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Hensley v. Saul

United States District Court, W.D. Louisiana, Shreveport Division

July 30, 2019

LYNDA JEANETTE HENSLEY
v.
ANDREW SAUL, COMMISSIONER OF SOCIAL SECURITY ADMINISTRATION

          S. MAURICE HICKS, JR. JUDGE

          REPORT & RECOMMENDATION

          KAREN L. HAYES UNITED STATES MAGISTRATE JUDGE

         Before the court is plaintiff's petition for review of the Commissioner's denial of social security disability benefits. The district court referred the matter to the undersigned United States Magistrate Judge for proposed findings of fact and recommendation pursuant to 28 U.S.C. § 636(b)(1)(B) and (C). For the reasons assigned below, it is recommended that the decision of the Commissioner be AFFIRMED, and this matter DISMISSED with prejudice.

         Background & Procedural History

         On, or about January 23, 2007, Lynda Hensley filed the instant applications for Title II Disability Insurance Benefits and Title XVI Supplemental Security Income payments. See Tr. 86, 140-144). She alleged disability as of August 12, 2006, because of liver disease. (Tr. 169, 172). On May 3, 2007, the state agency granted Hensley's application(s) and found her disabled as of her alleged onset date. (Tr. 70-71).

         In March 2015, the state agency initiated a continuing disability review (“CDR”) to determine whether Hensley's disabling conditions had experienced medical improvement. See Tr. 198-202. On April 20, 2015, the state agency determined that, as of that month, Hensley had experienced medical improvement, and therefore, her benefits would terminate effective June 2015. (Tr. 73, 75-77). Hensley asked the state agency to reconsider its decision, and elected to continue receiving benefits during the appeal process. (Tr. 79, 145-147). A disability hearing officer considered Hensley's request, but in a March 16, 2016, decision, found that her disability ceased as of April 2015. (Tr. 74, 83-94).

         Thereafter, Hensley requested and received a January 11, 2017, hearing before an Administrative Law Judge (“ALJ”). (Tr. 29-69). However, in a July 25, 2017, written decision, the ALJ determined that Hensley's disability ended as of April 1, 2015, and that she had not become disabled again since that date. (Tr. 7-18).

         Hensley appealed the adverse decision to the Appeals Council. On April 19, 2018, however, the Appeals Council denied Hensley's request for review; thus the ALJ's decision became the final decision of the Commissioner. (Tr. 1-3).

         On May 16, 2018, Hensley sought review before this court. Succinctly restated, she contends that for various reasons, the ALJ's residual functional capacity assessment is not supported by substantial evidence and/or is tainted by legal error. The matter is fully briefed and ripe for decision.

         Standard of Review

         This court's standard of review is (1) whether substantial evidence of record supports the ALJ's determination, and (2) whether the decision comports with relevant legal standards. Villa v. Sullivan, 895 F.2d 1019, 1021 (5th Cir. 1990). Where the Commissioner's decision is supported by substantial evidence, the findings therein are conclusive and must be affirmed. Richardson v. Perales, 402 U.S. 389, 390 (1971). The Commissioner's decision is not supported by substantial evidence when the decision is reached by applying improper legal standards. Singletary v. Bowen, 798 F.2d 818 (5th Cir. 1986). Substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. Richardson v. Perales, 402 U.S. at 401. Substantial evidence lies somewhere between a scintilla and a preponderance. Muse v. Sullivan, 925 F.2d 785, 789 (5th Cir. 1991). A finding of no substantial evidence is proper when no credible medical findings or evidence support the ALJ's determination. Johnson v. Bowen, 864 F.2d 340, 343-44 (5th Cir. 1988). The reviewing court may not reweigh the evidence, try the issues de novo, or substitute its judgment for that of the Commissioner. Greenspan v. Shalala, 38 F.3d 232, 236 (5th Cir. 1994) (citation omitted).

         Cessation of Disability

         Federal law provides that “[i]n any case where an individual is or has been determined to be under a disability, the case shall be reviewed by the applicable State agency or the Commissioner of Social Security (as may be appropriate), for purposes of continuing eligibility at least once every 3 years . . .” 42 U.S.C. § 421(i) (emphasis added). However, a disability recipient's benefits “may be terminated only if substantial evidence demonstrates both that ‘there has been any medical improvement' and that ‘the individual is now able to engage in substantial gainful activity.'” Hallaron v. Colvin, 578 Fed.Appx. 350, 353 (5th Cir. 2014) (citing 42 U.S.C. § 1382c(a)(4)(A)). A finding of continuing disability is not required where the benefits recipient “fails, without good cause, to cooperate in a review of his or her entitlement or to follow prescribed treatment which would be expected [ ]to restore his or her ability to engage in substantial gainful activity . . .” 42 U.S.C. § 1382c(a)(4)(C)).

         The Commissioner has prescribed regulations to implement the foregoing requirement. Specifically, a disability recipient's benefits will be terminated only where the Commissioner determines:

a) that there has been medical improvement in the individual's impairment or combination of impairments that is related to the individual's ability to work;[1]
b) or that one or more exceptions to medical improvement applies; and
c) in addition to a) or b), that the individual is currently able to engage in substantial gainful activity.

20 C.F.R. § 404.1594(a) (paraphrased).

         In evaluating the above-enumerated issues, the Commissioner employs an eight-step sequential analysis:

1. Whether the individual is engaged in substantial gainful activity? (if so, the Commissioner will find that disability has ended).
2. Whether the claimant has an impairment or combination of impairments which meets or equals the severity of an impairment listed in Appendix 1? (If so, disability will be found to continue).
3. If not, has there been medical improvement? (If so, step 4 is considered; if not, go to step 5).
4. If there has been medical improvement, is it related to the individual's ability to perform work? (If not, go to step 5; if so, go to step 6).
5. If there was no medical improvement at step 3 or the medical improvement was not related to the individual's ability to work at step 4, does an exception apply? (If not, disability continues; if one of the first exceptions to medical improvement applies, then go to step 6; if an exception from the second group of exceptions to medical improvement applies, then disability has ended).
6. If there has been medical improvement related to the individual's ability to do work or if one of the first group of exceptions to medical improvement applies, are the individual's current impairments in ...

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