The opinion of the court was delivered by: Honorable Michael A. Telesca United States District Judge
Plaintiff, Joseph S. Singletary ("Plaintiff"), brings this action pursuant to Title XVI of the Social Security Act ("the Act") seeking reversal of a final decision of the Commissioner of Social Security ("Commissioner") finding that he was not entitled to Supplemental Security Income ("SSI") benefits. Specifically, Plaintiff alleges that the decision of the Administrative Law Judge ("ALJ") James Dombeck denying him benefits was not supported by substantial evidence in the record and was in conflict with principles of res judicata and collateral estoppel.
The Plaintiff moves for judgment on the pleadings pursuant to Rule 12(c) of the Federal Rules of Civil Procedure and 42 U.S.C. 405(g) seeking to reverse the Commissioner's decision or, in the alternative, remand this case to the Commissioner for reconsideration of the evidence. The Commissioner cross-moves for judgment on the pleadings pursuant to 42 U.S.C. 405(g) on the grounds that the findings of fact of the Commissioner are supported by substantial evidence. This Court finds that the ALJ's decision is supported by substantial evidence in the record and is in accordance with the applicable legal standards. Therefore, for the reasons set forth below, the Commissioner's motion for judgment on the pleadings is granted, and the Plaintiff's motion is denied. Plaintiff's complaint is dismissed with prejudice.
Plaintiff first protectively filed for SSI on May 2, 1991, under Title XVI of the Act, alleging disability due to a gunshot injury sustained to his right arm on March 15, 1991. Transcript of the Administrative Proceedings at 128, 577-19 (hereinafter "Tr."). Plaintiff's application was denied at the initial and reconsideration levels. The Plaintiff was eventually granted a hearing before an ALJ, and appeared before Judge Stanley A. Moskal, Jr. with attorney, Paul Kelly, on July 20, 1992. Administrative Addendum Exhibit A (hereinafter "Admin. Add.").
In a Decision dated September 10, 1992, ALJ Moskal determined that Plaintiff had been disabled through the date of the decision. In his decision, ALJ Moskal acknowledged that Plaintiff did not meet the criteria under listing 1.13 of the regulations. Admin. Add. Exhibit A. He found Plaintiff to be disabled on the grounds that the medical treatment planned would be "the equivalent of a series of staged surgical procedures" and was therefore suffering from an impairment "equivalent" to 1.13. 20 C.F.R. 416.920(d). Admin. Add. Exhibit A. he recommended the file be reviewed in one year.
In August of 1996, Plaintiff was incarcerated and his benefits were suspended pursuant to section 1611(e)(1)(A) of the Act. Tr. 33, 383. His entitlement was then terminated in November of 1996 pursuant to section 1631(j)(1) which requires the termination of eligibility for SSI benefits after a claimant is ineligible for 12 consecutive months. There is no evidence, nor does Plaintiff assert, that he appealed the termination of his benefits. Tr. 33. Plaintiff was incarcerated from July 1996 through October 2002. Tr. 383, 574, 579-88.
Upon his release from prison, Plaintiff re-applied for SSI on November 25, 2002 claiming disability since May 2, 1991. On May 2, 2003 Plaintiff's application was initially denied, and he again requested a hearing before an ALJ. A hearing was held on June 14, 2005 in Rochester, New York, before ALJ Karen Peters by video-conference. In a decision dated August 15, 2005, ALJ Peters determined that Plaintiff was no longer disabled under the regulations. Tr. 28-35. In her decision, ALJ Peters determined that because the Plaintiff's benefits had been terminated and a new application had been filed, the new application was to be treated as a new claim and reviewed de novo. Tr. 33-34. Plaintiff appealed ALJ Peter's decision, and the Appeals Council ("AC") denied Plaintiff's request for review. Tr. 4-6.
Plaintiff then appealed to the Federal District Court for the Western District of New York and was assigned to Judge Charles Siragusa. By Decision and Order date January 22, 2008, Judge Siragusa remanded Plaintiff's case back to the Commissioner for determination of the issue whether the November 2002 application was subject to res judicata, thus making the September 1992 decision determinative. Tr. 409-17. On February 19, 2008, the Appeals Council vacated the August 5, 2005 hearing decision by ALJ Peters and remanded the case to an ALJ for further proceedings in accordance with the fourth sentence of Section 405(g) of the Act. Tr. 404-05. A hearing was held before ALJ James Dombeck on June 4, 2008. Plaintiff appeared and testified with counsel Dennis J. Annechino, an associate of Plaintiff's former attorney Mr. Kelly.
