Case Name in Social Security Case - Unavailable

UNITED STATES DISTRICT COURT
DISTRICT OF MINNESOTA
Tamera S.,1
Plaintiff, 	Case No. 25-cv-119 (NEB/SGE)
v. 	REPORT AND RECOMMENDATION
Frank Bisignano,
Commissioner of Social Security,
Defendant.
This matter is before the undersigned United States Magistrate Judge for disposition
pursuant to 28 U.S.C. § 636 and Local Rules 7.2(a)(1). Plaintiff, Tamera S. (hereinafter
“Plaintiff”), seeks judicial review of the decision of the Commissioner of the Social Security
Administration (“Defendant”) denying her claim for Disability Insurance Benefits under Title II
of the Social Security Act. The Court has jurisdiction over Plaintiff’s claims under 42 U.S.C. §
405(g).
Pursuant to the Federal Supplemental Rules of Civil Procedure which govern an action
seeking judicial review of a decision of the Commissioner of Social Security, the present action
should be “presented for decision by the parties’ briefs.” Fed. R. Civ. P. Supp. SS Rule 5. Plaintiff
filed a brief requesting reversal of the Commissioner’s final decision and an award of benefits or,
in the alternative, a remand to the Social Security Administration for further administrative
proceedings. (Dkt. 9).2
1 This District has adopted the policy of using only the first name and last initial of any
nongovernmental parties in Social Security opinions such as the present Order. Thus, when the
Court refers to Plaintiff by her name only her first name and last initial are provided.
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For the reasons discussed herein, this Court recommends Plaintiff’s request for relief (Dkt.
9) be GRANTED in part and DENIED in part, and Defendant’s request for relief (Dkt. 10), be
DENIED.
I. BACKGROUND
Plaintiff applied for Disability Insurance Benefits on February 23, 2022, alleging disability
as of December 31, 2021, due to bipolar, anxiety, and depression disorders. (See Tr. 1838-42.)3
Her claim was denied initially and upon reconsideration. (Tr. 1745-48, 1751-54.) On August 16,
2022, Plaintiff filed a written request for a hearing before an Administrative Law Judge (ALJ), and
a telephonic hearing was held on August 2, 2023. (Tr. 1755-56, 1701-15.) At the hearing, Plaintiff
was represented by counsel and testified. Medical expert Emily Thomas, Psy.D., and vocational
expert Jason Ogren were not present, did not testify, and instead responded to form interrogatories
after the hearing. (Tr. 1995-99, 2935-43.) On December 21, 2023, the ALJ issued his decision
finding that the Plaintiff was not disabled. (Tr. 15-28.)
Plaintiff requested review of the ALJ’s decision and submitted additional medical records
from the Mayo Clinic from May 8, 2023, through December 19, 2023, related to her attempted
Electroconvulsive Therapy (ECT) to the Appeals Council for review. (Tr. 34-1700, 1835-37.) The
Appeals Council denied Plaintiff’s request for review on November 19, 2024, stating it would not
include the new medical records as evidence because “[the] evidence does not show a reasonable
probability that it would change the outcome of the decision.” (Tr. 2.) Thus, the ALJ’s decision
became the final decision of the Commissioner. (Tr. 1-6.)
II. STANDARD OF REVIEW
3 Throughout this Order, the Court refers to the Administrative Record, (Dkt. 7), by the
abbreviation “Tr.” Where the Court cites to the Administrative Record, it refers to the page
numbers found in the bottom-right corner of each page of the record.
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A. Administrative Law Judge’s Analysis
The Court’s review of the Commissioner’s final decision is limited to a determination of
“whether the ALJ’s decision complies with the relevant legal standards and is supported by
substantial evidence in the record as a whole.” Lucas v. Saul, 960 F.3d 1066, 1068 (8th Cir. 2020)
(quoting Halverson v. Astrue, 600 F.3d 922, 929 (8th Cir. 2010)); 42 U.S.C. § 405(g). “Substantial
evidence is less than a preponderance, but enough that a reasonable mind might accept as adequate
to support a conclusion.” Kraus v. Saul, 988 F.3d 1019, 1024 (8th Cir. 2021) (quoting Phillips v.
