Laurie Wellington v. Nancy Berryhill
878 F.3d 867
9th Cir.2017Background
- Wellington applied for SSDI and SSI alleging onset December 24, 2008; her date last insured for SSDI was December 31, 2008.
- She has longstanding PTSD and anxiety and a 2009 fibromyalgia diagnosis; she had multiple ER visits from late 2008 through 2010 for anxiety and other complaints.
- First consultative mental-health exam was by Dr. Cushman on May 26, 2010, who found moderate anxiety and limited ability to maintain regular attendance; he assigned a GAF of 55.
- The ALJ—without calling a medical advisor—found Wellington disabled beginning May 26, 2010, making her ineligible for SSDI but eligible for SSI from that date.
- District court affirmed; Wellington appealed, arguing SSR 83-20 required a medical advisor to infer an earlier onset date.
- The Ninth Circuit majority affirmed, holding SSR 83-20 did not mandate a medical advisor here; Judge Watford dissented, arguing the evidence is ambiguous and remand for a medical advisor was required.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether SSR 83-20 required the ALJ to call a medical advisor to determine onset date | Wellington: ALJ should have appointed a medical advisor because onset could be inferred prior to May 26, 2010 | Commissioner: Record was sufficiently complete and unambiguous so ALJ could determine onset without a medical advisor | Court: No error — SSR 83-20 not triggered because record was adequately developed and no reasonable medical expert could infer onset before May 26, 2010 |
Key Cases Cited
- Diedrich v. Berryhill, 874 F.3d 634 (9th Cir. 2017) (SSR 83-20 may require medical advisor when gaps/ambiguities prevent reliable onset inference)
- DeLorme v. Sullivan, 924 F.2d 841 (9th Cir. 1991) (ALJ must obtain medical advisor where later psychiatric diagnosis could have earlier onset during insured period)
- Morgan v. Sullivan, 945 F.2d 1079 (9th Cir. 1991) (reversed onset finding where ALJ failed to consult medical advisor and earlier disabling mental illness was plausible)
- Armstrong v. Comm’r of Soc. Sec., 160 F.3d 587 (9th Cir. 1998) (medical advisor required where evidence suggested disability may have begun before insured date)
- Bailey v. Chater, 68 F.3d 75 (4th Cir. 1995) (medical advisors required in all but plain cases to meet evidentiary threshold for onset inference)
- Flaten v. Sec’y of Health & Human Servs., 44 F.3d 1453 (9th Cir. 1995) (SSD onset must be continuously disabling from onset through application)
- Garrison v. Colvin, 759 F.3d 995 (9th Cir. 2014) (mental symptoms may wax and wane; treatment response can undermine disability claim)