2003 D e c i sion s O p inion s of the U nit e d S t at e s C our t of Appe al s for the Thir d C ir c uit
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w . v i l l a no va . e du/thir dc ir c uit_2003/206NOT PRE CEDENT IAL UNITED STATES COURT OF APPEALS FO R T HE TH IRD CIR CU IT
No. 03-1358 JANICE NEWELL, Appellant v. COMM ISSI ONER OF SOCIAL SECURITY App eal from th e Un ited States District Co urt for the Dis tri ct of New Jersey (D.C. Civ. No. 01-2850) Distri ct Judge: Honorable Anne E. Thompson

Argued September 9, 2003 BEFORE: BARRY, BE CKER, and GR EE NB ER G, Circu it Judges

(Fil ed: October

14, 2003)
Abraham S. Alter

(argued) Langton & Alter 2096 St. Georges Avenue Rahway, NJ 07 065

A tto rn eys for Ap pellan t
Ch ristoph er J. C hristie United States Attorney Peter G. O’Malle y Assist ant Unite d States Attorney2 970 Broad Street , Suite 700 Newark, NJ 07102 Barbara L. Spi vak Chief C ounsel - R egion II Karen T. Callahan (argued) Assist ant RegionalCounsel Of fice o f the G enera l Cou nsel Region II 26 Federal Pl aza New Y ork, NY 10278 Social Sec urity Adminis tration

A tto rn eys for Appellee

OPINI ON OF THE COURT

GR EE NB ER G, Circu it Judge
. This matt er comes on befor e this court on appe al from an or der ente red on De cem ber 3 , 2002 , affirm ing the final d ecision of the Co mm issione r of S ocial S ecurity denying appe llant Jan ice N ew ell’s (“N ew ell”) req uest fo r wid ow ’s disab ility benefits under Title IIof the Soci al Securi ty Act. The dis tri ct court had juri sdiction pursuant to 42 U.S .C. § 405 (g) a nd w e ha ve ju risdi ction ove r N ew ell’s a ppe al pu rsua nt to 28 U .S.C . § 1291. For the reasons set forth below, we will reve rse the dist rict court’ s order a ffirmi ng the Commissione r’s dec isi on and inst ruct t he dist rict court to remand the cas e to the Co mm issio ner for fur ther pro cee din gs c ons isten t wi th th is op inio n.1 The Comm issi oner has not contended that we should not consider this case on the basis o f N ew ell allege dly being disab led fo r the rea sons she e mp hasize d at ora l argum ent. 3 I. PROCE DURAL HI STORY AN D FACTUA L BACKGROU ND A. Proc edural H istory Newellappl ie d for

widow’ s di sab il ity b enef it s on Nov ember

16, 1998. To
rece ive s uch ben efits , Ne we ll nee ded to d em ons trate , inter alia , that she i s (1) at least 50 but les s than 60 y ears ol d; (2) the widow of a wage earner; and (3) under a disabi lit

y as def ined in 4 2 U .S.C . § 42 3(d )(2)( A)
. See 42 U.S.C. § 402(e)(1); 20 C.F.R. § 404.336. Newell, who was 56 years old at the t ime of her hearing before the ALJ, i s the widow of wage earner Robert

S. Newell. In her appl ication for widow’s di sabil ity benefit s, she alle ged that

she had been di sabled s ince Jul y 1, 1997, due t o arthriti s in her lower back
an d ne ck , a

de te ri or at ed di sc , i nt er na l d er an ge men t o f h erkne e, sc iati ca , and d iabe te s. At oral arg um ent be fore th is cou rt, how ever, h er attorn ey indica ted tha t her dis ability is ba se d s ol ely o n h er liv er di se as e, d iab ete s, a nd ne ur op ath y. 1 The S ocial Secu rity Administration ("SS A") de nied N ewell’s app lication for widow’s disabi lit

y benefi ts on April20, 1999, and again upon re consider ation on J une 17, 1999. N ewell app ealed and a hearing w as held on Februa ry 9, 2000, before Administr ative Law Judge (“ALJ”) Gerald J. Ryan. On April17, 2000, ALJ Ryan issued a decisi on denyi ng her appli cati on for benefi ts. His decis ion became fi nal on April16, 200 1, af te r t he App ea ls Cou nc ilde ni ed Newe ll ’s re que st fo r a dmi ni st

