496 F. App'x 154
2d Cir.2012Background
- Douglass received SSI/DI benefits from age two due to asthma and a cardiac defect; the SSA terminated benefits in 2004 after a continuing disability review.
- The 2000 favorable determination cited organic mental disorders as the primary diagnosis and asthma as secondary; the 2004 decision reduced medical severity overall.
- The ALJ found a decrease in asthma, depression, and knee impairment, but did not acknowledge any improvement in Douglass’s intellectual functioning.
- Thomassen’s 2000 report indicated borderline intellectual functioning; his 2004 report did not diagnose this, but noted ability to perform rote tasks and simple instructions.
- Douglass’s previous low IQ scores and adaptive-functioning deficits remained central to the disability determination and were not adequately considered under the medical-improvement standard.
- The court reverses and remands for consideration consistent with the correct legal standards for medical-improvement analysis and for a proper evaluation under listing 12.05.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Medical improvement proper standard applied | Douglass’s intellectual functioning showed no meaningful improvement | ALJ based on evidence of decreased severity; improvement not required in intellect | Reversed and remanded for proper analysis |
| Incorrect application of mental retardation listing 12.05 | ALJ erred by requiring paragraph B criteria; 12.05A-D structure allows alternative criteria | ALJ properly applied the listing requirements | Reversed and remanded for correct 12.05 analysis |
Key Cases Cited
- Veino v. Barnhart, 312 F.3d 578 ((2d Cir. 2002)) (to determine medical improvement requires comparison of current vs. prior severity)
- Acierno v. Barnhart, 475 F.3d 77 ((2d Cir. 2007)) (focus on administrative ruling; deferential review)
- Berry v. Schweiker, 675 F.2d 464 ((2d Cir. 1982)) (substantial evidence standard; non-deferential in some contexts)
- Kohler v. Astrue, 546 F.3d 260 ((2d Cir. 2008)) (failure to apply correct legal standard is reversible error)
- Mongeur v. Heckler, 722 F.2d 1033 ((2d Cir. 1983)) (regular treating source evidence bears extra consideration)
- Ferraris v. Heckler, 728 F.2d 582 ((2d Cir. 1984)) (requires substantial specificity in support of disability determinations)
- Butts v. Barnhart, 388 F.3d 377 ((2d Cir. 2004)) (outlines appellate review framework)