Ligons v. Social Security Administration

Filing 20

OPINION AND ORDER by Magistrate Judge T Lane Wilson reversing and remanding Commissioner's decision (crp, Dpty Clk)

IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF OKLAHOMA
DARRYL LIGONS,
Plaintiff,
vs.
MICHAEL J. ASTRUE,
Commissioner of the Social Security
Administration,
Defendant.

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Case No. 10-cv-653-TLW

OPINION AND ORDER
Plaintiff Darryl Ligons, pursuant to 42 U.S.C. § 405(g) and 42 U.S.C. § 1383(c), requests
judicial review of the decision of the Commissioner of the Social Security Administration
partially granting him disability benefits under Titles II and XVI of the Social Security Act
(“Act”). In accordance with 28 U.S.C. § 636(c)(1) and (3), the parties have consented to proceed
before the undersigned United States Magistrate Judge. (Dkt. # 11).
Introduction
When applying for disability benefits, a plaintiff bears the initial burden of proving that
he or she is disabled. 42 U.S.C. § 423(d)(5); 20 C.F.R. § 416.912(a). “Disabled” under the
Social Security Act is defined as the “inability to engage in any substantial gainful activity by
reason of any medically determinable physical or mental impairment.”

42 U.S.C. §

423(d)(1)(A). A disability is a physical or mental impairment “that results from anatomical,
physiological, or psychological abnormalities which are demonstrable by medically acceptable
clinical and laboratory diagnostic techniques.”

42 U.S.C. § 423 (d)(3).

The evidence

establishing a disability must come from “acceptable medical sources” such as licensed and
certified psychologists and licensed physicians. 20 C.F.R. §§ 404.1513(a), 416.913(a). A

plaintiff is disabled under the Act only if his “physical or mental impairment or impairments are
of such severity that he is not only unable to do his previous work but cannot, considering his
age, education, and work experience, engage in any other kind of substantial gainful work in the
national economy.” 42 U.S.C. § 423(d)(2)(A).
Social Security regulations implement a five-step sequential process to evaluate a
disability claim. 20 C.F.R. §§ 404.1520, 416.920; Williams v. Bowen, 844 F.2d 748, 750 (10th
Cir. 1988) (setting forth the five steps in detail). “If a determination can be made at any of the
steps that a plaintiff is or is not disabled, evaluation under a subsequent step is not necessary.”
Williams, 844 F.2d at 750.
In reviewing a decision of the Commissioner, the court is limited to determining whether
the Commissioner has applied the correct legal standards and whether the decision is supported
by substantial evidence. Grogan v. Barnhart, 399 F.3d 1257, 1261 (10th Cir. 2005). Substantial
evidence is more than a scintilla but less than a preponderance and is such relevant evidence as a
reasonable mind might accept as adequate to support a conclusion. See id. The Court’s review
is based on the record, and the Court will “meticulously examine the record as a whole, including
anything that may undercut or detract from the ALJ’s findings in order to determine if the
substantiality test has been met.”

Id.

The Court may neither re-weigh the evidence nor

substitute its judgment for that of the Commissioner. See Hackett v. Barnhart, 395 F.3d 1168,
1172 (10th Cir. 2005). Even if the Court might have reached a different conclusion, if supported
by substantial evidence, the Commissioner’s decision stands. White v. Barnhart, 287 F.3d 903,
908 (10th Cir. 2002).

