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Sanchez v. Berryhill

United States District Court, D. New Mexico

July 8, 2019

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



         THIS MATTER is before the Court on Plaintiff Alex G. Sanchez' Motion to Reverse and Remand for a Rehearing with Supporting Memorandum (the “Motion”), (Doc. 15), filed March 7, 2019; 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. 17), filed May 7, 2019; and Mr. Sanchez' Reply in Support of Motion to Reverse and Remand for a Rehearing with Supportive Memorandum, (the “Reply”), (Doc. 18), filed May 21, 2019.

         Mr. Sanchez filed applications for disability insurance benefits and supplemental security income on September 6, 2014. (Administrative Record “AR” 293, 299). In both of his applications, Mr. Sanchez alleged disability beginning July 18, 2014. (AR 293, 299). Mr. Sanchez claimed he was limited in his ability to work due to arthritis in his knees, diabetes, and a history of falling. (AR 316). Mr. Sanchez' applications were denied initially on December 2, 2014 and upon reconsideration on October 5, 2015. (AR 209, 212, 221).

         Mr. Sanchez requested a hearing before an Administrative Law Judge (“ALJ”), which was held on February 21, 2017 before ALJ Lillian Richter. (AR 127). At the hearing, Mr. Sanchez appeared before ALJ Richter with a non-attorney representative, Vick Kendahl, and a non-partial Vocational Expert (“VE”), Kathleen Mundi. Id. ALJ Richter issued her decision on October 17, 2017 finding Mr. Sanchez not disabled at any time between his initial filing date through the date of her opinion. (AR 71). After ALJ Richter's decision, Mr. Sanchez submitted additional medical evidence for review by the Appeals Council. (AR 11-22, 30-31, 51-53). Shortly thereafter, the Appeals Council denied Mr. Sanchez' request for review, (AR 1-4), making ALJ Richter's opinion the Commissioner's final decision for purposes of judicial review.

         Mr. Sanchez, now represented by attorney Michael Armstrong, argues in his Motion that the Appeals Council committed reversible error in not considering additional evidence submitted for review and ALJ Richter failed to properly evaluate his impairments under Listing 1.02(A). (Doc. 15 at 1). 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 Appeals Council erred in not reviewing additional evidence submitted after ALJ Richter's decision, the Court finds that Mr. Sanchez' Motion should be GRANTED and this matter be REMANDED for further proceedings.

         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) (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 to show . . . that she has done so, are also 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 supplemental security income and disability insurance benefits, a claimant establishes a disability when he 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), 42 U.S.C. § 1382c(a)(3)(A); 20 C.F.R. §§ 404.1505(a), 416.905(a). 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.

         At the first four steps of the SEP, the claimant bears the burden of showing: (1) he is not engaged in “substantial gainful activity”; (2) he 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) his impairment(s) meet or equal one of the “listings”[1] of presumptively disabling impairments; or (4) he is unable to perform his “past relevant work.” 20 C.F.R. §§ 404.1520(a)(4)(i-iv); see also 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 bears the burden of showing 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. Grogan, 399 F.3d at 1261.

         III. Background

         Mr. Sanchez claimed he was limited in his ability to work due to arthritis in his knees, diabetes, and a history of falling. (AR 316). At step one, ALJ Richter determined that Mr. Sanchez had not engaged in substantial gainful activity since July 18, 2014, the alleged disability onset date. (AR 63). At step two, ALJ Richter found that Mr. Sanchez has the following severe impairments: diabetes mellitus, peripheral neuropathy, degenerative disk disease in the lumbar and thoracic spine, chronic ligament tear, osteoarthritis in the left knee, obesity, depression, and anxiety. Id.

         At step three, ALJ Richter determined that none of Mr. Sanchez' impairments, solely or in combination, equaled one of the listed impairments in 20 C.F.R. §§ 404.1520(d), 404.1525, 404.1526, 416.920(d), 416.925, and 416.926. (AR 64). ALJ Richter then found that Mr. Sanchez has the RFC to perform sedentary work with the following limitations: he can occasionally stoop, climb ramps, and climb stairs; he can never kneel, crouch, crawl, balance, or climb ladders, ropes or scaffolds; he should avoid exposure to unprotected heights and moving mechanical parts; he is limited to work that is primarily performed at the workstation; he may require use of a handheld assistive device for ambulation; he is limited to simple, routine work, and occasional interaction with supervisors, coworkers, and members of the public. (AR 65-66).

         In formulating Mr. Sanchez' RFC, ALJ Richter stated that she considered Mr. Sanchez' symptoms and the extent to which those symptoms can reasonably be accepted as consistent with objective medical and other evidence, as required by 20 C.F.R. §§ 404.1529, 416.929 and Social Security Ruling (“SSR”) 96-4p. (AR 66). In addition, ALJ Richter stated that she considered opinion evidence consistent with the requirements of 20 C.F.R. §§ 404.1527 and 416.927. Id. ALJ Richter concluded that some of Mr. Sanchez' impairments could be expected to cause his alleged symptoms, ...

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