United States District Court, D. Massachusetts
MEMORANDUM OF DECISION AND ORDER ON CROSS-MOTIONS REGARDING DENIAL OF SOCIAL SECURITY BENEFITS
JUDITH GAIL DEIN, Magistrate Judge.
Plaintiff Maria Martins ("Martins") has brought this action pursuant to sections 205(g) and 1631(c)(3) of the Social Security Act, 42 U.S.C. §§ 405(g) and 1383(c)(3), in order to challenge the final decision of the Commissioner of the Social Security Administration (the "Commissioner") denying her claims for Social Security Disability Insurance ("SSDI") and Supplemental Security Income ("SSI") benefits. The matter is presently before the court on the "Plaintiff's Motion to Reverse or Remand Defendant's Final Decision Denying Her Disability Be[ne]fits" (Docket No. 25) by which the plaintiff is seeking an order reversing the Commissioner's decision or remanding the matter to the Social Security Administration for further administrative proceedings. It is also before the court on the "Commissioner's Motion to Affirm Decision" (Docket No. 29), by which the Commissioner is seeking an order affirming her decision to deny Martins' claims for benefits. At issue is whether the Administrative Law Judge ("ALJ"), in reaching his conclusion that Martins was not disabled, erred by rejecting the opinions of Martins' treating psychiatrist and therapist regarding the extent of the plaintiff's mental limitations, and by determining that Martins' subjective complaints of pain and other symptoms were only partially credible. Also at issue is whether the ALJ erred by refusing to admit into the administrative record approximately 83 pages of records reflecting treatment that Martins received at the South Bay Mental Health Center ("South Bay") over the course of the time period from November 5, 2010 through May 10, 2012. The ALJ declined to consider those records because they were submitted after the deadline set forth in the Social Security regulations. However, Martins maintains that her tardiness should have been excused, and that the matter should be remanded for consideration of those records, because she demonstrated good cause for failing to produce them earlier.
For all the reasons described below, this court finds that the ALJ should have considered the additional evidence regarding Martins' treatment at South Bay, and that the matter should be remanded so that he can render a decision based on all of the relevant medical records. Accordingly, the Commissioner's motion to affirm the ALJ's decision is DENIED, and the plaintiff's motion to reverse or remand is ALLOWED to the extent that it seeks a remand for further administrative proceedings. Because it will be up to the ALJ in the first instance to evaluate the additional documents and determine how they will impact his analysis of Martins' claims of disabling impairments, this court declines to address the remaining issues raised by the parties' motions.
II. STATEMENT OF FACTS
Martins was born on January 9, 1963, and was 49 years old at the time of her hearing before the ALJ. (Tr. 35, 115, 117). She has a high school education and has been employed as a cashier at a donut shop, a housekeeper for a cleaning company, a line worker for a newspaper publisher, and an unloader for a shoe store. (Tr. 167). However, Martins has not worked in any capacity since March 1, 2004, and she contended initially that she has been incapable of working since January 2006 due to the severity of her physical and mental impairments. (Tr. 49, 166). She subsequently amended the alleged onset date of her disability to July 16, 2009. (Tr. 34). According to Martins, her impairments include debilitating back and leg pain, depression, anxiety, migraine headaches, and audio hallucinations. (See, e.g., Tr. 38-45, 198, 200, 218-19).
Martins filed applications for SSI and SSDI on July 27, 2010, claiming that she had been unable to work since January 1, 2006 as a result of symptoms stemming from her back problems, depression, and anxiety. (Tr. 115-23, 166). Her applications were denied initially in December 2010, and upon reconsideration in July 2011. (Tr. 55-62, 68-73).
