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Pace v. Colvin

United States District Court, D. Colorado

December 21, 2016

ASHLEY M. PACE (KLINEBRIEL), Plaintiff,
v.
CAROLYN W. COLVIN, Commissioner of Social Security, Defendant.

          ORDER

          R. Brooke Jackson United States District Judge.

         This matter is before the Court on review of the Commissioner's decision denying claimant Ashley M. Pace's application for Disability Insurance Benefits under Title II of the Social Security Act. Jurisdiction is proper under 42 U.S.C. § 405(g). For the reasons explained below, the Court reverses and remands the Commissioner's decision.

         I. Standard of Review.

         This appeal is based upon the administrative record and the parties' briefs. In reviewing a final decision by the Commissioner, the role of the District Court is to examine the record and determine whether it “contains substantial evidence to support the [Commissioner's] decision and whether the [Commissioner] applied the correct legal standards.” Rickets v. Apfel, 16 F.Supp.2d 1280, 1287 (D. Colo. 1998). A decision is not based on substantial evidence if it is “overwhelmed by other evidence in the record.” Bernal v. Bowen, 851 F.2d 297, 299 (10th Cir. 1988). Substantial evidence requires “more than a scintilla, but less than a preponderance.” Wall v. Astrue, 561 F.3d 1048, 1052 (10th Cir. 2009). Evidence is not substantial if it “constitutes mere conclusion.” Musgrave v. Sullivan, 966 F.2d 1371, 1374 (10th Cir. 1992). Regarding the application of law, “reversal may be appropriate when the [Social Security Administration] Commissioner either applies an incorrect legal standard or fails to demonstrate reliance on the correct legal standards.” Springer v. Astrue, No. 11-cv-02606, 2013 WL 491923, at *5 (D. Colo. Feb. 7, 2013).

         II. Background.

         Ms. Pace was born in 1983 and is now 33 years old. See R. 162. She joined the U.S. Navy in 2005 and served in active duty through 2008, after which she served in the Navy Reserve until 2011. R. 41-42.

         Ms. Pace began to develop several medical conditions during her military service. R. 42. She experienced trauma while serving in the Navy, triggering depression, anxiety, and posttraumatic stress disorder (PTSD). R. 327. She suffers from frequent diarrhea and has several bowel movements per day-including occasional “accidents”-which were eventually diagnosed as symptoms of lymphocytic colitis and irritable bowel syndrome. See R. 68, 721, 1007, 1016. At the time of her hearing, Ms. Pace's treatment involved periodic intravenous drug infusion in a hospital over the course of several hours. R. 52, 1007. Additionally, she has recurrent uveitis, an inflammatory eye condition that blurs her vision. R. 49, 375, 432. She has also been diagnosed with fibromyalgia. See R. 363.

         After being honorably discharged from the Navy, Ms. Paced worked as an office manager for the Department of Veterans Affairs' Everett Vet Center. R. 43-44. She took college classes during this time without earning a degree. R. 31, 196. In January 2013, however, Ms. Pace suffered a mental breakdown at work. R. 48. She took leave from her job, but ended up not returning after her anxiety symptoms persisted and her gastrointestinal problems and eye disorder flared up. Id. She has not worked since then. R. 181.

         A. Procedural History.

         On December 6, 2013 Ms. Pace applied for Disability Insurance Benefits, alleging disability beginning January 21, 2013. R. 162, 192. The claim was initially denied on April 22, 2014. R. 65-76. Ms. Pace requested reconsideration, and her claim was denied again on October 23, 2014. R. 77-92, 97. She then requested a hearing, which was held in front of Administrative Law Judge (ALJ) Kathryn D. Burgchardt on July 16, 2015. R. 24. The ALJ issued a decision denying benefits on July 24, 2015. R. 11. The Appeals Council denied Ms. Pace's request for review on November 9, 2015, rendering the ALJ's determination the final decision of the Commissioner for purposes of judicial review. R. 1. Ms. Pace filed a timely appeal in this Court.

         B. The ALJ's Decision.

         The ALJ issued an unfavorable decision after evaluating the evidence according to the Social Security Administration's standard five-step process. R. 16-23. First, she found that Ms. Pace had not engaged in substantial gainful activity since her alleged onset date of January 21, 2013. R. 16. At step two, the ALJ found that Ms. Pace had the severe impairments of uveitis, lymphocytic colitis, major depressive disorder, and posttraumatic stress disorder. R. 16. At step three, the ALJ concluded that Ms. Pace did not have an impairment or combination of impairments that met or medically equaled the severity of one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. R. 17.

