United States District Court, M.D. Pennsylvania
KAROLINE MEHALCHICK, Magistrate Judge.
This is an action brought under Sections 205(g) and 1631(c)(3) of the Social Security Act, 42 U.S.C. § 405(g), 42 U.S.C. § 1383(c)(3)(incorporating 42 U.S.C. § 405(g) by reference), seeking judicial review of the final decision of the Commissioner of Social Security ("Commissioner") denying Plaintiff's claims for Disability Insurance Benefits ("DIB") and Supplemental Security Income ("SSI") under Titles II and XVI of the Social Security Act. This matter has been referred to the undersigned United States Magistrate Judge on consent of the parties, pursuant to the provisions of 28 U.S.C. § 636(c) and Rule 73 of the Federal Rules of Civil Procedure. (Doc. 16, Doc. 17). For the reasons expressed herein, it is ordered that the decision of the Commissioner be VACATED and REMANDED for a new administrative hearing.
I. BACKGROUND & PROCEDURAL HISTORY
On July 17, 2010, Plaintiff, Christine Barnhart ("Barnhart") protectively filed a Title II application for DIB. On August 23, 2010, Barnhart protectively filed a Title XVI application for SSI. In both applications, Barnhart alleged that she became unable to work on January 1, 2010, due to her alleged impairments of heart disease, diabetes, depression, and anxiety. (Admin Tr. 202, Doc. 10-6 p. 6). Her claims were denied initially on February 9, 2011. Following this denial, Barnhart sought and was granted an opportunity to have her claims re-evaluated after an administrative hearing.
On September 27, 2012, Barnhart, with the assistance of counsel, appeared and testified at an administrative hearing before Administrative Law Judge ("ALJ") Randy Riley in Harrisburg, Pennsylvania. Impartial Vocational Expert ("VE") Paul A. Anderson also appeared and testified at the hearing.
Barnhart testified that as of the date of her hearing, she was a 39 year old mother of one, and resided in an apartment with her husband and young daughter. (Admin Tr. 36; Doc. 10-2 p. 37). Barnhart reported that she could read and write English, completed high school, attained an associate's degree in a paralegal program and was a certified bartender. Id. On June 7, 2010, Barnhart underwent a coronary artery bypass graft. (Admin Tr. 37; Doc. 10-2 p. 38). Barnhart did attempt to work as a bartender from April 2011 to December 2011 (after her alleged onset date), but her brief return to the workforce was complicated by continuing health problems and the ALJ determined that her earnings during this period did not reach the level of substantial gainful activity. Barnhart reported that during this brief period of employment she had to be rushed from work to the emergency room on two occasions. Id. Despite these continuing problems, Barnhart remains capable of showering herself, cooking "sometimes, " picking up items at the store, folding laundry, driving (when absolutely necessary), and caring for her daughter during the day while her husband works. (Admin Tr. 38; Doc. 10-2 p. 39). Barnhart also testified that, due to the combination of her impairments she is unable to bend, climb a full flight of stairs, climb ladders, walk for more than one block without resting, stand more than two minutes at one time, or sit for more than ten minutes at one time. (Admin Tr. 39-40; Doc. 10-2 pp. 40-41). Barnhart reported that she experiences pain in her upper and lower back, shoulders, neck and wrists due to endometriosis and fibromyalgia. (Admin Tr. 42, 44; Doc. 10-2 p. 43, 45). Barnhart also suffers from insulin dependent diabetes and experiences neuropathy in her hands and feet "a couple" times per week. (Admin Tr. 44-45; Doc. 10-2 pp. 45-46). For the time being, Barnhart reported that she is not a candidate for surgery to correct her endometriosis. (Admin Tr. 43-44; Doc. 10-2 pp. 44-45). Barnhart admits, however, that once she has several new stents placed in her heart her doctors will re-evaluate whether this surgery is advisable. Id.
With respect to mental impairments, Barnhart testified that she suffers from post-traumatic stress disorder ("PTSD"), depression, and anxiety. (Admin Tr. 46; Doc. 10-1 p. 47). As a result of post-traumatic stress disorder Barnhart asserts that she has difficulty gripping objects, and has been advised against lifting items heavier than a one-gallon jug of milk or bending down to retrieve dropped items from the ground. (Admin Tr. 44; Doc. 10-2 p. 45) Barnhart reported that she experiences nightmares and flashbacks at an unpredictable frequency. (Admin Tr. 46; Doc. 10-2 p. 47). In addition, due to her anxiety and depression Barnhart suffers from low energy, lack of interest in activities that she previously enjoyed, dislikes being around people or in situations where she feels "confined." (Admin Tr. 47; Doc. 10-2 p. 48).
Additionally, Barnhart reported numerous medication side-effects, including extreme fatigue, insomnia, dizziness, nausea, vomiting, and migraines due to a Leupron Depot injection. (Admin Tr. 41-42; Doc. 10-2 pp. 42-43). Barnhart is also prescribed Oxycontin (for pain), Plavix and Ranexa (for her heart condition). Id.
On October 16, 2012, the ALJ denied Barnhart's claims in a written decision. (Admin Tr. 11-24; Doc. 10-2 pp. 12-25). Thereafter, Barnhart sought review of her claims by the Appeals Council. Together with her request for review, Barnhart submitted additional medical evidence that was not before the ALJ when he issued his decision. (Admin Tr. 1246-53; Doc. 10-21 pp. 72-79). On February 26, 2014, the Appeals Council denied Barnhart's request for review, thus making the ALJ's October 2012 decision the final decision of the Commissioner subject to judicial review by this Court. (Admin Tr. 1-5; Doc. 10-2 pp. 2-6).
Barnhart initiated this action, seeking review of the Commissioner's final decision denying her claims, by filing a complaint in this Court on April 21, 2014. (Doc. 1). In light of several alleged errors made by the ALJ, Barnhart requests that this Court enter judgment reversing the final decision of the Commissioner without remand or, in the alternative, vacate the Commission's decision and remand for a new administrative hearing. On June 25, 2014, the Commissioner filed an Answer, in which she contends that the ALJ's decision is free of reversible error and is supported by substantial evidence. (Doc. 9). Together with her answer, the Commissioner filed a copy of the administrative record. (Doc. 10). Though this record includes evidence that was not before the ALJ when he rendered his decision, this Court's review is limited to whether the ALJ's decision is supported by substantial evidence, based on the evidence that was before him. See Matthews v. Apfel, 239 F.3d 589, 593 (3d Cir. 2001)(agreeing that "although evidence considered by the Appeals Council is part of the administrative record on appeal, it cannot be considered by the District Court making its substantial evidence review."). Thus, the Court has not considered the evidence Barnhart submitted to the Appeals Council in its determination of whether the ALJ's decision is supported by substantial evidence.
Having been fully briefed by the parties, this matter is now ripe for disposition. (Doc. 11, Doc. 12, Doc. 13).
II. STANDARD OF REVIEW
Resolution of the instant social security appeal involves an informed consideration of the respective roles of two adjudicators - the ALJ and this Court. At the outset, it is the responsibility of the ALJ in the first instance to determine whether a claimant has met the statutory prerequisites for entitlement to benefits.
To receive benefits under the Social Security Act by reason of disability, a claimant must demonstrate an inability to "engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 405(g); 42 U.S.C. § 1382c(a)(3)(A); see also 20 C.F.R. § 404.1505(a); 20 C.F.R. § 416.905(a). To satisfy this requirement, a claimant must have a severe physical or mental impairment that makes it impossible to do his or her previous work or any other ...