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Roy v. Berryhill

United States District Court, D. Colorado

April 4, 2017

CAROLINE MARGARET ROY, Plaintiff,
v.
NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.

          ORDER

          R. Brooke Jackson United States District Judge.

         This 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.

         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 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 1019.

         II. BACKGROUND

         Ms. Roy 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 id.

         Mr. Roy 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.

         A. Procedural History

         On 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. 107-23.

         Ms. Roy 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.

         B. The ALJ's Decision

         The ALJ 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.

         The ALJ 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, ...

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