Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-2_04-cv-02272/USCOURTS-arwd-2_04-cv-02272-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:405 Review of HHS Decision (DIWC)

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There appears to be some confusion as to when the actual onset date is. The form 1

Application for Disability Insurance Benefits notes that plaintiff became unable to work due

to a disabling condition July 15, 2002 (Tr. 57, 60), however plaintiff states in her handwritten Disability Report Adult, that she stopped working in July 2000 because of her taking

medication. (Tr. 63.) Further, the Pre-Hearing Brief filed by plaintiff's attorney prior to the

ALJ's hearing states that the alleged period of disability is from "July, 2000 and continuing

through the present." (Tr. 92.) The ALJ states that the onset date is July 15, 2002. (Tr.

15D.) 

IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

FORT SMITH DIVISION

DEBORAH R. NAPIER PLAINTIFF

v. Civil No. 04-2272

JO ANNE B. BARNHART, Commissioner

Social Security Administration DEFENDANT

MEMORANDUM OPINION

Plaintiff Deborah R. Napier brings this action under 42 U.S.C. § 405(g), seeking judicial

review of a decision of the Commissioner of Social Security Administration (Commissioner)

denying her claims for period of disability and disability insurance benefits (DIB) pursuant to §§

216(i) and 223 of Title II of the Social Security Act (hereinafter "the Act"), 42 U.S.C. §§ 416(i)

and 423. In this judicial review, the court must determine whether there is substantial evidence

in the administrative record to support the Commissioner's decision. See 42 U.S.C. § 405(g).

Procedural and Factual Background

The plaintiff filed her application for DIB on July 18, 2002 (Tr. 23), alleging an onset

date of July 2000. The application was initially denied (Tr. 27) and that denial was upheld upon 1

reconsideration (Tr. 29-31). Plaintiff then made a request for a hearing by an Administrative

Law Judge (ALJ). (Tr. 33.) 

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On July 9, 2003 a hearing was held by the ALJ. The plaintiff was represented by counsel

at this hearing. (Tr. 15D.) The ALJ issued an unfavorable ruling on April 8, 2004, deciding that

the plaintiff was not disabled within the meaning of the Act. (Tr. 15A-O.) The plaintiff then

requested a review of the hearing by the Appeals Council (Tr. 8-15), which denied that request

on October 22, 2004 (Tr.4-7); thus, the ALJ's decision became the final action of the

Commissioner. The plaintiff filed her complaint with this court on December 10, 2004, seeking

judicial review of that decision. (Doc. 1.) Both parties have filed appeal briefs with the court.

(Docs. 9-11.) This case is before the undersigned pursuant to the consent of the parties. (Doc.

4.) 

Plaintiff was 48 years of age at the time of the administrative hearing and had completed

the tenth grade in high school. (Tr. 323-24.) She has worked in the past as a fishing lure painter,

a home health worker, and in a chicken plant where she split backs and cut necks. (Tr. 325-27.)

Her last job was as a fishing lure painter, and she left that job when she "started throwing up and

having diarrhea on the line." (Tr. 325.) 

Plaintiff contends that she is disabled because of "[c]oronary atherosclerosis, acute

gastritis, anxiety, major depression, irritable bowel syndrome, liver disease, migraine headaches,

hypertension, carpal tunnel syndrome, and hypercholesterolemia." (Tr. 92.) She claims that she

meets the list of impairments as follows: Listing 12.04 (Depression), 12.06 (Anxiety), 5.05

(Chronic Liver Disease), 4.03 (Hypertensive Cardiovascular Disease), and 4.04 (Coronary

athersclerosis), as well as suffering from chronic diarrhea due to irritable bowel syndrome, acute

gastroenteritis, and frequent and debilitating ongoing migraine headaches. (Tr. 95.) 

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Applicable Law

This court's role is to determine whether the Commissioner's findings are supported by

substantial evidence on the record as a whole. Ramirez v. Barnhart, 292 F.3d 576, 583 (8th Cir.

2002). Substantial evidence is less than a preponderance but it is enough that a reasonable mind

would find it adequate to support the Commissioner's decision. The ALJ's decision must be

affirmed if the record contains substantial evidence to support it. Edwards v. Barnhart, 314 F.3d

964, 966 (8th Cir. 2003). As long as there is substantial evidence in the record that supports the

Commissioner's decision, the court may not reverse it simply because substantial evidence exists

in the record that would have supported a contrary outcome, or because the court would have

decided the case differently. Haley v. Massanari, 258 F.3d 742, 747 (8th Cir. 2001). In other

words, if after reviewing the record it is possible to draw two inconsistent positions from the

evidence and one of those positions represents the findings of the ALJ, the decision of the ALJ

must be affirmed. Young v. Apfel, 221 F.3d 1065, 1068 (8th Cir. 2000).

In cases involving the submission of supplemental evidence subsequent to the ALJ's

decision, the record includes that evidence submitted after the hearing and considered by the

Appeals Council. See Jenkins v. Apfel, 196 F.3d 922, 924 (8th Cir.1999) (citing Riley v. Shalala,

18 F.3d 619, 622 (8th Cir.1994)). Thus, in situations such as the present, this court's role is to

determine whether the ALJ's decision "is supported by substantial evidence on the record as a

whole, including the new evidence submitted after the determination was made." Riley v.

