Wednesday, October 26, 2005

disability - med. equivalency - evidence

Oakes v. Barnhart - ED Pa. - October 18, 2005

The court rejected the magistrate's recommendation that summary judgment be granted to plaintiff (P) and, rather, granted s/j to defendant (D).

The magistrate believed that the ALJ's equivalency decision was not supported by substantial evidence, because the ALJ failed to secure the testimony of a medical expert before determining that plaintiff's impairment did not equal a listing. The magistrate recommended that the case be remanded for the taking of medical evidence about whether the combination of P's impairments equaled a listed impairment.

The court rejected this reasoning and agreed with SSA that under its "testing modifications" policy set out at 20 CFR 404.906(b)(2), it had "fundamentally altered" its former long-standing policy by allowing an ALJ to use medical expert testimony when "appropriate," rather than requiring the opinion of a medical consultant to determine if a claimant met or equaled a listed impairment. This testing modification policy applies to cases decided in Pennsylvania and nine other states.

The court held that 20 CFR 404.906(b)(1) and (2) established a "single decisionmaker model" and that the ALJ is not required to seek a medical opinion of the issue of equivalence, although s/he may do so where "appropriate," thus going from a "mandatory to discretionary use of medical experts on the issue of equivalency."

The Court upheld the ALJ decision on (non)equivalency and granted s/j to defendant.

Donald Marritz
MidPenn Legal Services