Jenkerson v. SSA

2009 DNH 072

• Court: District Court, D. New Hampshire
• Decided: May 26, 2009
• Docket: CV-07-217-PB
• Status: Published

Opinion

Jenkerson v . SSA CV-07-217-PB 05/26/09 P UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE

Richard Jenkerson

v. Civil N o . 07-cv-217-PB Opinion N o . 2009 DNH 072 Michael J. Astrue, Commissioner, Social Security Administration

REPORT AND RECOMMENDATION

This action involves plaintiff Richard Jenkerson’s third

application for social security disability (“SSD”) benefits.

Jenkerson twice before applied for SSD benefits and was denied

both times, but did not seek further review of either denial. He

then obtained counsel, applied again and was awarded benefits

with an onset date of May 1 , 1998. As part of this third

application for benefits, Jenkerson sought review of the two

prior denials, but the Commissioner declined to reopen those

earlier decisions. The Commissioner found that Jenkerson had

failed to show a basis either for reopening or for extending the

time to request review based on mental incapacity, citing 20

C.F.R. § 404.988 and Social Security Ruling (“SSR”) 91-5p. The

Appeals Council declined to review that decision, rendering the Commissioner’s denial the last action by the Social Security

Administration (“SSA”). Jenkerson then commenced this action,

seeking review of the Commissioner’s decision not to reopen the

prior two denials. See 42 U.S.C. § 405(g) (Supp. 2008). He

claims the decision not to reconsider the prior applications

violated his Fifth Amendment due process rights.

Defendant moved to dismiss Jenkerson’s action for lack of

subject matter jurisdiction since the refusal to reopen is

discretionary and, therefore, not a final decision within the

meaning of § 405(g) (document n o . 4 ) . That motion was denied in

part, because Jenkderson’s complaint stated a colorable

constitutional claim that his due process rights were violated

when he failed to timely appeal the first two decisions due to

his alleged mental incapacity. See Jenkerson v . Astrue, Civ. n o .

07-217-PB, slip o p . at 7-8 (D.N.H. Sept. 3 0 , 2008) (“Mot. to

Dismiss Order”). Currently before the court is Jenkerson’s

motion to reverse or remand (document n o . 14) and defendant’s

motion to affirm (document n o . 1 6 ) . The matter was referred to

me for a recommendation of disposition. See 28 U.S.C. § 636(b)

(1)(B). For the reasons set forth below, I recommend that

Jenkerson’s motion be granted and that the matter be remanded.

2 Discussion

1. Background

Pursuant to this court’s local rules, see United States

District Court for the District of New Hampshire Rule 9.1(d), the

parties filed a joint statement of facts which are part of the

record and which I have reviewed. Only those facts relevant to

the disposition of this matter are discussed below, as needed.

2. Standard of Review

An individual seeking social security benefits has a right

to judicial review of a decision denying the application. See 42

U.S.C. § 405(g) (Supp. 2008). The court is empowered to affirm,

modify, reverse or remand the decision of the Commissioner, based

upon the pleadings and transcript of the record. See id. The

factual findings of the Commissioner shall be conclusive,

however, so long as they are supported by “substantial evidence”

in the record. See Ortiz v . Sec’y of HHS, 955 F.2d 765, 769 (1st

Cir. 1991) (quoting 42 U.S.C. § 405(g)). “Substantial evidence”

is “‘more than a mere scintilla. It means such relevant evidence

as a reasonable mind might accept as adequate to support a

conclusion.’” Richardson v . Perales, 402 U.S. 389, 401 (1971)

(quoting Consol. Edison C o . v . NLRB, 305 U.S. 1 9 7 , 229 (1938));

3 see also Currier v . Sec’y of HHS, 612 F.2d 5 9 4 , 597 (1st Cir.

1980). The Commissioner is responsible for resolving issues of

credibility and drawing inferences from the evidence in the

record. See Rodriguez v . Sec’y of HHS, 647 F.2d 2 1 8 , 222 (1st

Cir. 1981) (reviewing court must defer to the judgment of the

Commissioner). The Court does not need to agree with the

Commissioner’s decision but only to determine whether it is

supported by substantial evidence. See id. Finally, the court

must uphold a final decision denying benefits unless the decision

is based on a legal or factual error. See Manso-Pizarro v . Sec’y

of HHS, 76 F.3d 1 5 , 16 (1st Cir. 1996) (citing Sullivan v .

Hudson, 490 U.S. 8 7 7 , 885 (1989)).

