Garcia Ocasio v. Commisioner of Social Security

Filing 12

OPINION AND ORDER re 2 Complaint against Commisioner of Social Security, filed by Antia Garcia-Ocasio. We AFFIRM IN PART the Commissioner's determination with respect to Claimant's physical impairments. We GRANT Claimant's petition and REMAND the case to Commissioner pursuant to sentence four of 42 U.S.C. § 405(g), but only with respect to Claimant's mental condition subsequent to June 17, 2003, and prior to the last insured date of December 31, 2005. Signed by Chief Judge Jose A Fuste on 11/12/09.(mrj)

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UNITED STATES DISTRICT COURT DISTRICT OF PUERTO RICO ANTIA GARCÍA-OCASIO, Claimant, v. COMMISSIONER OF SOCIAL SECURITY, Respondent. Civil No. 08-2311 (JAF)

OPINION AND ORDER Claimant, Antia García-Ocasio, petitions this court under 42 U.S.C. § 405 (g) to review the decision of Respondent, Commissioner of Social Security ("Commissioner"), denying the payment of

disability benefits to Claimant. (Docket No. 2.) Commissioner opposes the petition. (Docket No. 9.) I. Factual and Procedural Synopsis Relevant Medical Record The following facts are derived from the parties' filings (Docket Nos. 1; 2; 7; 9) and the record in this case ("R") (Docket No. 2). Claimant, a high-school graduate, was born on April 18, 1953, and worked as an office secretary. 2000. Claimant suffered from a combination of impairments, including right-arm bursitis, tendinitis, osteoarthritis, disc bulge, a She left her job on December 29,

herniated disk, lumbar muscle spasms, fibromyalgia, and a major depressive disorder. Dr. Ana H. Martínez, a rheumatologist, evaluated

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Claimant on June 18, 2003, after complaints of multiple joint pain. (R. at 56-59.) On February 6, 2004, Dr. William Matos examined Claimant after she complained about morning stiffness, as well as joint pain. (R. at 67-70.) Dr. Sánchez performed an assessment of

Claimant's physical residual functioning capacity ("RFC") in March 2004. (R. at 92-99.) Dr. Sánchez concluded that Claimant could lift

twenty-five pounds frequently and fifty pounds occasionally; stand and walk for six hours in an eight-hour workday; and sit for about six hours in an eight-hour workday. (R. at 93.) Furthermore,

Claimant could climb stairs and ramps, balance and kneel, and could occasionally stoop, crouch, or crawl. (R. at 94.) Claimant continued to see Dr. Martínez for the next several years. On August 17, 2007,

Claimant visited Dr. David A. Flores, a psychiatrist, for anxiety and depression. (R. at 120.) Claimant continued to visit Dr. Flores for Dr. Flores found Furthermore,

a total of ten times, the last on March 8, 2006.

Claimant in a state of severe depression. (R. at 127.)

he stated that Claimant had a very poor prognosis and could not return to work. (R. at 259-262.) B. Procedural Summary Claimant filed a Disability Insurance Benefits application on August 13, 2003, alleging disability beginning December 29, 2002. It was denied initially on March 16, 2004, and upon reconsideration on July 22, 2004. Afterwards, on March 27, 2006, a hearing ("ALJ hearing") was held before Administrative Law Judge ("ALJ") Gilbert Rodríguez. Claimant, who was represented by counsel, testified at

Civil No. 08-2311 (JAF) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 the hearing. (R. at 264-281.)

-3On June 28, 2006, ALJ Rodríguez issued

a decision in which he concluded that Claimant did not engage in substantial gainful activity during the period from her alleged onset date of December 29, 2002, through her date last insured of

December 31, 2005. (R. at 36.)

The ALJ concluded that Claimant was

not under a disability because she had the RFC to perform a range of medium-level work that did not require dealing with the public and avoided frequent stooping, crouching, and crawling and concentrated exposure to vibration. (R. at 31-42.) Thus, the ALJ determined Claimant could perform her past work as a secretary. The Appeals Council reviewed the ALJ's decision and remanded on the issue of the duration and severity of Claimant's depression. (R. at 16.) The ALJ held a second hearing on January 22, 2008, in which Claimant testified once again. (R. at 282-311.) In addition, Carmen

Margarita Valladares, a vocational expert, furnished testimony. In his second decision of April 25, 2008, the ALJ concluded that Claimant has not been disabled through December 31, 2005, the last day she qualified for the disability insured status. (R. at 30.) The ALJ opined that Claimant's RFC did not allow her to perform her past relevant work, but she, nevertheless, had the RFC to perform jobs that existed in significant numbers in the national economy. (R. at 30.) On September 24, 2008, the Appeals Council denied Claimant's request to review the ALJ's second decision. (R. at 4-8.) On

November 13, 2008, Claimant filed the present petition seeking review

Civil No. 08-2311 (JAF) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 of the ALJ's second decision. (Docket No. 2.)

