United States District Court, D. Kansas
MEMORANDUM AND ORDER
JOHN W. LUNGSTRUM, District Judge.
Plaintiff seeks review of a decision of the Commissioner of Social Security (hereinafter Commissioner) denying Social Security Disability (SSD) benefits under sections 216(i) and 223 of the Social Security Act. 42 U.S.C. §§ 416(i) and 423 (hereinafter the Act). Finding error in the Commissioner's evaluation of the medical opinions, the court ORDERS that the decision shall be REVERSED and that judgment shall be entered pursuant to the fourth sentence of 42 U.S.C. § 405(g) REMANDING the case for further proceedings consistent with this opinion.
Plaintiff applied for SSD benefits alleging disability beginning June 3, 2010. (R. 15, 147-48). In due course, Plaintiff exhausted proceedings before the Commissioner, and now seeks judicial review of the final decision denying benefits. She alleges the Administrative Law Judge (ALJ) erred in evaluating the credibility of her allegations of symptoms resulting from her impairments and erred in weighing the non-treating source opinions of the consultative physician, Dr. Subramanian, the consultative psychologist, Dr. Mintz, and the non-examining source opinion of the state agency physician, Dr. Raju. She also claims that the Appeals Council erred in weighing the opinion of Plaintiff's treating physician, Dr. Haag, presented for the first time to the Council after the ALJ issued his decision.
The court's review is guided by the Act. Wall v. Astrue , 561 F.3d 1048, 1052 (10th Cir. 2009). Section 405(g) of the Act provides that in judicial review "[t]he findings of the Commissioner as to any fact, if supported by substantial evidence, shall be conclusive." 42 U.S.C. § 405(g). The court must determine whether the ALJ's factual findings are supported by substantial evidence in the record and whether he applied the correct legal standard. Lax v. Astrue , 489 F.3d 1080, 1084 (10th Cir. 2007); accord, White v. Barnhart , 287 F.3d 903, 905 (10th Cir. 2001). Substantial evidence is more than a scintilla, but it is less than a preponderance; it is such evidence as a reasonable mind might accept to support a conclusion. Richardson v. Perales , 402 U.S. 389, 401 (1971); Wall , 561 F.3d at 1052; Gossett v. Bowen , 862 F.2d 802, 804 (10th Cir. 1988).
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)); accord, Hackett v. Barnhart , 395 F.3d 1168, 1172 (10th Cir. 2005). Nonetheless, the determination whether substantial evidence supports the Commissioner's decision is not simply a quantitative exercise, for evidence is not substantial if it is overwhelmed by other evidence or if it constitutes mere conclusion. Gossett , 862 F.2d at 804-05; Ray v. Bowen , 865 F.2d 222, 224 (10th Cir. 1989).
The Commissioner uses the familiar five-step sequential process to evaluate a claim for disability. 20 C.F.R. §§ 404.1520, 416.920; Wilson v. Astrue , 602 F.3d 1136, 1139 (10th Cir. 2010) (citing Williams v. Bowen , 844 F.2d 748, 750 (10th Cir. 1988)). "If a determination can be made at any of the steps that a claimant is or is not disabled, evaluation under a subsequent step is not necessary." Wilson , 602 F.3d at 1139 (quoting Lax , 489 F.3d at 1084). In the first three steps, the Commissioner determines whether claimant has engaged in substantial gainful activity since the alleged onset, whether she has a severe impairment(s), and whether the severity of her impairment(s) meets or equals the severity of any impairment in the Listing of Impairments (20 C.F.R., Pt. 404, Subpt. P, App. 1). Williams , 844 F.2d at 750-51. After evaluating step three, the Commissioner assesses claimant's residual functional capacity (RFC). 20 C.F.R. § 404.1520(e). This assessment is used at both step four and step five of the sequential evaluation process. Id.
The Commissioner next evaluates steps four and five of the sequential process- determining at step four whether, in light of the RFC assessed, claimant can perform her past relevant work; and at step five whether, when also considering the vocational factors of age, education, and work experience, claimant is able to perform other work in the economy. Wilson , 602 F.3d at 1139 (quoting Lax , 489 F.3d at 1084). In steps one through four the burden is on Plaintiff to prove a disability that prevents performance of past relevant work. Blea v. Barnhart , 466 F.3d 903, 907 (10th Cir. 2006); accord, Dikeman v. Halter , 245 F.3d 1182, 1184 (10th Cir. 2001); Williams , 844 F.2d at 751 n.2. At step five, the burden shifts to the Commissioner to show that there are jobs in the economy which are within the RFC assessed. Id .; Haddock v. Apfel , 196 F.3d 1084, 1088 (10th Cir. 1999).
The court finds that remand is necessary because the ALJ erred in weighing the medical opinions of Dr. Subramanian, Dr. Raju, and Dr. Mintz. Because these errors necessitate remand, the court will not comment on the Appeals Council's allegedly deficient evaluation of Dr. Haag's belated treating source opinion regarding the adequacy of the ALJ's decision. Because the court's review of a credibility determination is deferential, because a credibility determination is an integral part of an RFC assessment, and because reevaluating the medical source opinions on remand will necessitate a reassessment of RFC, the court will not address the errors allegedly made in the credibility determination. Plaintiff may make those arguments to the Commissioner on remand.
II. Evaluation of the Medical Opinions
Plaintiff claims the ALJ's evaluation of the medical opinions is unsupported by the record evidence. Essentially, she argues that when the medical opinions of Dr. Raju, Dr. Subramanian, and Dr. Mintz are properly weighed in accordance with the regulatory factors designed for that purpose, they cannot be accorded "substantial weight" as the ALJ purported to do. She also argues that her treating physician, Dr. Haag, formulated an opinion after reviewing the ALJ's decision which then was provided to the Appeals Council along with Plaintiff's request for review of the ALJ's decision. She argues that Dr. Haag's opinion conclusively demonstrates the error of the ALJ's determination that Plaintiff is not disabled, but that the Council erred by failing to consider, evaluate, and accord weight to this opinion.
The Commissioner argues that the ALJ properly evaluated the medical opinions of Dr. Raju, Dr. Subramanian, and Dr. Mintz, accorded appropriate weight to those opinions, and provided reasons for his findings which are supported by the record evidence. She explains why, in her view, Plaintiff's view of the evidence need not have been accepted by the ALJ. In her final argument, the Commissioner argues that the Appeals Council properly determined that Dr. Haag's letter does not undermine the ALJ's decision.
A. The ALJ's Evaluation of the Medical Opinions
The ALJ provided this explanation of the weighting of the opinions of Dr. Raju, Dr. ...