Jones v. O'Malley

107 F.4th 489
Court of Appeals for the Fifth Circuit·Decided July 12, 2024·No. 23-30831·Published·Cited by 8 cases

Opinion

United States Court of Appeals for the Fifth Circuit

____________ United States Court of Appeals Fifth Circuit

FILED

No. 23-30831

July 12, 2024

Lyle W. Cayce

Joshua Jones, Clerk

Plaintiff—Appellant,

versus

Martin O’Malley, Commissioner of Social Security,

Defendant—Appellee.

Appeal from the United States District Court for the Eastern District of Louisiana USDC No. 2:22-CV-443

Before Smith, Engelhardt, and Ramirez, Circuit Judges. Kurt D. Engelhardt, Circuit Judge:

Plaintiff Joshua Jones appeals the judgment of the district court affirming the Commissioner of Social Security’s denial of his claims for disability insurance benefits (“DIB”) and supplemental security income (“SSI”) under Titles II and XVI of the Social Security Act (“Act”), 42 U.S.C. §§ 423, 1381. Because we conclude that the Commissioner’s decision is based upon proper legal standards and is supported by substantial evidence, we AFFIRM.

No. 23-30831

I.

On October 1, 2019, Jones submitted applications for SSI and DIB, asserting a disability onset date of February 22, 2018. 1 He alleged the following illnesses, injuries, or conditions: “cervical and lumbar regions, disc herniation bulging and derangement L4-5, L5-S1, C5-6, C7, blurring vision, diabetes, neuropathy, broken great toe on the right [foot], high blood pressure , high cholesterol.” The applications were denied, at the agency level, on March 12, 2020, and upon reconsideration, on November 10, 2020. 2 Thereafter, on February 23, 2021, Jones, represented by counsel, filed a request for a hearing before an administrative law judge (“ALJ”). The hearing was held, via telephone, on August 5, 2021. 3

1 Prior to the August 5, 2021 hearing before the ALJ, Jones amended his onset date to December 10, 2019.

2 As explained in Bowen v. Yuckert, 482 U.S. 137, 142 (1987):

The initial disability determination is made by a state agency acting under the authority and supervision of the [Commissioner]. 42 U.S.C. §§ 421(a), 1383b(a); 20 C.F.R. §§ 404.1503, 416.903 (1986). If the state agency denies the disability claim, the claimant may pursue a threestage administrative review process. First, the determination is reconsidered de novo by the state agency. §§ 404.909(a), 416.1409(a). Second, the claimant is entitled to a hearing before an administrative law judge (“ALJ”) within the Bureau of Hearings and Appeals of the Social Security Administration. 42 U.S.C. §§ 405(b)(1), 1383(c)(1) (1982 ed. and Supp. III); 20 C.F.R. §§ 404.929, 416.1429, 422.201 et seq. (1986). Third, the claimant may seek review by the Appeals Council. 20 C.F.R. §§ 404.967 et seq., 416.1467 et seq. (1986). Once the claimant has exhausted these administrative remedies, he may seek review in federal district court. 42 U.S.C. § 405(g). See generally Bowen v. City of New York, 476 U.S. 467, 472 (1986). 3 The hearing was held via telephone, with Jones’ consent, because of the extraordinary circumstances presented by the COVID-19 pandemic.

No. 23-30831

On October 6, 2021, the ALJ issued a decision denying Jones’ claims.

Jones timely appealed to the Appeals Council, which denied review on January 4, 2022.

On February 21, 2022, Jones sought judicial review of the Commissioner ’s final administrative decision by filing suit in federal district court. See 42 U.S.C. § 405(g). The magistrate judge, considering cross-motions for summary judgment, recommended that Jones’ motion be denied and that the Commissioner’s motion be granted. See 28 U.S.C. § 636(b). On September 26, 2023, the district judge overruled Jones’ objections, adopted the June 26, 2023 report and recommendation, denied Jones’ motion for summary judgment , granted the Commissioner’s cross-motion, and dismissed Jones’ claims with prejudice. Following entry of a final judgment, this appeal followed . Appellate jurisdiction is provided by 28 U.S.C. § 1291.

