Wake Forest Law Review
13Feb

Fourth Circuit Reverses and Remands Denial of Social Security Benefits

Categories: 4th Cir. Blog Civil Cases
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By: Kristina Wilson

On Thursday, January 19, 2017, the Fourth Circuit issued a published opinion in the civil case Patterson v. Commissioner of Social Security Administration. The Fourth Circuit reversed and remanded the Administrative Law Judge’s (“ALJ”) denial of the plaintiff’s disability benefits due to his failure to evaluate the plaintiff’s alleged mental impairment according to the “special technique” required by 20 C.F.R. § 404.1520a. The Fourth Circuit held that although failing to follow the special technique does not always necessitate remand, in this case, it was not a harmless error.

Facts and Procedural History

On July 21, 2010, the plaintiff filed her initial application for Social Security benefits. After the Social Security Administration (“SSA”) denied her application, the plaintiff filed a timely request for a hearing on May 12, 2011. The ALJ at the hearing upheld the denial of the plaintiff’s benefits, holding that she was not disabled during the period for which she sought benefits. The ALJ based this determination primarily on the conclusions of one doctor. The SSA conceded that the ALJ failed to follow the appropriate “special technique” protocol outlined in 20 C.F.R. § 404.1520a and that the ALJ failed to consider contradictory medical evidence. The plaintiff then filed suit in district court, but district court sided with the ALJ, stating that substantial evidence supported the ALJ’s findings and that the failure to use the special technique constituted harmless error. The plaintiff appealed from these findings.

The ALJ Failed to Employ the Special Technique

When evaluating a claimant’s alleged mental impairment, an ALJ must follow the special technique. 20 C.F.R. § 404.1520a(a). Under the special technique, an ALJ must evaluate the alleged mental impairment according to four areas of functional limitation including activities of daily living, social functioning, concentration, persistence, or pace, and episodes of decompensation. 20 C.F.R. § 404.1520a(c)(4). The ALJ must rate his findings in the final area, episodes of decompensation, according to a four-point scale. Id. Next, the ALJ determines if the mental impairment is severe and whether it qualifies as a listed impairment. Id. § 404.1520a(d). The regulation requires the ALJ to specifically document all of the steps of the special technique. Id.

Here, the ALJ relied on the findings of only two doctors and did not document the steps of the special technique. Moreover, the record contained evidence that conflicted with the doctors’ findings, but the ALJ did not address the discrepancies. The SSA conceded that the ALJ did not properly apply the special technique and that the doctors’ opinions were not a sufficient surrogate for the special technique.

The Fourth Circuit Cannot Apply the Special Technique

The SSA argues, as a matter of first impression, that the Fourth Circuit can apply the special technique on appeal. If the Fourth Circuit found that the ALJ’s denial of benefits was proper, it could affirm the district court’s opinion. However, the Fourth Circuit disagreed with this argument, stating that the plain language of the special technique statute requires the SSA to apply the special technique. 20 C.F.R. § 404.1520a(e). Therefore, according to the Fourth Circuit, the special technique could not have been intended as nonbinding guidance to aid reviewing courts. The Fourth Circuit further reasoned that the SSA frequently issues such nonbinding guidance, and if it had intended for the special technique to be nonbinding guidance, it would not have engaged in the burdensome regulation promulgation process. Finally, the Fourth Circuit reasoned that failure to apply and properly document the special technique in administrative hearings actually hampers judicial review by obscuring the manner in which the ALJ handled different types of evidence. Thus, the Fourth Circuit concluded that it could not independently apply the special technique.

The Failure to Apply the Special Technique Was Not Harmless Error

Although the failure to apply the special technique does not automatically require remand in every case, the failure in this case was not harmless. The Fourth Circuit stated that the ALJ’s failure to make and support his findings severely hindered judicial review. The Fourth Circuit had no way of knowing how the ALJ evaluated crucial factors such as the plaintiff’s IQ. Moreover, the Fourth Circuit could not ascertain how the ALJ weighed and treated the conflicting evidence. Thus, the Fourth Circuit was unable to say whether substantial evidence supported the ALJ’s findings because the ALJ failed to document and explain his findings according to mandatory procedure.

Conclusion

The Fourth Circuit did not reach the merits of the plaintiff’s application for disability benefits. Instead, it reversed the district court’s findings and remanded the case to the ALJ, directing him to follow the requirements of all applicable regulations.

