Otto v. Astrue
Filing
23
MEMORANDUM DECISION and ORDER. The court concludes that the ALJ erred in his evaluation of certain medical opinion evidence, as indicated above. Accordingly, IT IS HEREBY ORDERED that the Commissioners decision in this case is REVERSED AND REMANDED. Signed by Magistrate Judge Paul M. Warner on 09/27/2013. (tls)
IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF UTAH
CENTRAL DIVISION
TAMMY A. OTTO,
MEMORANDUM DECISION
AND ORDER
Plaintiff,
v.
Case No. 2:12-cv-754-PMW
CAROLYN W. COLVIN,1
Acting Commissioner of Social Security,
Defendant.
Magistrate Judge Paul M. Warner
Before the court is Tammy A. Otto’s (“Plaintiff”) appeal of the Commissioner’s final
decision denying Plaintiff’s claims for Disability Insurance Benefits (“DIB”) under Title II of the
Social Security Act, see 42 U.S.C. §§ 401-434, and Supplemental Security Income (“SSI”) under
Title XVI of the Social Security Act, see id. §§ 1381-1383f. After careful consideration of the
written briefs and the complete record, the court has determined that oral argument is
unnecessary in this case.
1
On February 14, 2013, Carolyn W. Colvin (“Commissioner”) became the Acting
Commissioner of Social Security. Accordingly, she has been automatically substituted for
Michael J. Astrue as the defendant in this action. See 42 U.S.C. § 405(g) (“Any action instituted
in accordance with this subsection shall survive notwithstanding any change in the person
occupying the office of Commissioner of Social Security or any vacancy in such office.”); Fed.
R. Civ. P. 25(d) (“An action does not abate when a public officer who is a party in an official
capacity dies, resigns, or otherwise ceases to hold office while the action is pending. The
officer’s successor is automatically substituted as a party.”).
BACKGROUND
Plaintiff alleges disability due to various physical and mental impairments. On June 1,
2009, applied for DIB and SSI, alleging disability beginning on May 30, 2009.2 Plaintiff’s
applications were denied initially and upon reconsideration.3 On February 25, 2010, Plaintiff
requested a hearing before an Administrative Law Judge (“ALJ”),4 and that hearing was held on
March 30, 2011.5 On April 28, 2011, the ALJ issued a written decision denying Plaintiff’s
claims for DIB and SSI.6 On June 26, 2012, the Appeals Council denied Plaintiff’s request for
review,7 making the ALJ’s decision the Commissioner’s final decision for purposes of judicial
review. See 42 U.S.C. §§ 405(g), 1383(c)(3); 20 C.F.R. §§ 404.981, 416.1481.
On August 1, 2012, Plaintiff filed her complaint in this case, which was assigned
preliminarily to Magistrate Judge Paul M. Warner.8 The Commissioner filed her answer on
October 9, 2012,9 and the court received the Administrative Record the same day.10
2
See docket no. 9, Administrative Record (“Tr.
3
See Tr. 106-109.
4
See Tr. 133-134.
5
See Tr. 31-105.
6
See Tr. 8-30.
7
See Tr. 1-4.
8
See docket no. 3.
9
See docket no. 7.
10
See docket no. 9.
2
”) 202-212.
On October 15, 2012, both parties consented to having a United States Magistrate Judge
conduct all proceedings in the case, including entry of final judgment, with appeal to the United
States Court of Appeals for the Tenth Circuit.11 Consequently, the case was assigned
permanently to Magistrate Judge Warner pursuant to 28 U.S.C. § 636(c) and rule 73 of the
Federal Rules of Civil Procedure.12
Plaintiff filed his opening brief on November 19, 2012.13 The Commissioner filed her
answer brief on December 17, 2012.14 Plaintiff filed his reply brief on January 4, 2013.15
STANDARD OF REVIEW
This court “review[s] the Commissioner’s decision to determine whether the factual
findings are supported by substantial evidence in the record and whether the correct legal
standards were applied.” Lax v. Astrue, 489 F.3d 1080, 1084 (10th Cir. 2007) (quotations and
citation omitted). The Commissioner’s findings, “if supported by substantial evidence, shall be
conclusive.” 42 U.S.C. § 405(g). “Substantial evidence is such relevant evidence as a
reasonable mind might accept as adequate to support a conclusion. It requires more than a
scintilla, but less than a preponderance.” Lax, 489 F.3d at 1084 (quotations and citation
omitted). “In reviewing the ALJ’s decision, [this court may] neither reweigh the evidence nor
11
See docket no. 15.
