From
May 2002 Update
Summary of Arguments
I. Case Update
II. Case Survey
§ 100 SEQUENTIAL
EVALUATION PROCESS
§ 101 DEFINITION OF DISABILITY
§ 101.1 Statutory Definition
§ 101.2 Purpose of the
Social Security Act
§ 101.3 Claimant’s
Burden to Prove Disability
§ 101.4 Evidence Considered
in Determining Disability
§ 101.5 Duration of
Impairments
§ 101.6 Childhood Disability
Insurance Benefits
§ 102 STEP 1:
SUBSTANTIAL GAINFUL ACTIVITY (SGA)
§ 102.1 Definition of SGA
§ 102.2 Part-time Work as
SGA
§ 102.3 Illegal Activity as
SGA
§ 102.4 Work Activity Which
is an Unsuccessful Work Attempt
§ 102.5 Return to Work as
Part of “Trial Work Period”
§ 102.6 Work Performed Under
Special Conditions
§ 103 STEP 2: SEVERE
IMPAIRMENT
§ 103.1 Definition of
Severity
§ 103.2 Severity: Need to
Consider Combined Effect of Impairments
§ 103.3 Severity: Need to
Consider Subjective Symptoms
§ 103.4 Severity: ALJ’s
Duty to List all Severe Impairments
§ 104 STEP 3: LISTED
IMPAIRMENT
§ 104.1 Effect of Impairment
Meeting or Equaling a Listing
§ 104.2 Meeting a Listing -
General
§ 104.3 Use of Medical
Expert Opinions in Evaluating Whether Listing is Met
§ 104.4 Medical Equivalence
to a Listing - General
§ 104.5 Medical Equivalence
to a Listing: ALJ’s Responsibility to Obtain Medical Expert Opinion
§ 104.6 Medical Equivalence
to a Listing: Need to Consider Combined Effect of Impairments
§ 104.7 ALJ’s Duty to
Discuss Whether Impairment(s) Meets/Equals a Listing
§ 105
RESIDUAL FUNCTIONAL CAPACITY (RFC)
§ 105.1 Definition of RFC
§ 105.2 Definition of
Sedentary Work
§ 105.3 Definition of Light
Work
§ 105.4 Definition of Medium
Work
§ 105.5 Sit/Stand Option and
its Impact on RFC
§ 105.6 RFC Forms
§ 105.7 RFC: Need to
Consider All Impairments
§ 105.8 RFC: Need to
Consider Effect of Mental Impairments
§ 105.9 Stress and its
Effect on the Ability to Work
§ 105.10 Lack of an Updated
or Any RFC Assessment in the Record
§ 105.11 RFC: Need to
Consider Non-Medical Evidence
§ 105.12 RFC: Must be
Supported by the Record
§ 105.13 Absenteeism and its
Effect on Ability to work
§ 106
STEP 4: PAST RELEVANT WORK
§ 106.1 Claimant’s
Burden to Establish Inability to Perform Past Relevant Work
§ 106.2 Past Relevant Work -
General
§ 106.3 ALJ’s Duty to
Make Findings Regarding Physical and Mental Demands of Past Relevant Work
§ 106.4 Past Relevant Work:
Work Performed for Short Periods of Time
§ 106.5 Past Relevant Work:
Job Training and Other Work Performed under Special Conditions
§ 106.6 Past Relevant Work:
Work Performed More than Fifteen Years Prior to the Date of Adjudication
§ 106.7 Past Relevant
Work: Work no Longer Available
§ 106.8 No Need for
Vocational Expert at Step Four
§ 106.9 Need for Past
Relevant Work to be SGA
§ 107
STEP 5: OTHER WORK
§ 107.1 Commissioner’s
Burden to Establish Other Work
§ 107.2 Other Work: Need to
Consider Combined Effect of Impairments
§ 107.3 Use of
Medical-Vocational Guidelines, or “Grids”
§ 107.4 Effect of Borderline
Age on the Application of the Grids
§ 107.5 Evaluation of
Illiteracy
§ 107.6 Evaluation of
Education
§ 107.7 Effect of the
Inability to Speak English on the Application of the Grids
§ 107.8 Skill Levels of Jobs
§ 107.9 Transferability of
Skills
§ 107.10 Application of the
Grids to Younger Claimants
§ 107.11 Effect of
Borderline Mental Capacity on the Application of the Grids
§ 107.12 Nonexertional
