Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_10-cv-00014/USCOURTS-azd-2_10-cv-00014-0/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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WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Stacy E. Pereira, 

Plaintiff, 

vs.

Michael J. Astrue, Commissioner of Social

Security, 

Defendant. 

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No. CV-10-0014-PHX-GMS

ORDER

Presently before the Court is a Motion to Remand pursuant to sentence six of 42

U.S.C. § 405(g), filed by Defendant Michael J. Astrue, Commissioner of Social Security.

(Doc. 19). For the reasons set forth below, the Court grants Defendant’s Motion and remands

this matter to the Commissioner for further administrative proceedings. 

BACKGROUND

On March 13, 2007, claimant Stacy Pereira filed an application for Disability

Insurance Benefits under Title II of the Social Security Act (“Act”), alleging a disability

onset date of March 18, 2007. (R. at 21). The claim was denied initially on October 25, 2007,

and upon reconsideration on February 12, 2008. (Id.). Plaintiff filed a timely request for a

hearing, and, on January 9, 2009, an Administrative Law Judge (“ALJ”) conducted a hearing

on Plaintiff’s claims. (Id.). At the hearing, Plaintiff, who was represented by counsel, testified

along with a vocational expert.

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In a decision dated April 20, 2009, the ALJ denied Plaintiff’s application, finding that

she was not disabled because “through the date last insured, the claimant did not have an

impairment or combination of impairments that significantly limited [her] ability to perform

basic work-related activities for 12 consecutive months.” (R. at 23). Thus, the ALJ concluded

she “was not under a disability, as defined in the Social Security Act, at any time from March

18, 2007, the alleged onset date, through March 31, 2007, the date last insured.” (R. at 29).

The ALJ’s decision became the final decision of the Commissioner when the Appeals

Council denied Plaintiff’s request for review on November 6, 2009. (R. at 1–4). 

Defendant’s motion for remand is based on a subsequent, favorable decision by the

agency, dated October 7, 2009, which granted plaintiff disability benefits at the initial level

of review. (Doc. 19). Specifically, the Notice of Award indicates that Plaintiff “[met] all the

rules to be eligible for SSI beginning March 13, 2007.” (Doc. 19-2). In essence, the

Commissioner requests a sentence six remand so that the agency can reconcile the ALJ’s

April 2009 finding that Plaintiff was not disabled through March 31, 2007, with the agency’s

subsequent finding that Plaintiff was disabled as of March 13, 2007. The Commissioner

seeks remand on grounds that the subsequent, favorable decision constitutes new and

material evidence that bears directly on the determination of the disability onset date. 

DISCUSSION

Under the Social Security Act, 42 U.S.C. § 401, et seq., there are only two kinds of

possible remands. Melkonyan v. Sullivan, 501 U.S. 89, 99 (1991). Sentence four permits

remand “in conjunction with a judgment affirming, modifying, or reversing the

[Commissioner’s] decision.” Id. at 99–100 (citing 42 U.S.C. § 405(g)). Sentence six permits

remand to allow the agency to take some further action, or to consider new evidence not

presented previously. See id. at 100. Pursuant to sentence six, the Court may remand the case

without ruling on the merits only in two situations: 1) “where the Secretary requests a remand

before answering the Complaint,” or 2) “where new, material evidence is adduced that was

for good cause not presented before the agency.” Shalala v. Schaefer, 509 U.S. 292, 297 n.2

(1993) (citing Melkonyan, 501 U.S. at 100 & n.2); Sullivan v. Finkelstein, 496 U.S. 617, 626

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 The statutory text providing for such orders states the following: “The court may,

on motion of the Commissioner of Social Security made for good cause shown before the

Commissioner files the Commissioner’s answer, remand the case to the Commissioner . . .

and it may at any time order additional evidence to be taken before the Commissioner of

Social Security, but only upon a showing that there is new evidence which is material and

that there is good cause for the failure to incorporate such evidence into the record in a prior

proceeding.” 42 U.S.C. § 405(g). 

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(1990)).1

 As Defendant’s answer preceded the motion to remand, the only avenue left for

the Commissioner is the second. Thus, Defendant must demonstrate that Plaintiff’s

subsequent favorable agency decision constitutes new and material evidence, and that there

is good cause for the failure to incorporate this evidence into the record in the prior

proceeding.

The Ninth Circuit has stated that “[n]ew evidence is material when it ‘bear[s] directly

and substantially on the matter in dispute,’ and if there is a ‘reasonabl[e] possibility that the

new evidence would have changed the outcome of the . . . determination.’” Luna v. Astrue,

623 F.3d 1032, 1034 (9th Cir. 2010) (alterations and omissions in original) (citing Bruton v.

Massanari, 268 F.3d 824, 827 (9th Cir. 2001)). In addition, evidence is new and material

only where it relates to the period on or before the date of the ALJ’s decision. See 20 C.F.R.

§ 404.970. 

Here, as in Luna, Plaintiff’s first application for benefits was denied, her subsequent

application was granted, and the two decisions are not easily reconcilable based on the record

before the Court. The district court in Luna “held that the finding of disability based on

Luna’s second benefits application was new and material evidence warranting remand for

further factual consideration because it commenced at or near the time Luna was found not

disabled based on the first application.” Luna, 623 F.3d at 1034. Accordingly, the district

court “remanded for further administrative proceedings to reconsider whether Luna was

actually disabled during the period of time relevant to her first application.” Id. Affirming

the district court’s determination, the Ninth Circuit stated: “The ‘reasonable possibility’ that

the subsequent grant of benefits was based on new evidence not considered by the ALJ as

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part of the first application indicates that further consideration of the factual issues is

appropriate to determine whether the outcome of the first application should be different.”

Id. (citing Booz v. Sec’y of Health & Human Servs., 734 F.2d 1378, 1380–81 (9th Cir.

1984)). The justification for remand is even more persuasive here than in Luna because

Plaintiff’s subsequent favorable decision pertains, at least in part, to the same time period

relevant to Plaintiff’s first application. Based on the limited record before the Court, it

appears that the two decisions are inconsistent because the first decision finds Plaintiff not

disabled from March 18, 2007 to March 31, 2007, while the subsequent decision finds her

disabled as of March 13, 2007. Thus, for an overlapping period of 18 days, the decisions

reach inconsistent results. Nothing in the record suggests why the favorable agency decision

indicates March 13, 2007 as the disability onset date. Plaintiff may have presented different

medical evidence to support her two applications, or there might be some other reason to

explain the differing outcomes. In any event, given this uncertainty, remand for further

proceedings is an appropriate remedy. See Am. Bird Conservancy v. FCC, 545 F.3d 1190,

1195 n.3 (9th Cir. 2008) (“The proper remedy for an inadequate record . . . is to remand to

the agency for further factfinding.”). 

Accordingly, Plaintiff’s subsequent, favorable benefits decision constitutes new and

material evidence supporting remand. The Court also finds that good cause supports

Defendant’s failure to incorporate the new evidence into the prior administrative record

because the new evidence did not exist at the time of the initial disability determination. 

IT IS HEREBY ORDERED:

1. Defendant’s Motion to Remand to the Social Security Administration pursuant

to sentence six of 42 U.S.C. § 405(g) is GRANTED (Doc. 19); and 

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2. The Clerk of the Court is directed to REMAND back to the Social Security

Administration pursuant to 42 U.S.C. § 405(g), sentence six, for further administrative

proceedings to reconsider whether Plaintiff was actually disabled during the period of time

relevant to her first application.

DATED this 25th day of January, 2011.

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