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Gomez v. Berryhill

United States District Court, D. New Mexico

August 14, 2017

NANCY A. BERRYHILL, Acting Commissioner of Social Security Administration, Defendant.



         THIS MATTER is before the Court on Plaintiff Ruben Augustine Gomez' Motion to Reverse and Remand for Payment of Benefits or in the Alternative, for Rehearing, With Supporting Memorandum (the “Motion”), (Doc. 23), filed April 19, 2017; Defendant Commissioner Nancy A. Berryhill's Brief in Response to Plaintiff's Motion to Reverse and Remand the Agency's Administrative Decision (the “Response”), (Doc. 25), filed June 13, 2017; and Mr. Gomez' Reply to Brief in Response to Motion to Reverse and Remand (the “Reply”), (Doc. 26), filed July 6, 2017. United States District Judge William P. Johnson referred this case to Magistrate Judge Carmen E. Garza to perform legal analysis and recommend an ultimate disposition. (Doc. 19).

         Mr. Gomez filed applications for disability insurance benefits and supplemental security income on January 26, 2012, alleging disability beginning January 1, 2009. (Administrative Record “AR” 17). Mr. Gomez claimed he was limited in his ability to work due to “back problems, ” “leg problems, ” and “right side pain.” (AR 220). Mr. Gomez' applications were denied initially on August 17, 2012, and upon reconsideration on June 11, 2013. (AR 17). Mr. Gomez requested a hearing before an Administrative Law Judge (“ALJ”), which was held on January 5, 2015, before ALJ John R. Morris. (AR 33). Mr. Gomez and Judith Beard, an impartial vocational expert (“VE”), testified at the hearing, (AR 35-61), and Mr. Gomez was represented by Andrew S. Youngman, a non-attorney representative, (AR 17).

         On February 25, 2015, ALJ Morris issued his decision, finding Mr. Gomez not disabled at any time between his alleged disability onset date through the date of the decision. (AR 27). Mr. Gomez requested review by the Appeals Council, (AR 12-13), which was denied, (AR 1-4), making the ALJ's decision the Commissioner's final decision for purposes of this appeal.

         Mr. Gomez now argues that the ALJ erred by: (1) finding that Mr. Gomez could work if he abstained from substance abuse; (2) failing to properly determine Mr. Gomez' residual functional capacity (“RFC”); and (3) improperly relying on the VE's testimony at step five. (Doc. 23 at 4-23). The Court has reviewed the Motion, the Response, the Reply, and the relevant law. Additionally, the Court has meticulously reviewed the administrative record. Because the Court finds that the ALJ erred in his determination that Mr. Gomez' substance abuse is a contributing factor material to the determination of disability, the Court recommends that Mr. Gomez' Motion be GRANTED IN PART.

         I. 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); Hamilton v. Sec'y of Health & Human Servs., 961 F.2d 1495, 1497-98 (10th Cir. 1992). If substantial evidence supports the Commissioner's findings and the correct legal standards were applied, the Commissioner's decision stands and the plaintiff is not entitled to relief. 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). The Commissioner's “failure to apply the correct legal standards, or show . . . that she has done so, are grounds for reversal.” Winfrey v. Chater, 92 F.3d 1017, 1019 (10th Cir. 1996) (citing Washington v. Shalala, 37 F.3d 1437, 1439 (10th Cir. 1994)). A court should meticulously review the entire record but should neither re-weigh the evidence nor substitute its judgment for the Commissioner's. Langley, 373 F.3d at 1118; Hamlin, 365 F.3d at 1214. A court's review is limited to the Commissioner's final decision, 42 U.S.C. § 405(g), which is generally the ALJ's decision, rather than the Appeals Council's denial of review. O'Dell v. Shalala, 44 F.3d 855, 858 (10th Cir. 1994).

         “Substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Langley, 373 F.3d at 1118; Hamlin, 365 F.3d at 1214; Doyal, 331 F.3d at 760. 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; Hamlin, 365 F.3d at 1214. While the Court may not re-weigh the evidence or try the issues de novo, its examination of the record 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). “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)).

         II. Applicable Law and Sequential Evaluation Process

         For purposes of disability insurance benefits and supplemental security income, a claimant establishes a disability when 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. § 423(d)(1)(A) (2015), 42 U.S.C. § 1382c(a)(3)(A) (2004); 20 C.F.R. §§ 404.1505(a), 416.905(a) (2012). In order to determine whether a claimant is disabled, the Commissioner follows a five-step sequential evaluation process (“SEP”). Bowen v. Yuckert, 482 U.S. 137, 140 (1987); 20 C.F.R. §§ 404.1520, 416.920 (2012).

         At the first four steps of the SEP, the claimant bears the burden of showing: (1) she is not engaged in “substantial gainful activity”; (2) she 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) her impairment(s) either meet or equal one of the “Listings”[1] of presumptively disabling impairments; or (4) she is unable to perform her “past relevant work.” 20 C.F.R. §§ 404.1520(a)(4)(i-iv), 416.920(a)(4)(i-iv); see Grogan v. Barnhart, 399 F.3d 1257, 1261 (10th Cir. 2005). If the ALJ determines the claimant cannot engage in past relevant work, the ALJ will proceed to step five of the evaluation process. At step five the Commissioner must show the claimant is able to perform other work in the national economy, considering the claimant's RFC, age, education, and work experience. Grogan, 399 F.3d at 1261.

         III. Background

         Mr. Gomez applied for disability insurance benefits and supplemental security income due to back and leg problems and pain on his right side. (AR 220). At step one, the ALJ determined that Mr. Gomez had not engaged in substantial gainful activity since January 1, 2009, the alleged onset date. (AR 20). At step two, the ALJ concluded that Mr. Gomez has the following severe impairments: degenerative disc disease of the lumbar spine; degenerative joint disease of the right hip; post-traumatic stress disorder (“PTSD”); anxiety; depression; alcohol abuse; and a history of polysubstance abuse. Id.

         At step three, the ALJ determined that Mr. Gomez' mental impairments, including the substance abuse disorders, meet Listings 12.04 and 12.09 of 20 C.F.R. §§ 404.1520(d) and 416.920(d). Id. The ALJ stated that he found Mr. Gomez credible concerning his limitations with memory, concentration, and social interactions, and regarding his multiple inpatient hospitalizations. (AR 21). The ALJ noted that Mr. Gomez' claims regarding his limitations are supported by treatment records and progress notes from Presbyterian Hospital, the University of New Mexico Hospital, and Kaseman Presbyterian Hospital, and with the findings of the consulting psychological examiner, Louis Wynne, Ph.D. Id. (citing AR 623-26). The ALJ noted that there is no treating physician opinion in the record, and that the State Agency medical and psychological consultants opined that Mr. Gomez was capable of simple, unskilled light work. Id. The ...

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