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w . vi ll anova . e du/thir dc ir c uit_2010/1142H onor abl e J . W i l l i am D i t t er , J r . , Seni orU ni t ed St at es D i s tr i ctJ udge forthe * E as t ern D i s tr i ctof Penns y l vani a, s i t t i ng bydes i gnat i on. NOT P RE CE DE NT I AL UN I TED STATES CO UR T OF A PP EALS F O R T H E T H IR D C IR C U IT

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Judge . T hi s i s an appe al fr om the fi nal or derof the U ni t ed St at es D i s tr i ctC our tforthe D istric t o f

N e w Je rse ya f

f irm in g th e d e c isio n o f

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S o c ial S e c u rity deny i ng H al l i e TheL os en’ s appl i cat i ons fordi s abi l i tybenef i t s pr ovi ded byT i t l e I I of the Soci al Secur i tyA ct . W e ar e pr es ent ed w i th tw o ques t i ons : 1) w hetherthe dec i s i on of the C om m i s s i onerthatT heLosen di d nothave a s ever e i m pai r m entdur i ng the r el evant per i ods i s s uppor t ed bys ubs t ant i al evi dence ; and 2) w hetherthe C om m i s s i onerw as r equi r ed t o s eek the hel p of a medi cal expertt o i nferan ea r l i erdi s abi l i tyons etdat e. T he D is tr ic t C o u rt a n s w e re d th e f ir s t q u e s tio n in th e a f

f ir m a tiv e ; th e s e c o n d in th e n e g a tiv e . W e wi l l a f

f i r m. I . T h eL o sen fil ed ap p li ca ti o n s fo r sup p lem en tal sec u ri tyinco m e b en ef it s (“S S I”), di s abi l i tyi ns ur ance benef i t s ( “D I B ”) , and di s abl ed adul tchi l d benef i t s ( “D A C ”) . She al l eged di s abi l i t i es begi nni ng i n 1977 r el at ed t o ey e di s eas e, al l er gi es , a l earni ng di s abi l i ty , and anxi ety - r el at ed di s or der s . H erappl i cat i on forSSI w as appr oved and s he w as aw ar ded bene fi t s r etr oact i ve t o J une 25, 2002, the dat e s he appl i ed forbenef i t s and th e e a r l i e s td a t e o f

h e rS S I e l i g i b i l i ty. T o qual i fyforD A C , T heLosen w as r equi r ed t o es t abl i s h thats he w as di s abl ed pr i ort o hertw enty - s econd bi r thday– O ct ober13, 1995. T o qual i fyforD I B , T heLosen w as re q u ir ed to es tablish sh e b ec am e d isab led d u ri n g h er last em p loym en t or th e statuto ryT hese st eps are sum m ari zed as fo l l ow s: 1 1. I f the cl ai m anti s w or ki ng orengage d i n s ubs t ant i al gai nful act i vi ty , a fi ndi ng of n o t disab led is d ir ec ted. If n o t, p roc ee d to S tep 2 . 2 0 C . F . R . § § 4 0 4 . 1 5 2 0 (b), 41 6 . 9 2 0 (b). 2 . If th e c laim a n t is f

o u n d n o t to h a v e a se v e re im p a irm e n t w h ich sig n if ica n tly l i m i t s hi s orherphy s i cal orm ent al abi l i tyt o do bas i c w or k act i vi ty , a fi ndi ng of not d i s a b l e d i s d i r e c t e d . I f

th e r e i s a s e v e r e i mp a i r me n t , p r o c e e d t o S t e p 3 . 2 0 C. F . R. § § 4 0 4 . 1 5 2 0 (c), 4 1 6 . 9 2 0 (c). 3. I f the i m pai r m entm eet s orequal s cr i t er i a fora l i s t ed i m pai r m entor im p a irm e n ts in A p p e n d ix 1 o f S u b p a rt P o f