Astrue, 671 F.3d 699, 702 (8th Cir. 2012)). This “threshold . . . is not high.” Biestek v. Berryhill,
587 U.S. 97, 103 (2019). “If, after reviewing the record, the court finds it is possible to draw two
inconsistent positions from the evidence and one of those positions represents the [ALJ's] findings,
the court must affirm the [ALJ's] decision.” Perks v. Astrue, 687 F.3d 1086, 1091 (8th Cir. 2012)
(quoting Pearsall v. Massanari, 274 F.3d 1211, 1217 (8th 2001)).
B. Appeals Council Review
If the claimant is dissatisfied with the administrative law judge’s decision, the claimant
may request review by the Appeals Council, although the Appeals Council is not required to grant
that request for review. See 20 C.F.R. §§ 404.967–404.982. If not available to the ALJ, the Appeals
Council must review additional evidence that is new and material where it relates to the period on
or before the date of the administrative law judge hearing decision is issued, and there is a
reasonable probability that the additional evidence would change the outcome of the decision. See
Bergmann v. Apfel, 207 F.3d 1065 (8th Cir. 2000) (citing 20 C.F.R. § 404.970(b)). The evidence
must be “new” and not merely cumulative of other evidence on the record, and it must be
“material” to the claimant’s condition for the time period for which benefits were denied. William
v. Sullivan, 905 F.2d 214, 216-17 (8th Cir. 1990). In reviewing the additional evidence, the Appeals
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Council shall evaluate the entire record including the new and material evidence submitted.
Bergmann, 207 F.3d at 1069.
C. Judicial Review
If a claimant is dissatisfied with the final decision of the Commissioner following the
request for review to the Appeals Council, the claimant may seek judicial review in federal district
court. In cases where there has been a submission of supplemental evidence following the ALJ’s
decision, the record before the district court includes that evidence submitted after the hearing and
considered by the Appeals Council. See Jenkins v. Apfel, 196 F.3d 922, 924 (8th Cir. 1999) (citing
Riley v. Shalala, 18 F.3d 619, 622 (8th Cir. 1994)).
Once it is clear that the Appeals Council has considered newly submitted
evidence, [the reviewing court does not] evaluate the Appeals Council’s
decision to deny review … [i]nstead [review] is limited to deciding whether
the administrative law judge’s determination is supported by substantial
evidence on the record as a whole, including the new evidence submitted
after the determination was made.
…
Of necessity, that means [a reviewing court] must speculate to some extent
on how the administrative law judge would have weighed the newly
submitted reports if they had been available for the original hearing.
Riley, 18 F.3d at 622 (citing Nelson v. Sullivan, 966 F.2d 363, 366 (8th Cir. 1992)).
Here, the reviewing court must consider the medical records (1143 pages) submitted to the
Appeals Council and covering the treatment of the Plaintiff from May 8, 2023, to December 19,
2023, and how the ALJ would have weighed these medical records in making a final ruling. (Tr.
2.) In doing so, the reviewing court must determine if, despite the reports, the ALJ’s decision is
still supported by substantial evidence in the record as a whole. The submission of additional
evidence to the Appeals Council slightly complicates the “substantial evidence” analysis. In
reviewing the record for substantial evidence, the court “looks at both evidence that supports and
evidence that detracts from the Commissioner’s decision,” Bergmann, 207 F.3d at 1068 (citing
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Cox v. Apfel, 160 F.3d 1203, 1207 (8th Cir. 1998)), and then “factor[s] in” the new evidence to
determine whether the ALJ’s decision is still supported by substantial evidence. Flynn v. Chater,
107 F.3d 617, 621-22 (8th Cir. 1997).
III. DISCUSSION
An individual is “disabled” under the Act if she is unable “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 twelve months.” 42 U.S.C. § 423(d)(1)(A). To determine the existence and extent
of a claimant’s disability, the administrative law judge must follow a five-step sequential analysis.