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BACKGROUND
Plaintiff, a forty-three year old male, applied for disability benefits on November 13,
2007, alleging an onset date of October 1, 2007. (R. 159-62). Plaintiff claimed his mental health
issues rendered him disabled. (R. 185-92). The initial denial found that plaintiff had a primary
diagnosis of affective mood disorder with a secondary diagnosis of substance abuse disorder, but
that he was not disabled. (R. 87). Plaintiff filed for reconsideration, and the denial was affirmed.
(R. 88).
Plaintiff then requested a hearing before an administrative law judge (“ALJ”). (R. 10001). The hearing was held in two parts: on the first date, the ALJ heard testimony from plaintiff
and then ordered, at plaintiff’s request, a psychological assessment. (R. 31-62). Once the ALJ
received the psychologist’s report, the hearing concluded on November 4, 2009, with testimony
from plaintiff, the consulting psychologist, and the vocational expert. (R. 63-86). Thereafter, the
ALJ issued a decision granting plaintiff disability benefits for the period beginning July 14,
2009, the date of plaintiff’s psychological assessment. Plaintiff appealed that decision.
Course of Treatment
Plaintiff began receiving treatment and services at a community therapy center on
November 13, 2007, the same date that he filed his application for disability benefits. (R. 15962, 258). He presented with complaints regarding anger management, sleep disruption, auditory
hallucinations, and paranoia. (R. 260). Plaintiff’s first appointment with Dr. LaFromboise (“the
doctor”) was on December 4, 2007. (R. 256-57). The doctor noted that plaintiff admitted to
homicidal ideations, but overall, he was quiet and unwilling to talk. (R. 256). She prescribed
some medication and ordered plaintiff to make a follow-up appointment in two weeks. (R. 257).

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Plaintiff attended follow-up appointments in December 2007 and January 2008. (R. 254,
255). At both appointments, plaintiff reported that he was not compliant with the medication
prescribed to help regulate sleep and diminish the auditory hallucinations. Id. He had also failed
to obtain the lab work that the doctor prescribed. Id. During the December appointment, the
doctor noted that plaintiff was angry and irritable. (R. 255). He appeared confused, and his
judgment appeared “to be hanging on by a thread.” Id. During the January appointment,
plaintiff seemed less angry, but his judgment was not improved, and the doctor noted that he was
“barely alert.” (R. 254). Plaintiff failed to attend his appointments for the next three months.
(R. 316). When he resumed treatment at the end of April 2008, he complained of increased
anger and paranoia, due in part to his failure to take his medication. Id. The doctor again noted
that plaintiff had failed to obtain the prescribed lab work.

Id.

The doctor adjusted his

medication and prescribed two additional drugs. Id.
Between May and August 2008, plaintiff attended his appointments, but he was not
always compliant with his medication. (R. 313-15). He continued to display a great deal of
anger, but he stated that his auditory hallucinations were less problematic. (R. 314-15). The
doctor noted that plaintiff seemed to display better logic while on his medications, but he always
seemed “ready to blow at any time.” (R. 313-15).
The doctor noted a significant amount of improvement in plaintiff’s mood and behavior
from August 2008 through November 2008. (R. 318-20). His behavior was more pleasant, and
his anti-social traits were much improved. (R. 319). Plaintiff stated that he was still suffering
from paranoia and had difficulty sleeping, but he was no longer hearing voices. (R. 317-20).
The doctor noted that plaintiff “looks so much different” when taking his medication. (R. 319).
In November 2008, the doctor noted that plaintiff was still having some difficulty affording and

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taking his medications and that he was still confrontational. (R. 317). His hallucinations,
however, were gone. Id. Plaintiff showed even more improvement during his December 4,
2008, appointment. (R. 324). Plaintiff was sleeping well and had joined a church. Id. He
expressed a desire to begin behavior modification therapy to improve his moods and seemed
“excited.” Id.
Due to plaintiff’s difficulty in remembering to take his medication as prescribed, the
doctor began writing out a schedule for plaintiff in December 2008. (R. 321, 322). The doctor
noted that plaintiff was not taking his medication at the time prescribed, thereby increasing his
inability to sleep. (R. 321). The doctor observed, however, that plaintiff no longer complained
of hearing voices and that his mood was “softer.”

(R. 322, 323).

Despite the written

instructions, plaintiff continued to take his medications off schedule and continued to have
difficulty sleeping. (R. 323). In February 2009, he suffered a set-back. (R. 328). Plaintiff told
the doctor that he suffered from a hallucination that led to a serious conflict with his roommate.
Id. As a result of the confrontation, plaintiff burned his left hand, apparently in an attempt to
harm himself. Id.
After his set-back, plaintiff once again began improving. (R. 327). Following the initial
disability hearing in April 2009, in which the ALJ stated that he believed plaintiff had a
substance abuse problem, plaintiff began taking his medication by injection so that he could also
take urinalysis drug screenings to prove that he was not using illegal drugs. (R. 348). All of his
drug screens were negative. (R. 345). However, this new regimen agitated plaintiff. (R. 346).
Although plaintiff was polite with the doctor, she was receiving complaints that he was
aggressive with other patients and the staff. (R. 345). Plaintiff also complained that his paranoia

