United States District Court, D. New Mexico
MEMORANDUM OPINION AND ORDER
FASHING, UNITED STATES MAGISTRATE JUDGE
MATTER comes before the Court on plaintiff Rita Luna
Casias's Motion to Reverse and Remand for a
Rehearing with Supporting Memorandum (Doc. 14), which was
fully briefed on January 28, 2019. See Docs. 16, 21,
22. The parties consented to my entering final judgment in
this case. Docs. 5, 6, 7. Having carefully reviewed the
parties' submissions, the administrative record, and the
relevant law, I find that the Appeals Council erred by
failing to consider the additional evidence submitted by Ms.
Casias. I therefore GRANT Ms. Casias's motion and remand
this case to the Commissioner for further proceedings
consistent with this opinion.
Standard of Review
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). 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
typical case, the Court's decision is based on a
“meticulous” review of the entire record, where
it may neither reweigh the evidence nor substitute its
judgment for that of the Commissioner. Flaherty v.
Astrue, 515 F.3d 1067, 1070 (10th Cir. 2007). This case,
however, can be resolved on an error of law. The Court read
and carefully considered all portions of the record that bear
on the legal arguments raised by Ms. Casias, but the Court
did not review every page of the medical documents in detail,
as is usually the case. See Grogan v. Barnhart, 399
F.3d 1257, 1262 (10th Cir. 2005) (“[W]e meticulously
examine the record as a whole, including anything that may
undercut or detract from the ALJ's findings in order to
determine if the substantiality test has been met.”).
In this case, because “the ALJ failed to apply the
correct legal test, there is a ground for reversal apart from
a lack of substantial evidence.” Thompson v.
Sullivan, 987 F.2d 1482, 1487 (10th Cir. 1993).
Applicable Law and Sequential Evaluation Process
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).
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 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.
Background and Procedural History
Casias was born in 1952, completed high school and a few
basic college courses, and lives with her husband. AR 41,
She has worked as a custodian, electronics assembler, and an
explosives truck driver. AR 45, 48, 81, 92-3, 212. Ms. Casias
filed an application for Disability Insurance Benefits
(“DIB”) on February 18, 2015, alleging disability
since February 9, 2015, due to complete knee replacement. AR
186-87, 211. The Social Security Administration
(“SSA”) denied her claim initially and on
reconsideration. AR 96-114. Ms. Casias requested a hearing
before an ALJ. AR 127-28. On April 6, 2017, ALJ Michael
Leppala held a hearing. AR 33-95. ALJ Leppala issued his
unfavorable decision on October 18, 2017. AR 18-32.
found that Ms. Casias met the insured status requirements of
the Social Security Act through June 30, 2018. AR 23. At step
one, the ALJ found that Ms. Casias had not engaged in
substantial, gainful activity since February 9, 2015, her
alleged onset date. Id. At step two, the ALJ found
that Ms. Casias's status post total right knee
replacement was a severe impairment. Id. The ALJ
also found that her vertigo was a non-severe impairment and
her anxiety was a non-medically determinable impairment. AR
23-24. At step three, the ALJ found that none of Ms.
Casias's impairments, alone or in combination, met or
medically equaled a Listing. AR 24. Because the ALJ found
that none of the impairments met a Listing, the ALJ assessed
Ms. Casias's RFC. AR 24-27. The ALJ found Ms. Casias had
the RFC to
perform light work as defined in 20 CFR 404.1567(b) except
the Claimant is capable of occasionally lifting and/or
carrying twenty pounds, frequently lifting and/or carrying
ten pounds, standing and/or walking for about six hours in an
eight-hour workday, and sitting for about six hours in an
eight[-]hour workday, all with normal breaks. The Claimant is
further limited to occasionally climbing ramps or stairs,
never climbing ladders, ropes, or scaffolds, frequently
balancing, occasionally stooping, occasionally kneeling,
occasionally crouching, and occasionally crawling.
four, the ALJ concluded that Ms. Casias was capable of
performing her past relevant work as an electronic assembler
as it was actually and generally performed. AR 27-28. The ALJ
thus found Ms. Casias not disabled at step four. AR 28.
Casias requested that the Appeals Council review the
ALJ's unfavorable decision. AR 183-85. Ms. Casias
submitted additional evidence to the Appeals Council.
See AR 10-11. The Appeals Council did not consider
or “exhibit” the additional evidence and found it
“does not relate to the period at issue.” AR 2.
On April 10, 2016, the Appeals Council denied the ...