Opinion ID: 555131
Heading Depth: 1
Heading Rank: 4

Heading: delorme's depression

Text: 17 DeLorme also contends that he should have been found disabled under the criteria in the Listing of Impairments on the basis of his depression. 14 The psychologist's report on DeLorme from 1986 appears to show that these criteria have been met, although the findings regarding daily life and social interaction are not specific. Of the symptoms in the first group, the psychologist reported appetite disturbance, sleep disturbance, and suicidal preoccupation. The psychiatrist also described feelings of hopelessness and depression, and he cannot relate to others other than as an invalid who has lost his ability to be a productive citizen. This description would seem to indicate that, as of 1986, DeLorme experienced feelings of guilt and worthlessness, which would meet the first set of criteria in the Listing of Impairments. Finally, the psychiatrist described DeLorme as suffering from a long term functional nonpsychotic disorder and found that he was unable to work or to function effectively in interpersonal relationships. 18 Based on the findings in the 1986 psychiatrist's report, DeLorme would have met the criteria set forth in the Listing of Impairments, depending on the duration of his mental problems. In Villa v. Heckler, 797 F.2d 794, 797 (9th Cir.1986), similar though more detailed findings (including inability to relate effectively with other people in a work setting because of depression) were the basis of a determination of disability. The brief notes made by physicians treating him for his back problems, however, do not establish how extensive or how continuous his mental symptoms were during the years of his insured status. The ALJ's review summarizing the psychiatric evaluation noted three characteristics of depressive syndrome but failed to note evidence of feelings of guilt or worthlessness. 15 19 Two Social Security Rulings require that relevant psychiatric records be obtained before inferences are made regarding the extent of DeLorme's depression during these years. If the profound and suicidal depression documented in 1986 had an onset date more than 12 months before his insured status expired, DeLorme might have established disability. Social Security Ruling [SSR] 83-20 sets forth guidelines for determining the date of onset of a disability and requires that all relevant medical records be obtained for determining onset date. 16 20 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 and to obtain all evidence which is available to make the determination. If medical evidence is not available, then lay evidence may be obtained. 21 With regard to previously hospitalized mental patients, SSR 83-20 states: 22 The medical history in a hospital report ... may describe an onset of pronounced mental symptoms at some time prior to admission to the hospital. The history may present significant information about the individual's condition prior to admission. Depending on the nature of events leading to institutionalization, onset of disability may sometimes be found at a time considerably in advance of admission. It is not unusual for the history to show that prior to hospitalization the person manifested personality changes such as refusing to go out of the house, refusing to eat, accusing others of being against him or her, threatening family and neighbors, etc. In such a case, a beginning date prior to hospitalization would be reasonable unless contradicted by the work history or other evidence. 23 SSR 83-20, reprinted in 2 Social Security Claims: Practice and Procedure Section 21.92 (Callaghan 1988). The requirements of SSR 83-20 are further reinforced by the guidelines for determining residual functional capacity given in SSR 83-15, Evaluation of Chronic Mental Impairments, which make it mandatory for the administrative law judge to gather all records of past treatment. 17 24 These requirements are of particular importance to DeLorme's claim. Since the Secretary has waived administrative res judicata, the entire period from DeLorme's first application for benefits can be considered. Depression was repeatedly noted in DeLorme's medical records, and Elavil was repeatedly listed among his medications. The records of the doctors who treated his back injury show the likely existence of records from the psychiatrists who attended him during his hospitalization for mental problems and his subsequent psychotherapy. 25 There are two different ways in which these rulings may be relevant to DeLorme. First, he may be able to show that he was depressed for twelve continuous months in the early 1980s, depending on the severity of his depression during this period. Dr. Vinson noted depression in September 1980. DeLorme's hospitalization in November to December 1980 contains no reference to depression; however, he was again hospitalized in February 1981 for depression with dissociative state. The records of his psychotherapy from February to November 1981 might demonstrate disabling depression during this period. If his February 1981 psychiatric records show an onset date at an earlier time, DeLorme may be able to prove that he met the criteria of the Listing of Impairments for mental impairment for twelve continuous months, thereby establishing his disability. It is also possible that the depression diagnosed in 1986 might be found to have an onset date at some other time prior to the expiration of insured status. Second, even if DeLorme's depression did not meet the criteria in the Listing of Impairments, an accurate assessment of his residual functional capacity during the period of his insured status is necessary to pose an adequate hypothetical for the vocational expert. 26 The ALJ has a duty to develop the record in Social Security cases. Brown v. Heckler, 713 F.2d 441, 443 (9th Cir.1983). This duty exists even when the claimant is represented by counsel. Id. Disability hearings are not adversarial in nature. Dixon v. Heckler, 811 F.2d 506, 510 (10th Cir.1987) (ALJ has basic duty to inform himself about facts relevant to his decision) (quoting Heckler v. Campbell, 461 U.S. 458, 471 n. 1, 103 S.Ct. 1952, 1959 n. 1, 76 L.Ed.2d 66 (1983) (Brennan, J., concurring)); see also Brown v. Heckler, 713 F.2d at 443. 27 In cases of mental impairments, this duty is especially important. Because mentally ill persons may not be capable of protecting themselves from possible loss of benefits by furnishing necessary evidence concerning onset, development should be undertaken in such cases to ascertain the onset date of the incapacitating impairment. SSR 83-20, supra. Since the Secretary has waived the res judicata effect of prior denials, on remand the administrative law judge should fully develop the record, paying particular attention to whether DeLorme suffered from low self-esteem and feelings of guilt and worthlessness during this period, and on the impact of his depression on his ability to work during the period of his insured status. 18