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Quezada v. Berryhill

United States District Court, D. New Mexico

March 28, 2019

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



         THIS MATTER comes before the Court on plaintiff Jesus Quezada's Motion to Reverse or Remand for a Rehearing with Supporting Memorandum (Doc. 17), which was fully briefed on August 10, 2018. Docs. 20, 21, 22. The parties consented to my entering final judgment in this case. Docs. 6, 7, 8. Having meticulously reviewed the record and being fully advised in the premises, the Court finds that the Administrative Law Judge (“ALJ”) failed to properly resolve the conflict between the Dictionary of Occupational Titles (“DOT”) and the vocational expert's (“VE”) testimony. The Court therefore GRANTS Mr. Quezada's motion and remands this case for an immediate award of benefits.

         I. Standard of Review

         The standard of review in a Social Security appeal is whether the Commissioner's final decision[1] is supported by substantial evidence and whether the correct legal standards were applied. Maes v. Astrue, 522 F.3d 1093, 1096 (10th Cir. 2008). 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). “The failure to apply the correct legal standard or to provide this court with a sufficient basis to determine that appropriate legal principles have been followed is grounds for reversal.” Jensen v. Barnhart, 436 F.3d 1163, 1165 (10th Cir. 2005) (internal quotation marks and brackets omitted).

         “Substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Langley, 373 F.3d at 1118. A 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.” Id. While the Court may not reweigh 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).

The possibility of drawing two inconsistent conclusions from the evidence does not prevent an administrative agency's findings from being supported by substantial evidence. We may not displace the agenc[y's] choice between two fairly conflicting views, even though the court would justifiably have made a different choice had the matter been before it de novo.

Lax v. Astrue, 489 F.3d 1080, 1084 (10th Cir. 2007) (internal quotations and citations omitted) (brackets in original).

         II. Applicable Law and Sequential Evaluation Process

         To qualify for disability benefits, a claimant must establish that 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. § 423(d)(1)(A); 20 C.F.R. §§ 404.1505(a), 416.905(a).

         When considering a disability application, the Commissioner is required to use a five-step sequential evaluation process. 20 C.F.R. § 416.920; Bowen v. Yuckert, 482 U.S. 137, 140 (1987). At the first four steps of the evaluation process, the claimant must show: (1) the claimant is not engaged in “substantial gainful activity”; (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 (3) the impairment(s) either meet or equal one of the Listings[2] 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 1260-61. If the claimant cannot show that his or her impairment meets or equals a Listing but proves that he or she is unable to perform his or her “past relevant work, ” the burden of proof shifts to the Commissioner, at step five, to show that 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. Id.

         III. Background and Procedural History

         Mr. Quezada is a 52-year-old man who lives with his long-term girlfriend. AR 159, 174, 185, 202, 480, 482, 554.[3] Mr. Quezada completed the sixth grade in Mexico and is able to read, speak, and write fluently in the Spanish language, although not in English. AR 34, 480, 482, 749. Mr. Quezada has a history of working as a roofer, but stopped working in 2008 due to a knee injury. AR 34, 165, 482, 545.

         Mr. Quezada filed his initial application for Disability Insurance Benefits (“DIB”) on October 29, 2008, alleging disability beginning on March 10, 2008 due to a right knee injury, diabetes, and high blood pressure (hbp). AR 137-43, 164. The Social Security Administration (“SSA”) denied his claims initially and on reconsideration. AR 65-72, 79-81. On April 26, 2010, Mr. Quezada requested a hearing. AR 82-83. On May 19, 2011, ALJ Ann Farris held a hearing, at which Mr. Quezada testified with the assistance of an interpreter. AR 28-53. ALJ Ferris issued an unfavorable decision on July 7, 2011. AR 9-27. Mr. Quezada requested review by the Appeals Council, which denied the request on September 20, 2012. AR 1-8, 134-35.

