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Wintersberger v. Saul

United States District Court, D. New Mexico

August 9, 2019

ANDREW M. SAUL, Commissioner of the Social Security Administration, [1] Defendant.



         THIS MATTER comes before the Court on plaintiff Carol Monica Wintersberger's Motion to Reverse and Remand for Payment of Benefits, or in the Alternative, for Rehearing with Supporting Memorandum (Doc. 15), which was fully briefed on January 16, 2019. Docs. 16, 18, 19. The parties consented to my entering final judgment in this case. Docs. 3, 5, 6. Having meticulously reviewed the record and being fully advised in the premises, the Court finds that the Administrative Law Judge (“ALJ”) failed to apply the correct legal standards when assessing Ms. Wintersberger's treating physician's opinion. The Court, therefore, GRANTS Ms. Wintersberger's motion and remands this case for further proceedings.

         I. Standard of Review

         The standard of review in a Social Security appeal is whether the Commissioner's final decision[2] 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)

         When considering a disability application, the Commissioner is required to use a five-step sequential evaluation process. 20 C.F.R. § 404.1520; 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[3] of presumptively disabling impairments; or (4) the claimant is unable to perform his or her “past relevant work.” 20 C.F.R. § 404.1520(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

          Ms. Wintersberger is a 59-year-old woman who lives in Albuquerque, New Mexico, with her two small dogs. AR 31, 149.[4] Ms. Wintersberger earned her bachelor's degree in Business Computer Systems from the University of New Mexico, and worked as a program analyst and a help desk analyst for more than 20 years. AR 31-33, 153. Ms. Wintersberger stopped working on October 2, 2014, because her job was eliminated. AR 33, 152.

         Ms. Wintersberger filed her initial application for Disability Insurance Benefits (“DIB”) on November 12, 2014, alleging disability beginning on October 2, 2014, due to multiple sclerosis and herpes simplex keratitis in her left eye. AR 134-35, 152. The Social Security Administration (“SSA”) denied her claims initially and on reconsideration. AR 50-70. Ms. Wintersberger requested a hearing by an ALJ. AR 85-86. On February 8, 2017, ALJ Doug Gabbard held a hearing, at which Ms. Wintersberger and a vocational expert (“VE”) testified. AR 26-49. ALJ Gabbard issued his unfavorable decision on March 23, 2017. AR 11-25.

         Following the five-step sequential evaluation process, the ALJ determined that Ms. Wintersberger met the insured status requirements of the Social Security Act through December 31, 2019. AR 16. At step one, the ALJ found that Ms. Wintersberger had not engaged in substantial, gainful activity since October 2, 2014, the alleged onset date. Id. Because Ms. Wintersberger 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 Ms. Wintersberger's only severe impairment is multiple sclerosis. AR 16. The ALJ found that Ms. Wintersberger's obesity, left-eye interstitial keratitis from herpes simplex virus, dural arteriovenous fistula status post embolization, hyperlipidemia, bladder urgency and frequency, and intermittent right arm numbness, “considered singly and in combination, do not cause more than minimal limitation in her ability to perform basic work activities and are therefore nonsevere.” Id.

         At step three, the ALJ found that none of Ms. Wintersberger's impairments, alone or in combination, met or medically equaled a Listing. AR 17. Because the ALJ found that none of the impairments met a Listing, the ALJ assessed Ms. ...

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