Vance v. Commissioner of Social Security, No. 1:2019cv00002 - Document 20 (W.D. Ky. 2019)
Court Description: MEMORANDUM OPINION AND ORDER by Magistrate Judge Lanny King on 8/14/2019. This matter is REMANDED to the Commissioner for calculation and payment of past-due Title II benefits for the closed period between 6/1/2013 and 2/24/2016. cc:counsel (JWM)
Download PDF
<![CDATA[
Vance v. Commissioner of Social Security Doc. 20 UNITED STATES DISTRICT COURT WESTERN DISTRICT OF KENTUCKY BOWLING GREEN DIVISION CIVIL ACTION NO. : CV LLK JAMES E. VANCE, o ehalf of MELANIE S. VANCE, de eased PLAINTIFF DEFENDANT . ANDREW SAUL, Co issio er of So ial Se urit MEMORANDUM OPINION AND ORDER This atte is efo e the Cou t o Plai tiff's o plai t seeki g judi ial e ie , pu sua t to U.“.C. § g , of the fi al de isio of the Co e efits. The fa t a d la su issio e de i g he lai fo “o ial “e u it disa ilit a ies of Plai tiff a d Defe da t a e at Do kets # ha e o se ted to the ju isdi tio of the u de sig ed Magist ate Judge to dete a d . The pa ties i e this ase, ith a appeal l i g efo e the “i th Ci uit Cou t of Appeals. Do ket # . Effe ti e Ju e , , the “o ial “e u it Ad i ist atio dete e ded due to edi al i p o e e t a d eased pa e t of Disa ilit I su a e Be efits pu sua t to Title II of the “o ial “e u it A t. The Ad i ist ati e La Judge ALJ affi dete i atio ut fou d that, effe ti e Fe ua she agai e a e disa led a d Ad i ist ati e Re o d AR at i ed that Plai tiff’s disa ilit , ed the Ad i ist atio ’s essatio , Plai tiff’s i pai as, the efo e, eligi le fo a e pe iod of Title II e efits. . I othe o ds, the ALJ fou d that Plai tiff as ot disa led du i g the losed pe iod et ee Ju e , a d Fe ua , . The ALJ’s fi di g of a e o set of disa ilit date of Fe ua , o po t ith appli a le legal sta da ds. The ALJ’s sele tio of Fe ua a a d, i fa t, o t adi ted e e ut ot ea lie did ot , as u suppo ted edi al opi io , hi h i di ated that the e as o pe iod of o disa ilit follo i g Plai tiff’s li e t a spla t i Ju e . The ALJ ased his sele tio o his o i depe de t la assess e t of the edi al e ide e, hi h he as u e ts o se ed su h that ualified to gi e. The efo e, the Dockets.Justia.com Cou t ill REMAND this atte to the Co issio e fo al ulatio a d pa e efits fo the losed pe iod et ee Ju e , a d Fe ua , e t of past due Title II . Ba kgrou d fa ts a d pro edural histor I Ma h , the “o ial “e u it Ad i ist atio fou d that Plai tiff as disa led as of Ap il , due to h o i li e disease satisf i g Listi g . I Ju e , Plai tiff u de B. AR at . e t li e t a spla t su ge . AR at . Ph si al the ap otes state that she as ed idde fo t o ea s afte the t a spla t. AR at Disa led i di iduals a e su je t to pe iodi e ie s to dete a d e titled to e efits. Ma C.F.R. § . , . i e if the o ti ue to e disa led a . As pa t of the o ti ui g disa ilit e ie p o ess, i , the Ad i ist atio ’s o e a i i g p og a ph si ia , P. “a a ga, assessed Plai tiff as apa le of pe fo i g a li ited a ge of light o k. AR at fou d that Plai tiff as o lo ge disa led as of Ju e Ad i ist atio eaffi . I Ju e , due to , the Ad i ist atio edi al i p o e e t. The ed its de isio upo e o side atio , a d Plai tiff sought e ie a ALJ. As des i ed i g eate detail elo , the edi al opi io s i the ad i ist ati e e o d e e u a i ous that that the edi atio Plai tiff as