Author: Catherine M. Callery (Kate)| Louise M. Tarantino
In another example of Appeals Council activism, Katie Courtney of the Rochester office of the Empire Justice Center got a similar result without having to experience the déjà vu part. In her case, following a voluntary remand from U.S. District Court, the Appeals Council intervened and issued a fully favorable decision without remanding the claim back to the ALJ for another hearing.
The claimant had been found disabled as child, but his benefits were discontinued following an age 18 redetermination. In reviewing the ALJ’s determination for a second time following the court remand, the Appeals Council relied on new evidence from a medical consultant to determine that the claimant meets Listing 12.05B. The medical consultant reviewed the evidence of record and concluded that the claimant had significant deficits in adaptive functioning in addition to the IQ scores with the 12.05B range. The ALJ had previously dismissed the valid and reliable IQ scores established by an SSA consultative examiner. He relied instead on the opinion of a nonexamining review physician, who had concluded that the claimant was functioning in the borderline to average range of intelligence based on earlier school records, some of which were not even included in the exhibit file.
Too bad that the Appeals Council could not have seen the light the first time around, but kudos to Katie for pursuing the claim. And congratulations to Katie, who was recently named an “Outstanding Young Lawyer of the Year” by the Women’s Bar Association of the State of New York.