The ALJ's Rejection of South Bay Records
The plaintiff subsequently requested a hearing before an ALJ. (Tr. 74-75). The request was granted, and a hearing was scheduled to take place on Monday, June 18, 2012 in Boston, Massachusetts. (Tr. 76-79, 83-94). On Friday, June 15, 2012, three days before the scheduled hearing, Martins' attorney sent a package of materials to the Social Security Administration ("SSA") by fax, which consisted of additional evidence relating to the plaintiff's claims for benefits. (Tr. 1192). In his cover letter to the agency, plaintiff's counsel stated in relevant part as follows:
This firm represents Ms. Maria Martins for her claim for Social Security benefits. A hearing is scheduled for June 18, 2012 at 2:00pm. An Appointment of Representation is on file. Enclosed, please find the following medical records to be associated with Ms. Martins' file:
I. South Bay Mental Health. November 5, 2010-April 17, 2012. 82 pages.
We apologize that the records were not submitted sooner. We initially attempted to obtain them in April but the request was met with no response by the facility. On follow-up request it was revealed that the records were in the facility's off-site storage facility and they were unwilling to retrieve records on an unscheduled trip absent court order, which we did not wish to request with Your Honor's existing workload. We have submitted the records immediately upon receiving them.
(Tr. 1192). On that same date, Martins' counsel sent a second letter by fax to the SSA, enclosing an additional record relating to the plaintiff's treatment at South Bay on May 10, 2012. (Tr. 1276). In his second letter, counsel again noted that a hearing on Martins' claims for benefits was scheduled for June 18, 2012 at 2:00 p.m., and asked that the additional record be added to Martins' file. (Id.).
The hearing before the ALJ took place on the afternoon of June 18, 2012 as scheduled. (Tr. 29-54). Martins, who was represented by her counsel, appeared and testified on her own behalf. (Tr. 35-49). A Vocational Expert also provided testimony regarding the plaintiff's ability to perform work existing in the national and regional economies. (Tr. 49-53). Significantly, during the hearing, Martins amended the alleged onset date of her disability from January 1, 2006 to July 16, 2009. (Tr. 34). The ALJ also rejected the plaintiff's request to admit as part of the administrative record the documents that Martins' counsel had submitted to the agency by fax on June 15, 2012. (Tr. 31). Therefore, the ALJ declined to consider 83 pages of records from Martins' treating psychiatrist and therapist relating to the time period from November 5, 2010 through May 10, 2012. As a result, the record considered by the ALJ contains no evidence describing treatment that Martins received for her mental impairments after January 2011.
On June 29, 2012, the ALJ issued a written decision denying Martins' claims for benefits on the grounds that the plaintiff had "not been under a disability, as defined in the Social Security Act, from July 16, 2009, through the date of [his] decision[.]" (Dec. Finding #11; Tr. 28). It is undisputed that the ALJ, in reaching his conclusion that Martins was not disabled, applied the five-step evaluation required by 20 C.F.R. §§ 404.1520 and 416.920. See also McDonald v. Sec'y of Health & Human Servs. , 795 F.2d 1118, 1120 (1st Cir. 1986) (the Social Security regulations prescribe a "five-step sequential inquiry into whether or not an applicant for benefits should be considered disabled' and thus eligible for benefits"). However, Martins contends that the ALJ's decision was not based on substantial evidence because he improperly rejected the opinions of her treating psychiatrist and therapist as to the severity of her mental health impairments, and erroneously assessed the credibility of her complaints regarding the extent of her pain and other symptoms. (See Pl. Mem. (Docket No. 26) at 14-20). In addition, Martins asserts that the ALJ committed reversible error by refusing to grant her request to consider the additional records from South Bay. ( Id. at 12-14). As described below, this court finds that Martins is entitled to have those records reviewed in connection with her claims for benefits, and that the matter should be remanded so that the ALJ has an opportunity to assess Martins' claims of disability based on all of the relevant medical evidence.
In his decision, the ALJ specifically addressed Martins' submission of additional written evidence regarding her treatment at South Bay. The ALJ noted that under 20 C.F.R. § 405.331(a) of the Social Security regulations, a claimant must submit all written evidence no later than five business days before the administrative hearing. (Dec. ...