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Pyle v. Commissioner of Social Security

United States District Court, E.D. Washington

August 14, 2017

ADAM D. PYLE, Plaintiff,



         BEFORE THE COURT are cross-motions for summary judgment. ECF No. 18, 20. Attorney Dana C. Madsen represents Adam D. Pyle (Plaintiff); Special Assistant United States Attorney Daniel P. Talbert represents the Commissioner of Social Security (Defendant). The parties have consented to proceed before a magistrate judge. ECF No. 6. After reviewing the administrative record and briefs filed by the parties, the Court GRANTS Defendant's Motion for Summary Judgment and DENIES Plaintiffs Motion for Summary Judgment.


         Plaintiff received Supplemental Security Income (SSI) benefits as a child. Tr. 30. Upon turning 18, his case was reviewed and it was deemed that he met the definition of disability for adults. Tr. 30, 47. On September 19, 2011, a review of the case found that his disability ceased as of September 1, 2011. Tr. 31, 47. Plaintiff requested reconsideration of the cessation, Tr. 50, and the cessation was affirmed, Tr. 51. On February 2, 2012, Plaintiff attended a hearing with a Disability Hearing Officer. Tr. 54. The Hearing Officer determined that cessation of benefits was appropriate, but the correct cessation date was April 1, 2012. Tr. 64. Plaintiff requested a hearing by an Administrative Law Judge (ALJ). Tr. 65. On February 6, 2013, ALJ Lori Freund held a hearing and continued the matter to allow Plaintiff time to hire an attorney. Tr. 811-827. A second hearing was held on August 21, 2013, and the ALJ heard testimony from Plaintiff and vocational expert, K. Diane Kramer. Tr. 828-870. The ALJ issued an unfavorable decision on April 21, 2014. Tr. 15-28. The Appeals Council denied review on March 31, 2016. Tr. 1-7. The ALJ's April 21, 2014 decision became the final decision of the Commissioner, which is appealable to the district court pursuant to 42 U.S.C. § 405(g). Plaintiff filed this action for judicial review on May 26, 2016. ECF No. 1, 4.


         The facts of the case are set forth in the administrative hearing transcript, the ALJ's decision, and the briefs of the parties. They are only briefly summarized here.

         Plaintiff was 19 years old at the date of cessation, April 1, 2012. Tr. 32. Plaintiff has an eleventh grade education followed by a GED. Tr. 610. He received services from Division of Vocational Rehabilitation but has no work history. Tr. 611-612. His alleged impairments include Asperger's syndrome, schizo-affective disorder, Ehlers-Danlos Syndrome (EDS), anxiety, irritable bowel syndrome (IBS), and a sun allergy. Tr. 210, 228, 855-859.


         The ALJ is responsible for determining credibility, resolving conflicts in medical testimony, and resolving ambiguities. Andrews v. Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995). The Court reviews the ALJ's determinations of law de novo, deferring to a reasonable interpretation of the statutes. McNatt v. Apfel, 201 F.3d 1084, 1087 (9th Cir. 2000). The decision of the ALJ may be reversed only if it is not supported by substantial evidence or if it is based on legal error. Tackett v. Apfel, 180 F.3d 1094, 1097 (9th Cir. 1999). Substantial evidence is defined as being more than a mere scintilla, but less than a preponderance. Id. at 1098. Put another way, substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. Richardson v. Perales, 402 U.S. 389, 401 (1971). If the evidence is susceptible to more than one rational interpretation, the court may not substitute its judgment for that of the ALJ. Tackett, 180 F.3d at 1097. If substantial evidence supports the administrative findings, or if conflicting evidence supports a finding of either disability or non-disability, the ALJ's determination is conclusive. Sprague v. Bowen, 812 F.2d 1226, 1229-1230 (9th Cir. 1987). Nevertheless, a decision supported by substantial evidence will still be set aside if the proper legal standards were not applied in weighing the evidence and making the decision. Brawner v. Secretary of Health and Human Services, 839 F.2d 432, 433 (9th Cir. 1988).


