STEVEN C. YARBROUGH, Magistrate Judge.
Claimant Robert Ernie Roble ("Mr. Roble") alleges that he became disabled on June 22, 2011, at the age of forty-eight because of post-traumatic stress syndrome and kidney stones. Tr. 255, 259.
On December 19, 2012, Mr. Roble filed an application for Social Security Disability Insurance Benefits ("DIB") under Title II of the Social Security Act (the "Act"), 42 U.S.C. § 401 et seq. Tr. 230-31. On June 3, 2013, he filed an application for Supplemental Security Income ("SSI") under Title XVI of the Act, 42 U.S.C. § 1381 et seq. Tr. 232-37. Mr. Roble's applications were initially denied on September 23, 2013. Tr. 97, 98, 99-115, 116-133, 163-66, 167-70. They were denied again at reconsideration on May 30, 2014. Tr. 134, 135, 136-47, 148-58, 173-75, 176-79. Mr. Roble requested a hearing before an Administrative Law Judge ("ALJ"), and ALJ Lillian Richter conducted a hearing on January 28, 2016. Tr. 44-96. Mr. Roble appeared in person at the hearing with attorney representative Michael Armstrong. Id. The ALJ took testimony from Mr. Roble, Geraldine Roble, and an impartial vocational expert ("VE"), Karen Provine. Id. On March 24, 2016, ALJ Richter issued a partially favorable decision. Tr. 19-35.
On July 15, 2017, the Appeals Council issued its decision denying Mr. Roble's request for review and upholding the ALJ's final decision. Tr. 1-5. On September 1, 2017, Mr. Roble timely filed a Complaint seeking judicial review of the Commissioner's final decision. Doc. 1.
An individual is considered disabled if he 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. § 423(d)(1)(A) (pertaining to disability insurance benefits); see also 42 U.S.C. § 1382(a)(3)(A) (pertaining to supplemental security income disability benefits for adult individuals). The Social Security Commissioner has adopted the familiar five-step sequential analysis to determine whether a person satisfies the statutory criteria as follows:
See 20 C.F.R. § 404.1520(a)(4) (disability insurance benefits); 20 C.F.R. § 416.920(a)(4) (supplemental security income disability benefits); Fischer-Ross v. Barnhart, 431 F.3d 729, 731 (10th Cir. 2005); Grogan v. Barnhart, 399 F.3d 1257, 1261 (10
This Court must affirm the Commissioner's denial of social security benefits unless (1) the decision is not supported by "substantial evidence" or (2) the ALJ did not apply the proper legal standards in reaching the decision. 42 U.S.C. § 405(g); Hamlin v. Barnhart, 365 F.3d 1208, 1214 (10
The ALJ determined that Mr. Roble was not disabled prior to August 30, 2013, but became disabled on that date and has continued to be disabled through the date of her decision. Tr. 24. In making this determination, the ALJ found at step one that Mr. Roble met the insured status requirements through March 31, 2012, and that he had not engaged in substantial gainful activity since his alleged onset date. Tr. 26. At step two, the ALJ found that since his alleged onset date, Mr. Roble had severe impairments of mood disorder, major depressive disorder, post-traumatic stress disorder, anxiety, traumatic brain injury, and rule out cognitive disorder. Tr. 26. She also found nonsevere impairments of obesity, cataract, hypertension, and alcohol use disorder. Tr. 27. The ALJ, however, determined that Mr. Roble's impairments did not meet or equal in severity one the listings described in Appendix 1 of the regulations. Tr. 27. As a result, the ALJ proceeded to step four and found that, prior to August 30, 2013, Mr. Roble had the residual functional capacity to perform a full range of work at all exertional levels but with the following nonexertional limitations:
Tr. 28. The ALJ determined that beginning on August 30, 2013, Mr. Roble had an additional nonexertional limitation of needing "frequent reminders from supervisors in order to remain on task." Tr. 30. The ALJ concluded at step four that Mr. Roble was not able to perform any past relevant work. Tr. 33. At step five, the ALJ determined that prior to August 30, 2013, based on Mr. Roble's age, education, work experience, RFC, and the testimony of the VE, there were jobs that existed in significant numbers in the national economy that Mr. Roble could perform and was, therefore, not disabled. Tr. 33-34. Beginning on August 30, 2013, however, based on Mr. Roble's age, education, work experience, RFC, and the testimony of the VE, the ALJ determined there were no jobs that existed in significant numbers in the national economy that Mr. Roble could perform and that he was, therefore, disabled as of that date.