3. Plaintiff’s Mental Capacity Claim

The sole issue before the court is whether the

Administrative Law Judge’s (“ALJ”) finding, that Jenkerson had

the mental capacity at the time of the first two benefits

application denials to understand the review procedures, is

supported by substantial evidence. Jenkerson claims that it is

not, because he suffered from a variety of generalized anxiety

and depressive disorders as part of his problems with post

traumatic stress syndrome (“PTSD”). He argues now that his PTSD

4 and related problems, combined with the fact that he represented

himself in those applications, prevented him from understanding

or availing himself of the review process. Defendant contends

the ALJ properly considered the medical record in concluding that

Jenkerson understood both the denials and the effect of not

appealing them and, therefore, cannot benefit now from the

tolling provisions in the regulations. The arguments proffered

in support of these positions are addressed below in turn.

a. SSR 91-5p

Although the regulations generally require a claimant to

seek review of an SSA decision within 60 days of its issue, see,

e.g., 20 C.F.R. § 404.909(a) (setting forth review process of the

initial determination), exceptions to this rule exist if the

claimant can show good cause for missing the deadline. See id.

at §§ 404.911, 404.988 & 416.1411, 416.1488. If a claimant

cannot satisfy one of the statutory bases for reopening an

application, “good cause” may still be established for having

missed the deadline if the claimant demonstrates that a mental

impairment prevented him from understanding and pursuing his

administrative remedies. See Klemm v . Astrue, 543 F.3d 1139,

1145 (9th Cir. 2008) (discussing SSR 91-5p); see also Boothby v .

5 SSA Comm’r, 132 F.3d 3 0 , 1997 WL 727535, at *1 (1st Cir. Nov. 1 8 ,

1997) (same); West’s Social Security Reporting Service - Rulings:

1983-1991 (1992) (“West’s”) at 809-11 (Policy Interpretation

Ruling (“SSR”) 91-5p regarding “Mental Incapacity and Good Cause

for Missing the Deadline to Request Review). The regulations

have been interpreted this way, because due process requires that

a claimant receive meaningful notice and an opportunity to be

heard before disability benefits may be denied.

See Klemm, 543 F.3d at 1144 (citing Califano v . Sanders, 430 U.S.

9 9 , 107-09 (1977) to explain the exception to the rule against

reopening when claimant’s due process rights may have been

violated); see also Udd v . Massanari, 245 F.3d 1096, 1099-1100

(9th Cir. 2001) (citing Mathews v . Eldridge, 424 U.S. 319, 333

(1976) to explain claimant’s due process rights). If at the time

benefits were denied, the claimant both represented himself and

lacked the mental capacity to understand the review procedures,

he may subsequently seek review of that decision based on the

lack of due process surrounding the initial denial. See Klemm,

543 F.3d at 1145; see also Udd, 245 F.3d at 1099-1100; Boothby,

1997 WL 727535 at * 1 .

In assessing whether claimant was sufficiently mentally

6 impaired to excuse his failure to seek review of a denial, SSR

91-5p directs the adjudicator to consider the following factors:

- inability to read or write;

- lack of facility with the English language;

- limited education;

- any mental or physical condition which limits the claimant’s ability to do things for him/herself. SSR 91-5p, West’s at 810. “If the claimant is unrepresented and

has one of the factors listed above, the adjudicator will assist

the claimant in obtaining any relevant evidence. The decision as

to what constitutes mental incapacity must be based on all the

pertinent facts in a particular case. The adjudicator will

resolve any reasonable doubt in favor of the claimant.” Id.,

West’s at 811. When seeking to reopen a previously denied

application, if claimant carries the burden of proof set forth in

SSR 91-5p, then the time limits for pursuing review are tolled

and the adjudicator reconsiders the denial as if it were timely.

See Udd, 245 F.3d at 1100 (requiring adjudicator to further

review the claim or dismiss i t , as appropriate for reasons other

than late filing).

7 b. The ALJ’s 91-5p Holding

As part of his third application for benefits filed on March

1 7 , 2005, Jenkerson sought to reopen the applications that had

been denied on June 2 7 , 1996 and April 2 3 , 1998. In this third

application, Jenkerson alleged a disability onset date of July

1 2 , 1995. See Certified Record (“CR”) at 1 4 . Upon initial

review of the third application, the SSA determined that

Jenkerson was entitled to disability benefits beginning May 1 ,

1998. See id. The SSA also found no basis to reopen the prior

two applications, and Jenkerson, represented now by counsel,

sought further review of that decision by timely filing a request

for a hearing on September 2 6 , 2005. Id. A hearing was held on

May 1 7 , 2006, at which Jenkerson presented evidence to

demonstrate first that the earlier applications should be

reopened, and second that his disability onset date should be the

alleged July 1 2 , 1995 onset date rather than the determined May

1 , 1998 onset date (the “91-5p hearing”). The ALJ concluded the

prior applications should not be reopened and, therefore, did not

reach the second issue regarding an earlier disability onset

date.

