Tamera S. v. Bisignano

Background

Tamera S. sought judicial review under 42 U.S.C. § 405(g) of the Commissioner of Social Security’s decision denying her claim for Disability Insurance Benefits under Title II of the Social Security Act. She applied on February 23, 2022, alleging disability beginning December 31, 2021, because of bipolar, anxiety, and depressive disorders.

An administrative law judge held a telephonic hearing on August 2, 2023, at which Tamera S. was represented by counsel and testified. On December 21, 2023, the administrative law judge found that she was not disabled. The judge found severe bipolar, depressive, and anxiety disorders but concluded that they did not meet or equal a listed impairment. The judge determined that Tamera S. could perform light work with several restrictions, could not perform her past work as a home health aide, but could perform other jobs identified as labeler, garment batter, or inserter. The Appeals Council denied review on November 19, 2024, and stated that it would not add the newly submitted Mayo Clinic records because they did not show a reasonable probability of changing the outcome.

Parties’ Arguments

Tamera S. argued that remand was required because the additional medical records were new and material, the administrative law judge improperly evaluated the medical opinions of Dr. Emily Thomas and Dr. Ashok Seshardri, and the residual functional capacity finding was not supported by the medical evidence. She requested reversal and an award of benefits or, alternatively, remand for further administrative proceedings.

The Commissioner argued that the additional reports were not reasonably likely to change the outcome, that the administrative law judge properly evaluated the medical opinions, and that the decision was supported by substantial evidence.

Analysis

The court explained that it reviews whether the administrative law judge applied the correct legal standards and whether the decision is supported by substantial evidence, meaning enough evidence that a reasonable person could accept it as adequate. Because the Appeals Council considered the additional evidence, the court reviewed the entire record, including that evidence, when assessing the administrative law judge’s decision.

The court concluded that the additional records were new and material. The records described Tamera S.’s continuing deterioration and her inability to undergo additional electroconvulsive therapy because of worsening anxiety and treatment side effects, including memory loss. The administrative law judge had relied on the initial electroconvulsive therapy treatments and their apparently positive effects when evaluating the mental-impairment criteria and residual functional capacity. The later records undermined that evidence and created a conflict that the administrative law judge had not had an opportunity to resolve. The court therefore concluded that it could not determine that the decision remained supported by substantial evidence.

The court did not decide whether the administrative law judge properly weighed Dr. Thomas’s and Dr. Seshardri’s opinions. It stated that, because the new records required remand and it was unclear which records Dr. Thomas reviewed, it could not and need not resolve that issue.

The court also concluded that the residual functional capacity finding was not supported by substantial evidence. The administrative law judge’s explanation relied on the promising initial electroconvulsive therapy results but did not include the later records from the relevant period that undermined those results. The court recommended further consideration of the full relevant timeframe.

Recommendation and Notice

The recommendation states that Tamera S.’s request for relief should be GRANTED in part and DENIED in part, and that the Commissioner’s request for relief should be DENIED. The recommended remedy is remand to the Commissioner for consideration of the new, material evidence and the evolving condition through December 21, 2023.

This report and recommendation is not a final district court order or judgment and is not directly appealable to the Eighth Circuit. The notice states that a party may file specific written objections within 14 days after being served with the report.