P a rt 4 0 4 o f

2 0 C .F .R ., a f

in d in g o f d isa b led is d ir ec ted. If n o t, p roc ee d to S tep 4 . 2 0 C . F . R . § § 4 0 4 . 1 5 2 0 (d), 41 6 . 9 2 0 (d). 4. I f the cl ai m antr et ai ns the r es i dual funct i onal capa ci tyt o per form pas tr el evant 3 p eriod – in h er c ase , o n o r be fo re M arc h 3 1 , 2 0 0 1 . H er a p p li ca ti o n s fo r D A C an d D IB w er e deni ed bec aus e the A dm i ni s tr at i ve Law J udge ( “A L J ”) det erm i ned thatT heLosen di d notes t abl i s h t he ons etof a s ever e di s abi l i tyw i thi n ei therof the appl i cabl e i ns ur ed peri od s. II. A s oci al s ecur i tycl ai m anti s di s abl ed i f s he i s unabl e t o engage i n “anys ubs t ant i al gai nful act i vi tybyr eas on of anym edi cal l ydet erm i nabl e phy s i cal orm ent al i m pai r m ent w hi ch ca n be expe ct ed t o r es ul ti n death orw hi ch has l as t ed orcan be expec t ed t o l as tfor a c o n tin u o u s p e ri o d o f

n o t le s s th a n tw e lv e m o n th s .” 2 0 C .F .R . § § 4 0 4 .1 5 2 0 , 4 1 6 .9 0 5 . T he Soci al Secur i tyA dm i ni s tr at i on has adopt ed a s y s t em of seque nt i al anal y s i s forthe e v a l u a t i o n o f

d i s a b i l i tyc l a i ms . Th i s f i v e - s t e p e v a l u a t i o n i s c o d i f i e d a t2 0 C. F . R. §§ 404. 1520, 416. 920. 1w or k, a fi ndi ng of notdi s abl ed i s di r ect ed. I f i ti s det erm i ned thatthe cl ai m antcannotdo

th e k i n d o f

wo r k h e o rs h e p e r f

o r me d i n th e p a s t , p r o c e e d t o S t e p 5 . 2 0 C. F . R. § § 4 0 4 . 1 5 2 0 (e), 4 1 6 . 9 2 0 (e). 5. T he C om m i s s i onerw i l l then cons i derthe cl ai m ant ’ s r es i dual funct i onal capa ci ty , age, educa t i on, and pas tw or k exper i ence i n conj unct i on w i th the cr i t er i a l i s t ed i n Ap p e n d i x 2 t o d e t e r mi n e i f th e c l a i ma n ti s o ri s n o td i s a b l e d . 2 0 C. F . R. § § 4 0 4 . 1 5 2 0 (f), 4 1 6 . 9 2 0 (f). 4 T heLosen c ont ends thatthe A L J err ed i n concl udi ng, ats t ep tw o, thats he w as not e lig ib le f o r D IB o r D A C b e n e f

its b e c a u se sh e d id n o t h a v e a se v e re im p a irm e n t p rio r to M ar ch 31, 2001. T heLosen c ont ends thi s det erm i nat i on i s nots uppor t ed bys ubs t ant i al evi dence and thatthe A L J fai l ed t o pr oper l ydevel op the r ecor d cons i s t entw i th Soci al Secur i tyR ul i ng ( “SSR ”) 83- 20. T heLosen c ont ends i tw as r eas onabl e t o i nferfr om t he s ever i tyof heri m pai r m ent s as of heraw ar d of SSI be nefi t s i n J une 2002 thather i m pai rm ent s exi s t ed l ong befor e thatt i m e. H ow ever , the i nfer ence of an e ar l i erons et dat e musthave s om e bas i s i n t he medi cal evi dence ; i ti s notenough t o s i m pl ypr ove a c u rr e n td i s a b i l i ty. III . W e w r i t e exc l us i vel yforthe part i es , w ho ar e fa m i l i arw i th the fa ctual and l egal hi s t oryof thi s cas e. T her efor e, w e w i l l s etfor th onl ythos e fa ct s nece s s aryt o our analy si s.5

