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Quintana v. Appeals Council Office of Disability Adjudication

United States District Court, S.D. California

February 24, 2017

KRISTIN J. QUINTANA, on behalf of herself, Plaintiff,
v.
APPEALS COUNCIL OFFICE OF DISABILITY ADJUDICATION, Defendant.

          ORDER GRANTING PLAINTIFF'S MOTION FOR SUMMARY JUDGMENT, DENYING DEFENDANT'S CROSS-MOTION FOR SUMMARY JUDGMENT, REMANDING FOR FURTHER PROCEEDINGS [DOC. NOS. 21, 23]

          Hon. Marilyn L. Huff United States District Judge

         On May 29, 2015, Kristin Quintana (“Plaintiff”), proceeding pro se, filed a complaint pursuant to 42 U.S.C § 405(g) requesting judicial review of the Appeals Council Office of Disability Adjudication's (“Defendant”) final decision denying her disability benefits. (Doc. No. 1.) Defendant filed the administrative record on July 11, 2016, (Doc. No. 16), and filed the operative amended answer on July 13, 2016, (Doc. No. 18). On August 30, 2016, Plaintiff filed a motion for summary judgment, requesting the Court reverse Defendant's final decision and order the payment of benefits, or alternatively, remand for further proceedings. (Doc. No. 21.) On September 23, 2016, Defendant filed a cross-motion for summary judgment and opposition to Plaintiff's motion, requesting the Court affirm the Commissioner's final decision. (Doc. Nos. 23, 24.) On November 11, 2016, Plaintiff filed a response in opposition to the cross-motion. (Doc. No. 34.) On November 15, 2016, Defendant filed a reply. (Doc. No. 36.) On November 17, 2016, Plaintiff filed a request to amend her opposition. (Doc. No. 38.) The Court granted the motion, (Doc. No. 39), and Plaintiff filed her amended brief on January 13, 2017, (Doc. No. 49). Defendant filed a reply on January 25, 2017. (Doc. No. 51.) For the reasons below, the Court grants Plaintiff's motion for summary judgment, denies Defendant's cross-motion for summary judgment, and remands to the ALJ for further proceedings.

         BACKGROUND

         On June 2, 2011, Plaintiff applied for disability insurance benefits, as well as supplemental security income benefits, claiming she became disabled on June 15, 2009. (AR177-91) (but see AR185) (SSI application stating onset date of June 1, 2009). The Social Security Administration initially denied Plaintiff's application on August 29, 2011, and again upon reconsideration on May 31, 2012. (AR92-99.) Plaintiff then requested a hearing before an ALJ. (AR100-06.)

         On July 30, 2013, an ALJ held a video hearing where Plaintiff appeared with counsel and testified. (AR60-77.) At the hearing, the ALJ also heard telephonic testimony from a vocational expert. (AR73-76.) In a decision dated August 26, 2013, the ALJ found that Plaintiff did not have an impairment or combination of impairments that equaled the severity of one of the listed impairments in 20 C.F.R. Part 404. (AR39-47.) In light of the lack of severity of her impairments, the ALJ found Plaintiff had the residual functional capacity (“RFC”) to perform a full range of sedentary work. (AR42.) Although Plaintiff could not perform past relevant work, (AR46), the ALJ determined that Plaintiff was not disabled pursuant to Medical-Vocational Rule 201.28, (AR46-47).

         On October 11, 2013, Plaintiff requested review of the ALJ's decision by the Appeals Council. (AR34.) Upon requesting review by the Appeals Council, Plaintiff also submitted additional medical records by Dr. Kotha, Dr. McSweeney, and Nurse Practitioner Lapadat. (AR5, 998-1074.) The Appeals Council included this additional evidence in the record. (AR5.) On April 1, 2015, the Appeals Council denied Plaintiff's request for review, rendering the ALJ's decision final. (AR1-5.)

         DISCUSSION

         I. The Legal Standard for Determining Disability

         “A claimant is disabled under Title II of the Social Security Act if [s]he is unable ‘to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or . . . can be expected to last for a continuous period of not less than 12 months.'” Parra v. Astrue, 481 F.3d 742, 746 (9th Cir. 2007) (quoting 42 U.S.C. § 423(d)(1)(A)). “To determine whether a claimant meets this definition, the ALJ conducts a five-step sequential evaluation.” Id.; see 20 C.F.R. §§ 404.1520, 416.920. The Ninth Circuit has summarized this process as follows:

The burden of proof is on the claimant as to steps one to four. As to step five, the burden shifts to the Commissioner. If a claimant is found to be “disabled” or “not disabled” at any step in the sequence, there is no need to consider subsequent steps. The five steps are:
Step 1. Is the claimant presently working in a substantially gainful activity? If so, then the claimant is “not disabled” within the meaning of the Social Security Act and is not entitled to disability insurance benefits. If the claimant is not working in a substantially gainful activity, then the claimant's case cannot be resolved at step one and the evaluation proceeds to step two.
Step 2. Is the claimant's impairment severe? If not, then the claimant is “not disabled” and is not entitled to disability insurance benefits. If the claimant's impairment is severe, then the claimant's case cannot be resolved at step two and the evaluation proceeds to step three.
Step 3. Does the impairment “meet or equal” one of a list of specific impairments described in the regulations? If so, the claimant is “disabled” and therefore entitled to disability insurance benefits. If the claimant's impairment neither meets nor equals one of the impairments listed in the regulations, then the claimant's case cannot be resolved at step three and the evaluation proceeds to step four.
Step 4. Is the claimant able to do any work that he or she has done in the past? If so, then the claimant is “not disabled” and is not entitled to disability insurance benefits. If the claimant cannot do any work he or she did in the past, then the claimant's case cannot be resolved at step four and the evaluation proceeds to the fifth and final step.[1]
Step 5. Is the claimant able to do any other work? If not, then the claimant is “disabled” and therefore entitled to disability insurance benefits. If the claimant is able to do other work, then the Commissioner must establish that there are a significant number of jobs in the national economy that claimant can do. There are two ways for the Commissioner to meet the burden of showing that there is other work in “significant numbers” in the national economy that claimant can do: (1) by the testimony of a vocational expert, or (2) by reference to the Medical-Vocational Guidelines. If the Commissioner meets this burden, the claimant is “not disabled” and therefore not ...

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