Documente Academic
Documente Profesional
Documente Cultură
No. 15-1098
GEORGE G. MONROE,
Plaintiff - Appellant,
v.
CAROLYN W. COLVIN, Acting Commissioner of Social Security,
Defendant - Appellee.
Appeal from the United States District Court for the Eastern
District of North Carolina, at Wilmington. Louise W. Flanagan,
District Judge. (7:13-cv-00074-FL)
Argued:
Decided:
of
(DIB)
and
conclude
his
supplemental
that
conducting
applications
the
for
disability
security
income
administrative
(SSI).
law
function-by-function
insurance
judge
analysis
benefits
Because
erred
of
by
we
not
Monroes
applications
were
denied
initially
and
on
Council
Leopolds
granted
Monroes
decision,
and
request
remanded
to
for
an
review,
ALJ
for
vacated
a
new
issues.
The
Appeals
Council
decision
noted
that
Monroe
had
filed subsequent DIB and SSI claims on May 7, 2010, and the
decision specified that the ALJ on remand was to associate the
files and issue a new decision on all claims.
A second ALJ (Judge Allen) then held a supplemental hearing
in
late
2011.
He
subsequently
found
that
Monroe
was
not
pleadings,
States
magistrate
judge
issued
the
benefits.
Commissioners
motion,
and
affirm
the
denial
of
appealed.
Legal Background
Before discussing the evidence in the record and the ALJs
analysis thereof, we begin with an overview of the five-step
sequential evaluation that ALJs must use in making disability
determinations.
showing at the first two steps, see Bowen v. Yuckert, 482 U.S.
137, 146 n.5 (1987), and if he fails to carry that burden, he is
determined not to be disabled.
determine
the
claimants
residual
functional
capacity
assessment,
the
ALJ
must
first
identify
In
the
or
her
work-related
abilities
on
function-by-function
636
(quoting
Social
Security
analysis
may
an
ALJ
Ruling
96-8p,
61
Fed.
Id.
Reg.
RFC
in
terms
of
the
Reg. at 34,475).
In
determining
claimants
RFC,
the
ALJ
must
consider
must
all
[the
claimants]
symptoms,
He
including
other
evidence.
416.929(a).
show
that
20
C.F.R.
404.1529(a);
see
20
C.F.R.
claimant
has]
medically
determinable
such
as
pain,
[the
ALJ]
must
then
evaluate
the
Once the ALJ has determined the claimants RFC, the ALJ
then proceeds to step four, where the burden rests with the
claimant to show that he is not able to perform his past work.
See Bowen, 482 U.S. at 146 n.5; Mascio, 780 F.3d at 635.
If he
economy,
considering
the
claimants
residual
20
The
C.F.R.
416.920(a)(4)(v),
Commissioner
typically
offers
Id.
416.960(c)(2),
this
evidence
Id.
before
the
ALJ,
as
it
is
relevant
to
this
appeal,
Then
He
he
was
nodding
off
and
falling
asleep
and
He
having
Dorlands
Illustrated
Medical
Dictionary
defines
narcolepsy as recurrent, uncontrollable, brief episodes of
sleep,
often
associated
with
hypnagogic
hallucinations,
cataplexy, and sleep paralysis. Dorlands, at 1098.
7
A.R. 87.
or
times
three
day.
A.R.
93.
He
said
they
seem
more
Monroe
bronchitis.
also
testified
that
he
suffered
from
chronic
the day he sits down and rests at least three or four times a
day, usually for a few minutes.
He also testified that he suffered from neck and back pain
as a result of multiple automobile accidents.
And he reported
under
times.
control,
although
he
still
had
some
problems
at
In
A.R. 110.
Medical Records
discussion
relating
to
of
the
Monroes
medical
episodes
records
of
primarily
fatigue
and
to
those
loss
of
A January 2008
10
A.R. 550. 5
The
Naiks
uncontrollable
A.R. 551.
impression
sleep
and
stated
daytime
in
part,
confusional
Symptoms
episodes
of
and
cataplexy
disorder.
and
A.R. 552.
symptoms
of
obstructive
sleep
apnea
Dorlands
Illustrated
Medical
Dictionary
defines
cataplexy as a condition in which there are abrupt attacks of
muscular weakness and hypotonia triggered by an emotional
stimulus such as mirth, anger, fear, or surprise and notes that
[i]t is often associated with narcolepsy. Dorlands, at 282.