Impairments and their Impact on the Application of Grids
§ 107.13 Inability to
Perform the Full Range of Work and its Impact on the Application of the Grids
§ 107.14 Manipulative
Limitations and their Effect on the Ability to Perform the Full Range of Sedentary Work
§ 107.15 Inability to Stoop
and its Effect on the Ability to Perform the Full Range of Sedentary Work
§ 107.16 Need for Vocational
Expert Testimony - Presence of Nonexertional Impairments
§ 107.17 Need for Vocational
Expert Testimony - Inability to Perform the Full Range of Work
§ 107.18 Effect of the ADA
on the Ability to Perform Other Work
§ 107.19 Significant Number
of Jobs in the National Economy
§ 107.20 Need to be Able to
Engage in Full-Time Work Activities
§ 107.21 Claimants Over Age
55 - Special Issues
§ 107.22 Application of the
“Worn Out Worker” Regulation
§ 200 ASSESSMENT OF
DISABILITY ISSUES
§ 201
MEDICAL IMPROVEMENT ISSUES
§ 201.1 Medical Improvement
Standard
§ 201.2 Medical Improvement:
Required in Closed Period of Disability Cases
§ 201.3 Medical Improvement:
Effect of Participation in a Vocational Rehabilitation Program
§ 201.4 Failure to Seek
Medical Treatment and its Impact on Medical Improvement
§ 201.5 Basis to Find
Medical Improvement
§ 202
WEIGHT OF TREATING PHYSICIAN’S OPINION
§ 202.1 Regulatory Standard
Regarding Weight of Treating Physician’s Opinion
§ 202.2 Treating Physician
Rule by Circuits
§ 202.3 Factors Affecting
Weight of Treating Physician’s Opinion
§ 202.4 Treating
Physician’s Opinion Regarding Ultimate Issue of Disability
§ 202.5 Retrospective
Opinion from Treating Physician
§ 202.6 ALJ’s Duty to
Develop Evidence from Treating Physician
§ 202.7 ALJ’s Duties
Regarding Consideration of Evidence from Treating Physician
§ 202.8 Need for ALJ to
Provide Good Cause for Rejecting Treating Physician’s Opinion
§ 202.9 Basis to Reject
Treating Physician’s Opinion
§ 202.10 Treating Therapist
is an Acceptable Medical Source
§ 203
WEIGHT OF THE EVIDENCE
§ 203.1 The ALJ’s Duty
to Weigh All the Evidence
§ 203.2 Weight of
Uncontroverted Medical Evidence
§ 203.3 Evaluating the
Weight of Any Medical Opinion
§ 203.4 Weight of Treating
Physician v. Consulting Physician
§ 203.5 Weight of Treating
Physician v. Non-Examining Physician
§ 203.6 Weight of the
Non-Examining Reviewing Consultant
§ 203.7 Weight of Examining
Physician v. Non-Examining Physician
§ 203.8 Weight of Specialist
v. Non-specialist
§ 203.9 Retrospective
Diagnosis by Physicians
§ 203.10 Weight of Recent
Medical Evidence
§ 203.11 Rejection of
Medical Opinion Which is Based on Symptomology
§ 203.12 Rejection of
Physician’s Opinion Secured by an Attorney
§ 203.13 Weight of an
Unsigned Medical Report from Consulting Physician
§ 203.14 Weight of
Evidence from a Chiropractor
§ 203.15 Weight of Evidence
from a Nurse Practitioner
§ 203.16 ALJ Cannot
Substitute His or Her Opinion for Medical Expert’s Opinion
§ 203.17 Weight of Testimony
of Lay Witnesses
§ 203.18 Weight of Evidence
from a Podiatrist
§ 204
CREDIBILITY
§ 204.1 Need for Credibility
Findings
§ 204.2 ALJ’s
Credibility Findings Entitled to Deference
§ 204.3 Factors to Consider
in Making Credibility Determinations
§ 204.4 Discrediting
Testimony Based on Inconsistencies in the Record
§ 204.5 Discrediting
Testimony Based on the Motives of Witnesses
§ 204.6 Lack of Medical
Treatment and Credibility
