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Baca v. Berryhill

United States District Court, D. New Mexico

April 11, 2017

JAMAL BACA, Plaintiff,
NANCY A. BERRYHILL, Acting Commissioner of the Social Security Administration, Defendant.



         THIS MATTER is before the Court on Plaintiff's Motion to Reverse and Remand for a Rehearing With Supporting Memorandum (Doc. 17) filed October 26, 2016 (hereinafter “motion”). On January 25, 2017, Defendant filed a response (Doc. 21) to Plaintiff's motion and, on February 21, 2017, Plaintiff filed a reply (Doc. 24). In accordance with 28 U.S.C. § 636(c)(1) and Fed.R.Civ.P. 73(b), the parties have consented to have the undersigned United States Magistrate Judge conduct all proceedings and enter a final judgment in this case. See [Docs. 6 and 8]. The Court has considered Plaintiff's motion, Defendant's response, Plaintiff's reply, and the relevant law. Additionally, the Court has meticulously reviewed and considered the entire administrative record. [Doc. 12]. For the reasons set forth below, the Court FINDS that Plaintiff's motion should be GRANTED, in part, and DENIED, in part, and the Commissioner's decision in this case should be REMANDED for further proceedings in accordance with this decision.

         I. Procedural History

         On July 12, 2012, Plaintiff protectively filed an application for Supplemental Security Income (hereinafter “SSI”). [Doc. 12-9 at 16-17]. Plaintiff's application was denied at the initial level on October 26, 2012 (Doc. 12-6 at 2), and at the reconsideration level on April 1, 2013 (id. at 9). On April 19, 2013, Plaintiff requested a hearing to review the denial of his application. Id. at 14. Administrative Law Judge Barry O'Melinn (hereinafter “ALJ”) conducted a hearing on April 23, 2014. [Doc. 12-4 at 2-30]. Plaintiff appeared, unrepresented, and testified (id. at 8-16), as did his mother, Rosella Monte Baca (id. at 16-19), and his father, Franklin Baca (id. at 19-22). Vocational Expert Nicole King (hereinafter “VE”) also appeared and testified (id. at 26-29).

         On August 28, 2014, the ALJ issued a decision (Doc. 12-3 at 21-28) finding that, under the relevant sections of the Social Security Act, Plaintiff was not disabled from the date his application was filed (id. at 21). Plaintiff requested that the Appeals Council review the ALJ's decision. Id. at 15. On January 27, 2016, the Appeals Council entered an order indicating it had received additional evidence[1] from Plaintiff, which it made a part of the record. Id. at 6. On January 27, 2016, the Appeals Council denied Plaintiff's request for review on the ground that there was “no reason under our rules to review the [ALJ]'s decision.” Id. at 2. The Appeals Council indicated that it had “considered” the additional evidence, and found that “this information does not provide a basis for changing the [ALJ]'s decision.” Id. at 3. This decision was the final decision of the Commissioner. On March 25, 2016, Plaintiff filed his complaint in this case. [Doc. 1].

         II. Standard of Review

         The standard of review in a Social Security appeal is whether the Commissioner's final decision is supported by substantial evidence and whether the correct legal standards were applied. Maes v. Astrue, 522 F.3d 1093, 1096 (10th Cir. 2008) (citing Hamilton v. Sec'y of Health & Human Servs., 961 F.2d 1495, 1497-98 (10th Cir. 1992)). If substantial evidence supports the ALJ's findings and the correct legal standards were applied, the Commissioner's decision stands, and the plaintiff is not entitled to relief. See Langley v. Barnhart, 373 F.3d 1116, 1118 (10th Cir. 2004); Hamlin v. Barnhart, 365 F.3d 1208, 1214 (10th Cir. 2004); Doyal v. Barnhart, 331 F.3d 758, 760 (10th Cir. 2003). A court should meticulously review the entire record but should neither re-weigh the evidence nor substitute its judgment for that of the Commissioner. Hamlin, 365 F.3d at 1214; Langley, 373 F.3d at 1118.

         “Substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Langley, 373 F.3d at 1118 (citation and quotation marks omitted); Hamlin, 365 F.3d at 1214 (citation and quotation marks omitted); Doyal, 331 F.3d at 760 (citation and quotation marks omitted). An ALJ's decision “is not based on substantial evidence if it is overwhelmed by other evidence in the record or if there is a mere scintilla of evidence supporting it.” Langley, 373 F.3d at 1118 (citation and quotation marks omitted); Hamlin, 365 F.3d at 1214 (citation and quotation marks omitted). While a court may not re-weigh the evidence or try the issues de novo, its examination of the record as a whole must include “anything that may undercut or detract from the ALJ's findings in order to determine if the substantiality test has been met.” Grogan v. Barnhart, 399 F.3d 1257, 1262 (10th Cir. 2005) (citations omitted). “The possibility of drawing two inconsistent conclusions from the evidence does not prevent [the ALJ]'s findings from being supported by substantial evidence.” Lax v. Astrue, 489 F.3d 1080, 1084 (10th Cir. 2007) (citing Zoltanski v. F.A.A., 372 F.3d 1195, 1200 (10th Cir. 2004)).

