Garcia v. Kijakazi
| Decision Date | 14 December 2021 |
| Docket Number | CV 21-176 MV/CG |
| Parties | JOHN LUIS GARCIA, Plaintiff, v. KILOLO KIJAKAZI, [1]Commissioner of the Social Security Administration, Defendant. |
| Court | U.S. District Court — District of New Mexico |
THIS MATTER is before the Court on Plaintiff John Luis Garcia's Motion to Reverse and Remand for a Rehearing or in the Alternative for the Immediate Payment of Benefits with Supporting Memorandum (the “Motion”) (Doc. 20), filed September 17, 2021; Defendant Commissioner Kilolo Kijakazi's Brief in Response to Plaintiff's Motion to Reverse and Remand the Agency's Administrative Decision (the “Response”) (Doc. 22), filed November 10, 2021; and Mr. Garcia's Reply in Support of Plaintiff's Motion to Reverse and Remand for a Rehearing (the “Reply”), (Doc 23), filed November 22, 2021.
In his Motion, Mr. Garcia asks the Court to reverse the Commissioner's decision denying Social Security benefits for the period prior to November 10, 2016, and to remand this case with instructions to award immediate retroactive benefits. (Doc. 20 at 26). The parties disagree only about whether the Administrative Law Judge (“ALJ”), who found Mr. Garcia disabled as of the established disability onset date of November 10, 2016 (the “established onset date”), reasonably concluded that Mr. Garcia was not disabled between that date and Mr. Garcia's alleged onset date of July 7, 2012. (Doc. 20 at 2-3); (Doc. 22 at 9); see also (Administrative Record “AR” 1177).
On March 8, 2021, United States District Judge Martha Vazquez referred this matter to the undersigned to review the decision of ALJ Jennifer Fellabaum, conduct legal analysis, and recommend an ultimate disposition, pursuant to 28 U.S.C. § 636(b). (Doc. 9). The Court has reviewed the Motion, the Response, the Reply, and the relevant law. Additionally, the Court has meticulously reviewed the administrative record. Because the Court finds that ALJ Fellabaum erred in her failure to consider the opinion of examining physician John Vigil, M.D., with regard to Mr. Garcia's ability to work prior to 2016, the Court RECOMMENDS Mr. Garcia's Motion be GRANTED, his request for an immediate payment of benefits be DENIED, and the case be REMANDED to the Commissioner for further proceedings consistent with this opinion.
Mr. Garcia initially applied for DIB on July 25, 2012, alleging disability beginning July 7, 2012. (AR 73). In his application, Mr. Garcia claimed he was unable to work due to two herniated discs resulting in degenerative disc disease, bulging discs, chronic pain in both knees, chronic pain in both elbows, and chronic migraines. (AR 73). Mr. Garcia subsequently filed an application for Supplemental Security Income (“SSI”) on January 13, 2017. (AR 845). This is the third time Mr. Garcia has challenged the denial of his Social Security benefits before this Court; the first case was remanded by United States Magistrate Judge Kirtan Khalsa, Garcia v. Berryhill, 1:16-cv-1398 KK (D.N.M. February 27, 2018) (Doc. 25), and the second case an unopposed remand by United States Magistrate Judge John F. Robbenhaar, Garcia v. Saul, 1:19-cv-577 JFR (D.N.M. April 2, 2020) (Doc. 27).
Mr. Garcia's application was denied initially on October 9, 2012, and upon reconsideration on June 25, 2013. (AR 72, 83). Mr. Garcia requested a hearing before an ALJ, which was held on February 13, 2015, before ALJ Michelle Lindsay. (AR 3163). At the hearing, Mr. Garcia appeared before ALJ Lindsay without counsel, along with impartial Vocational Expert (“VE”) Thomas Greiner. (AR 53). ALJ Lindsay issued an unfavorable decision on June 23, 2015, finding Mr. Garcia not disabled at any time between the alleged disability onset date and the date of her decision. (AR 15-25).
Mr. Garcia requested review of ALJ Lindsay's decision before the Appeals Council, which was denied on October 21, 2016. (AR 1). Mr. Garcia then filed an appeal with this Court, which remanded it on February 27, 2018. See Garcia v. Berryhill, 1:16-cv-1398 KK (D.N.M. February 27, 2018) (Doc. 25). On January 13, 2017, while Mr. Garcia's case was pending with this Court, he filed a second application for DIB, and an initial application for SSI. (AR 845).
At Mr. Garcia's second hearing, which was held on April 3, 2019, he appeared before ALJ Fellabaum with his attorney Michael Armstrong, and impartial VE Cornelius J. Ford. (AR 630, 1236). ALJ Fellabaum issued an unfavorable decision on April 24, 2019, finding that Mr. Garcia was not disabled at any time from July 7, 2012, the alleged onset date, through June 30, 2014, when his insured status for DIB expired.[2] (AR 1245).
