir. 2001) (in the absence of evidence to the contrary, it must be assumed that the claimant's IQ has remained relatively constant); Luckey v. Department of Health Human Servs., 890 F.2d 666, 668-69 (4th Cir. 1989) (adopting presumption of onset during developmental period); Guzman v. Bowen, 801 F.2d 273, 275 (7th Cir. 1986) (same); see also Whetstone v. Barnhart, 263 F. Supp.2d 1318, 1325 (M.D. Ala. 2003) (a claimant need not present evidence that she manifested deficits in adaptive functioning prior to the age of twenty-two when she presents evidence of low IQ test results after the age of twenty-two).
The ALJ, in concluding that plaintiff failed to establish that his alleged mental retardation manifested during the developmental period, did not address the presumption that plaintiff's IQ would have remained fairly constant. Moreover, there is no evidence in the record suggesting that plaintiff's IQ would have changed. While the ALJ is certainly entitled to discount plaintiff's IQ score as invalid, see McKown, 1993 WL 335788, at *3, it does not appear from the ALJ's decision that he necessarily believed the score was invalid; he simply stated that there was no evidence that any mental deficiencies manifested before age 22. To the extent the ALJ does believe the score is invalid, he may wish to consider having the test readministered or obtaining a second qualified opinion regarding the validity of the existing results. See id.
For the foregoing reasons, the court remands this case to the Commissioner for further consideration under the legal standards and presumptions appropriate to listing 12.05(B).
IT IS THEREFORE ORDERED BY THE COURT THAT plaintiff's motion for judgment (doc. #4) is denied to the extent he seeks an immediate award of benefits and is otherwise granted. The decision of the Commissioner is hereby reversed and the case is remanded pursuant to sentence four of 42 U.S.C. § 405(g) for further administrative proceedings as described in this opinion.