Walchli v. Berryhill
5:17-cv-01165
| S.D.W. Va | Feb 2, 2018Background
- Plaintiff Robert Walchli applied for DIB (May 2013) and SSI (June 2013), alleging onset Jan 1, 2008; DIB denied for pre-2013 period, SSI granted beginning May 31, 2013.
- Record contains no documented medical treatment before May 31, 2013; MRIs and clinic records begin in May–June 2013 showing multilevel degenerative spine disease and nerve compression.
- Plaintiff testified he had long‑standing back pain for years but delayed treatment because he lacked funds/insurance; a charitable organization paid for his May 2013 MRI.
- Treating clinicians (PA and physician) opined in 2015 that degeneration predated Dec 31, 2012 (the DLI) and was longstanding and progressive.
- ALJ found Walchli not disabled through his DLI (Dec 31, 2012), disabled beginning May 31, 2013, and capable of only light work since that date; no transferable skills to avoid a finding of disability for SSI period.
- Magistrate Judge recommended remand under 42 U.S.C. § 405(g) because the ALJ failed to obtain a medical advisor per SSR 83‑20 before inferring the onset date from an ambiguous record.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether substantial evidence supports ALJ's finding that disability onset was May 31, 2013 (post‑DLI) | Walchli: post‑DLI medical evidence and treating opinions permit inference that disabling condition existed before DLI (so DIB should be awarded) | Berryhill: earliest medical corroboration is May 31, 2013; absence of pre‑DLI records supports denial of DIB | Magistrate: Record ambiguous; ALJ erred by not using a medical advisor to determine onset under SSR 83‑20; remand recommended |
| Whether ALJ properly considered post‑DLI medical evidence to infer pre‑DLI condition | Walchli: post‑DLI MRIs and treating letters link condition to pre‑DLI period | Berryhill: post‑DLI evidence insufficient to establish disability before DLI | Magistrate: Post‑DLI evidence can be probative and here permits linkage; ALJ should have used medical advisor |
| Whether ALJ’s credibility findings and RFC for post‑May 31, 2013 period are supported | Walchli: ALJ found symptoms credible as of May 31, 2013 and granted SSI accordingly | Berryhill: ALJ’s RFC for post‑May 31, 2013 period is supported by record | Magistrate: ALJ’s SSI determination stands, but DIB onset requires further medical development on remand |
| Remedy: whether remand is required and what further steps are necessary | Walchli: seek remand for DIB determination and onset finding | Berryhill: defend ALJ decision | Held: Remand under sentence four of § 405(g) ordered; ALJ must consult a medical advisor per SSR 83‑20 to determine onset date |
Key Cases Cited
- Blalock v. Richardson, 483 F.2d 773 (4th Cir. 1972) (definition of substantial evidence)
- Wooldridge v. Bowen, 816 F.2d 157 (4th Cir. 1987) (post‑DLI evidence may be relevant to pre‑DLI disability)
- Bird v. Comm’r of Soc. Sec. Admin., 699 F.3d 377 (4th Cir. 2012) (post‑DLI evidence permitting linkage requires retrospective consideration; SSR 83‑20 and medical advisor guidance)
- Moore v. Finch, 418 F.2d 1224 (4th Cir. 1969) (post‑DLI evidence can be cogent proof of pre‑DLI disability)
- Johnson v. Barnhart, 434 F.3d 650 (4th Cir. 2005) (retrospective consideration of medical evidence)
- Bailey v. Chater, 68 F.3d 75 (4th Cir. 1995) (medical advisor generally required when onset must be inferred)
- Blea v. Barnhardt, 466 F.3d 903 (10th Cir. 2006) (ambiguous records preclude negative inference on onset; medical advisor required)
- Pleasant Valley Hosp., Inc. v. Shalala, 32 F.3d 67 (4th Cir. 1994) (administrative decisions must be supported by substantial evidence)