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was increasing. Id. In June 2009, plaintiff and the doctor agreed that plaintiff should return to
taking his medication orally. (R. 344).
Throughout this course of treatment, the treating physician diagnosed plaintiff as having
paranoid schizophrenia. (R. 325, 338). The doctor also suspected that plaintiff suffered from
post-traumatic stress disorder and anti-social personality traits. (R. 313-24, 327-28, 344-45, 34749). The doctor regularly adjusted plaintiff’s medication to help treat his symptoms.
Disability Proceedings
After filing his application for disability in November 2007, plaintiff took a mental status
exam in January 2008 with Dr. Morgan. (R. 272-73). Dr. Morgan reviewed plaintiff’s doctor’s
December 18, 2007, report from the community therapy center and conducted his own
examination. Id. Dr. Morgan found plaintiff to be irritable, hostile, and evasive. Id. He noted
that plaintiff was unwilling to answer questions or communicate openly, but he did not find that
plaintiff was suicidal or suffering from any disruption in his thought processes. Id. Based on
plaintiff’s behavior, Dr. Morgan diagnosed plaintiff with adjustment disorder with depressed
mood and substance abuse. Id. Dr. Morgan also made a notation to rule out malingering. Id.
Dr. Morgan did not comment on the doctor’s initial diagnosis of paranoid schizophrenia and
notation to rule our post-traumatic stress disorder. Id.
Dr. Morgan’s findings formed the basis of the denial of plaintiff’s claim and the denial of
the reconsideration of his claim. (R. 87-88). The community therapy center where plaintiff’s
doctor practiced maintained a policy not to provide medical source opinions in disability cases;
therefore, when plaintiff filed a request for a hearing to appeal the denial of his claim, his
attorney also requested full mental testing. (R. 243). The ALJ granted that request at the first
hearing date in April 2009. (R. 61-62).

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ALJ Hearing
On the first hearing date, plaintiff testified that he was paranoid and heard voices on a
daily basis telling him to hurt people. (R. 45-47). He claimed that his paranoia and anger
prevented him from holding a job. (R. 47-50). Plaintiff testified that he had been fired from
several jobs due to confrontations with supervisors, customers, and co-workers. Id. Plaintiff
admitted to a history of drug use but testified that he had not used cocaine in years and had last
smoked marijuana in 2007. (R. 41-42).
Plaintiff testified that he had been seeking treatment with a doctor since November 2007.
(R. 42). He stated that he took his medication, but that he often had trouble remembering when
to take it. (R. 42-45). He explained that the doctor had to write out a schedule for him. (R. 45).
Plaintiff also testified that he heard voices regularly but could not explain the
discrepancies between his testimony and the treatment notes, which indicated that plaintiff was
not having auditory hallucinations. (R. 45-46, 59-61). Plaintiff stated that he heard voices in
stressful situations and cited multiple incidents in which he had become aggressive with others.
(R. 47-50, 54). Plaintiff described his daily activities, including his habit of shopping early in the
morning or late at night to avoid interacting with other people. (R. 56-58). Following plaintiff’s
testimony, the ALJ noted multiple contradictions between plaintiff’s testimony and the record
evidence. (R. 59-61). The ALJ then ordered the mental examination that plaintiff had requested.
(R. 58-59, 62).
Psychological Assessment
Plaintiff underwent a psychological assessment with Dr. LaGrand, a licensed clinical
psychologist, on July 14, 2009. (R. 329). Dr. LaGrand conducted multiple tests, including a
mental status exam, the Wechsler Memory Scale test, the Wide-Range Achievement Test-Third

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Edition, and the Minnesota Multiphasic Personality Inventory-2 (“MMPI”). Id. She found
plaintiff’s physical appearance normal and his verbal skills low, but adequate.

(R. 331).