         The ALJ then found that Ms. Pace retained the residual functional capacity (RFC) to perform a range of unskilled light work with the following restrictions: lifting or carrying at most 10 pounds frequently and 20 pounds occasionally; performing pulling and pushing motions with the same weight restrictions; standing or walking up to a total of four hours and sitting up to a total of six hours, with normal breaks, in an eight-hour workday; avoiding unprotected heights, moving machinery, vibration, and concentrated noise; working only in a “relatively clean” environment (i.e., with low levels of pollutants and stable temperatures); only occasionally balancing, stooping, crouching, kneeling, crawling, or climbing; at most frequently ascending ramps or stairs, reaching overhead bilaterally, or using fine vision; having “reasonable” restroom access; not working in close proximity to coworkers or supervisors; and having only minimal contact with the public. R. 18.

         At step four, the ALJ concluded that Ms. Pace is unable to perform any past relevant work. R. 22. Finally, at step five, the ALJ determined that there were jobs that existed in significant numbers in the national economy that Ms. Pace could perform. R. 22. Therefore, the ALJ concluded that Ms. Pace was not disabled. R. 23.

         III. Discussion.

         Ms. Pace contends that the ALJ made five errors in the RFC determination. Specifically, Ms. Pace argues that the ALJ improperly: (1) rejected the opinions of three of Ms. Pace's mental health providers; (2) relied on the opinions of nonexamining State agency psychological consultants; (3) mischaracterized evidence of Ms. Pace's daily activities; (4) inadequately assessed Ms. Pace's limitations due to her irritable bowel syndrome; and (5) failed to address Ms. Pace's migraines. The Court will discuss each argument in turn.

         A. Ms. Augustine's, Ms. Akers', and Ms. Sorden's Opinions.

         The ALJ gave “little weight” to the Mental Impairment Questionnaires filled out by Ms. Augustine, Ms. Akers, and Ms. Sorden. R. 21, 909-25. Ms. Pace takes issue with the ALJ's evaluation of these medical opinions, claiming that the ALJ misapplied the relevant legal standards.

         1. Watkins factors.

         Ms. Pace first argues that the ALJ erred by failing to weigh these three opinions using the factors provided in 20 C.F.R. § 404.1527(c) and analyzed in Watkins v. Barnhart, 350 F.3d 1297 (10th Cir. 2003). The regulation requires an ALJ to consider:

• The examining relationship between the individual and the “acceptable medical source”;
• The treatment relationship between the individual and a treating source, including its length, nature, and extent as well as frequency of examination;
• The degree to which the “acceptable medical source” presents an explanation and relevant evidence to support an opinion, particularly medical signs and laboratory findings;
• How consistent the medical opinion is with the record as a whole;
• Whether the opinion is from an “acceptable medical source” who is a specialist and is about medical issues related to his or her area of specialty; and
• Any other factors brought to our attention, or of which we are aware, which tend to support or contradict the opinion.

         Social Security Ruling (SSR) 06-03p, 2006 WL 2329939, at *3 (Aug. 9, 2006).

         But Ms. Pace's argument is not quite right. The ALJ is required to consider these factors only in assessing “medical opinions.” 20 C.F.R. § 404.1527(c). “Medical opinions are statements from . . . acceptable medical sources.” Id. § 404.1527(a)(2). “Acceptable medical sources” include licensed physicians and psychologists, but do not cover many medical sources like nurse practitioners or therapists. SSR 06-03p, 2006 WL 2329939, at *1-2. Ms. Augustine is a nurse practitioner while Ms. Akers and Ms. Sorden are therapists, so they do not qualify as “acceptable medical sources” who can give “medical opinions.” See R. 810, 836, 913, 925.

         Social Security Ruling 06-03p clarifies that ALJs should still consider all opinions from medical sources who are not “acceptable medical sources” and that, at the ALJ's discretion, the aforementioned factors can be applied to these opinions. SSR 06-03p, 2006 WL 2329939, at *4, 6. The Ruling then summarizes the minimum relevant factors for considering such opinion evidence as follows:

• How long the source has known and how frequently the source has ...

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