United States District Court, D. Colorado
ORDER VACATING DECISION OF ADMINISTRATIVE LAW JUDGE
AND REMANDING FOR FURTHER PROCEEDINGS
D. Domenico, United States District Judge
Ramon Marquez suffered traumatic brain injury in a motorcycle
accident. He applied for, but was denied, social security
benefits by the Commissioner, and an administrative law judge
ruled that, while Mr. Marquez would be unable to perform past
relevant work, he was capable of light work and therefore
“not disabled” within the meaning of Title II of
the Social Security Act (“Act”), 42 U.S.C. §
401, et seq. This matter is before the Court on
review of the Commissioner's decision denying Mr.
Marquez's application for disability insurance benefits
and supplemental security income, together with the entire
administrative record and the briefing of the parties. (Docs.
11, 15, 16.) For the reasons stated below, the
Commissioner's decision is VACATED, and
the case is REMANDED for further fact
Entitlement to Disability Insurance Benefits
obtain disability insurance benefits under the Act, a
claimant must meet the insured status requirements, be
younger than 65 years of age, file an application for a
period of disability, and have a “disability”
within the meaning of the Act. 42 U.S.C. §§ 416(i),
423(a); Flint v. Sullivan, 951 F.2d 264, 267 (10th
Cir. 1991). The disability must also have begun before
expiration of the disability-insured status. 20 C.F.R. §
404.101; Social Security Ruling (“SSR”) 83-10,
1983 WL 31251, at *8 (1983). Relevant here, a person has a
only if his physical or mental impairment or impairments are
of such severity that he is not only unable to do his
previous work but cannot, considering his age, education, and
work experience, engage in any other kind of substantial
gainful work which exists in the national economy, regardless
of whether such work exists in the immediate area in which he
lives, or whether a specific job vacancy exists for him, or
whether he would be hired if he applied for work.
42 U.S.C. § 423(d)(2)(A). To qualify for benefits, the
disabling impairment must last-or be expected to last-at
least twelve months. Barn-hart v. Walton, 535 U.S.
212, 214-15 (2002). Evaluating the existence of a disability
is a five-step, sequential process that ends at any point at
which the claimant is found not disabled. See 20
C.F.R. § 404.1520; Bowen v. Yuckert, 482 U.S.
137, 140-42 (1987); Casias v. Sec'y of Health &
Human Servs., 933 F.2d 799, 801 (10th Cir. 1991)
the claimant must demonstrate that he or she is not currently
involved in any substantial, gainful activity. 20 C.F.R.
§ 404.1520(b). Second, the
claimant must show a medically severe impairment or
combination of impairments that significantly limits his or
her physical or mental ability to do basic work activities.
Id. at § 404.1520(c).
Third, if the impairment matches or
is equivalent to an established listing under the governing
regulations, the claimant is judged conclusively disabled.
Id. at § 404.1520(d). If the claimant's
impairment does not match or is not equivalent to an
established listing, the analysis proceeds to the fourth
step. Id. at § 404.1520(e).
Fourth, the claimant must show that
the “impairment prevents [him or her] from performing
work [he or she] has performed in the past.”
Williams v. Bowen, 844 F.2d 748, 751 (10th Cir.
1988) (citations omitted); accord 20 C.F.R. §
404.1520(f). Fifth, the
Commissioner must demonstrate: (1) that based on the
claimant's residual functional capacity, age, education,
and work experience, the claimant can perform other work; and
(2) the work that the claimant can perform is available in
significant numbers in the national economy. Frey v.
Bowen, 816 F.2d 508, 512 (10th Cir. 1987) (citation
omitted); see also 20 C.F.R. § 404.1520(g).
to the “treating physician rule, ” the Social
Security Administration (“SSA”) Commissioner will
generally give more weight to medical opinions from treating
sources than those from non-treating sources. 20 C.F.R.
§ 404.1527(d)(2). “In deciding how much weight to
give a treating source opinion, an ALJ must first determine
whether the opinion qualifies for ‘controlling
weight.'” Watkins v. Barnhart, 350 F.3d
1297, 1300 (10th Cir. 2003). To make this determination, the
must first consider whether the opinion is well-supported by
medically acceptable clinical and laboratory diagnostic
techniques. If the answer to this question is ‘no,'
then the inquiry at this stage is complete. If the ALJ finds
that the opinion is well-supported, he must then confirm that
the opinion is consistent with other substantial evidence in
the record. [I]f the opinion is deficient in either of these
respects, then it is not entitled to controlling weight.
Id. (quotations omitted); see also 20
C.F.R. § 404.1527(d)(2) (noting that although the SSA
will consider evidence from treating medical sources, the
final responsibility in deciding these issues remains with
the Commissioner). Even if a treating physician's opinion
is not entitled to controlling weight, “[t]reating
source medical opinions are still entitled to
deference” and must be weighed using the following
(1) the length of the treatment relationship and the
frequency of examination; (2) the nature and extent of the
treatment relationship, including the treatment provided and
the kind of examination or testing performed; (3) the degree
to which the physician's opinion is supported by relevant
evidence; (4) consistency between the opinion and the record
as a whole; (5) whether or not the physician is a specialist
in the area upon which an opinion is rendered; and (6) other
factors brought to the ALJ's attention which tend to
support or contradict the opinion.
Watkins, 350 F.3d at 1301 (quotation omitted).
Finally, “[u]nder the regulations, the agency rulings,
and our case law, an ALJ must give good reasons . . . for the
weight assigned to a treating physician's opinion,
” that are “sufficiently specific to make clear
to any subsequent reviewers the weight the adjudicator gave
to the treating source's medical opinion and the reason
for that weight.” Id. at 1300 (quotations
omitted). “[I]f the ALJ rejects the opinion completely,
he must then give specific, legitimate reasons for doing
so.” Id. at 1301 (quotations omitted).
the ALJ's responsibility to explain his decision
concerning the evidence extends to any evaluation of a
According to Social Security Ruling 96-7p, 1996 WL 374186
(July 2, 1996), which governs an ALJ's evaluation of a
claimant's description of symptoms, the evaluation must
contain specific reasons for a credibility finding; the ALJ
may not simply recite the factors that are described in the
regulations. It is well-established that an ALJ's
findings with respect to a claimant's credibility should
be closely and affirmatively linked to substantial evidence
and not just a conclusion in the guise of findings.
Hardman v. Barnhart, 362 F.3d 676, 678-79 (10th Cir.
2004) (internal quotations omitted).
Standard of Review ...