ra ti ve re vi ew. On2 Originally , Newell argued that her eligibi lity for widow ’s benefits ran unti l August 1998, but at oralargument her attorney aba ndoned that argument and t

hus accept ed August 31, 1997, as the cut -off date
. 4 June 14, 2001, Newell fil ed a complaint in the di stri ct court

chall enging the Commissioner’ s finalruli ng. The dis tri ct court affirmed t

he finaldecisi on of the Co mm issio ner on D ece mb er 3 , 200 2. Ne we ll thereaf ter filed this app eal. B. FactualBackground New ell was born on Aug ust 1, 1943, and married Robert S. Newell on A ugust 31, 1968. Thei r marri age ended in di vorce in J une 1987, and she ha s not re married. Her former husband, a wag e earner, died full y insured for SocialSecurity benefits on August 9, 1990, and Newell’s el igibi lit y for widow’s benefit s based on hi s earni ngs terminated at the cl ose of the 84t

h month (seven y ears) after his deat h, on August 31, 1997, so that her disa bility ha d to hav e co mm enc ed b y that d ate f or h er to be e ligib le fo r be nef its. See 42 U.S.C . § 402(e)(1); 20 C.F.R. § 4 04.336(c )(1). 2 Fro m 199 4 thr oug h Dec embe r 1 996 , Ne wel l wa s s el f- empl oy ed d oi ng p ar t- ti me consulting and cra ftwork. She es timat es that she earned $5000 to $6000 per y ear duri ng that t ime. From December 1996 through July 1997, she worked occa sional ly with a friend who was a carpe nter, painti ng and making stained gla ss windows. She es timat es that s he earned $3000 per year during t hat ti me. In Jul y 1997, Newell inj ured her bac k when she tri pped over a l awn mow er. Afte r that incide nt, s he stopped worki ng5

completel y. She also stopped doing y ardwork, gar dening, washing, and cl eaning. New ell contends tha t she becam e disabled o n July 1, 1997, bu t could not af ford medical care at t

hat ti me because she was uni nsured. Beginning on June 1, 1998, how eve r, she did see k m edic al atte ntio n w hen her fath er g ave her the m one y to pa y for it. Accordingly , most of t

he evidence i n her record is compri sed of doctor s’ repor ts dated pos t Au gus t 31 , 199 7, th e da te up on w hich her eligi bility fo r w ido w’ s be nef its ex pire d. Ne we ll conte nds th at rega rdless o f the d ates on her m edica l repor ts, she is e ntitled to widow’s benefit s because her medical condi tions -- l iver di sease, diabet es, and neurop athy -- were presen t prior to Aug ust 31, 199 7. She arg ues that these co nditions are slowlyprogress ive and that the y di sabled her within t he period of

her eli gibil ity

for ben efits
. 1. The Medical Evide nce Before ALJ Ryan The medical evi dence consi sts of reports from Newell’s fami ly doctor and he r ortho pedis t, reports f rom the S SA in the f orm of a R esidu al Ph ysical Fun ctiona l Cap acity Assessment and fr om a consultative e xaminer, as well as Newell’s t esti mony regarding her pain and functional limit ations.

a. Medical Evi dence Prior to August 31, 1997 Billi ng records and an emergencyroom report indicate that Newell re ceived services for treatm ent of an u nstable low back an d contusion of the w rist in 1990. Tr.3 Tr. ref ers to th e adm inistrative transc ript. 6

191-95, 199, 203. 3 Other bil ling s tate ments and phy sicaltherapy report s from 1990 indica te that sh e w as fitted for a c ustom mo lded lu mb osac ral cors et, wa s instruc ted in hom e ex ercis es a nd t he u se o f a h ot p ack , and wa s trea ted f or a n un stab le low er b ack
. Tr. 195-98, 202. Pres criptions dat ed September 14, 1990, and November 21, 1990, indicate that she was pre scri bed over-t he-counte r nonste roidalanti- inflammatories and Tyle nol. Tr . 194, 196, 200. In December 1990, she was refer red for el ectromy ogram (“EM G” ) and nerv e con ductio n stud ies. Tr. 2 00-0 1. A noth er billing statem ent ref lects that s he recei ved emergencyroom servi ces on December 10, 1993, for shoul der joi nt pain. Tr. 204.