§ 204.7 Work History and
Credibility
§ 204.8 Daily Activities and
Impact on Credibility
§ 204.9 Medical Regimen and
Impact on Credibility
§ 204.10 Lack of Objective
Medical Evidence and Credibility
§ 204.11 Credibility and
Medical Opinion that Claimant is Exaggerating
§ 205
EVALUATION OF COMPLAINTS OF PAIN AND OTHER SUBJECTIVE
SYMPTOMS
§ 205.1 Statutory and
Regulatory Pain Standard
§ 205.2 Pain Standard by
Circuits
§ 205.3 Application of the
Pain Standard to Other Subjective Symptoms
§ 205.4 Pain Testimony
Supported by Medical Evidence must be Afforded Great Weight
§ 205.5 Rejecting Subjective
Complaints Based on the Lack of Objective Evidence
§ 205.6 Rejecting Subjective
Complaints Based on Inconsistencies in the Record
§ 205.7 Rejecting Subjective
Complaints Based on the Failure to Seek Medical Treatment
§ 205.8 Rejecting Pain
Complaints Based on the Failure to Take Prescription Medication
§ 205.9 Rejecting Pain
Complaints Based on Daily Activities
§ 205.10 Need to Provide
Specific Reasons for Rejecting Pain Testimony
§ 205.11 Need to Consider
Episodic Nature of Subjective Symptoms
§ 205.12 Need to Consider
Side Effects of Medication in Evaluating Pain Testimony
§ 205.13 Effect of Failing
to Provide Sufficient Reasons for Rejecting Pain Testimony
§ 205.14 Pain and Medical
Opinion that Claimant is Exaggerating
§ 205.15 Need to Consider
Non-Medical Evidence in Evaluating Pain
§ 205.16 Sit and Squirm
Jurisprudence
§ 205.17 Need to Consider
Psychological Basis for Pain Complaints
§ 206
COMBINATION OF IMPAIRMENTS
§ 206.1 Need to Consider the
Combination of Impairments
§ 206.2 Effect of Failing to
Consider One Impairment
§ 207
EFFECT OF OPINIONS OF OTHER AGENCIES ON DISABILITY DETERMINATIONS
§ 207.1 Effect of Disability
Determinations of Other Agencies
§ 207.2 Effect of Receipt of
Unemployment Compensation
§ 208
FAILURE TO FOLLOW PRESCRIBED TREATMENT
§ 208.1 Failure to Follow
Prescribed Treatment as a Basis for Denial of Benefits
§ 208.2 Refusal to Follow
Prescribed Treatment Must Be Willful
§ 208.3 Following Treatment
Must Restore Claimant’s Ability to Work
§ 208.4 ALJ’s Duty to
Investigate Reasons for Claimant’s Alleged Noncompliance with Treatment
§ 208.5 Inability to Afford
Prescribed Treatment
§ 209
ONSET DATE
§ 209.1 Establishing Onset
§ 209.2 Retrospective
Opinion of Onset
§ 209.3 Need for a
Medical Advisor if Onset Date is Unclear
§ 209.4 Need to Consider
Other Evidence of Onset
§ 210
VOCATIONAL EXPERT (“VE”) TESTIMONY
§ 210.1 Purpose of VE
Testimony
§ 210.2 Weight of
Examining VE Evidence
§ 210.3 ALJ Must Pose a
Complete Hypothetical Question to the VE
§ 210.4 Hypothetical
Question Must Be Supported by the Record
§ 210.5 Effect of Incomplete
Hypothetical Question
§ 210.6 Effect of Complete
Hypothetical Question
§ 210.7 Need to Raise Issue
of Incomplete Hypothetical Question to ALJ
§ 210.8 Mental Health
Limitations and Their Impact on VE Testimony
§ 210.9 Need for VE to
Testify Regarding Claimant’s Ability to Engage in Full-time Work
§ 210.10 Specific Vocational
Preparation (“SVP”) as Set Forth in the DOT
§ 210.11 Language Skills
Required to Perform Jobs as Set Forth in the DOT
§ 210.12 VE Testimony Which
Conflicts with the DOT
§ 210.13 VE Testimony Which
Relies on the ADA
§ 210.14 Effect of
ALJ’s Mischaracterization of VE Testimony
§ 211
MEDICAL EXPERT TESTIMONY
§ 211.1 Need to
