Clark v. Commissioner of Social Security

Background

Ava Clark sought review of the Social Security Commissioner’s denial of her application for disability insurance benefits. She applied in 2012, alleging that her disability began on December 31, 2007. Her insured status ended on December 31, 2010, so she had to show that she was disabled by that date. After an earlier court remand for further administrative proceedings, Administrative Law Judge Michael Stacchini held additional hearings and again denied the claim on October 18, 2018. Clark then filed this action and represented herself.

The administrative law judge found that Clark had medically determinable impairments of hypercalcemia, hypertension, gastroesophageal reflux disease, and obesity. He concluded that none of those impairments, alone or together, significantly limited her ability to perform basic work activities for at least 12 months through December 31, 2010. He therefore stopped the required five-step disability analysis at step two and found that Clark was not disabled. The administrative law judge gave great weight to the testimony of a medical expert, who found no severe impairment during the relevant period. The judge also relied on normal examinations, Clark’s reported daily activities, and the lack of treatment for osteoarthritis or back conditions during that period.

Clark’s challenges

The court understood Clark’s filings to raise two arguments: that the administrative law judge’s decision was not supported by substantial evidence, and that the case should be sent back to the agency to consider new evidence.

Clark argued that the administrative law judge improperly weighed the medical expert’s opinion, failed to account for the progression of her conditions, and failed to consider the combined effect of her impairments. The court rejected those arguments. It concluded that the medical opinions Clark relied on either did not address the period before December 31, 2010 or did not relate her later limitations back to that period. The court also found that the medical expert’s opinion was consistent with the records from the relevant period, Clark’s testimony about her activities, and other medical evidence.

The court held that the administrative law judge did not violate the treating-physician rule because the treating-physician opinions Clark cited did not address her condition during the period when she was insured. The court further held that later diagnoses—including breast cancer, radiculopathy, adhesive capsulitis, peripheral neuropathy, and a knee cyst—did not establish that Clark was unable to work before December 31, 2010.

The court also found that the administrative law judge properly considered the combined effect of Clark’s impairments. Although the record showed diagnoses and medical histories involving several conditions, the court found little evidence that they caused more than a minimal effect on Clark’s ability to perform basic work activities. The record showed that Clark was independent, could drive, shop, do household chores, socialize, and attend school or training during the relevant period. The court concluded that substantial evidence supported the finding that she did not have a severe impairment or combination of impairments.

New evidence

Clark submitted three categories of evidence that were not part of the administrative record: a January 7, 2019 residual functional capacity questionnaire from Dr. John Galeno; progress notes dated November 16, 2007; and spinal images reportedly taken on May 24, 2018, after spinal surgery.

Under 42 U.S.C. § 405(g), a court may send a case back to the Commissioner to consider additional evidence only if the evidence is new, material, and supported by good cause for not presenting it earlier. The court found that Dr. Galeno’s questionnaire was new but not material because it addressed only the last three months of the relevant period, cited no clinical findings or objective signs supporting its conclusions, and concerned diagnoses different from the knee pain Clark identified as her main reason for being unable to work. The court found no reasonable possibility that the questionnaire would have changed the decision.

The court found that the November 2007 progress notes were not material because they predated the relevant period by more than a month, did not show that the knee pain continued into the relevant period, and were not supported by good cause for the failure to submit them earlier. The spinal images were also not material because they had no accompanying narrative report and did not address Clark’s condition during the relevant period. The court additionally found that Clark had not shown good cause for failing to submit them during the earlier administrative hearings.

Ruling

Judge Gabriel W. Gorenstein granted the Commissioner’s motion for judgment on the pleadings. The court concluded that substantial evidence supported the administrative law judge’s finding that Clark was not disabled before December 31, 2010, rejected the request to consider the new evidence, and directed the Clerk to enter judgment and close the case.