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C.S.A. v. Saul

United States District Court, D. Kansas

June 20, 2019

C.S.A., [1] Plaintiff,
ANDREW M. SAUL,[2] Commissioner of Social Security, Defendant.



         Plaintiff filed this action for review of a final decision of the Commissioner of Social Security denying Plaintiff's application for social security disability benefits under Title II of the Social Security Act, 42 U.S.C. § 401 et seq. The matter is fully briefed by the parties. (Docs. 11, 12, 13.) The Commissioner's decision is REVERSED and REMANDED for the reasons stated herein.

         I. Standard of Review

         The court's standard of review is set forth in 42 U.S.C. § 405(g), which provides that “the findings of the Commissioner as to any fact, if supported by substantial evidence, shall be conclusive.” The Commissioner's decision will be reviewed to determine only whether the decision was supported by substantial evidence and whether the Commissioner applied the correct legal standards. Glenn v. Shalala, 21 F.3d 983, 984 (10th Cir. 1994). Substantial evidence requires more than a scintilla, but less than a preponderance, and is satisfied by such evidence as a reasonable mind might accept as adequate to support the conclusion. Richardson v. Perales, 402 U.S. 389, 401 (1971).

         Although the court is not to reweigh the evidence, the findings of the Commissioner will not be mechanically accepted. Nor will the findings be affirmed by isolating facts and labeling them substantial evidence, as the court must scrutinize the entire record in determining whether the Commissioner's conclusions are rational. Graham v. Sullivan, 794 F.Supp. 1045, 1047 (D. Kan. 1992). The court should examine the record as a whole, including whatever fairly detracts from the weight of the Commissioner's decision and, on that basis, determine if the substantiality of the evidence test has been met. Glenn, 21 F.3d at 984.

         The Commissioner has established a five-step sequential evaluation process to determine disability. 20 C.F.R. § 404.1520; Wilson v. Astrue, 602 F.3d 1136, 1139 (10th Cir. 2010). If at any step a finding of disability or non-disability can be made, the Commissioner will not review the claim further. At step one, the agency will find non-disability unless the claimant can show that he or she is not working at a “substantial gainful activity.” Williams v. Bowen, 844 F.2d 748, 750 (10th Cir. 1988). At step two, the agency will find non-disability unless the claimant shows that he or she has a severe impairment. 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. Id. at 750-51. If the claimant's impairment does not meet or equal a listed impairment, the agency determines the claimant's residual functional capacity (“RFC”). 20 C.F.R. § 404.1520(e). The RFC assessment is used to evaluate the claim at both step four and step five. 20 C.F.R. § 404.1520(a)(4); § 404.1520(f), (g). At step four, the agency must determine whether the claimant can perform previous work. If a claimant shows that she cannot perform the previous work, the fifth and final step requires the agency to consider 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. Barnhart v. Thomas, 540 U.S. 20, 25 (2003).

         The claimant bears the burden of proof through step four of the analysis. Blea v. Barnhart, 466 F.3d 903, 907 (10th Cir. 2006). At step five, the burden shifts to the Commissioner to show that the claimant can perform other work that exists in the national economy. Id.; Thompson v. Sullivan, 987 F.2d 1482, 1487 (10th Cir. 1993). The Commissioner meets this burden if the decision is supported by substantial evidence. Thompson, 987 F.2d at 1487.

         II. Background and Procedural History

         Plaintiff protectively filed an application for disability insurance benefits on October 15, 2015, alleging a disability onset date of April 5, 2013, when she was 26 years of age. (R. at 15, 52.) Prior to the alleged onset date, Plaintiff held several jobs, most of which were in customer service. (R. at 184.)

         Plaintiff's claims were administratively denied, prompting her to request a hearing before an Administrative Law Judge (ALJ). On October 30, 2017, Plaintiff testified at a hearing before ALJ Michael Comisky, in Topeka, Kansas. (R. at 27.) Vocational expert Douglas C. Lindahl, appearing by telephone, also testified at the hearing. (R. at 44.) On January 4, 2018, the ALJ issued a written decision unfavorable to Plaintiff. (R. at 15-22.) Plaintiff's appeal of the ALJ ruling was denied by the Appeals Council, making the ALJ's ruling the Commissioner's final decision. (R. at 1.)

