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Collins v. Commissioner of Social Security

United States District Court, M.D. Louisiana

March 19, 2018




         Eric K. Collins (“Plaintiff”) seeks judicial review of a final decision of the Commissioner of the Social Security Administration (“Commissioner”) pursuant to 42 U.S.C. § 405(g) denying Plaintiff's application for Disability Insurance Benefits under the Social Security Act. (R. Doc. 1). Having found all of the procedural prerequisites met (Tr. 1-6), the Court has properly reviewed Plaintiff's appeal. See 42 U.S.C. § 405(g); 20 C.F.R. § 404.981 (“The Appeals Council's decision, or the decision of the administrative law judge if the request for review is denied, is binding unless you… file an action in Federal district court…”). For the reasons given below, the Court ORDERS that the decision of the Commissioner is REVERSED and this matter is REMANDED for further proceedings consistent with this Ruling.


         Plaintiff filed his application for disability insurance benefits and supplemental security income (Tr. 131-140) on May 20, 2014, alleging that he became disabled on November 9, 2009 because of a disabling condition, namely bad hip, bad knee, bad back, hand, legs and feet. (Tr. 132). Plaintiff's application was initially denied by an Administrative Law Judge (“ALJ”), who first held an administrative hearing (Tr. 33-55) before issuing a partially unfavorable decision on July 26, 2015. (Tr. 17-34). Plaintiff's request for review of the ALJ's decision (Tr. 13-14) was denied by the Appeals Council on December 28, 2016. (Tr. 1-6). The ALJ's decision rested as the Commissioner's final decision when the Appeals Council denied Plaintiff's request for review. See 20 C.F.R. § 404.981.


         This Court's review of the Commissioner's decision is limited to an inquiry into whether there is substantial evidence to support the findings of the Commissioner and whether the correct legal standards were applied. 42 U.S.C. § 405(g); Richardson v. Perales, 402 U.S. 389, 401 (1971); Falco v. Shalala, 27 F.3d 160, 162 (5th Cir. 1994); Villa v. Sullivan, 895 F.2d 1019, 1021 (5th Cir. 1990). Substantial evidence has been defined as “‘more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'” Richardson, 402 U.S. at 401 (quoting Consolidated Edison Co. of N.Y. v. N.L.R.B., 305 U.S. 197, 229 (1938) (defining “substantial evidence” in the context of the National Labor Relations Act, 29 U.S.C. § 160(e)). The Fifth Circuit has further held that substantial evidence “must do more than create a suspicion of the existence of the fact to be established, but no substantial evidence will be found only where there is a conspicuous absence of credible choices or no contrary medical evidence.” Hames v. Heckler, 707 F.2d 162, 164 (5th Cir. 1983) (quotations omitted). Conflicts in the evidence are for the Commissioner “and not the courts to resolve.” Selders v. Sullivan, 914 F.2d 614, 617 (5th Cir. 1990). The Court may not reweigh the evidence, try the case de novo, or substitute its own judgment for that of the Commissioner even if it finds that the evidence preponderates against the Commissioner's decision. See, e.g., Bowling v. Shalala, 36 F.3d 431, 434 (5th Cir. 1994) (“This is so because substantial evidence is less than a preponderance but more than a scintilla.”); Hollis v. Bowen, 837 F.2d 1378, 1383 (5th Cir. 1988) (“In applying the substantial evidence standard, we must carefully scrutinize the record to determine if, in fact, such evidence is present; at the same time, however, we may neither reweigh the evidence in the record nor substitute our judgment for the Secretary's.”); Harrell v. Bowen, 862 F.2d 471, 475 (5th Cir. 1988) (same).

         If the Commissioner's decision is supported by substantial evidence, then it is conclusive and must be upheld. Estate of Morris v. Shalala, 207 F.3d 744, 745 (5th Cir. 2000). If, on the other hand, the Commissioner fails to apply the correct legal standards, or fails to provide a reviewing court with a sufficient basis to determine that the correct legal principles were followed, it is grounds for reversal. Bradley v. Bowen, 809 F.2d 1054, 1057 (5th Cir. 1987).


