Decided: November 9, 2012
The Fourth Circuit Court of Appeals reversed a district court opinion that denied the plaintiff-appellant, Earl M. Bird (“Bird”), Social Security Benefits. The Court of Appeals held that the lower court erred in failing to consider medical evidence that was created after the last date of Bird’s insurance coverage, and in failing to give adequate weight to a disability determination made by the Department of Veterans Affairs (VA).
Bird served in the United States Marine Corps for several years and suffered from Post-Traumatic Stress Disorder (PTSD) as a result of his time in Vietnam. The VA awarded Bird 100 percent disability rating on November 14, 2007 for his PTSD. This disability rating was effective on the date Bird applied for the benefits, June 9, 2006. Bird applied for disability benefits with the Social Security Administration (SSA) in May 2009 and was denied because the Administrative Law Judge (ALJ) found his PTSD to be insufficient to qualify him for coverage.
The court of appeals found that retrospective consideration of medical evidence created after Bird’s date last insured (DLI) was required. This medical evidence was contained in the VA rating and report. The court stated that “post-DLI medical evidence generally is admissible in an SSA disability determination in such instances in which that evidence permits an inference of linkage with the claimant’s pre-DLI condition.”
The court also concluded that the ALJ did not afford the appropriate weight to the VA rating decision. Although the court had not previously determined the precise weight that must be afforded to a VA disability rating, the SSA is required to consider the evidence. The court held that substantial weight must be given to a VA disability rating, unless the ALJ clearly demonstrates that a deviation from this standard is appropriate in a given case.