A . E d u ca ti o n an d W o rk H ist o ry T heLosen w as bor n on O ct ober13, 1973. She gr aduat ed fr om hi gh s chool i n 1993 an d fro m co ll eg e in 2 0 0 1 . S h e is also c erti fied in co m p u ter training . T h eL o sen ’s w o rk exper i ence i s verys par s e. She w or ked tw o part - t i m e j obs i n 1990 dur i ng hi gh s chool and sh e w as e m p loy ed at tw o d iffe ren t r etail stores in 1 9 9 5 . S h e p arti cipa ted in a w o rk pr ogr am for the di s abl ed s pons or ed bythe U ni t ed St at es D epart m entof St at e i n the s um m erof 1998. I n t he w i nt erof 1999- 2000, T heLosen w as empl oy ed atthe C ent erfor O r thopedi cs and Spor t s per form i ng s ecr et ar i al dut i es . A tthe t i m e of the admi ni s tr at i ve h ea ri n g , T h eL o sen w as u n em p loy ed an d li v ing w ith h er m o ther. T h e L o s e n a lle g e s th a t s h e s u f f e re d f ro m le a rn in g d is a b iliti e s b e g in n in g in 1 9 7 7 . T hi s t es t i m onyw as s uppor t ed byherm other . T heLosen t es t i fi ed thati n fi r s tthr ough s eventh gr ades , s he r ece i ved r emedi al as s i s t ance i n r eadi ng, m athemat i cs , and w r i t i ng and thats he w as di agnos ed w i th dy s l exi a i n the fi fth gr ade. H ow ever , heras s ert i on thats he w as enr ol l ed i n s peci al educa t i on cl as s es thr oughouthi gh s chool w as nots uppor t ed byher schoo l recor ds. A s a s tudentatO cea n C ountyC ol l ege i n A ugus t1993, T heLosen w as eval uat ed by Jo ren e B u rke , a lea rnin g d isab il itysp ec ial ist . B u rke ’s rep o rtind icates tha t T h eL o sen ’s l earni ng defi ci t s w er e evi denti n t he ar ea of pr oces s i ng s peed, s hor t - t erm m emory , and bas i c r eadi ng. She demonstr at ed s tr ength i n br oad mat hemat i cs , pas s age c om pr ehens i on, and hol i s t i c w r i t t en expr es s i on. H erper s i s t ence , m ot i vat i on, and abi l i tyt o advoca t e for6

heraca demi c nee ds w er e cr edi t ed forherper form i ng bett erthan mi ghtotherw i s e be ex p ec ted. T o ac co m m o d ate T h eL o sen ’s l im it ati o n s, the c o ll eg e p rov ided m u lt i- sen so ry l earni ng, al t ernat i ve t es ts i t es , ext ended t i m e foras s i gnm ent s and t es t s , and s eat i ng att he f ro n t o f th e c las s. W ith th e se a c c o m m o d a tio n s, T h e L o se n w a s a b le to su c c e ss f u lly compl et e hercol l ege e ducat i on. C o g n iti v e tes tin g c o n d u c ted in S e p tem b e r 1 9 9 9 re v e a led th a t T h e L o se n ’s s h o rtt erm m emoryand herI Q s cor es w er e w i thi n the ave r age r ange. She al s o demonstr at ed g o o d w o r d k n o w l e d g e a n d v e rb a l f l u e n c y. A form r eportt o t he N ew J er s eyD i s abi l i tySer vi ces , dat ed D ece m ber3, 2001, compl et ed byM i chae l D i B el l a, M . D . , des cr i bed herpr i m arydi agnos i s as an uns peci fi ed l earni ng di s abi l i ty , and tw o m i nordi agnos es of m ot orvehi cl e ac ci denti nj uryand s eas onal pol l ens . A s t o t hes e mi nordi agnos es , D r . D i B el l a not es an ons etdat e of he r

“ in ju ry” a s J u n e 2 0 0 1 , th e d a te T h e L o s e n re p o rt e d s h e w a s in a m o to r v e h ic le a c c id e n t. ( A . R . 179) . H e opi nes thats he i s unabl e t o engage i n anyw or k act i vi ty , vol unt aryor comm uni tys ervi ce, oreduca t i onal orvocat i onal tr ai ni ng. H e al s o cl as s i fi es her o rth o p e d ic lim itatio n s a s “ C las s II I: a f u n c tio n a l ca p a c itya d e q u a te to p e rf o rm o n lylittle ornone of the dut i es of us ual occupa t i on orof s el f- car e. ” I d. D r . D i B el l a’ s r eportdoes no tdescri be an ydiagnost i c t est i ng perform ed to supp orthis con cl usi on s.T heL osen w as r eferr ed fo r a consult at i ve ex am i nati on byD r. S i egel atthe requ est 2 of the agen cyas a r esul tof h er appl i cat i on for di sabi l i tyben efi t s. T hyg e so n ’s s u

