United States District Court, D. Massachusetts
MEMORANDUM & ORDER
WILLIAM G. YOUNG, District Judge.
Paula Bray ("Bray") has brought this action pursuant to 42 U.S.C. § 405(g) seeking judicial review of the decision of the Commissioner of Social Security (the "Commissioner") denying her adult childhood disability benefits. Compl., ECF No. 1. After the Commissioner submitted to the Court a copy of the administrative record of Bray's claim, SSA Admin. R. Soc. Sec. Proceedings ("Admin. R."), ECF No. 21,  each party submitted a motion for judgment in its favor and a supporting memorandum, Pl.'s Mot. Order Reversing Decision Comm'r, ECF No. 24; Mem. Supp. Pl.'s Mot. Order Reversing Decision Comm'r ("Pl.'s Mem."), ECF No. 25; Def.'s Mot. Affirm Comm'r's Decision, ECF No. 27; Mem. Law Supp. Def.'s Mot. Affirm Comm'r's Decision ("Def.'s Mem."), ECF No. 28.
II. LEGAL FRAMEWORK
A. Standard of Review
When reviewing a decision denying social security benefits under the judicial review provisions of 42 U.S.C. § 405(g), the Court is obligated to uphold the Commissioner's decision so long as she has used the correct legal standard and has supported her factual findings with substantial evidence from the record. Manso-Pizarro v. Sec'y of Health & Human Servs., 76 F.3d 15, 16 (1st Cir. 1996). A decision is supported by substantial evidence "if a reasonable mind, reviewing the evidence in the record as a whole, could accept it as adequate to support [the Commissioner's] conclusion." Rodriguez v. Sec'y of Health & Human Servs., 647 F.2d 218, 222 (1st Cir. 1981). This standard may be met - thus mandating affirmance of the decision - "even if the record arguably could justify a different conclusion." Rodriguez Pagan v. Sec'y of Health & Human Servs., 819 F.2d 1, 3 (1st Cir. 1987); cf. Bath Iron Works Corp. v. U.S. Dep't of Labor, 336 F.3d 51, 56 (1st Cir. 2003) (noting that the substantial evidence standard "certainly does not approach the preponderance-of-the-evidence standard").
B. Disability Standard
Under governing law, a claimant is deemed disabled when she is unable "to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 423(d)(1)(A). This case in particular is about childhood disability benefits, which are available if a claimant is "18 years old or older and ha[s] a disability that began before [she] became 22 years old." 20 C.F.R. § 404.350(a)(5).
When evaluating whether a claimant is disabled, an Administrative Law Judge (the "hearing officer") working with the Social Security Administration uses a five-step process. At the first step, the hearing officer determines whether the claimant is engaged in substantial gainful activity, which is defined as work involving significant physical or mental activities for pay or profit. If the claimant is so engaged, she is deemed not disabled. Id. § 404.1520(a)(4)(i); id. § 404.1572. Claimants earning over a certain amount of money per month are presumed to be engaged in substantial gainful activity. See id. § 404.1574. At step two, the hearing officer examines the record to determine whether the claimant has any severe medical impairments; if not, she is deemed not disabled. Id. § 404.1520(a)(4)(ii). At step three, the claimant is deemed disabled if her severe impairment matches or equals one of a number of impairments listed in the governing regulations. Id. § 404.1520(a)(4)(iii). The hearing officer then determines the claimant's residual functional capacity to perform work. If the claimant retains the residual functional capacity to perform her past work, she is deemed not disabled at step four. Id. § 404.1520(a)(4)(iv). If she retains the capacity to perform some other kind of work that exists in significant numbers in the national economy, she is deemed not disabled at step five. Id. § 404.1520(a)(4)(v). The claimant bears the burden of showing that she is disabled at steps one through four; the burden shifts to the Commissioner at step five. Goodermote v. Sec'y of Health & Human Servs., 690 F.2d 5, 7 (1st Cir. 1982).
III. ADMINISTRATIVE PROCEEDINGS
Bray applied for a child's insurance benefits on April 16, 2010,  claiming that she was disabled due to bipolar disorder, learning disability, paranoia, anxiety, depression, and appetite disturbance. Admin. R. 19, 59-62. She alleged a disability onset date of January 1, 1989, which - given her birthdate of September 14, 1967 - occurred before her twenty-second birthday and thus made her eligible for adult childhood disability benefits. See id. at 59. Her claim was denied in September 2010 and again on reconsideration in February 2011. Id. at 22, 27. In July 2011, Bray filed a request for a hearing, id. at 29, which took place before the hearing officer on August 21, 2012, id. at 392-404.
The hearing officer issued a decision denying Bray's claim for benefits on August 29, 2012. Id. at 15-19. After determining that the purported disability onset date fell before Bray's twenty-second birthday, the hearing officer found at the first step of the disability determination process that Bray had engaged in substantial gainful activity in 1997. Id. at 17-18. Specifically, he summarized her earnings over a number of years between 1985 and 2010 and found that the $8, 284.77 Bray earned in 1997 fell above the threshold at which substantial gainful activity is presumed. See id. at 17-18; see also id. at 63 (detailing Bray's yearly earnings); 20 C.F.R. § 404.1574 (stating that, for the relevant time period, substantial gainful activity is presumed if monthly average earnings are more than $500). Although Bray's counsel claimed at the hearing that Bray received accommodations at work in 1997 that would disqualify her job from being considered substantial gainful activity, the hearing officer noted that "there is no significant evidence of these accommodations." Admin. R. 18. Despite so finding, the hearing officer then "[gave] the claimant the benefit of the doubt regarding this work for purposes of the claimant's eligibility for Disabled Adult Child benefits" and proceeded to step two of the disability determination process. Id. He additionally ruled that there had been continuous twelve-month periods in which Bray had not engaged in any substantial gainful activity and addressed his remaining findings to those periods. Id.
At step two, the hearing officer found that Bray had not carried her burden of showing that she suffered from a severe impairment before the age of twenty-two, as required for adult childhood disability benefits. Id. at 18-19. He stated that "[i]n claims in which there are no medical signs or laboratory findings to substantiate the existence of a medically determinable physical or mental impairment, the individual must be found not disabled." Id. Because the earliest medical evidence in the record came from 1995 - well after Bray's twenty-second birthday in September 1989 - the hearing officer concluded that there was "no means of determining what, if any, limitations the claimant experienced prior to age 22." Id. at 19. Accordingly, he found that Bray was not disabled at any time prior to September 13, 1989. Id.
Bray filed an appeal of the hearing officer's decision on October 3, 2012, claiming that newly found evidence demonstrated that she was indeed disabled before the age of twenty-two. Id. at 10. In November 2012, Bray submitted to the Appeals Council three medical reports from 1981 regarding treatment she received for mental illness. Id. at 151, 381-91. In a letter to the Appeals Council, Bray's attorney explained that this evidence was only recently uncovered because "[q]uestioning at ...