Guzman v. Kijakazi
| Decision Date | 22 December 2021 |
| Docket Number | 1:20-cv-0514 JLT |
| Court | U.S. District Court — Eastern District of California |
| Parties | MONICA TABAREZ GUZMAN, Plaintiff, v. KILOLO KIJAKAZI, [1] Acting Commissioner of Social Security, Defendant. |
ORDER GRANTING PLAINTIFF'S REQUEST FOR JUDICIAL REVIEW (DOC. 20) AND REMANDING THE ACTION PURSUANT TO SENTENCE FOUR OF 42 U.S.C. § 405(g)
ORDER DIRECTING ENTRY OF JUDGMENT IN FAVOR OF MONICA TABAREZ GUZMAN, AND AGAINST DEFENDANT KILOLO KIJAKAZI, ACTING COMMISSIONER OF SOCIAL SECURITY
Monica Tabarez Guzman asserts she is entitled to disability benefits, a period of disability, and supplemental security income under Titles II and XVI of the Social Security Act. Plaintiff argues the administrative law judge and Appeals Council erred in evaluating the record. (See generally Doc. 20.) For the reasons set forth below, the matter is REMANDED for further proceedings pursuant to sentence four of 42 U.S.C. § 405(g).
In February 2017, Plaintiff applied for benefits, alleging she came disabled in March 2015 due to depression, a mass on her right kidney, left kidney removal due to cancer, arthritis right shoulder pain with inflammation, and right knee inflammation. (Doc. 12-1 at 133-134.) The Social Security Administration denied the applications at the initial level and upon reconsideration. (See generally Id. at 126-186.) Plaintiff requested a hearing and testified before an ALJ on March 5, 2019. (Id. at 74, 92.) The ALJ found Plaintiff was not disabled and issued an order denying benefits on March 29, 2019. (Id. at 74-83.) Plaintiff requested review by the Appeals Council, which denied the request on February 7, 2020. (Id. at 6-9.) Thus, the ALJ's determination became the final decision of the Commissioner of Social Security.
District courts have a limited scope of judicial review for disability claims after a decision by the Commissioner to deny benefits under the Social Security Act. When reviewing findings of fact, such as whether a claimant was disabled, the Court must determine whether the Commissioner's decision is supported by substantial evidence or is based on legal error. 42 U.S.C. § 405(g). The ALJ's determination that the claimant is not disabled must be upheld by the Court if the proper legal standards were applied and the findings are supported by substantial evidence. See Sanchez v. Sec'y of Health & Human Serv., 812 F.2d 509, 510 (9th Cir. 1987).
Substantial evidence is Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting Consol. Edison Co. v. NLRB, 305 U.S. 197 (1938)). The record as a whole must be considered, because “[t]he court must consider both evidence that supports and evidence that detracts from the ALJ's conclusion.” Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985).
To qualify for benefits under the Social Security Act, Plaintiff must establish she is unable to engage in substantial gainful activity due to a medically determinable physical or mental impairment that has lasted or can be expected to last for a continuous period of not less than 12 months. 42 U.S.C. § 1382c(a)(3)(A). An individual shall be considered to have 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, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work.
42 U.S.C. § 1382c(a)(3)(B). The burden of proof is on a claimant to establish disability. Terry v. Sullivan, 903 F.2d 1273, 1275 (9th Cir. 1990). If a claimant establishes a prima facie case of disability, the burden shifts to the Commissioner to prove the claimant is able to engage in other substantial gainful employment. Maounis v. Heckler, 738 F.2d 1032, 1034 (9th Cir. 1984).
To achieve uniform decisions, the Commissioner established a sequential five-step process for evaluating a claimant's alleged disability. 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4). The process requires the ALJ to determine whether Plaintiff (1) is engaged substantial gainful activity, (2) had medically determinable severe impairments (3) that met or equaled one of the listed impairments set forth in 20 C.F.R. § 404, Subpart P, Appendix 1; and whether Plaintiff (4) had the residual functional capacity to perform to past relevant work or (5) the ability to perform other work existing in significant numbers at the state and national level. Id. The ALJ must consider testimonial and objective medical evidence. 20 C.F.R. §§ 404.1527, 416.927.
