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Herrera v. Saul

United States District Court, D. New Mexico

December 4, 2019

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



         THIS MATTER is before the Court on Plaintiff Elaine Herrera's Motion to Reverse or Remand the Administrative Record, (Doc. 16), filed July 3, 2019; Ms. Herrera's Memorandum Brief in Support of Plaintiff's Motion to Reverse or Remand the Administrative Agency Decision (the “Motion”), (Doc. 17), filed July 3, 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 October 30, 2019; and Ms. Herrera's Reply to Defendant's Response to Plaintiff's Motion to Reverse/Remand (the “Reply”), (Doc. 23), filed November 21, 2019.

         Ms. Herrera filed applications for disability insurance benefits and supplemental security income on January 29, 2016. (Administrative Record “AR” 175). In her applications, Ms. Herrera alleged disability beginning April 30, 2015. (AR 192). Ms. Herrera claimed she was limited in her ability to work due to a back impairment, sciatica, and a hip impairment. (AR 195). Ms. Herrera's applications were denied initially on May 27, 2016, and upon reconsideration on August 29, 2016. (AR 100, 105).

         At Ms. Herrera's request, (AR 108), a hearing was held on August 10, 2017, before Administrative Law Judge (“ALJ”) Michael Leppala, (AR 27). Ms. Herrera and Thomas Garner, an impartial vocational expert (“VE”), testified at the hearing and Ms. Herrera was represented by her attorney, Barbara Jarvis. (AR 27). On March 12, 2018, the ALJ issued his decision, finding Ms. Herrera not disabled at any time between her alleged onset date, April 30, 2015, through the date of his decision. (AR 17). Ms. Herrera requested review by the Appeals Council, (AR 22), which was denied, (AR 1-3), making the ALJ's opinion the Commissioner's final decision for purposes of this appeal.

         Ms. Herrera, represented by her attorney Barbara Jarvis, argues in her Motion that the ALJ: (1) erred in evaluating the opinions of Ms. Herrera's treating physician, Gerhard Nyase, M.D., (Doc. 17 at 8-9); and (2) erroneously determined that Ms. Herrera could perform her past relevant work as a contract clerk, id. at 12-18. Ms. Herrera further argues she is entitled to an immediate award of benefits because remanding this matter for additional fact finding would serve no useful purpose. Id. at 19. The Court has reviewed the Motion, the Response, the Reply, and the relevant law. Additionally, the Court has meticulously reviewed the administrative record. Because the ALJ erred in analyzing the opinion of Ms. Herrera's treating physician, the Court finds that Ms. Herrera's Motion should be GRANTED, and this matter shall be REMANDED to the Commissioner for additional 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) (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 v. Barnhart, 331 F.3d 758, 760 (10th Cir. 2003). 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) (2015), 1382c(a)(3)(A); 20 C.F.R. §§ 404.1505(a), 416.905(a). In order 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), 416.920(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 his 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 residual functional capacity (“RFC”), age, education, and work experience. Grogan, 399 F.3d at 1261.

         III. Background

         Ms. Herrera claimed she was limited in her ability to work due to a back impairment, sciatica, and a hip impairment. (AR 195). At step one, the ALJ determined that Ms. Herrera has not engaged in substantial gainful activity since April 30, 2015, the alleged disability onset date. (AR 12). At step two, the ALJ found Ms. Herrera has the severe impairment of lumbar degenerative disc disease. (AR 12-13). At step three, the ALJ determined that Ms. Herrera's impairment did not equal one of the listed impairments in 20 C.F.R. §§ 404.1520(d), 404.1525, and 404.1526. (AR 13).

         At step four, the ALJ found that Ms. Herrera has the RFC to perform light work and is capable of: occasionally lifting and/or carrying 20 pounds; frequently lifting and/or carrying ten pounds; sitting, and standing and/or walking for about six hours in an eight-hour workday, all with normal breaks; occasionally kneeling, crouching, and climbing ramps or stairs; never crawling, and never climbing ladders, ropes, or scaffolds; and she must avoid concentrated exposure to hazards. (AR 13).

         In formulating Ms. Herrera's RFC, the ALJ stated that he considered Ms. Herrera'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 and Social Security Ruling (“SSR”) 16-3p. (AR 14). The ALJ also stated that he considered opinion evidence consistent with the requirements of 20 C.F.R. § 404.1527. Id. The ALJ concluded that some of Ms. Herrera's impairments could be expected to cause her alleged symptoms, but he ...

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