Affirmation of Denial of Social Security Benefits: Upholding the Stone Severity Standard under SSR 85-28

Introduction

Case: Luzenia S. Keel, Plaintiff—Appellant, v. Andrew M. Saul, Commissioner of Social Security, Defendant—Appellee.
Court: United States Court of Appeals for the Fifth Circuit
Date: January 22, 2021
Citation: 986 F.3d 551

In this landmark Social Security case, the appellant, Luzenia Keel, sought judicial review after her application for Supplemental Security Income (SSI) and Disability Insurance benefits was denied by the Social Security Commissioner. Keel contended that the Administrative Law Judge (ALJ) erred in applying the severity standard to her impairments. The Fifth Circuit Court of Appeals affirmed the lower court's decision, reinforcing the application of the Stone severity standard in conjunction with Social Security Ruling (SSR) 85-28.

Summary of the Judgment

The United States Court of Appeals for the Fifth Circuit reviewed the denial of Social Security benefits to Luzenia Keel. After Keel's initial application in 2011 and subsequent denials by the ALJ and the Appeals Council, she sought judicial review in federal district court, which affirmed the ALJ's decision. On appeal, Keel argued that the ALJ failed to apply the correct severity standard as outlined in STONE v. HECKLER and that there were errors in assessing her residual functional capacity. The Fifth Circuit evaluated these arguments and ultimately decided to affirm the lower court's decision, finding that the ALJ appropriately applied the severity standard in line with SSR 85-28 and that any alleged errors were harmless.

Analysis

Precedents Cited

The Judgment extensively references several key precedents and regulatory standards:

STONE v. HECKLER (752 F.2d 1099, 1101-06 (5th Cir. 1985)): Established the severity standard, defining an impairment as not severe only if it is a slight abnormality having minimal effect on the individual's ability to work.
Garcia v. Berryhill (880 F.3d 700, 704 (5th Cir. 2018)): Outlined the five-step sequential approach for determining disability under Social Security law.
Whitehead v. Colvin (820 F.3d 776, 779 (5th Cir. 2016)): Provided the standard for reviewing Social Security denials based on substantial evidence and correct legal standards.
Taylor v. Astrue (706 F.3d 600, 602 (5th Cir. 2012)): Defined what constitutes substantial evidence in Social Security cases.
RIPLEY v. CHATER (67 F.3d 552, 557 (5th Cir. 1995)): Addressed the necessity of hardship or prejudice in cases of ALJ errors.
HAMPTON v. BOWEN (785 F.2d 1308, 1311 (5th Cir. 1986)): Discussed the presumption of error when ALJs fail to use the prescribed standards.
Snell v. Chater (68 F.3d 466 (5th Cir. 1995)): Emphasized that specific references to precedents are not always necessary if the ALJ's analysis is thorough.
Salmond v. Berryhill (892 F.3d 812, 817 (5th Cir. 2018)): Reaffirmed the traditional Stone standard in the Fifth Circuit.

Additionally, the court discussed Social Security Ruling 85-28 (SSR 85-28), a policy statement clarifying the agency's process for determining non-severe impairments. While some lower courts within the Fifth Circuit were divided on whether SSR 85-28 aligns with the Stone standard, the Fifth Circuit in this judgment held that SSR 85-28 is consistent with Stone.

Legal Reasoning

The court's legal reasoning focused on two main arguments presented by Keel: the alleged improper application of the Stone severity standard and errors in the residual functional capacity (RFC) assessment.

Severity Standard (Stone Error)

Keel contended that the ALJ did not apply the correct severity standard as established in STONE v. HECKLER. The Stone standard dictates that an impairment cannot be considered severe if it is a "slight abnormality" with minimal effect on the individual's ability to work. The ALJ, however, referenced SSR 85-28 instead of Stone directly. The Fifth Circuit evaluated whether SSR 85-28 provided a consistent standard with Stone and concluded that despite slight differences in wording, SSR 85-28 maintains the same fundamental principle regarding minimal effect.

The court emphasized that the ALJ's failure to cite Stone explicitly does not automatically constitute an error, especially if the ALJ cited an agency policy that aligns with Stone's principles. Moreover, even if an error in applying the severity standard were found, the court applied the "harmless error" doctrine, determining that the error did not influence the final outcome of denying benefits.

Residual Functional Capacity (Ripley Error)

Keel also argued that the ALJ made a Ripley error by assessing her RFC without a medical expert's opinion. However, the court found that even if such an error occurred, Keel did not demonstrate that this mistake prejudiced her case. The ALJ had considered the impact of Keel's obesity and other impairments and concluded that she could return to her previous sedentary job as a customer service representative. The court noted that Keel did not provide sufficient evidence to show that the ALJ's conclusions were incorrect or that a different outcome would have resulted from the alleged RFC error.

Consistency with Social Security Rulings

A pivotal aspect of the judgment was the court's determination that SSR 85-28 is consistent with the Stone standard. By aligning the agency's policy with established case law, the court reinforced the reliability of using SSR 85-28 as a valid reference point for assessing impairment severity.

Impact

This judgment has significant implications for future Social Security disability cases within the Fifth Circuit:

Affirmation of SSR 85-28: By recognizing SSR 85-28 as consistent with the Stone standard, the court provides clear guidance for ALJs on applying severity standards, reducing ambiguity in future assessments.
Harmless Error Doctrine: The reaffirmation that some errors, such as the failure to cite a specific precedent when agency policy aligns with it, may be deemed harmless reinforces the finality of decisions unless substantial prejudice is demonstrated.
Residual Functional Capacity Assessments: The judgment underscores the necessity for claimants to demonstrate actual prejudice from RFC assessment errors, setting a higher bar for overturning denials based on procedural missteps.

Overall, the decision upholds the procedural integrity of ALJs' assessments while providing clarity on interpreting severity standards, thereby influencing the adjudication of similar disability claims.

Complex Concepts Simplified

Severity Standard

The severity standard determines whether an individual's impairments are significant enough to qualify for disability benefits. According to STONE v. HECKLER, an impairment is not considered severe if it is a minor abnormality that does not substantially limit one's ability to work, regardless of other factors like age or education.

Residual Functional Capacity (RFC)

RFC refers to what a person can still do despite their disabilities. It assesses the claimant's physical and mental abilities to perform work-related activities. An accurate RFC assessment is crucial as it influences the determination of whether the individual can engage in substantial gainful activity.

Substantial Evidence

For a denial of benefits to be upheld, there must be substantial evidence supporting the decision. This means that a reasonable mind might accept the evidence as adequate to support the conclusion, though it doesn't require overwhelming proof.

Harmless Error

A harmless error occurs when a mistake in applying the law does not significantly affect the outcome of the case. Even if an error is identified, if it is deemed harmless, the original decision stands.

Conclusion

The Fifth Circuit's affirmation in Keel v. Saul reinforces the application of the Stone severity standard within the framework of Social Security Rulings, particularly SSR 85-28. By upholding the ALJ's decision and clarifying the consistency between agency policies and judicial precedents, the court ensures a balanced approach to evaluating disability claims. This decision underscores the importance of adhering to established legal standards while allowing for agency discretion in interpreting policies, thereby providing clarity and stability in the adjudication of future Social Security benefit claims.