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Ginger N. v. Commissioner, Social Security Administration

United States District Court, D. Maryland

April 29, 2019

Ginger N.
Commissioner, Social Security Administration;


         Dear Counsel:

         On June 20, 2018, Plaintiff Ginger N. petitioned this Court to review the Social Security Administration's (“SSA's”) final decision to deny her claims for Disability Insurance Benefits and Supplemental Security Income. ECF 1. I have considered the parties' cross-motions for summary judgment. ECF 12, 15. I find that no hearing is necessary. See Loc. R. 105.6 (D. Md. 2018). This Court must uphold the decision of the SSA if it is supported by substantial evidence and if the SSA employed proper legal standards. See 42 U.S.C. §§ 405(g), 1383(c)(3); Craig v. Chater, 76 F.3d 585, 589 (4th Cir. 1996). Under that standard, I will deny both motions, reverse the judgment of the SSA, and remand the case to the SSA for further analysis pursuant to sentence four of 42 U.S.C. § 405(g). This letter explains my rationale.

         After a prior denial of benefits, Plaintiff filed the instant claims for benefits on February 13, 2012, alleging an onset date of October 1, 2009 (“File #1”). Tr. 263-78. Her claims were denied initially and on reconsideration. Tr. 188-95, 204-07. A hearing was held on March 6, 2014, before an Administrative Law Judge (“ALJ”). Tr. 51-88. Following the hearing, the ALJ determined that Plaintiff was not disabled within the meaning of the Social Security Act during the relevant time frame. Tr. 8-50. The Appeals Council declined review. Tr. 1-6. Plaintiff then appealed the decision to this Court, and the case was remanded for further consideration. Tr. 2806-14. An ALJ held a second hearing on December 12, 2016. Tr. 2715-47. On February 6, 2017, the ALJ issued an opinion again denying benefits. Tr. 2684-702. The Appeals Council again declined review, Tr. 2674-80, making the ALJ's 2017 decision the final, reviewable decision of the SSA as to File #1. After the ALJ's denial of benefits on File #1, while Plaintiff appealed the decision, she also filed additional claims for benefits in September, 2015 (“File #2”).

         In the ALJ's 2017 opinion on File #1, the ALJ found that, during the relevant time frame, Plaintiff suffered from the severe impairments of “degenerative disc disease of the cervical and lumbar spine; asthma; major depressive disorder; and generalized anxiety disorder.” Tr. 2688. Despite these impairments, the ALJ determined that Plaintiff retained the residual functional capacity (“RFC”) to:

perform sedentary work as defined in 20 CFR 404.1567(a) and 416.967(a) except she can occasionally climb ramps, stairs, ladders, ropes, and scaffolds; she can occasionally balance, stoop, kneel, crouch, and crawl; she can have occasional exposure to extreme cold, extreme heat, wetness, humidity, vibration, fumes, odors, dust, gas, poor ventilation, and hazards, and she can perform simple, unskilled tasks, with no fast pace or strict production requirements, and occasional changes in the work setting.

Tr. 2690. After considering the testimony of a vocational expert (“VE”), the ALJ determined that Plaintiff could not perform her past relevant work, but could perform other jobs existing in the national economy. Tr. 2700-01. Therefore, the ALJ concluded that Plaintiff was not disabled. Tr. 2701-02.

         Plaintiff raises three primary arguments on appeal: (1) that the ALJ failed to merge File #1 and File #2 for consideration, as directed by the Appeals Council; (2) that the ALJ failed to evaluate or explain the weight accorded to opinions in the SSA's records pertaining to the relevant time frame; and (3) that the ALJ assigned inadequate weight to the opinions of some of her treating medical sources. ECF 12-1 at 10-18. I agree that the ALJ failed to assign weight to all of the relevant medical opinions, and I therefore grant remand under sentence four. In remanding for further explanation, I express no opinion as to whether the ALJ's ultimate conclusion that Plaintiff is not entitled to benefits is correct.

