Opinion
No. 02-4151-SAC
December 9, 2003
MEMORANDUM AND ORDER
This is an action to review the final decision of the defendant Commissioner of Social Security ("Commissioner") denying the claimant Mason L. Wilson's request for expedited reinstatement of disability benefits under Title II of the Social Security Act ("Act"). The plaintiff appears pro se and has filed a brief as well as several other pleadings that will be addressed prior to deciding the merits of his appeal. The plaintiff has filed an objection to the defendant's answer (Dk. 18), a motion for ruling (Dk. 19), and a motion to amend his objection (Dk. 21). In these other pleadings, the plaintiff argues in part that the defendant has not timely filed an answer or brief and that he is entitled to relief on that basis. The court finds that the defendant timely filed an answer within the period extended by the court and grants the defendant's request to file a responsive brief on or before October 9, 2003, for the reasons stated in the defendant's filing (Dk. 22). Thus, the court denies any relief requested in the plaintiff's other pleadings, but to the extent these pleadings advance or address arguments going to the merits of the plaintiff's appeal, the court shall consider them.
PROCEDURAL HISTORY
In a hearing decision issued on July 27, 1992, the claimant was found disabled as of September 15, 1989, based upon a finding that the severity of his combined impairments of depression, post-traumatic disorder and alcohol abuse met the severity regulations of 20 C.F.R. § 404.1525 and 416.925. (Tr. 16-19). As reflected in the Social Security computer database, the plaintiff's benefits ceased on January of 1997 because his disability finding had been based in part on a substance addiction disorder now subject to medical reexamination and because the plaintiff failed to submit to a consultative examination. (Tr. 207, 209). The record does not show the plaintiff filed any appeal from this decision terminating his benefits.
On July 3, 2001, the plaintiff filed a request for expedited reinstatement of his disability benefits. (Tr. 140-144). By letter dated July 13, 2001, the plaintiff was informed that his request was denied for the following reason:
On July 3, 2001, we talked to you. You requested expedited reinstatement of your social security disability benefit. We have determined that you do not qualify for expedited reinstatement because your prior period of disability terminated due to a change in the law. This change eliminated alcoholism or drug abuse as a diagnosis which can be used to establish entitlement to social security. In order to qualify for expedited reinstatement, your prior period of disability must have terminated due to the expiration of a trial work period and continued work activity at the substantial gainful level.
(Tr. 155). The plaintiff requested reconsideration which was denied on the same ground used to deny his initial request. At the claimant's request, a hearing before an administrative law judge ("ALJ") was held on March 21, 2002, and he appeared in person and waived the right to legal representation. (Tr. 28). Following the hearing, the ALJ issued his decision finding that the plaintiff was not eligible for expedited reinstatement. (Tr. 10-13). The Appeals Council denied the plaintiff's request for review. Thus, the ALJ's decision stands as the commissioner's final decision. O'Dell v. Shalala, 44 F.3d 855, 858 (10th Cir. 1994).
STANDARD OF REVIEW
The court's standard of review is set forth in 42 U.S.C. § 405(g), which provides that the commissioner's finding "as to any fact, if supported by substantial evidence, shall be conclusive." Substantial evidence is more than a scintilla and is that evidence which a reasonable mind might accept as adequate to support a conclusion. Richardson v. Persales, 402 U.S. 389, 401-02 (1971); Ray v. Bowen, 865 F.2d 222, 224 (10th Cir. 1989). "A finding of no substantial evidence will be found only where there is a conspicuous absence of credible choices." Trimiar v. Sullivan, 966 F.2d 1326, 1328 (10th Cir. 1992) (internal quotations and citations omitted). "Evidence is insubstantial if it is overwhelmingly contradicted by other evidence." O'Dell v. Shalala, 44 F.3d at 858 (citation omitted). The court "must examine the record closely to determine whether substantial evidence supports" the commissioner's determination. Winfrey v. Chater, 92 F.3d 1017, 1019 (10th Cir. 1996). The court is not to reweigh the evidence or substitute its judgment for the commissioner's. Glass v. Shalala, 43 F.3d 1392, 1395 (10th Cir. 1994).
