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Michael H v. Social Security Administration Commissioner

United States District Court, D. Maine

August 31, 2018

MICHAEL H., Plaintiff



         On Plaintiff's application for disability insurance benefits under Title II and supplemental security income benefits under Title XVI of the Social Security Act, Defendant, the Social Security Administration Commissioner, found that Plaintiff has severe impairments, but retains the functional capacity to perform substantial gainful activity. Defendant, therefore, denied Plaintiff's request for disability benefits. Plaintiff filed this action to obtain judicial review of Defendant's final administrative decision pursuant to 42 U.S.C. § 405(g).

         Following a review of the record, and after consideration of the parties' arguments, I recommend the Court vacate the administrative decision and remand the matter for further proceedings.

         The Administrative Findings

         The Commissioner's final decision is the September 19, 2017 decision of the Appeals Council. (ECF No. 9-2.) The Appeals Council adopted the ALJ's findings through Step 4 of the sequential evaluation process, 20 C.F.R. §§ 404.1520, 416.920. (R. 6.) The Appeals Council modified Defendant's step 5 determination. (R. 7.)

         Defendant found that Plaintiff has severe, but non-listing-level impairments consisting of anxiety and affective disorders; that Plaintiff has the residual functional capacity (RFC) for work at all levels of exertion, provided the work consists of simple, routine tasks and simple decisions, with few changes in routine, involves no more than occasional interaction with coworkers and no work in tandem with others, involves no more than frequent supervisor interaction, and does not involve public interaction; that Plaintiff can no longer perform past relevant work; and that Plaintiff is able to perform other substantial gainful activity existing in the national economy. (R. 7, 37, 40, 41.)

         The ALJ, based on her findings and the testimony of a vocational expert, determined that Plaintiff is not disabled because he is able to perform representative light exertion occupations such as linen grader and assembler, using section 202.14 of the Medical-Vocational Guidelines as a framework for her opinion. (R. 41.) The Appeals Council determined that Plaintiff is not disabled based on section 204.00 of the Medical-Vocational Guidelines, finding that Plaintiff is able to perform work at all exertional levels and that Plaintiff's mental impairments do not significantly impair his ability to perform work-related activities. (R. 7.)

         Standard of Review

A court must affirm the administrative decision provided the decision is based on the correct legal standards and is supported by substantial evidence, even if the record contains evidence capable of supporting an alternative outcome. Manso-Pizarro v. Sec'y of HHS, 76 F.3d 15, 16 (1st Cir. 1996) (per curiam); Rodriguez Pagan v. Sec'y of HHS, 819 F.2d 1, 3 (1st Cir. 1987). Substantial evidence is evidence that a reasonable mind might accept as adequate to support a finding. Richardson v. Perales, 402 U.S. 389, 401 (1971); Rodriguez v. Sec'y of HHS, 647 F.2d 218, 222 (1st Cir. 1981). “The ALJ's findings of fact are conclusive when supported by substantial evidence, but they are not conclusive when derived by ignoring evidence, misapplying the law, or judging matters entrusted to experts.” Nguyen v. Chater, 172 F.3d 31, 35 (1st Cir. 1999).


         Plaintiff argues Defendant's decision should be vacated and his claims remanded because (1) the Appeals Council failed to consider a medical opinion and a vocational expert opinion Plaintiff filed with the Appeals Council after the ALJ issued her decision; (2) the ALJ erroneously concluded that Plaintiff's back impairment and attention deficit hyperactivity disorder (ADHD) were not severe impairments, and failed to recognize limitations caused by Plaintiff's chronic back pain and difficulties maintaining attention; (3) the RFC findings are not supported by substantial evidence; and (4) the Appeals Council erred when it concluded that the nonexertional limitations described in the RFC finding would not significantly erode the occupational base, such that a not disabled finding based exclusively on the Guidelines would be supportable.

         1. Rejection of New Evidence Introduced on Appeal

         The ALJ issued her decision on March 28, 2016, and Plaintiff timely requested review by the Appeals Council. (R. 24.) On May 25, 2016, the Appeals Council notified Plaintiff that it was reviewing the ALJ's decision, that it found the decision was not supported by substantial evidence (R. 10), and that it planned “to make a decision again finding that [Plaintiff is] not disabled.” (R. 11.) The Appeals Council explained that it believed the ALJ erred when she applied the framework of Guideline 202.14 because the Guideline applies to individuals limited to light work, and Plaintiff did not have an exertional limitation. (Id.) The Appeals Council proposed finding Plaintiff not disabled based on Guideline 204.00. (Id.) The Appeals Council informed Plaintiff, however, that Plaintiff could submit additional evidence for the Council's consideration if the evidence was “new, material, and relate[d] 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.” (R. 10, 11.)

         Plaintiff supplied the Appeals Council with two items of evidence: a Maine Department of Health and Human Services “Employability Form” completed by Leslie Dixon, M.D., on June 1, 2016 (R. 20); and an affidavit prepared by David Meuse, a vocational expert retained by Plaintiff's counsel. (ECF No. 13-1.) The ...

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