Bilodeau v. Shalala

856 F. Supp. 18, 1994 U.S. Dist. LEXIS 8840, 1994 WL 314846
CourtDistrict Court, D. Massachusetts
DecidedJune 24, 1994
Docket4:92-cv-40061
StatusPublished
Cited by7 cases

This text of 856 F. Supp. 18 (Bilodeau v. Shalala) is published on Counsel Stack Legal Research, covering District Court, D. Massachusetts primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bilodeau v. Shalala, 856 F. Supp. 18, 1994 U.S. Dist. LEXIS 8840, 1994 WL 314846 (D. Mass. 1994).

Opinion

MEMORANDUM AND ORDER

GORTON, District Judge.

Pending before this Court is plaintiff’s motion to remand this action to the Secretary of Health and Human Services (“the Secre *20 tary”) for further administrative proceedings and reconsideration of its final decision in light of new evidence.

Donald Bilodeau (“Bilodeau”) filed an application for disability insurance benefits on December 11, 1989. He claimed to have been disabled since December 4, 1988 due to a neck injury. This application was denied initially on April 3, 1990, and twice on reconsideration, May 4 and September 14, 1990. As such, Bilodeau requested a hearing before an Administrative Law Judge (“ALJ”) who, on April 22, 1991, once again denied the requested disability benefits. Bilodeau’s request for review was denied on March 16, 1992, thereby rendering the ALJ’s decision the final decision of the Secretary. See, Da Rosa v. Secretary of Health and Human Services, 803 F.2d 24, 25 (1st Cir.1986).

Pursuant to 42 U.S.C. § 405(g), Bilodeau seeks review of the Secretary’s final decision in this Court. Based upon newly discovered evidence which Bilodeau asserts is material to the Secretary’s decision, Bilodeau has requested that this Court remand this action to the Secretary. The Secretary opposes that motion and requests that this Court enter an order affirming the Secretary’s final decision. Because this Court finds 1) that the new evidence is material and 2) that Bilodeau had good cause for failing to provide it at earlier proceedings, Bilodeau’s motion for remand will be allowed.

I. FACTUAL FOUNDATION

At the time of the hearing before the ALJ, Bilodeau was forty years of age. He had a high school education, and prior work experience as a masonry worker, a carpenter, a heavy equipment operator and an underground cable installer.

On December 4, 1988, Bilodeau injured his right shoulder and neck when he was caught by a cable being pulled by a winch truck. By the time of the ALJ hearing, Bilodeau had been examined by numerous doctors and, in July 1989, had undergone surgery to excise a herniated disc to relieve his pain. Despite this surgery, Bilodeau still complained in March 1990 of, among other maladies, weakness of his right arm and right shoulder stiffness and pain with any movement at all. The only objective medical findings available to the ALJ to substantiate Bilodeau’s claims of pain were 1) signs of cervical and right shoulder strain, 2) the excised, herniated cervical disc and 3) mild carpal tunnel syndrome.

In making his decision, the ALJ took into account the relatively sparse objective evidence, the absence of signs of muscle atrophy due to disuse and Bilodeau’s described ability to perform daily activities. He found that while maladies were capable of causing discomfort, the objective clinical evidence was insufficient to support Bilodeau’s assertions of pain, which the ALJ concluded were not credible. Bilodeau was denied disability benefits.

In October 1991, approximately six months after the hearing before the ALJ, Bilodeau sought the care of Dr. A. Jerome Philbin. Upon physical examination and evaluation of plaintiffs complaints of pain, Dr. Philbin recommended that a Magnetic Resonance Imaging study (“MRI”) of Bilodeau’s right shoulder be performed. That study was performed on October, 1991, and revealed a partially torn rotator cuff.

II. ANALYSIS

A. The Standard for Remand

There are two statutory requirements for remand of an action to review a final decision of the Secretary in light of additional evidence. The evidence must be new and material, and there must be good cause for failing to include this new evidence in prior proceedings. 42 U.S.C. § 405(g). For evidence to be considered material, it must permit the conclusion that the Secretary’s final decision might reasonably have been different had the evidence been present at the time of decision. Falu v. Secretary of Health and Human Services, 703 F.2d 24, 27 (1st Cir.1983). Further, for remand to be appropriate, the evidence must be 1) necessary to fully develop the facts of the case, 2) non-cumulative and 3) essential to a fair hearing. Evangelista v. Secretary of Health and Human Services, 826 F.2d 136, 139 (1st Cir.1987). With respect to the second requirement, to wit, that there was good cause *21 for not including the evidence, it is sufficient if the evidence proffered by plaintiff was unavailable at the time of the Secretary’s administrative proceedings. Geigle v. Sullivan, 961 F.2d 1395 (8th Cir.1992); Wilson v. Secretary of Health and Human Services, 733 F.2d 1181, 1182 (6th Cir.1984); Ward v. Schweiker, 686 F.2d 762, 764 (9th Cir.1982).

Finally, the burden is upon the party seeking remand to produce the new evidence or at least to show the nature of the evidence to the Court. Falu v. Secretary of Health and Human Services, 703 F.2d at 27.

B. Applying the Standard

The role of the ALJ is to assess the functional limitations experienced by the claimant in order to determine whether he is disabled. Given the information and evidence available at the time of the hearing at issue, the ALJ properly performed this role. However, at present, Bilodeau proffers additional evidence which was not available and therefore, could not have been considered at the time of the hearing. This Court must, therefore, determine whether that evidence could reasonably have made a difference in the ALJ’s findings.

A significant portion of Bilodeau’s claimed disability consisted of his allegations of pain. For disability to be based upon the functional limitation of pain, there must be some objective medical findings which demonstrate the existence of a condition which reasonably could be expected to produce such symptoms. Avery v. Secretary of Health and Human Services, 797 F.2d 19, 27 (1st Cir.1986); 20 C.F.R. § 404.1529.

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Bluebook (online)
856 F. Supp. 18, 1994 U.S. Dist. LEXIS 8840, 1994 WL 314846, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bilodeau-v-shalala-mad-1994.