Opinion ID: 3012754
Heading Depth: 3
Heading Rank: 2

Heading: The ALJ Failed To Apply SSR 83-20

Text: SSR 83-20, 1983 SSR LEXIS 25, provides ALJs with an analytical framework for determining a disability onset date. SSR 83-20 defines the “onset date of disability” as “the first day an individual is disabled as defined in the Act 13 and the regulations.” Id. at . In cases in which the onset date is critical to a determination of entitlement to benefits, an ALJ must grapple with and adjudicate the question of onset, however difficult. See id. (“In addition to determining that an individual is disabled, the decisionmaker must also establish the onset date of disability. In many claims, the onset date is critical; it may . . . even be determinative of whether the individual is entitled to or eligible for any benefits.”).6 Here, the ALJ’s task was to determine when, if ever, Newell’s liver disease, diabetes, and neuropathy became disabling. According to SSR 83-20, id. at -7, [w]ith slowly progressive impairments, it is sometimes impossible to obtain medical evidence establishing the precise date an impairment became disabling. Determining the proper onset date is particularly difficult, when, for example, the alleged onset and the date last worked are far in the past and adequate medical records are not available. In such cases, it will be necessary to infer the onset date from the medical and other evidence that describe the history and symptomatology of the disease process. . . . In some cases, it may be possible, based on the medical evidence to reasonably infer that the onset of a disabling impairment(s) occurred some time prior to the date of the first recorded medical examination . . . . How long the disease may be determined to have existed at a disabling level of severity depends on an informed judgment of the facts in the particular case. This judgment, however, must have a legitimate medical basis. At the hearing, the administrative law judge (ALJ) should call on the services of a medical advisor when onset must be inferred. . . . 6. Under SSR 83-20, 1983 SSR LEXIS 25, at , an ALJ should consider three factors in determining an onset date: (1) the claimant’s allegations; (2) the claimant’s work history; and (3) medical and other evidence. 14 If reasonable inferences about the progression of the impairment cannot be made on the basis of the evidence in file and additional relevant medical evidence is not available, it may be necessary to explore other sources of documentation. Information may be obtained from family members, friends, and former employers to ascertain why medical evidence is not available for the pertinent period and to furnish additional evidence regarding the course of the individual’s condition. Newell is correct that the ALJ in this case failed to follow this formula. The ALJ should have consulted a medical advisor to help him infer the onset date as required by SSR 83-20 and our decision in Walton v. Halter, 243 F.3d 703 (3d Cir. 2001).7 See DeLorme v. Sullivan, 924 F.2d 841, 848 (9th Cir. 1991) (“In the event that the medical evidence is not definite concerning the onset date and medical inferences need to be made, SSR 83-20 requires the administrative law judge to call upon the services of a medical advisor. . . .”); Spellman v. Shalala, 1 F.3d 357, 363 (5th Cir. 1993) (“[B]ecause Spellman’s mental impairment was of a slowly progressive nature, and the medical evidence was ambiguous with regard to the disability onset date, the Appeals Council could not have inferred an onset date based on an informed judgment of the facts without consulting a medical advisor.”); Bailey v. Chater, 68 F.3d 75, 79 (4th Cir. 1995) (“[T]he date on which the synergy [of the claimant’s numerous ailments] reached disabling severity remains an enigma. In the absence of clear evidence documenting the progression of Bailey’s condition, the ALJ did not have the discretion to forgo consultation with a medical advisor.”). 7. In Walton, we held that the ALJ must call upon the services of a medical advisor in a situation where the alleged impairment was a slowly progressing one, the alleged onset date was far in the past, and adequate medical records for the most relevant period were not available. See id. at 709. 15