b. Post -Coverage Medical Evidence (After August 31, 1997) Most of the me dical evidence is comprised of doctors’ report s dated post August 31, 1 997 . Ne we ll first we nt to Dr . Ha rold Ch afk in, h er fa mily p hysicia n, on Jun e 1, 1 998
. Dr. Chafkin t

reate d her diabe tes and t he pain i n her knees and ba ck. On August 12, 1998, she began treatment wit h an orthopedi st, Dr. Alfred Grei sman. In hi s notes, Dr. Greisman mentioned Newell’ s li ver condit ion, s tati ng that he was “apprehensi ve about putting her on any nons teroi dals because of her l iver condi tion. ” Tr. 152. His recor ds indi cate that Newell lost

50 pounds in 1998. Tr. 149. The 50 pounds apparently include d 40 pounds of muscle. Tr. 155. On September 17, 1998, Dr. Greisman concluded that “due to her cond ition sh e is un able to drive o r travel.” T r. 151 . In N ovem ber 1 998 , New ell7

underw ent an E MG , which ind icated results consistent w ith peripheral neu ropathy. Tr. 145. The medical evi dence from the SSA incl udes a ResidualPhysi cal Functional Capa city Assessmen t by a non-treating physician da ted De cemb er 15, 199 8, and a rep ort from consult ative examiner Dr. Phill ip B. Eatough dated March 11, 1999. Tr. 156-63; 164 -67. T he R esidu al Ph ysical Fun ctiona l Cap acity Ass essm ent ind icates th at Ne we ll occasionallycould lift and/or car ry 20 pounds; frequentlylift and/or carry ten pounds; stand and/o r wa lk for a bou t six ho urs in a n eigh t-hou r wo rkda y; sit for a tota l of ab out six hours in an eight- hour workday ; and push and pul l without limi tati on. Consultative examiner

Dr. Eatough not ed in his report that Newellhad endured gradual a nd progress ive back pr oblems for approximatel y se ven years; ne uropathyfor approximat elytwo year s, poss ibly related to her di abetes or alcohol excess; and diabet es for about two years . He also noted that when she stopped drinking al cohol, she lost about 45 pounds. Tr. 164-66. Dr. Eatough’s impressi ons incl uded (1) peripheralneuropathy with bil atera l carpal tunnel s yndr ome and neuropathy of both lower e xtremit

ies wit h possibl e atrophy

of the pro xima l mus cle gro ups; (2 ) diabe tes me llitus mo st prob ably seco ndar y to chron ic alcohol consumption; (3) peripheralvascular diseas e; (4) osteoarthri tis with low back syndr ome, possi ble sci atic a and lumbar neur opathy ; and (5) liver dysf unction. He found that she occa siona lly could lift 2 0 po und s; freq uently lift ten pou nds; sta nd an d w alk8

approximat elytwo hours in an eight- hour workday without a required a ssis tive de vice; and sit about si x hours in an eight- hour workday with peri odic st anding. He found that her ab ility to push a nd p ull w as limite d in the upp er and low er extre mities se cond ary to tenderne ss and neuropathy . He reported that she occasi onally

could cl imb, bal ance, stoop, kneel, crouch, and crawl. He found no manipul ative , vis ual, communicati ve, or environment al li mitations. Tr. 166-67. Less than two m onths later, on M ay 1, 1999, N ewell’s fam ily physi cian, Dr. Ch afkin , reporte d that N ew ell “is crip pled b y severe p eriphe ral neu ropa thy secon dary to diabet es and alc ohol consumpti on.” He noted t hat her prognosis “i s poor. . . . She has been seen bythe neurol ogist s, bythe ort hopedist s and myse lf and, unfortunately , we have
com e up w ith no a nsw er for this po or w om an’s p ain w hich w ill nega te her b eing g ainfu lly
em plo yed in any m ann er w hats oev er.” T r. 14 2. 2. Ne well ’s Testimon y Be for e t he ALJ Ne we ll testified th at at the tim e of h er hea ring, sh e w as takin g pre scription pain reli evers, sleep ai ds, and or al medicat ion for di abetes. She was also t aking nonprescripti on pain rel ievers and vitamins. She wore s plint s for her wrists and a brace for her back. She testifie d that he r pain was se vere and that it had prevent ed her from working or doi ng any hous ework since J uly 1997, when she fel l over a l awnmow er and hurt her back. Tr. 31, 43. She di d not seek medi cal attenti on untilJune 1998 because s he had no insur ance. Tr. 32. When she went to t he doctor, he diagnosed he r with di abetes9

and neuropathy. Tr. 33-34. She testifie d that s he is unabl e to bathe, dres s hersel f, and driv e. T r. 43 -44
. 3. The ALJ’s Findi ngs ALJ Ryan found that