Mr. Roble asserts two arguments in support of his Motion as follows: (1) the Appeals Council failed to properly analyze the opinion of consultative psychologist Louis Wynne, Ph.D. whose opinion undercuts ALJ Richter's decision; and (2) ALJ Richter failed to properly evaluate Mr. Roble's description of his symptoms in accordance with SSR 16-3p or SSR 96-7p. Doc. 20 at 16-24. Because the Appeals Council failed to consider Dr. Wynne's opinion, the case will be remanded so that the Appeals Council may reevaluate the ALJ's decision in light of the completed record.
On July 8, 2016, Louis Wynne, Ph.D., prepared a psychological evaluation, and completed a Medical Assessment of Ability To Do Work-Related Activities (Mental) and three listings forms on Mr. Roble's behalf.
Tr. 2.
Dr. Wynne explained in his psychological evaluation that he
Tr. 9. Dr. Wynne's psychological evaluation discussed Mr. Roble's pertinent histories, the information he obtained from Mr. Roble's wife about Mr. Roble's mood and behavior following the June 20, 2011, assault, and possible diagnoses. Dr. Wynne concluded that
Tr. 10.
In completing the Medical Assessment of Ability To Do Work-Related Activities (Mental), the instructions directed Dr. Wynne to consider Mr. Roble's "medical history and the chronicity of findings as from June 2011." Tr. 11-12. In doing so, Dr. Wynne assessed that Mr. Roble had moderate limitations in his ability to (1) understand and remember very short and simple instructions; (2) carry out very short and simple instructions; (3) ask simple questions or request assistance; and (4) maintain socially appropriate behavior and adhere to basic standards of neatness and cleanliness. Id. Dr. Wynne also assessed that Mr. Roble had marked limitations in ability to (1) remember locations and work-like procedures; (2) understand and remember detailed instructions; (3) carry out detailed instructions; (4) maintain attention and concentration for extended periods of time (i.e. 2-hours segments); (5) perform activities within a schedule, maintain regular attendance and be punctual within customary tolerance; (6) sustain an ordinary routine without special supervision; (7) work in coordination with/or proximity to others without being distracted by them; (8) make simple work-related decisions; (9) complete a normal workday and workweek without interruptions from psychological based symptoms and to perform at a consistent pace without unreasonable number and length of rest periods; (10) interact appropriately with the general public; (11) accept instructions and respond appropriately to criticism from supervisors; (12) get along with coworkers or peers without distracting them or exhibiting behavioral extremes; (13) respond appropriately to changes in the work place; (14) be aware of normal hazards and take adequate precautions; (15) travel in unfamiliar places or use public transportation; (16) set realistic goals or make plans independently of others. Id.
Finally, Dr. Wynne completed three listings forms that indicated Mr. Roble met the A, B and C criteria for 12.04 Affective Disorder, 12.06 Anxiety-Related Disorders, and 12.02 Organic Mental Disorders (Hepatic Encephalopathy). Tr. 13-15.
Mr. Roble argues that the Appeals Council improperly determined that the additional submitted evidence was not material. Doc. 20 at 16-21. Mr. Roble asserts that the additional evidence is material because it raises a question as to whether ALJ Richter's decision is supported by substantial evidence because it points to functional limitations that could reasonably change the outcome of the ALJ's determination. Id. The Commissioner contends that Mr. Roble's argument is misplaced because, under current regulations, the Appeals Council will review a case based on additional evidence only if, in addition to meeting other requirements, there is a reasonable probability that it would change the outcome of the decision. Doc. 22 at 13-14. The Commissioner contends that Mr. Roble failed to demonstrate a reasonable probability that the additional evidence would change the outcome of the decision. Id. at 14. The Commissioner adds that, even if the additional evidence were considered, Dr. Wynne opined in his psychological evaluation on an issue reserved to the Commissioner; i.e., that Mr. Roble was disabled since June 2011, and that Dr. Wynne used check-the-box-forms which, without more, are not highly probative of Mr. Roble's condition in 2011 and 2012. Id. at 15. As such, the Commissioner contends that the ALJ's decision remains supported by substantial evidence. Id. at 15-16.
The question before the Court, therefore, is whether the Appeals Council should have considered the additional evidence in Mr. Roble's request for review. Whether evidence qualifies for consideration by the Appeals Council is a question of law subject to de novo review. Krauser v. Astrue, 638 F.3d 1324, 1328 (10
Additional evidence should be considered only if it is new, material, and relates to the period on or before the date of the hearing decision, and there is a reasonable probability that the additional evidence would change the outcome of the decision. 20 C.F.R. §§ 404.970(a)(5), 416.1470(a)(5).
