Peggy Mayes v. Larry G. Massanari, Commissioner of Social Security

276 F.3d 453, 2001 Cal. Daily Op. Serv. 10543, 2001 Daily Journal DAR 13238, 2001 U.S. App. LEXIS 27065, 2001 WL 1636587
Court of Appeals for the Ninth Circuit·Decided December 21, 2001·No. 00-35181·Published·Cited by 1,226 cases

Opinion

ORDER AND AMENDED OPINION

MOLLWAY, District Judge:

ORDER

The opinion filed on August 27, 2001, slip op. 11597, and reported at 262 F.3d 963, is amended by adding a new footnote 3, at the end of the fourth sentence (first paragraph) of Part III.A, slip op. at 11610, 262 F.3d at 970, as follows:

We need not decide whether good cause is required for submission of new evidence to the Appeals Council, as Mayes conceded in her briefs that good cause was indeed required. In a petition for rehearing, which we deny, Mayes raises *456 for the first time the argument that 20 C.F.R. § 404.970(b)(2001) requires the Appeals Council to receive new evidence without regard to the issue of good cause. Citing Ramirez v. Shalala, 8 F.3d 1449 (9th Cir.1993), Mayes belatedly argues that good cause is required only when new evidence is submitted to a district court. Mayes misapprehends Ramirez. Because the parties agreed that the new evidence submitted for the first time to the Appeals Council should be considered, id. at 1451-52, Ramirez does not address whether submissions to the Appeals Council are or are not subject to the good cause requirement.

All subsequent footnotes are renumbered accordingly.

With the foregoing amendments, the petition for panel rehearing is denied.

OPINION

Peggy J. Mayes (“Mayes”) appeals the district court’s affirmance of a decision by an Administrative Law Judge (“ALJ”) that ended her disability insurance benefits under the Social Security Act. Mayes also appeals the district court’s refusal to remand the case to the ALJ in light of evidence obtained after the ALJ issued his decision.

The ALJ found that, although Mayes had numerous medical problems, she could not be deemed disabled if, as required by 42 U.S.C. § 423(d)(2)(C) (Supp.2001), the ALJ disregarded her alcohol dependence. Mayes contends that, had the ALJ developed the record, he would have discovered her herniated discs, diagnosed after the hearing held by the ALJ (“ALJ Hearing”). The ALJ would then have found her disabled and therefore eligible to receive disability insurance benefits, Mayes says. Mayes therefore asks this court to reverse the district court’s affirmance of the ALJ’s decision and to remand the case to the ALJ for further consideration of whether she is disabled in light of her herniated discs.

We affirm the ALJ’s determination that Mayes was not disabled. Substantial evidence supports that determination, and the ALJ applied the proper legal standard. We also affirm the district court’s refusal to remand the case to the ALJ for consideration of the subsequent herniated disc diagnosis. On de novo review, we find that this “new” evidence was not material to the ALJ’s disability determination. Even if it was material, the district court did not abuse its discretion in refusing to remand the case to the ALJ because Mayes did not demonstrate good cause for having failed to provide that evidence earlier.

I. PROCEDURAL HISTORY AND FACTUAL BACKGROUND.

The Social Security Act, 42 U.S.C. § 423(a)(1) (Supp.2001), allows certain people with disabilities to obtain disability insurance benefits. Mayes initially applied for these benefits on January 11, 1988, fisting “Spinal Problems” as her disability. After an administrative hearing, Mayes was found disabled for purposes of the Social Security Act. Although Mayes’ petition for an administrative hearing had been based on alleged back problems, she was found disabled on the basis of “severe alcoholism with depression, characterized by suicidal attempts and ideation, inability to eat or sleep, feelings of worthlessness, and blackouts.”

About seven and a half years later, on November 7, 1995, Mayes was notified that the determination that she was disabled was being reviewed by the Social Security *457 Administration. 1 In conjunction with that review, Mayes told the Social Security Administration that her disabling conditions were “rheumatoid arthritis (spine, hips, knees, ankles are worst),” a cancer known as Bowens’ disease, “lung problems,” and a “hormone imbalance.” The Social Security Administration determined that, as of April 30, 1996, Mayes would cease to be eligible for disability insurance benefits. It reasoned that Mayes “show[ed] pretty good voluntary control over her drinking.” It concluded that Mayes’ depression was mild and that her “activities of daily living and social functions [were] normal.” On February 12, 1996, Mayes filed for reconsideration, stating that her “physical ailments [had] worsened.”

On March 29, 1996, 42 U.S.C. § 423 was amended. Under the amended section 423, “[a]n individual shall not be considered disabled for purposes of this subchap-ter if alcoholism or drug addiction would (but for this subparagraph) be a contributing factor material to the Commissioner’s determination that the individual is disabled.” 2 42 U.S.C. § 423(d)(2)(C) (Supp. 2001). In light of this amendment, the Social Security Administration, on August 19, 1996, notified Mayes that it would be terminating her disability benefits as of January 1997. See Pub.L. 104-121 (1996) (stating that the effective date of the amendment for persons already receiving disability insurance benefits was January 1, 1997). This notification appears to have acted as a denial of Mayes’ February 12, 1996, request for reconsideration of the decision to end her disability benefits.

Mayes then requested a “face-to-face ev-identiary hearing,” claiming that she was disabled independent of her alcoholism. On September 19, 1996, the disability hearing officer found that Mayes was still disabled, that her disability arose from alcoholism, and that she was not entitled to disability benefits, citing Pub.L. 104-121 (enacted as 42 U.S.C. § 423(d)(2)(C)). The disability hearing officer noted that Mayes “had been treated for back pain, but her primary condition was alcoholism.”

In March 1997, Mayes requested a hearing before an ALJ. At that time, she said that she had rheumatoid arthritis, bronchitis, asthma, a hormone imbalance, Bowens’ disease, “blockage somewhere between heart & brain that cause[d her] to stop breathing,” peripheral vision problems, and continuing weakness. She noted that, two years earlier, she had seen Dr. C.E.

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Peggy Mayes v. Larry G. Massanari, Commissioner of Social Security, 276 F.3d 453, 2001 Cal. Daily Op. Serv. 10543, 2001 Daily Journal DAR 13238, 2001 U.S. App. LEXIS 27065, 2001 WL 1636587 (9th Cir. 2001).

276 F.3d 453 (Peggy Mayes v. Larry G. Massanari, Commissioner of Social Security) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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