CHARLES F. EICK, Magistrate Judge.
Pursuant to sentence four of 42 U.S.C. section 405(g), IT IS HEREBY ORDERED that Plaintiff's and Defendant's motions for summary judgment are denied and this matter is remanded for further administrative action consistent with this Opinion.
Plaintiff filed a complaint on July 17, 2013, seeking review of the Commissioner's denial of disability benefits. The parties filed a consent to proceed before a United States Magistrate Judge on August 12, 2013. Plaintiff filed a motion for summary judgment on January 3, 2014. Defendant filed a cross-motion for summary judgment on March 5, 2014. The Court has taken the motions under submission without oral argument.
Plaintiff asserts disability based on alleged physical and mental impairments (Administrative Record ("A.R.") 30-268). With regard to her alleged mental impairments, Plaintiff reported feeling "very overwhelmed," unable to handle stress, and "depressed and stressed out all the time" (A.R. 168, 172). A medical treatment record dated in May of 2011 also mentions "depression" (A.R. 243). At the hearing before the Administrative Law Judge ("ALJ"), Plaintiff referenced "stress" a number of times, and also claimed she had not gone to the doctor because she did not have insurance (A.R. 64-66). At the same hearing, the following colloquy occurred between Plaintiff's representative and the ALJ:
(A.R. 62-63).
The ALJ found Plaintiff has severe physical impairments but no severe mental impairment (A.R. 32). The ALJ's decision, which is dated July 5, 2011, states:
Following the ALJ's decision, Plaintiff submitted additional medical evidence. This evidence, which is attached to "Plaintiff's Motion for Summary Judgment or Remand," includes opinions from two physicians. Both of these physicians diagnosed depression and anxiety, and both physicians opined Plaintiff is not capable of performing even low stress jobs (Exhibits A and B to "Plaintiff's Motion for Summary Judgment or Remand"). Although the matter is not entirely free from doubt, it appears that one of these opinions, that of Dr. Muzaffer, expressly relates to the time period beginning October 19, 2010 (Exhibit B, page 4). The other opinion, that of Dr. Mory, expressly relates to the time period beginning December 13, 2011 (Exhibit A, page 4).
The Appeals Council considered this additional evidence but denied review (A.R. 9-14). As the Appeals Council stated: "[t]his means that the Administrative Law Judge's decision is the final decision of the Commissioner of Social Security. . . ." (A.R. 9)
Under 42 U.S.C. section 405(g), this Court reviews the Administration's decision to determine if: (1) the Administration's findings are supported by substantial evidence; and (2) the Administration used proper legal standards.
Where, as here, the Appeals Council considered additional evidence but denied review, the additional evidence becomes part of the record for purposes of the Court's analysis.
As Defendant appears to concede, the Court "may look to evidence submitted for the first time to the Appeals Council to determine whether the ALJ's decision is still supported by substantial evidence and free of reversible error" ("Defendant's Motion for Summary Judgment" p. 2, ll. 19-22 (citing
An alleged impairment may be found "not severe" "when the medical evidence establishes only a small abnormality . . . which would have no more than a minimal effect on an individual's ability to work.. . ." Social Security Ruling ("SSR") 85-28.
When the evidence submitted to the Appeals Council for the first time is included in the record, the evidence of record no longer "clearly establishes" the non-severity of Plaintiff's alleged mental impairments. In arguing the contrary, Defendant claims that the medical opinions submitted to the Appeals Council are irrelevant to the time period at issue. However, one of the opinions, that of Dr. Muzaffer, appears to be expressly directed to part of the time period at issue (10/19/10 - 7/15/11). Moreover, many if not most mental impairments are progressive in nature.
Also undercutting the validity of the Administrative decision in the present case is the Administration's special duty to develop the record. The Administration "has a special duty to fully and fairly develop the record and to assure that the claimant's interests are considered."
On the present record, this Court cannot deem the errors in the Administrative decision to have been harmless. The circumstances of this case indicate that there is a substantial likelihood the ALJ's consideration of the additional evidence submitted to the Appeals Council would materially alter the ALJ's disability analysis. Therefore, remand is appropriate.
For all of the foregoing reasons,
LET JUDGMENT BE ENTERED ACCORDINGLY.
Notably, Plaintiff testified she did not go to doctors because she lacked insurance.