Shalala, 18 F.3d at 622. In practice, this requires a decision as to how the ALJ would have

weighed the new evidence had it existed at the initial hearing. See id. As the United States

Court of Appeals for the Eighth Circuit has often noted, "this [is] a peculiar task for a reviewing

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court." Id. Critically, however, this court may not reverse the decision of the ALJ merely

because substantial evidence may allow for a contrary decision. See Woolf v. Shalala, 3 F.3d

1210, 1213 (8th Cir.1993).

It is well-established that a claimant for Social Security disability benefits has the burden

of proving her disability by establishing a physical or mental disability that has lasted at least one

year and that prevents her from engaging in any substantial gainful activity. Pearsall v.

Massanari, 274 F.3d 1211, 1217 (8th Cir.2001); see also 42 U.S.C. § § 423(d)(1)(A),

1382c(a)(3)(A). The Act defines “physical ormental impairment” as “an impairment that results

from anatomical, physiological, or psychological abnormalities which are demonstrable by

medically acceptable clinical and laboratory diagnostic techniques.” 42 U.S.C. § § 423(d)(3),

1382(3)(c). A plaintiff must show that her disability, not simply her impairment, has lasted for

at least twelve consecutive months.

The Commissioner's regulations require her to apply a five-step sequential evaluation

process to each claim for disability benefits: (1) whether the claimant has engaged in substantial

gainful activity since filing her claim; (2) whether the claimant has a severe physical and/or

mental impairment or combination of impairments; (3) whether the impairment(s) meet or equal

an impairment in the listings; (4) whether the impairment(s) prevent the claimant from doing past

relevant work; and, (5) whether the claimant is able to perform other work in the national

economy given her age, education, and experience. See 20 C.F.R. §§ 404.1520, 416.920. Only

if the final stage is reached does the fact finder consider the plaintiff's age, education, and work

experience in light of her residual functional capacity. See McCoy v. Schweiker, 683 F.2d 1138,

1141-42 (8th Cir. 1982); 20 C.F.R. §§ 404.1520, 416.920.

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Discussion

After the ALJ rendered his decision, plaintiff presented additional evidence to the

Appeals Council. This evidence included a Mental Residual Functional Capacity Assessment

(Tr. 292-298), a Mental Status and Evaluation of Adaptive Functioning report (Tr. 299-301), and

a Psychiatric Review Technique (Tr. 302-314). These reports were completed by Dr. Douglas

A. Brown, who specializes in Clinical Neuropsychology and works at Psychology Services of

Fort Smith. (Tr. 299.) His assessment was made on June 9, 2004, but included an assessment

time from 5 years earlier to the date of assessment. (Tr. 302.) 

According to 20 C.F.R. § 404.970(b):

If new and material evidence is submitted, the Appeals Council shall consider the

additional evidence only where it relates to the period on or before the date of the

administrative law judge hearing decision. The Appeals Council shall evaluate

the entire record including the new and material evidence submitted if it relates

to the period on or before the date of the administrative law judge hearing

decision. 

Thus, the Appeals Council must consider evidence submitted with a request for review

if it is "(a) new, (b) material, and (c) relates to the period on or before the date of the ALJ's

decision." Box v. Shalala, 52 F.3d 168, 171 (8th Cir.1995) (quoting Williams v. Sullivan, 905

F.2d 214, 216-17 (8th Cir.1990)). To be "new," evidence must be more than merely cumulative

of other evidence in the record. See Williams v. Sullivan, 905 F.2d at 216 (concluding that

psychiatrist's report was new because it was not merely cumulative but instead presented more

specific findings and conclusions). To be "material," the evidence must be relevant to claimant's

condition for the time period for which benefits were denied. See id. Thus, to qualify as

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decision deterioration of a pre-existing condition. See Jones v. Callahan, 122 F.3d 1148, 1154

(8th Cir.1997) (holding immaterial evidence detailing a single incident occurring after decision

and noting proper remedy for post-ALJ deterioration is a new application); Williams v. Sullivan,

905 F.2d at 216 (finding that despite failure to identify onset date, doctor's report was material

because it provided sufficient basis to conclude it related to the relevant time). Further, there

must be a reasonable likelihood that it would have changed the determination. Krogmeier v.

Barnhart, 294 F.3d 1019, 1025 (8th Cir.2002).

In the instant matter, the ALJ states in his decision:

The claimant also alleges disability due to depression and anxiety. Ms. Napier

testified she has had anxiety/depression for over 28 years, that it is mostly

controlled with medication and that she has occasional flashbacks of

event/occurrences. Records from the VA show that physicians there have

prescribed Diazepam since at least June 2000 on a regular basis as well as other

medications including, but not limited to, Zoloft, Amitriptyline, Citalopram,

Prozac and Effexor at various times for the claimant's complaints of depression,

stress, etc. (Exhibits 4F and 8F).