e ui ed to take to p e e t eje tio of he t a spla ted li e aused se ious side effe ts su h as ausea, o iti g, eak ess, se e e fatigue, loss of sta i a ith histo of falls , a d loss of o e t atio . Those edi al opi io s e e f o Plai tiff’s t eati g ph si ia , Jaso Ca p ell, M.D. AR at P og a AR at “a uel Be , ; D . Ch istophe Jo es, Di e to of Li e T a spla t ; a d the edi al ad iso the ALJ alled to testif at the ad i ist ati e hea i g, a , M.D. AR at . I additio , afte he t a spla t, Plai tiff e pe ie ed episodes of h po at e ia lo le el of sodiu i the lood , hi h e e se e e e ough to e ui e hospitalizatio o t o o asio s. AR at , , . A o di g to D . Jo es, [a]lo g ith this [h po at e ia] issue o e o fusio , eak ess a d dizzi ess. Id. I De e e li e steatosis a o , Plai tiff as e pe ie i g s pto s of h po at e ia, a d a iops e ealed al ete tio of lipids . AR at . Plai tiff as hospitalized fo se e al da s to ule out the possi ilit of o ga eje tio . Id. I Fe ua h po at e ia s , Plai tiff pto s. AR at I De e e I “epte e AR at as agai hospitalized fo se e al da s due to e u e e of . , Plai tiff as diag osed ith olo /a al a e . AR at . , at Plai tiff’s e uest, D . Ca p ell o pleted the ph si al assess e t fo . . I Ma , D . Ch istophe ote a lette i suppo t of Plai tiff’s disa ilit lai . AR at . D . Ch istophe stated that Plai tiff has had a e o k ou se si e he t a spla t a d that the side effe ts of these edi atio s to p e e t eje tio a e eak ess, ausea, loss of sta i a, loss of o e t atio a d se e e fatigue. Id. D . Ch istophe opi ed that Plai tiff is ot a le to o k at this ti e a d f o he past histo she p o a l ill e e e a le to hold do a jo ithout ultiples a se es. Id. I Ju e ad iso . AR at , the ALJ held a ad i ist ati e hea i g at hi h D . Be I Jul “epte e AR at . , D . Ca p ell ga e a state e t to the effe t that the li itatio s he assessed i appl at least as fa a k as Ju e , he the Ad i ist atio te i ated e efits. . I Ja ua as of Ju e , the ALJ issued a de isio , affi due to edi al i p o e e t. AR at i g the Ad i ist atio ’s essatio dete , u a le to o k a d disa led as of Fe ua . AR at i atio . Additio all , the ALJ fou d that Plai tiff’s h o i li e disease post t a spla t o se ed afte Ju e a testified as a edi al . to the poi t that she agai e a e I No e e de isio the Co issio e ’s fi al de isio su je t to this judi ial e ie . AR at . I Ja ua I Ma h Do ket # , the Appeals Cou il de li ed to distu the ALJ’s de isio , aki g the ALJ’s , Plai tiff filed he o plai t seeki g judi ial e ie . Do ket # . , Plai tiff died of olo /a al a e a d i hosis of the li e . Death Ce tifi ate, . Su ar of the ALJ’s de isio that Plai tiff’s disa ilit e ded i Ju e The ALJ fou d that Plai tiff’s disa ilit e ded egi i g o Ju e , . The ALJ ade this fi di g pu sua t to the eight step se ue tial e aluatio p o ess that applies i ases of te The e aluatio p o ess is odified at C.F.R. § . f Fi st, the ALJ fou d that, f o efo e Ju e , i atio of e efits. . , the date Plai tiff’s disa ilit e ded, o up to the p ese t, Plai tiff has ot e gaged i a su sta tial gai ful a ti it . AR at . Plai tiff o edes this fi di g is suppo ted su sta tial e ide e. Do ket # “e o d, the ALJ fou d that, si e Ju e , Listi g. AR at . . Plai tiff otes that D . Be at . , Plai tiff did ot ha e a i pai a testified that he olo /a al a e e ualed Listi g B s ua ous ell a i o a of the a us, e u e t afte su ge disease e ualed o e of the Listi gs at . e t satisf i g the a d that he h o i li e A G ut ad its that the testi o la ked suffi ie t spe ifi it to e e titled to ase dispositi e eight. Do ket # at efe e i g testi o at AR Thi d, the ALJ fou d that edi al i p o e e t o u ed as of Ju e , . afte the p io fi di g of disa ilit , o o pa iso poi t de isio , CPD e ause Plai tiff’s h o i li e disease o lo ge satisfies Listi g . B. AR at . Plai tiff does ot halle ge this fi di g. Fou th, the ALJ fou d that the e is a p esu ptio that the edi al i p o e e t is elated to the a ilit to o k e ause Plai tiff o lo ge satisfies the Listi g. AR at . Plai tiff does ot halle ge this fi di g. “tep applies o l if fou d at step . f e fou d at step that the e has ee o edi al i p o e e t o if e that the edi al i p o e e t is ot elated to ou a ilit to o k. C.F.R. § . “tep is i appli a le i this ase. “i th, the ALJ fou d that, as of Ju e , sig ifi a t, i pai e ts. AR at , Plai tiff o ti ues to ha e se e e, o o atio all . Those i pai t a spla tatio , e ote histo of gast i e ts a e h o i li e disease pass su ge , al ohol depe de e a d su sta e a use, a ood diso de , a iet a d OCD [o sessi e o pulsi e diso de ]. AR at fi di g is suppo ted su sta tial e ide e. Do ket # . Plai tiff o edes that this at , . As i a ase that ad a es e o d “tep , the ALJ as e ui ed to dete fu tio al apa it [RFC] ased o all ou u e t i pai losed pe iod et ee Ju e , ith li e a d Fe ua , i e Plai tiff’s esidual e ts, i.e., Plai tiff’s i pai . “e tio du i g that pe iod, ph si all , Plai tiff had a RFC to pe fo . f e ts du i g the . The ALJ fou d that, a li ited a ge of light o k. AR at . Me tall , Plai tiff had a RFC to u de sta d a d follo outi e tasks i ol i g to steps; sustai ade uate o e t atio , pe siste e o pa e fo su h tasks fo t o hou s at a ti e; f e ue t o ta t ith o o ke s a d supe iso s a d o l o asio al o ta t ith the ge e al pu li ; a d o o asio al ha ges i the o k outi e o e i o o e tha e t. Id. Plai tiff a gues that oth the ph si al a d e tal o po e ts of the ALJ’s RFC fi di gs a e ot suppo ted su sta tial e ide e. Do ket # at . “e e th, the ALJ fou d that, as of Ju e , , Plai tiff as u a le to pe fo AR at . E ept fo the ALJ’s allegedl u suppo ted RFC dete past ele a t o k. i atio , Plai tiff does ot halle ge this fi di g. Eighth, the ALJ fou d that Plai tiff’s disa ilit e ded as of Ju e , pe fo a sig ifi a t u e of u skilled, light jo s i the atio al e o o , e ause she as a le to su h as ge e al offi e helpe , i spe to , a d ha d pa ke . AR . E ept fo the ALJ’s allegedl u suppo ted RFC dete i atio , Plai tiff does ot halle ge this fi di g. Su ar of the ALJ’s de isio that Plai tiff e a e eligi le for a e period of disa ilit i Fe ruar 6 ut ot earlier As oted a o e, the ALJ fou d that Plai tiff’s disa ilit e ded o Ju e , , due to edi al i p o e e t. If a ALJ fi ds that a lai a t’s disa ilit e ded, the ALJ is e ui ed to o side the possi ilit that the disa ilit su se ue tl esu ed du i g the pe iod et ee the essatio date a d the de isio date. “tated o e te h i all , the ALJ ust dete dete i e hethe the i itial edi al essatio i atio as o e t a d, if so, hethe the lai a t has agai e o e disa led at a ti e th ough the date of his o he dete