Estilita Rodriguez Torres v. Commissioner of Social Security

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[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
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No. 19-14197
Non-Argument Calendar
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D.C. Docket No. 8:18-cv-01982-SPF
ESTILITA RODRIGUEZ TORRES,
Plaintiff-Appellant,
versus
COMMISSIONER OF SOCIAL SECURITY,
Defendant-Appellee.
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Appeal from the United States District Court
for the Middle District of Florida
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(August 7, 2020)
Before WILSON, LUCK, and ANDERSON, Circuit Judges.
PER CURIAM:
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Estilita Rodriguez Torres appeals the district court’s decision affirming the
Social Security Administration’s denial of her applications for a period of disability
and disability insurance benefits. Torres contends that the administrative law judge
(ALJ) erred in refusing to give res judicata effect to a previous ALJ’s determination
that Torres was severely disabled from fibromyalgia. We affirm.
FACTUAL BACKGROUND AND PROCEDURAL HISTORY
On November 18, 2010, Torres applied to the Social Security Administration
for a period of disability and disability insurance benefits, alleging she had become
disabled on July 15, 2010. An ALJ denied Torres’s application on April 17, 2013
because, although she had not worked since July 15, 2010 and had a severe medical
impairment due to fibromyalgia, her impairment was not equivalent to those listed
in the federal regulations. Thus, for the period of July 15, 2010 through April 17,
2013, Torres was not entitled to a period of disability and disability insurance
benefits.
Two years later, Torres again filed for a period of disability and disability
insurance benefits, claiming that she was disabled due to fibromyalgia for a different
period of time––from April 18, 2013 through December 31, 2013. This time, the
ALJ determined that Torres’s claim failed because “there were no medical signs or
laboratory findings to substantiate the existence of a medically determinable
impairment.” The ALJ emphasized that Torres did not provide any treatment
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records during the relevant period that would support her claim. According to the
ALJ, Torres’s treatment records “extend[ed] through January 2013, with no further
treatment records until June 9, 2014.” Torres admitted “to a significant gap in her
treatment history” and testified that, even though her condition has worsened over
the years, it was “not as bad” in 2013. The ALJ concluded that there was
“insufficient subjective and objective evidence, and no medical signs or laboratory
findings, to substantiate the existence of a medically determinable impairment
through the date last insured.” The ALJ concluded that he was not bound by the
decision on Torres’s previous application because this case dealt with an
“unadjudicated period,” that is, the period after April 17, 2013, when the Social
Security Administration decided her last disability claim.
After the Appeals Council declined to review the ALJ’s decision, Torres
sought review in the district court. Torres argued that the doctrine of administrative
res judicata bound the ALJ to the previous ALJ’s decision as to the severity of her
impairment. The district court affirmed the ALJ’s denial of benefits, concluding that
(1) res judicata did not bind the ALJ to the previous decision on the severity of
Torres’s impairment because the previous decision was based on a different time
period, and (2) the ALJ’s decision was supported by substantial evidence. Torres
appeals.
STANDARD OF REVIEW
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“[W]e review de novo the legal principles upon which the [ALJ]’s decision is
based.” Moore v. Barnhart, 405 F.3d 1208, 1211 (11th Cir. 2005). “The [ALJ]’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 v. Sullivan, 936 F.2d 1143, 1145–46 (11th Cir. 1991).
DISCUSSION
Torres argues here, as she did before the district court, that the doctrine of
administrative res judicata bound the ALJ to the previous determination that Torres
had the medically severe impairment of fibromyalgia. Administrative res judicata
applies when an agency has “made a previous determination or decision . . . about
[a claimant’s] rights on the same facts and on the same issue or issues, and [that]
previous determination or decision has become final by either administrative or
judicial action.” 20 C.F.R. § 404.957(c)(1); see also Cash v. Barnhart, 327 F.3d
1252, 1255 (11th Cir. 2003). The question before us is whether the previous
determination that Torres suffered from a severe impairment based on fibromyalgia
before April 17, 2013 is the “same fact” and “same issue” that was before the ALJ
in Torres’s disability claim for a different and later time period.
We agree with the district court that the previous determination did not
determine the same facts and issues as this case and the ALJ was not bound by
administrative res judicata. “Any earlier proceeding that found or rejected the onset
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of a disability could rarely, if ever, have actually litigated and resolved whether a
person was disabled at some later date.” See Earley v. Comm’r of Soc. Sec., 893
F.3d 929, 933 (6th Cir. 2018) (internal quotation marks omitted)); see also Albright
v. Comm’r of Soc. Sec., 174 F.3d 473, 476 (4th Cir. 1999) (“The [Social Security
Administration] treats a claimant’s second or successive application for disability
benefits as a claim apart from those earlier filed, at least to the extent that the most
recent application alleges a previously unadjudicated period of disability.” (footnote
omitted) (internal quotation marks omitted)); Rucker v. Chater, 92 F.3d 492, 495
(7th Cir. 1996) (“The first ALJ’s finding was a binding determination with respect
to [the claimant]’s eligibility for disability benefits for that time period. It has no
effect, however, on an application for disability benefits for a subsequent time
period.”); see also Tomaszewski v. Colvin, 649 F. App’x 705, 706 (11th Cir. 2016)
(unpublished) (holding that “res judicata [did] not apply because [the claimant]’s
new [disability] application cover[ed] a different time period, and involve[d] new
evidence that [was] independent from the prior application”); Griffin v. Comm’r of
Soc. Sec., 560 F. App’x 837, 844 (11th Cir. 2014) (unpublished) (declining to apply
administrative res judicata when “the prior [ALJ’s] decision did not finally
adjudicate any issues or facts that were raised in this proceeding”); McKinzie v.
Comm’r of Soc. Sec., 362 F. App’x 71, 73 (11th Cir. 2010) (unpublished) (“[A]n
ALJ should not consider prior applications when the instant application involves a
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different period of time than that alleged in the prior applications.”); Moreno v.
Astrue, 366 F. App’x 23, 27 (11th Cir. 2010) (unpublished) (refusing to “give
preclusive effect” to a prior determination because the “instant application
concerned an unadjudicated time period”); Luckey v. Astrue, 331 F. App’x 634, 638
(11th Cir. 2009) (unpublished) (“Because the factual time period for [the claimant]’s
current application is different from her previous application, administrative res
judicata does not apply.”). Because the ALJ was not bound by the previous
determination of Torres’s disability, and there was substantial evidence supporting
the ALJ’s determination that she was not disabled from April 18, 2013 to December
31, 2013,1 we agree with the district court that the ALJ’s decision was due to be
affirmed.
AFFIRMED.
1
The substantial evidence supporting the ALJ’s decision included: (1) Torres did not
provide or cite to any medical records, evidence, or testing that occurred from April 18, 2013 to
December 31, 2013; (2) Torres testified that she did not seek treatment in 2013 because her
condition was not “as bad” that year; and (3) a 2015 consultative evaluation concluded that
Torres’s condition was non-severe.
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