Lopez v. O'Malley, Commissioner of Social Security

Background

Jacqueline Lopez sued under Section 205(g) of the Social Security Act, 42 U.S.C. § 405(g), challenging the Commissioner of Social Security’s final decision denying her application for Disability Insurance Benefits. Lopez and the Commissioner filed cross-motions for judgment on the pleadings, asking the court to reverse or affirm the denial.

On December 14, 2021, Magistrate Judge Stewart D. Aaron issued a report and recommendation advising that Lopez’s motion be granted, the Commissioner’s cross-motion be denied, and the case be remanded for further administrative proceedings. The Commissioner objected. The court reviewed the challenged portions of the report independently and reviewed the remainder for clear error.

The opinion states that Kilolo Kijakazi replaced Andrew Saul as Acting Commissioner on July 9, 2021, and was substituted into the caption under Federal Rule of Civil Procedure 25(d).

Later Favorable Decision

Lopez had been denied benefits on her initial application but later received a favorable decision on a second application for a period beginning the day after the unfavorable administrative decision being reviewed. The magistrate judge had treated that later decision as new and material evidence supporting remand.

The district court rejected that reasoning. Under 42 U.S.C. § 405(g), a court may remand for consideration of new evidence only when the evidence is new, material, and supported by good cause for not presenting it earlier. The court found good cause because the later decision had not yet been issued during the earlier administrative proceedings. But it held that the later decision was not material evidence about the earlier application because it concerned a later period and was only a conclusion based on evidence, not evidence of disability itself. The court therefore declined to adopt the report and recommendation to the extent it recommended remand on that ground.

Step-Three Disability Analysis

The Social Security Administration uses a five-step process to decide whether a claimant is disabled. At step three, it considers whether the claimant’s impairment meets or equals a listed impairment. If it does, the claimant may be found disabled without further consideration of age, education, or work experience.

The administrative law judge found that Lopez’s impairments did not meet or equal Listing 1.04, which addressed disorders of the spine. The listing required, among other things, nerve-root or spinal-cord involvement, nerve-root compression, pain in a corresponding anatomical pattern, limited spinal movement, motor loss with muscle weakness, sensory or reflex loss, and—when the lower back was involved—positive straight-leg-raising tests in sitting and lying positions.

The district court found substantial evidence in the record supporting a possible finding that Lopez met the listing’s requirements. Because the evidence presented a colorable basis for meeting the listing, the administrative law judge had to explain the reasoning for finding that the requirements were not met and explain the credibility determinations and inferences supporting that conclusion. The court found the administrative decision insufficient because it did not discuss the rationale the Commissioner later offered concerning the absence of certain elements, including reflex or sensory loss and motor loss for a continuous twelve-month period.

The court did not decide that Lopez was disabled. It decided that the administrative law judge had not adequately explained the step-three determination and that further analysis was required.

Disposition

The court ordered that the report and recommendation be adopted in part and remanded the case for further proceedings before the Social Security Administration. The court declined to adopt the portion recommending remand based on the later favorable decision. The Clerk was requested to terminate the motions listed at Electronic Court Filing Nos. 13 and 19.