KAREN E. SCOTT, Magistrate Judge.
On October 25, 2013, Willie C. H. ("Plaintiff") filed an application for supplemental security income ("SSI") alleging disability commencing August 1, 2013. Administrative Record ("AR") 122.
On August 19, 2015, an Administrative Law Judge ("ALJ") conducted a hearing at which Plaintiff, who was represented by counsel, appeared and testified, as did a vocational expert ("VE"). AR 33-58. On September 16, 2015, the ALJ issued a decision denying Plaintiff's SSI application. AR 18-32. The ALJ found that Plaintiff suffered from medically determinable severe impairments consisting of "a history of left shoulder surgery; hypertension; coronary artery disease; and a history of a myocardial infarction." AR 23. Despite these impairments, the ALJ determined that Plaintiff had the residual functional capacity ("RFC") to perform light work "except for any work involving more than frequent stooping, kneeling, crouching or crawling; and more than frequent climbing ladders, walking on uneven terrain, or working at heights." AR 24. "Light work involves lifting no more than 20 pounds at a time with frequent lifting or carrying of objects weighing up to 10 pounds." 20 C.F.R. § 416.967. Generally, light work requires standing or walking, off and on, for a total of approximately six hours of an eight-hour workday. Social Security Ruling ("SSR") 83-10.
Based on this RFC and the VE's testimony, the ALJ found that Plaintiff could work as a cashier II, Dictionary of Occupational Titles ("DOT") 211.462-010; housekeeping cleaner, DOT 323.687-014; and sales attendant, DOT 299.677-010. AR 27. The ALJ concluded that Plaintiff was not disabled. AR 28.
Plaintiff requested that the Appeals Council review the ALJ's decision. AR 14-17. The Appeals Council denied the request for review on April 5, 2017. AR 1-7. In denying the request, the Appeals Council noted that Plaintiff had presented new evidence to the Appeals Council that had not been presented to the ALJ, consisting of the following:
AR 2. The Appeals Council made the earlier MLK Center records part of the record but found that they did not provide a basis for changing the ALJ's decision.
A district court may review the Commissioner's decision to deny benefits. The ALJ's findings and decision should be upheld if they are free from legal error and are supported by substantial evidence based on the record as a whole. 42 U.S.C. § 405(g);
"A decision of the ALJ will not be reversed for errors that are harmless."
Plaintiff's appeal presents the sole issue of whether the ALJ's RFC has the support of substantial evidence. (Dkt. 30, Joint Stipulation ["JS"] at 4.) Plaintiff contends that as the result of his submission of new evidence to the Appeals Council, the RFC assessed by the ALJ is not supported by substantial evidence.
Plaintiff failed to attach the more recent MLK Center records as exhibits to the JS or to the Notice of Lodging filed on June 21, 2018, in response to the Courts request to provide missing exhibits. (
Rather, Plaintiff's entire argument is that the RFC Form completed by Jacqueline Schwartz, M.D., from Harbor-UCLA Medical Center, should have been considered by the Appeals Council and should have tipped the scale in favor of reversing the ALJ's decision.
After the ALJ renders a decision denying benefits, the claimant may seek review by the Appeals Council. 20 C.F.R. § 416.1470. The Appeals Council will review the case under circumstances enumerated in the regulations, including where the ALJ's action, findings, or conclusions are not supported by substantial evidence.
When the Appeals Council "declines review, `the ALJ's decision becomes the final decision of the Commissioner,' and the district court reviews that decision for substantial evidence, based on the record as a whole."
Here, the Appeals Council declined to make the RFC Form part of the record.
To be material, the new evidence must bear "directly and substantially on the matter in dispute."
"To demonstrate good cause, the claimant must demonstrate that the new evidence was unavailable earlier."
Because the RFC Form was not part of the administrative record in this case, the Court asked Plaintiff to lodge it with the Court, which Plaintiff did. (
Medical opinions that describe a deterioration in the claimant's condition after the ALJ's decision are not probative of the claimant's condition during the relevant time period.
Here, Dr. Schwartz's RFC Form is dated December 4, 2015, with the length of the patient/doctor relationship being six months. The ALJ issued his decision on September 16, 2015. Therefore, about one half of Plaintiff's treating relationship with Dr. Schwartz took place after the ALJ's decision. Dr. Schwartz gives no information about the frequency of doctor/patient visits over this period. Furthermore, the RFC Form is a standardized, check-box form in which all of the questions are written in the present tense; none indicates that the answers given reflect Plaintiff's condition prior to the ALJ's decision. Furthermore, even if it were supposed that Dr. Schwartz considered the entire six month treating relationship when filling out the RFC Form, there is no reason to think that her assessment of Plaintiff's physical functional limitations would apply to any date other than the date she made the assessment.
Plaintiff argues that Dr. Schwartz's opinions pertain to the time before September 16, 2015, because Plaintiff had received treatment from Harbor-UCLA in June 2015, and Dr. Schwartz works at Harbor-UCLA. JS at 5. Defendant points out that Plaintiff testified that his primary physician was at MLK Center and that he only went to Harbor-UCLA for "surgery." JS at 12, citing AR 40. The surgical records for Plaintiff's stent procedure in June 2015 do not mention Dr. Schwartz.
In sum, there is no clear evidence in Dr. Schwartz's RFC Form to suggest that she provided a retrospective opinion on Plaintiff's condition. Therefore, Plaintiff has failed to demonstrate that Dr. Schwartz's form is probative of Plaintiff's condition before September 16, 2015.
As an independent reason for rejecting Plaintiff's claim, Plaintiff has not shown good cause for not obtaining the opinion earlier. If, in fact, Plaintiff had a treating relationship with Dr. Schwartz prior to the ALJ's decision, then Plaintiff should have been able to obtain opinion evidence from Dr. Schwartz earlier. In the JS, Plaintiff fails entirely to address good cause. The record is devoid of any evidence as to when Plaintiff first asked Dr. Schwartz to complete a check-the-box RFC Form. Plaintiff has been represented by counsel since at least March 7, 2014. AR 83. At the hearing, the ALJ listed and accepted the exhibits without counsel mentioning Dr. Schwartz or any outstanding evidence. AR 35.
All of Plaintiff's challenges to the RFC are based on Dr. Schwartz's RFC Form. JS at 5-10. For the reasons given above, the RFC Form is not material, Plaintiff did not show good cause for failing to incorporate Dr. Schwartz's opinions into earlier administrative proceedings, and the RFC Form need not be considered in assessing Plaintiff's RFC. Because Plaintiff's arguments are based entirely on the RFC Form, the Commissioner's decision should be affirmed.
For the reasons stated above, IT IS ORDERED that judgment shall be entered AFFIRMING the decision of the Commissioner denying benefits.