This analysis requires the administrative law judge to make a series of factual findings about the
claimant’s impairments, residual functional capacity, age, education, and work experience. See 20
C.F.R. §§ 404.1520(a)(4), 416.920(a)(4); Locher v. Sullivan, 968 F.2d 725, 727 (8th Cir. 1992).4
In reaching his decision here, the ALJ followed the five-step sequential analysis process
laid out in 20 C.F.R. §§ 404.1520(a), 416.920(a). The ALJ determined at step one that Plaintiff
had not engaged in substantial gainful activity since the alleged disability onset date of December
31, 2021. (Tr. 20.) At step two, the ALJ found Plaintiff had the following severe impairments:
bipolar disorder, depressive disorder, and anxiety disorder. (Tr. 21.) At step three, the ALJ
4 Step one of this process involves determining whether a claimant is engaged in substantial gainful
activity. If not, the ALJ must next decide (in step two) whether the claimant’s impairments are
severe, and of a duration of at least twelve continuous months. At step three, the ALJ determines
whether the claimant’s impairments are severe enough to equal a listed impairment under appendix
1 to subpart P of part 404. If so, the claimant is considered disabled without further inquiry. If not,
the ALJ must determine the claimant’s residual functional capacity, and determine (at step four)
whether the claimant can still do their past work given their limitations. Finally, if the ALJ
concludes a claimant cannot perform their prior work, step five requires the ALJ to determine
whether they can do other work, considering their Residual Functional Capacity, age, education,
and work experience. 20 C.F.R.§ 416.920(a)(4)(i–v); 20 C.F.R. § 404.1520(a)(4)(i-v).
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concluded none of Plaintiff’s impairments individually or collectively met or medically equaled
any impairment in 20 C.F.R. Part 404, Subpart P, App’x 1 (“Listing of Impairments”). 20 C.F.R.
§ 416.920(a)(4)(iii).5 (Tr. 21.)
Specifically, at step three, the ALJ reviewed the criteria for the listings 12.04 and 12.06
(Mental Disorders) and considered whether Plaintiff’s mental impairments satisfied the “paragraph
B” criteria. (Tr. 21.) “These criteria represent the areas of mental functioning a person uses in a
work setting …[and] determine the degree to which [a] medically determinable mental impairment
affects the four areas of mental functioning and [the] ability to function independently,
appropriately, effectively, and on a sustained basis.” 20 C.F.R. 404, Subpart P App’x 1, 12.00
(A)(2)(b) (citing 20 CFR §§ 404.1520a(c)(2) and 416.920a(c)(2).) To satisfy the “paragraph B”
criteria, the mental impairments of the Plaintiff must result in one extreme limitation or two marked
limitations in a broad area of functioning to meet or medically equal a listed impairment. Id.
In this case, the Disability Determination Service (DDS) psychological consultants
assessed the Plaintiff’s limitations on June 28, 2022, and August, 7, 2022, under the “paragraph
B” criteria and found that she had a mild limitation in the area of “understand, remember, or apply
information;” a moderate limitation in the area of “interact with others;” a moderate limitation
with “concentrate, persist, or maintain pace;” and a mild limitation in the area of adapt or manage
oneself.” (Tr. 22, 1725- 32 (emphasis added).) Based on the records they had as of August 7, 2022,
the DDS assessed her limitations and vocational factors and decided Plaintiff was not disabled.
(Tr. 1741.) It appears, however that the DDS consultants did not have any evidence of record after
August 4, 2022, and were unable to review the medical records of the Plaintiff’s worsening medical
5 The Listing of Impairments is a catalog of presumptively disabling impairments categorized by
the relevant “body system” affected. See 20 C.F.R. Part 404, Subpart P, App. 1.
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condition over the following twelve months and her ECT treatments through July 31, 2023. Dr.
Emily Thomas, the Defendant’s medical expert, found similar limitations in functioning in the
check-the-box form and interrogatories filled out by her. (Tr. 22, 2935-43.) While the ALJ found
the DDS assessment and Dr. Thomas’ opinion largely persuasive and supported by the record, the
ALJ deviated from their opinions and, “in considering the overall record, including the evidence
of further mental health treatment with ECT therapy,” found the Plaintiff to have a moderate
limitation in adapting or managing oneself. (Tr. 22.)
Like the consultants, the ALJ found the Plaintiff to have a moderate limitation in
interacting with others. The ALJ balanced Plaintiff’s reported difficulty getting along with others,
anxiety in social situations, her worry others are looking at her and making judgements, and the
anxiety she feels making it difficult to communicate in those situations on one side, and the
maintenance of a relationship with her fiancé, her ability to relate appropriately with providers,
her therapists observations that she has normal speech and good eye-contact at visits despite
presenting as anxious and tearful at times, and her psychiatric provider’s description of the
claimant as cooperative on the other. (Tr. 22.) Ultimately, the ALJ found, because the Plaintiff’s
mental impairments do not cause at least two “marked” limitations or one “extreme” limitation,
the “paragraph B” criteria are not satisfied and the Plaintiff’s impairments are not severe enough
to equal a listed impairment under appendix 1 to subpart P of part 404, and the analysis must
continue.
