Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-4_04-cv-04163/USCOURTS-arwd-4_04-cv-04163-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:405 Review of HHS Decision (SSID)

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IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

TEXARKANA DIVISION

PATRICIA A. CHAPMAN PLAINTIFF

vs. Civil No. 04-4163

JO ANNE B. BARNHART,

Commissioner, Social Security Administration DEFENDANT

MEMORANDUM OPINION

Factual and Procedural Background:

 Patricia A. Chapman (hereinafter "Plaintiff"), has appealed the final decision of the

Commissioner of the Social Security Administration (hereinafter "Commissioner"), denying her 

claim for supplemental security income (hereinafter "SSI") benefits, pursuant to § 1602 of Title

XVI, 42 U.S.C. § 1381a. 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).

Each party has filed an appeal brief (Doc. #9 & 10). The history of the administrative

proceedings is contained in the respective appeal briefs and will not be recited herein, except as

is necessary.

The SSI application now before the undersigned was filed on July 24, 2002 (T. 46-49). 

Said application alleges an onset date of December 11, 2001 (T. 46).

Plaintiff alleges that she is disabled due to: anterior and posterior osteophyte formation

at L5-S1; degenerative arthritis; disc degeneration at L5-S1 associated with moderate central

and mild right paracentral posterior prolapse of the nucleus pulposis with mild thecal sac

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encroachment; right lumbar radiculopathy; weakness at L4-5; pain in back, leg, shoulder, ankle

and wrist; cervical and lumbar tenderness and muscle spasms; severe edema of the lower

extremities; hypertension; chronic obstructive pulmonary disorder; degenerative arthritis of the

left ankle; depression; joint pain; bulging discs at C3-4, C4-5, C5-6, and C6-7; central spinal

stenosis with cord flattening at C3-4; hypertrophy associated with bone spur centrally at C5-6;

mild neural foraminal encroachment on the right and left at C5-6; chronic neck pain, radiating

into both arms with tingling of the fingers and hands; crepitance of the left knee; insomnia;

anxiety; dizziness; syncope; right pulmonary nodule; cancer of the right kidney; cancer of the

cervix; cancer of the gall bladder; suicidal tendencies with suicide attempt; visual

hallucinations; sleep apnea; bipolar disorder; depression disorder with psychotic features;

personality disorder; and, obesity (Doc. #9, pp. 6-7). The issue before this Court is whether the

decision of the Commissioner is supported by substantial record evidence. 

Plaintiff, whose date of birth is May 19, 1965, was 38 years of age at the time of the

administrative hearing (T. 224). Plaintiff has a 10th grade education and has not obtained her

GED (T. 224). Plaintiff previously worked as a certified nurses aid (hereinafter "CNA"), and

as a night auditor/clerk in the hotel industry (T. 224-225). 

The Social Security Administration denied plaintiff’s application initially and on

reconsideration. She then requested and received a hearing before an Administrative Law Judge

(hereinafter “ALJ”), which hearing was conducted on March 4, 2004 (T. 221-249). The ALJ

rendered an unfavorable decision on July 26, 2004 (T. 15-21). Plaintiff then sought the review

of the Appeals Council and provided a significant amount of additional evidence for review by

the Appeals Council (T. 8, 160-220, 250-388). Although the appeals counsel considered the

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additional evidence submitted by Plaintiff, her request for review was denied by the Appeals

Council on September 14, 2004 (T. 5-8), thus making the ALJ’s decision the final decision of

the Commissioner. Plaintiff now seeks judicial review of that decision (Doc. #1). The matter

is before the undersigned by consent of the parties (Doc. #8). 

Applicable Law:

Our role on review is to determine whether the Commissioner's findings are supported

by substantial evidence on the record as a whole. See Prosch v. Apfel, 201 F.3d 1010, 1012 (8th

Cir. 2000); see also Craig v. Apfel 212 F.3d 433, 435-436 (8th Cir. 2000). Substantial

evidence is relevant evidence that a reasonable mind would accept as adequate to support the

Commissioner's conclusion. See Haggard v. Apfel, 175 F.3d 591, 594 (8th Cir. 1999). In

considering whether existing evidence is substantial, we consider evidence that detracts from

the Commissioner's decision as well as evidence that supports it. See Prosch, 201 F.3d at 1012. 

We may not reverse the Commissioner's decision merely because substantial evidence exists in

the record that would have supported a contrary outcome. See id. 

However, the Court may not reverse the Commissioner’s decision merely because

substantial evidence would have supported an opposite decision. Woolf v. Shalala, 3 F.3d

1210, 1213 (8th Cir. 1993). Even if this Court might have weighed the evidence differently, the

decision of the ALJ may not be reversed if there is enough evidence in the record to support the

decision. Browning v. Sullivan, 958 F.2d 817, 822 (8th Cir. 1992). And, it is well settled that

proof of a disabling impairment must be supported by at least some objective medical evidence. 

Marolf v. Sullivan, 981 F.2d 976, 978 (8th Cir.1992).

The Commissioner has established, by regulation, a five-step sequential evaluation for

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determining whether an individual is disabled.

The first step involves a determination of whether the claimant is involved in substantial

gainful activity. 20 C.F.R. § 416.920(b). If the claimant is so involved, benefits are denied; if

not, the evaluation goes to the next step.