6
Overview
and
Facts,
http://www.sleepeducation.org/disease-detection/multiple-sleeplatency-test/overview-and-facts
(saved
as
ECF
opinion
attachment).
11
where
MSLT
will
obstructive
sleep
narcolepsy.
be
done
apnea
if
sleep
disorder.
study
is
negative
for
This
is
to
out
rule
underwent
sleep
A.R. 552.
study
on
February
7,
2008.
CPAP titration.
pressures.
water
by
mask.
restless
A.R. 611.
using
heated
A.R. 611.
leg
and
by
using
full
face
syndrome
or
periodic
limb
movement
disorder,
treatment
of
that
architecture.
may
improve
sleep
efficiency
and
sleep
A.R. 611.
A treatment note from Dr. Naik from the day after the study
indicated that Monroe continued to be sleepy and fatigued and
that he had been turned down for government assistance paying
for medications.
Dr. Naiks
sleepiness
excessive
with
daytime
symptoms
of
sleepiness.
narcolepsy
A.R.
612.
and
cataplexy
The
record
stated that Dr. Naik planned for Monroe to repeat [the] sleep
study using a CPAP and undergo MSLT testing to evaluate for
continue[d] daytime sleepiness to see if the patient does have
narcolepsy.
A.R. 612.
[Monroe]
might
benefit
from
[an]
agent
like
venlafaxine for cataplexy. He also would benefit from
[an] agent like modafinil for excessive daytime
sleepiness, but . . . he needs financial help.
Note
will be given to take to social services to assess for
financial help of his medical treatment and further
evaluation by doing repeat sleep study and MSLT
testing.
In meantime, [Monroe] is cautioned . . .
not to drive long distance[s] and [to] stop driving
when he is sleepy. . . . Neurological evaluation also
will be helpful to make sure he does not have partial
complex seizures causing passing out episodes.
A.R. 613.
Monroe underwent a second sleep study on April 1, 2008.
Dr. Naik observed, Good sleep efficiency with good sleep stages
13
day
after
A.R. 656.
the
second
study,
Monroe
underwent
MSLT
has
symptoms
of
cataplexy,
this
efficiency
and
had
poor
strongly
favors
the
control
of
his
sleep
apnea
A.R. 657.
noted
that
Monroe
was
focused
on
having
for
narcolepsy,
cataplexy,
14
and
obstructive
sleep
apnea.
A.R. 681.
A.R. 681.
Gatiwala
described
as
normal,
A.R.
690,
Dr.
Gatiwala
[Monroe]
absolutely
that
there
was
no
functional
impairment
noted during this hospitalization and that would not support his
request for disability.
Related
to
his
A.R. 678.
second
DIB
and
SSI
applications,
Monroe
December 11, 2010, report from Dr. Morton Meltzer indicated that
Monroe had continued to complain of daily seizures and that he
had reported that he could not return to one of his past jobs
until he had been cleared of the seizures for at least six
months.
A.R. 837.
A.R. 837.
that
narcolepsy,
he
that
had
he
been
uses
diagnosed
CPAP
machine,
sleep
and
apnea
that
he
and
falls
are
Monroes
mental
relevant.
limitations,
Ashley
L.
Booth,
two
particular
M.A.,
Licensed
applications,
marginally
low
directions
and
in
and
terms
determined
of
procedures
that
reliably
and
that
Monroe
and
his
safely
ability
appeared
mastering
to
sustain
558.
In
contrast,
Dr.
Meltzer
opined
after
his
able
tasks.
to
sustain
attention
to
perform
simple
repetitive
A.R. 839.
limited
detailed
in
his
ability
instructions
in
to
that
understand
he
and
could
only
[a
normal]
moderately
workday,
limited
in
his
A.R.
144,
159;
(2)
to
carry
out
ability
he
was
detailed
workweek
symptoms
without
and
to
interruptions
perform
at
from
psychologically
consistent
pace
based
without
an
in
his
public
ability
to
in
he
[with]
enviro[n]ments
that
that
coworkers
d[id]
not
interact
could
but
appropriately
with
the
accept
supervision
and
would
work
require
frequent
best
in
interpersonal
17
severe,
medically
narcolepsy,
disorder. 8
At
myalgias,
step
three,
Monroes
impairments
nor
medically
equaled
of
any
uveitis,
the
any
the
ALJ
impairments:
anxiety,
determined
combination
impairments
in
and
that
thereof
the
sleep
mood
none
of
met
or
Listing
of
Impairments.
