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Kimes v. Berryhill

United States District Court, D. New Mexico

September 25, 2017

JAMES A. KIMES, Plaintiff,
v.
NANCY A. BERRYHILL, 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 James Kimes' Motion to Reverse and Remand the Social Security Commissioner's final decision denying Plaintiff disability insurance benefits. Doc. 17. For the reasons discussed below, the Court will GRANT Plaintiff's motion and remand this action to the Commissioner for further proceedings consistent with this opinion.

         I. Background

         Plaintiff is a sixty-two year old male. Plaintiff filed for disability on April 30, 2013, alleging disability due to degenerative disc disease. AR 11, 72. He alleged a disability onset date of January 16, 2011. AR 11. Plaintiff's claim was initially denied on August 1, 2013, and upon reconsideration on October 11, 2013. AR 11. Plaintiff filed a written request for hearing on November 11, 2013. AR 11. The hearing was held before Administrative Law Judge (ALJ) Eric Weiss on January 15, 2015. AR 11. On March 18, 2015, the ALJ issued his decision denying Plaintiff's claim. AR 18.

         Because the parties are familiar with record in this case, the Court will discuss Plaintiff's medical history to the extent that it is relevant to the issues before the Court. Plaintiff reports a long history of back problems. See AR 220. In July 2013, Plaintiff received a consultative examination by Jeffrey Glassheim, D.O. AR 220. Plaintiff reported chronic lower back pain that was exacerbated by sitting, standing, and physical activity. AR 220. Plaintiff indicated that he was unable to obtain treatment for these issues due to financial limitations. Dr. Glassheim found that Plaintiff has mild limitations with sitting, standing, and walking due to degenerative disc disease. AR 225. Dr. Glassheim further found that Plaintiff has mild limitations with lifting and carrying weight and limitations in his ability to bend, stoop, crouch, and squat. AR 225. An x-ray performed that month showed “relatively advanced multilevel degenerative disc disease.” AR 228.

         In 2014, after Plaintiff obtained financial support, he was treated by Dr. Roland Sanchez. AR 241. Plaintiff had two visits with Dr. Sanchez. Plaintiff reported many of the same issues as he had with Dr. Glassheim. AR 241. Dr. Sanchez found that Plaintiff had good muscle coordination and strength but diminished sensation in his fingers. AR 242. Dr. Sanchez further found that Plaintiff's cervical spine was tender to palpation and had restricted motion but was otherwise normal. AR 242. Dr. Sanchez referred Plaintiff for an MRI. The MRI showed central canal stenosis at one level with foraminal compromise, uncovertebral arthritic changes with bilateral foraminal compromise, and degenerative discs. AR 252. At a follow up appointment a few months later, Dr. Sanchez further recorded tenderness in Plaintiff's lower back, shoulder, wrists, and knees, but noted that his spine was normal at all levels. AR 246.

         In June 2014, Dr. Sanchez completed a form entitled “Medical Opinion Re: Ability To Do Work-Related Activities.” AR 253. Dr. Sanchez opined that Plaintiff's ability to stand and walk, as well as sit, was limited to less than two hours. AR 253. Dr. Sanchez further found that Plaintiff was limited to carrying less than ten pounds. AR 253. Dr. Sanchez opined that Plaintiff would need the freedom to shift at will between sitting and standing and would need to lie down at unpredictable times during an eight-hour work day. AR 253. Finally, Dr. Sanchez opined that Plaintiff would, on average, be absent from work three times a month due to his limitations. AR 253. In an affidavit, Dr. Sanchez stated that

It is my opinion, based on a reasonable degree of medical certainty, that in June of 2012, [Plaintiff] (1) would not have been able to stand and walk for more than 1 hours during an 8 hour [workday], (2) would not have been able to sit for more than 1 hours during an 8 hour [workday], (3) would have had more than 3 absences each month because of the severity and treatment of his medical condition.

AR 254.

         Ultimately, after reviewing the evidence, the ALJ gave “little weight” to Dr. Sanchez's opinion. AR 15. The ALJ found that Plaintiff could perform medium work, in that he could lift and carry fifty pounds occasionally and twenty-five pounds frequently. AR 14. The ALJ further found that Plaintiff could stand or walk six hours in an eight-hour work day and sit for two hours with normal breaks. AR 14. Finally, the ALJ found that Plaintiff could frequently climb ramps and stairs and occasionally climb ladders, ropes, and scaffolds, as well as occasionally stoop, crouch, and crawl but frequently kneel. AR 14. The ALJ concluded that there existed work in significant numbers that Plaintiff could perform with these limitations. AR 18. Accordingly, the ALJ denied Plaintiff's claim. Plaintiff appealed the ALJ's determination to the Appeals Council but the Appeals Council denied his request for review. AR 7. This appeal followed.

         I. 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 ...

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