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Lively v. Secretary of Health and Human Serv

United States Court of Appeals, Fourth Circuit
Jun 29, 1987
820 F.2d 1391 (4th Cir. 1987)

Summary

finding it"utterly inconceivable that [claimant's] condition had so improved in two weeks as to enable him to perform medium work" in the two weeks since a previous ALJ found the same claimant able to perform only light work

Summary of this case from Richardson v. Astrue

Opinion

No. 87-3033.

Argued June 2, 1987.

Decided June 29, 1987.

John T. Birmingham, Oberlin, Ohio, (Kirk B. Roose, on brief), for plaintiff-appellant.

James A. Winn, Asst. Regional Counsel, Washington, D.C., Office of the General Counsel, Dept. of Health and Human Services (Beverly Dennis, III, Chief Counsel, Region III, Charlotte Hardnett, Supervisory Asst., Regional Counsel, Charlotte R. Lane, U.S. Atty., Charleston, W.Va., Amy M. Lecocq, Asst. U.S. Atty., on brief) for defendant-appellee.

Appeal from the United States District Court for the Southern District of West Virginia.

Before WINTER, Chief Judge, WILKINS, Circuit Judge, and SMALKIN, United States District Judge for the District of Maryland, sitting by designation.


On October 19, 1981, the appellant, a coal miner, was denied disability insurance benefits (DIB) under the Social Security Act, because he was not disabled under the Secretary's Grid Rules, 20 C.F.R. Part 404, Subpart P, App. 2. The particular Grid Rule applied was Rule 202.10, pertaining to persons under age 55, whose exertional limitations preclude more than "light work," as defined in the Secretary's regulations, 20 C.F.R. § 404.1567(b). The Administrative Law Judge, after full evaluation of the evidence, specifically found that Mr. Lively "has the residual functional capacity for substantial gainful activity of a light nature." The Appeals Council affirmed the October, 1981 decision, and the appellant was unsuccessful in his quest for judicial review of that decision. It thus became final for all purposes.

On November 3, 1981, just several weeks after the ALJ's denial of his DIB claim, Mr. Lively became 55 years of age, thus qualifying as an individual of "advanced age" under the Secretary's regulations. 20 C.F.R. § 404.1563(d). A person with appellant's educational and vocational backgrounds, of advanced age, and limited to light work is considered disabled under the Grid Rules. 20 C.F.R. Part 404, Subpart P, App. 2, Rule 202.02. When plaintiff filed a second disability benefits application (on December 14, 1983), an ALJ hearing was held, which resulted in a conclusion that plaintiff was not disabled. The ALJ, without discussion of the 1981 finding that appellant was limited to light work, found that the claimant retained the functional capacity for the performance of work activity at any exertional level on and prior to December 31, 1981. After the ALJ's decision was adopted by the Appeals Council, the appellant sought judicial review, but a United States Magistrate concluded that the evidence before the ALJ on the 1983 application was sufficient to sustain his conclusion of non-disability as of December 31, 1981, the date on which appellant's insured status expired. The District Judge adopted the Magistrate's Report and Recommendation, and this appeal ensued. We reverse.

It is by now well-established that fundamental and familiar principles of res judicata apply in Social Security disability cases. Benko v. Schweiker, 551 F. Supp. 698, 701 (D.N.H. 1982). Congress has clearly provided by statute that res judicata prevents reappraisal of both the Secretary's findings and his decision in Social Security cases that have become final, 42 U.S.C. § 405(h), and the courts have readily applied res judicata to prevent the Secretary from reaching an inconsistent result in a second proceeding based on evidence that has already been weighed in a claimant's favor in an earlier proceeding. Gavin v. Heckler, 811 F.2d 1195, 1200 (8th Cir. 1987). In the present case, it is true that the prior administrative proceeding did not result in a decision favorable to the appellant. Thus, Gavin is not strictly controlling. The statute upon which Gavin's holding rests, though, 42 U.S.C. § 405(h), gives finality to findings, as well as decisions, made in previous proceedings between the parties.

The first ALJ found, in 1981, that plaintiff was limited to light work, and the Secretary successfully defended that finding on judicial review. Some two weeks after appellant was found limited to light work, he became 55 years of age. It is utterly inconceivable that his condition had so improved in two weeks as to enable him to perform medium work. Principles of finality and fundamental fairness drawn from § 405(h), as discussed above, indicate that the Secretary must shoulder the burden of demonstrating that the claimant's condition had improved sufficiently to indicate that the claimant was capable of performing medium work. Cf. Dotson v. Schweiker, 719 F.2d 80 (4th Cir. 1983). Certainly, there was no evidence of any such miraculous improvement, and, as Gavin makes clear, 811 F.2d at 1200, such evidence, not considered in the earlier proceeding, would be needed as an independent basis to sustain a finding contrary to the final earlier finding.

In reviewing the 1981 decision, the District Court, in an opinion filed November 18, 1983, specifically held that the Secretary's conclusion as to appellant's residual capacity to work ( i.e., limited to light work) was supported by substantial evidence. Mem.Op. at 6.

Because the appellant was limited to light work when he attained 55 years of age, he was entitled to benefits on his second application therefor. Thus, the decision of the District Court will be reversed, and the matter will be remanded for the entry of judgment in favor of the appellant.

REVERSED AND REMANDED.