ALJ'S FINDINGS
In his order of April 19, 2002, the ALJ made the following findings:
1. The claimant filed an application on July 3, 2001 requesting expedited reinstatement of a Period of Disability and Disability Insurance Benefits.
2. The claimant was previously awarded benefits based on disability. His benefits were terminated effective January, 1997.
3. The claimant's benefits were not terminated based on work activity, earnings or substantial gainful activity. The claimant's benefits were terminated pursuant to a review associated with a drug addiction and alcoholism redetermination authorized under Public Law 104-12, the 1996 amendment to the Social Security Act.
4. The requirements allowing an individual to request expedited reinstatement of a previous entitlement are not met and the claimant is not eligible for expedited reinstatement based on his current application. Public Law 106-170, Section 112.
(Tr. 13).
SUMMARY OF ARGUMENTS
The plaintiff argues the ALJ's decision is not supported by substantial evidence in that he failed to consider the plaintiff's post-traumatic stress disorder as a basis for disability. Disputing that benefits were terminated for any failure to submit to a consultative examination, the plaintiff cites letters from Social Security Administration which omit any reference to this reason for termination. The plaintiff then leaps to the conclusion that he is entitled to expedited reinstatement because this was not the reason for the termination of benefits.
DISCUSSION AND HOLDING
By statute, 42 U.S.C. § 423(i)(1)(B)(i)(II), an individual may seek reinstatement of benefits only if "such entitlement terminated due to the performance of substantial gainful activity." The Social Security Administration's computer database on the plaintiff shows benefits were terminated as of January of 1997 following a drug addiction and alcoholism redetermination and the plaintiff's failure to submit to a consultative examination. The codes and notations appearing on the printout verify this reason for the termination and the ALJ's findings comport with this documentary evidence. There is no evidence of record contradicting the codes and notations appearing on this printout. The transcript from the evidentiary hearing confirms that the plaintiff provided no evidence of any notification from the Administration that his benefits were terminated due to the performance of substantial gainful activity.
That the plaintiff may have had substantial gainful activity during the relevant period does not establish that this was the reason for the Administration's decision to terminate his benefits. There is nothing of record that inferentially indicates the plaintiff's work activity or earnings had anything to do with the Administration's termination decision. Rather, the 1996 amendment of the Act, Pub.L. 104-121, § 105(a)(1) added the following language: "An individual shall not be considered to be disabled for purposes of this subchapter if alcoholism or drug addiction would (but for this subparagraph) be a contributing factor material to the Commissioner's determination that the individual is disabled." 42 U.S.C. § 423(d)(2)(C). Social Security regulations established a process by which it would redetermine whether drug addiction or alcoholism was material to the disability determination. 20 C.F.R. § 404.1535. Regulations further provide that the Administration may find that a disability has ended if the individual without good cause fails to cooperate by not attending a physical or medical examination. 20 C.F.R. § 404.1594(e)(2). Considering together the timing of the statutory amendment, the existing regulatory framework, and the nature of the plaintiff's disability, the reasonable inference is that the plaintiff's benefits were terminated for the reasons reflected on the database printout.
Based on the facts and reasons stated above, the court concludes there is substantial evidence supporting the ALJ's finding that the plaintiff's benefits were terminated for reasons other than work activity, earnings or substantial gainful activity. The court also concludes that the ALJ correctly interpreted and applied the statutory standards governing requests for expedited reinstatement. Consequently, the plaintiff's motion for reinstatement did not provide the ALJ with a proper legal avenue for considering whether the plaintiff's post-traumatic stress disorder is disabling.
CONCLUSION
After carefully reviewing the entire record, the parties' arguments and the relevant law, the court concludes that the commissioner's decision is supported by substantial evidence on the whole record and comports with the relevant legal standards.
IT IS THEREFORE ORDERED that the plaintiff is denied the relief requested in his objection to the defendant's answer (Dk. 18), his motion for ruling (Dk. 19), and his motion to amend his objection (Dk. 21), but the arguments advanced therein are considered insofar as they are relevant to the merits of the plaintiff's appeal;
IT IS FURTHER ORDERED that the decision of the commissioner is affirmed.