The ALJ next determined that Monroe had the RFC to perform
light
work, 9
except
that
he
should
climb
stairs
or
ramps
occasionally,
limited
to
should
occasional
never
climb
bending,
ropes
balancing,
or
ladders,
stooping,
is
crawling,
tasks.
A.R.
16.
The
ALJ
recognized
that
this
his
the
symptoms
ALJ
found
and
that
resulting
Monroes
functional
claimed
limitations.
symptoms
could
relevant
to
this
appeal
is
the
ALJs
A.R. 17.
analysis
A.R. 19.
The ALJ cited the fact that Dr. Naik consistently described the
claimants sleep apnea as mild or moderate.
20
A.R. 19.
were
consistent
described.
with
with
the
RFC
that
the
ALJ
had
A.R.
subsequent
December
2010
consultative
examination,
which
follow
perform
instructions
simple,
and
repetitive
able
objective evidence.
to
tasks,
A.R. 20.
sustain
was
attention
supported
by
to
the
the
considered
ALJ
the
had
identified.
state
agency
A.R.
20.
medical
Finally,
consultants,
the
whom
ALJ
he
activities
of
daily
living
21
and
maintaining
social
functioning
and
moderate
limitation
A.R. 20.
in
concentration,
subjective
significant weight.
At
step
four,
complaints
and
that
the
he
gave
them
A.R. 20.
considering
the
RFC
that
the
ALJ
had
expert, the ALJ determined that jobs did exist in the national
economy
for
person
with
Monroes
age,
education,
work
Life Ins. Co., 474 F.3d 101, 104 (4th Cir. 2006).
A district
are
supported
by
substantial
evidence.
Bird
v.
Commission of Soc. Sec. Admin., 699 F.3d 337, 340 (4th Cir.
2012).
Monroe argues that the ALJ committed several legal errors
in analyzing the record before him.
22
A.
Monroe first argues that Judge Allen erred in not affording
great weight to the findings Judge Leopold made regarding his
severe
impairments
in
the
now-vacated
2010
decision.
We
disagree.
The fact that the Appeals Council vacated Judge Leopolds
decision and remanded for a new decision is dispositive here.
The SSA treats the doctrine of res judicata as applying when it
has made a previous determination or decision . . . on the same
facts
and
on
determination
the
same
issue
or
decision
or
has
(emphasis
added);
issues,
and
this
become
final
previous
by
either
20 C.F.R. 404.957(c)(1),
see
Lively
v.
Secretary
of
Health and Human Servs., 820 F.2d 1391, 1392 (4th Cir. 1987)
(Congress has clearly provided by statute that res judicata
prevents reappraisal of both the Secretarys findings and his
decision in Social Security cases that have become final.).
Here,
Judge
Leopolds
decision,
having
been
vacated,
never
became final, and thus the doctrine of res judicata did not
apply.
Monroe maintains that our decisions in Lively and Albright
v. Commissioner of the Social Security Administration, 174 F.3d
473 (4th Cir. 1999), and Social Security Acquiescence Ruling 001(4), 65 Fed. Reg. 1936-01 (Jan. 12, 2000), require a different
23
result.
Interpreting Albright
all
relevant
facts
and
circumstances
when
adjudicating
decisions
are
entitled
to
any
weight.
See
20
C.F.R.
10
We agree.
on
function-by-function
basis,
including
the
34,475).
We
explained
analyzing
the
creates
the
have
claimants
danger
that
that
expressing
limitations
the
the
function
adjudicator
RFC
before
by
function
[will]
overlook
Id. at 636
the
consistent
thereby
limitations
with
created
that
the
caused
RFC,
danger
by
the
Monroes
ALJ
that
made
the
impairments
this
ruling
very
error
identifies.
were
and
The
11
would lose consciousness about two or three times per day and
would need to take several breaks during the day because of
fatigue.
The
ALJ
indeed
found
that
Monroe
had
the
severe
episodes
of
loss
of
consciousness
or
fatigue
must
[i]nclude
resolution
of
any
that
exceptions
he
Monroe
was
identified)
capable
and
that
of
light
Monroes
Rather, he simply
work
(with
claimed
the
symptoms
were not credible to the extent they are inconsistent with the
RFC the ALJ identified. 12
12
However, we
claimants
capacity
to
perform
relevant
functions,
(alterations
and
internal
quotation
marks
omitted).
