STEPHAN M. VIDMAR, Magistrate Judge.
THIS MATTER is before me on Plaintiff's Motion to Reverse or Remand Administrative Agency Decision [Doc. 33] and Memorandum Brief in Support [Doc. 34] ("Motion"), filed on April 23, 2018. The Commissioner responded on June 7, 2018. [Doc. 36]. Plaintiff replied on July 17, 2018. [Doc. 37]. The Honorable Judith C. Herrera, United States District Judge, referred this matter to me for analysis and a recommended disposition. [Doc. 19]. Having meticulously reviewed the entire record and being fully advised in the premises, the Court finds that, considering the entire administrative record, the Administrative Law Judge's ("ALJ") findings at step three are not supported by substantial evidence. Accordingly, I recommend that the Motion be granted and that the case be remanded for further proceedings. See 42 U.S.C. § 405(g) (sentence four).
The standard of review in a Social Security appeal is whether the Commissioner's final decision
"Substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Langley, 373 F.3d at 1118; Hamlin, 365 F.3d at 1214; Doyal, 331 F.3d at 760. The 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." Langley, 373 F.3d at 1118; Hamlin, 365 F.3d at 1214. While a court may not re-weigh the evidence or try the issues de novo, its examination of the record as a whole must include "anything that may undercut or detract from the [Commissioner]'s findings in order to determine if the substantiality test has been met." Grogan v. Barnhart, 399 F.3d 1257, 1262 (10th Cir. 2005). "The possibility of drawing two inconsistent conclusions from the evidence does not prevent [the] findings from being supported by substantial evidence." Lax v. Astrue, 489 F.3d 1080, 1084 (10th Cir. 2007) (citing Zoltanski v. F.A.A., 372 F.3d 1195, 1200 (10th Cir. 2004)).
"The failure to apply the correct legal standard or to provide this court with a sufficient basis to determine that appropriate legal principles have been followed is grounds for reversal." Jensen v. Barnhart, 436 F.3d 1163, 1165 (10th Cir. 2005) (internal quotation marks omitted).
In order to qualify for disability benefits, a claimant must establish that she 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. § 1382c(a)(3)(A); 20 C.F.R. § 416.905(a).
In light of this definition for disability, a five-step sequential evaluation process has been established for evaluating a disability claim. 20 C.F.R. § 416.920; Bowen v. Yuckert, 482 U.S. 137, 140 (1987). At the first four steps of the evaluation process, the claimant has the burden to show that: (1) she is not engaged in "substantial gainful activity"; and (2) she has a "severe medically determinable . . . impairment . . . or a combination of impairments" that has lasted or is expected to last for at least one year; and either (3) her impairment(s) either meet or equal one of the "Listings"
Plaintiff applied for supplemental security income on November 8, 2012. Tr. 15. She alleged a disability-onset date of July 28, 2011. Id. Her claim was denied initially and on reconsideration. Id. ALJ Frederick Upshall, Jr., held the first of three hearings in Albuquerque, New Mexico, on June 25, 2014. Tr. 15, 35-46. Plaintiff appeared in person and pro se. Id. The hearing was continued to allow for the submission of missing medical records and to allow Plaintiff to find representation. Id. ALJ Upshall held the second hearing in Albuquerque on December 9, 2014. Tr. 15, 47-59. Plaintiff appeared in person with Ione Gutierrez, an attorney. Tr. 47. The second hearing, however, was also postponed to allow for the submission of missing medical records. Tr. 58-59. ALJ Upshall held the third and final hearing in Albuquerque on June 2, 2015. Tr. 15, 60-83. Plaintiff appeared in person with Zachary Green, an attorney. Id. The ALJ heard testimony from Plaintiff and an impartial vocational expert ("VE") Patricia McLaughlin. Id.