         At step one, the ALJ found Plaintiff had not been engaged in substantial gainful activity since the alleged onset date of April 5, 2013. (R. at 17.) At step two, the ALJ found Plaintiff has the following severe impairments: spine disorder, fractures, and some apparent alcohol abuse. (Id.) At step three, the ALJ found Plaintiff did not have an impairment or combination of impairments that meets or medically equals the severity of a listed impairment. (R. at 18.)

         The ALJ determined that Plaintiff has the RFC to perform light work as defined in 20 C.F.R. § 404.1567(b). He found she can carry 20 pounds occasionally and 10 pounds frequently; can stand or walk for 6 hours in an 8-hour workday; can push and pull within the limits for lifting and carrying; can frequently climb ramps and stairs and occasionally climb ladders, ropes, or scaffolds; and can balance frequently as well as stoop, kneel, and crouch. (R. at 18.) In making these findings, the ALJ acknowledged that Plaintiff has significant physical problems, having had a motorcycle accident in August 2011 in which she suffered numerous fractures, including an ankle, left lower ribs, and a burst fracture in her lumbar spine. (R. at 18.) Plaintiff's extensive follow-up treatment included surgery in September of 2011 to stabilize her spine with placement of screws and rods involving the T9-10, T12, and L12 vertebrae. (R. at 506.) The ALJ noted Plaintiff complained of continued back pain through 2014 and 2015 and was diagnosed with degenerative joint disease, thoracic spinal stenosis, thoracic radiculopathy, and thoracic post-laminectomy, and was subsequently prescribed medications, epidural injections, and physical therapy to manage pain. Although treatment provided some relief, Plaintiff reported chronic pain and physical restriction due to back pain, and her condition was exacerbated in March 2015 when she had another motorcycle accident. (R. at 18.)

         In formulating the RFC, the ALJ considered the opinion of John May, M.D., a consulting physician who reviewed records and opined in April 2016 that although Plaintiff had some limitations and deficits in lifting and carrying, she could perform a range of work in the light exertional category. (R. at 19.) The ALJ also considered the opinion of Dawood Sayed, M.D., Plaintiff's treating physician, who opined that Plaintiff's thoracic pain was severely limiting and made it difficult for Plaintiff to stand, walk, lift, or bend, such that she had too much pain and fatigue to work. (Id.) The ALJ gave greater weight to Dr. May's opinion, saying he “cited more evidence in his evaluation and provided a rationale based upon this evidence to support his finding.” (Id.) The ALJ found that Dr. Sayed provided little support for his findings, relied heavily on Plaintiff's subjective complaints of pain, and did not consider the improvement Plaintiff received from treatment. The ALJ further discussed Plaintiff's subjective complaints as follows:

The undersigned also finds it counterintuitive for the claimant to become pregnant in 2016 when she reportedly had debilitating by [sic] pain, including debilitating back pain. The claimant, however, did become pregnant and birthed a baby girl in November 2016. * * * Since the birth, the claimant has continued to complain of fatigue and thoracic pain …, but the claimant having child [sic] raises questions about the degree of pain and limitation she was actually experiencing over the years.
The claimant, as discussed, indicates that she is struggling with pain. She also testified that she needs a sit/stand option and that she can do little physically because of her condition. The claimant, at the hearing, however, did not need to stand, although the undersigned gave her that option. She also did not squirm in her chair or appear uncomfortable while sitting. Additionally, the claimant lifted her 11-month-old child during the hearing to change her diapers. The claimant had no difficulty do [sic] this despite the fact that her child clearly weighed well over 10 pounds. The claimant also testified at the hearing that she does most of the cooking in the house as well as most of the lifting. She also takes care of newborn baby [sic], which is a significant chore.

(R. at 19-20.) The ALJ further found Plaintiff had “downplayed” her second motorcycle accident, which was “more serious” than she indicated and which occurred after the alleged onset date, and said “driving around on a motorcycle appears incongruent with her complains [sic] of debilitating pain and disability during this period.” (R. at 20.) The ALJ said treatment and medication have helped Plaintiff and “the claimant's pregnancy; the current raising of her newborn; and her activities of daily living show her to be more capable than she now alleges.” (Id.) The ALJ said he considered all the evidence but placed “special emphasis” on Dr. May's opinion, the motorcycle crash ...

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