Plaintiff was organized, logical, and focused, and his thought processes were normal. Id. Dr.
LaGrand also found that plaintiff was cooperative and put forth his best effort in completing the
testing. (R. 334).
Plaintiff performed at an 8th grade reading level, a 7th grade spelling level, and a 6th
grade math level. (R. 332). He had adequate memory skills and no problems with persistence
and pace. (R. 332, 333). Plaintiff’s score on the MMPI was invalid due to his critical responses.
(R. 332). Dr. LaGrand opined that “while this can be the result of an attempt to portray oneself
in a negative light,” she suspected that plaintiff’s invalid results were due to his being “in
considerable distress and overwhelmed by [his] perceived problems.”

Id.

Dr. LaGrand

diagnosed plaintiff with post-traumatic stress disorder and major depressive disorder with
psychotic features. (R. 333). She concluded that plaintiff’s ability to perform a job adequately,
handle the stress of a job, and interact with others was “low average.” Id. She did not find that
plaintiff would significantly improve in the next twelve months. (R. 334).
Continuation of the ALJ Hearing
Following receipt of Dr. LaGrand’s report, the ALJ continued the hearing on November
4, 2009. Dr. Bedwell, a clinical psychologist, and Ms. Ward, a vocational expert testified at the
hearing, and plaintiff offered additional testimony. (R. 64). Dr. Bedwell adopted Dr. LaGrand’s
findings with regard to plaintiff’s residual functional capacity. (R. 72). He concluded that
plaintiff “would have a hard time keeping a job” due to plaintiff’s marked limitations to maintain
regular attendance and a regular schedule and his moderate limitations with respect to pace. (R.
75, 78).

Plaintiff offered additional testimony about his anger, paranoia, and auditory

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hallucinations. Id. Plaintiff maintained that he continued to hear voices encouraging him to hurt
people on a daily basis, particularly when he was out in public. Id. Plaintiff also stated that he
“freaks out” in public and becomes confrontational due to his paranoia. (R. 76).
Based on this testimony, Ms. Ward, the vocational expert, classified plaintiff as a “store
laborer,” a category “with an SVP of two, with a medium exertional level.” (R. 80). The ALJ
then posed two hypotheticals for Ms. Ward. In the first hypothetical, the ALJ asked Ms. Ward to
consider a forty-five year old able to perform medium, light, or sedentary work with an ability to
understand, remember, and carry out simple instructions. (R. 81). The ALJ also included
routine supervision and only limited interaction with the public. Id. Based on those limitations,
Ms. Ward found multiple jobs in the region that plaintiff could perform, including a bench
assembler, hotel housekeeper, optical goods assembler, and circuit board assembler. (R. 82-83).
When the ALJ posed the second hypothetical, which included all of the elements of the first
hypothetical but added “frequent to constant supervision,” Ms. Ward testified that there were no
jobs that plaintiff could perform. (R. 83-84). Ms. Ward explained that constant supervision was
“not compatible with competitive employment.” (R. 84).
The ALJ’s Decision
The ALJ issued a partially favorable decision granting plaintiff benefits from July 14,
2009, the date of his psychological assessment with Dr. LaGrand. (R. 24). The ALJ relied on
Dr. Morgan’s mental exam and Dr. LaGrand’s psychological assessment as the effective dates of
plaintiff’s diagnoses; therefore, the ALJ’s findings regarding the date of plaintiff’s disability
were determined wholly by the dates of those examinations. (R. 17-18).
Relying on Dr. Morgan’s January 2008 exam, the ALJ found that from October 1, 2007,
until July 14, 2009, plaintiff suffered from “adjustment disorder with depressed mood, primary,