We
experienced
episodes
of
loss
of
consciousness
and
See
Hines v. Barnhart, 453 F.3d 559, 566 (4th Cir. 2006) (In order
for a vocational experts opinion to be relevant or helpful, it
must be based upon a consideration of all other evidence in the
record,
and
it
must
be
in
response
to
proper
hypothetical
On remand,
the ALJ will need to consider Monroes narcolepsy and apnea, and
all of his other physical and mental impairments, severe and
otherwise, and determine, on a function-by-function basis, how
they
affect
his
ability
to
work.
Only
once
the
ALJ
has
C.
Independent
analysis,
from
Monroe
the
also
aforementioned
contends
that
flaw
in
the
ALJ
the
did
ALJs
not
regarding
resulting
from
his
the
symptoms
impairments.
and
functional
Relatedly,
limitations
Monroe
maintains
that the ALJ did not satisfactorily explain his decision to not
rely on certain medical records that Monroe contends support his
testimony. 13
Security
Ruling
96-8p
explains
that
the
RFC
13
Fed. Reg. at 34,478; see also Clifford v. Apfel, 227 F.3d 863,
872
(7th
accurate
Cir.
2000)
and
logical
conclusion).
(observing
bridge
that
from
the
ALJ
the
must
evidence
build
to
an
his
Radford
However, he failed to
Clifford,
A.R. 19.
Simply put, the ALJ does not indicate how any of the facts
he cited show that Monroe did not lose consciousness two or
three times daily or suffer extreme fatigue.
times
described
significant
his
evidence
problems
in
the
as
record
Although Monroe at
blackouts
suggests
and
that
seizures,
Monroes
diagnosis
of
narcolepsy
with
cataplexia);
A.R.
837
(Dr.
pulmonary and respiratory tests and an EEG, the ALJ did not
explain why he believed these results had any relevance to the
question of what symptoms Monroe suffered from narcolepsy. 14
does
the
ALJ
explain
why
he
believed
that
the
Nor
intensity
of
and
[f]rom
that
point
forward,
his
conditions
were
14
Dr. Naik, after all, was aware of all of the test results
other than the EEG when he determined that the MSLT results
strongly
favor[ed]
the
diagnosis
of
narcolepsy
with
cataplexia. A.R. 657. And the records seemed to indicate that
Dr. Gatiwala ordered the EEG to rule out complex partial
seizures, as opposed to narcolepsy. See A.R. 681 (Dr. Gatiwala
ordered EEGs to rule out complex partial seizures); see also
A.R. 613 (report from Dr. Naik indicating that MSLT would test
for narcolepsy and that neurological evaluation would help rule
out partial complex seizures).
31
reported that use of the CPAP has not significantly helped those
problems, and that was his testimony as well.
ALJ
decides
episodes
to
of
loss
discredit
of
Monroes
consciousness
On remand, if the
testimony
and
regarding
fatigue,
it
his
will
be
significant
narrative
example
discussion
of
the
ALJs
describing
how
failure
the
to
evidence
degrees
of
weight
he
gave
to
differing
opinions
For example,
and
marginally
Mr.
Booths
low,
in
report
terms
of
concluded
mastering
that
Monroe
basic
appeared
directions
or
A.R.
Nor did the ALJ even mention that Monroes testimony and
Dr. Naiks medical records indicated that Dr. Naik wanted to
treat Monroe with medication but that Monroe could not afford
it.
32
19-20.
claimants
treatment
history
did
not
A.R. 20.
support
the
As such, the
similarly
e.g.,
A.R.
examiners
conclusory
20
(The
findings
consistent
with
of
undersigned
some
the
analysis
weight,
gives
to
residual
other
the
functional
The ALJ
opinions.
the
See,
consultative
extent
that
it
capacity.
is
The
capacity.
The
objective
evidence
supports
the
is
of
consistent
record,
with
such
as
the
the
objective
first
evidence
consultative
and
other
physical
limited
weight.
After
reviewing
the
objective
significant weight.
the
objective
complaints.).
evidence
and
the
claimants
subjective
neither
we
nor
the
district
court
can
undertake
at 295.
III.
For the foregoing reasons, we reverse the district courts
judgment and remand with instructions to vacate the denial of
Monroes
application
for
benefits
and
remand
for
further
administrative proceedings.
REVERSED AND REMANDED WITH INSTRUCTIONS
34