United States District Court, D. New Mexico
MEMORANDUM OPINION AND ORDER
HONORABLE CARMEN E. GARZA CHIEF UNITED STATES MAGISTRATE
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.
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).
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
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.
Standard of Review
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).
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)).
Applicable Law and Sequential Evaluation Process
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,
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” 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).
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
2) If not, has there been medical improvement?
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
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
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. §§ ...