12
See id.
13
See docket no. 17.
14
See docket no. 18.
15
See docket no. 19.
3
substitute [its] judgment for that of the [ALJ].” Madrid v. Barnhart, 447 F.3d 788, 790 (10th
Cir. 2006) (quotations and citation omitted). “The failure to apply the correct legal standard or to
provide this court with a sufficient basis to determine that appropriate legal principles have been
followed [are] grounds for reversal.” Jensen v. Barnhart, 436 F.3d 1163, 1165 (10th Cir. 2005)
(quotations and citation omitted).
A five-step evaluation process has been established for determining whether a claimant is
disabled. See 20 C.F.R. §§ 404.1520(a)(4)(i)-(v), 416.920(a)(4)(i)-(v); see also Williams v.
Bowen, 844 F.2d 748, 750-51 (10th Cir. 1988) (discussing the five-step process). If a
determination can be made at any one of the steps that a claimant is or is not disabled, the
subsequent steps need not be analyzed. See 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4).
Step one determines whether the claimant is presently
engaged in substantial gainful activity. If [the claimant] is,
disability benefits are denied. If [the claimant] is not, the decision
maker must proceed to step two: determining whether the claimant
has a medically severe impairment or combination of
impairments. . . . If the claimant is unable to show that his
impairments would have more than a minimal effect on his ability
to do basic work activities, he is not eligible for disability benefits.
If, on the other hand, the claimant presents medical evidence and
makes the de minimis showing of medical severity, the decision
maker proceeds to step three.
Williams, 844 F.2d at 750-51 (quotations and citations omitted); see 20 C.F.R.
§§ 404.1520(a)(4)(i)-(ii), 416.920(a)(4)(i)-(ii).
“Step three determines whether the impairment is equivalent to one of a number of listed
impairments that . . . are so severe as to preclude substantial gainful activity . . . . If the
impairment is listed and thus conclusively presumed to be disabling, the claimant is entitled to
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benefits. If not, the evaluation proceeds to the fourth step . . . .” Williams, 844 F.2d at 751
(quotations and citations omitted); see 20 C.F.R. §§ 404.1520(a)(4)(iii), 416.920(a)(4)(iii). At
the fourth step, the claimant must show that the impairment prevents performance of his “past
relevant work.” 20 C.F.R. §§ 404.1520(a)(4)(iv), 416.920(a)(4)(iv). “If the claimant is able to
perform his previous work, he is not disabled.” Williams, 844 F.2d at 751. If, however, the
claimant is not able to perform his previous work, he “has met his burden of proof, establishing a
prima facie case of disability.” Id.
At this point, “[t]he evaluation process . . . proceeds to the fifth and final step.” Id. At
this step, the burden of proof shifts to the Commissioner, and the decision maker must determine
“whether the claimant has the residual functional capacity [(“RFC”)] . . . to perform other work
in the national economy in view of his age, education, and work experience.” Id.; see 20 C.F.R.
§§ 404.1520(a)(4)(v), 416.920(a)(4)(v). If it is determined that the claimant “can make an
adjustment to other work,” 20 C.F.R. §§ 404.1520(a)(4)(v), 416.920(a)(4)(v), he is not disabled.