The ALJ issued an unfavorable decision on September 15, 2015. Tr. 27. At step one the ALJ found that Plaintiff had not engaged in substantial gainful activity since November 2, 2012. Tr. 17. At step two, the ALJ found that Plaintiff suffered from the following severe impairments: rheumatoid arthritis, diabetes mellitus, morbid obesity, osteoarthritis, degenerative joint disease, depression, and borderline intellectual functioning. Id.
At step three the ALJ determined that none of Plaintiff's impairments, alone or in combination, met or medically equaled a Listing. Tr. 17-21. Because none of Plaintiff's impairments met or medically equaled a Listing, the ALJ went on to assess Plaintiff's RFC. Tr. 21-25. The ALJ found that Plaintiff had
Tr. 21.
At step four the ALJ found that Plaintiff had no past relevant work. Tr. 25. Accordingly, the ALJ went on to consider Plaintiff's RFC, age, education, work experience, and the testimony of the VE at step five. Tr. 25-27. He found that Plaintiff could perform work that exists in significant numbers in the national economy and, therefore, was not disabled. Id. Plaintiff requested review from the Appeals Council, but that request was denied on December 1, 2016. Tr. 1-4. Plaintiff filed the instant action on April 28, 2017.
At the time the ALJ issued his decision, Listing 12.05(C), for intellectual disability,
Listing 12.05(C), 20 C.F.R. pt. 404, subpt. P, app. 1 (2016). In other words, to meet Listing 12.05(C), a claimant must show that she has (1) a qualifying IQ score, and (2) an additional severe impairment. Beyond the two requirements described in subparagraph C, Plaintiff must also meet the introductory paragraph of Listing 12.05, which is often referred to as the "capsule definition."
In this case, the ALJ found that Plaintiff met the two requirements described in subparagraph C but did not meet the capsule definition:
Tr. 20-21 (italics in ALJ's decision). The use of italics by the ALJ indicates the core of his finding. He found that the record contained no evidence that Plaintiff's intellectual disability manifested itself during Plaintiff's developmental period, i.e., before the age of 22. Id. I refer to this as the "temporal requirement."
Plaintiff argues that the record, in fact, does contain evidence that would meet the temporal requirement, and therefore, the case should be remanded. [Doc. 34] at 18. Specifically, Plaintiff points to the Dr. Padilla's supplemental report November 15, 2015.
The Court agrees with Plaintiff that remand is warranted. The ALJ found that Plaintiff did not meet Listing 12.05(C) because the "record fail[ed] to contain . . . evidence [that would meet the temporal requirement]." Tr. 21. This was the only reason given by the ALJ. The ALJ found that the other requirements of Listing 12.05(C) were met. Tr. 20-21. The ALJ's finding (that the record contains no evidence that could meet the temporal requirement) is not supported by substantial evidence because Dr. Padilla's supplemental report could satisfy the temporal requirement. In his supplemental report, Dr. Padilla was asked whether Plaintiff's "intellectual deficiencies [were] the kind [that Dr. Padilla] would expect to have been established at a developmental age (i[.]e.[, d]uring childhood, before the age of 22, etc.)[.]" Tr. 559. Dr. Padilla responded "Yes." Id. He explained that Plaintiff "could recall struggling in the classroom and dropped out of school after 8th grade due to pregnancy." Id. A fact-finder could be persuaded by Dr. Padilla's supplemental report and rely on it to find that Plaintiff meets the temporal requirement of Listing 12.05(C). Accordingly, the critical finding here—that the record contained no evidence of the temporal requirement—is not supported by substantial evidence.
Importantly, Defendant does not argue otherwise. See [Doc. 36]. The most she offers is an acknowledgement that Dr. Padilla submitted a supplemental report to the Appeals Council, the report was made part of the record, and the Appeals Council found that it did not provide a basis for changing the ALJ's decision. [Doc. 36] at 6 n.5 (citing Tr. 1-3, 558-60). Otherwise, she offers nothing opposing Plaintiff's argument that the supplemental report could satisfy the temporal requirement. See [Doc. 36].