At step four, the ALJ determined Plaintiff’s residual functional capacity (RFC), explaining
that his “assessment reflects the degree of limitation [he] found in the ‘paragraph B’ mental
function analysis.” (Tr. 23.) The ALJ found that although she could work, the Plaintiff could not
perform her past relevant work as a home health aide. (Tr. 26-27.) Instead, the ALJ found:
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the claimant has the residual functional capacity to perform light work as
defined in 20 CFR 404.1567(b) but with the following nonexertional
limitations: no exposure to dangers to life or limb in the workplace; no
exposure to vibrating objects or surfaces in completing tasks and not
required to work in high, exposed places; no work in excess of simple,
routine, repetitive tasks; occasional changes in work setting; no public
interaction; brief and superficial interaction with supervisors and
coworkers; … no complex decision making; and no rapid, assembly-line
paced work (daily quotas by not hourly quotas).
(Tr. 23.) In making this finding, the ALJ weighed the evidence, including the testimony of the
Plaintiff and her claimed inability to engage in work activity as a result of the limitations she
experiences with bipolar disorder, the progression of her bipolar disorder since 2019, and her many
trials of different medications with negative side effects against the evidence that her bipolar
disorder has been managed with medication, psychotherapy, “and more recently, with ECT
treatment,” finding “[t]he course of treatment has resulted in improvement.” (Tr. 24.) In
conclusion, the ALJ found
Psychotherapy has been helpful, and she has had a positive response to ECT
treatment. The limitations in the residual functional capacity accommodate
the severe mental impairments indicated by the record.
(Tr. 24.)
Thus, at step five, the ALJ found that Plaintiff could perform work as a “labeler,” “garment
batter,” or “inserter,” with a combine 95,000 jobs nationally. (Tr. 27.) The ALJ thus concluded
that the Plaintiff was not disabled. (Tr. 28.)
IV. ANALYSIS
Plaintiff contends that remand is required because (1) the new medical records submitted
to the Appeals Council are material and the Appeals Council wrongly concluded that the evidence
would not have changed the ALJ’s decision, (2) the ALJ erred by giving greater weight to the
opinion of Dr. Emily Thomas based on her review of records over the Plaintiff’s longstanding
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treating medical provider, Dr. Ashok Seshardri, and (3) the RFC Assessment is not supported by
the weight of the medical evidence. (Dkt. 9.) As such, the Plaintiff asks the Court to reverse the
Commissioner’s final decision and award benefits, or in the alternative, remand the case for further
proceedings before the Commissioner of Social Security. (Id.)
Defendant contends that each of Plaintiff’s arguments is unavailing, the newly submitted
reports did not have a reasonable probability of changing the outcome of the ALJ’s decision, and
that the ALJ’s decision is supported by substantial evidence. (Def.’s Mem. (Dkt. 10).) Defendant
asks this Court to affirm the ALJ’s decision. (Id.)
A. The New, Material Evidence Submitted to the Appeals Council
The Appeals Council will only review cases in limited circumstances: (1) if there appears
to be an abuse of discretion by the ALJ; (2) if there is an error of law; (3) if the action, finding, or
conclusions in the ALJ’s decision or dismissal order are not supported by substantial evidence; (4)
if there is a broad policy or procedural issue that may affect the general public interest; or (5) if
the Appeals Council receives additional evidence that is new, material, and relates to the period
on or before the date of the hearing decision of the ALJ, and “there is a reasonable probability that
the additional evidence would change the outcome of the decision.”6 See 20 C.F.R. § 404.970(a).
Here, the Appeals Council concluded that there was not “a reasonable probability” that the
new evidence would change the outcome of the ALJ’s decision. This Court disagrees. This Court,
however, does not review the Appeals Council’s determination and instead considers the new
6 This additional evidence will only be considered if the Petition is able to show “good cause” for
not informing the Commissioner about the evidence as described in § 404.935 because of a variety
of reasons, none of which are challenged by the Defendant in this case. See 20 C.F.R. § 404.970
(b) and Dkt. 10. Defendant does not challenge Plaintiff’s “good cause” for submitting the evidence
to the Appeals Council after the hearing with the ALJ and that the records “relate[] to the period
on or before the date of the hearing decision of the ALJ.”