i atio o de isio e ause of a o se i g of a e isti g i pai e t o the o set of a e i pai e t, the e aki g the lai a t eligi le fo a e pe iod of disa ilit . “o ial “e u it Ruli g ““R p, WL , at * . Plai tiff as e su ed fo Title II e efits th ough “epte de isio , the ALJ fou d that, as of Fe ua , e , Plai tiff’s i pai . AR at . I his Ja ua e ts o se ed su h that she agai e a e disa led a d as, the efo e, eligi le fo a e pe iod of disa ilit . AR at of this fi di g, the ALJ fou d that, egi i g o Fe ua , , Plai tiff had the sa e ph si al a d e tal li itatio s she had du i g the losed pe iod of o disa ilit et ee Ju e , , , e ept that [i] additio , as of Fe ua , . I suppo t a d Fe ua , [Plai tiff] ill eed t o to th ee u s heduled eaks du i g the da a d ould iss to da s of o k o thl . AR at . The o atio al e pe t VE testified that this le el of a se teeis f o the jo a d the jo site ould e i tole a le to ost e plo e s a d ould e de Plai tiff disa led. AR at I othe o ds, the ALJ fou d that, egi . i g o Fe ua , , Plai tiff as disa led e ause she as o lo ge a le to egula l atte d a jo o jo site. Plai tiff states that she ag ees that [she as disa li g o Fe ua , ] ut disag ees ith the sta t date of the li itatio s. Do ket # at . A o di g to Plai tiff, the ALJ should ha e fou d that he disa ilit ega [a]t the e least, … a easo a le pe iod efo e hospitalizatio o Fe ua , . Id. The ALJ’s deter i atio of the date of re o set of Plai tiff’s disa ilit Fe ruar , 6 as u supported a edi al opi io . E e edi al opi io i the ad i ist ati e e o d i di ates that Plai tiff as u a le to atte d o k egula l o pe fo e e lo st ess tasks afte he Ju e li e t a spla t ith o i et ee pe iod of o disa ilit . This as due to the side effe ts of edi atio Plai tiff took to p e e t eje tio of he t a spla ted li e . Jaso Ca p ell, M.D., ega t eati g Plai tiff i Ca p ell o pleted the sta da d ph si al assess e t fo Ca p ell fou d that Plai tiff ould e ui e dail , . AR at . AR at . I “epte e , D . . A o g othe thi gs, D . i ute u s heduled eaks du i g a o kda due to us le eak ess, h o i fatigue, a d ad e se side effe ts of edi atio a d ould e off task o o e of the o kda due to s pe fo pto s i te fe i g ith atte tio a d o e t atio eeded to e e si ple o k tasks . AR at , . I Jul li itatio s applied at least as fa a k as Ju e disa ilit eased. AR at he li e t a spla t [i Ju e , D . Ca p ell i di ated that these , he the Ad i ist atio fou d that Plai tiff’s . A o di g to D . Ca p ell, Plai tiff has ee e poo l fu tio al si e ]. Me tall u h slo e . Ph si all u h o e f ail. AR at ALJ eje ted D . Ca p ell’s disa li g opi io s fo the pe iod et ee Ju e at % a d Fe ua . The . AR . I Ma effe ts of these , D . Ch istophe Jo es, Di e to of Li e T a spla t P og a , stated that the side edi atio s to p e e t eje tio a e o e t atio a d se e e fatigue. AR at eak ess, ausea, loss of sta i a, loss of . D . Ch istophe opi ed that Plai tiff is ot a le to o k at this ti e a d f o he past histo she p o a l ill e e e a le to hold do a jo ithout ultiples a se es. Id. The ALJ ga e little eight to D . Ch istophe ’s state e t ega di g the side effe ts of edi atio a d eje ted D . Ch istophe ’s opi io ega di g Plai tiff’s a ilit to hold do that issue as ese ed fo e [the ALJ] as a age t fo the Co “a uel Be issio e . AR at a jo e ause . a , M.D., testified as a edi al e pe t at the ad i ist ati e hea i g. D . Be testified that, afte he li e t a spla t i Ju e , Plai tiff e pe ie ed e u e t a e ia, eut ope ia lo lood ou t of a e tai t pe of hite lood ell , a d ele t ol te distu a es. AR at De e e . AR at . Afte Ju e , i D . Be et o e ualed the li i al ite ia of Listi g afte su ge . I , a pe ia al lesio as e ised, a d Plai tiff as diag osed ith a al s ua ous ell a i o a, i asi e, ode ate to poo l diffe e tiati g. AR at Ja ua a . . Plai tiff ega he othe ap i a ’s opi io , Plai tiff’s i pai B s ua ous ell a i o a of the a us, e u e t a d/o a listi g fo h o i li e disease i.e., Listi g . Additio all o alte ati el , afte Ju e e ts as a hole A G . AR at . , the edi atio Plai tiff took to p e e t eje tio of the t a spla t aused disa li g side effe ts su h as ausea, o iti g, eak ess, fatigue, loss of sta i a ith histo of falls , loss of o e t atio . AR at the pe iod et ee Ju e a d Fe ua . The ALJ eje ted D . Be . AR at , , a ’s disa li g opi io s fo . No e a i i g p og a ph si ia P. “a a ga assessed Plai tiff as apa le of pe fo o k i Ma . AR at i g light . The ALJ ga e g eate eight to D . “a a ga’s opi io . AR at Ho e e , D . “a a ga as ot i a positio i . to p edi t a su se ue t date of e o set of disa ilit . The ALJ’s deter i atio of the date of re o set of Plai tiff’s disa ilit Fe ruar , 6 did ot o port ith appli a le legal sta dards set forth i SSR . As oted a o e, ““R p e ui ed the ALJ to dete i e hethe the i itial edi al essatio dete i atio as o e t a d, if so, hethe Plai tiff has agai e o e disa led at a ti e th ough the date of his o he dete o set of a e i pai i atio o de isio e ause of a o se i g of a e isti g i pai e t o the e t, the e aki g Plai tiff eligi le fo a e pe iod of disa ilit . , at * . P io to adoptio of ““R p i WL , if a ALJ fou d that the Ad i ist atio ’s edi al essatio date as app op iate, ut e ide e sho ed that the lai a t had agai e o e disa led, the ALJ ould soli it a e appli atio fo title II disa ilit e efits. Id. at * . ““R p eli i ated the eed fo fili g a e appli atio fo ee title e t. Id. at * . The efo e, ee title e t ases su h as the p ese t o e a e effe ti el e appli atio s fo Title II e efits. Be ause the ALJ ade a fi di g of disa ilit fo a e pe iod of disa ilit , the ALJ as e ui ed to dete a d that dete Se ., i atio ust e suppo ted F. d , th Ci . i e he Plai tiff’s disa ilit ega , su sta tial e ide e. See M Cla aha . Co O e a fi di g of disa ilit is ade, the ALJ ust dete 'r of So . i e the date of o set. . The appli a le legal sta da ds fo dete “e u it Ruli g ““R , WL i i g the o set of disa ilit date a e set fo th i “o ial . It is esse tial that the o set date e o e t e ause, i Title II lai s, it affe ts the a ou t of the e efit. Id. at * . Fa to s ele a t to the dete i atio of disa ilit o set i lude the lai a t’s allegatio s, the o k histo , a d the edi al e ide e. Id. With slo l p og essi e i pai e ts, the e ide e i the ad i ist ati e e o d is ofte i suffi ie t to esta lish the p e ise date he a lai a t’s i pai e ts e a e disa li g, a d the o set date ust e i fe ed. Id. at * . Be ause the i fe e e ust ha e a legiti ate edi al asis, he e the e is o su h asis, at the hea i g, the ALJ should all o the se i es of a edi al ad iso . Id. I pa ti ula , the ALJ should all o a edi al ad