Brian Rothfeldt v. Acting Commissioner of the Social Security Administration
669 F. App'x 964
| 11th Cir. | 2016Background
- Rothfeldt applied for SSI; ALJ denied benefits after hearing and Appeals Council refused review; district court affirmed; Rothfeldt appealed.
- At hearing Rothfeldt reported only a sixth-grade special-education education, inability to read or write, limited work history (six months ~10 years earlier), homelessness, and minimal social contacts.
- Medical consultative psychologists flagged possible borderline intellectual functioning and recommended IQ testing; no IQ test was ever performed.
- ALJ found severe physical impairments and non-severe mental impairments, rejected counsel’s request for IQ testing, and determined Rothfeldt could perform light, simple, routine work.
- ALJ did not explicitly evaluate Listing 12.05 (intellectual disability); relied on residual functional capacity and availability of jobs to deny disability.
- The Eleventh Circuit found the record had an evidentiary gap because IQ testing was necessary to determine whether Rothfeldt met Listing 12.05(C), and remanded for further development.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ failed to fully and fairly develop the record by denying consultative IQ testing | ALJ should have ordered IQ testing because psychologists recommended it and an IQ ≤70 could satisfy Listing 12.05(C) given physical impairments | ALJ reasonably denied testing because record showed ability to perform simple, routine tasks and some independent daily activities | Remanded: ALJ erred by not ordering IQ testing; missing IQ score created prejudicial evidentiary gap preventing determination under Listing 12.05(C) |
| Whether claimant met Listing 12.05’s adaptive functioning requirement | Rothfeldt’s limited education, inability to read/write, poor work history, and limited social functioning show adaptive deficits | ALJ implicitly concluded adaptive functioning not sufficiently impaired based on some independent activities | Held: Substantial evidence supports adaptive deficits; ALJ’s contrary implicit conclusion rejected |
| Whether a qualifying IQ score is necessary to evaluate Listing 12.05(C) here | IQ test is necessary to establish ‘‘significantly subaverage general intellectual functioning’’; without it the ALJ cannot determine listing match | Commissioner argued other evidence supported RFC and no consultative testing was needed | Held: IQ testing necessary; absence of valid IQ score left the ALJ unable to determine if Listing 12.05(C) was met |
| Whether the record gap caused prejudice requiring remand | Rothfeldt: gap is prejudicial because an IQ ≤70 plus his physical impairments could satisfy Listing 12.05(C) | Commissioner: no prejudice shown because other evidence supports denial | Held: Gap caused clear prejudice; remand required for consultative IQ testing and reassessment |
Key Cases Cited
- Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176 (11th Cir.) (standard for reviewing ALJ decisions)
- Doughty v. Apfel, 245 F.3d 1274 (11th Cir.) (ALJ decision is Commissioner’s final decision when Appeals Council denies review)
- Lewis v. Callahan, 125 F.3d 1436 (11th Cir.) (definition of substantial evidence)
- Dyer v. Barnhart, 395 F.3d 1206 (11th Cir.) (courts must not reweigh evidence)
- Ellison v. Barnhart, 355 F.3d 1272 (11th Cir.) (ALJ’s duty to fully and fairly develop the record)
- Reeves v. Heckler, 734 F.2d 519 (11th Cir.) (reversible error to deny consultative exam when necessary)
- Brown v. Shalala, 44 F.3d 931 (11th Cir.) (remand required when evidentiary gaps cause unfairness or prejudice)
- Sullivan v. Zebley, 493 U.S. 521 (U.S.) (to meet a listing claimant must satisfy all specified criteria)
- Edwards v. Heckler, 755 F.2d 1513 (11th Cir.) (‘‘significant’’ additional impairment may be less than ‘‘severe’’ for Listing 12.05(C))
- Hodges v. Barnhart, 276 F.3d 1265 (11th Cir.) (qualifying IQ score creates rebuttable presumption of deficits manifesting before age 22)
- Hutchison v. Bowen, 787 F.2d 1461 (11th Cir.) (an ALJ’s failure to address a listing can be inferred from denial of necessary testing)