Source: https://casetext.com/case/russom-v-astrue-1
Timestamp: 2019-04-26 12:03:19+00:00

Document:
DANNY J. RUSSOM, Plaintiff, v. MICHAEL J. ASTRUE, Commissioner of Social Security, Defendant.
The matter before me is plaintiff's Complaint [#1], filed July 20, 2011, seeking review of the Commissioner's decision denying plaintiff's claim for disability insurance benefits under Title II of the Social Security Act, 42 U.S.C. § 401, et seq. I have jurisdiction to review the Commissioner's final decision under 42 U.S.C. § 405(g). The matter has been fully briefed, obviating the need for oral argument. I reverse and remand.
"[#1]" is an example of the convention I use to identify the docket number assigned to a specific paper by the court's electronic case filing and management system (CM/ECF). I use this convention throughout this order.
Plaintiff alleges that he is disabled as a result of pain and limitations resulting from a left ankle fracture and surgical repair. After his application for disability insurance benefits was denied, plaintiff requested a hearing before an administrative law judge. This hearing was held on August 4, 2010. At the time of the hearing, plaintiff was 49 years old. He has an 11th grade education and past relevant work experience as a plasterer. He has not engaged in substantial gainful activity since April 1, 2008.
The ALJ found that plaintiff was not disabled and therefore not entitled to disability insurance benefits. Although the medical evidence established that plaintiff suffered from severe impairments, the judge concluded that the severity of those impairments did not meet or equal any impairment listed in the social security regulations. The ALJ found that plaintiff had the residual functional capacity to perform light work with specified postural and other limitations. Although this finding precluded plaintiff's past relevant work, the ALJ concluded that there were jobs existing in significant numbers in the national and local economies that he could perform. She therefore found plaintiff not disabled at step five of the sequential evaluation. Plaintiff appealed this decision to the Appeals Council. The Council affirmed. Plaintiff then filed this action in federal court.
A person is disabled within the meaning of the Social Security Act only if his 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 effects 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).
2. The ALJ must then determine whether the claimed impairment is "severe." A "severe impairment" must significantly limit the claimant's physical or mental ability to do basic work activities.
20 C.F.R. § 404.1520(b)-(f). See also Williams v. Bowen 844 F.2d 748, 750-52 (10th Cir. 1988). The claimant has the initial burden of establishing a disability in the first four steps of this analysis. Bowen v. Yuckert , 482 U.S. 137, 146 n.5, 107 S.Ct. 2287, 2294 n.5, 96 L.Ed.2d 119 (1987). The burden then shifts to the Commissioner to show that the claimant is capable of performing work in the national economy. Id. A finding that the claimant is disabled or not disabled at any point in the five-step review is conclusive and terminates the analysis. Casias v. Secretary of Health & Human Services , 933 F.2d 799, 801 (10th Cir. 1991).
Review of the Commissioner's disability decision is limited to determining whether the ALJ applied the correct legal standard and whether the decision is supported by substantial evidence. Hamilton v. Secretary of Health and Human Services , 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 of the evidence. 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). Although a reviewing court should meticulously examine the record, it may not reweigh the evidence or substitute its discretion for that of the Commissioner. Id.
Plaintiff' claims the ALJ's residual functional capacity assessment is not supported by substantial evidence. Specifically, he argues that the ALJ failed to properly account for his need to elevate his injured ankle periodically throughout the day, neglected to incorporate his need to alternate periods of sitting and standing throughout the day, and failed to properly specify any lifting and carrying restrictions. As I agree with respect to the first of these arguments, I do not consider the remainder.
Nevertheless, any potential deficiencies highlighted by these additional arguments may be addressed by the ALJ in her reassessment of plaintiff's residual functional capacity assessment on remand.
Considering these treating source opinions, the ALJ found that plaintiff had the residual functional capacity to perform light work "as defined in 20 CFR 404.1567(b)," except that he could stand and walk for no more than four hours in an eight-hour day and had to be able to elevate his foot to chair level for 15 minutes out of every three hours. (Tr. 14.) Plaintiff maintains that this determination is not supported by substantial evidence because it fails to adequately explain important differences between the limitations imposed by the treating sources and the ALJ's ultimate residual functional capacity determination, or to consider Dr. Richman's 2010 opinion. I agree and therefore remand.
Residual functional capacity is an administrative determination reserved to the Commissioner. See 20 C.F.R. § 404.1546; Rutledge v. Apfel , 230 F.3d 1172, 1175 (10th Cir. 2000). Nevertheless, "[i]f the RFC assessment conflicts with an opinion from a medical source, the adjudicator must explain why the opinion was not adopted." Social Security Ruling 96-8p, 1996 WL 374184 at *7 (SSA July 2, 1996). Moreover, any residual functional capacity finding that runs contrary to a medical source statement must be based on something more than simply the ALJ's own lay opinion regarding the import of the medical evidence. See Hamlin v. Barnhart , 365 F.3d 1208, 1221 (10th Cir. 2004).
The ALJ here purported to afford "significant weight" to Dr. Simpson's opinion regarding plaintiff's need to elevate his foot. However, while Dr. Simpson stated that plaintiff would need to elevate the foot every two to three hours for 15 to 20 minutes at a time, the ALJ limited plaintiff's residual functional capacity to simply elevating the foot for 15 minutes every three hours. ( Cf. Tr. 14 with Tr. 468.) The ALJ failed to explain what evidence in the record supported her adoption of the most liberal reading of Dr. Simpson's opinion, rather than a more restrictive one. See Haga v. Astrue , 482 F.3d 1205, 1208 (10th Cir. 2007) ("An ALJ is not entitled to pick and choose through an uncontradicted medical opinion, taking only the parts that are favorable to a finding of nondisability.").
Nor did she present the vocational expert with a hypothetical incorporating the more restrictive ends of the ranges provided by Dr. Simpson. This lapse is problematic, especially in light of plaintiff's testimony that he needed to elevate his foot for no less than 20 minutes at a time to achieve relief. (Tr. 31.) See Hargis v. Sullivan , 945 F.2d 1482, 1492 (10th Cir. 1991) ("[T]estimony elicited by hypothetical questions that do not relate with precision all of a claimant's impairments cannot constitute substantial evidence to support the Secretary's decision.") (citation and internal quotation marks omitted).
To the extent the ALJ was unclear as to the import of this apparent omission, she could have contacted Dr. Simpson for further explication. See 20 C.F.R. § 404.1512(e); Social Security Ruling 96-5p,1996 WL 374183 at *6 (SSA July 2, 1996).
The Commissioner points out that Dr. Richman opined that plaintiff did not need to "lie down to rest during an 8 hour workday." (Tr. 455.) However, the ALJ did not acknowledge or address the July 2010 report from which this opinion originated at all. I cannot accept the Commissioner's invitation to affirm the ALJ's determination based on arguably ambiguous evidence she herself did not consider. See Grogan v. Barnhart , 399 F.3d 1257, 1263 (10th Cir. 2005) ("[T]he district court may not create post-hoc rationalizations to explain the Commissioner's treatment of evidence when that treatment is not apparent from the Commissioner's decision itself."). Accordingly, this case must be remanded.
Plaintiff asks me to direct an award of benefits in his favor. Given the ambiguity introduced by Dr. Richman's 2010 opinion, I find it would not be proper to exercise my discretion in that regard here. See Nielson v. Sullivan , 992 F.2d 1118, 1122 (10th Cir. 1993). By this decision, I do not find or imply that plaintiff is or should be found to be disabled.
d. Reassess the disability determination.
Dated September 19, 2012, at Denver, Colorado.

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