Newell’s al legations were not supporte d by obj ecti ve medical evi dence and were contr adict ed by her own statement s and acti ons. He noted, for example, t

hat the re was no evidenc e that Newell sought or

recei ved regular medical treat me nt fr om 199 0 to 199 8. N or d id sh e rec eive treat me nt fo r he r ba ck in jury in 1 997
. AL J Ryan also fo und that it w as no t until A ugu st 199 8, a year af ter she wa s last eligib le for benefi ts, that s he began to experience neur opathyin her l ower extremi ties and that her med ical pro blem s wo rsene d. Th us, he conc luded that prio r to A ugu st 31, 1 997 , she d id not have a se vere impai rment that las ted or coul d be expected to last 12 months or more,
w hi ch sig ni fic an tly li m ite d h er ab ilit y to en ga ge in w or k- re lat ed ac tiv itie s. A cc or di ng ly, he determined that she was not entitled t o widow ’s disabil itybenefits.

II . D IS CUSSI ON A. Standard of Revi ew W e ex ercis e ple nar y revie w o ver the o rde r ofthe d istrict cou rt, see Knepp v. Apfel , 204 F .3d 78 , 83 (3 d C ir. 2000 ), but rev iew th e dec ision o f the C om missio ner to dete rmin e w heth er it is s upp orte d by su bsta ntial evid enc e. See Richardson v. Perales , 402 U.S. 389, 390, 91 S.Ct. 1420, 1422 (1971). Substantial e vidence has been defined as10

"such releva nt evid ence as a rea sona ble m ind m ight ac cept a s ade quate to sup port a conclusion." Id. at 401, 91 S.Ct. at 1427 (quoting Cons ol id at ed Ed is on Co . v . NLRB , 305 U.S. 197, 229, 59 S.Ct. 206, 217 (1938)). It i s more than a mer e scintill a of evidence but
ma y be le ss th an a pre pon der anc e. See Brown v. Bowen , 845 F.2d 1211, 12 13 (3d C ir. 198 8). O f co urse , we exe rcise plen ary rev iew ove r qu estio ns o f law
. See Krysztoforski v. Chater , 55 F.3d 8 57, 858 (3 d Cir. 199 5). B. Statutory and R egulatory Fram ewo rk In order to establi sh a disabili ty under the Social SecurityAct, a claimant must demonstrate that

there i s some “‘medica lly determi nable basi s for an i mpairment t hat prevents him from engaging i n any “s ubstantial gainful a ctivi ty ” for a st atutor y twelvemonth period. ’” Stunkard v. Secretary of Health & H uman Servs. , 841 F.2d 57, 59 (3d Cir. 1988) (quoti ng Kangas v. Bowen , 823 F.2 d 77 5, 77 7 (3 d C ir. 19 87) ); 42 U.S .C. § 423(d)(1) (A). A clai mant is cons idered unable to e ngage in anysubstant ial gainful activity "on ly if his physica l or me ntal im pairm ent or im pairm ents ar e of s uch s everity that he is not

only unable t o do his pre vious work but c annot, considering his age, education , and w ork exp erience, enga ge in any other kind of substan tial gainful wo rk wh ich e xists in th e na tion al ec ono my . . . ." 4 2 U .S.C . § 42 3(d )(2)( A)
. The SSA has promulgated re gulati ons incor porati ng a five- step se quentia l
eva luati on p roc ess f or d eterm inin g w heth er a c laim ant is und er a d isab ility. See 20 C.F .R. § 4 04.15 20; Willi ams v. Sull ivan , 970 F.2d 1178, 1180 (3d C ir. 1992). The firs t11

