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Mom loses SSDI appeal for extra benefits on behalf of son

April 16, 2019

A mother seeking additional disability benefits for her ailing son has failed to convince the 7th Circuit Court of Appeals that her child was entitled to benefits before he was 7 years old.

The case of L.D.R. v. Nancy A. Berryhill, 18-1763, traces back to the Social Security Administration’s determination that L.D.R. was disabled as of Aug. 1, 2015, when he was preparing to enroll in second grade. According to the 7th Circuit Court of Appeals, L.D.R. has a long history of medical issues, which sometimes have improved and other times have deteriorated. Throughout his life, L.D.R. has received care in pediatrics, pulmonology, psychology, speech and pathology, as well as ear, nose and throat care.

As a result, L.D.R.’s mother, Roshonda Wagner, began applying for Social Security Disability Insurance benefits for her son when he was 1 year old. Her applications have consistently sought back payment for the first year of L.D.R.’s life.

An administrative law judge denied Wagner’s application in 2012, but the decision was remanded for insufficient detail in the ALJ’s reasoning. Wagner had by that point submitted another benefits application, and the two were consolidated.

The ALJ then issued a “thorough and extensive” decision determining L.D.R.’s conditions did not meet the requirements for disability benefits until August 2015, when his behavioral issues worsened. August 2015 was also the time when the child demonstrated “marked” limitations in interacting with others and caring for himself, according to the 7th Circuit.

The Indiana Northern District Court affirmed that decision, finding substantial evidence to support the ALJ’s ruling. The district court also rejected Wagner’s argument against the constitutionality of laws prohibiting retroactive disability payments for a time before an application was filed.

The 7th Circuit Court of Appeals likewise affirmed Monday, with Judge Michael Brennan writing that the ALJ appropriately “compared L.D.R.’s functions to typical children of his age without impairments” and properly considered medical evidence relating to his asthma, middle ear inflammation and sleep apnea.

“The August 1, 2015 disability date is also well supported in the ALJ’s decision,” Brennan wrote. “In second grade, L.D.R.’s conditions worsened markedly. School reports, counseling records, and a report card from L.D.R.’s second grade teacher all show that his condition had deteriorated.”

Finally, the 7th Circuit said there were several rational bases to support the laws prohibiting retroactive disability payments from before the time an application was filed.

“For example, social security benefits are means-tested monthly … so retrospective determinations before an application is filed would present proof difficulties and create administrative burdens,” Brennan wrote. “Another rational basis is that the current rule incentivizes prompt applications, which serves the law’s purpose of helping people meet their basic food, clothing, and shelter needs.

“Because the challenged statute and regulation prohibiting retroactive benefits pass the rational basis test,” Brennan concluded, “they do not violate the constitutional guarantee of equal protection.”

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