Step two involves a determination, based solely on the medical evidence, of whether

claimant has a severe impairment or combination of impairments. Id., § 416.920(c); see 20

C.F.R. § 416.926. If not, benefits are denied; if so, the evaluation proceeds to the next step.

The third step involves a determination, again based solely on the medical evidence, of

whether the severe impairment(s) meets or equals a listed impairment which is presumed to be

disabling. Id., § 416.920(d). If so, benefits are awarded; if not, the evaluation continues.

Step four involves a determination of whether the claimant has sufficient residual

functional capacity, despite the impairment(s), to perform past work. Id., § 416.920(e). If so,

benefits are denied; if not, the evaluation continues.

The fifth step involves a determination of whether the claimant is able to perform other

substantial and gainful work within the economy, given the claimant’s age, education and work

experience. Id., § 404.920(f). If so, benefits are denied; if not, benefits are awarded.

In addition, 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

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

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 ALJ’s 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). This requires us to speculate on how the ALJ would

have weighed the newly submitted evidence had it been available at the initial hearing. Flynn v.

Chater, 107 F.3d 617, 622 (8th Cir.1997). Thus, we have endeavored to perform this function

with respect to the newly submitted evidence. Id.; Mackey v. Shalala, 47 F.3d 951, 953 (8th

Cir. 1995).

Discussion:

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

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

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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 this analysis;

thus, this court now turns to that additional evidence.

Here, the Appeals Council initially considered 60 additional pages of medical evidence

before denying review on September 14, 2004 (T. 5-8, 160-220). Later, the Appeals Council

discovered and considered an additional 138 pages of medical records which it failed to

previously associate with Plaintiff’s file (T. 250). Although the matter before the undersigned

was pending when the further additional evidence was discovered and considered, the Appeals

Council provided an explanation of such and reaffirmed the denial of review by letter dated

March 4, 2005 (T. 250-388). 

The administrative record before the undersigned contains psychological and

physiological medical records, not previously included in the administrative record (T. 5-8, 160-

220, 250-388). This additional evidence reveals medical evidence of a suicide attempt,

psychiatric hospitalization, cancer of the kidney and gallbladder, removal of the right kidney

and gallbladder, chemotherapy treatments, as well as diagnoses of depressive disorder with

psychotic features, personality disorder, bipolar disorder, and anxiety/panic attacks (T. 256, 168,

170, 171, 174, 205, 264, 252, 327, 329, 339, 340, 342, 357, 361, 375). This information was

not previously made available to or considered by the ALJ. 

Notably, the ALJ specifically found that Plaintiff’s alleged depression was not a severe

impairment (T. 17), yet the additional evidence includes medical evidence of Plaintiff’s suicide

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attempt, psychological treatment, psychiatric medications, admission to an inpatient psychiatric

facility and psychological diagnoses (T. 250-388). Following the suicide attempt, Plaintiff was

treated with multiple psychiatric medications, such as: Haldol; Cogentin; Ativan; Restoril;

Effexor; Provigil; Seroquel; Wellbutrin; Proventil; Tenormin; and, Zyprexa (T. 260-264, 271-

311). However, the ALJ was not provided with that information, and therefore could not

consider said information. The ALJ did not have the benefit of any of this information when he

found that Plaintiff did not suffer from a severe mental illness. Clearly, such voluminous,

detailed mental health treatment records with the aforementioned treatment and findings could

reasonably cause the ALJ to reach a different conclusion. 

Although the ALJ determined that Plaintiff’s only severe physical impairment was "a

history of treatment for a back disorder" (T. 15), the ALJ again did not have benefit of all

available information with respect to Plaintiff’s cancer or cancer treatment. The records before

the ALJ indicated that Plaintiff’s cervical cancer was controlled and not expected to spread

elsewhere in Plaintiff’s body. However, the additional evidence indicates that the cancer was

also found in Plaintiff’s right kidney and gall bladder. Plaintiff underwent surgical removal of

both organs as well as subsequent treatment. Yet again, the ALJ did not have benefit of this

information when he rendered his decision. 

The undersigned is required to consider whether the knowledge of the additional

evidence considered by the Appeals Council would impact the ALJ’s decision. We find that the

additional evidence would impact upon the ALJ’s analysis. This evidence belies the ALJ’s

findings with respect to what physical and or mental impairments are severe. Specifically, the

evidence of Plaintiff’s psychological treatment and medications, as well as surgeries and

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oncology medications, would likely change the ALJ’s findings with respect to Plaintiff’s severe

impairments. The ALJ’s findings of Plaintiff’s severe physical and mental must be

reconsidered in view of the additional record evidence.

In order to reach the same conclusion with respect to Plaintiff’s severe impairments as

noted in the decision, the ALJ would be forced to disregard Plaintiff’s diagnoses, surgeries and

medications. The evidence of record before the undersigned does not contain substantial

evidence to support such disregard of the additional objective medical evidence considered by

the Appeals Council. Therefore, the ALJ should have an opportunity to consider the additional

evidence considered by the Appeals Council.

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 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 consistent with this opinion.

ENTERED this 3rd day of February, 2006.

/s/Bobby E. Shepherd 

Honorable Bobby E. Shepherd 

United States Magistrate Judge 

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