Wells v. Social Security

Background

Kai S. Wells sought judicial review under the Social Security Act of the Commissioner’s decision that she was not disabled from May 25, 2013, her alleged disability-onset date, through November 27, 2019, the date of the administrative law judge’s decision. She applied for disability insurance benefits and supplemental security income. The administrative law judge found that Wells had severe back and joint disorders, hypertension, obesity, bipolar disorder, panic disorder, and posttraumatic stress disorder, but retained the capacity for limited sedentary work. The judge relied on vocational-expert testimony to find that Wells could perform jobs such as addresser, document preparer, and call-out operator.

Wells appeared without a lawyer at the administrative hearing. After the administrative law judge denied her applications, she retained counsel and submitted additional medical evidence to the Appeals Council. That evidence included a January 2020 assessment from treating nurse practitioner Shauna Roach and a May 2020 assessment from examining psychologist Christina Nicole Ryser. The Appeals Council declined to review the decision, stating that the additional evidence did not relate to the relevant period.

Court’s Analysis

The court concluded that the Appeals Council incorrectly treated the additional evidence as unrelated to the relevant period merely because the assessments were prepared after the administrative law judge’s decision. The Roach assessment relied on treatment records covering months before that decision, and the Ryser assessment offered a retrospective opinion about Wells’s earlier condition. The court determined that this evidence should have been considered to the extent it addressed Wells’s condition during the period under review.

The court also found that the administrative law judge failed to develop the record about the number of days Wells’s mental-health conditions would cause her to miss work. Roach reported that Wells would be absent two to three days per month, and Ryser reported that she would likely be absent more than three days per month. The court stated that this information could reasonably change the outcome because three or more absences per month can prevent gainful employment. Wells’s appearance without a lawyer, together with the administrative law judge’s duty to develop the record, also supported accepting the later evidence.

The court independently found that substantial evidence did not support the finding that Wells would be off task only 5% of the workday. The administrative law judge relied heavily on a state-agency psychologist’s 2017 opinion, even though that psychologist had not reviewed later treatment records. Other providers described greater limitations, including that Wells might be off task for 50% to 75% of the workday. The court also found that Wells’s temporary part-time work and volunteer activities did not by themselves establish that she could perform substantial gainful activity.

Disposition

The court held that remand was appropriate so the agency could consider the additional medical evidence, develop the record regarding likely absences, and reassess the effect of time off task on Wells’s ability to work. The court granted Wells’s motion for judgment on the pleadings and denied the Commissioner’s motion for judgment on the pleadings. The court did not reach Wells’s argument that the administrative law judge improperly evaluated her testimony.