         III. Applicable Law and Sequential Evaluation Process

         For purposes of SSI, a person establishes a disability when he or she 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. § 1382c(a)(3)(A); 20 C.F.R. § 416.905(a). In light of this definition for disability, a five-step sequential evaluation process (hereinafter “SEP”) has been established for evaluating a disability claim. 20 C.F.R. § 416.920; Bowen v. Yuckert, 482 U.S. 137, 140 (1987). At the first four steps of the SEP, the claimant has the burden to show that: (1) the claimant is not engaged in “substantial gainful activity;” and (2) the claimant has a “severe medically determinable . . . impairment . . . or a combination of impairments” that has lasted or is expected to last for at least one year; and either (3) the claimant's impairment(s) meet(s) or equal(s) one of the “Listings” of presumptively disabling impairments; or (4) the claimant is unable to perform his or her “past relevant work.” 20 C.F.R. § 416.920(a)(4)(i-iv); Grogan, 399 F.3d at 1261. At the fifth step of the evaluation process, the burden of proof shifts to the Commissioner to show that the claimant is able to perform other work in the national economy, considering his or her residual functional capacity (hereinafter “RFC”), age, education, and work experience. Grogan, 399 F.3d at 1261.

         IV. Plaintiff's Age, Education, Work Experience, and Medical History; and the ALJ's Decision

         Plaintiff was born on April 25, 1994 and was 18 years old on July 12, 2012, the date he filed his disability application. [Doc. 12-9 at 16]. Thus, for the purposes of his disability claim, Plaintiff is considered to be a “younger person.”[2] In his application, Plaintiff claimed to be disabled due to having broken both legs at the ankle, broken his kneecap, and asthma. Id. at 20. Plaintiff completed high school with a diploma (Doc. 12-4 at 11), and reads, writes, and understands English (Doc. 12-9 at 19). At the hearing, Plaintiff testified that he weighed 420 pounds (Doc. 12-4 at 13), and that he lives with his parents (id. at 8-9).

         Plaintiff's medical records include: knee MRI reports dated July 11, 2012 (Doc. 12-12 at 6-8) and March 18, 2013 (Doc. 12-19 at 13-14) by Carlos Mena, M.D.; operative report dated September 10, 2012 by Douglas C. Allen, M.D. (Doc. 12-12 at 9-11); treatment records for the period from July 19, 2011 to January 10, 2013 (id. at 12 through Doc. 12-13 at 3), and dated May 28, 2013 (Doc. 12-19 at 16-17), from New Mexico Orthopaedics; emergency and physical therapy records for the period from July 14, 2011 to January 31, 2013 (Doc. 12-14 at 6 through Doc. 12-18 at 39), and treatment records for the period from February 27, 2014 to March 17, 2014 (Doc. 12-19 at 18-33) from Alamo Navajo Health Center. Additional records, consisting of treatment records for the period from February 27, 2014 to September 25, 2014 (id. at 34-41) from Alamo Navajo Health Center, and medical assessments dated September 26, 2014 (id. at 44-45) from Wren T. Kennedy, CRNP, were submitted to the Appeals Council sometime between September 26, 2014, when the last such document was created, and January 27, 2016, when the documents were made part of the record (see Doc. 12-3 at 6). Where relevant, Plaintiff's medical records are discussed in more detail below.

         At step one of the five-step evaluation process, the ALJ found that Plaintiff had not engaged in substantial gainful activity since the filing of his disability application on July 12, 2012. [Doc. 12-3 at 23]. At step two, the ALJ found that Plaintiff has the following severe impairments: “obesity, knee disorder, asthma, hypertension, and chronic edema.” Id. At the third step, the ALJ found that Plaintiff “does not have an impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR 416.920(d), 416.925, and 416.926).” Id. In reaching his conclusion, the ALJ considered Listings 1.02 (Major Dysfunction of Joints), 3.03 (Asthma), and 4.00(H)(1) (Evaluating Hypertension), as well as Soc. Sec. Rep. 02-1p (Obesity). Id. Before step four, the ALJ found that Plaintiff had the RFC:

to perform sedentary work as defined in 20 CFR 416.967(a) except occasionally climb ramps and stairs, never climb ladders, ropes and scaffolds, occasionally balance with a hand held assistive device, occasionally stoop, kneel, crouch, and crawl, should avoid concentrated exposure to extreme cold, extreme heat, pulmonary irritants such as fumes, odors, dusts, gases, poorly ventilated areas, moving hazardous machinery, and unprotected heights, and can understand remember and carry out simple instructions and make commensurate work related decisions, respond appropriately to supervision, coworkers and work situations, deal with routine changes in a work setting, maintain concentration, persistence and pace for up to and including two hours at a time with normal breaks throughout the work day.

Id. at 24. In support of this RFC assessment, the ALJ stated that “[Plaintiff] and his witnesses were generally credible. However, when taken in combination with the objective medical evidence, the record supports the conclusions [sic] that [he] can work within I [sic] the limits I have fashioned herein.” Id. at 25.

         At step four, the ALJ found that Plaintiff had no past relevant work. Id. at 26. At step five, the ALJ found that jobs exist in significant numbers in the national economy that Plaintiff can perform. Id. at 27. In support of this finding, the ALJ relied on the VE's testimony that an individual of Plaintiff's age, with the same education, work experience, and RFC, could perform representative jobs such as document preparer (DOT[3] 249.587-018), with 2, 500, 000 jobs nationally; final assembler (DOT 713.687-018), with 235, 000 jobs nationally; and table worker (DOT 739.687-182), with 430, 000 jobs nationally. Id. All three of these representative jobs have a designated SVP[4] rating of 2. The ALJ concluded that Plaintiff was not disabled within the meaning of the Social Security Act “since July 12, 2012, the date the application was filed.” Id.

         V. ...

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