         On November 20, 2012, Mr. Quezada appealed the Commissioner's decision to this Court. See Quezada v. Social Security Administration, 1:12-cv-01204-MCA-WPL (D.N.M. 2012). On September 9, 2013, the Commissioner agreed to remand the case “pursuant to sentence four (4) of § 205(g) of the Social Security Act, 42 U.S.C. § 405(g). Melkonyan v. Sullivan, 501 U.S. 89 (1991).” AR 561-62. During the pendency of the appeal, on April 12, 2013, Mr. Quezada applied for supplemental security income (“SSI”). AR 567. The state agency[4] issued a favorable determination on September 20, 2013, finding Mr. Quezada disabled beginning April 1, 2013. Id. Subsequently, on October 21, 2013, the Appeals Council issued an order remanding the DIB case to an ALJ for further proceedings in accordance with the order of the District Court. AR 567-69. In its October 2013 order, the Appeals Council affirmed the state agency determination that Mr. Quezada was disabled beginning April 1, 2013, but ordered that “the period prior to April 1, 2013 requires further administrative proceedings.” AR 567.

         Pursuant to the October 2013 order of the Appeals Council, ALJ Farris held another hearing on November 5, 2014. AR 523, 540-59. Mr. Quezada testified at the November 2014 hearing with the assistance of an interpreter. AR 540, 542. ALJ Farris issued a second unfavorable decision on December 19, 2014. AR 517-39. Pursuant to 20 C.F.R. § 404.984(a), (c), and (d), the 2014 ALJ decision became the final decision of the Commissioner on February 17, 2015 because no exceptions were filed, and the Appeals Council did not assume jurisdiction. On April 7, 2015, Mr. Quezada once again appealed the Commissioner's final decision to this Court. See Quezada v. Social Security Administration, 1:15-cv-00282-LAM (D.N.M. 2015). This Court remanded the case “for consideration of the sole issue of the date of onset of Plaintiff's disability . . . .”[5] AR 820-21.

         On remand, ALJ Raul C. Pardo held a brief hearing on February 15, 2017. AR 762-69. Mr. Quezada appeared at the hearing and was assisted by an interpreter. AR 762, 764, 768. A VE, Tom Griner, was also present. AR 762, 764. The February 2017 hearing was continued because a medical expert was not present. AR 766-68. The hearing was rescheduled for June 15, 2017. AR 770-99. Mr. Quezada was not present during the June 2017 hearing, but he was represented by counsel. AR 772. Testimony was taken from two medical experts and a VE, Phunda Yarbrough. AR 738, 770-95. The hearing specifically focused on the period from March 10, 2008 to March 31, 2013. AR 772. ALJ Pardo issued his unfavorable decision on July 27, 2017. AR 732-61. Once again, Mr. Quezada did not file exceptions to the ALJ's decision, and the Appeals Council did not assume jurisdiction. Instead, Mr. Quezada opted to file a complaint in this Court. Doc. 1. It is this third decision by ALJ Pardo-based on Mr. Quezada's October 2008 application-that forms the basis for this appeal.

         Because Mr. Quezada already had been found to be disabled, the issue before ALJ Pardo was limited to when Mr. Quezada's disability began. AR 738. The ALJ concluded that

the claimant has been under a disability within the meaning of the Social Security Act beginning May 28, 2011, but not before. Since the claimant was not under a disability within the meaning of the Social Security Act from March 10, 2008, though the date last insured of December 31, 2009, he is not entitled to benefits under sections 216(i) and 223(d) of the Social Security Act.

AR 739. The ALJ found that Mr. Quezada was disabled as of May 28, 2011-the date he attained the age 45[6]-because a finding of “disabled” was directed by Medical-Vocational Rule 201.17.[7] AR 752.

         Following the five-step sequential evaluation process, the ALJ determined that Mr. Quezada met the insured status requirements of the Social Security Act through December 31, 2009. AR 741. At step one, the ALJ found that Mr. Quezada had not engaged in substantial, gainful activity since March 10, 2008, the alleged onset date. Id. Because Mr. Quezada had not engaged in substantial gainful activity for at least twelve months, the ALJ proceeded to step two. At step two, the ALJ found that Mr. Quezada had the following severe impairments: “right medial meniscal tear status post subtotal meniscectomy, patella-femoral syndrome, type II diabetes, anxiety, and depression.” Id. (citation omitted). The ALJ found that Mr. Quezada's hypertension was non-severe. Id.

         At step three, the ALJ found that prior to May 28, 2011, none of Mr. Quezada's impairments, alone or in combination, met or medically equaled a Listing. AR 741-43. Because the ALJ found that none of the impairments met a Listing, ...

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