The claimant reported to Dr. Lachowsky on May 28, 2003, that she had a history

of clinical depression and was also under a lot of stress. The claimant reported

that she had insomnia but denied suicidal ideation and stated that she frequently

dwelled on and cried about her twins who had died in an automobile accident 28

years earlier. Dr. Lachowsky prescribed Prozac at that time. However, it does

not appear that the claimant has ever undergone a psychiatric evaluation or that

she has ever been treated or even seen by a mental health professional. Further,

it does not appearthat the claimant experiences significant functional limitations

as the result of a mental impairment. The claimant reports in a disability

supplemental interview outline (Exhibit 2E) that she is able to care for her

personal grooming needs without assistance, run errands, use a checkbook, count

change, drive, use public transportation, watch television, read, and visit friends

and relatives. Lastly, asreflected by the claimant's own testimony at the hearing,

these symptoms are relatively well controlled by the medication she takes. The

evidence as a whole reveals that the claimant experiences no restriction of her

activities of daily living, mild difficulties in maintaining social functioning and

mild difficulties in maintaining concentration, persistence or pace and that she

has experienced no repeated episodes of decompensation of extended duration.

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There is no evidence of the presence of the "C" criteria. Therefore, the undersigned finds that

the claimant does not have a severe impairment with regard to her allegation of disability due to

depression or anxiety. 

(Tr. 15G-15H.) 

According to Dr. Brown's assessment, plaintiff is "markedly limited" in her abilities to

(1) understand and remember detailed instructions, (2) carry out detailed instructions, (3)

maintain attention and concentration for extended periods, (4) work in coordination with or

proximity to others without being distracted by them, (5) complete a normal workday and

workweek without interruptions from psychologically based symptoms and to perform at a

consistent pace without an unreasonable number and length of rest periods, and (6) set realistic

goals or make plans independently of others. Dr. Brown found plaintiff to be "moderately

limited" in her abilities to (1) remember locations and work-like procedures, (2) understand and

remember very short and simple instructions, (3) carry out very short and simple instructions,

(4) perform activities within a schedule, maintain regular attendance, and be punctual within

customary tolerances, (5) sustain ordinary routine without special supervision, (6) make simple

work-related decisions, (7) interact appropriately with the general public, (8) ask simple

questions or request assistance, (9) accept instructions and respond appropriately to criticism

from supervisors, (10) get along with co-workers or peers without distracting them or exhibiting

behavioral extremes, (11) maintain socially appropriate behavior and to adhere to basic standards

of neatness and cleanliness, (12) respond appropriately to changes in the work setting, (13) be

aware of normal hazards and take appropriate precautions, and (14) travel in unfamiliar places

or use public transportation. (Tr. 292-94.) 

Dr. Brown opines that plaintiff "is markedly impaired by depression and anxiety in ability

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to deal with work stresses and maintain attention/concentration." (Tr. 296.) He further notes that

plaintiff's "intellectual limitations and poor concentration due to anxiety [and] depression

markedly impair [her] capacity for complex job instructions." (Tr. 296-97.) Dr. Brown also

finds that plaintiff has had repeated episodes of decompensation, each of extended duration. (Tr.

312.) The record had repeated references to plaintiff's complaints concerning depression and

anxiety. (Tr. 92, 103, 144, 158, 168, 173, 185, 192, 204, 221, 277, 282.) 

Many of Dr. Brown's determinations contradict the findings of the ALJ as those findings

pertain to the plaintiff's mental capacities and limitations brought on by depression and anxiety.

For instance, Dr. Brown determined that plaintiff does suffer from some functional limitations

due to her mental impairment, that she does experience restrictions of her activities of daily

living, that she has more than mild difficulties in maintaining social functioning and in

maintaining concentration, persistence, or pace, and that she has experienced repeated episodes

of decompensation of extended duration. Dr. Brown's assessment refers back to 1999 and

includes the relevant time period for her DIB claim. These records were not before the ALJ at

the time he rendered his decision. Thus, the ALJ's determination that plaintiff does not suffer

from a severe mental impairment is not supported by substantial evidence of record, in light of

the additional evidence submitted to and considered by the Appeals Council. For this reason,

this matter must be remanded for proper analysis of all of the evidence pertaining to plaintiff’s

alleged mental impairments. The undersigned finds there is a reasonable likelihood that the

additional evidence would have changed the ALJ’s determination. See Krogmeier v. Barnhart,

294 F.3d at 1025.

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Conclusion:

Accordingly, the ALJ’s decision, denying DIB to the plaintiff, is not supported by

substantial evidence and should be reversed. This matter should be remanded to the

Commissioner for consideration of the evidence submitted to and considered by the Appeals

Council, which was not before the ALJ when he rendered his decision. On remand, the ALJ

should also determine the proper onset date for the plaintiff. In light of this decision, other issues

raised by the plaintiff are not reached. 

DATED this 2nd day of March 2006.

/s/ Beverly Stites Jones

_________________________________________

HON. BEVERLY STITES JONES 

UNITED STATES MAGISTRATE JUDGE

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