KAREN B. MOLZEN, Chief Magistrate Judge.
THIS MATTER comes before the Court on Plaintiff's Motion to Reverse and Remand for a Rehearing (Doc. 17) filed on December 23, 2014, and fully briefed May 18, 2015 (Doc. 25). Pursuant to 28 U.S.C. § 636(c) and Fed. R. Civ. P. 73(b), the parties have consented to me serving as the presiding judge and entering final judgment. Doc. 9. Having carefully reviewed the parties' submissions and the administrative record, the Court finds the motion is well taken and will be granted.
Plaintiff is a 45-year old woman with an 11th grade education who lives with her minor son and has previously worked as a cashier and dietary aide. Administrative Record, (AR)
Using the five-step sequential evaluation process,
Plaintiff requested that the Appeals Council review the ALJ's unfavorable decision. AR 52-53. On December 14, 2012, Plaintiff submitted additional medical records to the Appeals Council dated between October 26, 2012, and November 9, 2012. See Exhibit A to Plaintiff's Motion (Doc. 17-1).
On February 25, 2014, the Appeals Council issued its decision denying Plaintiff's request for review. The Appeals Council noted it specifically considered "Records from UNM Hospitals and Clinics from 11/01/2012 to 11/06/2012" (AR 1, 6), but it declined to consider records generated after November 8, 2012, the date of ALJ Farris' decision and explained:
AR 2. Having denied Plaintiff's request for review, the ALJ's decision became the final decision of the Commissioner. AR 1-4.
Plaintiff asserts that the ALJ erred by: (1) failing to properly evaluate treating source opinions; (2) failing to properly evaluate medical evidence from the consulting physician and failing to develop the record; and (3) failing to take certain evidence in to account when formulating Plaintiff's RFC. Plaintiff also contends that the Appeals Council erred when it failed to consider additional relevant medical records submitted after the ALJ's decision. Docs. 17 and 19.
Judicial review of the Commissioner's determination is limited in scope by 42 U.S.C. § 405(g) to two inquiries: first, whether the decision was supported by substantial evidence; and second, whether the correct legal standards were applied. Hamlin v. Barnhart, 365 F.3d 1208, 1214 (10th Cir. 2004) (quotation omitted).
Substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. However, "[a] decision is not based on substantial evidence if it is overwhelmed by other evidence in the record or if there is a mere scintilla of evidence supporting it."
Id. (quoting Doyal v. Barnhart, 331 F.3d 758, 760 (10th Cir. 2003) and Bernal v. Bowen, 851 F.2d 297, 299 (10th Cir.1988)) (brackets in original).
Generally, my assessment is based on a "meticulous" review of the entire record, where I can neither reweigh the evidence nor substitute my judgment for that of the agency. Id. However, this case can be resolved on an error of law. Therefore, all portions of the record that bear on the legal argument raised by Plaintiff have been read and carefully considered, but I did not review every single page of the medical documents in detail, as is normally the case. See Grogan v. Barnhart, 399 F.3d 1257, 1262 (10th Cir. 2005) ("we meticulously examine the record as a whole, including anything that may undercut or detract from the ALJ's findings in order to determine if the ALJ's findings in order to determine if the
The Court finds that the Appeals Council erroneously declined to consider some of the new evidence submitted to it by Plaintiff, and that this error requires remand to the agency for further proceedings. Regulations require that the Appeals Council evaluate the entire record, including new evidence when it relates to the relevant period. 20 C.F.R. 404.970(b). The evidence submitted must be "(a) new, (b) material, and (c) relate[d] to the period on or before the date of the ALJ's decision." Threet v. Barnhart, 353 F.3d 1185, 1191 (10th Cir. 2003) (brackets in original). "If the Appeals Council fails to consider qualifying new evidence, the case should be remanded for further proceedings." Id.
Whether evidence qualifies as "new, material, and chronologically pertinent" is a question of law. Id. Evidence is "new" if it is not duplicative or cumulative. Threet, 353 F.3d at 1191. Here, the parties do not dispute that the evidence presented to the Appeals Council is new. It was not available to the ALJ at the time she made her decision "and is thus neither duplicative nor cumulative." See id.
Evidence is "chronologically pertinent" or, in other words, temporally relevant where it relates to the period before the ALJ's decision. Threet, 353 F.3d at 1191. The Appeals Council recited that it did consider
Yet the Appeals Council ignored other additional evidence that was created prior to the ALJ's decision and, therefore, clearly within the relevant time period, without any explanation why it was not considered. The new evidence included treatment records by Shanna Diaz, D.O. dated October 26, 2012 (AR 557-561), in which she notes that Plaintiff feels that "things have gotten `much worse,'" and that Plaintiff "endorses symptoms that are consistent with chronic paranoid schizophrenia" with "clear bizarre delusions which are likely contributing to her anxiety symptoms and depression." AR 561. Like the other new information gathered before the ALJ's decision discussed in the preceding paragraph, these treatment records were
The Appeals Council also apparently rejected consideration of other newly submitted evidence, concluding that reports and treatment notes generated
Here, the Appeals Council failed to consider a medical source statement by a treating provider
New evidence is "material" if there is a reasonable possibility that it would change the outcome. Id. Citing O'Dell v. Shalala, 44 F.3d 855 (10th Cir. 1994), the Commissioner argues that the additional evidence discussed above would not change the outcome. In O'Dell, the court found that the new evidence did not contradict the ALJ's findings. Id. at 859.
Yet the new, unconsidered information here calls into question the ALJ's determination that Plaintiff's impairments do not meet the Listings and that her nonexertional limitations are restricted to "performing only simple, routine tasks, with no interaction with the public and only occasional and superficial interaction with coworkers." See AR 62. As this evidence contradicts the ALJ's finding that Plaintiff's impairments do not meet the part "B" requirements, there is a reasonable possibility that it would change the outcome. See Padilla, 525 F. App'x at 712 (agreeing with plaintiff that "the ALJ's RFC could reasonably be found to be unsupported by substantial evidence because if failed to take into account the nonexertional limitations revealed by the additional evidence").
The Commissioner next speculates that the ALJ would have accorded Dr. Diaz' opinion little weight because other evidence in the record supported a finding that Plaintiff's impairments did not meet the Listings. Doc. 23 at 13. However, speculating about the likelihood of the ALJ's decision on matters neither she nor the Appeals Council considered would risk violating the general rule against post hoc justification of administrative actions. See Money v. Astrue, 515 F.Supp.2d 1211, 1219, n.3 (D. Kan. 2007) (citing Allen v. Barnhart, 357 F.3d 1140, 1145 (10th Cir. 2004)).
Finally, it is troubling to the Court that the additional new evidence submitted by Plaintiff to the Appeals Council was not included in the administrative record originally filed by the Commissioner; rather, it was lodged with the Court only after Plaintiff submitted her motion to remand. See Doc. 22 ("Notice of Lodging of the Transcript of the Supplemental Administrative Record"). This could indicate that, contrary to the Appeals Council's Notice of Action and Order,
Nevertheless, the failure of the Appeals Council to consider and evaluate the entire record, which includes the new additional material evidence identified above that it was