United States District Court, D. Kansas
MEMORANDUM AND ORDER
JULIE A. ROBINSON, District Judge.
This matter is before the Court for review of the final decision of Defendant Commissioner of Social Security denying Plaintiff Mary Harriman's applications for a period of disability and disability insurance benefits under Title II of the Social Security Act and supplemental security income under Title XVI of the Social Security Act. Upon review, the Court finds that the underlying decision is not supported by substantial evidence in the record, and thus reverses and remands the decision of the Commissioner pursuant to sentence four of 42 U.S.C. § 405(g).
I. Procedural History
On April 19, 2011, Plaintiff protectively filed applications for a period of disability and disability insurance benefits, and for supplemental security income, alleging disability beginning January 1, 2009. Her applications were denied initially and upon reconsideration. Plaintiff timely requested a hearing before an administrative law judge (ALJ). After a hearing, the ALJ issued a decision in July 2012 finding that Plaintiff was not disabled; in September 2013, the Appeals Council denied Plaintiff's request for review of the ALJ's decision. Plaintiff then timely sought judicial review before this Court.
II. Standard for Judicial Review
Judicial review under 42 U.S.C. § 1383(c)(3) is limited to whether the defendant's decision is supported by substantial evidence in the record as a whole and whether the defendant applied the correct legal standards. The Tenth Circuit has defined "substantial evidence" as "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." In the course of its review, the court may not re-weigh the evidence or substitute its judgment for that of the defendant.
III. Legal Standards and Analytical Framework
Under the Social Security Act, "disability" means the "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment." An individual "shall be determined to be under a disability 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." The Secretary has established a five-step sequential evaluation process to determine whether a claimant is disabled. If the ALJ determines the claimant is disabled or not disabled at any step along the way, the evaluation ends.
IV. Issue Presented
Plaintiff does not challenge the ALJ's determinations at steps one, two and three that: Plaintiff has not engaged in substantial gainful activity since the alleged onset date of January 1, 2009; Plaintiff has medically severe impairments of degenerative disc disease, fibromyalgia, obesity, depression, and anxiety; and Plaintiff's impairments or combination of impairments do not meet or medically equal listings.
Rather, Plaintiff challenges the ALJ's determination at step four that Plaintiff has the residual functional capacity (RFC) to perform work at a range between the sedentary and light exertional levels. In making this determination, the ALJ expressly gave no weight to the opinions of Plaintiff's treating physician, Dr. Divina San Diego, who opined that Plaintiff's functional limitations were, inter alia,  that Plaintiff: could not sit, stand or walk for more than sixty minutes at a time or for more than four hours total in an eight-hour workday; would need unscheduled fifteen-minute breaks every two hours during an eight-hour workday; would likely miss work two times a month; and would need to shift at will from sitting, standing, or walking positions. Dr. San Diego further opined, inter alia,  that Plaintiff: would need to recline or lie down during an eight-hour workday in excess of the typical break schedules; could walk no more than one city block; could sit only thirty minutes at a time and for a total of no more than four hours of an eight-hour workday; could walk or stand for five minutes at a time and for no more than one hour total during an eight-hour workday; and would need to take unscheduled fifteen-minute breaks.
Plaintiff contends that the ALJ's RFC determination is the product of his improper evaluation of the opinions of her treating physician. The issue presented is thus whether the ALJ properly evaluated Dr. San Diego's opinion in determining to give her opinion no weight.
It is the responsibility of the ALJ to evaluate a claimant's "physical and mental RFC." The RFC represents "the most that the claimant can still do despite her limitations, and must include all of the claimant's medically determinable impairments." Social Security Ruling 96-8p requires that the ALJ perform a function-by-function assessment of the claimant's functional limitations and expressly identify the functional limitations or restrictions that affect the claimant's work-related abilities. The ALJ must consider all the relevant evidence, including the claimant's description of limitations, the medical evidence, and observations of physicians and others. The RFC is not based solely on medical evidence; rather, it is based on all credible evidence of record, including Plaintiff's medical history and treatment, objective evidence, and Plaintiff's daily activities. Here, the ALJ acknowledged that he had considered all of the evidence in the record, expressly acknowledging consideration of Plaintiff's statements and testimony; medical records of examination, tests, diagnoses, treatments, and medications; Plaintiff's reports of daily activities; Plaintiff's earnings record; the opinions of Dr. San Diego and the state agency medical consultant, Dr. Goering; and a ...