two steps involve threshold determinati ons. In step one, the Commissioner must dete rmin e w heth er th e cla ima nt cu rren tly is en gag ing in su bsta ntial gain ful a ctivi ty. Burnett v. Comm’r Soc. Sec. Admin. , 220 F .3d 11 2, 118 (3d C ir. 2000 ). If a claim ant is fou nd t o be eng agin g in sub stan tial g ainf ul ac tivity, the disa bility cla im w ill be den ied. Id. In step two , the C om missio ner m ust de termin e w hethe r the cla iman t has a m edica lly
sev ere im pair me nt o r co mb inati on o f im pair me nts. See id. If the c laimant does not have
a se ver e im pair me nt o r co mb inati on o f im pair me nts, th e dis abili ty claim is de nied
. See id. In ste p t hr ee , th e C om m iss io ne r c om pa re s th e m ed ica l ev id en ce of th e c lai m an t's impairment

to a li st of i mpairments presumed severe enough to pre clude anygainful
wo rk. Id. If the im pairm ent is eq uivale nt to a liste d imp airme nt the d isability claim is granted wit

hout furt her anal ysi s. I f a clai mant does not s uffer from a l ist ed impairment or its eq uiv alen t, the a nalysis pro cee ds to step s fo ur a nd f ive. Id. Ste p fou r r equi res the ALJ to con sider w hethe r the cla iman t retains th e resid ual fu nction al cap acity to perf orm his pas t rele van t wo rk. Id. The claim ant be ars the burd en of dem onstra ting an inability to return to his past r elevant work. Id. If the c laima nt do es no t mee t the bu rden the cla im is den ied. If the c laimant is unabl e to res ume his former oc cupati on, the evaluation moves to th e fin al ste p. Id. At this stage, the bu rden of p roduction sh ifts to the Com missioner, wh o m ust de mo nstrate th e claim ant is ca pable of p erfor ming other a vailab le wo rk in ord er to den y a clai m o f dis abili ty. Id. The Comm issi oner must show the re are ot her jobs4 Social Sec urity Rulings constitute the S SA 's interpretations of the statute it admin isters

and of its ow n re gul ation s. Chavez v. D ep’t of Health & H uman Servs. , 103 F.3d 849, 851 (9th Cir . 199 6). S ocia l Se cur ity Ru ling s do not hav e the for ce o f law , id. ; nev erth eles s, on ce p ubl ishe d, th ey are bin din g on all co mp one nts o f the SS A. Walton v. Halter , 243 F.3d 703, 708 (3d Cir. 200 1). 12 exi stin g i n si gni fi can t n umbe rs in th e na ti ona l e con omy whi ch t he c la ima ntcan perform, consistent with hi s or her medi cal i mpairments , age, educati on, past work experienc e, and resid ual f unc tion al ca pac ity. Id. The ALJ must analy ze the cumulative e ffect of al l the claim ant's imp airme nts in d eterm ining w hethe r he is c apab le of p erfor ming wo rk an d is not disa bled
. Id. at 11 8-1 9. C. The Step-Two Determinat ion As mention ed ab ove, atst ep t wo of the fi ve- st ep s eque nti al inq uiry t he ALJ determi nes whether t

he clai mant has a medica lly severe i mpairment or

combinati on of imp airm ents . See Bow en v. Y uckert , 482 U .S. 137, 140 -41, 107 S .Ct. 2287, 22 91 (198 7); Social Sec urity Ruli ng (“SSR”) 86-8, 1986 SSR LEX IS 15, at *6-7; SSR 85-28, 1985 SSR L EXIS 1 9, at *1. The Social SecurityRegulations and Rulings, 4 as well as case la w apply ing them, discuss the step-two severity determi nation i n terms of what i s "not severe." Smolen v. Chater , 80 F.3d 1273, 1290 (9th Cir . 1996). According to t he Co mm issione r's regula tions, “a n imp airme nt is no t sever e if it do es no t signific antly limit [the cl aimant' s] phy sicalabili ty to do basi c work acti viti es.” Id. (quoti ng 20 C.F.R. §§ 404.1520(c) , 404.1521( a)(1991) ). Basi c work acti viti es are " abili ties and apti tudes
necessary t o do most jobs , inc luding, for example, walking, standi ng, si tti ng, li fting,5 SSR 85-28, 1985 SSR LEX IS 19, at *11-12, s tate s that

