United States District Court, D. Colorado
BRADLEY L. MOORE, Plaintiff,
v.
NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.
ORDER
LEWIS
T. BABCOCK, JUDGE
Plaintiff
Bradley L. Moore, appeals from the Social Security
Administration (“SSA”) Commissioner's final
decision denying his application for disability insurance
benefits (“DIB”), filed pursuant to Title II of
the Social Security Act, 42 U.S.C. §§ 401-433.
Jurisdiction is proper under 42 U.S.C. § 405(g). Oral
argument would not materially assist me in the determination
of this appeal.
After
consideration of the parties' briefs, as well as the
administrative record, I REVERSE and REMAND the
Commissioner's final order for further proceedings.
I.
Statement of the Case
Plaintiff
is a 58 year-old man who has a GED. [Administrative Record
(“AR”) 123] He seeks judicial review of SSA's
decision denying his application for DIB. Pl.'s Br., ECF
No. 21 at 1. Plaintiff filed his application in March 2014
alleging that his disability began in March 2012 (although
this was amended during an oral hearing to November 2012).
[AR 115, 250]
The
application was initially denied on May 14, 2014. [AR 156]
The Administrative Law Judge (“ALJ”) conducted
two evidentiary hearings and issued a written ruling on
September 23, 2015. [AR 95-107, 113-19, 120-51] In that
ruling, the ALJ denied Plaintiff's application on the
basis that he was not disabled because, considering his age,
education, and work experience, he had the residual
functional capacity to perform jobs that exist in significant
numbers in the national economy. [AR 106] The SSA Appeals
Council subsequently denied Plaintiff's administrative
request for review of the ALJ's determination, making
SSA's denial final for the purpose of judicial review.
[AR 1-3]; see 20 C.F.R. §404.981. Plaintiff
timely filed his complaint with this court seeking review of
SSA's final decision. ECF No. 1.
II.
Relevant Medical History
In
November 2012, Plaintiff fell and had an MRI showing
foraminal narrowing, osteophytes, and disc protrusion. [AR
751] He also had disc degeneration, numbing in his arm, and a
severely limited range of motion in his neck. [Id.]
Jaymi Devans, FNP, and others from the Salud Family Health
Centers saw Plaintiff over the proceeding years. [See
e.g. AR 690, 698, 702, 718, 770] Devans stated that
Plaintiff was in a cervical collar which allowed no movement
of his head nor lifting of his arms and was in a great deal
of pain. [AR 801] Devans noted that Plaintiff's lack of
insurance limited his referral options. [AR 790]
Plaintiff
was prescribed Oxycodone and told Devans he would attempt to
obtain Medicaid. [AR 788] He entered into a narcotics
contract after finishing the medication early and continued
his attempt to obtain Medicare after initial denial. [AR
785-86] Plaintiff's pain persisted and he sought pain
management, even though he would have to pay without
insurance. [AR 779] Plaintiff began to taper his medicine and
managed his pain. [AR 772]
Past
his date last insured, Plaintiff noted that his back and neck
pain flared when he had to take a flight. [AR 770] In early
2014, after being approved for Medicaid, Plaintiff underwent
a decompression and fusion surgery. [AR 363, 801, 816] A few
weeks after the surgery, he was noted to be doing well and
was happy as he had regained function and sensation in his
right arm and hand, but was with similar pain as to before
the surgery. [AR 712] However, Plaintiff fell again in
mid-2014, leading to severe back pain and seeking other
options despite being on a high dose of pain medication. [AR
706-08] Plaintiff had lumbar foraminotomy surgery and
subsequent infections related to the surgery. [AR 503-04,
698, 859] ¶ 2015, Plaintiff underwent another fusion
surgery. [AR 834] This surgery failed and in 2016, he had yet
another spinal fusion surgery. [AR 17-20]
III.
Legal Standards
A.
SSA's Five-Step Process for Determining
Disability
A
claimant is “disabled” under Title II of the
Social Security Act if he is unable to “engage in any
substantial gainful activity by reason of any medically
determinable physical or mental impairment which can be
expected to result in death or which has lasted or can be
expected to last for a continuous period of not less than 12
months.” 42 U.S.C. § 423(d)(1)(A); see Bowen
v. Yuckert, 482 U.S. 137, 140 (1987). SSA has
established a five-step sequential evaluation for determining
whether a claimant is disabled and thus entitled to benefits.
20 C.F.R. § 404.1520.
At step
one, SSA asks whether the claimant is presently engaged in
“substantial gainful activity.” If he is,
benefits are denied and the inquiry stops. 20 C.F.R. §
404.1520(b). At step two, SSA asks whether the claimant has a
“severe impairment”-that is, an impairment or
combination of impairments that “significantly limits
[his] physical or mental ability to do basic work
activities.” 20 C.F.R. § 404.1520(c). If he does
not, benefits are denied and the inquiry stops. If he does,
SSA moves on to step three, where it determines whether the
claimant's impairments “meet or equal” one of
the “listed impairments”-impairments so severe
that SSA has determined that a claimant who has them is
conclusively disabled without regard to the claimant's
age, education, or work experience. 20 C.F.R. §
404.1520(d). If not, SSA goes to step four.
At step
four, SSA determines the claimant's residual functional
capacity (“RFC”)-that is, what he is still able
to do despite his impairments-and asks whether the claimant
can do any of his “past relevant work” given that
RFC. 20 C.F.R. § 404.1520(e). If not, SSA goes to the
fifth and final step, where it has the burden of showing that
the claimant's RFC allows him to do other work in the
national economy in view of his age, education, and work
experience. 20 C.F.R. § 404.1520(g). At this step,
SSA's “grid rules” may mandate a finding of
disabled or not disabled without further analysis based on
the claimant's age, education, and work experience. 20
C.F.R. Pt. 404, Subpt. P, App. 2.
In
contrast with step five, the claimant has “the burden
of establishing a prima facie case of disability at steps one
through four.” Doyal v. Barnhart, 331 F.3d
758, 760 (10th Cir. 2003).
B.
...