ROBERT W. PRATT, District Judge.
Plaintiff, Cristy L. Thudium, filed a Complaint in this Court on June 27, 2014, 2014, seeking review of the Commissioner's
Plaintiff filed an applications for benefits on December 14 and 15, 2010. Tr. at 133-34 and 361-67. Plaintiff, whose date of birth is October 6, 1979, was 33 years old (Tr. at 409) at the time of the hearing on November 7, 2012 before Administrative Law Judge Eric S. Basse (ALJ). Tr. at 403-39. At the hearing, the ALJ explained that Plaintiff had previously been awarded a closed period of disability benefits which came to an end in 2007
The ALJ issued a Notice Of Decision-Unfavorable on January 9, 2013. Tr. at 14-27. The Appeals Council declined to review the ALJ's decision on May 2, 2014. Tr. at 6-10. Thereafter, Plaintiff commenced this action.
The ALJ found that Plaintiff was last insured for Title II benefits on March 31, 2014. At the first step of the sequential evaluation, the ALJ found that Plaintiff has not engaged in substantial gainful activity after October 13, 2010, the amended alleged disability onset date. At the second step, the ALJ found Plaintiff has the following severe impairments: mood disorder, anxiety disorder, and borderline personality disorder. Tr. at 19. The ALJ found that Plaintiff's impairments were not severe enough to qualify for benefits at the third step of the sequential evaluation. Tr. at 20. At the fourth step, that ALJ found:
Tr. at 21. The ALJ found that Plaintiff is unable to perform her past relevant work. Tr. at 25. At the fifth step, the ALJ found that Plaintiff is able to do a significant number of jobs, examples of which include housekeeper, vending machine operator and laundry sorter. Tr. at 26. The ALJ found that Plaintiff is not disabled nor entitled to the benefits for which she applied. Tr. at 27.
On November 12, 2012, Rosham Dasari, M.D. wrote a letter on behalf of Plaintiff. Tr. at 353-54. Dr. Dasari stated that he had been Plaintiff's psychiatrist for three years. The doctor's treatment notes are included in the record. Tr. at 300-13 and 356-60. The doctor wrote that Plaintiff's diagnoses include chronic posttraumatic stress disorder, mood disorder not otherwise specified, anxiety disorder not otherwise specified, "and a primary severe persistent mental illness of borderline personality disorder with severe primitive, but regressive defenses and core abandonment issues." The doctor wrote
The doctor went on to state his opinion that Plaintiff's prognosis is poor for any reasonable and meaningful recovery. "[S]he will have her symptoms indefinitely." The doctor wrote: "I sincerely do not believe [Plaintiff] can do any full time competitive work and do believe that she is permanently disabled and not being able to hold any job meaningfully." Tr. at 353. The doctor opined that although Plaintiff has struggled with drug and alcohol abuse as a means of self medication, "it is my professional opinion that neither alcohol nor cannabis are directly attributable to her disability or her inability to work." Tr. at 354.
The ALJ considered Dr. Dasari's opinion but gave it "little weight" because the ALJ found it to be inconsistent with the treatment notes in which GAF scores fluctuated and did not indicate that Plaintiff's symptoms were as severe as described in the doctor's letter. The ALJ noted that Plaintiff sees Dr. Dasari once a month and the doctor "did not test her functioning." The ALJ went on: "Further, a conclusion by a treating physician that the patient is `disabled' or `unable to work,' standing alone does not constitute a sufficient basis for a finding of disability within the meaning of the Social Security Act." Tr. at 24. The ALJ wrote that with the exception of Dr. Dasari, no other treating or examining physician opined that Plaintiff is disabled or that she has limitations greater than those found by the ALJ. The ALJ wrote that he gave "substantial weight" to the opinions of the physicians employed by Disability Determination Services who had neither treated nor examined Plaintiff. Tr. at 25.
Owen v. Astrue, 551 F.3d 792, 798 (8th Cir.2008.) In Brand v. Secretary of Dept. of Health, Education and Welfare, 623 F.2d 523, 527 (8th Cir.1980), Chief Judge Lay wrote that Universal Camera Corp. v. NLRB, 340 U.S. 474, 71 S.Ct. 456, 95 L.Ed. 456 (1951) is "the guideline for the evaluation of the standard of review." In Universal Camera, the Court wrote:
Id., 340 U.S. at 490, 71 S.Ct. 456. In reviewing disability decisions from the Social Security Administration, the Court sits in an appellate capacity and is responsible for giving the agency decision a scrutinizing analysis. This requires the Court to determine the substantiality of the evidence by determining if the ultimate decision is supported by substantial evidence on the record as a whole. Gavin v. Heckler, 811 F.2d 1195, 1199 (8th Cir.1987).
In Jackson v. Bowen, 873 F.2d 1111, 1113 (8th Cir.1989), the Court described its duty as follows:
Id. (citations omitted).
In short, a reviewing court should neither consider a claim de novo, nor abdicate its function to carefully analyze the entire record. Wilcutts v. Apfel, 143 F.3d 1134, 1136-37 (8th Cir.1998) citing Brinker v. Weinberger, 522 F.2d 13, 16 (8th Cir. 1975).
In her brief, Plaintiff makes three arguments: 1) "New and material evidence submitted at the Appeals Council level requires a remand;" 2) "The ALJ's RFC assessment is inconsistent with his own findings and unsupported by substantial evidence based on the record as a whole;" and, 3) "The ALJ submitted an inaccurate hypothetical to the vocational expert and the vocational expert testimony in this case does not constitute substantial evidence upon which the ALJ can rely."