-4Commissioner filed a Claimant has not

memorandum of law on May 14, 2009. (Docket No. 9.) replied. II. Standard of Review

Under the Social Security Act ("the Act"), an individual is disabled if she is unable to do her prior work or, "considering her age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy." 42 U.S.C. 423 (d). The Act provides that "the findings of the

Commissioner . . . as to any fact, if supported by substantial evidence, shall be conclusive." 42 U.S.C. § 405(g). Substantial evidence exists "if a reasonable mind, reviewing the evidence in the record as a whole, could accept it as adequate to support the conclusion." Irlanda-Ortíz v. Sec'y of Health & Human Servs., 955 F.2d 765, 769 (1st Cir. 1991). Commissioner's decision must be upheld if we determine that substantial evidence supports the ALJ's findings, even if we would have reached a different conclusion had we reviewed the evidence de novo. Lizotte v. Sec'y of Health & Human Servs., 654 F.2d 127, 128 (1st Cir. 1981). consider all When reviewing a denial of benefits, the ALJ must contained in the record. 20 C.F.R.

evidence

§ 404.1520(a)(3). Matters pertaining to credibility and "conflicts in the evidence . . . are for the ALJ, rather than the courts to resolve." Evangelista v. Sec'y of Health & Human Servs., 826 F.3d 31,

Civil No. 08-2311 (JAF) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 from A. Physical Impairments 35 (1st Cir. 1987).

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The ALJ may be reversed only if we find that he

arrived at the decision "by ignoring evidence, misapplying the law, or judging matters entrusted to experts." Nguyen v. Chater, 72 F.3d 31, 35 (1st Cir. 1999). is Review of to denial of Social whether Security the ALJ

disability

benefits

limited

determining

deployed the proper legal standards and found facts upon the proper quantum of evidence. III. Analysis

The record reflects that the ALJ weighed the objective findings multiple physicians and several laboratory findings of

Claimant's physical condition against the severity requirements under the Act. (R. at 23-26.) The ALJ concluded that Claimant's physical

problems did not satisfy the level of severity required under the Act. As it appears that the ALJ's evaluation of Claimant's physical

RFC took into consideration all medical evidence, we find that the ALJ's assessment of Claimant's physical impairments is supported by substantial evidence. B. Mental Impairments We similarly analyze the ALJ's method in assessing Claimant's alleged mental impairment. We consider whether the ALJ properly concluded that Claimant was not mentally disabled based on the evidence in the record. (R. at 24.) An ALJ is not qualified to assess the claimant's RFC based on bare medical findings, as such are

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unintelligible to laypersons. Berríos López v. Sec'y of Health & Human Servs., 951 F.2d 427, 430 (1st Cir. 1991). The record reveals that Dr. Flores, a psychiatrist, examined Claimant with regard to her alleged mental symptoms. (R. at 24.) Claimant saw Dr. Flores a total of seven times between August 17, 2005, and the last date she was insured, December 31, 2005. In his

findings, Dr. Flores concluded that "due to her anhedonia, poor modification and severe cognitive deterioration, [Claimant] would not be able to perform a single hour of normal uninterrupted work. She

does not persist in her goals and continues to be totally disabled to work in any type of remunerated task." (R. at 123.) Furthermore, the

vocational expert's testimony that a person under Claimant's mental condition "could not do any work in our the national economy" (R. at 310) supports this conclusion. Dr. Flores first examined Claimant on August 17, 2005, which was within the relevant disability period from December 29, 2002, to December 31, 2005. Upon examining the record, we find no evidence to

contradict Dr. Flores' psychiatric assessments. More importantly, we fail to find any other mental or psychiatric evaluations at all. In

his second opinion, the ALJ even acknowledged that Claimant "has not received any prior psychiatric treatment nor has she alleged any psychiatric symptoms prior to this date." (R. at 24.) Because

Dr. Flores' medical evaluation constitutes Claimant's sole mental evaluation in the record, this unique assessment must be taken into consideration. Indeed, Dr. Martínez, a rheumatologist, referred

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Claimant to Dr. Flores precisely because she suspected depression in Claimant. (R. at 277). Turning to the merits, while ALJ Rodríguez asserted that this particular psychiatric evaluation is "in conflict with and not well-supported in severity to the preponderance of the medical or other evidence record" (R. at 28), we believe that such judgment is erroneous. The record contains only a single instance in which a

treating medical doctor, Dr. Flores, examined Claimant for the exclusive purpose of assessing her psychiatric condition. (R. at 12023.) Without evidence to contradict Dr. Flores' findings, his

findings must not be brushed aside. The ALJ may not ignore or fabricate evidence. Therefore, we do not find substantial evidence

in the record to support the ALJ's determination that Claimant lacks a mental impairment which would severely limit her non-exertional abilities to work. The record does not reveal the exact date on which Dr. Martínez referred Claimant to Dr. Flores. Meanwhile, the record does reflect

that Dr. Flores first examined Claimant on August 17, 2005. Since Dr. Martínez examined Claimant for the first time on June 18, 2003 (R. at 56), the referral, and the onset of Claimant's alleged depression, must have taken place at some point between June 18, 2003, and August 17, 2005. For the aforementioned reasons, we find that the ALJ's mental disability determination for the period from December 29, 2002, ending December 31, 2005, lacks basis in substantial evidence. See 42

Civil No. 08-2311 (JAF) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 In view of the

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U.S.C. § 405(g). When an ALJ's evaluation falls short of evidentiary support, the standard remedy is to remand for further consideration of relevant medical records. See Seavy v. Barnhart, 276 F.3d 1, 12-13 (1st Cir. 2001) (noting that two avenues for remand exist under the fourth and sixth sentences of 42 U.S.C § 405(g)). IV. Conclusion foregoing, we hereby AFFIRM IN PART the

Commissioner's determination with respect to Claimant's physical impairments. We GRANT Claimant's petition (Docket No. 2) and REMAND

the case to Commissioner pursuant to sentence four of 42 U.S.C. § 405(g), but only with respect to Claimant's mental condition subsequent to June 17, 2003, and prior to the last insured date of December 31, 2005. IT IS SO ORDERED. San Juan, Puerto Rico, this 12th day of November, 2009. s/José Antonio Fusté JOSE ANTONIO FUSTE Chief U.S. District Judge