 

 

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19Mar

Grant of SSA Commissioner’s Motion for Judgment on the Pleadings Reversed

Categories: 4th Cir. Blog
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By Evelyn Norton

Yesterday, in a published opinion, in the civil case of Mascio v. Colvin, the Fourth Circuit reversed the decision of the District Court for the Eastern District of North Carolina to grant the motion of the Social Security Administration Commissioner for judgment on the pleadings.

The District Court Found that the SSA Properly Denied Mascio Supplemental Benefits

Plaintiff Bonnilyn Mascio alleged that she was disabled from severe degenerative disc disease, carpal tunnel syndrome, and adjustment disorder.  Thus, Mascio applied for supplemental security income benefits from the SSA.  However, the SSA denied Mascio’s application.

In 2008, an administrative law judge found Mascio was not disabled.  The district court reversed and remanded the decision.  A second administrative law judge also found that Mascio was not disabled from March 15, 2005, to November 30, 2009.  In response, Mascio filed a complaint in the district court.  The district court granted the Commissioner’s  motion for judgment on the pleadings, upholding the denial of benefits to Mascio.

Upon De Novo Review, the Fourth Circuit Concluded Remand was Required

On appeal, Mascio argued that the administrative law judge erred in: (1) not conducting a function-by-function analysis; (2) not including Mascio’s concentration, persistence, or pace limitation in his hypothetical to the vocational expert; (3) determining Mascio’s residual functional capacity before assessing her credibility; and (4) not applying the “great weight rule” to Mascio’s subjective claims of pain.

The Fourth Circuit reviewed the district court’s decision on a motion for judgment on the pleadings de novo.  The Court affirms a disability determination when an administrative law judge applies correct legal standards and substantial evidence supports the factual findings.

The Fourth Circuit Found the Administrative Law Judge Failed to Provide a Thorough Analysis

First, the Court agreed with Mascio that the administrative law judge failed to conduct a function-by-function analysis in assessing Mascio’s residual functional capacity.  The Court found that the administrative law judge’s opinion was “sorely lacking in the analysis needed . . . to review meaningfully [its] conclusions.”  Furthermore, the Court found that the administrative law judge neglected to address conflicting evidence in the record regarding Mascio’s residual functional capacity.  As a result, the Court stated that it was left only to guess as to how the administrative law judge arrived at his conclusions.  Therefore,  remand was necessary.

Second, the Fourth Circuit found that the administrative law judge gave no explanation as to why he did not include Mascio’s concentration, persistence, or pace limitation in the hypothetical tendered to the vocational expert.  The Court entertained possible explanations, such as the administrative law judge found excluding Mascio’s concentration, persistence, or pace limitation from the hypothetical was appropriate because the limitation does not affect her ability to work.  Ultimately, however, the administrative law judge’s failure to provide his explanation on this matter necessitated a remand.

Third, the Fourth Circuit found that the administrative law judge determined Mascio’s residual functional capacity without properly assessing her credibility.  Indeed, the administrative law judge only employed vague boilerplate language stating that he did not believe Mascio’s claims of limitations.  Nowhere else did the administrative law judge explain his decision to discredit Mascio’s statements.  Thus, the Court concluded such a lack of explanation required remand.

Fourth, the Fourth Circuit stated that the “great weight rule” does not exists in this circuit, as Mascio argued.  Mascio simply misread unpublished cases, which are not binding on the Court.  Thus, the Court declined to adopt the rule.

District Court Reversed

The Fourth Circuit reversed and remanded the grant of the SSA Commissioner’s motion for judgment on the pleadings.

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17Feb

Fourth Circuit Defers to the Social Security Administration Commissioner in Case Deciding Benefits

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By Taylor Ey

Last Friday, February 13, the Fourth Circuit issued its unpublished opinion in the civil case Watson v. Colvin.

History of the Case

Mr. Watson was seeking disability insurance benefits and supplemental security income, but acting Social Security Commissioner Colvin (“the Commissioner”) denied his claim.  Mr. Watson sought review of the Commissioner’s determination before a magistrate judge in the United States District Court for the District of Maryland, at Baltimore.  The magistrate judge upheld the Commissioner’s decision, and Mr. Watson sought review before the Fourth Circuit.

The Commissioner’s Determination Is Reviewed Under a Substantial Evidence Standard

The Fourth Circuit reviewed the record to determine whether the Commissioner’s findings were supported by substantial evidence.  Under this standard, the Fourth Circuit was not permitted to reweigh the evidence or make credibility determinations.  Even where reasonable minds could differ, the court deferred to the Commissioner’s determination.

The Fourth Circuit Affirmed the Lower Court’s Decision

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