Consider Medical Expert Testimony
§ 211.2 Use of Medical
Expert Who Had Prior Connection with Claim
§ 211.3 Weight of Medical
Expert’s Testimony
§ 212
CHILDREN’S SSI CLAIMS
§ 212.1 1996 Changes to
Children’s SSI Disability Statute: Overview
§ 212.2 Effect of Changes to
Children’s SSI Disability Statute on Applicants and Recipients
§ 212.3 Step 1: Substantial
Gainful Activity by Children
§ 212.4 Step 2: Severity of
Childhood Listing
§ 212.5 Step 3: Meeting a
Childhood Listing
§ 212.6 Step 3: Medical
Equivalency to a Childhood Listing
§ 212.7 Step 3: Functional
Equivalency to a Childhood Listing
§ 212.8 SSI Children’s
Claims: Marked Limitations in Two Domains
§ 212.9 SSI Children’s
Claims: Cases Decided Under Old Law
§ 212.10 SSI Children’s
Claims: Testimony of Parents
§ 212.11 SSI Children’s
Claims: School Records
§ 212.12 SSI Children’s
Claims: Evaluation of Adolescents
§ 300 SPECIFIC
IMPAIRMENTS ISSUES
§ 301
ALCOHOLISM AND DRUG ADDICTION
§ 301.1 Alcoholism and Drug
Addiction: Effective Date of 1996 Legislation
§ 301.2 New Law: Alcoholism
or Drug Addiction as a Material Contributing Factor
§ 301.3 Establishing
Disability Based on Alcoholism under the Old Law
§ 301.4 Establishing
Disability Based on Drug Addiction under the Old Law
§ 302
CARDIOVASCULAR IMPAIRMENTS
§ 302.1 Evaluation of
Hypertension
§ 303
CHEMICAL SENSITIVITY IMPAIRMENTS
§ 304
CHRONIC FATIGUE SYNDROME (CFS)
§ 304.1 CFS Is a Medical
Determinable Impairment
§ 304.2 Evaluation of CFS
§ 304.3 CFS: Objective
Findings Not Necessary
§ 304.4 Need to Consider
Agency Policy in Evaluating CFS
§ 305
DIGESTIVE SYSTEM IMPAIRMENTS
§ 305.1 Evaluation of
Crohn’s Disease
§ 305.2 Evaluation of Other
Digestive System Impairments
§ 306
ENDOCRINE IMPAIRMENTS (EXCEPT OBESITY)
§ 307
FIBROMYALGIA
§ 307.1 Fibromyalgia
is a Medically Determinable Impairment
§ 307.2 Fibromyalgia:
Credibility of Complaints of Pain
§ 308
GENITO-URINARY SYSTEM IMPAIRMENTS
§ 308.1 Evaluation of
Urinary and Bowel Problems
§ 309
GROWTH IMPAIRMENTS (CHILDHOOD LISTINGS)
§ 310
HEMIC AND LYMPHATIC SYSTEM IMPAIRMENTS
§ 311
IMMUNE SYSTEM IMPAIRMENTS
§ 311.1 Evaluation of
AIDS/HIV Infection
§ 311.2 Evaluation of Lupus
§ 311.3 Evaluation
Connective Tissue Disorders
§ 311.4 Evaluation of
Hodgkin’s Disease
§ 312 MENTAL IMPAIRMENTS
§ 312.1 Claimant’s
Burden to Establish Existence of Mental Impairment
§ 312.2 Duty to Develop
Record Regarding Mental Impairments
§ 312.3 Severity of Mental
Impairments - General
§ 312.4 Limitations
Contained on Mental RFC Forms
§ 312.5 Required Completion
of the Psychiatric Review Technique Form (“PRTF”)
§ 312.6 Evaluation of
Organic Mental Disorders
§ 312.7 Evaluation of
Psychotic Illnesses
§ 312.8 Evaluation of
Affective Disorders
§ 312.9 Evaluation of Mental
Retardation
§ 312.10 Evaluation of
Anxiety
§ 312.11 Evaluation of
Attention Deficit Hyperactivity Deficit (“ADHD”) Disorder
§ 312.12 Validity of IQ
Scores
§ 312.13 Evaluation of
Mental Retardation in Children
§ 312.14 Evaluation of
Somatoform Disorders
§ 312.15 Evaluation of
Personality Disorders
§ 313
MUSCULOSKELETAL IMPAIRMENTS
§ 313.1 Evaluation of
Arthritis
§ 313.2 Evaluation of Back
Impairments under Listing 1.05
§ 313.3 Evaluation of
Amputations
§ 313.4 Evaluation of Other
Musculoskeletal Impairments
§ 314
MULTIPLE BODY SYSTEMS (CHILDHOOD LISTINGS)
§ 315
NEOPLASTIC DISEASES
§ 316
NEUROLOGICAL IMPAIRMENTS
