Decided: October 29, 2013
On appeal, the Fourth Circuit Court of Appeals held that the district court did not err in its application of Listing 1.04A, the Social Security Administration regulation identifying disorders of the spine that merit an award of social security disability benefits. However, the Fourth Circuit vacated the district court’s judgment because its decision to direct the Administrative Law Judge to award benefits was an abuse of discretion.
Radford worked as a tree trimmer, and sustained an injury in 2002 lifting part of a tree at work. For the next five years, Radford consulted several doctors who collectively observed different symptoms of nerve root compression. In 2007, Radford applied for social security disability benefits. Under the Social Security Administration regulation, Listing 1.04A, a claimant is entitled to a conclusive presumption that he is disabled if he can show that his disorder results in compromise of a nerve root or the spinal cord. In addition, Listing 1.04A describes the criteria a claimant must “meet or equal” to merit this presumption. An Administrative Law Judge (“ALJ”) denied Radford’s claim, finding that he was not disabled because his back impairment did not “meet or equal” Listing 1.04A. The federal district court found that the evidence did show that Radford met Listing 1.04A and reversed the decision of the ALJ as unsupported by substantial evidence, and remanded for an award of benefits.
The issues on appeal were whether the district court applied the wrong legal standard in ruling that Radford’s condition met or equaled Listing 1.04A and whether the district court erred in remanding with instructions to award benefits.
The Fourth Circuit held that the district court applied the correct legal standard. The Social Security Commissioner argued that the district court improperly interpreted the regulation to require intermittent, rather than simultaneously present signs and symptoms for establishing a lasting impairment. The Fourth Circuit rejected the Commissioner’s argument, based on the text and structure of the regulation. The listed symptoms are connected by the word “and,” which means that all of the symptoms must be present, but not necessarily at the same time. The provision does not specify when the symptoms must be present. Moreover, the regulation already imposes a duration requirement on the claimant, who must prove the impairment lasted for a continuous period of at least 12 months. Furthermore, a court owes no deference to an agency’s interpretation where the regulation’s meaning is unambiguous. Because Listing 1.04A says nothing about a claimant’s need to show symptoms present simultaneously or in close proximity, the regulation is unambiguous and, therefore, the court owes no deference to the Commissioner’s interpretation.
Finally, the Fourth Circuit held that the district court erred in reversing and remanding with instructions to award benefits to Radford, and should have vacated and remanded with instructions for the ALJ to clarify why Radford did not satisfy Listing 1.04A. If the reviewing court has no way of evaluating the basis for the ALJ’s decision, then the proper course, except in rare circumstances, is to remand to the agency for additional investigation or explanation. Because the ALJ provided no explanation for his conclusion that Radford’s impairment did not meet or equal a listed impairment, the district court had no way of reviewing the basis of his decision. In addition, the ALJ cited to state medical opinions in support of his conclusion, rather than the opinions of Radford’s treating physicians, which is especially suspect. The Court explained that remand would not be futile where there is at least conflicting evidence in the record as to whether Radford satisfied the listing. Moreover, the Court noted that it was not the province of the appellate or district court to reweigh conflicting evidence, make credibility determinations, or substitute its judgment for that of the ALJ.
– Sarah Bishop