Kyler v. Saul

District Court, District of Columbia·Decided April 20, 2022·No. Civil Action No. 2019-3334·Published

Opinion

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

WANDA KYLER, Plaintiff,

v. Civil Action No. 1:19-cv-03334 (CJN)

KILOLO KIJAKAZI, Acting Commissioner of the Social Security Administration,

Defendant.

MEMORANDUM OPINION

Wanda Kyler seeks reversal of the Social Security Administration’s denial of her claims for disability insurance benefits under Title II of the Social Security Act. See 42 U.S.C. §§ 401– 433. Kyler contends that the Administrative Law Judge applied the wrong law and that the decision is not supported by substantial evidence. See generally Pl.’s Mot. for Judgment of Reversal (“Pl.’s Mot.”), ECF No. 13. The Administration argues that the Court should affirm the decision. See generally Def.’s Mot. for Judgment of Affirmance (“Def.’s Mot.”), ECF No. 14. Upon consideration of the motions and the administrative record, the Court will deny Kyler’s motion for judgment of reversal and grant the Administration’s motion for judgment of affirmance.

I. Statutory Framework & Legal Standards The Social Security Act of 1935 established a framework to provide “disability insurance benefits” to eligible claimants. 42 U.S.C. § 423(a)(1)(A). The Act defines “disability” in pertinent part as an “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.” Id. §

423(d)(1)(A). To establish eligibility for disability-based benefits, the claimant must show that she has met the statutory definition of disability prior to her “date last insured.” See 42 U.S.C. § 423; 20 C.F.R. § 404.101; Kathy R. v. Comm’r of Soc. Sec., No. 6:19-CV-385, 2020 WL 1862967, at *4 n.4 (N.D.N.Y. Apr. 14, 2020) (noting that the “date last insured” “is a technical term used . . . to mark the last day on which a claimant is eligible for” disability benefits). The time between the alleged disability onset-date and the date last insured represents the operative timeframe, also known as the “relevant period,” for purposes of deciding an individual’s claim for disability benefits. See Shimanek v. Kijakazi, No. CIV-20-417-J, 2022 WL 896817, at *3 (W.D. Okla. Mar. 10, 2022); Cauthen v. Saul, 827 F. App’x 444, 446 (5th Cir. 2020) (noting that “disability evidence completely unrelated to the relevant period is irrelevant to adjudication of the claim”).

A multi-layered administrative process undergirds an individual’s claim for disability benefits. See Carr v. Saul, 141 S. Ct. 1352 (2021). A claimant must first seek an initial determination. 20 C.F.R. § 404.900(1). If unsatisfied with the outcome, the claimant may seek reconsideration. Id. § 404.900(2). Where the claimant finds fault with the reconsideration determination, the claimant may “request a hearing before an administrative law judge.” Id. § 404.900(3).

The Commissioner of Social Security has promulgated regulations outlining a five-step process that applies at each stage, including before the ALJ. See 20 C.F.R. § 404.1520; Dowell v. Colvin, 232 F. Supp. 3d 1, 5 (D.D.C. 2017). At step one, a claimant is not disabled if the claimant is engaged in “substantial gainful activity.” 20 C.F.R. § 404.1520(a)(4)(i). Substantial gainful activity includes work for pay or profit requiring significant mental or physical ability. Id. § 404.1572(a)-(b).

At step two, and only if the claimant is not engaged in substantial gainful activity, the ALJ determines whether the claimant has a “severe medically determinable physical or medical impairment that meets the duration requirement . . . or a combination of impairments that is severe and meets the duration requirement.” Id. § 404.1520(a)(4)(ii). To meet the duration requirement, a severe impairment or combination thereof “must have lasted or must be expected to last for a continuous period of at least 12 months.” Id. §§ 404.1509, 416.909.

At step three, and only if the claimant suffers from a severe impairment, the ALJ assesses whether the impairment “meets or equals one of the listings [of impairments].” Id. § 404.1520(a)(4)(iii). The listings of impairments describe impairments considered “severe enough to prevent an individual from doing any gainful activity, regardless of his or her age, education, or work experience.” Id. § 404.1525(a). If a claimant’s impairments meet all the criteria of a particular listing, id. § 416.925(c)(3), or are equivalent to a listing, id. § 416.926, the claimant counts as disabled, id. § 416.920(d); see also Cunningham v. Colvin, 46 F. Supp. 3d 26, 29 (D.D.C. 2014) (noting that where the ALJ finds that the claimant suffers from an impairment that meets one of those listed, then, the claimant qualifies as disabled, ending the inquiry at step three). The medical criteria defining the listed impairments has been set “at a higher level of severity than the statutory standard” for disability. Sullivan v. Zebley, 493 U.S. 521, 532 (1990).

At step four, and only if the claimant does not satisfy one of the listed impairments, the ALJ will evaluate the claimant’s “residual functional capacity.” Id. § 404.1520(a)(4)(iv); see also Id. § 404.1545(a)(1) (defining “residual functional capacity” as “the most you can still do despite your limitations”). After evaluating the claimant’s residual functional capacity, the ALJ will assess whether the claimant has shown that she cannot perform her “past relevant work.” Id. § 404.1520(a)(4)(iv).

At step five, and only if the claimant cannot perform her past relevant work, the ALJ evaluates the claimant’s residual functional capacity, “age, education, and work experience to see if [the claimant] can make an adjustment to other work.” Id. § 404.1520(a)(4)(v). If a claimant can make a feasible adjustment, then she is not disabled; a finding that there are no feasible adjustments results in a finding that the claimant is disabled. Id.; see also Butler v. Barnhart, 353 F.3d 992, 997 (D.C. Cir. 2004) (noting that the claimant bears the burden on the first four steps, whereas the Administration bears the burden on the fifth step).

In performing this five-step process, the ALJ “must adhere to certain regulatory requirements.” Saunders v. Kijakazi, 6 F.4th 1, 4 (D.C. Cir. 2021). The ALJ must consider the “objective medical evidence from an acceptable medical source,” medical opinions, and the claimant’s subjective statements. 20 C.F.R. § 416.929(a). More weight must be accorded to physicians who have treated and examined the claimant. Id. § 404.1527(c)(1), (c)(2).

Assuming the claimant disagrees with the ALJ’s conclusion, the claimant may request review by the “Appeals Council.” Id. § 404.900(4). If the claimant is dissatisfied with the Appeals Council’s determination, the claimant may seek judicial review. Id. § 404.900(5); 42 U.S.C. § 405(g) (noting that a claimant may seek judicial review of “any final decision of the Commissioner of Social Security made after a hearing to which [she] was a party”).

The Administration’s determination will not be disturbed if it is supported by substantial evidence and when the Administration applied the correct legal standards. 42 U.S.C. §§ 405(g), 1383(c); see also Thigpen v. Colvin, 208 F. Supp. 3d 129, 138 (D.D.C. 2016). The substantial- evidence standard is “highly deferential.” Rossello ex rel. Rossello v. Astrue, 529 F.3d 1181, 1185 (D.C. Cir. 2008) (Kavanaugh, J.) (quoting Pierce v. Underwood, 487 U.S. 552, 565 (1988)). As the Supreme Court recently noted, the substantial-evidence standard does not present a high bar.

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