Gross v. Colvin
1:13-cv-01274
| D. Maryland | Jul 22, 2014Background
- Plaintiff Christina Gross (also known as Aurora Moon) applied for Disability Insurance Benefits (DIB) and Child’s Insurance Benefits (CIB) claiming disability onset in September 1984; DLI for DIB was September 30, 1985 and CIB requires disability before Nov 21, 1984.
- Administrative history was lengthy and disordered: an initial unfavorable ALJ decision (2000), Appeals Council vacated due to a lost file, a second unfavorable ALJ decision (2009) was vacated by the Appeals Council, and a third ALJ hearing occurred July 17, 2012; Appeals Council denied review for DIB but issued final denial for CIB.
- The ALJ found severe impairments of gender identification disorder and depression, and assessed RFC for all exertional levels but limited to simple/routine tasks and only occasional contact with others; concluded jobs exist that plaintiff can perform and denied benefits.
- Plaintiff contends lifelong disability from hermaphroditism and chronic depression, challenges the ALJ’s treatment of a favorable VA determination (VA found her permanently incapable of self-support) and argues she meets Listings 12.04 and 12.06.
- Magistrate Judge recommended remand because the ALJ failed to give the VA disability determination the substantial weight required under Bird v. Commissioner, and otherwise found the ALJ’s Listing analysis supported by substantial evidence.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Weight to be given to VA disability rating | VA found plaintiff permanently incapable of self-support; ALJ should have given it controlling or substantial weight | ALJ gave VA decision little weight because VA and SSA use different standards | Remand: ALJ did not "clearly demonstrate" why deviation from the substantial-weight standard (per Bird) was appropriate; further consideration required |
| Whether plaintiff meets Listings 12.04 (Affective Disorders) and 12.06 (Anxiety-related) | Plaintiff argues she is markedly limited and has repeated decompensation meeting paragraph A/B/C criteria | ALJ found mild ADLs restrictions, some social functioning, intact memory; not meeting paragraph C | Held: ALJ’s Listing analysis supported by substantial evidence; no remand on this ground |
| Sufficiency of evidentiary record given lost/missing early records | Plaintiff contends reconstructed file is incomplete and skews evaluation of lifelong disability | Defendant proceeded with reconstructed file and relied on available records and hearings | Court acknowledged missing early records but remanded only for further VA-consideration; made no finding on ultimate disability |
| Whether substantial evidence supports ALJ’s overall denial | Plaintiff points to history of suicide attempts, ongoing depression, and VA decision | Defendant relies on ALJ’s RFC, vocational expert testimony, and portions of medical record showing some functioning | Court: Cannot resolve factual contest; remand ordered for inadequate consideration of VA rating; otherwise ALJ’s Listing findings upheld |
Key Cases Cited
- Bird v. Commissioner of Social Security, 699 F.3d 337 (4th Cir. 2012) (SSA must give at least substantial weight to VA disability ratings unless record clearly justifies deviation)
- Craig v. Chater, 76 F.3d 585 (4th Cir. 1996) (standard for reviewing Commissioner decisions—substantial evidence)
- Coffman v. Bowen, 829 F.2d 514 (4th Cir. 1987) (review of administrative disability determinations)