In a decision dated March 4, 2009, ALJ Dombeck decided res judicata was not applicable in this case and a de novo determination of Plaintiff's potential disability was required. Tr. 380-404. ALJ Dombeck determined that Plaintiff was not disabled as defined by the listings and was capable of performing activities within the "light" exertional range. Tr. 380-404. The Appeals Council denied Plaintiff's request for review on December 4, 2010, making ALJ Dombeck's decision the final decision of the Commissioner. This action followed.
I. Jurisdiction and Scope of Review
42 U.S.C. § 405(g) grants jurisdiction to Federal District Courts to hear claims based on the denial of Social Security benefits. Matthews v. Eldridge, 424 U.S. 319, 320 (1976). Additionally, the section directs that when considering such a claim, the Court must accept the findings of fact made by the Commissioner, provided that such findings are supported by substantial evidence in the record. See Bubnis v. Apfel, 150 F.3d 177, 181 (2d Cir. 1998); see also Williams v. Comm'r of Soc. Sec., No. 06-2019-cv, 2007 U.S. App. LEXIS 9396, at *3 (2d Cir. Apr. 24, 2007).
Substantial evidence is defined as "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229 (1938). Section 405(g) thus limits this Court's scope of review to two inquiries: 1) whether the Commissioner's conclusions are supported by substantial evidence in the record as a whole, and (2) whether the Commissioner's conclusions are based upon an erroneous legal standard. Green-Younger v. Barnhard, 335 F.3d 99, 105-06 (2d Cir. 2003); see also Wagner v. Secretary of Health & Human Serv., 906 F.2d 856, 860 (2d Cir. 1990)(holding that review of the Secretary's decision is not de novo and that the Secretary's findings are conclusive if supported by substantial evidence).
The Commissioner asserts that the ALJ's decision is supported by substantial evidence in the record and is in accordance with the applicable legal standards, and moves for judgment on the pleadings pursuant to Rule 12(c). Under Rule 12(c), judgment on the pleadings may be granted where the material facts are undisputed and where judgment on the merits is possible merely by considering the contents of the pleadings. Sellers v. M.C. Floor Crafters, Inc., 842 F.2d 639 (2d Cir. 1988). If, after reviewing the record, the Court is convinced that Plaintiff has not set forth a plausible claim for relief, judgment on the pleadings may be appropriate. See generally Bell Atlantic Corp. v. Twombly, 550 U.S. 544 (2007).
II. Standard for Entitlement to SSI Benefits
Under the Social Security Act, a disability is defined as the "inability to engage in substantial gainful activity by reason of a medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months..." 42 U.S.C. §1382c(a) (3). An individual will only be considered "under a disability" if his impairment is so severe that he is both unable to do his previous work and unable to engage in any other kind of substantial gainful work that exists in the national economy.
42 U.S.C. §1382c(a)(3)(b). "Substantial gainful work" is defined as "work that exists in significant numbers either in the region where the individual lives or in several regions of the country." Id. Work may be considered "substantial" even if it is done on a part-time basis, if less money is earned, or if work responsibilities are lessened from previous employment. 20 C.F.R. § 416.972(a). Work may be considered "gainful" if it is the kind of work usually done for pay or profit, whether or not a profit is realized. 20 C.F.R. §416.972(b). Furthermore, "substantial gainful work" is considered available to an individual regardless of whether such work exists in his immediate area, whether a specific job vacancy exists for him, or whether he would be hired if he were to apply for work. 42 U.S.C. §1382c(a)(3)(B).
In determining whether or not a claimant is disabled, SSA regulations require the ALJ to perform a five-step sequential evaluation. In doing so, the ALJ must determine:
(1) Whether the claimant is currently engaged in substantial gainful activity;
(2) if not, whether the claimant has a severe impairment which significantly limits his physical or mental ability to do basic work activities;
(3) if the claimant suffers a severe impairment, the ALJ considers whether the claimant has an impairment which is listed in Appendix 1, Subpart P, Regulation No. ...