iso he as he e it is e essa to dete i e he a alig a i.e., Plai tiff’s olo /a al a e e o es i ope a le o e o d o t ol othe odes of the ap . Id. at * . As oted a o e, the edi al ad iso , D . Be a , testified that Plai tiff’s i pai e ts e ualed the Listi gs fo a e a d/o h o i li e disease a d that she suffe ed f o disa li g side effe ts of edi atio fo the e ti e pe iod afte he li e t a spla t i Ju e testi o . AR at , , , ; a d the ALJ eje ted that . Be ause the ALJ e ei ed a d reje ted e phasis added testi o f o a edi al ad iso [ hi h the ALJ eeded due to a i suffi ie t edi al asis fo i fe i g the o set date], [the ALJ] did ot use that edi al ad iso 's testi o to help hi dete o set date o to la if the a i e plai tiff's disa ilit iguous e o d ega di g plai tiff's disa ilit o set date, thus iolati g the spi it a d u de l i g pu pose of ““R , at * E.D. N.Y. Ma . , . Cata eo . Co ’r, No. CV KAM , . As i Cata eo, the ALJ’s edi al e pe tise did ot i WL ease su h that he o lo ge eeded a edi al ad i e o the o set date si pl e ause he eje ted the edi al ad iso ’s opi io o the atte . The ALJ’s deter i atio of the date of re o set of disa ilit Fe ruar , 6 as ased o a i proper i depe de t la assess e t of the edi al e ide e. Ha i g eje ted e e edi al opi io ega di g the date of e o set of disa ilit , the ALJ ga e a i depe de t la assess e t of the edi al e ide e i suppo t of his sele ted date of Fe ua , : I August , a othe spe ialist sa the la a t a out the e u e t h po at e ia [lo le el of sodiu i the lood]. The spe ialist oted that the ea lie episodes of h po at e ia had ee as pto ati ith s pto s epo ted to ha e sta ted th ee o ths ago. If the h po at e ia as i itiall as pto ati , the efo e it ould e a o se e e i pai e t si e the e e e o s pto s to est i t o i te fe e ith asi o k a ti ities … p io to the late esta lish o set date. … D . Be a testified that the a e ia a d ele t ol te distu a e [h po at e ia] ould e due to al ohol a use. … Although sodiu le els ha e ot d opped as lo as du i g the Fe ua hospitalizatio , the le els ha e e ai ed lo th ough the latte half of a d i to …. Although the i p o e e t i the h po at e ia ould e att i uted to the lai a t’s e e t so iet , it ould also e uall e elated to the eph ologist’s i st u tio o fluid est i tio …. “i e othe auses a ha e esulted i the lo h po at e ia le els, I a u a le to e lude that the s pto s of dizzi ess a d eak ess egi i g i Fe ua e e defi itel elated to the lai a t’s al ohol a use. AR at , . ALJs ust ot su u to the te ptatio to pla do to a d ake thei o edi al fi di gs. Si pso . Co F. d , th Ci . ’r, F. App’ , th Ci . uoti g Roha . Co s. Rudd . Co F. d , st Ci . 'r, . A ALJ F. App' , th Ci . a ot su stitute his o uoti g Nguye edi al judg e t fo that of the t eati g ph si ia he e the opi io of the t eati g ph si ia is suppo ted e ide e. Mee e . Co ’r, . As a la pe so , ... the ALJ as si pl ot ualified to i te p et a edi al data i fu tio al te . Co ’r, i depe de t ’r, F. App’ , th Ci . . the edi al To the e te t the ALJ’s assess e t of the edi al e ide e as ased o Plai tiff’s al ohol use, it as o t a to the opi io s of D s. Be a a d Ca p ell. D . Be fo … the edi atio ould e the t a spla t hi h as aused a testified that the o igi al eed … the al ohol. AR at . But … e e if she had d opped d i ki g a d as so e , she ould