Chambers, 389 F.3d at 1142 (quoting O'Dell v. Shalala, 44 F.3d 855, 859 (10
The additional evidence is new because it is not duplicative or cumulative. Dr. Wynne's psychological evaluation, Medical Assessment of Ability To Do Work-Related Activities (Mental), and listing forms were not available to the ALJ at the time she made her decision. As such, the evidence is not duplicative. Additionally, Dr. Wynne is the only examining acceptable medical source
The additional evidence is material and creates a reasonable possibility that the outcome of the case would change.
Finally, the additional evidence relates to the period at issue. It is undisputed that the date on which Dr. Wynne completed psychological evaluation and the Medical Assessment of Ability To Do Work-Related Activities (Mental) post-date the ALJ's decision. However, the additional evidence makes a direct reference to the time period adjudicated by the ALJ; i.e., as from June 2011.
Lastly, the Commissioner argues that even if the Court were to find that the additional evidence should have been considered, it would not undermine the ALJ's decision. Doc. 22 at 15-16. However, in this case, the Appeals Council did not accept or consider the new evidence in denying Mr. Roble's request to review the ALJ's decision. Thus, the only question before the Court is whether the Appeals Council should have done so. Padilla v. Colvin, 525 F. App'x 710, 712, n. 1 (10
For the foregoing reasons, the Court finds that the additional evidence from Louis Wynne, Ph.D., is new, material and, chronologically pertinent.
The Court will not address Mr. Roble's remaining claim of error because it may be affected by the ALJ's treatment of this case on remand. Wilson v. Barnhart, 350 F.3d 1297, 1299 (10
For the reasons stated above, Mr. Roble's Motion to Reverse and Remand for Rehearing With Supporting Memorandum (Doc. 20) is
On September 19, 2013, State agency nonexamining psychological consultant Donald Gucker, Ph.D., reviewed Mr. Roble's medical record evidence and assessed certain Section I moderate limitations. Tr. 110-12, 127-29. Dr. Gucker concluded in Section III that "[a]ll considered, and based on mental issues only, when treatment compliant, claimant retains the capacity to understand, remember, and carry out simple instructions, attend and concentrate sufficient to complete a routine work day without significant interruptions from psychologically-based symptoms; exercise reasonable judgment; interact appropriately with coworkers; supervisors and the general public on an incidental basis." Id. On May 20, 2014, Dr. Wewerka affirmed Dr. Gucker's decision. Tr. 142, 154. The ALJ accorded the State agency nonexamining psychological consultant opinions limited weight because "these experts appear to have given little serious consideration to the nonmedical factors contained in 20 CFR 404.1529(c)(3)/416.929(c)(3)." Indeed, the ALJ clearly rejected their opinions when she determined that Mr. Roble was disabled as of August 30, 2013.
On October 3, 2014, LISW Walker assessed as from a year prior to initial visit to current examination that Mr. Roble had marked limitations in his ability to (1) remember locations and work-like procedures; (2) understand and remember detailed instructions; (3) carry out detailed instructions; (4) maintain attention and concentration for extended periods of time (i.e., 2-hour segments); (5) perform activities within a schedule, maintain regular attendance and be punctual within customary tolerance; (6) sustain an ordinary routine without special supervision; (7) work in coordination with/or proximity to others without being distracted by them; (8) make simple work-related decisions; (9) complete a normal workday an workweek without interruptions from psychological based symptoms and to perform at a consistent pace without unreasonable number and length of rest periods; (10) interact appropriately with the general public; (11) ask simple questions or request assistance; (12) accept instructions and respond appropriately to criticism from supervisors; (13) get along with coworkers or peers without distracting them or exhibiting behavioral extremes; (14) maintain socially appropriate behavior and adhere to basic standards of neatness and cleanliness; (15) respond appropriately to changes in the work place; (16) be aware of normal hazards and take adequate precautions; and (17) travel in unfamiliar places or use public transportation. Tr. 617-18.
On December 24, 2015, LISW Walker made the same assessment, but added that Mr. Roble also had marked limitations in his ability to (1) understand and remember very short and simple instructions; and (2) carry out very short and simple instructions. Tr. 952-53.
On December 24, 2015, LISW Gregory Bussey assessed as from a year prior to initial visit to current examination that Mr. Roble had marked limitations in his ability to (1) maintain attention and concentration for extended periods of time (i.e., 2-hour segments); (2) sustain an ordinary routine without special supervision; (3) work in coordination with/or proximity to others without being distracted by them; (4) accept instructions and respond appropriately to criticism from supervisors; (5) get along with coworkers or peers without distracting them or exhibiting behavioral extremes; (6) respond appropriately to changes in the work place; (7) travel in unfamiliar places or use public transportation; and (8) set realistic goals or make plans independently of others. Tr. 947-48.