§ 316.1 Evaluation of
Epilepsy
§ 316.2 Evaluation of
Parkinson’s Disease
§ 316.3 Evaluation of
Multiple Sclerosis
§ 316.4 Evaluation of
Headaches
§ 316.5 Evaluation of Post
Polio Impairments
§ 316.6 Evaluation of
Strokes
§ 317
OBESITY LISTING
§ 317.1 Obesity Listing:
Weight Requirements
§ 317.2 Obesity Listing:
Accompanying Impairment Requirements
§ 318
RESPIRATORY IMPAIRMENTS
§ 318.1 Evaluation of Asthma
§ 318.2 Evaluation of Other
Respiratory Impairments
§ 319
SKIN IMPAIRMENTS
§ 320
SPECIAL SENSES AND SPEECH IMPAIRMENTS
§ 320.1 Visual Impairments
§ 320.2 Speech Impairments
§ 400 NON-DISABILITY
ISSUES
§ 401
SOCIAL SECURITY INSURANCE BENEFITS: ELIGIBILITY ISSUES
§ 401.1 Quarters of Coverage
- Generally
§ 401.2 Quarters of Coverage
- Self-Employed Workers
§ 401.3 Amending Earnings
Records
§ 401.4 Family Maximum
§ 401.5 Benefit Amounts
§ 401.6 Earnings Limits
§ 402
REDUCTION/SUSPENSION OF SOCIAL SECURITY INSURANCE BENEFITS
§ 402.1 Workers’
Compensation Offsets
§ 402.2 Reductions in
Benefits due to Receipt of Federal, State or Local Pension
§ 402.3 Nonpayment of
Benefits to Persons in Prisons
§ 402.4 Nonpayment of
Benefits to Persons in Prisons: Vocational Rehabilitation Exception
§ 402.5 Social Security:
Anti-Assignment Clause
§ 403
RETIREMENT BENEFITS
§ 403.1 Burden to Establish
Retirement
§ 403.2 Fictitious Family
Salary Arrangements
§ 404
BENEFITS FOR SPOUSES
§ 404.1 Spouse Relationship
- Generally
§ 404.2 Spouse Relationship
- State Law
§ 404.3 Deemed Valid
Marriage
§ 404.4 Divorced Spouses
§ 405
BENEFITS FOR CHILDREN
§ 405.1 Child Relationship -
Generally
§ 405.2 Child Relationship -
Dependency Requirement
§ 405.3 Child Relationship -
State Inheritance Laws
§ 405.4 Child Relationship -
Acknowledgment in Writing
§ 405.5 Child Relationship -
Court Order of Paternity
§ 405.6 Child Relationship -
Evidence of Paternity and Living with or Supporting Child
§ 405.7 Benefits for Adopted
Children
§ 405.8 Benefits for
Stepchildren
§ 405.9 Benefits for
Grandchildren and Stepgrandchildren
§ 406
BENEFITS FOR PARENTS
§ 407
SSI ELIGIBILITY RULES
§ 407.1 Purpose of SSI
Program
§ 407.2 Conditions of
Eligibility - Generally
§ 407.3 Citizenship/Legal
Residency Rules
§ 407.4 Age Requirement
§ 408
SSI INCOME RULES
§ 408.1 Definition of Income
§ 408.2 In-Kind Support and
Maintenance - Generally
§ 408.3 In-Kind Support and
Maintenance - Rental Subsidies
§ 408.4 Deeming of Income
§ 408.5 SSI Benefit Amounts
§ 408.6 SSI: Windfall Offset
Provisions
§ 408.7 SSI: Anti-Assignment
Clause
§ 408.8 Non-Payment of SSI
Benefits to Persons in Institutions
§ 409
SSI RESOURCE RULES
§ 409.1 Definition of
Resource
§ 409.2 Resource Exclusions
- Generally
§ 409.3 Resource Exclusions
- Trusts
§ 409.4 Resource Exclusions
- Conservatory Accounts
§ 409.5 Resource Exclusions
- Life Insurance
§ 410
OVERPAYMENTS
§ 410.1 Liability for
Overpayments - Generally
§ 410.2 Liability for
Overpayments - Representative Payees
§ 410.3 Waiver of
Overpayments - Generally
§ 410.4 Waiver of
Overpayments - Burden of Proof
§ 410.5 Waiver of
Overpayments - Fault
§ 410.6 Waiver of
Overpayments - Defeat the Purpose of the Act
§ 410.7 Waiver of
Overpayments - Against Equity and Good Conscience
§ 410.8 Waiver of
Overpayments - Credibility Determinations
§ 411
REPRESENTATIVE PAYEES
§ 411.1 Representative
Payees - Generally
§ 411.2 Order of Preference
