Goudy v. Berryhill
Filing
19
JUDGMENT in favor of Michael Ray Goudy against Nancy Berryhill. CASE CLOSED. Signed by Magistrate Judge Roy Percy on 10/4/19. (bnd)
THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF MISSISSIPPI
GREENVILLE DIVISION
MICHAEL RAY GOUDY
PLAINTIFF
v.
CIVIL CASE NO. 4:19-CV-64-RP
COMMISSIONER OF SOCIAL SECURITY
DEFENDANT
JUDGMENT
This cause is before the Court on the Plaintiff’s complaint pursuant to 42 U.S.C. § 405(g)
for judicial review of an unfavorable final decision of the Commissioner of the Social Security
Administration regarding an application for supplemental security income. The parties have
consented to entry of final judgment by the United States Magistrate Judge under the provisions
of 28 U.S.C. § 636(c), with any appeal to the Court of Appeals for the Fifth Circuit. The Court,
having reviewed the record, the administrative transcript, the briefs of the parties, and the
applicable law; and having heard oral argument; and for the reasons below and for those
announced on the record at the conclusion of the parties’ oral argument in this matter, finds as
follows:
The Commissioner’s decision is not supported by substantial evidence because the ALJ
failed to fulfill his duty to fully and fairly develop the record. After learning at the
administrative hearing that the plaintiff had received treatment at Baptist Medical Center Attala
in the time since he allegedly became disabled, the ALJ informed the plaintiff, who was
unrepresented at the hearing, that the records from that medical provider would be ordered.
However, the record is devoid of evidence that the ALJ ordered or considered those records
before rendering his decision. This failure to develop the record prejudiced the plaintiff because
the Baptist records contain evidence that might have altered the result. See Kane v. Heckler,
731 F.2d 1216, 1220 (5th Cir. 1984) (holding that to show prejudice from failure to develop
adequate record, plaintiff “must show that, had the ALJ done his duty, she could and would have
adduced evidence that might have altered the result”).
Specifically, the Baptist records contain a December 5, 2016 x-ray report that found
moderately severe osteoarthritis of the left hip, a copy of which report the plaintiff submitted to
this court. Without obtaining or considering this report, the ALJ rejected consultative
examining physician George Smith’s opinion essentially limiting the plaintiff to sedentary work,
in part because Dr. Smith’s opinion is inconsistent with a June 13, 2018 x-ray report finding only
mild degenerative arthritis in both hips. Had the ALJ ordered and considered the Baptist x-ray
report finding a more severe degenerative condition (as he said he would do), the ALJ might
have given more weight to Dr. Smith’s opinion which, if accepted, would have resulted in a
finding of disability under the grid rules.
The Commissioner argues that remand for consideration of the Baptist x-ray report is not
permitted under 42 U.S.C. § 405(g), which permits remand for consideration of additional
evidence “only upon a showing that there is new evidence which is material and that there is
good cause for the failure to incorporate such evidence into the record in a prior proceeding.”
The Commissioner challenges both the materiality of the subject x-ray report and the plaintiff’s
good cause for failing to incorporate it into the record in a prior proceeding.
Implicit in the materiality requirement is that “the new evidence relate to the time period
for which benefits were denied, and that it not concern evidence of a later-acquired disability or
of the subsequent deterioration of the previously non-disabling condition.” Haywood v.
Sullivan, 888 F.2d 1463, 1472 (5th Cir. 1989) (quoting Johnson v. Heckler, 767 F.2d 180, 183
(5th Cir. 1985)). The Commissioner argues that because supplemental security income benefits
may not be awarded for any period of time prior to the date of the application for benefits, and
that because the December 5, 2016 Baptist x-ray report predates the plaintiff’s June 13, 2017
application for benefits in this case, the report does not relate to the period for which benefits
were denied. The court disagrees.
There is no rigid requirement that in order to relate to the time period for which benefits
were denied, the new evidence must be dated within that time period. See, e.g., Ripley v.
Chater, 67 F.3d 552, 556 (5th Cir. 1995) (finding evidence obtained from surgery subsequent to
ALJ’s decision related to time period for which benefits were denied); Latham v. Shalala, 36
F.3d 482, 483-484 (5th Cir. 1994) (finding VA disability rating that post-dated ALJ’s decision
related to time period for which benefits were denied); Perkins v. Shalala, 36 F.3d 90 (summary
calendar), 1994 WL 523788, at *3-5 (5th Cir. 1994) (unpublished) (finding medical evidence that
post-dated ALJ’s decision was material because there was strong showing that it confirmed
plaintiff was suffering from disabling condition at time ALJ denied benefits).
In this case, although the Baptist x-ray report predates the plaintiff’s application for
supplemental security income benefits by approximately six months, the x-ray report found
moderately severe osteoarthritis of the left hip, a degenerative condition that by definition can be
expected to worsen over time or, at the very least, to not improve on its own. In other words,
one may reasonably infer from the report that the plaintiff continued to suffer from this condition
after he applied for benefits six months later. The court finds that this evidence reasonably
relates to the time period for which benefits were denied.
In addition to the timing element of materiality, there must exist the “reasonable
possibility that it would have changed the outcome of the Secretary’s determination.” Latham v.
Shalala, 36 F.3d 482, 484 (5th Cir. 1994) (quoting Chaney v. Schweiker, 659 F.2d 676, 679 (5th
Cir. 1981)). The court finds that such a possibility exists for the same reason the court finds the
plaintiff suffered prejudice from the ALJ’s failure to develop the record as discussed above.
As to the Commissioner’s challenge of the plaintiff’s good cause for failing to
incorporate the Baptist x-ray report into the record in a prior proceeding, the court believes the
unrepresented plaintiff was reasonably entitled to rely upon the ALJ’s representation that the
Baptist records would be ordered. The Commissioner points out that the plaintiff appointed
counsel to represent him after the hearing decision and before the Appeals Council decision, but
it is unclear from the record whether counsel was aware either that the ALJ had stated he would
order the Baptist records or that those records contained an x-ray report that might affect the
Commissioner’s decision. See Taylor v. Callahan, No. Civ.A. 96-2603, 1997 WL 345786, at *4
(E.D. La. June 19, 1997) (finding good cause for failure to present evidence of IQ tests to
Appeals Council where, although plaintiff was represented by counsel in Appeals Council
proceedings, it was unclear from record whether counsel was aware of test results). The court
finds there is good cause for the plaintiff’s failure to incorporate the subject x-ray report in prior
proceedings, and § 405(g) does not preclude remand to the Commissioner for consideration of
this new evidence.
For these reasons, this case is remanded to the Commissioner for a reevaluation of the
plaintiff’s application that takes into account the plaintiff’s medical records from Baptist Medical
Center Attala, including specifically the December 5, 2016 x-ray report.
SO ORDERED, this the 4th day of October, 2019.
/s/ Roy Percy
UNITED STATES MAGISTRATE JUDGE
Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.
Why Is My Information Online?