United States District Court, W.D. Kentucky, Louisville
JAMES D. MOYER, Magistrate Judge.
The plaintiff, Jody L. Macias, filed this action pursuant to 42 U.S.C. §405(g), seeking judicial review of an administrative decision of the Commissioner of Social Security, who denied his application for disability insurance benefits. At issue is whether the administrative law judge erred by failing to properly evaluate the evidence regarding Mr. Macias's physical residual functional capacity. Mr. Macias asserts that the ALJ erred by not give controlling weight to the opinion of Mr. Macias's treating physician and did not give sufficient weight to Mr. Macias's subjective complaints.
After reviewing the parties' fact and law summaries and the administrative record, the court concludes that the ALJ erred and that this opinion should be reversed and remanded for further proceedings.
Mr. Macias is a veteran of the Iraq War, who was severely injured in September 2004, when an improvised explosive device detonated near him, fracturing his ankle so badly it needed surgical repair, removing a large portion of one of his calves, sending shrapnel into his back, neck, face and lower legs, and perforating his left eardrum. That explosion (and the injuries it caused), along with other aspects of his combat experience, also caused him to suffer from depression and post-traumatic stress disorder. Nevertheless, he attempted to work for several years and was largely successful until 2011. In the latter part of that year, he quit working due to his back pain and inability to deal well with routine workplace stressors.
Mr. Macias filed an application for disability insurance benefits in September 2011 and alleged he became disabled in October 2004. After his application was denied by the state agency, he requested a hearing with an administrative law judge (an "ALJ"). Following the evidentiary hearing,  at which Mr. Macias and a vocational expert testified, the ALJ issued an opinion in which she determined that Mr. Macias suffers from the severe impairments of "history of right ankle fracture status post shrapnel wounds to legs with associated nerve damages, degenerative disc disease of the lumbar spine, post-traumatic stress disorder (PTSD), and depression, " none of which, either singly or in combination, meet or equal the criteria of any of the impairments listed at 20 C.F.R. Part 404, Subpart P, App. 1.
The ALJ further determined that Mr. Macias retains the residual functional capacity to perform sedentary work with a sit/stand option, and permissible use of a cane, plus other limitations necessary to accommodate his physical and mental impairments. The ALJ based these conclusions on his review of Mr. Macias's treatment records; the opinion evidence from treating sources, consultative examiners, and record-reviewing consultants; and Mr. Macias's reported symptoms and activities. In so doing, the ALJ gave only little weight to the opinion of Mr. Macias's treating physician, who recommended that Mr. Macias be limited to four-hour work days, and opined that back pain would likely cause Mr. Macias to be absent from work two days each month. The ALJ deemed this inconsistent with Mr. Macias's reported activities of riding motorcycles, skydiving, and caring for his mother. He also discounted the credibility of Mr. Macias's complaints of back pain for the same reasons, but included additional supporting facts gleaned from Mr. Macias's medical treatment records.
Based on the ALJ's assessment of Mr. Macias's residual functional capacity, the vocational expert testified that Mr. Macias is not capable of returning to his past relevant work, but can perform certain jobs that exist in the national economy. The vocational expert also testified, however, that no jobs would be available if Dr. Cavanaugh's recommendations were adopted. Mr. Macias asks that this court set aside the Commissioner's decision and, based on the existing evidence in the record, remand this matter, preferably with instructions that Mr. Macias be awarded benefits, but at least for a de novo review.
This court must affirm the conclusions of the Commissioner of Social Security unless the administrative law judge failed to apply the correct legal standards or made findings of fact unsupported by substantial evidence in the record. 42 U.S.C. §405(g). "Substantial evidence" as "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion, " and the reviewing court must affirm if substantial evidence exists, even if it would have reached a different conclusion. Jordan v. Comm'r of Soc. Sec., 548 F.3d 417, 422 (6th Cir. 2008)(citing Richardson v. Perales, 402 U.S. 389, 401 (1971)). That being said, the concept of "substantial evidence" cannot be satisfied by a highly selective reading of the administrative record, it must be supported by the record "taken as a whole." Garner v. Heckler, 745 F.2d 383, 387 (6th Cir. 1984). "Substantial evidence is not simply some evidence, or even a great deal of evidence. Rather, the substantiality of evidence must take into account whatever in the record fairly detracts from its weight." Id. at 388 (internal quotes and citations omitted).
With respect to the correct legal standards, administrative law judges must perform a five-step analysis to determine whether a claimant is disabled within the meaning of the Social Security Act:
1. If the claimant is engaged in substantial gainful activity, he is not disabled.
2. If the claimant is not engaged in substantial gainful activity, but his impairment is not "severe, " he is not disabled.
3. If the claimant is not engaged in substantial gainful activity and is suffering from a "severe" impairment that has lasted or is expected to last for a continuous period of at least twelve months, and his impairment meets or equals a listed ...