in Selecting Payees
§ 411.3 Duties of the
Representative Payee
§ 500 Administrative
Review Issues
§ 501
FILING OF APPLICATION AND APPEALS
§ 501.1 Need to File
Application for Benefits
§ 501.2 Timing of
Application
§ 501.3 Period of Time
Effected by Application
§ 501.4 Duty to Advise
Claimant of Need to File Application
§ 501.5 Timely Filing of
Administrative Appeals
§ 502
RIGHT TO COUNSEL
§ 502.1 Claimant’s
Statutory Right to Counsel
§ 502.2 Waiver of Right to
Counsel
§ 502.3 Need to Show
Prejudice by Lack of Representation
§ 503
HEARING PROCEDURES
§ 503.1 Pre-hearing
Procedures
§ 503.2 Right to Appear at a
Hearing
§ 503.3 Notification of
Issues at Hearing
§ 503.4 Nonadversarial
Nature of Hearing
§ 503.5 Right to Subpoena -
General
§ 503.6 Right to Subpoena
and Cross-examine Those Who Submit Pre- hearing Reports
§ 503.7 Waiver of Right to
Subpoena and Cross-examine Those Who Submit Pre-hearing Reports
§ 503.8 Consideration
of Non-record Evidence
§ 503.9 Notice of Hearing
Decision
§ 503.10 ALJ’s Duty to
Follow Remand Orders
§ 504
ALJ’S DUTY TO DEVELOP THE RECORD
§ 504.1 ALJ’s Duty to
Develop Record - General
§ 504.2 Heightened Duty When
Claimant Not Represented by Counsel
§ 504.3 Heightened Duty When
Claimant Has Mental Impairments
§ 504.4 Duty to Obtain All
Pertinent, Available Medical Records
§ 504.5 Duty to Elicit
Testimony from Witnesses
§ 504.6 Duty to Order
Consultative Examination
§ 504.7 Duty to Consider the
Side Effects of Medications
§ 505
CLAIMANT’S RIGHT TO EXAMINE POST-HEARING EVIDENCE
§ 505.1 The ALJ Is Permitted
to Obtain Post-Hearing Evidence
§ 505.2 Right to
Cross-examine Those Who Submit Post-Hearing Evidence
§ 505.3 Waiver of the Right
to Subpoena and Cross-Examine Those Who Submit Post-Hearing Reports
§ 506
RES JUDICATA AND COLLATERAL ESTOPPEL
§ 506.1 Res Judicata
§ 506.2 Doctrine of
Collateral Estoppel
§ 507
REOPENINGS
§ 507.1 Regulatory Basis to
Reopen Prior Claims
§ 507.2 Good Cause for
Reopening Prior Claims
§ 507.3 Faulty SSA Notices
Warrant Reopening at Any Time
§ 508
ALJ BIAS
§ 508.1 ALJ Must Afford
Claimant a Full and Fair Hearing
§ 508.2 Need to Present Bias
Claim Administratively
§ 508.3 If Bias Found, Case
Should Be Heard by Different ALJ on Remand
§ 509
APPEALS COUNCIL REVIEW
§ 509.1 Timeliness of
Requesting Appeals Council Review
§ 509.2 Scope of Appeals
Council Review
§ 509.3 New Evidence
Submitted to the Appeals Council
§ 509.4 Basis to Deny
Appeals Council Review
§ 600 FEDERAL COURT
ISSUES
§ 601
WAIVER OF RIGHT TO RAISE ISSUES
§ 601.1 Waiver: Failure to
Raise Issues Administratively
§ 601.2 Waiver: Failure to
Properly Raise Issues in Federal Court
§ 602 JUDICIAL REVIEW OF DENIAL OF REOPENING REQUEST
§ 602.1 Denials of Requests
for Reopening Generally Not Subject to Judicial Review
§ 602.2 Exception to
Reopening Rule: Claimant Raises a Constitutional Challenge
§ 602.3 Exception to
Reopening Rule: ALJ Reconsiders the Evidence of the Prior Claim
§ 603
OTHER PROCEDURAL ISSUES
§ 603.1 Judicial Review of
Dismissal of Claim by SSA
§ 603.2 Need to Exhaust
Administrative Remedies
§ 603.3 Record on Appeal
§ 603.4 Law of the Case
Doctrine
§ 603.5 Post Hoc
Justification of Administrative Decision
§ 603.6 Benefits Pending
Review
§ 603.7 The Circuit Law to
Apply When the Claimant Moves
§ 603.8 Writs of Mandamus
Against SSA
§ 603.9 Relationship Between