         The Commissioner has established an eight-step sequential evaluation process for determining whether a person's disability has ended. 20 C.F.R. § 416.994(b)(5). This process is similar to the five-step sequential evaluation process used to evaluate initial claims, with additional attention as to whether there has been medical improvement. Compare 20 C.F.R. § 416.920 with 20 C.F.R. § 416.994(b)(5). A claimant is disabled only if his impairment is "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." 42 U.S.C. § l382c(a)(3)(B).

         The first step addresses whether the claimant has an impairment or combination of impairments that meet or equal the severity of listed impairments set forth at 20 C.F.R. pt. 404, subpt. P, app. 1. 20 C.F.R. § 4l6.994(b)(5)(i). If the impairment does not equal a listed impairment, the second step addresses whether there has been medical improvement in the claimant's condition. 20 C.F.R. § 4l6.994(b)(5)(ii). Medical improvement is "any decrease in the medical severity" of the impairment that was present at the time the individual was disabled or continued to be disabled. 20 C.F.R. § 4l6.994(b)(1)(i). If there has been medical improvement, a step three determination is made addressing whether such improvement is related to the claimant's ability to perform work-that is, whether there has been an increase in the individual's residual functional capacity. 20 C.F.R. § 4l6.994(b)(5)(iii).

         If the answer to step three is yes, the Commissioner skips to step five and inquires whether all of the claimant's current impairments in combination are severe. At step five, if medical improvement is shown to be related to the claimant's ability to work, a determination will be made to assess whether the claimant's current impairments, in combination, are severe-that is, whether they impose more than a minimal limitation on his physical or mental ability to perform basic work activities. 20 C.F.R. § 4l6.994(b)(5)(v). If the answer to that inquiry is yes, the claim proceeds to step six and the ALJ must determine whether the claimant can perform past relevant work. 20 C.F.R. § 4l6.994(b)(5)(vi). If the claimant can perform past relevant work, his disability will be deemed to have ended. Id. If the claimant cannot perform his past relevant work, at step seven a limited burden of production shifts to the Commissioner to prove there is alternative work in the national economy that the claimant can perform given his age, education, work experience, and residual functional capacity. 20 C.F.R. § 4l6.994(b)(5)(vii). Similarly, if the claimant has no past relevant work, step eight mimics step seven in considering his ability to perform other work in the national economy. 20 C.F.R. § 4l6.994(b)(5)(viii). If the claimant cannot perform a significant number of other jobs, he remains disabled despite medical improvement; if, however, he can perform a significant number of other jobs, disability ceases. 20 C.F.R. § 4l6.994(b)(5)(vii)-(viii).

         Alternatively, if the answers to steps two or three is no, the evaluation proceeds to step four. At step four, consideration is given to whether the case meets any of the special exceptions to medical improvement for determining that disability has ceased. 20 C.F.R. § 4l6.994(b)(5)(iv). If no special exception applies, the claimant's disability will be found to continue.

         While the claimant bears the burden of proving disability, Tackett, 180 F.3d at 1098-1099, once a claimant has been found disabled, a presumption of continuing disability arises in his favor. Bellamy v. Sec. of Health & Human Serv., 755 F.2d 1380, 1381 (9th Cir. 1985). The Commissioner bears the burden of producing evidence sufficient to rebut this presumption. Id.


         On April 21, 2014, the ALJ issued a decision finding Plaintiffs disability under section 1614(a)(3)(A) of the Social Security Act ended on April 1, 2012 and that Plaintiff had not been disabled again since that date. Tr. 28.

         The ALJ identified the most recent favorable medical decision in the case to be November 15, 2010 and deemed it the point of comparison. In that determination, Plaintiff had the medically determinable impairments of EDS and Asperger's disorder and was found to meet section 11.04B of 20 C.F.R. Part 404, Subpart P, Appendix 1. Tr. 17.

         The ALJ then found that as of April 1, 2012, Plaintiff had the following medically determinable impairments: hypermobility syndrome; IBS; somatization disorder; attention deficit hyperactivity disorder (ADITD); anxiety disorder, not otherwise specified; and personality disorder with schizoid and dependent features. Tr. 17.

         At step one, the ALJ found that Plaintiff did not have an impairment or combination of impairments which met or medically equaled the severity of an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. Tr. 17.

         At step two, the ALJ determined that medical improvement had occurred ...

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