Rogelio Garcia v. Nancy Berryhill, Acting Cmsnr
880 F.3d 700
5th Cir.2018Background
- Rogelio Garcia applied for Social Security disability insurance benefits in Jan 2012, alleging disability beginning Jan 1, 2007, based on hearing loss and PTSD from Vietnam service.
- VA awarded Garcia a 100% disability rating for PTSD in June 2011 (effective Aug 28, 2009) after a one-time psychological evaluation by Dr. Paul Hamilton; prior medical records showed no PTSD diagnosis or treatment in the preceding 30 years.
- State-agency reviewers found insufficient evidence to determine disability; VA examiner Dr. Noel Nick (2012) questioned a combat-linked etiology for Garcia’s symptoms.
- An ALJ held a hearing in Nov 2013, found Garcia had some physical impairments, concluded his PTSD was non-severe, determined he retained RFC for light work, and found he could perform his past work as an agriculture/produce broker.
- Appeals Council denied review; district court adopted the magistrate judge’s recommendation to affirm. The Fifth Circuit reviewed for substantial evidence and proper legal standards and affirmed the denial of benefits.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ erred by relying on VA summary instead of obtaining Hamilton’s original report | Garcia: ALJ required to procure and review Hamilton’s report; absence prejudiced decision | Commissioner: Omission harmless because record described Hamilton’s findings and Garcia shows no prejudice | Harmless error; no remand because omitted report unlikely to change result |
| Whether ALJ incorrectly found PTSD non-severe at step two | Garcia: ALJ applied too stringent standard; PTSD produced significant work-related limits | Commissioner: ALJ applied regulatory framework and Stone standard; evidence showed only mild limitations | ALJ correctly applied the standard; PTSD non-severe and any step-two error would be harmless |
| Weight to give VA’s 100% disability rating | Garcia: VA rating is strong evidence of disability and should carry substantial weight | Commissioner: VA decision not binding; ALJ permissibly considered timing, one-time evaluation, lack of treating records, and state reviewers’ uncertainty | ALJ permissibly discounted VA rating; substantial evidence supports that it did not prove disability before insured-date |
Key Cases Cited
- Masterson v. Barnhart, 309 F.3d 267 (5th Cir. 2002) (five-step disability-evaluation framework and review standard)
- Perez v. Barnhart, 415 F.3d 457 (5th Cir. 2005) (burden shift to Commissioner at step five)
- Newton v. Apfel, 209 F.3d 448 (5th Cir. 2000) (ALJ may reject physician opinion when evidence supports contrary conclusion)
- Chaparro v. Bowen, 815 F.2d 1008 (5th Cir. 1987) (finding at any step that claimant is not disabled ends inquiry)
- Brock v. Charter, 84 F.3d 726 (5th Cir. 1996) (applicant must show prejudice from omitted evidence)
- Morris v. Bowen, 864 F.2d 333 (5th Cir. 1988) (harmless-error review for omitted materials)
- Stone v. Heckler, 752 F.2d 1099 (5th Cir. 1985) (definition of non-severe impairment as slight abnormality)
- Chambliss v. Massanari, 269 F.3d 520 (5th Cir. 2001) (VA disability determinations are evidence but not binding)
- Villa v. Sullivan, 895 F.2d 1019 (5th Cir. 1990) (ALJs may consider lack of treatment as indication of nondisability)
- Anthony v. Sullivan, 954 F.2d 289 (5th Cir. 1992) (claimant must prove disability before insured-status expiration)