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Garcia Maestas v. Colvin

United States District Court, D. Colorado

February 23, 2018




         This matter comes before the court on review of the Commissioner's denial of Plaintiff Florence S. Garcia Maestas's application for (1) Disabled Widows Benefits (“DWB”), (2) Disability Insurance Benefits (“SSDI”) and (3) Supplemental Security Income (“SSI”) pursuant to Title XVI of the Social Security Act.[1] Jurisdiction is proper under 42 U.S.C. § 405(g). Plaintiff filed her opening brief on August 22, 2016 (Doc. No. 13 [“Opening Br.”]), Defendant filed her response on September 12 (Doc. No. 14 [“Resp.”]), and Plaintiff filed her reply on September 26, 2016 (Doc. No. 17 [“Reply”]).

         Plaintiff's SSDI benefits are not presented for judicial review. See Opening Br. at 2. In addition, because Plaintiff has largely made arguments that are common to both the ALJ's January 20, 2015 decision (AR 12-31) and January 16, 2015 decision (AR 32-55)-and since Defendant's response has followed a similar approach (Resp. at 2)-the Court's analysis will largely track these arguments and provide dual citations where appropriate.


         In both decisions, the Commissioner found Plaintiff not disabled under the Social Security Administration's regulations (“SSA”). (AR 15-31, 35-51). In determining disability, the ALJ used the sequential evaluation process.[2] At step one, the ALJ found “claimant's earnings record documents no income since the amended alleged disability onset date, and she denies working since prior to that date (citing ex. 10D, 11D, 3E).” (AR 18, 38.) At step two, where the “severity” of claimant's impairments is assessed, the ALJ found Plaintiff had the following severe impairments: obesity; varicose veins and/or thrombosis of the bilateral lower extremities; depressive disorder; and anxiety disorder (20 CFR 404.1520(c), 416.920(c)). (AR 19, 39.) None of Plaintiff's severe impairments were found presumptively disabling at step three. (AR 19-20, 39-40.)

         Prior to reaching step four, the ALJ assessed Plaintiff's residual functional capacity (“RFC”), and found her capable of working as follows: “Physically, she is able to lift 20 pounds occasionally and 10 pounds frequently. During an eight-hour workday, she is able to stand and/or walk for two hours and sit for at least six hours. Mentally, the claimant is able to: use judgment in making work decisions; respond appropriately to supervision, coworkers and work situations; and deal with changes in a routine work setting. She should not perform any assembly-line work (because of limitations in persistence, pace, and stress). She cannot engage in work requiring intense, sustained concentration.” (AR 20, 40). In making this assessment the ALJ found Plaintiff not credible in relating the severity of her impairments. He also found that since Plaintiff was not credible, her medical evidence was not credible either. (AR 28, 48.)

         Plaintiff sought timely review before this Court.


         A person is disabled within the meaning of the Social Security Act only if her physical and/or mental impairments preclude him from performing both his previous work and any other “substantial gainful work which exists in the national economy.” 42 U.S.C. § 423(d)(2). “When a claimant has one or more severe impairments the Social Security [Act] requires the [Commissioner] to consider the combined effect of the impairments in making a disability determination.” Campbell v. Bowen, 822 F.2d 1518, 1521 (10th Cir. 1987) (citing 42 U.S.C. § 423(d)(2)(C)). However, the mere existence of a severe impairment or combination of impairments does not require a finding that an individual is disabled within the meaning of the Social Security Act. To be disabling, the claimant's condition must be so functionally limiting as to preclude any substantial gainful activity for at least twelve consecutive months. See Kelley v. Chater, 62 F.3d 335, 338 (10th Cir. 1995).

         Review of the Commissioner's disability decision is limited to determining whether the ALJ (1) applied the correct legal standard and (2) whether the decision is supported by substantial evidence. Hamilton v. Sec'y of Health and Human Servs., 961 F.2d 1495, 1497-98 (10th Cir. 1992); Brown v. Sullivan, 912 F.2d 1194, 1196 (10th Cir. 1990). Substantial evidence is evidence a reasonable mind would accept as adequate to support a conclusion. Brown, 912 F.2d at 1196. It requires more than a scintilla but less than a preponderance. Hedstrom v. Sullivan, 783 F.Supp. 553, 556 (D. Colo. 1992). “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 a lack of substantial evidence.” Thompson v. Sullivan, 987 F.2d 1482, 1487 (10th Cir. 1993). The court “meticulously examine[s] 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.” Wall v. Astrue, 561 F.3d 1048, 1052 (10th Cir. 2009) (citations omitted). However, the court may not reweigh the evidence or substitute its discretion for that of the Commissioner. Thompson, 987 F.2d at 1487.

         As the Tenth Circuit observed in Baca v. Dep't of Health & Human Servs., 5 F.3d 476, 480 (10th Cir. 1993), the ALJ also has a basic duty of inquiry to “fully and fairly develop the record as to material issues.” Id. This duty exists even when the claimant is represented by counsel. Id. at 480. Moreover, the court may not affirm an ALJ's decision based on a post-hoc rationale supplied in an appellate brief, since doing so would “usurp essential functions committed in the first instance to the administrative process.” Allen v. Barnhart, 357 F.3d 1140, 1142 (10th Cir. 2004). Although the Tenth Circuit has applied the doctrine of harmless error in administrative appeals, it is only appropriate where “no reasonable administrative factfinder, following the correct analysis, could have resolved the factual matter in any other way.” Id. at 1145.


         Plaintiff raises several issues for consideration: (1) the ALJ's RFC finding does not account for all of the relevant mental limitations contained in the medical opinions; (2) the ALJ erred in assessing Plaintiff's credibility, (3) the ALJ's hypothetical questions to the vocational expert did not precisely reflect Plaintiff's limitations; (3) the ALJ's analysis engaged in cherry-picking evidence that was consistent with the final outcome, while ignoring evidence that was supportive of Plaintiff's claim; and (4) that ALJ erred in application of treating physician principles.

         While each of Plaintiff's arguments holds merit, the Court finds arguments addressing the fourth issue most persuasive.

         A. The ALJ Erred in Application of Treating ...

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