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Denial of disability benefits remanded for better explanation

August 3, 2015

A rejection of a claimant’s application for disability is being remanded after the 7th Circuit Court of Appeals found the “abstruse signals” in the denial did not sufficiently explain the reasons for disregarding new evidence.

Shelia Stepp applied for disability insurance benefits under Title II of the Social Security Act for degenerative disc disease and chronic pain. The administrative law judge denied her claim, finding surgery medication and therapy had improved Stepp’s condition and she could engage in sedentary work.

Next, Stepp turned to the Social Security Administration’s Appeals Council for review and submitted additional evidence from another treating physician, Allan MacKay M.D., which indicated her condition had not improved.

In upholding the judge’s decision, the council did not expressly address the physician’s notes. Before the 7th Circuit, Stepp argued, in part, that a remand for further proceedings was necessary in light of the “new and material” evidence presented by MacKay.

The commissioner of Social Security maintained the council did consider the additional evidence because the order of the appeals council includes the records from MacKay in the list of exhibits. Just the inclusion on the exhibit list did not persuade the 7th Circuit.

“The minimal information provided by the Appeals Council in its denial of Stepp’s request for review is insufficient to allow us to determine with any confidence that the Council accepted Dr. MacKay’s notes as new and material evidence,” Judge Joel Flaum wrote for the unanimous appellate panel.

“While the Commissioner has pointed to a handful of ambiguous reference in the order and denial notice that suggest that the Appeals Council may have deemed this evidence qualifying, these references fall considerably short of the Council’s express analysis of the newly submitted evidence at issue in (Perkins v. Chater, 107 F.3d 1290). We therefore cannot conclude that these abstruse signals, without more, demonstrate that the Council considered Dr. MacKay’s treatment notes.”

In Shelia B. Stepp, v. Caolyn Colvin, Acting Commissioner of Social Security, 14-3163, The 7th Circuit ruled the administrative law judge properly analyzed the range of conflicting testimony and medical opinions and reached a conclusion adequately supported by the record.

However, the court agreed with Stepp that the appeals council seemed to have not accepted MacKay’s treatment notes as new and material evidence. It remanded the case to the agency to re-evaluate Stepp’s condition in light of MacKay’s diagnosis.   









 
 

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