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cannabis abuse, noncompliance with treatment, and rule out malingering.” (R. 18). Based on
this diagnosis, the ALJ found plaintiff’s claims about his symptoms and limitations not credible.
(R. 19). The ALJ also found that plaintiff “has not generally received the type of medical
treatment one would expect for a totally disabled individual,” categorizing plaintiff’s treatment at
the community therapy center as “routine and conservative.” Id. The ALJ concluded that
plaintiff’s combination of mental impairments did not meet a listing under 20 C.F.R. Part 404,
Subpart P, Appendix 1. (R. 17).
Likewise, the ALJ relied on Dr. Morgan’s January 2008 exam in formulating the first
hypothetical that he posed to the vocational expert during the November 4, 2009, hearing. (R.
17, 81-83). The ALJ applied the first hypothetical in his findings, namely that plaintiff could
perform “medium, light and sedentary” work with the limitation of understanding, remembering,
and carrying out “simple to moderately detailed instructions” under routine supervision with only
occasional interaction with the public. (R. 17). The vocational expert testified that a number of
jobs existed with those limitations. (R. 81-83). Therefore, the ALJ concluded that plaintiff was
not disabled because he had the residual functional capacity to perform a number of jobs in the
region. (R. 17, 20).
The ALJ did find, however, that plaintiff’s symptoms were “generally credible” after July
14, 2009, the date of plaintiff’s psychological exam with Dr. LaGrand. (R. 21). The ALJ listed
plaintiff’s reported symptoms, as plaintiff reported them to Dr. LaGrand, and the results of the
psychological testing. Id. The ALJ also relied on Dr. LaGrand’s Medical Source Statement
(Mental), which reported that plaintiff had moderate limitation in understanding, remembering,
and carrying out complex instructions and marked limitations on his ability to act with others.
(R. 21-22). The ALJ applied these limitations to the second hypothetical he posed to the

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vocational expert at the hearing. (R. 83-84). The ALJ then adopted the vocational expert’s
opinion that plaintiff could not perform any jobs, given plaintiff’s residual functional capacity
and the level of constant supervision that plaintiff would require. (R. 21-22).
ANALYSIS
Plaintiff appealed the determination that he was not disabled prior to July 14, 2009, and
alleged four points of error: (1) that the ALJ failed to properly consider the medical source
evidence; (2) that the ALJ improperly found that plaintiff was not credible in reporting his
symptoms; (3) that the ALJ improperly analyzed plaintiff’s residual functional capacity; and (4)
that the ALJ’s finding of plaintiff’s disability onset date is not supported by the evidence. All of
these errors are related to the ALJ’s finding that plaintiff was not disabled prior to July 14, 2009,
the date of Dr. LaGrand’s psychological assessment. The Commissioner’s response brief argues
that the ALJ properly limited its finding of disability to the date of Dr. LaGrand’s assessment,
given plaintiff’s contradictory statements throughout the course of his treatment and Dr.
LaGrand’s assessment, which is dated from July 14, 2009.
Credibility Findings
The ALJ found that plaintiff’s complaints regarding his symptoms were not credible
between October 1, 2007, plaintiff’s alleged onset date, and July 14, 2009, the date of Dr.
LaGrand’s psychological assessment.

The ALJ compared plaintiff’s testimony to the

documentation from the treatment center and Dr. Morgan’s January 2008 examination and
concluded that “[t]he claimant has described daily activities which are not limited to the extent
one would expect, given the complaints of disabling symptoms and limitations.” (R. 19). The
ALJ also found that plaintiff’s subjective complaints had “generally been inconsistent and

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unpersuasive and the claimant has not provided convincing details regarding factors that
precipitate the allegedly disabling symptoms.” (R. 19-20).
This Court will not disturb an ALJ’s credibility findings if they are supported by
substantial evidence, because “[c]redibility determinations are peculiarly the province of the
finder of fact.” Cowan v. Astrue, 552 F.3d 1182, 1190 (10th Cir. 2008) (citing Diaz v. Secretary
of Health & Human Svcs., 898 F.2d 774, 777 (10th Cir. 1990). Credibility findings “should be
closely and affirmatively linked to substantial evidence and not just a conclusion in the guise of
findings.”

Id. (citing Huston v. Bowen, 838 F.2d 1125, 1133 (10th Cir. 1988) (footnote

omitted)).
In this case, the ALJ’s credibility findings are supported by substantial evidence. The
ALJ noted generally the inconsistencies in plaintiff’s various statements to doctors and his
testimony in finding that plaintiff’s subjective complaints were not reliable.

(R. 20).

Specifically, the ALJ referenced plaintiff’s descriptions of his daily activities, which included
caring for himself and, at the date of his application for disability benefits, caring for his twoyear-old child. (R. 19). The ALJ also considered plaintiff’s evasiveness during Dr. Morgan’s
examination in January 2008, which was inconsistent with his specific complaints of paranoia,
anger and depression when he presented for treatment at the therapy center in November 2007.
(R. 18-19). The inconsistencies that the ALJ noted in his decision are just a few examples of the
inconsistencies in plaintiff’s records and testimony.