Concurrent ADA and Social Security Claim
§ 604
FEDERAL COURT PRACTICE
§ 604.1 Timeliness of Filing
Complaint
§ 604.2 Filing Federal Court
Case In Forma Pauperis
§ 604.3 Appointment of
Counsel
§ 604.4 Federal Court
Memoranda Seeking Review of Commissioner’s Decision
§ 604.5 Oral Argument
§ 604.6 Filing Objections to
Magistrate Judge’s Report & Recommendations
§ 604.7 Time Frames for
Remand Proceedings
§ 604.8 Calculation of
Federal Court Deadlines
§ 604.9 Parties to the Case
§ 604.10 Timeliness of
Appeals
§ 604.11 Scope of Federal
Court Review of Newly Submitted Evidence to Appeals Council
§ 605
TYPES OF FEDERAL COURT REMANDS
§ 605.1 Fourth Sentence
Remands
§ 605.2 Sixth Sentence
Remands
§ 606
REMANDS DUE TO NEW EVIDENCE
§ 606.1 Statutory Standard
Set Forth in 42 U.S.C. § 405(g)
§ 606.2 Requirement That the
Evidence Be “New”
§ 606.3 Materiality
Requirement
§ 606.4 Good Cause
Requirement
§ 607
REVERSALS FOR PAYMENT OF BENEFITS
§ 607.1 Reversal Warranted
Where Entitlement is Clear from the Record
§ 607.2 Reversal Warranted
Because Claimant’s Impairment Meets a Listing
§ 607.3 Reversal Warranted
Because Commissioner Failed to Meet Burden of Proof
§ 607.4 Reversal Warranted
Due to the Failure to Apply Correct Legal Standards
§ 608
SOCIAL SECURITY CLASS ACTION CASES
§ 608.1 State Disability
Agencies Class Action Cases
§ 608.2 Other Disability
Class Action Cases
§ 608.3 Non-disability Class
Action Cases
§ 700 ATTORNEY’S
FEES
§701
Federal Court Fees Under § 406(b)
§ 701.1 Entitlement to Fees
Under 406(b) - Generally
§ 701.2 § 406(b) Fees:
Contingency Method of Determining Fee
§ 701.3 § 406 (b) Fees:
Lodestar Method of Determining Reasonable Fee
§ 701.4 § 406 (b) Fees:
Establishing Market Rates
§ 701.5 § 406 (b) Fees:
Documentation of Time
§ 701.6 § 406 (b) Fees:
Need to Explain Basis for Fee Award
§ 701.7 § 406 (b) Fees:
Relationship with EAJA Fees
§ 701.8 § 406 (b) Fees:
Timeliness of Fee Application
§ 701.9 Appellate Review of
§ 406(b) Fees
§ 702
Equal Access to Justice Act
§ 702.1 Purpose of the EAJA
§ 702.2 Duty to File for
EAJA Fees
§ 702.3 EAJA: Prevailing
Party Requirement
§ 702.4 EAJA: Substantial
Justification Standard
§ 702.5 EAJA: Amount of
Award — Hourly Rate
§ 702.6 EAJA: Amount of
Award — Results Obtained
§ 702.7 EAJA: Amount of
Award — Hours Claimed
§ 702.8 EAJA: Documentation
of Time
§ 702.9 EAJA: Fees for Law
Clerk/Paralegal Time
§ 702.10 EAJA: Costs
Recoverable
§ 702.11 EAJA: Fees for Fees
§ 702.12 EAJA: Relationship
with § 406(b) fees
§ 702.13 EAJA: Timeliness of
Fee Application
§ 702.14 Appellate Review of
EAJA Fees
§ 800 SOURCE OF LAW
ISSUES
§ 801
Legal Authority: Social Security Regulations
§ 802 Legal Authority: Social Security Rulings
§ 803 Legal Authority: POMS and HALLEX
§ 804 Legal Authority: Dictionary of Occupational
Titles (DOT)
III. Issue Topics
Sequential Evaluation Process
§ 1103
The Definition of a “Severe Impairment”
§ 1104.5 Medical Equivalence to a Listing: The
ALJ’s Responsibility to Obtain Medical Expert Opinion
§ 1105.1 Cases Citing on SSR 96-8p, Governing the
Assessment of RFC in Initial Claims
§ 1105.2 Social Security Ruling 96-9p and the
Erosion of the Unskilled Sedentary Occupational Work Base
§ 1105.8 Residual Functional Capacity: Impact of
Sit/Stand Option on the Sedentary Work
RFC
§ 1105.9 Lack of an Updated or Any Residual
Functional Capacity Assessment in the Record
