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Mark W. Hagans v. Commissioner of Social Security

September 14, 2012


On Appeal from the United States District Court for the District of New Jersey (No. 2-10-cv-01951) District Judge: Honorable Faith S. Hochberg

The opinion of the court was delivered by: Chagares, Circuit Judge.


Argued November 17, 2011

Before: FUENTES and CHAGARES, Circuit Judges, and POGUE, Chief Judge.*fn1


Mark Hagans appeals the cessation of his Social Security disability insurance benefits following a determination by the Social Security Administration ("SSA") that he was no longer disabled. Hagans argues the District Court erred by reviewing his disability status as of September 1, 2004 - the day on which, according to the SSA, Hagans's disability ceased. This contention requires us to decide what level of deference, if any, we should afford the SSA's Acquiescence Ruling interpreting the cessation provision of the Social Security Act, 42 U.S.C. § 423(f), as referring to the time of the SSA's initial disability determination. Hagans further argues that substantial evidence does not support the SSA's conclusion that he was not fully disabled as of September 1, 2004. For the following reasons, we will affirm.


Until January 2003, Mark Hagans worked as a security guard for a federal agency and as a sanitation worker for the city of Newark. That month, however, when he was 44 years old, Hagans began suffering from chest pains. He required immediate open-heart surgery to repair a dissecting aortic aneurysm, a potentially life-threatening condition that occurs when a tear in the aorta's inner layer allows blood to enter the middle layer. Hagans was hospitalized for the surgery and recovery during intermittent periods between January 29, 2003, and February 28, 2003. He then spent approximately three months in a rehabilitation center, where he underwent physical and speech therapy. He left this facility sometime in April or May of 2003.

In addition to his heart ailment, Hagans claims he has underlying medical problems relating to his cerebrovascular and respiratory systems, as well as hypertension and dysphagia (difficulty in swallowing). Hagans also complains of other issues, such as insomnia and back pain, which he alleges affect his ability to stand, sit, and lift. He has also been diagnosed with depression.

Hagans's initial application for disability benefits was granted and he began receiving benefits as of January 30, 2003. On September 21, 2004, however, pursuant to an updated Residual Function Capacity ("RFC") assessment showing Hagans's condition had improved, the SSA determined that Hagans was no longer eligible for benefits because his disability had terminated on September 1, 2004. Hagans's appeal to a Disability Hearing Officer was denied. Hagans continued to pursue an appeal and received a hearing before an Administrative Law Judge ("ALJ") in September 2008, at which he was unrepresented by counsel.*fn2

The record reflects that Hagans received a great deal of medical care between his surgery in January 2003 and the termination of his benefits in September 2004. The ALJ considered several evaluations of Hagans's condition, most of which were completed in mid-2004. For instance, the ALJ reviewed an August 31, 2004, report from Dr. Ramesh Patel, Hagans's treating physician. Dr. Patel diagnosed Hagans with obesity, post-surgery illness, hypertension, hearing problems, possible arthritis of the neck, and shortness of breath. This report showed that an EKG of Hagans's heart was normal and a chest X-ray indicated clear lungs and no sign of heart failure. Dr. Patel indicated Hagans's range of motion was limited, but did not opine on his ability to perform work-related activities.*fn3 The ALJ also considered the evaluation of Dr. Burton Gillette, the SSA's staff physician, which was performed on September 15, 2004. Dr. Gillette's evaluation included an RFC assessment which indicated that Hagans could not stand or walk for more than four hours per day, but could sit for about six hours during an eight-hour day and had improved lifting abilities. Further, the ALJ considered the evaluation of Ernest Uzondu, a disability adjudicator, conducted on the same day as Dr. Gillette's RFC assessment. Uzondu determined that Hagans could not perform his past relevant work, but that he was able to perform other work. Finally, the ALJ considered an internal medicine evaluation from Dr. David Tiersten conducted on March 16, 2006. In this 2006 evaluation, Dr. Tiersten diagnosed Hagans with obesity, post-surgery illness, chest pain, back pain, leg pain, and hypertension, but found that Hagans did not have significant limitations to prevent him from working.