The ALJ observed additional

inconsistencies in plaintiff’s testimony during the first hearing in April 2009, including his
history of child abuse and his inconsistent statements about the frequency of his auditory
hallucinations. (R. 59-61).

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The Court also finds that plaintiff’s work history prior to October 1, 2007, belies
plaintiff’s testimony and statements to doctors that he has had problems with paranoia, anger,
and auditory hallucinations since age ten. While plaintiff never worked at a regular full-time job,
his FICA earnings statements indicate that he worked consistently, albeit at multiple jobs, in
2004, 2005, and 2007. (R. 167). In fact, plaintiff earned more money prior to his alleged onset
date in 2007 than he did in any prior calendar year. Id. This evidence is inconsistent with
plaintiff’s subjective complaints about the severity of his limitations, despite plaintiff’s
statements that he has suffered from mental health issues almost his entire life. (R. 45-46).
Accordingly, the ALJ’s finding that plaintiff’s subjective statements about his symptoms
and limitations were not credible is supported by substantial evidence, both in the ALJ’s opinion
and in the record, and is, therefore affirmed.
Disability Onset Date
Although the ALJ’s findings that plaintiff was not credible are supported by substantial
evidence, the ALJ may have erred in concluding that plaintiff’s onset date was July 14, 2009.
The ALJ concluded that the medical opinion evidence, which consisted of Dr. Morgan’s mental
exam in January 2008 and Dr. LaGrand’s psychological assessment on July 14, 2009, determined
plaintiff’s onset date. (R. 17-18, 20, 21-22). The ALJ found that Dr. LaGrand’s opinion should
be “given great weight as it is consistent with the objective medical evidence.” (R. 22).
Three of plaintiff’s four points of error address this portion of the ALJ’s decision.
Plaintiff argues that Dr. LaGrand did not intend for her exam date to serve as the onset date for
plaintiff’s disability, primarily because Dr. LaGrand reviewed all of the treatment notes from the
community therapy center as part of her assessment. (Dkt. # 16 at 5-6, 8, 9). Plaintiff argues

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that the evidence does not support such a finding and that nothing in the record indicates that Dr.
LaGrand intended for her assessment to be limited in that way. (Dkt. # 16 at 5-6, 8, 9).
The Commissioner argues that the ALJ properly inferred that Dr. LaGrand’s opinion
found plaintiff disabled only from the date of her assessment and was not intended to be a
“retrospective analysis.” (Dkt. # 18 at 5-6). The Commissioner also argues that the ALJ’s
findings regarding plaintiff’s residual functional capacity are consistent with the medical
evidence and should be affirmed. (Dkt. # 18 at 8-9). Finally, the Commissioner contends that
the July 14, 2009, date is consistent with the evidence contained in the treatment notes and with
the vocational expert’s testimony. (Dkt. # 18 at 9-10).
Although plaintiff framed this argument in three different ways, the sole issue is whether
the ALJ erred in finding that plaintiff was not disabled prior to July 14, 2009, even though
plaintiff’s symptoms are alleged to have been consistent for the entire relevant period. While the
psychological assessment does constitute a medical source opinion finalizing plaintiff’s
diagnosis, it does not establish the onset date for plaintiff’s disability, nor does it draw any
conclusions regarding the progression, if any, of plaintiff’s symptoms. The record reflects that
neither the ALJ nor plaintiff’s attorney mentioned their respective interpretations of Dr.
LaGrand’s assessment during the hearing.
Social Security Ruling 83-201 discusses the factors that an ALJ should consider in
determining the disability onset date.

Where the claimant suffers a traumatic injury, the

disability onset date is clear: the date of the injury is applied. SSR 83-20 at *2. In cases of
“nontraumatic origin,” the Commissioner advised that “the determination of onset involves
1

Social Security Rulings “are binding on all components of the Social Security
Administration,” including administrative law judges. 20 C.F.R. § 402.35(b)(1). See also
Sullivan v. Zebley, 493 U.S. 521, 530 n. 9, 110 S.Ct. 885, 107 L.Ed.2d 967 (1990).
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consideration of the applicant’s allegations, work history, if any, and the medical and other
evidence concerning impairment severity. The weight to be given any of the relevant evidence
depends on the individual case.”2 SSR 83-20 at *2.
SSR 83-20 states that for disabilities of nontraumatic origin, “[t]he starting point in
determining the date of onset of disability is the individual’s statement as to when disability
began.” SSR 83-20 at *2. The ALJ should then consider the claimant’s work history because
“[t]he day the impairment caused the individual to stop work is frequently of great significance
in selecting the proper onset date.” Id. The ruling also states that “medical evidence serves as
the primary element in the onset determination” and that “reports from all medical sources”
should be considered.

