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Maestas v. Berryhill

United States District Court, D. New Mexico

June 19, 2018

KATHLEEN REGINA MAESTAS, Plaintiff,
v.
NANCY A. BERRYHILL, Deputy Commissioner for Operations, Social Security Administration, Defendant.

          MEMORANDUM OPINION AND ORDER

          HONORABLE CARMEN E. GARZA CHIEF UNITED STATES MAGISTRATE JUDGE

         THIS MATTER is before the Court on Plaintiff Kathleen Regina Maestas' Motion To Reverse And Remand For Payment of Benefits, Or In The Alternative, For Rehearing, With Supporting Memorandum (the “Motion”), (Doc. 17), filed January 10, 2018; Defendant Deputy Commissioner Nancy A. Berryhill's Brief in Response to Plaintiff's Motion to Reverse and Remand the Agency's Administrative Decision (the “Response”), (Doc. 19), filed March 1, 2018; and Ms. Maestas' Reply to Brief in Response to Plaintiff's Motion to Reverse and Remand (the “Reply”), (Doc. 20), filed March 22, 2018.

         Ms. Maestas filed applications for supplemental security income and disability insurance benefits on May 8, 2013, alleging disability beginning August 20, 2012. (Administrative Record “AR” 18). She later amended her disability onset date to March 11, 2013. (AR 18, 256). Ms. Maestas claimed she was limited in her ability to work due to: chronic hypoxemia, multiple pulmonary emboli, clotting disorder, severe iron deficiency, menorrhagia, massive obesity, dyspnea, menometrorrhagia, pulmonary hypertension, asthma, and obstructive sleep apnea. (AR 326). Ms. Maestas' applications were denied initially on March 17, 2014, and upon reconsideration on July 10, 2014. (AR 18). Ms. Maestas requested a hearing before an Administrative Law Judge (“ALJ”), which was held on January 6, 2016, before ALJ Lawrence T. Ragona. (AR 43). Ms. Maestas, her mother Maria Maestas, and Vocational Expert (“VE”) Leonard Francois, testified at the hearing, and Ms. Maestas was represented by attorney Patricia Glazek. (AR 45-118).

         On February 25, 2016, the ALJ issued his decision, finding that Ms. Maestas was disabled under the Social Security Act from March 11, 2013, through August 19, 2014, but her disability ended on August 20, 2014. (AR 35). Ms. Maestas requested review by the Appeals Council, (AR 252), which was denied, (AR 2-4), making the ALJ's decision the Commissioner's final decision for purposes of this appeal.

         Ms. Maestas, who is now represented by attorney Francesca MacDowell, challenges the ALJ's finding that she was no longer disabled as of August 20, 2014. (Doc. 17). Ms. Maestas argues in her Motion that the ALJ: (1) did not properly weigh the medical opinions of Cynthia Comly, M.D., John G. Lang, Ph.D., and Tracey Garcia, Licensed Independent Social Worker; (2) failed to properly consider whether Ms. Maestas' physical and mental limitations improved; (3) erred in assessing Ms. Maestas' credibility; and (4) improperly adopted the VE's testimony. Id. at 6-24. 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 ALJ erred in his consideration of the opinions of Dr. Comly, Dr. Lang, and Ms. Garcia, the Court finds that Ms. Maestas' Motion should be GRANTED.

         I. Standard of Review

         The standard that courts apply in reviewing the Commissioner's decision is the same regardless of whether the issue is termination of benefits or the initial denial of benefits. See Glenn v. Shalala, 21 F.3d 983, 984 (10th Cir. 1994). 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 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 (“DIB”) and supplemental security income (“SSI”), 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 residual functional capacity (“RFC”), age, education, and work experience. Grogan, 399 F.3d at 1261 Using this five-step sequential evaluation procedure, the ALJ found that Ms. Maestas was disabled for a closed period from March 11, 2013, through August 19, 2014. (AR 18-20). Next, the ALJ determined that Ms. Maestas' disability ended as of August 20, 2014. Benefits may be terminated on the basis of a finding that the physical or mental impairment on which the benefits are provided “has ceased, does not exist, or is not disabling.” 42 U.S.C. § 423(f)(1). This finding must be supported by substantial evidence which demonstrates that there has been a medical improvement and the claimant is now able to engage in substantial gainful activity. Id. The burden in termination cases rests with the Commissioner at each step. See Hayden v. Barnhart, 374 F.3d 986, 988, 990-91 (10th Cir. 2004).

         The termination of benefits review process consists of eight steps for DIB and seven steps for SSI. 20 C.F.R. § 404.1594(f)(1)-(8); 20 C.F.R. § 416.994(b)(5)(i)-(vii). Whether the claimant is engaging in substantial gainful activity is not considered for purposes of continued SSI eligibility, otherwise the steps are identical for both DIB and SSI. Compare 20 C.F.R. § 404.1594(f)(1)-(8) (DIB review - eight steps), with 20 C.F.R. § 416.994(b)(5)(i-vii) (SSI review - seven steps). The remaining steps are as follows:

1) Does the claimant have an impairment or combination of impairments which meets or equals the severity of a listed impairment?
2) If not, has there been medical improvement?[2]
3) If there has been medical improvement, does the improvement relate to the claimant's ability to do work, i.e., has there been an increase in the claimant's RFC based on the impairment(s) present on the date of the most recent favorable medical determination?
4) If there has been no medical improvement, or if such improvement is not related to claimant's ability to work, do any of the exceptions to medical improvement apply? See 20 C.F.R. §§ 404.1594(d)-(e), 416.994(b)(3)-(4) (list of the applicable exceptions).
5) If there is medical improvement related to the claimant's ability to work, are the claimant's current impairments severe when considered in combination?
6) If the claimant's impairments are severe, does the claimant retain the ability to perform his or her past relevant work?
7) If the claimant's impairments are severe and the claimant cannot perform his or her past relevant work, does the claimant nevertheless possess the RFC to perform other work?

         III. Background

         Ms. Maestas claimed she was limited in her ability to work due to: chronic hypoxemia, multiple pulmonary emboli, clotting disorder, severe iron deficiency, menorrhagia, massive obesity, dyspnea, menometrorrhagia, pulmonary hypertension, asthma, and obstructive sleep apnea. (AR 326). At step one, the ALJ determined Ms. Maestas had not engaged in substantial gainful activity since March 11, 2013, the alleged onset date. (AR 22). At step two, the ALJ found that from March 11, 2013 through August 19, 2014, Ms. Maestas had the following severe impairments: anemia, thrombocytopenia, post-traumatic stress disorder, and depression. Id. At step three, the ALJ determined that during this same time period, Ms. Maestas' anemia met the criteria of Listing 7.18 (repeated complications of hematological disorders) of 20 C.F.R. ยงยง ...


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