Sepulveda-Vega v. Commissioner of Social Security

CourtDistrict Court, D. Puerto Rico
DecidedSeptember 30, 2019
Docket3:17-cv-01835
StatusUnknown

This text of Sepulveda-Vega v. Commissioner of Social Security (Sepulveda-Vega v. Commissioner of Social Security) is published on Counsel Stack Legal Research, covering District Court, D. Puerto Rico primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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Sepulveda-Vega v. Commissioner of Social Security, (prd 2019).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF PUERTO RICO

ANGEL LUIS SEPULVEDA-VEGA,

Plaintiff,

v. CIVIL NO.: 17-1835 (MEL)

COMMISSIONER OF SOCIAL SECURITY,

Defendant.

OPINION AND ORDER Pending before the court is Angel Luis Sepulveda-Vega’s (“Plaintiff”) appeal from the decision of the Commissioner of Social Security (“the Commissioner”) denying his application for disability benefits under the Social Security Act. ECF Nos. 1, 13. Plaintiff challenges the Commissioner’s finding that he is not entitled to disability benefits following a redetermination review. Plaintiff alleges that the Administrative Law Judge (“the ALJ”) erred in his decision finding that Plaintiff was not entitled to disability benefits, and that the redetermination review violated his Fifth Amendment procedural due process rights. I. Procedural and Factual Background On June 27, 2011, Plaintiff filed an application for Social Security benefits alleging that on November 2, 2010 (“the onset date”), he became unable to work due to disability. Tr. 37.1 Plaintiff was found disabled on February 10, 2012. Id. For several years, Plaintiff received benefits under the Social Security disability insurance program. ECF No. 13, at 5-6. After an extensive fraud investigation conducted by the United States Department of Justice and the Social Security Administration’s Office of the Inspector General (“OIG”), the

1 “Tr.” refers to the transcript of the record of proceedings. Social Security Agency (“the SSA”) notified Plaintiff, on December 26, 2013, that his benefits were suspended pending a redetermination of his entitlement to them. Tr. 37. Plaintiff was provided with the opportunity to respond and he submitted additional evidence for consideration on January 28, 2014. Tr. 324, 346-48. In the redetermination review, the SSA disregarded evidence submitted by two sources, Dr. Jose R. Hernández-González

(“Dr. Hernández”) and non-attorney representative Mr. Samuel Torres-Crespo (“Mr. Torres- Crespo”), who had been criminally charged. Tr. 315-18, 574. On February 1, 2014, the SSA determined that Plaintiff was not disabled due to insufficient evidence. Tr. 319-31. On March 3, 2014, Plaintiff appealed the termination decision; the termination was affirmed. Tr. 37. Thereafter, Plaintiff requested a hearing, which was held on August 16, 2016, before Administrative Law Judge Henry Kramzyk, (“the ALJ”). Tr. 52. Plaintiff submitted 90 pages of additional evidence before his hearing. Tr. 19-30, 37, 84-114, 159-72, 187-211, 213-27, 242-52. On January 3, 2017, the ALJ issued a written decision finding that the evidence “did not

support a finding of disability on February 10, 2012.” Tr. 39. Plaintiff’s request for review was denied by the Appeals Council, rendering the ALJ’s decision the final decision of the Commissioner, subject to judicial review. ECF No. 1, at 2-3. Plaintiff filed a Complaint on June 22, 2017. ECF No. 1. Both parties have filed supporting memoranda. ECF Nos. 13, 16. II. The ALJ’s Redetermination Decision A. Standard of Review Once the Commissioner has rendered a final determination on an application for disability benefits, a district court “shall have power to enter, upon the pleadings and transcript of the record, a judgment affirming, modifying, or reversing [that decision], with or without remanding the cause for a rehearing.” 42 U.S.C. § 405(g). The court’s review is limited to determining whether the ALJ employed the proper legal standards and whether his factual findings were founded upon sufficient evidence. Specifically, the court “must examine the record and uphold a final decision of the Commissioner denying benefits, unless the decision is based on a faulty legal thesis or factual error.” López-Vargas v. Comm’r of Soc. Sec., 518 F. Supp. 2d

333, 335 (D.P.R. 2007) (citing Manso-Pizarro v. Sec’y of Health & Human Servs., 76 F.3d 15, 16 (1st Cir. 1996) (per curiam)). Additionally, “[t]he findings of the Commissioner . . . as to any fact, 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.” Richardson v. Perales, 402 U.S. 389, 401 (1971). The standard requires “‘more than a mere scintilla of evidence but may be somewhat less than a preponderance’ of the evidence.” Ginsburg v. Richardson, 436 F.2d 1146, 1148 (3d Cir. 1971) (quoting Laws v. Celebrezze, 368 F.2d 640, 642 (4th Cir. 1966)).

While the Commissioner’s findings of fact are conclusive when they are supported by substantial evidence, they are “not conclusive when derived by ignoring evidence, misapplying the law, or judging matters entrusted to experts.” Nguyen v. Chater, 172 F.3d 31, 35 (1st Cir. 1999) (per curiam) (citing Da Rosa v. Sec’y of Health & Human Servs., 803 F.2d 24, 26 (1st Cir. 1986) (per curiam); Ortiz v. Sec’y of Health & Human Servs., 955 F.2d 765, 769 (1st Cir. 1991) (per curiam)). Moreover, a determination of substantiality must be made based on the record as a whole. See Ortiz, 955 F.2d at 769 (citing Rodríguez v. Sec’y of Health & Human Servs., 647 F.2d 218, 222 (1st Cir. 1981)). However, “[i]t is the responsibility of the [ALJ] to determine issues of credibility and to draw inferences from the record evidence.” Id. Therefore, the court “must affirm the [Commissioner’s] resolution, even if the record arguably could justify a different conclusion, so long as it is supported by substantial evidence.” Rodríguez Pagán v. Sec’y of Health & Human Servs., 819 F.2d 1, 3 (1st Cir. 1987) (per curiam). B. Disability under the Social Security Act To establish entitlement to disability benefits, a plaintiff bears the burden of proving that

he is disabled within the meaning of the Social Security Act. See Bowen v. Yuckert, 482 U.S. 137, 146 n.5, 146–47 (1987). An individual is deemed to be disabled under the Social Security Act if 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 which has lasted or can be expected to last for a continuous period of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A). Claims for disability benefits are evaluated according to a five-step sequential process. 20 C.F.R. § 404.1520; Barnhart v.

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