Although Hagans claims he is limited to standing for 4-5 minutes, sitting for 30 minutes, walking only at a slow pace, and lifting no more than ten pounds, the record reflects disagreement among the doctors about Hagans's abilities. A vocational expert testified that there were jobs available that someone with Hagans's infirmities could perform, such as ticket seller, assembler of small products, and garment sorter. At the time of the ALJ hearing, Hagans represented that he spent his time watching television, helping at church, napping, and visiting a nearby park. He claims he requires assistance shaving and showering. As of September 1, 2004, he had not engaged in any substantial gainful activity following his heart surgery.

On February 26, 2009, the ALJ issued a decision finding that Hagans's disability had ceased on September 1, 2004. Specifically, the ALJ found that Hagans's condition had improved and he was capable of engaging in substantial gainful activity, although he could not perform his past relevant work. On May 21, 2009, the Appeals Council denied review, which rendered the ALJ's opinion the final decision of the SSA.

Hagans then filed the instant action. On April 8, 2011, the District Judge affirmed the SSA's decision that Hagans's eligibility for disability benefits ended on September 1, 2004. Hagans has continued to receive benefits pending the outcome of this appeal. Hagans also filed a new application for disability insurance benefits on January 20, 2010.*fn4


The District Court had jurisdiction to review the final decision of the Commissioner of Social Security under 42 U.S.C. § 405(g). We have jurisdiction over this appeal pursuant to 28 U.S.C. § 1291.

We exercise plenary review over all legal issues. Schaudeck v. Comm'r of Soc. Sec. Admin., 181 F.3d 429, 431 (3d Cir. 1999). We review an ALJ's decision under the same standard of review as the District Court, to determine whether there is substantial evidence on the record to support the ALJ's decision. See 42 U.S.C. § 405(g); Plummer v. Apfel, 186 F.3d 422, 427 (3d Cir. 1999). Substantial evidence has been defined as "more than a mere scintilla"; it means "such relevant evidence as a reasonable mind might accept as adequate." Plummer, 186 F.3d at 427 (quotations marks omitted). "Where the ALJ's findings of fact are supported by substantial evidence, we are bound by those findings, even if we would have decided the factual inquiry differently." Fargnoli v. Massanari, 247 F.3d 34, 38 (3d Cir. 2001).


We begin with the issue to which we will devote the bulk of this opinion: Hagans's assertion that the District Court erred by finding that the relevant date for determining whether he continued to be disabled was the date on which the SSA asserts that his disability had ceased - September 1, 2004 - rather than the date of the ALJ's hearing or the date of the ALJ's ruling (September 22, 2008 or February 26, 2009, respectively). Use of one of these later dates would bolster Hagans's claim for disability benefits because he had advanced into a different age category by the time of the ALJ's hearing.*fn5 The SSA contends that review of Hagans's disability should be confined to the date on which the SSA first found that Hagans was no longer disabled - that is, September 1, 2004.*fn6

The provision we must interpret to resolve this dispute is 42 U.S.C. § 423(f), which is entitled "Standard of review for termination of disability benefits." This section provides:

A recipient of benefits . . . may be determined not to be entitled to such benefits on the basis of a finding that the physical or mental impairment on the basis of which such benefits are provided has ceased, does not exist, or is not disabling only if such finding is supported by--

(1) substantial evidence which demonstrates that--

(A) there has been any medical improvement in the individual's impairment or combination of impairments (other than medical improvement which is not related to the individual's ability to work), and

(B) the individual is now able to engage in substantial gainful activity . . .

Any determination under this section shall be made on the basis of all the evidence available in the individual's case file, including new evidence concerning the individual's prior or current condition which is presented by the individual or secured by the Commissioner of Social Security.

Id. (emphasis added).

In support of its position, the SSA asserts that we should follow the Acquiescence Ruling it issued in 1992, which interpreted § 423(f) as requiring the evaluation of a benefits recipient's disability status as of the time that the SSA first determined that cessation of benefits was proper. Specifically, the ruling stated:

SSA interprets the term "current," as used in the statutory and regulatory language concerning termination of disability benefits, to relate to the time of the cessation under consideration in the initial determination of cessation. In making an initial determination that a claimant's disability has ceased, SSA considers the claimant's condition at the time SSA is making the initial determination. In deciding the appeal of that cessation determination, the Secretary considers what the claimant's condition was at the time of the cessation determination, not the claimant's condition at the time of the disability hearing/reconsideration determination, ALJ decision or Appeals Council decision. However, if the evidence indicates that the ...

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