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Yanni v. Saul

United States District Court, D. New Mexico

October 30, 2019

ANDREW SAUL, Commissioner of the Social Security Administration, Defendant.



         THIS MATTER is before the Court on Plaintiff Luanne Theresa Yanni's Motion to Reverse and Remand for a Rehearing with Supportive Memorandum (the “Motion”), (Doc. 17), filed May 23, 2019; Defendant Commissioner Andrew Saul's Brief in Response to Plaintiff's Motion to Reverse and Remand the Agency's Administrative Decision (the “Response”), (Doc. 22), filed August 27, 2019; and Ms. Yanni's Reply in Support of Motion to Reverse and Remand for a Rehearing with Supportive Memorandum, (the “Reply”), (Doc. 23), filed September 9, 2019.

         Ms. Yanni filed an application for supplemental security income under Title XVI of the Social Security Act on January 4, 2012, with a protective filing date of December 14, 2011. (Administrative Record “AR” 172). Ms. Yanni claimed she was limited in her ability to work due to head, neck, shoulder and back injuries resulting from a slip and fall accident. (AR 198). Ms. Yanni's application was initially denied on May 7, 2012, id., and upon reconsideration on March 7, 2013. (AR 115).

         Ms. Yanni requested a hearing before an Administrative Law Judge (“ALJ”), which was held on September 25, 2013, before ALJ Myriam C. Fernandez Rice. (AR 44, 119, 122). Ms. Yanni, represented by attorney Rose Eileen Provan, and Leslie White, a non-partial vocational expert (“VE”), testified at the hearing. (AR 44). On February 5, 2014, ALJ Fernandez Rice issued her decision, finding Ms. Yanni not disabled at any time between her protective filing date, December 14, 2011, through the date of her decision. (AR 38). Ms. Yanni requested review of the ALJ's decision by the Appeals Council, which was denied, (AR 1), thus making ALJ Fernandez Rice's opinion the Commissioner's final decision for purposes of judicial review.

         On October 19, 2015, Ms. Yanni filed a complaint in the United States District Court for the District of New Mexico (“District Court”), requesting review of ALJ Fernandez Rice's decision. (AR 1127). Ms. Yanni alleged ALJ Fernandez Rice erred in applying the appropriate legal standards in evaluating opinions of Ms. Yanni's treating physician and finding Ms. Yanni's residual functional capacity (“RFC”) and credibility determinations to be contrary to substantial evidence. The District Court noted that the consultative psychologist, Paula Hughson, M.D., opined that Ms. Yanni has moderate limitations in social functioning and maintaining concentration, persistence, and pace. (AR 34). The District Court also acknowledged that Ms. Yanni's treating physician, Thomas Whalen, M.D., found much greater restrictions on Ms. Yanni's ability to work, even though Dr. Whalen submitted his opinion on these restrictions after ALJ Fernandez Rice made her decision. (AR 1207-09). The District Court found the ALJ afforded significant weight to the medical opinion of Dr. Hughson, while being “unable to indicate what weight, if any, ” the ALJ would afford Ms. Yanni's treating physician. (AR 1208-09). Remanding the case for further administrative proceedings, the District Court reasoned “a treating physician's opinion must generally be accorded controlling weight, [and that in this case, it] is not simply a conflict between evidence on equal footing.” (AR 1201, 1208 (citing Doyal v. Barnhart, 331 F.3d 758, 762 (10th Cir. 2003)). The Appeals Council subsequently instructed the ALJ to offer Ms. Yanni the opportunity for a hearing and issue a new decision. (AR 1213).

         While her District Court case was pending, Ms. Yanni submitted another claim for supplemental security income and disability insurance benefits on September 2, 2015. (AR 1213). Pursuant to the District Court's remand order, dated June 21, 2017, the Appeals Council directed the ALJ to consolidate her claim in the original case with the subsequent claims for Title II and XVI benefits, filed on September 2, 2015, thus creating a single electronic record. Id.

         On September 5, 2018, Ms. Yanni appeared before ALJ Stephen Gontis with attorney Laura Johnson and non-partial VE Kristie Wilson. (AR 1048). ALJ Gontis issued his decision on September 21, 2018, finding Ms. Yanni not disabled prior to January 15, 2016. (AR 1037). ALJ Gontis further concluded that Ms. Yanni became disabled when she changed age categories on January 15, 2016, from a “younger individual” to an “individual closely approaching advanced age.” Id. Ms Yanni then requested review by the Appeals Council, which was denied, making ALJ Gontis' opinion the Commissioner's final decision for purposes of this appeal.

         Now, Ms. Yanni, represented by attorney Laura Johnson, argues in her motion that: (1) ALJ Gontis failed to comply with the District Court's instructions directing remand and proper analysis of the medical opinions of treating physician Dr. Whalen; (2) ALJ Gontis failed to account for all of the moderate limitations assessed by non-examining psychiatric consultant Scott Walker, M.D.; (3) ALJ Gontis failed to give proper reasons for rejecting the assessments of 96-6p consultative evaluator, psychiatrist Dr. Hughson; and therefore this case should be remanded for the immediate payment of benefits. (Doc. 17 at 2). The Court has reviewed the Motion, the Response, the Reply, and the relevant law. Additionally, the Court has meticulously reviewed the administrative record.

         The Court finds that Ms. Yanni's Motion should be GRANTED and this matter be REMANDED for further proceedings because ALJ Gontis violated the mandate rule by failing to adequately explain why he only gave partial weight to Dr. Whalen's opinions.

         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, 331 F.3d at 760. 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). 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 RFC, age, education, and work experience. Grogan, 399 F.3d at 1261.

         III. Background

         Ms. Yanni claimed she was limited in her ability to work since September 30, 2005, due to head, neck, shoulder and back injuries from a slip and fall accident. (AR 76). At step one, ALJ Gontis determined that Ms. Yanni had not engaged in substantial gainful activity since September 30, 2005, the alleged disability onset date. (AR 1021). At step two, ALJ Gontis found that Ms. Yanni had the following severe impairments: bipolar disorder; post-traumatic stress disorder (“PTSD”); carpal tunnel syndrome; and degenerative disc disease of the lumbar spine. (AR 1022).

         At step three, ALJ Gontis determined that none of Ms. Yanni's 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 1022). ALJ Gontis then found that Ms. Yanni has the RFC to perform a limited range of sedentary work limiting Ms. Yanni to: lift and/or carry ten pounds occasionally and less than ten pounds frequently; sit for six hours and stand and/or walk for two hours in an eight-hour work day; handle, finger, and feel frequently bilaterally; occasionally climb ramps and stairs and never climb ladders, ropes or scaffolds; occasionally stoop, kneel, crouch, and crawl; work in environments with significant vibration only occasionally; be limited to simple and routine tasks; be able to respond appropriately to supervisors frequently and to co-workers and the public occasionally, and be allowed to take normal breaks to accommodate her time off task. (AR 1024).

         In formulating Ms. Yanni's RFC, ALJ Gontis stated that he considered Ms. Yanni's 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”) 16-3p. Id. ALJ Gontis also stated that he considered opinion evidence consistent with the requirements of 20 C.F.R. ยงยง 404.1527 and 416.927. (AR 1025). ALJ Gontis concluded that some of Ms. Yanni's impairments could be expected to cause her alleged ...

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