United States District Court, D. Colorado
Brooke Jackson United States District Judge.
matter is before the Court on review of the Social Security
Administration (“SSA”) Commissioner's
decision denying claimant Caroline Margaret Roy's
applications for Disability Insurance Benefits
(“DIB”) under Title II of the Social Security Act
and for Supplemental Security Income (“SSI”)
under Title XVI. Jurisdiction is proper under 42 U.S.C.
§ 405(g). For the reasons below, the Court REVERSES and
REMANDS the Commissioner's decision.
STANDARD OF REVIEW
appeal is based upon the administrative record and the
parties' briefs. In reviewing a final decision by the
Commissioner, the District Court examines the record and
determines whether it contains substantial evidence to
support the Commissioner's decision and whether the
Commissioner applied the correct legal standards. Winfrey
v. Chater, 92 F.3d 1017, 1019 (10th Cir. 1996). 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). In addition, reversal may be
appropriate if the Commissioner applies an incorrect legal
standard or fails to demonstrate that the correct legal
standards have been followed. Winfrey, 92 F.3d at
was born on January 26, 1992. R. 121. She has a college
education and speaks English. Id.; R. 493. In the
past, Ms. Roy worked as a website designer. R. 121. However,
since her alleged disability onset date of July 2, 2014, Ms.
Roy has not held substantial gainful employment. See
suffers from numerous medical conditions, including Postural
Orthostatic Tachycardia Syndrome (“POTS”),
Ehlers-Danlos Syndrome (“EDS”), chronic pain,
fibromyalgia, depression, intracranial hypotension, nonsevere
sleep apnea, and restless leg syndrome. See, e.g.,
R. 109, 428-32, 479, 620-23, 717-18, 919. She has an
extensive history of medical treatment for her chronic pain
and psychological impairments. Her symptoms from some of
these conditions allegedly worsened following a car accident
in March of 2014. R. 730.
November 4, 2014, Ms. Roy filed applications for DIB and SSI,
alleging disability beginning on July 2, 2014. See
R. 249. Her claims were initially denied on April 7, 2015. R.
158-59. Ms. Roy subsequently requested a hearing, which was
held before Administrative Law Judge (“ALJ”)
Kathryn D. Burgchardt on September 15, 2015. R. 128-57. The
ALJ denied Ms. Roy's application on October 27, 2015. R.
then filed a request for review with the Appeals Council, see
R. 25-26, providing that body with additional evidence in the
form of: (1) medical evidence from Ellen Roy Elias, MD, see
R. 9-10, 27-56; (2) medical evidence from Stuart M. Kassan,
MD, see R. 57-73; (3) medical evidence from Anthony Casey,
MD, see R. 11-24; and (4) medical evidence from the
University of Colorado Hospital, see R. 74-103. Finding that
this evidence concerned a time period after the ALJ's
date of decision and would not therefore “provide a
basis for changing the [ALJ's] decision[, ]” the
Appeals Council rejected Ms. Roy appeal on March 24, 2016. R.
1-7. Ms. Roy then filed her case in this Court on April 4,
2016. ECF No. 1.
The ALJ's Decision
issued an unfavorable decision after evaluating the evidence
according to the SSA's standard five-step process. R.
107-23. First, the ALJ found that Ms. Roy had not engaged in
substantial gainful activity since her alleged onset date of
July 2, 2014. R. 109. At step two, the ALJ found that Ms. Roy
had the severe impairments of fibromyalgia, depression, and
intracranial hypotension. Id. At step three, the ALJ
concluded that Ms. Roy 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. 110.
then found that Ms. Roy retained the residual functional
capacity (“RFC”) to perform “sedentary
work” as defined in 20 C.F.R. § 404.1567(b) and
§ 416.967(b) with the following limitations:
[T]he claimant ha[s] no restrictions on sitting, but the
individual [c]ould stand and/or walk for up to three hours
with normal breaks during an eight hour workday. The claimant
could perform pushing and pulling within the sedentary weight
restrictions. She should avoid unprotected heights and moving
machinery. The claimant could occasionally climb ramps and
stairs, balance, stoop, crouch kneel, ...