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Garcia v. Colvin

United States District Court, D. Colorado

March 15, 2016

CAROLYN W. COLVIN, Acting Commissioner of Social Security, Defendant.



This action comes before the court pursuant to Title XVI of the Social Security Act (“Act”), 42 U.S.C. §§ 1381-83(c), for review of the Commissioner of Social Security’s final decision denying Plaintiff Marlene M. Garcia’s (“Plaintiff” or “Ms. Garcia”) application for Supplemental Security Income (“SSI”). Pursuant to the Order of Reference dated June 5, 2015 [#22], this civil action was referred to the undersigned Magistrate Judge for all purposes pursuant to 28 U.S.C. § 636(c) and D.C.COLO.LCivR 72.2. The court has carefully considered the Complaint [#1, filed Oct. 27, 2014], Defendant’s Answer [#10, filed Feb. 11, 2015], Plaintiff’s Opening Brief [#14, filed Apr. 17, 2015], Defendant’s Response Brief [#13, filed May 18, 2015], Plaintiff’s Reply Brief [#18, filed June 1, 2015], the entire case file, the administrative record, and applicable case law. For the following reasons, I REVERSE the Commissioner’s final decision and REMAND for further proceedings.


Plaintiff filed an application for SSI under Title XVI of the Act on February 9, 2011. [#11-5 at 149].[1] Plaintiff was 28 years old when she filed her application for benefits. [#11-2 at 24]. She alleged in her application that she became disabled in January 2011 due to scoliosis and arthritis in her back. [#11-3 at 49]; [#11-5 at 149-57]; [#11-6 at 193]. Subsequently, however, Ms. Garcia alleged during the March 2013 administrative hearing before the ALJ that “[t]he scoliosis and the arthritis does play a part, ” but that “depression is the majority” of the basis of her disability claim “at this point.” [#11-2 at 40]. Plaintiff’s SSI application was denied in a notice dated April 21, 2011. [#11-4 at 69].

On May 4, 2011, Plaintiff filed a request for an administrative hearing. [#11-3 at 63]. Ms. Garcia did not show up for the hearing, which was set for April 25, 2012. [#11-2 at 15, 26-28]. The ALJ then issued a Notice to Show Cause for Failure to Appear, informing Ms. Garcia that although she failed to appear at the hearing, she was afforded the opportunity to file a written statement providing good cause for that absence. [#11-4 at 112]. On May 14, 2012, the ALJ entered an Order of Dismissal on Plaintiff’s request for hearing due to her failure to appear. [#11-3]. Ms. Garcia then asked the Appeals Council to review the ALJ’s Order of Dismissal, and the Appeals Counsel found that dismissal of Ms. Garcia’s request for a hearing was improper because the claimant’s representative appeared at the scheduled hearing even if Ms. Garcia did not. [Id. at 66].

The ALJ afforded Ms. Garcia a hearing on March 19, 2013, in which she testified about the reasons why she did not appear for the first hearing, and did not respond to the ALJ’s Order to Show Cause. [#11-2 at 36-37]. The ALJ also asked her about her weight, and the number of children she had, but very little else. [#11-2 at 33-47]. The ALJ then asked a vocational expert about potential occupations for Ms. Garcia, but never included any mental health limitation. [Id. at 42-45]. The ALJ issued a hearing decision on March 25, 2013, which denied the application for disability benefits at step five of the five-step sequence for determining disability. [Id. at 24-25]; see Wall v. Astrue, 561 F.3d 1048, 1052 (10th Cir. 2009) (summarizing steps).

At step one, the ALJ determined that Ms. Garcia had not engaged in substantial gainful activity since February 9, 2011, the application date. [#11-2 at 18]. At step two, the ALJ found that Ms. Garcia “has the following severe impairments: (1) Obesity; (2) Degenerative changes of the thoracic and lumbar spine; (3) Depressive disorder; and (4) Anxiety disorder.” [#11-2 at 18]. The ALJ noted that the objective medical evidence of record establishes that Ms. Garcia was diagnosed with these impairments and found that these impairments impose more than minimal restrictions on her ability to perform basic work activities and therefore are “severe” impairments within the meaning of the Social Security Regulations. [#11-2 at 18]. The ALJ did not discuss any minor impairments or other ailments that Ms. Garcia claimed to suffer which were not considered impairments. At step three, the ALJ found that Ms. Garcia did not have an impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1. [#11-2 at 18]. The ALJ then concluded that Ms. Garcia had the residual functional capacity (“RFC”) to perform light work as defined in 20 CFR 416.967(b) except that Ms. Garcia can only work in a low stress environment; is limited to unskilled work with GED levels no higher than R2, M2, and L2; and cannot have frequent or prolonged contact with supervisors, co-workers, or the general public. [#11-2 at 20]. At step four, the ALJ found that Ms. Garcia has no past relevant work. [#11-2 at 24].

