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Casias v. Soul

United States District Court, D. New Mexico

August 26, 2019

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



         THIS MATTER comes before the Court on plaintiff Rita Luna Casias's[2] 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.

         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). 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).

         In the 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).

         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. Casias was born in 1952, completed high school and a few basic college courses, and lives with her husband. AR 41, 96.[4] 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.

         The ALJ 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.

         AR 24.

         At step 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.

         Ms. 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 ...

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