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Pondel v. Saul

United States District Court, W.D. Tennessee, Western Division

December 17, 2019




         Before the court is plaintiff Timothy Steele Pondel's appeal on behalf of his late father, Timothy Todd Pondel, from a final decision of the Commissioner of Social Security (“Commissioner”) denying Timothy Todd Pondel's application for disability insurance benefits under Title II of the Social Security Act (“the Act”), 42 U.S.C. §§ 401-434. The parties have consented to the jurisdiction of the United States magistrate judge under 28 U.S.C. § 636(c). (ECF No. 10.) For the reasons below, the decision is vacated and remanded for consideration of new material evidence.


         On July 20, 2015, Timothy Todd Pondel applied for disability insurance benefits under Title II of the Act. (R. 437.) Pondel alleged disability beginning on January 1, 2015, due to anxiety, degenerative disc disease, osteoporosis, back pain, arthritis, gout, a separated collar bone, blood poisoning, high blood pressure, and a thyroid condition. (R. 297-298.) Pondel's application was denied initially and upon reconsideration by the Social Security Administration (“SSA”). (R. 309; 328; 330.) At Pondel's request, a hearing was held before an Administrative Law Judge (“ALJ”) on February 20, 2018. (R. 261.)

         After considering the record and the testimony given at the hearing, the ALJ used the five-step analysis to conclude that Pondel was not disabled from January 1, 2015 through the date of his decision. (R. 196-208.) At the first step, the ALJ found that Pondel had not “engaged in substantial gainful activity since December 7, 2011, the alleged onset date.” (R. 198.) At the second step, the ALJ concluded that Pondel suffers from the following severe impairments: degenerative disc disease of the cervical and thoracic spine, traumatic arthritis of the left hand, osteoarthritis of the bilateral knees, right elbow epicondylitis, hypertension, asthma, degenerative joint disease of the right shoulder, obesity, generalized anxiety disorder, and panic disorder. (R. 199.) At the third step, the ALJ concluded that Pondel's impairments do not meet or medically equal, either alone or in the aggregate, one of the impairments listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. (R. 199.) Accordingly, the ALJ had to then determine whether Pondel retained the residual functional capacity (“RFC”) to perform past relevant work or could adjust to other work. The ALJ found that:

[Pondel] can perform a range of work that is limited to: lifting and/or carrying up to 25 pounds occasionally, and up to 20 pounds frequently; standing or walking up to or about 6 hours and sitting up to or about 6 hours in an 8hour workdays with normal breaks; frequent pulling or pushing with the bilateral upper extremities; frequent climbing of stairs or ramps; stooping, kneeling, or crouching; no climbing ladders, ropes, or scaffolds; occasional pull [sic]; occasional overhead reaching (bilateral upper extremities); frequent handling and fingering with the hands (bilateral); occasional exposure to pulmonary irritants such as dust, fumes, odors, gasses or poor ventilation; occasional exposure to workplace hazards like unprotected heights or dangerous moving machinery. [Pondel] can understand, remember or apply simple and detailed directions; can maintain concentration[, ] persistence and pace for simple and detailed tasks; can have occasional interaction with the general public, coworkers and supervisors on a superficial bass [sic]; and can adapt to infrequent workplace changes.[1]

(R. 202.) The ALJ then found at step four that Pondel was unable to perform any of his past relevant work. (R. 206.) However, at step five the ALJ found that considering Pondel's age, education, work experience, and RFC, there were jobs that exist in significant numbers in the national economy that Pondel could perform. (R. 207.) Accordingly, on September 13, 2018, the ALJ issued a decision denying Pondel's request for benefits after finding that Pondel was not under a disability because he retained the RFC to adjust to work that exists in significant numbers in the national economy. (R. 196-208.)