“[g]reat care shoul d be exerc ised in a pplying th e not s evere impa irmen t conc ept. If a n adju dicato r is una ble to determi ne clearly the effect of an impairment or combinat ion of impai rments on t he individ ual's ability to do basic w ork a ctivities, the sequ ential ev aluatio n pro cess sh ould not end wit h th e no t sev ere e valu ation step . Ra ther , it sho uld be c ont inu ed.” 13 pushing, pulling, reaching, carry ing or handling." Id. (qu otin g 20 C.F .R. § 140 .152 1(b )). The step-two inquiryis a de minim is screening device to dispose of groundless claim s. See Smolen v. Chater , 80 F.3d at 1290 ; McD onald v. Secretary of Health & Hum an Servs. , 795 F.2d 1118, 1124 (1st Ci r. 1986) . An impairment or combinat ion of impairment s can be found "not severe" only if the evidence es tabli shes a sl ight abnormali ty or a combination of sl ight abnormalities which have "no more than a mi nimal effect on an individual’s abil ityto work." SSR 85-28, 19 85 SS R L EX IS 19, at *6-7
. On ly those cla iman ts with slight ab norm alities that d o no t signific antly limit an y "basic
wo rk a ctivi ty" can be d enie d be nef its at s tep tw o. See Bow en v. Y uckert , 482 U.S. at 158, 107 S.Ct. at 2300 (O’Connor, J., concurri ng). I f the evi dence prese nted bythe clai mant present s more than a " sli ght abnormal ity ," the step- two requirement of "seve re" is m et, an d th e se que ntial eva luati on p roc ess s hou ld co ntin ue. See Smolen v. Chater , 80 F.3d at 129 0. Re ason able d oub ts on se verity are to be res olved in fav or of the cla iman t. 5 1. The ALJ Denied Newell’s Claim At Step Two on Erroneous Bases Ac cord ing to A LJ R yan, the o bjectiv e me dical e viden ce in N ew ell’s reco rd did not support

her all egati on of disabi lit y and t hus he denied he r clai m at step two of the14

sequenti al eval uation. It i s true that he r recor d lacks evi dence of tr eatment for liver diseas e, di abetes, or neuropat hy prior t o August 31, 1997. Nonetheless , thi s lack of evide nce in the pa rticular c ircum stance s of th is case did n ot pro vide a n ade quate basis to support a conclusi on that Newellwas not disabled pri or to August 31, 1997. We note that severalcourts have questi oned the re levance of i nfrequent medical vi sit s in determining wh en o r w heth er a c laim ant is disa bled
. For e xam ple, the C ourt o f A ppea ls for th e N inth Circuit has held t

hat the fact that a “cl aimant maybe one of the mil lions of people who did not s eek tre atment for a mental di sorder unt

il l ate i n the day ” was not a subst antia l bas is to r ejec t that an im pair me nt ex isted
. Nguyen v. Chat er , 100 F .3d 14 62, 14 65 (9 th Cir . 199 6). In f act, SSR 96 -7p, 1996 SSR LEX IS 4, at *22, states that “the adjudicator must not draw anyinfere nces about a n indivi dual’s sympt oms and their functi onal effect s from a fail ure to s eek or purs ue regular medicaltreat ment without

firs t consi dering any explanations that the indivi dual may provide, or other information in t

he case re cord, t

hat may expl ain inf

requent or

irr egular medi cal vi sit s or fai lure to seek medicaltreat ment.” He re, Ne we ll’s exp lanatio n fo r her f ailure to seek treatm ent prio r to A ugu st 31, 1 997 , is adeq uate -- s he cla ims sh e cou ld no t affo rd treatm ent un til her fa ther ga ve he r mo ney in June 1998. Moreover, the rec ord demonstr ates t hat her i ncome during the germane peri od was very low and that

she did not

have medical insurance, ci rcumstance s that support he r clai m that she c ould not af ford tr eatment. Accordingly , we disagree with the AL J’s15

stat ement that

“[i]t is re asonable to assume that if [Newell] was experienc ing the de gree of pain and functional l imit ation whic h she has al leged that she would have sought medical t reatment .” Tr. 16. It is Ne we ll’s positio n that h er liver d isease , diabe tes, and neur opath y are slow ly progress ing condit

ions that exi sted wellbefore their document ation i n 1998. She argues that he r medicalrecord must be studi ed retrospecti velyto dete rmine when her medica l cond itions ac tually beca me d isabling . Retro spec tive dia gno sis of a n imp airme nt, eve n if uncorrobor ated bycontemporaneous medical records, but corr oborated by layevidence relat ing bac k to the c laim ed p erio d of disa bility, ca n su ppo rt a f ind ing of p ast im pair me nt. See Loza v. Apfel , 219 F .3d 37 8, 396 (5th C ir. 2000 ); Likes v. Callahan , 112 F.3d 189, 191 (5th Cir . 1997). Thus, even non-c ontemporaneous records of Newell’ s li ver dis ease, diabet es, and neuropathyare rel evant t o the det ermination of whether their onset occur

