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Yanni v. Colvin

United States District Court, D. New Mexico

March 21, 2017

LUANNE YANNI, Plaintiff,
v.
CAROLYN W. COLVIN, Acting Commissioner of the Social Security Administration, Defendant.

          ORDER GRANTING PLAINTIFF'S MOTION TO REVERSE OR REMAND

         THIS MATTER is before the Court on Plaintiff Luanne Yanni's Amended Motion to Remand to Agency for a Rehearing with Supporting Memorandum. Doc. 20. Defendant filed its response on September 29, 2016. Doc. 24. Plaintiff filed her reply on October 20, 2016. Doc. 25. Because the Court concludes that Defendant failed to apply the correct legal standard in evaluating the opinion of Plaintiff's treating physician, Dr. Thomas Whalen, the Court will GRANT the Motion and this case will be remanded for further proceedings.

         I. BACKGROUND

         Plaintiff is a fifty-one year old woman with a prior work history as an EMT and x-ray technician. Administrative Record (AR) 52, 76, 81. Plaintiff filed an application for supplemental security income alleging a disability onset date of December 14, 2011, due to head, neck, shoulder and back injuries. AR 76.

         A. Medical History

         Because the parties are familiar with the record in this case, the following will recount Plaintiff's medical history in so far as it is relevant to the issues presented in this case. Plaintiff's medical records reveal that she had an extensive treatment relationship with Dr. Thomas Whalen dating back to 2004. AR 293-357, 379-383. Plaintiff initially presented to Dr. Whalen with complaints of depression, lower back pain, and right shoulder pain. AR 293-357, 379-383. Plaintiff's complaints were due, in part, to a work-related injury. AR 327. Plaintiff continued to report chronic lower back pain throughout her subsequent visits with Dr. Whalen. AR 482, 485, 610-33, 636-43, 652-54. Dr. Whalen diagnosed Plaintiff with chronic lower back pain with a history of degenerative disc disease. AR 482. Plaintiff was prescribed oxycodone for pain management. AR 700.

         The ALJ acknowledged the above evidence in her decision. However, after the ALJ denied Plaintiff's claim, Plaintiff submitted a medical source statement from Dr. Whalen to the Social Security Appeals Council. Dr. Whalen opined that Plaintiff had moderate limitations in her ability to maintain attention and concentration for extended periods, work in coordination with/or proximity to others without being distracted by them, and make simple work-related decisions. AR 971. Dr. Whalen further opined that Plaintiff had marked restrictions in her ability to perform activities within a schedule, maintain regular attendance and be punctual within customary tolerance, sustain an ordinary routine without special supervision, or complete a normal workday and workweek without interruptions from pain or fatigue based symptoms, and to perform at a consistent pace without unreasonable number and length of rest periods. AR 971. The Appeals Council considered the evidence but ultimately denied review.

         B. Procedural History

         Plaintiff filed an application for supplemental social security income in December 2011. AR 26. Plaintiff alleged a disability start date of September 30, 2005. AR 26. Plaintiff's claim was initially denied on May 13, 2013 and upon reconsideration on March 7, 2013. AR 26. Plaintiff subsequently requested a hearing which was held on September 25, 2013 before Administrative Law Judge (ALJ) Myriam Fernandez-Rice. AR 26. On February 5, 2014, the ALJ issued her decision denying Plaintiff's claim. As noted above, following the ALJ's decision, Plaintiff submitted additional medical evidence to the Appeals Council, including a medical source statement from Dr. Whalen. AR 6. The Appeals Council subsequently denied Plaintiff's request for review. AR 1-3. This appeal followed.

         II. APPLICABLE LAW

         A. Disability Determination Process

         A claimant is considered disabled for purposes of Social Security disability insurance benefits if that individual is unable “to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A). The Social Security Commissioner has adopted a five-step sequential analysis to determine whether a person satisfies these statutory criteria. See 20 C.F.R. § 404.1520. The steps of the analysis are as follows:

(1) Claimant must establish that she is not currently engaged in “substantial gainful activity.” If claimant is so engaged, she is not disabled and the analysis stops.
(2) Claimant must establish that she has “a severe medically determinable physical or mental impairment . . . or combination of impairments” that has lasted for at least one year. If claimant is not so impaired, she is not disabled and the analysis stops.
(3) If claimant can establish that her impairment(s) are equivalent to a listed impairment that has already been determined to preclude substantial gainful activity, claimant ...

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