The argument that Defendant offers instead does not change the result. Rather than arguing about the temporal requirement, Defendant heads in a new direction. She interprets the ALJ's decision as based on lack of evidence of "deficits in adaptive functioning." [Doc. 36] at 11-12. Defendant does not argue about the temporal requirement; she focuses on deficits in adaptive functioning. Id. For example, Defendant defines "adaptive functioning." Id. at 11. She argues that evidence of deficits in adaptive functioning is important because IQ scores have a margin of error. Id. at 11-12. She then cites to evidence that she believes affirmatively shows that Plaintiff does not have the requisite deficits in adaptive functioning, such as Plaintiff's apparently having completed written forms, evidencing that she could read and write with proper spelling and in a manner that made sense. Id. at 12 (citing Tr. 297-98, 318-25). For at least two reasons, this argument does not carry water.
First, the ALJ's decision, on its face, indicates that the ALJ did not find that Plaintiff lacked deficits in adaptive functioning. Tr. 20-21. Rather, the language and font indicates that he found that there was no evidence that could meet the temporal requirement:
Tr. 20-21 (italics in ALJ's decision). The relevant finding is about the temporal requirement, not deficits in adaptive functioning. Moreover, as to the finding at issue, the ALJ found that the record "fail[ed] to contain such evidence." Id. The ALJ did not find that the evidence was present but cut against Plaintiff, which is what Defendant argues. See [Doc. 37] at 12.
The precise meaning of the ALJ's finding is critical here because this Court may only review the decision based on the reasoning provided by the ALJ himself. This Court may not supply a missing finding. To do so would be an impermissible post hoc rationalization. See Havenar v. Astrue, 438 F. App'x 696, 699 (10th Cir. 2011) (rejecting the Commissioner's argument that the plaintiff could not meet the capsule definition of Listing 12.05(C) because "the ALJ never made any findings regarding the capsule definition, and it would be beyond the scope of appellate review to make such a finding in the first instance. Indeed, any such finding would be an impermissible post-hoc justification for the ALJ's deficient explanation."); Peck v. Barnhart, 214 F. App'x 730, 736 (10th Cir. 2006) (rejecting the Commissioner's argument that the plaintiff failed to meet the capsule definition because the ALJ did not make that finding himself in the first instance).
Second, it is not at all clear that evidence of "deficits in adaptive functioning" is required above and beyond the requirements listed is subparagraph C. Therefore, even if the ALJ had rejected Listing 12.05(C) on this basis—which he did not—I am not convinced the rejection would have been proper. See Barnes v. Barnhart, 116 F. App'x 934, 938-40 (10th Cir. 2004) (holding that the requirements for meeting the capsule definition are not clear, and to the extent that evidence of "deficits in adaptive functioning" is required—above and beyond the requirements of subparagraph C—the ALJ is required to choose and apply one "of the measurement methods recognized and endorsed by [one of] the [four major] professional organizations" dealing with mental retardation) (quoting 67 Fed. Reg. at 20,022.); Wall v. Astrue, 561 F.3d 1048, 1073-74 (10th Cir. 2009) (Holloway, J., dissenting) (applying Barnes to opine that remand should be required to allow the ALJ to explain which of the four standards he applied vis-a-vis deficits in adaptive functioning); see also, Crane v. Astrue, 369 F. App'x 915, 921 (10th Cir. 2010) (interpreting the capsule definition as a temporal requirement rather than a requirement for evidence of deficits in adaptive functioning (quoting Wall v. Astrue, 561 F.3d 1048, 1062 (10th Cir. 2009)).
Considering the entire administrative record, the ALJ's finding—that the record contains no evidence that could meet the temporal requirement of Listing 12.05(C)—is not supported by substantial evidence because Dr. Padilla's supplemental report could satisfy the temporal requirement. Remand is warranted for reconsideration of Listing 12.05(C). Passing on Plaintiff's other alleged errors is not necessary at this time because proper consideration of Listing 12.05(C) may render them moot.