II.

Title II of the Act provides for the payment of insurance benefits to persons who have contributed to the program and suffer from a physical or mental disability. 42 U.S.C. § 423(a)(1)(D). Title XVI of the Act provides for the payment of disability benefits to indigent persons under the SSI program. 42 U.S.C. § 1382(a). Both titles of the Act define “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); § 1382c(a)(3)(A); see also Newton v. Apfel, 209 F.3d 448, 452 (5th Cir. 2000) (claimant must have “a medically determinable physical or mental impairment lasting at least twelve months that prevents [the claimant] from engaging in substantial gainful activity”).

No. 23-30831

As authorized by Congress, the Commissioner has promulgated regulations establishing procedures for evaluating claims and determining disability. See 42 U.S.C. §§ 405(a) and 1383(d)(1). Pursuant to 20 C.F.R. § 404.1520, a five-step sequential process is used to decide whether the applicant is disabled. Newton, 209 F.3d at 453 (citing 20 C.F.R. § 404.1520).

Specifically, the Commissioner determines (1) whether the claimant is performing substantial gainful activity (if so, he is not disabled); (2) whether the claimant has a severe impairment (if not, he is not disabled); (3) whether the claimant’s impairment meets or equals one of the listed impairments set forth in Appendix 1 of the applicable regulations, see 20 C.F.R. pt. 404, subpt. P, app. 1 (if so, he is disabled; if not, the inquiry proceeds to step four); (4) whether the claimant’s residual functional capacity allows him to perform his past work (if so, he is not disabled); and, (5) if not, whether the claimant, considering his residual functional capacity, age, education, and work experience, is able to adjust to other work. See 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4); Barnhart v. Thomas, 540 U.S. 20, 24–25 (2003).

The claimant bears the burden of proof for the first four steps and it shifts to the Commissioner for the fifth step. Newton, 209 F.3d at 453. If the Commissioner fulfills the burden of pointing out potential alternative employment, the burden then shifts back to the claimant to prove that he cannot perform the alternate work. Boyd v. Apfel, 239 F.3d 698, 705 (5th Cir. 2001) (citing Muse v. Sullivan, 925 F.2d 785, 789 (5th Cir. 1991)); Newton, 209 F.3d at 453.

III.

On appeal, Jones asserts three issues. We review a denial of social security benefits “only to ascertain whether (1) the final decision is supported by substantial evidence and (2) whether the Commissioner used the proper

No. 23-30831

legal standards to evaluate the evidence.” Newton, 209 F.3d at 452. “A finding of no substantial evidence is appropriate only if no credible evidentiary choices or medical findings support the decision.” Boyd, 239 F.3d at 704 (quoting Harris v. Apfel, 209 F.3d 413, 417 (5th Cir. 2000)).

A. “Retroactive” Application of Listing 1.15 Jones’ first issue concerns step three of the five-step sequential process. At step three, the ALJ considers whether the claimant’s impairment meets or equals one of the listed impairments set forth in Appendix 1 of the regulations, see 20 C.F.R. pt. 404, subpt. P, app. 1, Listing of Impairments (“Listings”). The listed impairments are physical and mental impairments that are considered disabling regardless of the claimant’s age, education, or work experience. Sullivan v. Zebley, 493 U.S. 521, 529–30 (1990); 20 C.F.R. pt. 404, subpt. P, app. 1. Thus, if a claimant has one of the listed impairments, and satisfies the requisite criteria of severity, the claimant is disabled, and the sequential evaluation ends at step three. 20 C.F.R. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii); see also Zebley, 493 U.S. at 530; Bowen v. Yuckert, 482 U.S. 137, 141 (1987).

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