Mr. Garcia then filed an appeal with this Court, which remanded it for a second time, pursuant to the Commissioner's unopposed motion for remand, on April 2, 2020. See Garcia v. Saul, 1:19-cv-577 JFR (D.N.M. April 2, 2020) (Doc. 27). The Appeals Council vacated ALJ Fellabaum's decision and remanded the case for another hearing on June 9, 2020, instructing the ALJ to, among other things, give further consideration to the opinion of Dr. Mullins, a doctor of osteopathic medicine whom ALJ Fellabaum had incorrectly identified as “not a physician.” (AR 1262).
Mr. Garcia's third hearing was held via phone due to the covid-19 pandemic, on December 3, 2020. (AR 1160). Mr. Garcia appeared before ALJ Fellabaum for a second time, with his attorney, Laura Johnson, and impartial VE Leslie White. (AR 1160). ALJ Fellabaum issued a partially unfavorable decision on January 7, 2021, finding that Mr. Garcia was not disabled at any time prior to November 10, 2016, which date is after the expiration of his DIB insured status. (AR 1177). In this decision, ALJ Fellabaum made multiple RFC assessments; the first RFC finding relates to Mr. Garcia's ability to work prior to November 10, 2016, and the second relates to his ability to work beginning on November 10, 2016. Pursuant to 20 C.F.R. § 404.984, this decision by ALJ Fellabaum is the final decision of the Commissioner.
In the instant Motion, Mr. Garcia argues ALJ Fellabaum erred in three respects:
(1) she failed to weigh the opinion of consultative examiner Dr. Vigil for the period prior to the established onset date; (2) she improperly weighed the opinion of treating physician Sharon Mullins, D.O.; and (3) her RFC assessment is not based on substantial evidence because she failed to account for Mr. Garcia's subjective allegations of pain and other symptoms. (Doc. 20 at 2, 6-25). Due to the protracted nature of Mr. Garcia's case, he also argues that the Court should remand for an immediate payment of benefits. Id. at 25-26.
The standard of review in a Social Security appeal is whether the Commissioner's final decision is supported by substantial evidence and whether the correct legal standards were applied. Maes v. Astrue, 522 F.3d 1093, 1096 (10th Cir. 2008) (citing Hamilton v. Sec'y of Health & Hum. Servs., 961 F.2d 1495, 1497-98 (10th Cir. 1992)). If substantial evidence supports the Commissioner's findings and the correct legal standards were applied, the Commissioner's decision stands and the plaintiff is not entitled to relief. See Langley v. Barnhart, 373 F.3d 1116, 1118 (10th Cir. 2004); Hamlin v. Barnhart, 365 F.3d 1208, 1214 (10th Cir. 2004); Doyal v. Barnhart, 331 F.3d 758, 760 (10th Cir. 2003). The Commissioner's “failure to apply the correct legal standards, or to show . . . that she has done so, are also grounds for reversal.” Winfrey v. Chater, 92 F.3d 1017, 1019 (10th Cir. 1996) (citing Washington v. Shalala, 37 F.3d 1437, 1439 (10th Cir. 1994)). A court should meticulously review the entire record but should neither re-weigh the evidence nor substitute its judgment for the Commissioner's. See Langley, 373 F.3d at 1118; Hamlin, 365 F.3d at 1214. A court's review is limited to the Commissioner's final decision. See 42 U.S.C. § 405(g) (2018).
Therefore, when the Appeals Council denies review, the ALJ's decision becomes the Commissioner's final decision for purposes of judicial review. Threet v. Barnhart, 353 F.3d 1185, 1187 (10th Cir. 2003) (citing O'Dell v. Shalala, 44 F.3d 855, 858 (10th Cir. 1994)).
“Substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Doyal, 331 F.3d at 760 (quoting Fowler v. Bowen, 876 F.2d 1451, 1453 (10th Cir.1989)) (internal quotation marks omitted). An ALJ's decision “is not based on substantial evidence if it is overwhelmed by other evidence in the record or if there is a mere scintilla of evidence supporting it.” Langley, 373 F.3d at 1118 (quoting Bernal v. Bowen, 851 F.2d 297, 299 (10th Cir.1988)) (internal quotation marks omitted). While the Court may not re-weigh the evidence or try the issues de novo, its examination of the record must include “anything that may undercut or detract from the ALJ's findings in order to determine if the substantiality test has been met.” Grogan v. Barnhart, 399 F.3d 1257, 1262 (10th Cir. 2005) (citing Sisco v. United States Dep't of Health and Human Servs., 10 F.3d 739, 741 (10th Cir.1993); Washington, 37 F.3d at 1439). However, “[t]he possibility of drawing two inconsistent conclusions from the evidence does not prevent [the ALJ]'s findings from being supported by substantial evidence.” Lax v. Astrue, 489 F.3d 1080, 1084 (10th Cir. 2007) (quoting Zoltanski v. F.A.A., 372 F.3d 1195, 1200 (10th Cir. 2004)) (internal quotation marks omitted).
For purposes of SSI and DIB, a claimant establishes a disability when she is unable “to engage in any substantial gainful...
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