§ 1106.4 Past Relevant Work: Work Performed for Less
than Three Months
§ 1106.6 Past Relevant Work: Work Performed More
than Fifteen Years Prior to the Date of Adjudication
§ 1107.4 Effect of Borderline Age on the Application
of the Medical-Vocational Guidelines (“Grids”)
§ 1107.5 Effect of the Claimant’s Illiteracy on
the Application of the Medical-Vocational Guidelines (“Grids”)
§ 1107.7 Effect of Inability to Speak English on the
Application of the Medical-Vocational Guidelines (“Grids”)
§ 1107.11 Effect of Borderline Mental Capacity (IQ of 71-79) on the
Application of the
Medical-Vocational
Guidelines (“Grids”)
§ 1107.14 Manipulative Limitations and their Effect
on the Ability to Perform the Full Range of Sedentary Work
§ 1107.15 Inability to Stoop and its Effect on the
Ability to Perform the Full Range of Sedentary Work
§ 1107.18 Effect of Americans with Disabilities Act
Accommodation on the Ability to Perform Other Work
§ 1107.22 Application of the "Worn-Out
Worker" Regulation
Assessment of Disability Issues
§ 1202.6
The ALJ’s Duty to Recontact the Treating Physician Pursuant to §
404.1512(e)
§ 1203.6 Weight of Non-Examining Reviewing
Consultant
§ 1203.14 Weight of Evidence from a Chiropractor
§ 1203.15 Weight of Evidence from a Nurse
Practitioner
§ 1205 Significant Reported Circuit Court Decisions
Governing the Analysis of Subjective Complaints of Pain
§ 1207.1 Effect of Disability Determinations of
Other Agencies
§ 1208.5 Failure to Follow Prescribed Treatment Due
to the Inability to Afford Treatment
§ 1209.3 Onset Date: The Need for a Medical Expert
if the Onset Date is Unclear
§ 1210.5 Incomplete Hypothetical Questions and their
Effect on Vocational Expert (“VE”) Testimony
§ 1210.8 Limitations Contained on the Psychiatric
Review Technique Form (“PRTF”) and their Impact on Vocational Expert Testimony
§ 1210.12 Vocational Expert Testimony Which
Conflicts with the Dictionary of Occupational Titles (“DOT”)
Specific Impairments
§ 1301.1
Alcohol and Drug Addiction - Effective Date of the 1996 Legislation
§ 1301.4 Establishing Disability Based on Alcohol or
Drug Addiction under New Law
§ 1303 Specific Impairments: Chemical Sensitivity
and Environmental Illness and/or Limitation Cases
§ 1304 Specific Impairments: Chronic Fatigue
Syndrome (CFS)
§ 1307 Specific Impairments: Fibromyalgia
§ 1311.2 Specific Impairments: Disseminated
(Systemic) Lupus Erythematosus
§ 1312.5 Mental Impairments: Impact of the
ALJ’s Failure to Complete Psychiatric Review Technique Form
§ 1312.9 The Required Severity of the “Other
Impairment(s)” Under Listing 12.05 (C)
§ 1317 Specific Impairments: Meeting the Obesity
Listing
§ 1317.1 Specific Impairments: the Effect of the
Deletion of the Obesity Listing on
Claimants
Suffering from Obesity
Administrative Review Issues
§ 1505
Claimant’s Right to Cross-Examine Post Hearing Evidence -
Consultant’s Report
§ 1508 ALJ Bias
Federal Court Issues
§ 1601
Waiver: Raising Issues Before the District Court that were not Raised
Before the Appeals Council
§ 1603.5 Post Hoc Justification: No Monday Morning
Quarterbacking Allowed
Attorneys’ Fees
§ 1702.7
Equal Access to Justice Act: Reasonableness of Number of Hours Claimed
by Attorney
Source of Law
§ 1802
Legal Authority: Retroactivity of Social Security Rulings Issued in
1996
§ 1803.1 Legal Authority: Authority of HALLEX and
POMS |