red by the date Ne we ll alleg es. See Ivy v. Sull ivan , 898 F.2 d 10 45, 1 049 (5th Cir . 199 0). Here, the ALJ failed pr operlyto consi der the non- contemporaneous evidence pr esented by Newell in order to perform a retrospecti ve analysi s. The ALJ also erre d in usi ng Newell’s l ack of tr eatment prior t o August 31, 1997, as a basi s for di scredi ting her credibi lit

y r egarding he r pain and l evel of function. Lay evid enc e ne ed n ot b e co rrob ora ted b y con tem por ane ous me dica l evid enc e to b e cre dib le. See Basinger v. Heckler , 725 F.2d 1166, 1169 (8th Cir . 1984) ( layevidence must be considered even if un corrobora ted by medical ev idence). Moreover, SSR 96-7p, 199616

SSR LEX IS 4, at

*1, provi des that

an “indi vidual’ s statements about the intensity and persi stence of

pain or ot

her sy mptoms or about t he effect t

he sy mptoms have on his or her abili ty to work may not be disr egarded sol elybecause they are not subst antiated by objective medicalevidence. ” The ALJ also fail ed to give proper r easons for discr editi ng her credibili ty . Thus in Sousa v. Call ahan , 143 F .3d 12 40 (9 th Cir. 1 998 ), the A ppea ls Council had ci ted the length of time between the actua l event s and the testi mony and the lack of cor

roborating objec tive e vidence as reasons f or rej ecti ng the lay t esti mony but t he court of ap peals fou nd that “[t]hese justifications for the rejection o f the lay testimony are not suffi cient .” Id . at

1244. 2. The ALJ Failed To ApplySSR 83-20 SSR 83-20, 19 83 SS R L EX IS 25, prov ides AL Js with an a nalytical framew ork for dete rmin ing a dis abili ty ons et da te. SS R 83 -2 0 d ef in es th e “ on se t d ate of di sa bi lity” as “the f irst day an i ndividual

is di sabled as defined i n the Act and the regulations .” Id. at *1. In cases in w hich th e ons et date is critical to a determ ination of en titlemen t to benefit s, an ALJ must gr apple with and adjudi cate the questi on of onset, however diff icult
. See id. ("In addi tion to determi ning that an indivi dual is disabl ed, the decisi onmaker must al so establis h the onset date of di sabil ity . In manyclai ms, the ons et date i s cri tica l; i t may . . . e ven be determinati ve of whether the indivi dual is entitled to or6 Un der S SR 83-2 0, 198 3 SS R L EX IS 25 , at *3, an AL J sho uld co nside r three f actors in

de ter m in in g a n o ns et d ate : (1 ) th e c lai m an t's a lle ga tio ns ; (2 ) th e c lai m an t's w or k h ist or y; and (3) m edic al an d ot her evid enc e. 17 eligible for any bene fits."). 6 Here, the ALJ’s task was t o determi ne when, if ever , Newell’s liver diseas e, diabet es, and neuropathybecame disabl ing. Accordi ng to SSR 83-20, id. at *6 -7, [w ]ith sl owl y pr ogr es si ve i mpairme nt s, it is som et ime s impo ssible to obtai n medical evidence es tabli shing the preci se d ate an i mpairme ntbec ame disabl ing. De termin ing the prop er on set date is parti cularly diffi cult, when, for example, t

he all eged onsetand the date last worked are far in the past and adequate medi cal re cords ar e not avai lable
. In suc h cases, it wil l be necessary to infe r the onset date from the medic al and other evide nce that describe the hist ory and sy mptomatology of the disease process.

. . . In some cases, it maybe possibl e, based on th e me dical e viden ce to reaso nably infer t

hat the onset of

a di sa bl in g i mpairme nt (s ) o ccu rr ed s ome ti me prior to the da te of th e fir st rec ord ed m edic al ex am inati on . . . . How long the disease may be det ermined t o have existed at a di sabli ng level of seve rity depen ds on an inform e d judgment of t he facts in the parti cular case. This jud gment, ho wev er , m us t h av e ale gi ti mate me di ca l b as is . A t the hearing, the administ rati ve law judge (ALJ) s hould cal l on the s ervice s of a me dica l adv isor w hen ons et m ust b e inf erre d.