         In determining disability, the Commissioner (through an ALJ) works through a five-step sequential evaluation process. See 20 C.F.R. § 404.1520(a)(4). The burden rests upon the claimant throughout the first four steps of this five-step process to prove disability. If the claimant is successful in sustaining his or her burden at each of the first four steps, the burden shifts to the Commissioner at step five. See Muse v. Sullivan, 925 F.2d 785, 789 (5th Cir. 1991) (explaining the five-step process). First, the claimant must prove he or she is not currently engaged in substantial gainful activity. 20 C.F.R. § 404.1520(b). Second, the claimant must prove his or her impairment is “severe” in that it “significantly limits your physical or mental ability to do basic work activities…” 20 C.F.R. § 404.1520(c). At step three, the ALJ must conclude the claimant is disabled if he or she proves that his or her impairments meet or are medically equivalent to one of the impairments contained in the Listing of Impairments. See 20 C.F.R. § 404.1520(d) (step three of sequential process); 20 C.F.R. pt. 404, subpt. P, app'x 1 (Listing of Impairments). Fourth, the claimant bears the burden of proving he or she is incapable of meeting the physical and mental demands of his or her past relevant work. 20 C.F.R. § 404.1520(f).

         If the claimant is successful at all four of the preceding steps then the burden shifts to the Commissioner to prove, considering the claimant's residual functional capacity, age, education and past work experience, that he or she is capable of performing other work. 20 C.F.R § 404.1520(g)(1). If the Commissioner proves other work exists which the claimant can perform, the claimant is given the chance to prove that he or she cannot, in fact, perform that work. Muse, 925 F.2d at 789.

         Here, the ALJ made the following determinations:

1. Plaintiff had met the insured status requirements of the Social Security Act through December 31, 2013.
2. Plaintiff had not engaged in substantial gainful activity since November 9, 2009.
3. From November 9, 2009 through February 13, 2014, Plaintiff had the following severe impairments: reconstructive surgery of weight bearing joint and facture of lower lib status-post ORIF of left lateral plateau fracture.
4. From November 9, 2009 through February 13, 2014, Plaintiff did not meet or medically equal a Listing.
5. From November 9, 2009 through February 13, 2014, Plaintiff retained the RFC to perform light work, except he could lift/carry 10 lbs. frequently, 20 lbs. occasionally, sit/stand/walk 2 hours in an 8-hour work day with unlimited push/pull, frequently balance, stoop, and climb ramps/stairs, occasionally climb ladders/ropes/scaffolds, and would miss at least 3 days per month and require use of a cane to assist with ambulation.
6. From November 9, 2009 through February 13, 2014, Plaintiff was unable to perform any past relevant work.
7. Plaintiff was a younger individual as of the disability onset date.
8. Plaintiff had at least a high school education and is able to communicate in English.
9. Plaintiff's acquired job skills did not transfer to other occupations within the residual functional capacity.
10. From November 9, 2009 through February 13, 2014, and considering Plaintiff's age, education, work experience, and residual functional capacity, there were no jobs that existed in significant numbers in the national economy that Plaintiff could have performed.
11. Plaintiff was disabled from November 9, 2009 through February 13, 2014.

         As is the case here, if the claimant is found disabled at any point in the above process, the Commissioner must then determine if his or her disability continues through the date of the ALJ's decision. A cessation of disability benefits requires a finding of medical improvement. A finding of medical improvement requires consideration of whether the claimant: (1) is currently engaging in substantial gainful activity; (2) has an impairment or combination of impairments that meets or medically equals one listed in the regulations; (3) has experienced medical improvement; (4) has experienced medical improvement that is related to the ability to work; (5) has experienced medical improvement, but an exception to the medical improvement applies; (6) has current impairments that when considered in combination are severe; (7) can perform past relevant work; and (8) can perform other work that exists in the national economy. 20 C.F.R. § 404.1594(f).

         For the period after February 13, 2014, the ALJ made the following determinations about Plaintiff's ability to engage in substantial gainful activity:

12. Plaintiff had not developed any new impairment or impairments since February 14, 2014, the date his disability such that his severe impairments are the same as those present ...

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