Regarding Plaintiff first argument that the case should be remanded for further consideration of the evidence submitted to the Appeals Council. The Court agrees with the Commissioner that the report of Kathleen Murray, Ph.D., which the Appeals Council acknowledges receiving, was generated and concerns a period of time after the ALJ's decision which is the subject of review now. "The regulations provide that the Appeals Council must evaluate the entire record, including any new and material evidence that relates to the period before the date of the ALJ's decision. See 20 C.F.R. § 404.970(b)." Cunningham v. Apfel, 222 F.3d 496, 500 (8th Cir.2000). The Appeals Council wrote that evidence submitted from Kathleen Murray, Ph.D. dated April 19, 2013 related to a period of time after the decision of the ALJ which was issued on January 9, 2013. Furthermore, because the Court finds an award of benefits to be the appropriate remedy, the Court will not consider remanding the case for consideration of Dr. Murray's report.
The most important issue in any disability case which proceeds beyond step three of the sequential evaluation is that of residual functional capacity:
McCoy v. Schweiker, 683 F.2d 1138, 1147 (8th Cir.1982) (en banc).
The medical evidence in this case is limited to the report and treatment records provided by Dr. Dasari. Dr. Dasari is the only physician Plaintiff sees, and he is a specialist-a psychiatrist. In Bernard v. Colvin, 774 F.3d 482, 487 (8th Cir.2014), the Court wrote:
In the case before the Court, there is no suggestion that Dr. Dasari's opinion is not supported by medically acceptable clinical and laboratory diagnostic techniques. Likewise, there are no other medical assessments, either from treating or examining sources—Plaintiff does not see other doctors, and no consultative examinations were arranged. Therefore, Dr. Dasari's opinion should be given controlling weight unless it can be shown that the doctor rendered inconsistent opinions which undermine his credibility.
The only inconsistency pointed to by the ALJ is Dr. Dasari's fluctuating diagnoses on Axis V of the multiaxial diagnosis utilized in his treatment records.
The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), states that a multiaxial system involves diagnoses on several axes each of which helps the clinician plan treatment and predict outcome. On Axis I, clinical disorders and other conditions that may be a focus of clinical attention are diagnosed. On Axis II, personality disorders and mental retardation are diagnosed. Axis III is for general medical conditions. On Axis IV, psychosocial and environmental problems are noted. Axis V is a global assessment of functioning or GAF. DSM-IV-TR at 27.
According to the DSM-IV-TR, "Axis V is for reporting the clinician's judgment of the individual's overall level of functioning. This information is useful in planning treatment and measuring its impact, and predicting outcome." Id. at 32.
Because the DSM-IV-TR states that the GAF scale is used to rate "psychological, social, and occupational functioning" Id., it might be seen as a tool for lay people to glean the doctor's day to day opinion of a patient's ability to engage in substantial gainful activity. However, the DSM-IV-TR itself contains a caveat about how information in treatment records can be misunderstood.
Id. at xxxii-iii. In the case at bar, Dr. Dasari, by means of his report, provided the additional information needed to make a factual determination of the severity of Plaintiff's mental illness. In the opinion of the Court, Dr. Dasari does not attempt to render an opinion on issues reserved to the Commissioner. See, 20 C.F.R.
20 C.F.R. § 404.1527(b)(2).
The ALJ gave "substantial weight" to the opinions of the physicians employed by Disability Determination Services. These doctors, however, neither treated nor examined Plaintiff. Not only does the above cited regulation state that such opinions are less valuable then one rendered by a treating and/or examining physician, but the regulation is consistent with the case law of the Eighth Circuit. "The opinions of doctors who have not examined the claimant ordinarily do not constitute substantial evidence on the record as a whole." Nevland v. Apfel, 204 F.3d 853, 858 (8th Cir.2000) citing Jenkins v. Apfel, 196 F.3d 922, 925 (8th Cir.1999). There is, therefore, no substantial evidence which contradicts the opinion rendered by Dr. Dasari.
Dr. Dasari opined that Plaintiff illnesses would cause her to be absent from work several days each month. The vocational expert testified that if Plaintiff's illnesses caused her to be off task for three hours per week for at least an hour at a time, then no work is possible. The finding that Plaintiff can work in unskilled work which requires only brief and superficial interactions with the public, coworkers, and supervisors is not supported by any substantial evidence in this record. In fact, it is directly contrary to the opinion of the treating physician who wrote: "In terms of social interaction she would have marked limitations because of her posttraumatic stress disorder and her very maladaptive response to stress."
In Rhines v. Harris, 634 F.2d 1076, 1079 (8th Cir.1980), the Court, quoting Thomas v. Celebrezze, 331 F.2d 541, 546 (4th Cir.
Plaintiff has proven her case with medical and vocational evidence and is entitled to the benefits for which she applied. A remand for further development of the record would only delay the receipt of the benefits for which Plaintiff is clearly entitled.
The Court has considered the evidence which supports, as well as the evidence which detracts from the decision made by the ALJ. After applying the balancing test noted in Gavin v. Heckler, 811 F.2d at 1199 (8th Cir.1987), and cases cited therein, this Court holds that the final decision of the Commissioner is not supported by substantial evidence on the record as a whole. This case is reversed and remanded for an award of benefits.
The judgment to be entered will trigger the running of the time in which to file an application for attorney's fees under 28 U.S.C. § 2412(d)(1)(B) (Equal Access to Justice Act). See also, McDannel v. Apfel, 78 F.Supp.2d 944 (S.D.Iowa 1999) (discussing, among other things, the relationship between the EAJA and fees under 42 U.S.C. § 406(B), and LR 54.2(b))
IT IS SO ORDERED.