United States District Court, D. New Mexico
MEMORANDUM OPINION AND ORDER
HONORABLE CARMEN E. GARZA CHIEF UNITED STATES MAGISTRATE
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,
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).
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.
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.
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.
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.
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
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
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) (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).
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)).
Applicable Law and Sequential Evaluation Process
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.
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” 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.
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).
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).
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. §§ 404.1527 and
416.927. (AR 1025). ALJ Gontis concluded that some of Ms.
Yanni's impairments could be expected to cause her