p e rfic ia l p u n c ta te k e ra tit is i s an ey e di s eas e pr i m ar i l yaff ect i ng t he 3 c o rn e a a n d is g e n e ra lly c h a ra c te ri z e d b yth e p re s e n c e o f s m a ll e p ith e a l le s io n s . D o rlan d ’s Il l ustrat ed MedicalD i ct i on ary 9 7 2 -73 (30 th ed . 2 0 0 3 ). 7 I n contr as tw i th ear l i erI Q t es t i ng, E l eanorSi egal , Ph. D . , i n J anuary2003, pl ace d 2 T h e L o se n (th e n a g e 2 9 ) in th e b o rd e rlin e ra n g e o f in telle c tu a l f

u n c tio n in g : h e r a rith m e tic s cor e w as i n t he ment al l yr et ar ded r ange a nd heratt ent i on s pan and pe r ceptual o rga n izati o n sk il ls w ere p o o r. D r. S iege l do es n o t i n d icate tha t she rev iew ed T h eL o sen ’s pr i ort es t i ng s cor es and s he pr ovi des no expl anat i on forthe di s par i tyi n herconcl us i ons and tho se ear l i er r esul t s. B . M ed ical H ist o ry 1 . E y e D isease (T h y g eso n ’s S u p erf ici al P u n ctate K era ti ti s (“T S P K ”)) 3 T heLosen w as fi r s ttr eat ed forcompl ai nt s of ey e pai n, r ednes s , t ear i ng, and phot os ens i t i vi tyi n J ul y1993. She w as di agnos ed w i th T SPK and pr es cr i bed cont act len se s, a n tib io tics , ey e d ro p s, a n d m ild ste ro id s. A lth o u g h sh e h a d re c u rre n c e s o f th is co n d it ion thro u g h o u t th e y ea rs, w ith flare-u p s o cc u rri n g ab o u t on ce a y ea r, T h eL o sen ’s v isi o n rem aine d 2 0 /20 o r be tt er.

2. A l l er gi es T heLosen ha s a hi s t oryof al l er gi es begi nni ng w hen s he w as s i xt een. T heLosen tes tifie d th a t h e r a llerg ies c a u se d h e r to e n d b rie f p e rio d s o f

e m p lo ym e n t at a b a k e ryin8

1993 and ata r et ai l s t or e i n 1995. I n D ece m ber1995, a C T s can s ugges t ed mi l d but chronic si nu si t i s. S he h as r ou t i nelybeen treat ed w i th all ergym edicat i on s. I n M ay2001, T heLosen w as tr eat ed forr ecurr i ng s i nus pr obl ems and br eathi ng d if f ic u ltie s . S h e w a s d ia g n o s e d w ith s e v e re a lle rg ic rh in itis a n d p re s c ri b e d m e d ic a tio n . A C T sc a n sh o w e d n o e v id e n c e o f a c u te o r c h ro n ic s in u sitis. T h e L o se n w a s re f e rre d to R obertR abi now i t z, D . O . , fortr eatm entof heral l er gi es i n Sept ember2001. She compl ai ned of pe r s i s t ents ym pt om s of pos tnas al dr i p, heada ches , and s i gni fi cant s e n s itiv ity to a v a ri e ty o f a c ro a lle rg a n s in c lu d in g m o ld , d u s t, g ra s s , a n d p e rf u m e s . T heLosen w as di agnos ed w i th al l er gi c rhi ni t i s and pos s i bl e chr oni c s i nus i t i s and pr es cr i bed C l ar i t an D , A s t el i n, and Zi thr om ax. I tw as al s o r ecomm ended thats he con si der al l ergyi nject i on s. T heLosen’ s tr eatm entcont i nued i n 2002. I n J ul y2002, s he r eport ed an i ns t ance of lo s s o f c o n s c io u s n e s s w h e n s h e v is ite d a n e w s to re a n d f e lt o v e rc o m e b ys tr o n g s m e lls . She cont i nued on medi cat i on, and aga i n i tw as r ecomm ended thats he cons i deral l er gy i nj ect i ons . She w as al s o advi s ed t o carryan Epi - Pen and B enadry l w i th heron a r egul ar basi s. 3 . M en tal D isord ers I tw as al s o dur i ng herD ece m ber2001 appoi nt m entw i th D r . D i B el l a that T heLosen c om pl ai ned of di ffi cul tys l eepi ng and anxi etyatt acks . H i s r eportdoes not in c lu d e a n ya n x iety -re late d d iag n o sis o r e v a lu a tio n , b u t D r. D iB e lla d id p re sc rib e P a x il,A g o ra p h o b ia i s a n i n t e n s e , i rr a t i o n a l f e a ro f o p e n s p a c e s , c h a r a c t e r i z e d b y a 4 m a rk e d f e a r o f b e in g a lo n e o r o f

