Adams v. Bisignano
- Dulce Foster
- 0:24-cv-01310
- U.S. District Court · District of Minnesota
- 17
In Adams v. Bisignano, Judge Foster granted Stacey A.'s motion for summary judgment in part and sent her Social Security disability case back to the agency for further review because the Appeals Council wrongly refused to consider new medical test results — conducted just fifteen days after the original decision — showing severe nerve damage in both of Plaintiff's arms.
Social Security disability claimants, particularly those whose cases involve evidence submitted to the Appeals Council after an ALJ decision, and claimants with upper extremity impairments whose treatment history or duration of disability may have been evaluated under an incorrect standard.
What happened
In Adams v. Bisignano (Case No. 24-cv-1310), Stacey A., a 50-year-old woman, applied for two types of Social Security disability benefits — Disabled Widow(er)'s Benefits and Supplemental Security Income — claiming she became disabled on January 1, 2020 due to multiple conditions including carpal tunnel syndrome and other upper extremity nerve problems. An Administrative Law Judge (ALJ) — the Social Security official who initially hears these cases — found her upper extremity impairments were not severe enough to limit her ability to work and concluded she could perform jobs like routing clerk, mail clerk, and merchandise marker. Stacey A. then appealed and submitted new medical test results, specifically nerve and electrical conduction studies conducted fifteen days after the ALJ's decision, which showed severe nerve damage in both arms; the Appeals Council refused to consider this evidence because it was dated after the ALJ's decision.
The central legal question was whether the Appeals Council was required to consider those new test results. The court applied the rule that new evidence must be considered if it is not merely a repeat of existing evidence, is relevant to the claimant's condition during the time period under review, would reasonably have a chance of changing the outcome, and there was good cause for not submitting it earlier. Although the tests were conducted fifteen days after the ALJ's decision, the court reasoned that a chronic nerve condition does not suddenly appear in fifteen days, so the results related back to the period the ALJ examined. The court also noted that a vocational expert at the hearing had testified that limiting Stacey A. to only occasional hand use would eliminate all jobs identified, making the new evidence directly relevant to whether she could work.
Judge Foster granted Stacey A.'s motion in part, denied the Commissioner's request to affirm the decision, and sent the case back to the Social Security Administration for further proceedings. On remand, the ALJ must consider the new nerve study evidence, re-evaluate the weight given to Dr. Grace Totoe's medical opinion in light of that evidence, and correct two additional errors: (1) the ALJ incorrectly stated Stacey A. had no prior carpal tunnel treatment when records showed she had been treated and had a cancelled nerve test due to COVID-19, and (2) the ALJ applied the wrong legal standard for the twelve-month disability duration requirement by measuring it from when treatment began rather than from when the impairment became disabling. The court found no independent error in the ALJ's handling of Stacey A.'s mental health impairments.
The detailed version
Case: Adams v. Bisignano, No. 24-cv-1310 (DJF), U.S. District Court for the District of Minnesota. Judge: Magistrate Judge Dulce J. Foster. Decided: July 23, 2025.
Background and Procedural History Plaintiff Stacey A. applied for Disabled Widow(er)'s Benefits (DWB) under Title II and Supplemental Security Income (SSI) under Title XVI of the Social Security Act on May 5, 2021, alleging disability onset of January 1, 2020. Her claimed impairments included blurry vision, type two diabetes, tuberculosis, back pain, heart issues, chest palpitations, human papillomavirus symptoms, and eventually carpal tunnel syndrome and other upper extremity neuropathies.
After two levels of administrative denial, an ALJ held a hearing on January 12, 2023. The ALJ found multiple severe impairments in combination (obesity, thoracic degenerative disc disease, borderline intellectual function, learning disorder, depression, anxiety, and diabetes mellitus) but found several others — including carpal tunnel syndrome — to be non-severe. The ALJ assessed Plaintiff's residual functional capacity (RFC) — the most work-related activity a claimant can do — as capable of light work with postural and social interaction limitations. At step five of the five-step sequential disability evaluation, the ALJ found Plaintiff could perform three occupations existing in significant numbers nationally: Routing Clerk (~140,000 jobs), Mail Clerk (~11,000 jobs), and Merchandise Marker (~137,000 jobs), and therefore found her not disabled through May 3, 2023.
After the ALJ's May 3, 2023 decision, Plaintiff obtained abnormal electromyography (EMG) and nerve conduction velocity (NCV) studies dated May 18–23, 2023 — fifteen days after the decision — showing severe bilateral ulnar neuropathies (cubital tunnel syndrome), moderate bilateral median neuropathies (carpal tunnel syndrome), and likely diffuse axonal polyneuropathy. She submitted these as 'Additional Evidence' to the Appeals Council. The Appeals Council declined to consider the evidence, stating it did not relate to the period at issue (on or before May 3, 2023), and denied review. Plaintiff then filed in federal district court.