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evidence and the record as a whole when determining if substantial evidence supports the ALJ’s
decision. Davidson v. Astrue, 501 F.3d 987, 990 (2007); Riley, 18 F.3d at 622. The new reports
are available for the Court’s review as part of the administrative record because the Appeals
Council considered them when it decided whether to review the ALJ’s decision. See Davidson,
501 F.3d at 990.
At step three of the disability determination, the ALJ evaluated Plaintiff’s mental
capabilities using the four broad areas of mental functioning set out in the disability regulations
for evaluating mental disorders and in the Listing of Impairments. These areas, known as the
“paragraph B” criteria, are: (1) understanding, remembering, or applying information; (2)
interacting with others; (3) concentrating, persisting, or maintaining pace; and (4) adapting or
managing oneself. See 20 C.F.R. Part 404, Subpart P, App. 1. In assessing whether Plaintiff had
any limitations, the ALJ reviewed the medical record of Plaintiff’s severe impairments of bipolar
disorder, depressive disorder, and anxiety disorder. In doing so, he considered the positive effect
of Plaintiff’s newly attempted ECT treatment. In comparing the Plaintiff’s impairments with the
criteria, the ALJ found that the Plaintiff had a moderate limitation in adapting or managing oneself
based on “the overall record, including evidence of further mental health treatment with ECT
therapy.” (Tr. 22.) Similarly, the ALJ found the Plaintiff was only moderately limited in adapting
or managing oneself based on his finding,
[h]er mental health symptoms have been managed largely with medication
management. Psychotherapy started in August 2022 . . . [she] has been
unable to tolerate current medications at higher does, and in June 2023 she
was referred for ECT treatment. She had a positive response to ECT
therapy, and is continuing to take her medications at previous doses.
(Exhibit B8F/6).
(Tr. 23.)
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In his Residual Functional Capacity (RFC) determination at step five, the ALJ also relied
on the Plaintiff’s recent ECT treatment, hospitalization from July 1-7, 2023, to undergo treatment,
and its effectiveness in controlling Plaintiff’s symptoms. (Tr. 22, 23, 24, 25-26). The ALJ
recognized,
As she had not responded to the present medication therapy, and she was
unable to tolerate current medications at a higher dose, a referral for ECT
was made. Given the need for decreases in the dosages of her current
medications to optimize the ECT treatment, she was hospitalized from July
1-7, 2023, while she underwent three ECT treatments. She had
improvement in depression and anxiety by the time of discharge, and the
plan was to continue the ECT treatment as an outpatient. (Exhibits B8F/79).
She had an excellent response to ECT, and the severity of her depressive
symptoms had decreased to the milder range. She did report having had a
severe panic episode after the fourth treatment, and ways to manage those
episodes were discussed. (Exhibit B8F/7-8).
(Tr. 26.) Thus, in steps three and four, the ALJ acknowledged Plaintiff’s inability to handle the
side effects of various medications but was encouraged by Plaintiff’s recent ECT treatments and
her seemingly positive response to it.
The new medical records and reports submitted to the Appeals Council track the Plaintiff’s
ongoing deterioration and her inability to undergo additional ECT treatments because of her
worsening anxiety surrounding the treatments and side effects (including memory loss). These
worsening symptoms and unsuccessful ECT medical treatments both directly affect Plaintiff’s
limitations and RFC at steps three and four of the ALJ’s sequential analysis. See above. At the
time the ALJ issued his opinion, he knew that on July 1, 2023, Plaintiff was admitted into the
hospital for ECT treatments. At the time of her admission, she expressed,
suffering with significant depression over the past 17 months with
worsening over the last month. She reports that she has tried several
medications trials with no minimal improvement. Prior to this episode of
depression, she experienced an episode of hypomania . . . . She describes
her depression as ‘the worst it is ever been.’ She endorses amotivation,
decreased energy, weight gain of 100 lb., [sic] worthlessness, and feeling
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guilty. She is also no longer working and has decreased ADLs including
hygiene and laundry. She reports that she was having intrusive thoughts of
suicide, but over the past couple of months, her suicidal ideation has become
more passive and decreased in intensity. She denies suicidal intent and
reports that she “knows I am in the right place” and hopeful for her [ECT]
treatment. Her goal for hospitalization is to ‘feel more human.’
(Tr. 2526.) The ALJ also had the medical records from her initial ECT treatments, which seemed
to initially help her mental health. But the ALJ did not have the records regarding Plaintiff’s
attempts at further ECT treatment and her worsening anxiety surrounding the significant side
effects of ECT, leading to a complete inability undergo any additional treatments, despite her
motivation to do so. (Tr. 80, 151-52, 247, 291.)
