United States District Court, D. Colorado
MARCOS A. VIGIL, Plaintiff,
CAROLYN W. COLVIN, Acting Commissioner of Social Security, Defendant.
WILEY Y. DANIEL, Senior District Judge.
THIS MATTER is before the Court on review of the Commissioner's decision that denied Plaintiff's application for disability insurance benefits and supplemental security income. For the reasons stated below, this case is reversed and remanded to the Commissioner for further fact finding.
In January 2011, Plaintiff protectively filed applications for disability insurance benefits and supplemental security income. He claimed that he was disabled by limitations caused by back pain, schizophrenia, depression and alcoholism, and that his disability began in January 2006. (ECF No. 13, Administrative Record ["AR"] 127-39, 154, 160.) Plaintiff was born on August 18, 1977, and was 20 years old, which is defined as a younger individual age 18-49, on the alleged onset date. ( Id. 23.) His father reported to a medical provider that Plaintiff lost touch with reality when he was about 20; he has paranoia that people do not like him and are going to hurt him; he is isolated and cannot take care of himself. ( Id. 231.)
After Plaintiff's application was denied initially (AR 61-88), he requested a hearing before an Administrative Law Judge ["ALJ"] which was held on April 10, 2012. ( Id. 32-60.) On April 30, 2012, the ALJ issued a decision finding that Plaintiff was disabled but was not entitled to benefits because alcohol abuse was a prohibited contributing factor material to the finding of disability. ( Id. 14-31.)
More specifically, in the sequential evaluation process required by law, the ALJ found at step one that Plaintiff met the insured status requirements of the Act through December 31, 2010. (AR 19). He also found that Plaintiff had not engaged in substantial gainful activity since January 1, 2006, the alleged onset date. ( Id. 20.)
At step two, the ALJ found that Plaintiff had the following "severe" impairments: "(1) Alcohol abuse; (2) Major depressive disorder; (3) Schizophrenia; and (4) Schizoid personality disorder." (AR 20.) At step three, the ALJ found that Plaintiff did not have an impairment or combination of impairments that met or medically equaled the criteria one of the listed impairments in 20 C.F.R. pt. 404, Subpt. P, app. 1. ( Id. )
The ALJ then addressed Plaintiff's residual functional capacity ["RFC"]. He found that based on all the impairments, including the substance use disorder, Plaintiff has the RFC "to perform a full range of work at all exertional levels but with the following nonexertional limitations: the claimant is unable to sustain concentration, persistence, or pace necessary to complete a normal workday or workweek." (AR 21.)
At step four, the ALJ found that Plaintiff has no past relevant work. (AR 23.) At step five, the ALJ considered Plaintiff's age, education, work experience, RFC, and impairments (including the substance use disorder), and found that there are no jobs that exist in significant numbers in the national economy that Plaintiff can perform. ( Id. )
The ALJ then considered the effect of Plaintiff's alcohol use. He found that if Plaintiff stopped the substance use, his remaining limitations would not cause more than a minimal impact on his ability to perform basic work activities; therefore, Plaintiff would not have a severe impairment or combination of impairment. (AR 24.) He further found that the substance use disorder is a contributing factor material to the determination of disability because Plaintiff would not be disabled if he stopped the substance use. ( Id. 27.) In so finding, the ALJ stated that if Plaintiff "stopped the substance abuse, ... [his] medically determinable impairments could reasonably be expected to produce the alleged symptoms; however, [his] statements concerning the intensity, persistence and limiting effects of these symptoms are not credible to the extent they are inconsistent with the finding that the claimant has no severe impairment or combination of impairments for the reasons" explained in the decision. ( Id. 25.) Accordingly, the ALJ found that Plaintiff "has not been disabled within the meaning of the Act at any time from the alleged onset date through the date of this decision. ( Id. )
The Appeals Council denied Plaintiff's request for review of the ALJ's decision (AR 1-6), making the ALJ's decision the Commissioner's final decision. See 20 C.F.R. § 422.210(a). Plaintiff timely requested judicial review, and this appeal followed.
Plaintiff argues that the ALJ's determination that his alcohol abuse is a contributing factor material to his disability is not supported by substantial evidence. He requests that the ALJ's decision be reversed or that benefits be awarded outright.
A. Standard of Review
A Court's review of the determination that a claimant is not disabled is limited to determining whether the Commissioner applied the correct legal standard and whether the decision is supported by substantial evidence. Hamilton v. Sec. of Health and Human Servs., 961 F.2d 1495, 1497-98 (10th Cir. 1992). Substantial evidence is evidence a reasonable mind would accept as adequate to support a conclusion. Brown v. Sullivan, 912 F.2d 1194, 1196 (10th Cir. 1990). "It requires more than a scintilla of evidence but less than a preponderance of the evidence." Gossett v. Bowen, 862 F.2d 802, 804 (10th Cir. 1988).
"Evidence is not substantial if it is overwhelmed by other evidence in the record or constitutes mere conclusion." Musgrave v. Sullivan, 966 F.2d 1371, 1374 (10th Cir. 1992). Further, "if the ALJ failed to apply the correct legal test, there is a ground for reversal apart from substantial evidence." Thompson v. Sullivan, 987 F.2d 1482, 1487 (10th Cir. 1993). However, the court "must exercise common sense' in reviewing an ALJ's decision and must ...