still ha e the side effe ts f o edi atio ausi g the eak ess, ausea, o iti g a d so o . Id. D . Ca p ell e p essed skepti is that Plai tiff had a sig ifi a t al ohol use afte he li e t a spla t ut, e e if she did, she likel ould ha e still e pe ie ed s pto s su h as eak ess, ausea, a d o iti g. AR at . To the e te t the ALJ’s assess e t as ased o Plai tiff’s h po at e ia, it as i p ope . The ALJ ga e g eat sig ifi a e to D . Be s a ’s suggestio that Plai tiff’s h po at e ia a d asso iated pto s of o fusio , eak ess, a d dizzi ess ould e due to al ohol a use. AR at so e i di atio that the h po at e ia . The e as ight e due to ps hoge i pol dipsia e essi e o su ptio due to ps hiat i o pulsio . AR at ate . I a e e t, e e if the h po at e ia as due to al ohol use, Plai tiff suffe ed f o side effe ts of edi atio su h as ausea, o iti g, eak ess, se e e fatigue, loss of sta i a ith histo of falls , a d loss of o e t atio . These side effe ts ould likel i pai Plai tiff’s a ilit to atte d o k egula l , a d the e as o e ide e that the e e elated to al ohol use. The ALJ’s e te ded dis ussio of Plai tiff’s al ohol use as at odds ith the ALJ’s a k o ledge e t that su h use as i aterial to his de isio . The ALJ’s de isio o tai s fu the efe e es to Plai tiff’s al ohol use. Fo e a ple, the ALJ oted that Plai tiff testified that p io to a f ie d of the fa il as suppl i g [he ] ith al ohol [if ot othe su sta es] o p o ided [he ] t a spo tatio to the li uo sto e a d that she as likel … u de the i flue e he ps hologist A ette F eel e a i ed he . AR at . As o luded a o e, the ALJ’s fi di g that Plai tiff as ot disa led du i g the losed pe iod et ee Ju e , a d Fe ua al ohol use, hi h the ALJ as u , , as ased o edi al i fe e es elated to Plai tiff’s ualified to ake. E e if the ALJ ere ualified to ake su h i fe e es, the a e at odds ith the ALJ’s o o t i uti g fa to ate ial to the dete The ke fa to e ill e a i e i dete fa to ate ial to the dete fi di g that Plai tiff’s su sta e use diso de s a e ot a i atio of disa ilit . AR at . See C.F.R. § . i i g hethe d ug addi tio o al oholis is a o t i uti g i atio of disa ilit is hethe e ould still fi d ou disa led if ou stopped usi g d ugs o al ohol. . The ALJ fou d that Plai tiff as ot disa led du i g the losed pe iod ith o ithout a al ohol use, a d that fi di g appea s to ha e ee di tated the u a i ous edi al opi io s of D s. Be a a d Ca p ell that Plai tiff ould likel ha e o ti ued to e pe ie e disa li g side effe ts of edi atio du i g the losed pe iod ith o ithout al ohol use. AR at , . The ALJ’s e te ded dis ussio of Plai tiff’s al ohol use as at odds ith the ALJ’s a k o ledge e t that su h use as i ate ial to his de isio . I su a , the ALJ’s fi di g of a e o set of disa ilit date of Fe ua , did ot o po t ith appli a le legal sta da ds. The ALJ’s sele tio of Fe ua u suppo ted a a d, i fa t, o t adi ted e e , as edi al opi io , hi h i di ated that the e as o pe iod of o disa ilit follo i g Plai tiff’s li e t a spla t i Ju e his o ut ot ea lie . The ALJ ased his sele tio o i depe de t la assess e t of the edi al e ide e, hi h he as u ualified to gi e. That assess e t as also at odds ith the ALJ’s fi di g that Plai tiff’s al ohol use as i ate ial to his de isio . A judi ial a ard of e efits is arra ted. The e ai i g uestio is the app op iate e