b e in g in p u b lic p lac e s w h e re e sc a p e w o u ld b e d if f icu lt a n d m a yb e a s s o c ia te d w ith p a n ic a tta c k s . D o rlan d ’s at40. So m atof orm d e n o tes p h y sic a l sym p to m s th a t ca n n o t b e a ttribu ted to o rg a n ic 5 d is e a s e a n d a p p e a r t o b e o f a p s y c h ic o ri g in . D o rlan d ’s at1722.

9 an ant i - anxi etym edi cat i on. I n Sept ember2002, T heLosen r eques t ed a r efi l l of her pr es cr i pt i on forPaxi l w hen s he w as exami ned atthe C om m uni tyM edi cal C ent er . T he at t end i ng ph y si ci an requ est ed thatshe fi rs tun dergo a psy cho l og i cal evaluat i on – a requ est s he r efus ed. H erpr ogr es s not es fr om the C om m uni tyM edi cal C ent eri ndi cat e s he w as di agnos ed w i th anxi etyi n O ct ober2002 and al s o not es herr efus al t o part i ci pat e i n any couns el i ng. In her eval uati on w i th D r. S i egel i n Janu ary20 03 , T heL osen repo rt ed thatshe w as s u f f e ri n g f ro m p a n ic a tta c k s – th e m o s t r e c e n t o c c u rr in g th e d a yb e f o re th e e v a lu a tio n . D r . Si egel not ed thatT heLosen w as pr es cr i bed Paxi l byherfami l yphy s i ci an, and thats he w as s t i l l notbei ng tr eat ed bya ps y chol ogi s torps y chi atr i s t . T heLosen a l s o r eport ed d ifficu ltysleep ing , o b sess ive-c o m p u lsi v e sy m p tom s, an d a g en era l l o ss o f in terest. D r. Si egel di agnos ed TheL os en as s uffe r i ng fr om a pani c di s or derw i th agor aphobi a, 4 o b sess ive-c o m p u lsi v e d isord er, an d so m atof o rm d isord er (n o t othe rw ise classified ). 5 C . A dm i ni s tr at i ve H ear i ng O n F e b ru a ry 6 , 2 0 0 3 , a s ta te a g e n c yp s y c h o lo g ic a l c o n s u lta n t, I ra G a s h , P h .D ., co m p let ed a m en tal residu al ca p ac ityasse ssm en t and p sy ch iatri c re v iew b ase d o n D r. S ieg e l’s re p o rt. It w a s D r. G a sh ’s o p in io n th a t T h e L o se n ’s p sy c h o lo g ica l im p a irm e n ts10

w er e the bas i s forherdi s abi l i tyand thatherphy s i cal l i m i t at i ons w er e onl y“contr i but i ng fa ctors.” (A . R . 2 9 0 , 2 9 2 ). I n A pr i l and A ugus t2003, tw o otheragenc yps y chol ogi cal cons ul t ant s anal y zed the seve ri tyof T heL osen’s cond i t i on from O ct ob er 1995 throug h M arch 31 , 20 01 . T hese c o n su ltan ts d e ter m in e d th a t th e re w a s in su f f icie n t ev id e n c e th a t T h e L o se n ’s im p a irm e n ts w er e s ever e atanyt i m e pr i ort o M ar ch 31, 2001, thus pr ovi di ng s ubs t ant i al evi dence t hat w o u ld p re c lu d e D A C a n d D IB a w a rd s. H o w e v e r, T h e L o se n w a s a w a rd e d S S I b e n e f its b a se d o n h e r p sy c h o lo g ica l im p a irm e n ts. S h e re q u e ste d a n a d m in istra tiv e h e a rin g to c o n s i d e rth e d e n i a l o f