. . . If reasonabl e infer ences about the progressionof the i mpairment cannot be made on the basi s of the evi dence in fi le and addi tionalrelevant medical evidence i s notavail able, it maybe necessary t o explore ot her sourc es of documentati on. Information may be obtained from family members, friends, and former employ ers t o ascert ain why medi cal evi dence is not availa ble for the pe rti nent peri od and to furni sh additiona l evidence regardi ng the cours e of the i ndividual 's c onditi on. Ne we ll is correc t that the A LJ in this cas e failed to follo w th is form ula
. The ALJ7 In Walton , we held that the ALJ must call upon t he servi ces of a medica l advis or in a situation where the al leged i mpairment was a sl owly pr ogressi ng one, the all eged onset date w as far in the pa st, and adequ ate med ical records for the most releva nt period w ere not ava ilabl e. See id. at 70 9. 18 should have cons ulted a medical advi sor to he lp him i nfer the onset date as requi red by SSR 83-20 and our decis ion in Walton v. Halter , 243 F.3d 703 (3d Cir. 2001 ). 7 See DeLorme v. Sulli van , 924 F.2d 841, 848 (9th Cir . 1991) ( "In the event that the medical evidence i s not defi nite c oncerning t he onset date and medical infere nces need t o be made, SSR 83-20 requi res the administ rati ve law judge t o call upon the services of a med ical ad visor. . . ."); Spe llman v. Sh alala , 1 F.3d 357, 363 (5th Cir. 1993) ("[B]ecause Spellman' s mental i mpairment was of a s lowly progress ive nature, and t he medical evide nce w as am bigu ous w ith rega rd to the disab ility onset da te, the A ppea ls Co uncil could not ha ve inferred an onset date base d on an informed j udgment of the fa cts wit hout consulting a medical advisor." ) ; Baileyv. Chater , 68 F.3d 75, 79 (4th Cir . 1995) ( “[T]he date on which the sy nergy [of the cl aimant’ s numerous ai lments] reached di sabli ng severi ty remains an e nigma. I n the absenc e of clear evidence documenting the progress ion of Bail ey’ s condition, t he ALJ did not have the discretion to forgo consultation w ith a medica l advisor.”).

II I. CONCLUS ION A distri ct court , aft er revi ewing the deci sion of the Commissioner mayunder 4219

U.S .C. § 4 05(g ) affirm , mod ify, or reve rse the Co mm issione r's decisio n w ith or w ithout a
rem and to th e C om mis sion er fo r a re hea ring
. See Pod edw orny v. H arris , 745 F.2d 210, 221 (3d Cir. 1984). A court of appeals also r etai ns thi s discretion and, in reversi ng or modifyi ng the Commissione r' s decis ion, maychoose to di rect a remand of the ca se to t he Com missioner fo r a further hea ring or simply direct the district court to orde r the awa rd of b ene fits. Id. But a court of appeals should make thedecisi on to direct the dist rict court t o order the award of benefit s onlywhen the adminis trative rec ord of the c ase has been developed ful ly and when substantial e vidence on the record a s a whole indi cates that t he c laim ant is disa bled and entit led to ben efits
. Id. at 221-22. As N ew ell note s, this case has not

been developed ful ly as the ALJ denie d her claim at step two of the sequ ential ev aluatio n on erron eous base s. He failed prop erly to revie w th e evid ence in the rec ord dated pos t August 31, 1997, and he i mproperly used Newell’s lack of t reatment dur ing hercove rag e periodas abas is fordis cre dit ing hercre dib il ity. Fin al ly , the ALJ failed to com ply with S SR 83-2 0, and he fa iled to c onsu lt with a med ical ad visor to determ ine the onse t date o f N ew ell’s alleg ed dis ability. It is theref ore n ecess ary to
rev erse the d istrict cou rt’s o rde r aff irmi ng t he C om mis sion er’s d enia l of b ene fits. For the for egoing rea sons we will reverse t he order of December 3, 2002, and will remand the case to the dis tri ct court to remand i t in t

urn to t he Commissioner for further proceedi ngs in accordance with this opi nion.20 /s/ Morton I. Greenberg Circuit Judge