Rogers v. Astrue
895 F. Supp. 2d 541
S.D.N.Y.2012Background
- Plaintiff Roy W. Rogers seeks SSDI benefits for June 1, 1984 to December 31, 1989, challenging an ALJ denial.
- ALJ concluded no disability during the insured period due to lack of contemporaneous medical evidence; Plaintiff’s post-1989 PTSD records were noted but not tied to the period.
- Plaintiff’s VA records and later treating notes indicate long-standing PTSD with flashbacks and hallucinations, including retrospective diagnoses after the insured period.
- Magistrate Judge Smith recommended denying the SSA complaint; the Court remanded for further proceedings after objections were filed.
- A central dispute is whether the ALJ adequately developed the record, including potential retrospective diagnoses and onset-date inference under SSR 83-20.
- The SSA onset-date issue and the treatment of a retrospective opinion from Dr. Fortner are critical to determine eligibility for benefits during the insured period.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Duty to develop record and treat retrospective diagnoses | Fortner's letter supports disability dating to the insured period and should receive significant weight. | Fortner was not a treating physician during the insured period; memorialized retrospective opinions may be given weight but not controlling. | Remand for record development and evaluation of retrospective diagnosis. |
| Onset date determination under SSR 83-20 | Ambiguous evidence allows inference of an earlier onset date based on medical records and hospital histories. | Lack of contemporaneous medical records precludes inferring onset earlier than 1997 without expert advice. | Remand to obtain medical-advisor input to infer onset date. |
| Consequence of failure to develop the record on substantial evidence | The record contains PTSD history suggesting disability during the period; ALJ erred by not developing. | ALJ properly weighed the available evidence and relied on lack of contemporaneous records. | Remand for further development to ensure proper application of standards. |
Key Cases Cited
- Schaal v. Apfel, 134 F.3d 496 (2d Cir. 1998) (not our function to determine disability de novo; review for legal error or lack of substantial evidence)
- Rosa v. Callahan, 168 F.3d 72 (2d Cir. 1999) (ALJ must develop the record; retrospective opinions may require evaluation)
- Butts v. Barnhart, 388 F.3d 377 (2d Cir. 2004) (court defers to SSA decision if supported by substantial evidence and correct law)
- Jones v. Chater, 65 F.3d 102 (8th Cir. 1995) (PTSD may be non-degenerative and onset can be after traumatic event)