DAC a n d DI B. A n ad m inistrati v e h ea ri n g w as h eld o n Ju n e 2 3 , 2 0 0 5 , d u ri n g w h ich th e A L J h ea rd tes tim o n yf

ro m T h e L o se n a n d h e r m o th e r. B e c a u se th is te stim o n yd e sc rib e d im p a irm e n ts thatw er e of a gr eat ers ever i tythan w er e s how n bythe s chool and medi cal r ecor ds that h a d b e e n su b m itt e d , the A L J le f t th e re c o rd o p e n f

o r th irtyd a y s to p e rm it co u n se l to pr ovi de furtherdocument at i on. N o addi t i onal evi dence w as s ubm i t t ed and he r appl i cat i ons forD A C and D I B w er e deni ed i n the A L J ’ s deci s i on dat ed N ovember9, 2005. I V. W e agr ee w i th t he thor ough and w el l - r eas oned opi ni on of the D i s tr i ctC our tthat th e d e c i s i o n o f

th e Commi s s i o n e ri s s u p p o r t e d b ys u b s t a n t i a l e v i d e n c e . Th e ALJ11

car eful l ycons i der ed the medi cal evi dence and the t es t i m onyof M s . T heLosen a nd her m otherand pr ovi ded s uffi ci entexpl anat i on forhi s det erm i nat i on of herons etdat e. T heLosen c l ai m s thatthe dec i s i on of the C om m i s s i oneri s err oneous , buts he does notpoi ntt o anyevi dence i n t he r ecor d thatw oul d s uppor ta fi ndi ng thats he s uffe r ed fr om a s ever e i m pai r m entpr i ort o O ct ober13, 1995, orM ar ch 31, 2001. D es pi t e herl earni ng di s abi l i ty , al l er gi es , and chr oni c ey e pr obl ems, s he s ucce s s ful l ygr aduat ed fr om hi gh sc h o o l an d c o lleg e . H e r T S P K w a s c h ro n ic w ith sp o ra d ic f lar e -u p s, b u t w a s tre a ted w ith m ild ste ro id s. T h e re is n o e v id e n c e th a t ite v e r se rio u slylim ited h e r a c tiv iti e s o f d a ily l i vi ng. S im ilarly , h e r a llerg ies w e re c o n sis ten tlyd e sc rib e d in th e m e d ica l re c o rd s a s m ild i n natur e. I tw as notunt i l Sept ember2001 thats he w as di agnos ed w i th s i nus i t i s and al l er gi c rhi ni t i s , cons i s t entw i th T heLosen’ s t es t i m onythatheral l er gi es had w or s ened w i th age. St i l l , T heLosen w as tr eat ed w i th comm on al l er gym edi cat i ons and the medi cal r ecor ds do noti ndi cat e anys i gni fi cantfunct i onal l i m i t at i ons r es ul t i ng fr om hercondi t i on. C l ear l y , the medi cal and s chool r ecor ds w er e notcons i s t entw i th T heLosen’ s and herm other ’ s t es t i m onydes cr i bi ng the s ever i tyof hervar i ous al i m ent s . I n part i cul ar , t he hi gh s chool r ecor ds pr ovi ded di d noti ndi cat e s he w as enr ol l ed i n a s peci al educa t i on p ro g ra m . T h e A L J p ro v id e d T h e L o se n w ith a n o p p o rtu n ityto su p p lem e n t th e re c o rd to re so lv e th is c o n f

lict b u t n o a d d iti o n a l ev id e n c e w a s s u b m itt e d . T h e L o se n ’s a b ili tytoW e not e thatT heLosen c ont ends the A L J err ed i n s i m pl yadopt i ng thi s dat e as t he 6 ons etdat e bec aus e i tw as bas ed on the dat e of he rappl i cat i on forbenef i t s as r equi r ed underSSI, butthi s i s nota corr ects t at ement . T he A L J found s he w as notel i gi bl e for D I B orD A C benef