Id.

The ruling notes that with “slowly progressive impairments,”

determining the onset date is nearly impossible; therefore, the ALJ may be required to “infer the
onset date from the medical and other evidence that describe the history and symptomatology of
the disease process.” Id. If the date alleged by the claimant is consistent with the medical
evidence, the claimant’s alleged onset date should be applied. See id. at *3. SSR 83-20 also
recognizes that in some cases, the medical evidence cannot provide the ALJ with enough
information to reasonably infer the onset date of a disability if it occurred before the date of any
recorded medical evidence. See id. If the onset date must be inferred, the ALJ is required to
seek the services of a “medical advisor” and ensure that any additional medical evidence is
obtained before making such an inference. Id.

2

The section of SSR 83-20 titled “Onset in Disabilities of Nontraumatic Origin” references
physical disability rather than mental disability; however, the section applicable to mental health
issues refers only to “cases of currently or previously hospitalized claimants” and is, therefore,
inapplicable to plaintiff. SSR 83-20 at *4-5. Plaintiff was seeking only outpatient treatment at
the time he alleged the onset of his disability and at the time the ALJ determined plaintiff was
disabled. Accordingly, the Court will apply the factors applicable to disabilities of nontraumatic
origin.
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In this case, the ALJ partially applied the principles of SSR 83-20 when he considered
plaintiff’s alleged onset date, plaintiff’s statements, and the medical evidence. The ALJ erred,
however, by adopting the July 14, 2009, date without any explanation of his reasons for choosing
the date of the psychological assessment. In light of the other evidence in the record, the July 14,
2009 date is arbitrary.
Notwithstanding the ALJ’s credibility findings regarding plaintiff’s subjective
complaints, which this Court will not disturb, the evidence reflects that plaintiff complained of
the same symptoms consistently throughout the relevant period. More importantly, the treatment
notes indicate that plaintiff may have suffered from serious issues with anger, paranoia, and
depression throughout the relevant period and that his treatment plan was the same before and
after July 14, 2009. In fact, plaintiff was much improved by the time Dr. LaGrand conducted the
psychological assessment, which the ALJ relied upon to find that plaintiff was disabled.
Although the ALJ’s conclusion that plaintiff became disabled on the date of the psychological
assessment might ultimately be born out, that conclusion is simply not supported by substantial
evidence in the current record. See Brockway v. Astrue, 781 F.Supp.2d 1145, 1151-54 (D.Kan.
2011).
When the evidence of the symptoms and course of treatment are consistent both before
and after the onset date, the ALJ is required to explain his reasoning. See id. at 1153. In this
case, the ALJ offers no rationale for adopting July 14, 2009, as the onset date. In fact, the record
does not reflect whether the ALJ considered the onset date to be an issue or whether he applied
the standards and guidelines of SSR 83-20. Moreover, the medical evidence to support a finding
of plaintiff’s disability onset date is ambiguous. The two medical source opinions presented
were conducted approximately eighteen months apart and employed different modes of

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examination. Additionally, the treatment notes from the community therapy center, which were
arguably the best source of medical evidence, could not be used as medical source opinion
evidence due to the doctor’s explicit statement that she would not provide an opinion for use in
the disability proceedings. The record establishes that the onset date must be inferred and that a
medical advisor will be necessary to reach that inference. See id. at 1154-55. Therefore, remand
is appropriate in this case. On remand, the ALJ shall implement the guidelines of SSR 83-20 and
determine the onset date with the assistance of a medical advisor.
CONCLUSION
For the above stated reasons, this Court REVERSES and REMANDS the
Commissioner’s decision granting partial Disability Insurance Benefits for further proceedings
consistent with this opinion.
SO ORDERED this 20th day of March, 2012.

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