         On August 27, 2018, a little more than two weeks before the ALJ's decision, Pondel saw a rheumatologist for the first time, Dr. Emilio Rodriguez.[2] (R. 215.) Dr. Rodriguez diagnosed Pondel with moderate-severe rheumatoid arthritis with an onset three years earlier, changed Pondel's medication regimen, and scheduled a follow-up appointment a month later. (R. 215.) Dr. Rodriguez's treatment notes for the next visit in September 2018 reassessed Pondel's condition as severe and worsening. (R. 187.) Dr. Rodriguez observed that Pondel was suffering constitutional symptoms due to his rheumatoid arthritis, including fatigue, chills, fever, “eye symptoms, ” abdominal pain, and a rash. (R. 187-190.) Dr. Rodriguez ordered a more aggressive course of treatment. (R. 187.) At the same visit, Dr. Rodriguez completed a form assessing Pondel's postural and manipulative limitations, endorsing severe limitations in almost every category of activity. (R. 183-186.) Dr. Rodriguez's treatment notes for the next visit in October 2018 reassess Pondel's rheumatoid arthritis severity as moderate-severe, but note minimal improvement with pain and swelling. (R. 177.) Pondel was still suffering from constitutional symptoms and Dr. Rodriguez ordered a yet more aggressive course of treatment. (R. 177-178.) A few weeks later, Dr. Rodriguez assessed that treatment had reduced the severity of Pondel's symptoms, and that his rheumatoid arthritis was now of moderate severity. (R. 169.) However, Dr. Rodriguez noted Pondel's white blood cell count was unusually low. (R. 169.) In January 2019, after testing, Dr. Rodriguez diagnosed Pondel with Felty's syndrome. (R. 148.) Felty's syndrome is a serious complication of rheumatoid arthritis characterized by “hypersplenism with compromised immune competence[.]” 20 C.F.R. Part 404 Subpart P App'x 1 § 14.00(A)(6)(e)(iii). In treatment notes from the January visit, Dr. Rodriguez summarized Pondel's condition as having a duration of “many years, ” though in the same visit, he also said Pondel “[h]as new issue with Felty's syndrome with low wbc [(white blood cell)] counts and splenomegaly[.]” (R. 144.) Two days later, Pondel's kidneys failed and he had a resulting heart attack. (R. 64.) Pondel was rushed to the emergency room where he had several more heart attacks and died. (R. 63.)

         In September and November 2018, and twice again in January 2019, Pondel's attorney petitioned the SSA's Appeals Council to remand the case back to the ALJ for reconsideration based on new material evidence, submitting Pondel's treatment records as they became available. (R. 8-192; 220-260; 416-421.) On March 12, 2019, the SSA's Appeals Council denied Pondel's request for review. (R. 1.) The ALJ's decision then became the final decision of the Commissioner. (R. 1.)

         On May 1, 2019, Pondel filed the instant action. Pondel argues that: (1) new material evidence justifies remand to the Commissioner, and (2) the ALJ made various errors in weighing the medical evidence, developing the record, and formulating the RFC.


         A. Standard of Review

         Under 42 U.S.C. § 405(g), a claimant may obtain judicial review of any final decision made by the Commissioner after a hearing to which he or she was a party. “The court shall have power to enter, upon the pleadings and transcript of the record, a judgment affirming, modifying, or reversing the decision of the Commissioner of Social Security, with or without remanding the cause for a rehearing.” 42 U.S.C. § 405(g). Judicial review of the Commissioner's decision is limited to whether there is substantial evidence to support the decision and whether the Commissioner used the proper legal criteria in making the decision. Id.; Cardew v. Comm'r of Soc. Sec., 896 F.3d 742, 745 (6th Cir. 2018); Cole v. Astrue, 661 F.3d 931, 937 (6th Cir. 2011); Rogers v. Comm'r of Soc. Sec., 486 F.3d 234, 241 (6th Cir. 2007). Substantial evidence is more than a scintilla of evidence but less than a preponderance, and is “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Kirk v. Sec'y of Health & Human Servs., 667 F.2d 524, 535 (6th Cir. 1981) (quoting Richardson v. Perales, 402 U.S. 389, 401 (1971)).

         In determining whether substantial evidence exists, the reviewing court must examine the evidence in the record as a whole and “must ‘take into account whatever in the record fairly detracts from its weight.'” Abbott v. Sullivan, 905 F.2d 918, 923 (6th Cir. 1990) (quoting Garner v. Heckler, 745 F.2d 383, 388 (6th Cir. 1984)). If substantial evidence is found to support the Commissioner's decision, however, the court must affirm that decision and “may not even inquire whether the record could support a decision the other way.” Barker v. Shalala, 40 F.3d 789, 794 (6th Cir. 1994) (quoting Smith v. Sec'y of Health & Human Servs., 893 F.2d 106, 108 (6th Cir. 1989)). Similarly, the court may not try the case de novo, resolve conflicts in the evidence, or decide questions of credibility. Ulman v. Comm'r of Soc. Sec., 693 F.3d 709, 713 (6th Cir. 2012) (citing Bass v. McMahon, 499 F.3d 506, 509 (6th Cir. 2007)). Rather, the Commissioner, not the court, is ...

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