The ALJ concluded “[s]pecifically, during the relevant time

8 periods, the claimant (1) was not mentally incompetent; (2) was

not diagnosed with any mental illness that would preclude him

from understanding his right of appeal or to counsel; and (3)

demonstrated knowledge of the procedures in his multiple filings

for benefits.” CR at 1 5 . In support of those conclusions, the

ALJ made the following findings. First, he determined that the

record contained no objective medical evidence during the sixty

day periods following the first two denials that supported a

finding of any mental impairment which would have precluded

Jenkerson from understanding the review procedures. Id. at 16. 1

The ALJ found Jenkerson’s many acitivities particularly damaging

to his claimed mental impairment. He attended classes, had

primary physical custody of his daughter and expressed thoughtful

concern about her welfare, was pursuing a relationship with a

girlfriend and saw a therapist. The ALJ found these actions were

not consistent with a person who lacked the mental capacity to

pursue review of an unfavorable benefits decision.

Next the ALJ relied on Jenkerson’s own statements about his

1 The record reflects no dispute that Jenkerson could speak, read and write English, that his education was not an issue, and that he represented himself in the first two applications. The only question was whether he had the mental capacity to understand the review procedures.

9 applications, which the ALJ determined revealed that Jenkerson

fully understood the SSA disability process. Jenkerson did not

allege the SSA had misled him. He testified at the hearing that

he was angered and disgusted by how the bureaucracy did not take

care of veterans, which led Jenkerson to believe he was “better

off out of the system.” Id. at 1 6 . The ALJ interpreted

Jenkerson’s testimony as a statement of defeat rather than

confusion about how the system worked. He also found the

multitude of records from the Veterans Administration (“VA”)

reflective of the care Jenkerson had received and his knowledge

of how to get i t . Id. at 1 7 . The ALJ concluded that Jenkerson’s

continued pursuit of benefits from both the VA and the SSA

evinced his understanding of the remedies available to him.

Finally, the ALJ addressed two doctors’ opinions, neither of

which he found persuasive. The ALJ determined that D r . Michael

G. Carvalho first diagnosed Jenkerson with PTSD on September 1 9 ,

2005, which reflected a change from his prior diagnoses of

dysphasia. This newly diagnosed mental impairment was more than

seven and nine years after the earlier denials. The ALJ also

discounted D r . Hans W . Standow’s evaluation from March 1998.

Although D r . Standow first diagnosed Jenkerson with PTSD at that

10 time, he also opined that Jenkerson was well-oriented, showed

fair insight and judgment, and had average intelligence that

would have enabled him to understand and remember “even more

complex written or oral instructions.” Id. The ALJ found these

opinions, on which Jenkerson relied to demonstrate his mental

impairment, actually undermined that claim.

As a result of these conclusions, the deadlines for seeking

reconsideration were not tolled, and the prior denials from June

1996 and April 1998 remain the final decisions of the SSA,

entitled to preclusive effect. Jenkerson was not found to have

been disabled beginning July 1 2 , 1995, and the May 1 , 1998 onset

date remains in effect. Id. at 1 8 .

c. Evidence of Jenkerson’s Mental Capacity

The only issue before the court is whether substantial

evidence supports the ALJ’s finding that Jenkerson was not

mentally impaired during the sixty day time frame following his

prior denials on June 2 7 , 1996 and April 2 3 , 1998. Jenkerson

challenges all three bases of the ALJ’s decision.

i. Mental Incompetence Standard

The parties dispute whether the ALJ applied the correct

mental competency standard. Jenkerson claims he did not need to

11 prove he was mentally incompetent as defined by the regulations,

but only had to demonstrate he did not have the mental capacity

to understand the review procedures, suggesting a lower level of

proof. Defendant argues this is a semantic distinction without a

difference, and, in any event, the record shows the ALJ properly

considered all the factors outlined in SSR 91-5p. Under the

circumstances presented here, defendant is correct and no further

discussion is warranted. See Evans v . Chater, 110 F.3d 1480,

1483 (9th Cir. 1997) (citing cases and using mental impairment,

mental illness and mental incompetence interchangeably); see also

Udd, 245 F.3d at 1100 (describing mental problems that “met the

listing of impairments” to find claimant lacked mental capacity);

