United States District Court, D. Kansas
MEMORANDUM OPINION AND ORDER
DANIEL D. CRABTREE, District Judge.
This matter comes before the Court on an appeal of an unfavorable final decision of the Commissioner of Social Security on plaintiff's applications for disability insurance benefits ("DIB") under Title II and supplemental security income benefits ("SSI") under Title XVI of the Social Security Act. 42 U.S.C. §§ 401, 1381. Plaintiff timely sought review of that decision, and it is now before the Court for briefing and decision under D. Kan. Rule 83.7(d).
I. Legal Standard
The Court's jurisdiction and review are guided by 42 U.S.C. § 405(g), which provides that "[t]he findings of the Commissioner of Social Security as to any fact, if supported by substantial evidence, shall be conclusive...." When reviewing the Commissioner's decision, the Court may "neither reweigh the evidence nor substitute [its] judgment for that of the agency.'" Bowman v. Astrue, 511 F.3d 1270, 1272 (10th Cir. 2008) (quoting Casias v. Sec'y of Health & Human Servs., 933 F.2d 799, 800 (10th Cir. 1991)). Instead, the Court must "review the [Administrative Law Judge's ("ALJ")] decision only to determine whether the factual findings are supported by substantial evidence in the record and whether the correct legal standards were applied.'" Id. (quoting Doyal v. Barnhart, 331 F.3d 758, 760 (10th Cir. 2003)).
"Substantial evidence' requires more than a scintilla, but less than a preponderance, ' and is satisfied by such evidence that a reasonable mind might accept to support the conclusion.'" Ray v. Bowen, 865 F.2d 222, 224 (10th Cir. 1989) (quoting Campbell v. Bowen, 822 F.2d 1518, 1521 (10th Cir. 1987)). "[E]vidence is not substantial if it is overwhelmed by other evidence or if it really constitutes mere conclusion." Id. (citing Fulton v. Heckler, 760 F.2d 1052, 1055 (10th Cir. 1985); Knipe v. Heckler, 755 F.2d 141, 145 (10th Cir. 1985)).
II. Five-Step Disability Determination
To qualify for DIB or SSI, "a claimant must establish a severe physical or mental impairment expected to result in death or last for a continuous period of twelve months which prevents the claimant from engaging in substantial gainful activity." Thompson v. Sullivan, 987 F.2d 1482, 1486 (citing 42 U.S.C. § 423(d)(1)(A)); Knipe, 755 F.2d at 145 n.8 (citations omitted)). The impairment(s) must be of "such severity that [the claimant] 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...." 42 U.S.C. §§ 423(d)(2)(A), 1382c(a)(3)(B).
The Commissioner evaluates disability using a five-step sequential evaluation process. Barnhart v. Thomas, 540 U.S. 20, 24 (2003) (citing 20 C.F.R. § 404.1520 (2003) (governing claims for disability insurance benefits); § 416.920 (parallel regulation governing claims for Supplemental Security Income)); see also Hackett v. Barnhart, 395 F.3d 1168, 1171 (10th Cir. 2005) (citing Williams v. Bowen, 844 F.2d 748, 750-52 (10th Cir. 1988)). If the Commissioner can make a finding of disabled or not disabled at any step of the analysis, the evaluation will go no further. Thomas, 540 U.S. at 24.
At the first step, the agency will find nondisability unless the claimant shows that he is not working at a "substantial gainful activity." §§ 404.1520(b), 416.920(b).
At step two, the SSA will find nondisability unless the claimant shows that he has a "severe impairment, " defined as "any impairment or combination of impairments which significantly limits [the claimant's] physical or mental ability to do basic work activities." §§ 404.1520(c), 416.920(c). At step three, the agency determines whether the impairment which enabled the claimant to survive step two is on the list of impairments presumed severe enough to render one disabled; if so, the claimant qualifies. §§ 404.1520(d), 416.920(d). If the claimant's impairment is not on the list, the inquiry proceeds to step four, at which the SSA assesses whether the claimant can do his previous work; unless he shows that he cannot, he is determined not to be disabled. If the claimant survives the fourth stage, the fifth, and final, step requires the SSA to consider so-called "vocational factors" (the claimant's age, education, and past work experience), and to determine whether the claimant is capable of performing other jobs existing in significant numbers in the national economy. §§ 404.1520(f), 404.1560(c), 416.920(f), 416.960(c).
Id. at 24-25. Additionally, before going from step three to step four, the ALJ assesses the claimant's residual functional capacity ("RFC"), which is used to evaluate the claim at steps four and five. 20 C.F.R. §§ 404.1520(a)(4), (e)-(g); 416.920(a)(4), (e)-(g).
"The claimant bears the burden of establishing a prima facie case of disability at steps one through four." Hackett, 395 F.3d at 1171 (citing Williams, 844 F.2d at 751 n.2). "If the claimant successfully meets this burden, the burden of proof shifts to the Commissioner at step five to show that the claimant retains sufficient RFC to perform work in the national economy...." Id. (citing Williams, 844 F.2d at 751). The Commissioner "meets this burden if the decision is supported by substantial evidence...." Thomson, 987 F.2d at 1487 (citations omitted).
III. Factual Background and Procedural History
Plaintiff was working as a truck driver on October 8, 2008, when he fell from his semi-trailer and aggravated a pre-existing lumbar degenerative disc disease. (R. at 526-27.) He has seen several medical professionals and received numerous treatments and prescriptions for back pain and related complications both before and after his fall. ( See, e.g., R. at 393-418.) Plaintiff also has sought treatment and medications for a variety of other impairments, including but not limited to arthritis, colitis, depression, enteritis, hypertension, and possible Crohn's disease. ( See, e.g., R. at 316-17, 393-418, 440-41, 448-68, 634-41.)
Mr. Branstetter protectively filed applications for DIB and SSI on March 26, 2010, alleging disability beginning on October 8, 2008 due to back problems and colitis. (R. at 20, 135-48, 233-43.) The Regional Commissioner of the Social Security Administration denied plaintiff's claims initially on July 19, 2010. (R. at 76-86.) Plaintiff asked for reconsideration and submitted a Disability Report Appeal Form SSA-3341, adding an additional claim of arthritis in his right wrist. (R. at 244-51.) The Regional Commissioner denied his claims on March 29, 2011. (R. at 88-93.) Plaintiff requested a hearing before an ALJ on April 7, 2011. (R. at 96-97.) Before the hearing and without adding any additional claims of impairments, plaintiff submitted new evidence and reports, including a new Disability Report Appeal Form SSA-3341 (R. at 252-59), recent medical treatment and medications forms (R. at 267-68), medical records from CRC Health Group, including a Mental Residual Functional Capacity Assessment and Physical Questionnaire signed by Barbara Spurlock, dated July 28, 2011 to August 9, 2011 (R. at 380-92), and assorted treatment records dated August 5, 2010 through September 1, 2011 (R. at 633-41).
After a video hearing, the ALJ found that plaintiff was not disabled under sections 216(i), 223(d), and 1614(a)(3)(A) of the Social Security Act. (R. at 17-34.) Specifically, the ALJ made the following findings at each step of the five-step process:
Step 1: Plaintiff has not engaged in substantial activity since October 8, 2008, the alleged onset date. (R. at 22 (citing 20 C.F.R. §§ 404.1571 et seq., 416.971 et seq. ).)
Step 2: Plaintiff has the following severe impairments: back problems, colitis, and affective disorder. (R. at 22 (citing 20 C.F.R. §§ 404.1520(c), 416.920(c)).)
Step 3: Plaintiff does not have an impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. (R. at 23 (citing 20 C.F.R. §§ ...