United States District Court, D. Vermont
OPINION AND ORDER (DOCS. 14, 16)
JOHN
M. CONROY UNITED STATES MAGISTRATE JUDGE.
Plaintiff
Diane B. brings this action pursuant to 42 U.S.C. §
405(g) of the Social Security Act, requesting review and
remand of the decision of the Commissioner of Social Security
denying her application for Disability Insurance Benefits
(DIB). Pending before the Court are Plaintiff's motion to
remand the Commissioner's decision for further
proceedings and a new decision (Doc. 14), and the
Commissioner's parallel motion to remand the
Commissioner's decision for further proceedings and a new
decision (Doc. 16). This is an unusual case, as the parties
agree that the claim should be remanded but disagree
regarding the terms of the remand order, particularly,
whether the order should include a requirement that a hearing
be held. (See Doc. 16 at 5-6, Doc. 18 at 1-3.)
For the
reasons explained below, the Court GRANTS Plaintiff's
motion to remand (Doc. 14), in part; GRANTS the
Commissioner's motion to remand (Doc. 16); and REMANDS
the claim for further proceedings and a new
decision.[1]
Procedural
and Factual Background
Plaintiff
was 54 years old on her alleged disability onset date of
December 30, 2010. She has a high school education and
experience working as a laundry worker and a home health
aide/personal care attendant. She lives with her husband.
On or
around December 30, 2009, Plaintiff stopped working due to
the following impairments: arthritis, depression, bladder
issues, chronic obstructive pulmonary disease (COPD), pain in
her hips and knees, high blood pressure, thyroid problems,
and cholesterol issues. (AR 179-80.) In a December 2015
Function Report, Plaintiff stated that she is “very
depressed” and “in so much pain.” (AR 211.)
She explained that she cannot stand, sit, or walk for lengthy
periods (AR 209); and that her husband “has to take
care of [her], ” including cooking her dinner most
nights (AR 211).
On
April 28, 2011, Plaintiff filed her first DIB application
(referred to herein as the “prior claim”), which
was denied at the initial stage on June 29, 2011. She did not
request reconsideration of the denial. A few years later, on
November 25, 2015, Plaintiff filed her second DIB
application, which is the claim under review in this
litigation. (AR 160-61.) Therein, Plaintiff alleges
disability from December 30, 2010 through her date last
insured of March 31, 2011. The claim was denied initially and
on reconsideration; and on April 12, 2017, Administrative Law
Judge (ALJ) Thomas Merrill conducted an administrative
hearing on the claim. (AR 30-47.) Plaintiff appeared and
testified, with representation from counsel, as did a
vocational expert.
On June
20, 2017, ALJ Merrill issued a decision denying
Plaintiff's claim, finding that Plaintiff “was not
under a disability . . . at any time from December 30, 2010,
the alleged onset date, through March 31, 2011, the date last
insured.” (AR 25.) Despite the fact that Plaintiff was
54 years old on both the alleged disability onset date and
the date last insured, the ALJ did not consider
Plaintiff's “borderline age” status at step
five of the sequential evaluation, erroneously explaining in
his decision that, “[d]uring the entire relevant period
in this case, through her date last insured, [Plaintiff] did
not change age category [and thus] [t]he [borderline age]
exception does not apply.” (AR 15.) The ALJ also denied
Plaintiff's request to reopen the denial of her initial
April 2011 claim, finding that the denial “is
administratively final” and there is “no
basis” to reopen it. (AR 25.)
Thereafter,
the Appeals Council denied Plaintiff's request for
review, rendering the ALJ's decision the final decision
of the Commissioner. (AR 1-3.) Having exhausted her
administrative remedies, Plaintiff filed the Complaint in
this action on January 3, 2018. (Doc. 3.)
Standard
of Review
The
Social Security Act defines the term “disability”
as the “inability to engage in any substantial gainful
activity by reason of any medically determinable physical or
mental impairment which can be expected to result in death or
which has lasted or can be expected to last for a continuous
period of not less than 12 months.” 42 U.S.C. §
423(d)(1)(A). A person will be found disabled only if it is
determined that his “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.” 42 U.S.C. §
423(d)(2)(A).
In
considering the Commissioner's disability decision, the
court “review[s] the administrative record de novo to
determine whether there is substantial evidence supporting
the . . . decision and whether the Commissioner applied the
correct legal standard.” Machadio v. Apfel,
276 F.3d 103, 108 (2d Cir. 2002) (citing Shaw v.
Chater, 221 F.3d 126, 131 (2d Cir. 2000)); see
42 U.S.C. § 405(g). The court's factual review of
the Commissioner's decision is thus limited to
determining whether “substantial evidence” exists
in the record to support such decision. 42 U.S.C. §
405(g); Rivera v. Sullivan, 923 F.2d 964, 967 (2d
Cir. 1991); see Alston v. Sullivan, 904 F.2d 122,
126 (2d Cir. 1990) (“Where there is substantial
evidence to support either position, the determination is one
to be made by the factfinder.”). “Substantial
evidence” is more than a mere scintilla; it means such
relevant evidence as a reasonable mind might accept as
adequate to support a conclusion. Richardson v.
Perales, 402 U.S. 389, 401 (1971); Poupore, 566
F.3d at 305. In its deliberations, the court should bear in
mind that the Social Security Act is “a remedial
statute to be broadly construed and liberally applied.”
Dousewicz v. Harris, 646 F.2d 771, 773 (2d Cir.
1981).
Summary
of Arguments
Preliminarily,
Plaintiff argues that the denial of her prior DIB claim is
not administratively final. (Doc. 14 at 1-4.) According to
Plaintiff, because ALJ Merrill reviewed the “entire
record” in considering Plaintiff's current claim,
and because the alleged disability periods of the prior and
current claim overlap for the period from December 30, 2010
through March 31, 2011, the ALJ constructively reopened the
prior claim. (Id. at 2.) Given that constructive
reopening, Plaintiff contends ALJ Merrill should have
corrected a clear error contained in ...