This additional evidence7 undermines the medical evidence before the ALJ at the time the
order was issued. It is both new and material as to the Plaintiff’s deterioration and her inability to
complete ECT treatments, thereby affecting her work limitations and RFC. Accordingly, the record
that was before the ALJ has been significantly altered by the additional evidence. The evidence
supporting the ALJ’s determination is now undermined, and this Court cannot determine that the
ALJ’s decision is supported by substantial evidence because the ALJ did not have the opportunity
to reconcile this conflicting evidence. This Court therefore recommends remand to the
Commissioner for its consideration of the new, material evidence of Plaintiff’s evolving condition
through December 21, 2023.
B. The Weight of the Medical Opinions
The Plaintiff next alleges that it was “improper for the ALJ to accord the greatest weight
to the opinion of Dr. Thomas over Dr. Seshardri.” (Dkt. 9 at 16.) The Defendant argues that the
7 The additional evidence submitted to the Appeals Council may be found in the Transcript at
pages 34-1700, but the only relevant reports for this Court’s consideration are those up to and
through December 21, 2023, the date the ALJ issued their decision. (Tr. 18.)
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ALJ properly applied the regulations in weighing the supportability and consistency of the medical
opinions. (Dkt. 10 at 9.)
There is no per se rule that an ALJ must assign greater weight to an examining physician’s
opinion than to a non-examining physician’s opinion. See Tindell v. Barnhart, 444 F.3d 1002,
1006 (8th Cir. 2006) (affirming ALJ’s decision to give little weight to Plaintiff’s examining
physicians’ opinions and greater weight to non-examining state agency physician’s opinion); Betts
v. Colvin, No. 14-CV-2434 (JJK), 2015 WL 2105855, at *27 (D. Minn. May 6, 2015) (same).
The ALJ determined that Dr. Seshardri’s April 18, 2022 opinion on Plaintiff’s limitations
was not persuasive, as it was not consistent with or supported by “his mental status observations”
in the records. (Tr. 26.) Instead, the ALJ found “the DDS assessments and the medical expert’s
opinion are largely persuasive and supported by the record” and “reflect a careful review of the
entire body of medical evidence.” (Tr. 22, 26.)
As discussed above, however, Dr. Seshardri’s opinions were based on information prior to
his April 18, 2022 report, and the DDS consultant’s assessments were based on information that
did not contain medical records past August 7, 2022. Similarly, Dr. Thomas, the Commissioner’s
medical expert, gave limited responses to the form interrogatories sent to her by the ALJ and did
not include any reference to the ECT therapy records submitted in Exhibit B8F. (Tr. 2935-43).
The record is unclear if Dr. Thomas had all the medical records available when responding
to the ALJ’s request for her professional opinion. (Tr. 2917.) Following the August 2, 2023 ALJ
hearing, the record was left open to allow for the submission of additional medical records from
the Mayo Clinic, as Plaintiff’s attorney represented that the Plaintiff had received additional
treatments since the last record in the case at Exhibit B7F. (Tr. 18.) Thereafter, the additional
records were received and entered into the record at Exhibit B8F. (Tr. 2706-916.) An interrogatory
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was sent to Dr. Thomas, and her response was entered into the record as Exhibit B11F. (Tr. 2935-
43.) Dr. Thomas says very little in her responses to the interrogatories and instead generally cites
to various exhibits in support of the boxes she checked. (Id.) She does not cite the additional
records related to Plaintiff’s ECT appointments, treatments, and aftercare. (See Tr. 2935-43.)
Dr. Thomas determined Plaintiff’s limitations to be as follows: Understanding,
Remembering, or Applying Information, Mild; Interacting with Others, Moderate; Concentrating,
Persisting or Maintaining Pace, Moderate; Adapting or Managing Oneself, Mild. (Tr. 2940.)
Although the ALJ found Dr. Thomas’ opinion largely persuasive and supported by the record, the
ALJ deviated from her opinion in one respect: “in considering the overall record, including the
evidence of further mental health treatment with ECT therapy,” the ALJ found the Plaintiff to have
a moderate limitation in the area of adapting or managing oneself. (Tr. 22.)
Because this Court recommends remand based on the newly submitted reports provided to
the Appeals Council because they undermine the previous evidence relied upon by the ALJ in his
decision, and because the Court cannot discern what medical records were reviewed by Dr.
