FLORES v. SAUL

CourtDistrict Court, S.D. Indiana
DecidedDecember 16, 2019
Docket1:18-cv-01072
StatusUnknown

This text of FLORES v. SAUL (FLORES v. SAUL) is published on Counsel Stack Legal Research, covering District Court, S.D. Indiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
FLORES v. SAUL, (S.D. Ind. 2019).

Opinion

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF INDIANA INDIANAPOLIS DIVISION

JESUS F., ) ) Plaintiff, ) ) v. ) No. 1:18-cv-01072-DLP-TWP ) ANDREW M. SAUL, Commissioner of the ) Social Security Administration, ) ) Defendant. )

ORDER

Plaintiff Jesus F.1 seeks judicial review of the denial by the Commissioner of the Social Security Administration (“Commissioner”) of his application for Social Security Disability Insurance Benefits (“DIB”) under Title II and for Supplemental Security Income (“SSI”) under Title XVI of the Social Security Act (“the Act”). See 42 U.S.C. §§ 423(d), 405(g). For the reasons set forth below, this Court hereby REVERSES the ALJ’s decision denying the Plaintiff benefits and REMANDS this matter for further consideration. I. PROCEDURAL HISTORY

On June 10, 2008, Jesus filed his initial application for Title II and Title XVI applications for a period of disability and disability insurance benefits. [Dkt. 29 at 156-157 (R. 157-58).] On February 14, 2011, the Social Security Administration

1 The Southern District of Indiana has adopted the recommendations put forth by the Court Administration and Case Management Committee regarding the practice of using only the first name and last initial of any non-government parties in Social Security opinions. The Undersigned has elected to implement that practice in this Order. (“SSA”) issued a preliminary determination that Jesus was not eligible for SSI benefits because of his monthly income of $1,200. [Dkt. 29 at 169 (R. 170).] On March 1, 2011, Jesus filed a second application for Title II Disability

Insurance Benefits (“Second Application). [Dkt. 29 at 159-160 (R. 160-61).] On March 1, 2011, the SSA again issued a preliminary determination stating Jesus was not eligible for SSI benefits based on his monthly income of $1,200. [Dkt. 29 at 166 (R. 167).] On April 12, 2011, Jesus received a letter denying his application for Title II benefits because his physical impairments did not prevent him from working. [Dkt. 29-1 at 1-3 (R. 174-76).] Jesus did not request reconsideration of this decision.

On July 20, 2012, Jesus filed a third application for Title II disability insurance benefits and for Title XVI SSI benefits, collectively (“Third Application”). [Dkt. 29-1 at 4-13 (R. 177-186).] On September 27, 2012, the SSA denied Jesus’s application for Title XVI SSI benefits based on income. [Dkt. 29-1 at 62 (R. 230).] On November 28, 2012, Jesus filed a request for reconsideration of his Third Application because he believed the SSA had incorrect information regarding his monthly income. [Dkt. 29-1 at 75 (R. 243).] On January 16, 2013, the SSA found

that their initial decision denying Title XVI SSI benefits was correct. [Dkt. 29-1 at 82-84 (R. 250-52).] On March 8, 2013, Jesus filed a request for a hearing before an Administrative Law Judge. [Dkt. 29-1 at 94 (R. 262).] On July 11, 2013, Plaintiff’s counsel submitted a letter to the SSA requesting to reopen Jesus’s Second Application regarding his Title II application. [Dkt. 29-1 at 101-102 (R. 269-270).] On July 16, 2013, the SSA sent a letter to Jesus’s counsel stating that he was medically denied for Title II benefits in his Third Application, and all subsequent Title II applications would be automatic technical denials based on res judicata. [Dkt. 29-1 at 135 (R. 303).] Moreover, the SSA concluded that “[a] new medical

decision will never be made for Title II.” [Id.] On September 30, 2014, Jesus filed an application for Title II and Title XVI benefits with the SSA, and again requested reopening and consolidation of prior claims (“Fourth Application”). [Dkt. 29-1 at 142, 173 (R. 310, 336).] On June 6, 2016, ALJ Albert J. Velasquez conducted a hearing, where Jesus testified. The ALJ determined that a supplemental hearing was necessary, where

medical experts would be required to appear and testify. [Dkt. 29-11 at 50-51 (R. 1976- 77).] The ALJ also gave Plaintiff’s counsel an opportunity to provide a brief on why the ALJ should reopen and consolidate the previous cases, why no medical determination had been made previously, and the effect of Plaintiff’s personal injury settlement. [Id.] On September 16, 2016, the ALJ conducted a supplemental hearing, where Jesus, vocational expert Dewey Franklin, and medical expert Dr. James Wargel testified. On May 1, 2017, ALJ Velasquez issued a partially favorable decision finding

that Jesus was disabled as of January 7, 2016 for purposes of SSI on his Fourth Application. [Dkt. 29 at 30 (R. 30).] The ALJ stated that he would not reopen Jesus’s initial application for Title II and Title XVI benefits filed on May 30, 2008, nor would he reopen the Second Application requesting Title II benefits, filed on March 1, 2011. [Id.] In assessing Jesus’s Title II claim in the Fourth Application, the ALJ found that Jesus was not disabled through the date last insured of December 31, 2010. [Id.] On February 6, 2018, the Appeals Council issued an order denying Plaintiff’s Request for Review of the ALJ’s decision. Jesus now requests judicial review of the Commissioner’s decision. See 42 U.S.C. § 1383(c)(3).

II. STANDARD OF REVIEW

To prove disability, a claimant must show he is unable 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 twelve months.” 42 U.S.C. § 423(d)(1)(A). To meet this definition, a claimant’s impairments must be of such severity that he is not able to perform the work he previously engaged in and, based on his age, education, and work experience, he cannot engage in any other kind of substantial gainful work that exists in significant numbers in the national economy. 42 U.S.C. § 423(d)(2)(A). The Social Security Administration (“SSA”) has implemented these statutory standards by, in part, prescribing a five-step sequential evaluation process for determining disability. 20 C.F.R. § 404.1520. The ALJ must consider whether: (1) the claimant is presently [un]employed; (2) the claimant has a severe impairment or combination of impairments; (3) the claimant's impairment meets or equals any impairment listed in the regulations as being so severe as to preclude substantial gainful activity; (4) the claimant's residual functional capacity leaves [him] unable to perform [his] past relevant work; and (5) the claimant is unable to perform any other work existing in significant numbers in the national economy.

Briscoe ex rel. Taylor v. Barnhart, 425 F.3d 345, 351-52 (7th Cir. 2005) (citation omitted). An affirmative answer to each step leads either to the next step or, at steps three and five, to a finding that the claimant is disabled. 20 C.F.R. § 404.1520; Briscoe, 425 F.3d at 352. A negative answer at any point, other than step three, terminates the inquiry and leads to a determination that the claimant is not

disabled. 20 C.F.R. § 404.1520.

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