WILCOX v. O'MALLEY

CourtDistrict Court, W.D. Pennsylvania
DecidedMarch 31, 2025
Docket2:23-cv-01823
StatusUnknown

This text of WILCOX v. O'MALLEY (WILCOX v. O'MALLEY) is published on Counsel Stack Legal Research, covering District Court, W.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
WILCOX v. O'MALLEY, (W.D. Pa. 2025).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF PENNSYLVANIA

DANIELLE MARIE WILCOX, ) ) Plaintiff, ) ) v. ) Civil Action No. 23-1823 ) COMMISSIONER OF SOCIAL SECURITY, ) ) Defendant. )

O R D E R AND NOW, this 31st day of March, 2025, upon consideration of Defendant’s Motion for Summary Judgment (Doc. No. 16) filed in the above-captioned matter on March 28, 2024, IT IS HEREBY ORDERED that said Motion is DENIED. AND, further, upon consideration of Plaintiff’s Motion for Summary Judgment (Doc. No. 13) filed in the above-captioned matter on February 23, 2024, IT IS HEREBY ORDERED that said Motion is GRANTED. This matter is hereby reversed and remanded to the Commissioner of Social Security (“Commissioner”) for the calculation and award of benefits under sentence four of 42 U.S.C. § 405(g) consistent with this Order. I. Background Plaintiff Danielle Marie Wilcox protectively filed a claim for supplemental security income benefits under Subchapter XVI of the Act, 42 U.S.C. § 1381 et seq., effective July 27, 2020, claiming that she became disabled on April 19, 2012, due to type 1 diabetes, coronary disease, and diabetic retinopathy. (R. 13, 299-305, 336). After being denied initially on February 11, 2021, and upon reconsideration on May 18, 2021, Plaintiff sought, and obtained, a telephone hearing before an Administrative Law Judge (“ALJ”). (R. 13, 153, 180, 196). The initial hearing was held on October 21, 2021, and a supplemental hearing was held on May 10, 2022. (R. 13, 34-78, 80-107). In a decision dated July 12, 2022, the ALJ denied Plaintiff’s request for benefits. (R. 13-24). On August 22, 2023, the Appeals Council declined to review the decision. (R. 1-4). Plaintiff filed an appeal with this Court, and the parties have filed cross- motions for summary judgment.

II. Standard of Review Judicial review of a social security case is based upon the pleadings and the transcript of the record, and the scope of that review is limited to determining whether the Commissioner applied the correct legal standards and whether the record, as a whole, contains substantial evidence to support the Commissioner’s findings of fact. See 42 U.S.C. § 405(g); Matthews v. Apfel, 239 F.3d 589, 592 (3d Cir. 2001) (noting that “‘[t]he findings of the Commissioner of Social Security as to any fact, if supported by substantial evidence, shall be conclusive’” (quoting § 405(g)); Schaudeck v. Comm’r of Soc. Sec. Admin., 181 F.3d 429, 431 (3d Cir. 1999) (stating that the court has plenary review of all legal issues, and reviews the ALJ’s findings of

fact to determine whether they are supported by substantial evidence). If the district court finds this to be so, it must uphold the Commissioner’s final decision. See Rutherford v. Barnhart, 399 F.3d 546, 552 (3d Cir. 2005). The Court may not set aside a decision that is supported by substantial evidence “even if [it] would have decided the factual inquiry differently.” Hartranft v. Apfel, 181 F.3d 358, 360 (3d Cir. 1999) (citing § 405(g)); Monsour Med. Ctr. v. Heckler, 806 F.2d 1185, 1190-91 (3d Cir. 1986)). “Substantial evidence” is defined as “more than a mere scintilla.” Plummer v. Apfel, 186 F.3d 422, 427 (3d Cir. 1999) (quoting Ventura v. Shalala, 55 F.3d 900, 901 (3d Cir. 1995)). It means “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Id.; Biestek v. Berryhill, 139 S. Ct. 1148, 1154 (2019). However, a “‘single piece of evidence will not satisfy the substantiality test if the [Commissioner] ignores, or fails to resolve, a conflict created by countervailing evidence.’” Morales v. Apfel, 225 F.3d 310, 317 (3d Cir. 2000) (quoting Kent v. Schweiker, 710 F.2d 110, 114 (3d Cir. 1983)). “‘Nor is evidence substantial if it is overwhelmed by other evidence – particularly certain types of evidence (e.g., that offered by treating physicians) – or if it really constitutes not evidence but mere

conclusion.’” Id. So as to facilitate the district court’s review, an ALJ’s findings must “be accompanied by a clear and satisfactory explication of the basis on which [they] rest[].” Cotter v. Harris, 642 F.2d 700, 704 (3d Cir. 1981). Decisions that are conclusory in their findings or indicate the ALJ’s failure to consider all the evidence are not supported by substantial evidence. See id. at 705-06. Moreover, the Court must ensure the ALJ did not “reject evidence for no reason or for the wrong reason.” Id. at 706 (citing King v. Califano, 615 F.2d 1018 (4th Cir. 1980)). A disability is established when the claimant can demonstrate some medically determinable basis for an impairment that prevents him or her from engaging in any substantial gainful activity for a statutory twelve-month period. See Fargnoli v. Massanari, 247 F.3d 34, 38-39 (3d Cir. 2001). “A claimant is considered unable to engage in any substantial gainful

activity ‘only if his physical or mental impairment or 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 . . . .’” Id. at 39 (quoting 42 U.S.C. § 423(d)(2)(A)). The Social Security Administration (“SSA”) has promulgated regulations incorporating a five-step sequential evaluation process in guiding ALJs in determining whether a claimant is under a disability as defined by the Act. See 20 C.F.R. § 416.920. At Step One, the ALJ must determine whether the claimant is currently engaging in substantial gainful activity. See id. at § 416.920(a)(4)(i). If so, the disability claim will be denied. See Bowen v. Yuckert, 482 U.S. 137, 140 (1987). If not, the second step of the process is to determine whether the claimant is suffering from a severe impairment. See 20 C.F.R. § 416.920(a)(4)(ii).

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Bowen v. Yuckert
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Roseann Zirnsak v. Commissioner Social Security
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Biestek v. Berryhill
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Monsour Medical Center v. Heckler
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WILCOX v. O'MALLEY, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wilcox-v-omalley-pawd-2025.