Summaries of

Lively v. Secretary of Health and Human Serv

United States Court of Appeals, Fourth Circuit
Jun 29, 1987
820 F.2d 1391 (4th Cir. 1987)

finding it"utterly inconceivable that [claimant's] condition had so improved in two weeks as to enable him to perform medium work" in the two weeks since a previous ALJ found the same claimant able to perform only light work

Summary of this case from Richardson v. Astrue

reversing an ALJ's decision to ignore a previous finding when the relevant passage of time spanned only two weeks

Summary of this case from Morris v. Berryhill

In Lively v. Secretary of Health Human Servs., 820 F.2d 1391 (4th Cir. 1987), the Fourth Circuit found that administrative res judicata applied against the Commissioner based on facts similar to those in the case at bar.

Summary of this case from Drummond v. Commissioner of Social Security

observing that the claimant filed his second application just two weeks after the ALJ denied his first application and that it was "utterly inconceivable" that his condition had significantly improved in such a short timeframe

Summary of this case from Bennett v. Berryhill

In Lively, 820 F.2d 1393, the court found that the ALJ erred in concluding the claimant could perform his PRW at the medium exertional level during a period two weeks after a prior final decision had found him to be limited to light work and incapable of performing his PRW.

Summary of this case from Hall v. Berryhill

noting that res judicata applies to Social Security disability cases and "prevents reappraisal of both the Secretary's findings and his decision in Social Security cases that have become final"

Summary of this case from Karriker v. Berryhill

In Lively, the Court held that the finding in the claimant's first SSI claim that he was limited to light work had res judicata effect and precluded a contrary finding in the claimant's second SSI claim where the court failed to explain or acknowledge the discrepancy between the two conclusions.

Summary of this case from Timmons v. Colvin

noting that res judicata applies to Social Security disability cases and "prevents reappraisal of both the Secretary's findings and his decision in Social Security cases that have become final"

Summary of this case from Sanford v. Colvin

In Lively, the Fourth Circuit applied res judicata to a prior ALJ's finding that the claimant could perform light work. 820 F.2d at 1392.

Summary of this case from Johnson v. Colvin

noting that res judicata applies to Social Security disability cases and "prevents reappraisal of both the Secretary's findings and his decision in Social Security cases that have become final"

Summary of this case from Myers v. Colvin

In Lively v. Sec'y of Health and Human Serv., 820 F.2d 1391 (4th Cir. 1987), which the Fourth Circuit discussed in Albright, the relevant time period was two weeks—from the time the plaintiff's initial application was denied to when the plaintiff turned 55, qualifying him as an applicant of "advanced age."

Summary of this case from Smith v. Colvin

noting that the second ALJ did not discuss the first ALJ's findings

Summary of this case from Sydnor v. Colvin

In Lively, an ALJ denied the plaintiff disability benefits and found that he was limited to light work. 820 F.2d at 1391-92.

Summary of this case from Carter v. Astrue

In Lively, the claimant who was in the closely approaching advanced age category had been found capable of light work and denied benefits.

Summary of this case from Linney v. Colvin

explaining that "[p]rincples of finality and fundamental fairness ... indicate that the Secretary must shoulder the burden of demonstrating ... [new evidence] to sustain a finding contrary to the final earlier finding" of RFC

Summary of this case from Chapa v. Astrue

In Lively v. Sec. Health & Human Servs., 820 F.2d 1391 (4th Cir. 1987), the Fourth Circuit noted that "[i]t is by now well-established that fundamental and familiar principles of res judicata apply in Social Security disability cases."

Summary of this case from Farrar v. Astrue

In Lively, an ALJ found the plaintiff could perform light work and was not disabled under the Medical-Vocational Guidelines ("the Grids"). Two weeks after the decision, the plaintiff turned 55 years old. Under the Grids, a person of the plaintiff's educational and vocational background who is limited to light work and is 55 years of age or older is considered disabled.

Summary of this case from Doyle v. Astrue

In Lively, the claimant filed a previous application for benefits in which he was found capable of light work. By decision dated October 19, 1981, the ALJ denied Claimant's application for benefits, and the decision became final after the Appeals Council affirmed the ALJ's decision.

Summary of this case from Gilliam v. Astrue

In Lively, the plaintiff was denied benefits because the ALJ found that he was capable of light work and was not disabled under the Act.

Summary of this case from Zavilla v. Astrue

In Lively, the ALJ found that the claimant had the capacity to do light work and therefore found him not disabled. 820 F.2d at 1391-92.

Summary of this case from Melvin v. Astrue

In Lively, the claimant's first application for disability insurance benefits was denied by an ALJ, and that decision was later affirmed by the district court.

Summary of this case from Large v. Barnhart

In Lively v. Secretary of Health Human Servs., 820 F.2d 1391 (4th Cir. 1987), the Fourth Circuit found that administrative res judicata applied against the Commissioner based on facts similar to those in the case at bar.

Summary of this case from Hughes v. Barnhart

In Lively, plaintiff Joseph Lively applied for disability benefits and was denied benefits because it was determined that he retained the RFC to perform work at a light exertional level.

Summary of this case from Hughes v. Barnhart
Case details for

Lively v. Secretary of Health and Human Serv

Case Details

Full title:JOSEPH E. LIVELY, PLAINTIFF-APPELLANT, v. SECRETARY OF HEALTH AND HUMAN…

Court:United States Court of Appeals, Fourth Circuit

Date published: Jun 29, 1987

Citations

820 F.2d 1391 (4th Cir. 1987)

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