At step five, the ALJ determined that considering Ms. Garcia’s age, education, work experience, and residual functional capacity, there are jobs that exist in significant numbers in the national economy that she can perform. [#11-2 at 24]. The ALJ based this determination on testimony from a Vocational Expert that a hypothetical person with the relevant RFC could perform jobs including work on a production assembly, as an electronics worker, and as a housekeeper-cleaner. [#11-2 at 25]. Because the ALJ found that considering Ms. Garcia’s age, education, work experience, and RFC, Ms. Garcia is capable of making a successful adjustment to other work that exists in significant numbers in the national economy, the ALJ concluded that a finding of “not disabled” was appropriate. [#11-2 at 25].

On September 18, 2014, the Appeals Council denied Plaintiff’s request for review of the ALJ’s decision, thereby rendering the ALJ’s decision the final decision of the Commissioner. See [#11-2 at 1]; 20 C.F.R. § 404.981; Nelson v. Sullivan, 992 F.2d 1118, 1119 (10th Cir. 1993). Plaintiff filed this action on October 27, 2014. See [#1]. The court has jurisdiction to review the final decision of the Commissioner. 42 U.S.C. §§ 405(g) & 1383(c).


I. Standard of Review

In reviewing the Commissioner’s final decision, the court is limited to determining whether the decision adheres to applicable legal standards and is supported by substantial evidence in the record as a whole. Berna v. Chater, 101 F.3d 631, 632 (10th Cir. 1996) (citation omitted); Angel v. Barnhart, 329 F.3d 1208, 1209 (10th Cir. 2003). The court may not reverse an ALJ simply because the court may have reached a different result based on the record; the question instead is whether there is substantial evidence showing that the ALJ was justified in his decision. See Ellison v. Sullivan, 929 F.2d 534, 536 (10th Cir. 1990). “Substantial evidence is more than a mere scintilla and is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Flaherty v. Astrue, 515 F.3d 1067, 1070 (10th Cir. 2007) (internal citation omitted). “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) (internal citation omitted). The court will not “reweigh the evidence or retry the case, ” but must “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.” Flaherty, 515 F.3d at 1070 (internal citation omitted). Nevertheless, “if 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) (internal citation omitted).

II. Social Security Disability Appeal Process

Supplemental Security Income is available to an individual who is financially eligible, files an application for SSI, and is disabled as defined in the Act. 42 U.S.C. § 1382. An individual is determined to be under a disability only if his “physical or mental impairment or impairments are of such severity that [he] is not only unable to do [his] previous work but cannot, considering [his] age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy . . . .” 42 U.S.C. §§ 423(d)(2)(A); 1382c(a)(3)(B).

The Commissioner has developed a five-step evaluation process for determining whether a claimant is disabled under the Act. See Williams v. Bowen, 844 F.2d 748, 750-52 (10th Cir. 1988) (describing the five steps in detail). “If a determination can be made at any of the steps that a claimant is or is not disabled, evaluation under a subsequent step is not necessary.” Id. at 750. “Step one requires the agency to determine whether a claimant is ‘presently engaged in substantial gainful activity.’” Wall, 561 F.3d at 1052 (quoting Allen v. Barnhart, 357 F.3d 1140, 1142 (10th Cir. 2004). Step two requires the agency to consider whether a claimant has “a medically severe impairment or impairments.” Allen, 357 F.3d at 1142. “An impairment is severe under the applicable regulations if it significantly limits a claimant’s physical or mental ability to perform basic work activities.” Wall, 561 F.3d at 1052 (citing 20 C.F.R. § 404.1521). At step three, the ALJ considers whether a claimant’s medically severe impairments “meets or equals an impairment listed in 20 C.F.R. Pt. 404, Subpt. P, App. 1.” Vigil v. Colvin, 805 F.3d 1199, 1203 (10th Cir. 2015).

If the claimant’s impairments are not equivalent to a listed impairment, at step four of the evaluation process, the ALJ must determine a claimant’s Residual Functional Capacity (RFC) and compare the RFC to the claimant’s past relevant work. The RFC is what a claimant is still “functionally capable of doing on a regular and continuing basis, despite his impairments: the claimant’s maximum sustained work capability.” Williams, 844 F.2d at 751. “The ...

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