United States District Court, D. Columbia.
Frederick C. Gilliland, Plaintiff,
Carolyn W. Colvin, Acting Commissioner of Social Security, Defendant
For FREDERICK C. GILLILAND, Plaintiff: Stephen F. Shea, ELKIND & SHEA, Silver Spring, MD.
For SOCIAL SECURITY ADMINISTRATION, 2255: Christian Vainieri, LEAD ATTORNEY, SOCIAL SECURITY ADMINISTRATION, Office of the General Counsel, Baltimore, MD.
For MICHAEL JAMES ASTRUE, Commissioner of Social Security, Defendant: Christian Vainieri, LEAD ATTORNEY, SOCIAL SECURITY ADMINISTRATION, Office of the General Counsel, Baltimore, MD.
Gladys Kessler, United States District Judge.
Frederick C. Gilliland (" Plaintiff" or " Gilliland" ) brings this action seeking judicial
review of a final decision of the Acting Commissioner of the Social Security Administration (" Defendant" or " Commissioner" ) pursuant to Section 205(g) of the Social Security Act, 42 U.S.C. § 405(g), denying his claim for disability insurance benefits (" DIB" ) pursuant to Title II of the Social Security Act, 42 U.S.C. § § 401 et seq.
This matter is presently before the Court on Plaintiff's Motion for Judgment of Reversal [Dkt. No. 10] and Defendant's Motion for Judgment of Affirmance [Dkt. No. 11]. Upon consideration of the parties' cross-motions, the administrative record, the entire record herein, and for the reasons stated below, Plaintiff's Motion for Judgment of Reversal is hereby granted, and Defendant's Motion for Judgment of Affirmance is hereby denied.
A. Procedural Background
On July 31, 1986, Plaintiff filed an application for disability insurance benefits (" DIB" ), claiming that starting on April 13, 1985, headaches and fatigue left him disabled. Administrative Record (" AR" ) 22 [Dkt. No. 8].
On November 23, 1988, Administrative Law Judge Russell Rowell (" ALJ Rowell" ) issued an opinion denying Plaintiff's application. AR 21-25. On January 18, 1990, the Social Security Administration's (" SSA" ) Appeal Council denied Plaintiff's intra-agency appeal. AR 33-34. Plaintiff did not and was not required to bring an action in federal court at that time.
In December of 1996, Plaintiff began working again, closing the period of alleged disability. AR 96, 139, 146. Accordingly, the period of alleged disability relevant to this matter covers April 13, 1985 to December 1, 1996. AR 14, 146.
On February 7, 2002, the United States District Court for the Middle District of Pennsylvania approved a class action settlement in the matter of Grant v. Comm'r, Soc. Sec. Admin., 111 F.Supp.2d 556 (M.D. Pa. 2000). AR 35-37. The class included " all applicants for Social Security disability benefits . . . who received an adverse decision from [ALJ] Russell Rowell . . . on or after January 1, 1985." AR 35. As part of the settlement, the SSA agreed to provide each eligible class member with de novo review of his or her application by a different ALJ. AR 36. Defendant concluded that Plaintiff's DIB claim was eligible for de novo review under the Grant settlement and sent Plaintiff a letter informing him of his right to another hearing. AR 63-64.
On December 14, 2011, ALJ James Mangrum (" ALJ Mangrum" or " the ALJ" ) held a hearing at which Plaintiff, his counsel, and a vocational expert were present. AR 233-58.
On January 26, 2012, the ALJ denied Plaintiff's claim, ruling that Plaintiff had not shown that he was disabled during the period from April 13, 1985 through December 1, 1996. AR 14-20.
On October 23, 2013, the SSA's Appeal Council denied Plaintiff's request for review of ALJ Mangrum's decision. AR 6 (" We found no reason under our rules to review the Administrative Law Judge's decision. Therefore, we have denied your request for review." ).
On December 20, 2012, Plaintiff filed his Complaint challenging Defendant's denial of his claim for DIB pursuant to 42 U.S.C. § 405(g).
[Dkt. No. 1]. On June 3, 2013, Defendant filed its Answer. [Dkt. No. 7]. On August 2, 2013, Plaintiff filed a Motion for Judgment of Reversal. [Dkt. No. 10]. On September 30, 2013, Defendant filed a Motion for Judgment of Affirmance and its Opposition to Plaintiff's Motion for Judgment of Reversal. [Dkt. No. 11]. Finally, on October 16, 2013, Plaintiff filed his Opposition to Defendant's Motion for Judgment of Affirmance and Response to Defendant's Opposition. [Dkt. No. 14].
