Rivera v. Commissioner of Social Security, 6:17-cv-02021

Rivera was found disabled effective September 28, 2010 based primarily on a mental RFC (MRFC) and a 2011 consultative psychiatric exam; treating records from Dr. Ortiz‑Tavarez were noted as part of the original file.
A continuing disability review in 2014 concluded Rivera’s condition improved and benefits ceased as of December 1, 2014.
A DHO and then an ALJ reviewed post‑CPD records and state‑agency assessments and concluded Rivera could perform light, unskilled work with restrictions (limited handling/fingering, simple tasks, occasional interaction).
The ALJ expressly considered the 2011 consultative exam (Dr. Martinez‑Cotto) and many post‑2014 treatment records and state consultants’ opinions, but did not discuss or otherwise analyze the actual pre‑CPD treating records of Dr. Ortiz‑Tavarez (which are missing from the administrative file before the ALJ).
Plaintiff argued the ALJ failed to compare the pre‑CPD medical evidence that supported the original disability finding with the post‑CPD evidence as required to establish medical improvement.
The magistrate judge recommended reversal and remand because the ALJ did not perform the required comparison (and the record lacked the pre‑CPD treatment file material), preventing substantial‑evidence support for the medical‑improvement finding.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether the ALJ satisfied the statutory/regulatory duty to compare pre‑CPD and post‑CPD medical evidence before finding medical improvement	Rivera: ALJ failed to compare the actual pre‑CPD medical records (notably Dr. Ortiz‑Tavarez’s records and the MRFC) with later evidence, so there is no substantial evidence of improvement	Commissioner: ALJ had summaries of pre‑CPD evidence (DDS MRFC and CDR notes); missing treating records is speculative and plaintiff bears burden to show prejudice	Remanded: ALJ erred. The Commissioner must prove improvement by substantial evidence, which requires an actual comparison of pre‑ and post‑CPD medical evidence; relying on summaries or omitting pre‑CPD records is insufficient

Vaughn v. Heckler, 727 F.2d 1040 (11th Cir. 1984) (benefits cannot be terminated absent substantial evidence of actual medical improvement and the court must compare pre‑ and post‑CPD evidence)
Simpson v. Schweiker, 691 F.2d 966 (11th Cir. 1982) (Commissioner bears burden to show medical improvement to end benefits)
Dyer v. Barnhart, 395 F.3d 1206 (11th Cir. 2005) (district court review limited to whether ALJ’s factual findings are supported by substantial evidence)
Lamb v. Bowen, 847 F.2d 698 (11th Cir. 1988) (ALJ must apply correct legal standards in disability determinations)