Issues Presented
- Whether the court has jurisdiction to review the Appeals Council's refusal to consider the Additional Evidence.
- Whether the Appeals Council erred by refusing to consider the Additional Evidence.
- Whether the ALJ made factual and legal errors warranting remand.
- Whether the ALJ erred by failing to address Plaintiff's schizophrenia spectrum disorder and post-traumatic stress disorder.
Jurisdictional Ruling The Commissioner argued, relying on Browning v. Sullivan, 958 F.2d 817 (8th Cir. 1992), that the Appeals Council's denial of review is not a final agency action subject to judicial review. The court rejected this argument, distinguishing Browning on the ground that in Browning the Appeals Council actually considered the new evidence before declining review, whereas here the Appeals Council refused to consider the Additional Evidence at all. The court held it has jurisdiction to review whether the Appeals Council's refusal to consider newly submitted evidence was erroneous, citing Box v. Shalala, 52 F.3d 168 (8th Cir. 1995) and Williams v. Sullivan, 905 F.2d 214 (8th Cir. 1990), among other precedents.
Appeals Council Analysis Under 20 C.F.R. §§ 404.970(a)(5), (b) and 416.1470(a)(5), (b), the Appeals Council must consider additional evidence that is: (1) new (not merely cumulative), (2) material (relevant to the claimant's condition during the denied period), (3) related to the period on or before the hearing decision, (4) reasonably likely to change the outcome, and (5) supported by good cause for not submitting it earlier.
The court reviewed the new/material/timing requirements de novo (i.e., without deference to the agency). It held the Additional Evidence is new — it consists of specific EMG and NCV diagnostic test results not previously in the record. It held the timing requirement is satisfied because: (a) exact timing is not dispositive under Williams; (b) Plaintiff's nerve conditions were chronic and the same conditions the ALJ already evaluated; (c) there is no plausible suggestion that severe bilateral nerve damage emerged in the fifteen days between the decision and the tests. The court further held the evidence is material because it directly addresses the severity of upper extremity impairments the ALJ found non-severe, is relevant to the persuasiveness of Dr. Totoe's medical opinion (which the ALJ discounted partly for lack of objective evidence of hand weakness), and — given vocational expert testimony that limiting Plaintiff to occasional handling and fingering would eliminate all identified jobs — could directly affect the disability determination.
Neither party nor the Appeals Council addressed the good cause requirement. The court followed other district courts in holding that when good cause is unaddressed but the substantive requirements appear met, remand is appropriate.
Factual and Legal Errors The court identified two additional errors for correction on remand:
1. Factual error: The ALJ stated Plaintiff received no carpal tunnel treatment until late 2021. But the administrative record (R. 791) shows that during her December 2021 appointment, Plaintiff reported prior carpal tunnel treatment, a gabapentin prescription, and a nerve test that was cancelled due to the COVID-19 pandemic. The ALJ's treatment-gap finding was thus contradicted by the record.
2. Legal error: The ALJ applied the incorrect legal standard for the twelve-month duration requirement by stating there was 'no objective evidence that limitations will persist for 12 months now that treatment has begun,' tethering the twelve-month period to the start of treatment. The court held the correct standard, per 20 C.F.R. § 404.335(c)(1) and SSR 23-1p, is that the twelve-month period may be measured from any date when the impairment became disabling, not from the start of treatment.
Mental Impairments The court rejected Plaintiff's argument that the ALJ's failure to specifically mention a schizophrenia spectrum disorder and post-traumatic stress disorder diagnosis was an independent basis for remand. Applying Gregory v. Comm'r Soc. Sec. Admin., 742 F. App'x 152 (8th Cir. 2019), the court found these diagnoses appeared only once in the record (from a December 2022 appointment), were contradicted elsewhere by Plaintiff's own denials of relevant symptoms, and were not 'separate and apart' from the mental impairments the ALJ did address in detail. The court found the ALJ adequately evaluated the entire mental health record.
Disposition The court: (1) granted Plaintiff's Motion for Summary Judgment in part; (2) denied the Commissioner's request for relief; (3) reversed the Commissioner's denial of benefits and remanded pursuant to sentence four of 42 U.S.C. § 405(g) for further administrative proceedings; and (4) dismissed the case with prejudice (meaning the federal court case is closed, with review to continue at the administrative level on remand).
On remand, the ALJ is directed to: (1) consider whether the Additional Evidence alters the conclusion that Plaintiff can perform jobs existing in significant numbers nationally; (2) re-weigh the persuasiveness of Dr. Totoe's medical opinion in light of the Additional Evidence; (3) correct the identified factual and legal errors regarding treatment history and the twelve-month duration standard; and (4) recall a vocational expert if necessary to address a new hypothetical based on any modified RFC.
Reviewer note from the AI+
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