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Cauley v. Colvin

United States District Court, Middle District of Georgia, Albany Division

March 7, 2014

JAMES A. CAULEY, Plaintiff,
CAROLYN COLVIN, Acting Commissioner of Social Security, Defendant.



The Plaintiff herein filed this Social Security appeal on March 29, 2013, challenging the Commissioner's final decision denying his application for disability benefits, finding him not disabled within the meaning of the Social Security Act and Regulations. Jurisdiction arises under 42 U.S.C. § 405(g) and 42 U.S.C. § 1383(c). All administrative remedies have been exhausted.


In reviewing the final decision of the Commissioner, this Court must evaluate both whether the Commissioner's decision is supported by substantial evidence and whether the Commissioner applied the correct legal standards to the evidence. Boyd v. Heckler, 704 F.2d 1207, 1209 (11th Cir. 1983); Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983). The Commissioner's factual findings are deemed conclusive if supported by substantial evidence, defined as more than a scintilla, such that a reasonable person would accept the evidence as adequate to support the conclusion at issue. Richardson v. Perales, 402 U.S. 389, 401 (1971); Cornelius v. Sullivan, 936 F.2d 1143, 1145 (11th Cir. 1991). In reviewing the ALJ's decision for support by substantial evidence, this Court may not reweigh the evidence or substitute its judgment for that of the Commissioner. "Even if we find that the evidence preponderates against the [Commissioner's] decision, we must affirm if the decision is supported by substantial evidence." Bloodsworth, 703 F.2d at 1239. "In contrast, the [Commissioner's] conclusions of law are not presumed valid. . . . The [Commissioner's] failure to apply the correct law or to provide the reviewing court with sufficient reasoning for determining that the proper legal analysis has been conducted mandates reversal." Cornelius, 936 F.2d at 1145-1146.

Administrative Proceedings

The Plaintiff filed an application for disability benefits with a protective filing date of September 29, 2009. (T-246-52, 299). His claims were denied initially and upon reconsideration. (T – 154-63). Two hearings were held before an ALJ, in January and June 2011. (T-32-129). Thereafter, in a hearing decision dated October 12, 2011, the ALJ determined that the Plaintiff was not disabled. (T- 130-53). The Appeals Council subsequently denied review and the ALJ=s decision thereby became the final decision of the Commissioner. (T-1-7).

Statement of Facts and Evidence

The Plaintiff was 49 years of age at the time of the ALJ=s decision with a date last insured for Title II purposes of September 30, 2008. (T – 246, 272). Plaintiff alleges disability since August 27, 2004, due to a heart attack, post traumatic stress disorder, personality disorder, anxiety, seizures, high blood pressure, shortness of breath, and arthritis. (T - 289). He graduated from high school and attended two (2) years of college, and has past relevant work experience as a general laborer, truck driver, tire repairer, and military instructor. (T- 296, 290). As determined by the ALJ, Plaintiff suffers from severe impairments in the form of a seizure disorder, a history of head trauma with residual headaches and depression, release of right small finger Dupuytren’s contracture, essential hypertension, a personality disorder, and cocaine, alcohol, and marijuana dependence in remission. (T – 136). The ALJ found that the Plaintiff did not have an impairment or combination thereof that met or medically equaled a listed impairment, and remained capable of performing medium work activity with certain restrictions. (T - 137). The ALJ relied on the testimony of Vocational Experts to determine that although the Plaintiff could not return to his past relevant work, the Plaintiff remained capable of performing other jobs that existed in significant numbers in the national economy and thus was not disabled. (T- 147-49).


New evidence

Plaintiff initially asserts that new evidence in the form of a Veterans Administration disability determination from July 2012 was allegedly presented to the Appeals Council but not included in the record before the Administration, and that this evidence merits a remand of this action under Sentence Six. (Doc. 8). However, Plaintiff has not shown that the evidence is material in that it could reasonably be expected to change the ALJ’s decision. Pursuant to Sentence Six of 42 U.S.C. § 405(g), the Court is empowered to remand a case to the Commissioner for consideration of material, new evidence if the plaintiff can demonstrate good cause as to why it was not previously submitted. Cherry v. Heckler, 760 F.2d 1186 (11th Cir. 1985). In order to obtain a remand under Sentence Six, the Plaintiff must establish that: 1) there is new, noncumulative evidence; 2) the evidence is material in that there is a reasonable possibility that it would change the administrative result; and 3) there is good cause for failure to submit the evidence at the administrative level. Caulder v. Bowen, 791 F.2d 872, 879 (11th Cir. 1986).

The new evidence presented by the Plaintiff consists of a finding of disability by the Veterans Administration, an issue specifically reserved to the Commissioner in deciding Social Security claims. Gray v. Comm’r. of Social Security, ___ Fed.Appx. ___, 2013 WL 6840288 (11th Cir., Dec. 30, 2013) (noting that “disability is an issue reserved to the Commissioner as an administrative finding”). The new evidence does not provide any additional, relevant medical information regarding Plaintiff’s impairments other than that already considered by the ALJ. (Docs. 7, 8). The Veterans Administration specifically and primarily relied on medical records and findings dated between 1981 and 2003 and 2009 and 2012, prior to and after the relevant period under consideration by the Social Security Administration, and based its determination only on a conclusion that the Plaintiff had suffered some level of impairment that was connected to his time of military service. (Docs. 7, 8). The Veterans Administration found the Plaintiff disabled only on a scale between 20% and 70% regarding the same impairments identified by the ALJ. (Doc. 8, p. 5; T - 136). The Commissioner’s regulations provide that “[a] decision by . . . any other governmental agency about whether you are disabled or blind is based on its rules and is not our decision about whether you are disabled or blind.” 20 C.F.R. § 404.1504.

“The VA relies on independent and distinct criteria to assess disability, however, and its determination would not have controlled whether [the Plaintiff] was eligible for Social Security disability benefits.” Deloge v. Comm’r. of Social Sec. Admin., 540 Fed.Appx. 517, 518-19 (6th Cir. 2013). As noted by the Commissioner, the determination of another governmental agency is based on the rules of the other agency, and is not binding on the Commissioner, despite such determinations being entitled to great weight. 20 C.F.R. § 404.1504; Bloodsworth v. Heckler, 703 F.2d 1233, 1241 (11th Cir. 1983). Plaintiff has not established that the new evidence presents a ...

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