B. Factual Background
At the time he filed this action, Plaintiff Frederick Gilliland was 80 years old and resided in Kamloops, British Columbia, Canada. AR 120; Pl.'s Compl. [Dkt. No. 1]. Plaintiff had earned a General Equivalency Diploma, had completed journeyman steamfitter training, and had attended one year of college. AR 171. Before the onset of his headaches and fatigue, Plaintiff had worked as a pipefitter, pipefitter foreman, piping general foreman, and capital project superintendent. AR 140, 156-60. Most recently, he had served as a capital projects supervisor in a pulp mill. AR 140, 156-60.
Plaintiff was 52 years old when the alleged period of disability began on April 13, 1985 and was 62 years old when he returned to work, ending the alleged period of disability on December 1, 1996. AR 14-20, 146-47.
In March of 1985, Plaintiff started to experience debilitating headaches and severe fatigue. AR 14-19, 189-192, 214-215. Despite the investment of significant time and medical resources, none of the physicians who Plaintiff saw were able to provide a diagnosis for his condition. Id.
From February 19, 1986 until March 6, 1986, Plaintiff was hospitalized at Foothills Hospital in Calgary, Canada in order to identify the cause of his " nonspecific illness characterized by extreme fatigue, malaise, myalgias and left orbital and retro-orbital headache, accompanying a sense of tugging at the left eye." AR 189-192. During that time, a number of physicians examined Plaintiff, including a neurologist and an ear, nose, and throat specialist. Id.
The doctors at Foothills Hospital were unable to reach a definitive diagnosis of Plaintiff's condition. AR 189-192. The report from Foothills Hospital relates that " the headache follow[ed] a daily pattern with gradual onset in late morning, increasing in severity later in the day. [Plaintiff] did not seem to have a nocturnal headache. . . . He ha[d] had several episodes of pain, severe enough to require hospitalization for narcotics." AR 189. Plaintiff underwent a battery of tests and examinations, all of which yielded " essentially unremarkable" results. AR 17-18. Dr. Mukherjee of Foothills Hospital did note, however, that during his examination Plaintiff demonstrated, " some focal tenderness in the left supraorbital region[.]" AR 190. Unable to determine the cause of Plaintiff's symptoms, the physicians at Foothills Hospital referred him to a pain management clinic. AR 191.
In addition to the specialists at Foothills Hospital, Plaintiff also met with his family physician, Dr. H.C. Muendel. AR 146, 206, 214-215, 221. Plaintiff first visited Dr. Muendel in July of 1985 and described the reasons for his visits as " examination,"
" treatment," " diagnosis," and prescri[ption of] medication." AR 206. Although at one point, Plaintiff described his visits with Dr. Muendel as " irregular," AR 206, by June 10, 1987, Plaintiff was visiting Dr. Muendel an average of twice a month, AR 221.
Although many of Dr. Muendel's records were lost or destroyed when he relocated his practice, AR 146, Plaintiff was able to recover a letter summarizing his findings, AR 214-15. The letter notes that Dr. Muendel was unable to identify a " specific cause" of Plaintiff's intense, recurrent headache. Id. " However, it ha[d] been determined that [the headache] [was] related to the facial nerves over the left eye." Id. Dr. Muendel wrote, " [t]hat nerve has been injected by myself and by the anesthesiologist, Dr. Dhiel, several times with dramatic relief of pain for a short period of time, half an hour to four hours of dulling of the pain." Id. Near the end of his letter, Dr. Muendel added that " [s]ince the onset of this, at present time, incurable headache, [Plaintiff] has also become somewhat depressed." Id.
Plaintiff's headaches severely affected nearly every aspect of his life. AR 235-58. He experienced fatigue, " headaches, joint pain, loss of memory, inability to express [himself], [and] severe weakness." AR 165. Until Plaintiff's condition abated in December of 1996, Plaintiff spent much of his time sleeping, " required a big effort just to walk up a flight of stairs[,]" and " spent his days in and out of consciousness." AR 17-20, 146-47.
Because of the passage of time between Plaintiff's submission of his DIB application in 1985 and his most recent hearing before ALJ Mangrum in 2011, many potentially relevant medical records are absent from the record. AR 236-37. Plaintiff was able to recover several documents from the Canadian government, including Dr. Muendel's letter and the report from Foothills Hospital. AR 237-42. Unfortunately, Defendant was unable to recover any of the 32 exhibits appended to ALJ Rowell's 1988 decision. AR 239.
C. Disability Determination Process
In order to qualify for disability insurance benefits, an individual must prove that she has a disability that renders her unable " to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment" for a period of " not less than 12 months." 42 U.S.C. § § 423(a) (1) & (d) (1) (A). The claimant must support her claim of impairment with " [o]bjective medical evidence" that is " established by medically acceptable clinical or laboratory diagnostic techniques." 42 U.S.C. § 423 (d) (5) (A). In addition, the impairment must be severe enough to prevent the claimant from doing either her previous work or any other ...