         Plaintiff's first argument is that the ALJ's failure to merge her two duplicate claims files warrants remand. ECF 12-1 at 10-12. The Appeals Council's remand order expressly directed the ALJ to “consolidate the claim files, create a single electronic record and issue a new decision on the consolidated claims.” Tr. 2813. At the 2017 hearing on File #1, after remand, Plaintiff's attorney specifically informed the ALJ that the claims had been merged, but that the mental RFC and physical RFC analyses performed at the reconsideration level by the State agency physicians for File #2 were missing from the transcript. Tr. 2718. Instead of investigating whether the claims and files had been properly merged, the ALJ stated, “I do not have that in the, in the electronic file at all, so obviously it's not something I'll consider because it's not before me, it's not part of this record.” Id.

         Federal courts have split on the issue of whether an ALJ's failure to comply with an order of the Appeals Council, standing alone, justifies remand, or whether federal courts are limited to considering whether the ALJ's opinion is supported by substantial evidence. See Norris v. Berryhill, No. 6:16-cv-2040-Orl-37JRK, 2018 WL 798221, at *10 (M.D. Fla. Feb. 5, 2018), adopted by 2018 WL 814702 (Feb. 9, 2018) (remanding the case for failure to consolidate cases as directed by the Appeals Council where “the second ALJ was under the mistaken impression both during the hearing and in drafting the Decision that only the [first] applications were at issue”); Hardister v. Berryhill, Cause No. 1:16-cv-2575-WTL-DML, 2018 WL 636001, at *3 (S.D. Ind. Jan. 31, 2018) (“Despite being given notice of the deficiency, the ALJ failed to fully comply with the Appeals Council order. This failure constitutes error that requires remand.”); but see Spurlock v. Berryhill, No. 3:17-cv-02240, 2018 WL 1956119, at *11 (S.D. W.Va. Apr. 2, 2018), adopted by 2018 WL 1954835 (“Several district courts in this circuit have held that an Appeals Council's remand order is merely an intermediate agency action and not the final decision of the Commissioner; such courts have emphasized that the court's review is limited to whether the ALJ's decision is supported by substantial evidence, or was reached through the application of an incorrect legal standard.”) The United States Court of Appeals for the Fourth Circuit has not addressed the issue. In this case, I need not determine whether the failure to comply with the Appeals Council order alone warrants remand, because, as noted below, the failure to merge the two files resulted in the ALJ failing to consider relevant medical opinion evidence.

         Plaintiff's second argument, then, justifies remand of her claims. Plaintiff contends that the ALJ failed to evaluate or explain the weight accorded to the RFC assessments rendered by State agency physicians in the adjudication of File #2. The regulations provide that the SSA “will evaluate every medical opinion we receive” using a list of relevant factors to conduct the evaluation. 20 C.F.R. §§ 404.1527(c); 416.927(c). Longstanding case law requires an ALJ to consider and assign weight to every medical opinion. As the Fourth Circuit has held:

We cannot determine if findings are unsupported by substantial evidence unless the Secretary explicitly indicates the weight given to all of the relevant evidence. See, e.g., Myers v. Califano, 611 F.2d 980, 983 (4th Cir. 1980); Stawls v. Califano, 596 F.2d 1209, 1213 (4th Cir. 1979); Arnold v. Secretary, 567 F.2d 258, 259 (4th Cir. 1977). As we said in Arnold:
The courts . . . face a difficult task in applying the substantial evidence test when the Secretary has not considered all relevant evidence. Unless the Secretary has analyzed all evidence and has sufficiently explained the weight he has given to obviously probative exhibits, to say that his decision is supported by substantial evidence approaches an abdication of the court's “duty to scrutinize the record as a whole to determine whether the conclusions reached are rational.”
567 F.2d at 259. Neither the ALJ nor the Appeals Council indicated the weight given to the various medical reports submitted by the appellant. We therefore remand to the district court with instructions further to remand the case to the Secretary with directions to the Secretary to reconsider the case and to ...

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