Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-6_04-cv-06129/USCOURTS-arwd-6_04-cv-06129-0/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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IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

HOT SPRINGS DIVISION

GLEN W. EASLEY PLAINTIFF

v. Civil No. 04-6129

JO ANNE B. BARNHART, 

Commissioner, Social 

Security Administration DEFENDANT

MEMORANDUM OPINION

Factual and Procedural Background:

Glen Easley, the plaintiff in this case, has appealed the final decision of the

Commissioner of the Social Security Administration (hereinafter "Commissioner") denying his

applications for disability insurance benefits (hereinafter “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. 

Both parties have filed appeal briefs (Doc. #8 & 9). In this judicial review, the court

must determine whether there is substantial evidence in the administrative record to support the

Commissioner's decision. 42 U.S.C. § 405(g).

The history of the administrative proceedings is contained in the respective appeal

briefs and will not be recounted here except as necessary. However, it should be noted

additional evidence was submitted for consideration by the Appeals Council, after the date of

the administrative hearing and the issuance of the ALJ decision (T. 382-385). It appears that

this evidence includes: records from Dr. John Balay for the period beginning on March 19,

2004 and ending May 27, 2004. Although the Appeals Council considered the evidence, it

denied the plaintiff’s request for review of the hearing decision. In addition, additional

evidence was submitted to the Appeals Council on or about August 25, 2004, the day of or after

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the Appeals Council denied the plaintiff’s request for review of the hearing decision (T. 415-

471). It appears that this additional evidence and the Appeals Council Order crossed in the

mail, nonetheless, the Appeals Council considered the evidence, and made the evidence and its

letter dated January 12, 2005, a part of a supplemental transcript filed with the court (T. 413). 

The most recently submitted additional evidence consists of records from Schuck Chiropractic

which appear to be duplicates of records contained in the original transcript (T. 418-423, 372-

378); and, new evidence from the Veterans Hospital, beginning February 2, 2004 and ending

July 6, 2004 (T. 424-471). Ultimately, on January 12, 2005, the Appeals Council considered

the additional evidence, but concluded that the evidence did not provide a basis for changing

the ALJ’s decision (T. 413). 

Plaintiff was 42 years of age at the time of the administrative hearing and has a high

school education and training as a data processor (T. 389-390). He has worked in the past as an

air force mechanic, in pest control and as video rental clerk/cashier (T. 159-162391, 267). He

claims disability due to: depression/anxiety; degenerative disc disease; borderline intellectual

functioning (hereinafter “BIF”); degenerative arthritis of the right knee; headaches;

gastroesophageal reflux disease (hereinafter “GERD”); gout; hypertension; deficiencies in

memory and concentration; and insomnia/fatigue. He filed his application on September 17,

1998 (T. 103-108).

The plaintiff was allowed disability benefits under the Act on December 2, 1998, due to

bipolar disorder and panic disorder with agoraphobia. When his medical re-examination review

was performed, it was determined that his condition had improved medically and that he has the

ability to perform semi-skilled work (T. 63). Plaintiff appealed that decision, and requested an

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administrative hearing, which hearing was held on January 14, 2004 (T. 388-412), after which

the ALJ issued an unfavorable decision dated May 25, 2004 (T. 33-45). Because the Appeals

Council’s decisions made the ALJ’s decision the final decision of the Commissioner, plaintiff

appealed that decision to the undersigned, and this matter is ready for consideration. 

 In his written decision, the ALJ determined that the plaintiff has not engaged in

substantial gainful activity since the onset date for disability associated with his application or,

December 29, 1997 (T. 43). Further, the ALJ found that at the time of the comparison point

decision, the medical evidence establishes that plaintiff has severe physical and mental

impairments, as follows: some limitation of motion status postop, lumbar 4-5 microdiscectomy

with removal of herniated disc; major depressive disorder, recurrent, severe; mood disorder ;

and, BIF. However, the ALJ also found that plaintiff does not have an impairment or

combination of impairments listed in, or medically equal to one listed in Appendix 1, Subpart

P, Regulation No. 4 (T. 43). Finding further, the ALJ determined that there has been medical

improvement in plaintiff’s condition, such improvement is related to the plaintiff’s ability to

work and that he would only be limited to unskilled sedentary work (T. 43). It was determined

that plaintiff’s subjective complaints and alleged nonexertional limitations are not totally

credible. The ALJ concluded that the plaintiff is physically limited in his ability to: lift no

more than 10 pounds at a time and occasionally lift or carry articles like docket files, ledgers

and small tools; stand and walk with normal breaks for a total of 2 hours in an 8-hour work day;

and sit with normal breaks for a total of 6 hours in an 8-hour work day (SSR 96-8p). In

addition, the plaintiff would be limited to “occasionally” stooping, crouching, kneeling,

crawling, would be restricted from walking up and down stairs, and due to a partial amputation

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of his left index finger, would have a problem with fine manipulation with the left, his nondominant hand (T. 44). 

With respect to plaintiff’s asserted mental limitations, the ALJ found:

Despite his mental limitations including anxiety and nerves, the claimant

remains able to perform work where: interpersonal contact is incidental to the

work performed; the complexity of tasks is learned and performed by rote,

involves few variables and requires little independent judgment; [and,] the

supervision required is simple, direct and concrete. Basically, this constitutes

unskilled work (SSR 96-8p).