Thomas when she responded to the interrogatories, the Court cannot and need not address the
supportability and consistency of the medical opinions.
C. The Residual Functional Capacity Assessment
Plaintiff next contends the RFC finding at step four was not supported by substantial
evidence in the medical record. (Dkt. 9 at 16-18.) The Defendant submits that substantial evidence
supports the ALJ’s finding. (Dkt. 10 at 16-18.)
The ALJ must build a logical bridge between the RFC and the evidence by “includ[ing] a
narrative discussion describing how the evidence supports each conclusion.” Social Security
Ruling (“SSR”) 96-8p, 1996 WL 374184, at *7. “[T]he [ALJ] must also explain how any material
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inconsistencies or ambiguities in the evidence in the case record were considered and resolved.”
Id.; see also Lee R. v. Kijakazi, No. 20-cv-1989 (BRT), 2022 WL 673259, at *4 (D. Minn. Mar. 7,
2022) (finding ALJ failed to create a “logical bridge” between the evidence and his conclusions);
Weber v. Colvin, No. 16-cv-332 (JNE/TNL), 2017 WL 477099, at *26 (D. Minn. Jan. 26, 2019)
(same).
In his analysis at step four, the ALJ included a narrative discussion describing how the
evidence supported his conclusions with the evidence he had at the time. As Plaintiff’s symptoms
changed over time, the ALJ had more information than Dr. Seshardri or the DDS consultants in
their respective 2022 findings. But the ALJ’s narrative relies on the promising ECT treatment and
its seeming effectiveness in treating the Plaintiff’s severe mental health impairments. In
determining Plaintiff’s RFC and in reviewing the records, the ALJ noted,
The claimant presented for a medication management visit on June 19,
2023, reporting a gradual worsening of depressive symptoms over the past
month. . . . She was noted to have depressed mood and affect but showed
some reactivity. She continued to have intact attention and concentration,
intact memory, normal speech, stable rapport, and fair insight and judgment.
She expressed interest in ECT therapy. As she had not responded to the
present medication therapy, and as she was unable to tolerate current
medications at higher doses, a referral for ECT was made. . . . [S]he was
hospitalized from July 1-7, 2023, while she underwent three ECT
treatments. She had improvement in depression and anxiety by the time of
discharge, and the plan was to continue ECT treatments as an outpatient.
She had excellent response to ECT, and the severity of her depressive
symptoms had decreased to the milder range. She did report having had a
severe panic episode after the fourth treatment, and ways to manage those
episodes were discusssed.
(Tr. 25-26.) If this were the end of the reports for the relevant timeframe, the Court would conclude
that the ALJ’s findings were supported by substantial evidence. But the ALJ’s assessment of
Plaintiff’s RFC did not include the medical records from the relevant timeframe submitted to the
Appeals Council which, as this Court determines above, undermines the evidence relied upon by
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the ALJ in his opinion. For these reasons, this Court finds that the ALJ’s RFC determination is not
supported by substantial evidence and the case should be remanded to the Commissioner for
further consideration of the records from the full, relevant timeframe.
V. RECOMMENDATION
Therefore, based on the foregoing, and on all the files, records, and proceedings herein, IT
IS HEREBY RECOMMENDED THAT:
1. Plaintiff’s request for relief (Dkt. 9) be GRANTED in part and DENIED in part, as set
forth above; and
2. Defendant’s request for relief (Dkt. 10) be DENIED.
Dated: January 19, 2026 	s/Shannon G. Elkins
SHANNON G. ELKINS
United States Magistrate Judge
NOTICE
Filing Objections: This Report and Recommendation is not an order or judgment of the District
Court and is therefore not appealable directly to the Eighth Circuit Court of Appeals.
Under Local Rule 72.2(b)(1), “a party may file and serve specific written objections to a magistrate
judge’s proposed finding and recommendations within 14 days after being served a copy” of the
Report and Recommendation. A party may respond to those objections within 14 days after being
served a copy of the objections. LR 72.2(b)(2). All objections and responses must comply with the
word or line limits set for in LR 72.2(c).
Under Advisement Date: This Report and Recommendation will be considered under advisement
14 days from the date of its filing. If timely objections are filed, this Report and Recommendation
will be considered under advisement from the earlier of: (1) 14 days after the objections are filed;
or (2) from the date a timely response is filed.
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