i t s beca us e s he coul d notes t abl i s h a s ever e i m pai r m entw i thi n the app l i cable i nsured p eri od s. 12 s ucce s s ful l ycompl et e hi gh s chool , col l ege, and comput ertr ai ni ng i s s tr ong evi dence t hat herl earni ng di s abi l i tyw as nots ever e pr i ort o M ar ch 31, 2001. F inally , the e arli est reco rd o f h er p sy ch o log ical i ssu es a p p ea rs t o b e D r. D iB ell o ’s not es fr om D ece m ber2001. T heLosen r eport ed di ffi cul tys l eepi ng, notw ant i ng t o l eave h e r h o m e , an d a n x ietya ttac k s. H is d e sig n a tio n o f Ju n e 2 0 0 1 a s a n o n se t d a te a p p e a rs to be bas ed on the dat e s he w as i nj ur ed i n a mot orvehi cl e ac ci dentand s eems t o be r el at ed to th e o rt h o p e d ic p ro b le m s h e w a s h a v in g a t th a t tim e – n o t a n yp s y c h o lo g ic a l d ia g n o s is . In f ac t, T h eL o sen w as n o t diag n o sed w ith an x ietyu n ti l 20 0 2 , an d h er p an ic diso rde r, o b s e s s iv e -c o m p u ls iv e d is o rd e r, a n d s o m a to f o rm d is o rd e r w e re f

ir s t d ia g n o s e d in 2 0 0 3 . H erm edi cal r ecor ds w er e r evi ew ed byagenc ycons ul t ant s w ho found i ns uffi ci ent e v i d e n c e t o c o n c l u d e th a th e ri mpa i r me n t s wer e s e v e r e p r i o rt o J u n e 2 0 0 2 . Th e ALJ 6 p ro p e rlyre lied o n th e c o n su ltan ts’ re p o rts to d e ter m in e th e se v e rityo f h e r im p a irm e n ts a n d th e o n s e td a t e o f

h e rd i s a b i l i ty. Th e Di s tr i c tCou r twas a l s o c o rr e c ti n r e j e c t i n g Th e Lo s e n ’ s c l a i m t h a tth e ALJ fai l ed t o adequa t el ydevel op the r ecor d as r equi r ed bySSR 83- 20. T heLosen c ont ends t he A L J w as r equi r ed t o cons ul ta medi cal advi s ort o as s i s thi m i n r eac hi ng byi nfer ence earl i er dat es for the o nset s of he r di sabi l i t i es.13

SSR 83- 20 des cr i bes the i ndi vi dual ’ s al l egat i on, w or k hi s t ory , and medi cal e vi de nc e a s the fa c t or s r e l e va ntt o a de t e r mi na t i on of the on s e tda t e of

a di s a bi l i ty . SSR 83- 20. M edi cal evi dence i s the pr i m arycons i der at i on i n det erm i ni ng the di s abi l i tyons et d a te . I d. T h e c laim a n t’s a lleg e d d a te o r th e d a te s h e las t w o rk e d a re sig n if ica n t o n lyif c o n s is te n t w ith th e s e v e ri ty o f th e c o n d itio n s s h o w n b ym e d ic a l e v id e n c e . I d. A m edi cal advi s ors houl d be ca l l ed w her e the i m pai r m entati s s ue i s s l ow l ypr ogr es s i ng and the a lleg e d o n se t d a te is so f a r in th e p a st th a t o b tain in g a d e q u a te m e d ica l re c o rd s is im p o s s ib le . See i d. ; W

al t on v. H

al t er , 2 4 3 F . 3 d 7 0 3 , 7 0 9 (3d C ir . 2 0 0 1 ). In this case, the A L J had ac cess t o the m edical recor ds from the 1 99 0s and tho se rec o rds w ere rev iew ed b ym ed ical co n su lt an ts w h o d eterm ined there w as n o su p p o rtfo r ear l i erons etdat es . A ft ercons i der i ng the medi cal evi dence , the cons ul t at i ve r eport s , and the hea r i ng t es t i m ony , the A L J det erm i ned thatthe evi dence di d nots uppor ta fi ndi ng, at s t e p two o f

th e s e q u e n t i a l e v a l u a t i o n , th a tTh e Lo s e n h a d a s e v e r e i mp a i r me n ta ta t i me that w ou l d q uali fyher t o recei ve D IB or D A C ben efi t s. In short , T heL osen co ntends the A L J should hav e soug ht m edical assi st ance so thatbyi nfer ence he coul d r eac h a conc l us i on thatw oul d be contr aryt o the medi cal evi dence al r eadybefor e hi m . W e fi nd the D i s tr i ctC our tw as corr ecti n concl udi ng that th e A L J p ro p e rlyc o n sid e re d th e m e d ica l ev id e n c e b e f o re h im a n d w a s n o t re q u ire d to obt ai n addi t i onal as s i s t ance . F o r th e se re a so n s, w e w ill a f f irm th e ju d g m e n t o f

th e D istric t C o u rt.