If, on the other hand, it is determined that the claimant “cannot make an adjustment to other
work,” 20 C.F.R. §§ 404.1520(a)(4)(v), 416.920(a)(4)(v), he is disabled and entitled to benefits.
ANALYSIS
In support of her claim that the Commissioner’s decision should be reversed, Plaintiff
presents several arguments. One of those arguments is dispositive of Plaintiff’s appeal because it
mandates reversal. Accordingly, the court will address only that argument here and “will not
reach the remaining issues raised by [Plaintiff] because they may be affected by the ALJ’s
treatment of this case on remand.” Watkins v. Barnhart, 350 F.3d 1297, 1299 (10th Cir. 2003);
5
see also Gilbert v. Astrue, 231 Fed. App’x 778, 785 (10th Cir. 2007) (“In light of the remand of
this case, we do not reach the remainder of [the plaintiff’s] claims on appeal . . . .”).
Plaintiff argues that the ALJ erred in evaluating the medical opinion evidence from
several of Plaintiff’s providers. Plaintiff presents arguments for each provider. The court
concludes that Plaintiff’s common argument concerning three of those providers is dispositive of
this appeal. In that common argument, Plaintiff contends that the ALJ erred by failing to provide
any discussion of the weight he assigned to the opinions of Nancy Mathis, N.P. (“Ms. Mathis”);
Dr. Elizabeth Allen (“Dr. Allen”); and Dr. A.L. Carlisle (“Dr. Carlisle”).
Under the relevant regulations, an ALJ is required to consider certain factors when
determining the weight to be assigned to a medical opinion. See 20 C.F.R. §§ 404.1527(c),
416.927(c). Further, Social Security Ruling (“SSR”) 06-03p provides that an ALJ must consider
all relevant evidence in the case record when determining whether a claimant is disabled. See
SSR 06-03p; see also 20 C.F.R. §§ 404.1527(b); 416.927(b). That includes evidence from “other
sources,” like Ms. Mathis, who is a nurse practitioner. See SSR 06-03p. An ALJ
generally should explain the weight given to opinions from these
“other sources,” or otherwise ensure that the discussion of the
evidence in the determination or decision allows a claimant or
subsequent reviewer to follow the adjudicator’s reasoning, when
such opinions may have an effect on the outcome of the case.
Id.
6
With those concepts in mind, the court first addresses the opinions of Ms. Mathis. In this
case, the ALJ failed to provide any explanation about the weight he assigned to the opinions of
Ms. Mathis. The court concludes that the ALJ erred in that respect.
The court now turns to the opinions of Dr. Allen and Dr. Carlisle. The ALJ likewise
failed to include any explanation about the weight he assigned to the opinions from those two
providers. The Commissioner argues that the ALJ was not required to provide any such
explanation because the opinions of Dr. Allen and Dr. Carlisle do not qualify as medical
opinions. See 20 C.F.R. §§ 404.1527(a)(2); 416.927(a)(2) (providing that medical opinions
reflect judgments about the nature and severity of the claimant’s impairments, including
symptoms, diagnosis and prognosis, what the claimant can do despite his or her impairments, and
the claimant’s physical or mental restrictions). That argument fails. The court has reviewed the
opinions of Dr. Allen and Dr. Carlisle contained in the record and concludes that they do indeed
qualify as medical opinions under the relevant regulations. As such, the ALJ was required to
provide an explanation about the weight he assigned to those opinions. This is particularly true
given that the ALJ discussed those opinions in portions of his decision. For these reasons, the
court concludes that the ALJ erred in his treatment of the opinions of Dr. Allen and Dr. Carlisle.
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CONCLUSION AND ORDER
The court concludes that the ALJ erred in his evaluation of certain medical opinion
evidence, as indicated above. Accordingly, IT IS HEREBY ORDERED that the
Commissioner’s decision in this case is REVERSED AND REMANDED.
IT IS SO ORDERED.
DATED this 27th day of September, 2013.
BY THE COURT:
PAUL M. WARNER
United States Magistrate Judge
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