ed . Whe a ou t fi ds that a ALJ's de isio is ot suppo ted su sta tial e ide e, it a a a d e efits as opposed to e a di g fo a e de isio a d fu the ad i ist ati e p o eedi gs if the p oof of disa ilit is o e hel i g, o p oof of disa ilit is st o g a d e ide e to the o t a is la ki g. Mo ery . Se 'y of Health & Hu a Ser s., th Ci . F. d , . A judi ial a a d of e efits is p ope o l if all esse tial fa tual issues ha e ee esol ed a d the e o d ade uatel esta lishes a plai tiff's e title e t to e efits. Fau her . Se 'y, F. d , th Ci . “i e . , the “i th Ci uit has applied the fo egoi g sta da d a d a a ded e efits o fou o asio s. Mi or . Co ’r, edy . Co F. App’ ’r, th Ci . F. App’ ; Kal th Ci . a h . Co ’r, F. App’ th ; Marti . Co ’r, F. App’ th Ci . ; Ke Ci . . Fo the easo s elo , a a a d of e efits is at least as ell suppo ted i this ase. I Kal a h a d Marti , the Cou t ited the follo i g i suppo t of a a a d of e efits: The edi al opi io s a d diag oses of t eati g ph si ia s a e ge e all a o ded su sta tial defe e e, a d if the opi io s a e u o t adi ted, o plete defe e e. Kal . Se ’y, F. d , ph si ia ’s opi io th Ci . ; Marti at uoti g Harris . I Mi or, although it as ot u o t adi ted, the t eati g as fou d to ot ithsta di g. Mi or at a h at e e titled to g eat defe e e, its o o t olli g status . I this ase, the t eati g ph si ia ’s D . Ca p ell’s disa li g opi io as u o t adi ted a d, the efo e, e titled to o plete defe e e. Alte ati el , D . Ca p ell’s opi io as e titled to o t olli g eight e ause it as ell suppo ted edi all a epta le li i al a d la o ato diag osti te h i ues a d is ot i o siste t ith the othe su sta tial e ide e i the ad i ist ati e e o d. Ke C.F.R. § . . edy, like the p ese t ase, as a te i atio of e efits ase. I Ke ase, the e as o t eati g ph si ia ’s opi io suppo ti g te Ke edy, u like the p ese t i atio . Ne e theless, the Cou t a a ded ed e efits e ause the ulti ate u de is o the Co e ha e fou d that su sta tial e ide e does ot suppo t the te issio e i te i atio . Ke i atio p o eedi gs a d edy at . I this ase, e e if D . Ca p ell’s opi io as ot e titled to o plete defe e e o o t olli g eight, su sta tial e ide e did ot suppo t the ALJ’s te I Kal i atio de isio . a h, the Cou t held that a judi ial a a d of e efits as suppo ted, i pa t, e ause: I ie of the plai tiff's t eati g ph si ia s' opi io s a d the plai tiff's o asse tio s of disa li g pai , stiff ess, fatigue, a d i a ilit to o e t ate, the e e ists st o g e ide e that the plai tiff's o i pai e ts eet o e eed a listed i pai e t u de the “o ial “e u it egulatio s. Kal I this ase, Plai tiff testified to disa li g side effe ts of Plai tiff’s olo /a al a e e ualed Listi g afte su ge . edi atio , a d D . Be i ed a h at . a testified that B s ua ous ell a i o a of the a us, e u e t a d that he h o i li e disease e ualed o e of the Listi gs at . A G . AR at . Order The efo e, it is he e ORDERED that this al ulatio a d pa Fe ua , issio e fo e t of past due Title II e efits fo the losed pe iod et ee Ju e , . August 14, 2019 atte is REMANDED to the Co a d
]]>
Some case metadata and case summaries were written with the help of AI, which can produce inaccuracies. You
should read the full case before relying on it for legal research purposes.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