Pursuant to the five-step process, the ALJ determined Plaintiff did not engage in substantial gainful activity after the alleged onset date of March 31, 2015. (Doc. 12-1 at 76.) Second, the ALJ found Plaintiff had “disorder of [the] urinary tract, unspecified arthropathies, rotator cuff injury and rotator cuff tear, right knee arthritis, obesity chronic kidney disease stage two-status post left nephrectomy in 2011, renal neoplasm, carpel tunnel syndrome of the right upper extremity (CTS of RUE) and gastritis.” (Id. at 77-78.) At step three, the ALJ determined Plaintiff's impairments did not meet or medically equal a Listing. (Id. at 24-25.) Next, the ALJ found:
[T]he claimant has the residual functional capacity to perform light work as defined in 20 CFR 404.1567(b) and 416.967(b) except no operation of foot controls with the right lower extremity and the claimant can occasionally push and pull with the right upper extremity. The claimant can occasionally stoop, balance, knee, crawl, climb ramps or stairs-yet never crouch, or climb ladders, ropes or scaffolds. The claimant is excluded from reaching overhead with the right upper extremity and is limited to simple routine tasks and simple decision making.
(Id. at 78, emphasis omitted.) With this residual functional capacity, the ALJ determined at step four that Plaintiff was “unable to perform any past relevant work.” (Id. at 81.) However, ALJ found “there are jobs that exist in significant numbers in the national economy that the claimant can perform.” (Id. at 82-83.) Therefore, the ALJ concluded Plaintiff was not disabled as defined by the Social Security Act from March 31, 2015, through the date of the decision. (Id.)
Plaintiff argues the ALJ in finding her depression was not a severe impairment at step two, and new evidence submitted to the Appeals Council concerning her mental impairments would change the outcome of the decision. (Doc. 20 at 23-30.) In addition, Plaintiff contends the ALJ erred in evaluating her subjective complaints and the medical record, which resulted in the residual functional capacity lacking the support of substantial evidence. (Id. at 30-39.) Finally Plaintiff asserts the ALJ did not resolve a conflict between the Dictionary of Occupational Titles and testimony from the vocational expert. (Id.) On the other hand, the Commissioner argues the Court should affirm the “decision because the ALJ's findings are supported by substantial evidence and free from reversible legal error.” (Doc. 22 at 14.)
As an initial matter, in arguing that the ALJ erred at step two, Plaintiff asserts “new and material evidence submitted to the Appeals Council … would change the outcome of the decision.” (Doc. 20 at 28, emphasis omitted.) According to Plaintiff, the Appeals Council “improperly failed to consider the ‘New and Material Evidence' because it was dated after the ALJ decision.” (Id. at 28.) However, Plaintiff does not specifically address the findings of the Appeals Council related to the additional evidence, the Appeals Council did not exhibit. (See Id. at 28-29; see also Doc. 12-2 at 6-9, 11.)
The Regulations govern when Appeals Council is obligated to review additional evidence submitted after the ALJ issues a decision. See 20 C.F.R. §§ 404.970, 416.1570 (effective January 17, 2017). The Regulations indicate the Appeals Council “will review a case if ... the Appeals Council receives additional evidence that is new, material, and relates to the period on or before the date of the hearing decision, and there is a reasonable probability that the additional evidence would change the outcome of the decision.” 20 C.F.R. §§ 404.970(a)(5), 416.1470(a)(5). Evidence is new if it is not duplicative or cumulative. Meyer v. Astrue, 662 F.3d 700, 704-05 (4th Cir. 2011). In addition, evidence can be deemed new if it was not available when the ALJ made issued the decision. Threet v. Barnhart, 353 F.3d 1185, 1191 (10th Cir. 2003).
The Ninth Circuit distinguished between evidence the Appeals Council “considered” and evidence the Appeals Council merely “looked at” to determine whether the additional evidence was incorporated into the record. The Court explained that evidence the Appeals Council considered becomes part of the administrative record as “evidence upon which the findings and decision complained of are based.” Brewes v. Comm'r of Soc. Sec. Admin., 682 F.3d 1157, 1162 (9th Cir. 2012). In contrast, where “the Appeals Council only looked at the evidence... the new evidence did not become part of the record.” Amor v. Berryhill 743 Fed.Appx. 145, 146 (9th Cir. 2018) (emphasis added); see also De Orozco v. Comm'r of Soc. Sec., 2019 WL 2641490 at *11 (E.D. Cal. June 26, 2019)...
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