(T. 44). Thus, the ALJ found the plaintiff retains the residual functional capacity (hereinafter

“RFC”), for unskilled, sedentary work. Based upon vocation expert (hereinafter “VE”)

testimony, the ALJ determined that a significant number of jobs exist in the economy which

plaintiff remains capable of performing, for example: document preparer; call out operator;

and, order clerk-food and beverage (T. 44). Concluding, the ALJ decided that the plaintiff’s

disability had properly ceased in September 2002, as he was not under a “disability” as defined

in the Act (T. 45).

It should be noted that whenever adult claimants allege mental impairment, the

application of a special technique must be followed at each level of the administrative review

process. See 20 C.F.R. § 416.920a(a).

The Commissioner is then charged with rating the degree of functional limitation, and

applying the technique to evaluate mental impairments. See 20 C.F.R. § 416.920a(d). 

Application of the technique must be documented by the Commissioner at the ALJ hearing and

Appeals Council levels. See 20 C.F.R. § 416.920a(e). 

The Commissioner's decision denying benefits will be affirmed if it is supported by

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substantial evidence on the record as a whole. See Clark v. Apfel, 141 F.3d 1253, 1255 (8th

Cir.1998); Ghant v. Bowen, 930 F.2d 633, 637 (8th Cir.1991); 42 U.S.C. § 405(g). 

"Substantial evidence is less than a preponderance, but enough that a reasonable mind might

accept it as adequate to support [the Commissioner's] decision." Cox v. Apfel, 160 F.3d 1203,

1206-07 (8th Cir.1998). In determining whether existing evidence is substantial, this court

looks at both evidence that supports and evidence that detracts from the Commissioner's

decision. See id. at 1207; see also Warburton v. Apfel, 188 F.3d 1047, 1050 (8th Cir.1999).

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 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).

An individual is "disabled" under the Act 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

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period of not less than twelve months." 42 U.S.C. §§ 423(d)(1)(A) and 1382c(a)(3)(A). The

burden of establishing a compensable disability under the Act is initially on the claimant. See

Kerns v. Apfel, 160 F.3d 464, 466 (8th Cir.1998); Riley v. Shalala, 18 F.3d at 621 (quoting

Bowen v. Yuckert, 482 U.S. 137, 146 n. 5, 107 S.Ct. 2287, 96 L.Ed.2d 119 (1987)). However, 

the submission of the additional evidence to the Appeals Council complicates the analysis; thus,

this court now turns to that additional evidence. 

Discussion:

20 C.F.R. § 404.970(b) provides: 

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 "material," the additional evidence must not merely detail after-acquired

conditions or post-decision deterioration of a pre-existing condition. See Jones v. Callahan,

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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 stated in his decision:

There is nothing in the evidential record or testimony which indicates that the

claimant’s mental impairment would significantly or adversely affect his ability

to perform basic work related activities. Accordingly, I find that he has a severe

but non-disabling mental impairment. ...Furthermore, I specifically find that his

mental impairment does not substantially diminish his ability to perform

unskilled sedentary work activity (SSR 96-8p). 

(T. 42). This statement is belied by the supplemented record (T. 424-471), which documents,

among other facts, that plaintiff had a Global Assessment of Functioning (hereinafter “GAF”),

of 21 when seen at the VA (T. 455, 460, 461, 465, 466). A GAF in this range indicates

“behavior is considerably influenced by delusions or hallucinations OR serious impairment in

communications or judgment (e.g., sometimes incoherent, acts grossly inappropriately, suicidal

preoccupation) OR inability to function in almost all areas (e.g., stays in bed all day; no job,

home, or friends). See Diagnostic and Statistical Manual of Mental Disorders, p. 34 (4th

Edition, Text Revision, 2000). 

These records were not before the ALJ when he rendered his decision.

The record evidence before the ALJ contains allegations of depression/anxiety (T. 405-

406, 76, 78, 196, 246, 267, 275, 347, 340, 348, 350, 351, 356, 357, 370, 368, 367, 366, 364,

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373, 372, 381, 383). Additional evidence submitted to and considered by the Appeals Council

is largely devoted to plaintiff’s mental health treatment (T. 446, 447, 448, 450, 451, 454, 455,

459, 461, 465-466, 467, 468). 

Thus, the ALJ’s determination that plaintiff’s asserted mental impairment is severe, but

does not “substantially diminish his ability to perform unskilled sedentary work activity” (T.

42), is not supported by substantial evidence of record, in light of the additional medical

evidence submitted to and considered by the Appeals Council. Such evidence must be

evaluated by the undersigned. 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. Krogmeier v. Barnhart 294 F.3d at 1025.

Conclusion:

Accordingly, the decision of the ALJ, denying benefits to the plaintiff, is not supported

by substantial evidence, and should be reversed. This is especially true in light of the

additional evidence submitted to and considered by the Appeals Council, which was not before

the ALJ when he rendered his decision. This matter should be remanded to the Commissioner,

for further consideration of the plaintiff’s residual functional capacity, particularly in light of

the additional evidence which is now a part of the administrative record. 

ENTERED this 14 day of December, 2005. th 

/s/ Bobby E. Shepherd 

HONORABLE BOBBY E. SHEPHERD 

 UNITED STATES MAGISTRATE JUDGE

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