Boothby, 1997 WL 727535 at *1-2 (describing evidence of mental

impairments that showed claimant lacked the mental competency to

pursue his claims); c f . Stieberger v . Apfel, 134 F.3d 3 7 , 40-41

(2d Cir. 1997) (defining mental impairment “short of mental

incompetency” as a heightened standard of “sufficient severity to

impair comprehension,” like mental illness, not mere confusion).

ii. Medical Records

The parties next dispute whether there is objective medical

evidence that Jenkerson had some mental impairment during the

12 relevant time periods that prevented him from pursuing his right

for reconsideration of the prior denials. The ALJ found there

was none, and that the opinions of Drs. Carvalho and Standow

undermined Jenkerson’s claim of mental incapacity. Jenkerson

contends the ALJ did not give proper weight to D r . Carvalho’s

opinion, which should have been afforded deference because he was

his treating physician. He also asserts that there is nothing in

the medical records that contradicts either doctor’s opinion.

After carefully reviewing the medical records on file, I find

that Jenkerson is correct and that the ALJ did not apply the

correct legal standard in reviewing the medical records.

As an initial matter, the record shows that on August 1 9 ,

2005, as part of his third application for SSD benefits, the SSA

concluded that Jenkerson met the requirements for disability

benefits beginning May 1 , 1998. See CR at 20-21. The SSA

explained its onset date determination as follows:

You alleged an onset date of 7/12/95. A prior claim was denied as of 4/30/98. We are not permitted to invade that period of time, therefore, we have established an onset date of 5/1/98.

Id. at 2 1 . This statement clearly reveals that the SSA did not

affirmatively determine Jenkerson was not disabled before May 1 ,

1998, but only that the SSA understood it could not consider the

13 record prior to May 1 , 1998. Whether or not the record contained

evidence that showed Jenkerson lacked mental capacity before May

1 , 1998, therefore, was not reviewed at the initial assessment of

his third application.

The records show that Jenkerson first suffered a heart

attack in 1990, and that in July 1995 he had bypass surgery for

his heart condition which prevented him from continuing his

former work as a painter. See CR at 179. He first applied for

SSD benefits in April 1996, which application was denied on June

2 7 , 1996. The records indicate that as early as January 1996

Jenkerson was receiving psychotherapy and prescription drug

treatment at the VA for his mental health problems. See CR at

83-109 (progress notes). The notes from January 1996 through

June 1997 indicate Jenkerson sought help for his anxiety, tension

and anger, id. at 1 0 8 , and that he suffered from depression and

stress. Although the notes indicate he had “no evidence of

psychosis” and that he was “oriented x 3 , memory intact,” his

judgment was “somewhat impaired” and he appeared and reported to

be anxious. Id. at 107. On August 26 and 3 0 , 1996, Jenkerson

reported increased anxiety symptoms and asked to resume his

therapy sessions because of his stress, anxiety and depressed

14 mood, which he identified were caused by his “experience in the

military, and especially in Vietnam,” among other things. Id. at

98 & 100. This evidence supports both Drs. Carvalho and

Standow’s opinions that Jenkerson suffered from PTSD stemming

from his experience in Vietnam.

The record reflects that Jenkerson continued to be treated

at the VA throughout 1997. He applied for SSD benefits again in

November 1997, which application was denied on April 2 3 , 1998

based on a finding that he was not physically or mentally

disabled. He represented in the second application for benefits

that he was unable to work because of a heart condition,

arthritis, kidney problem, and right knee problem, none of which

the SSA determined prevented Jenkerson from working. The SSA

also found Jenkerson’s medical records “revealed that [he] ha[d]

been treated for a generalized anxiety disorder since early

1997.” CR at 35. 2 The Commissioner found that though this

condition limited Jenkerson to a low stress work setting, he had

the capacity to understand, remember and carry out short and

2 This is an error because the VA records show Jenkerson was being treated for his anxiety disorder at least as early as January 1996, and there are many records from 1990-94. See CR at 110-17. A progress note from June 6, 1991, states that Jenkerson was depressed and described himself as being “extremely anxious always about everything.” Id. at 111.

15 simple instructions and did not require any special supervision

to complete a normal work day or week. Id. Accordingly, though

Jenkerson could not return to his former work as a painter, the

SSA concluded there were several other jobs he could perform.

The medical records surrounding this second denial clearly

and consistently establish that Jenkerson suffered from PTSD. On

March 2 7 , 1998, one month before the second benefits application

was denied, D r . Standow examined Jenkerson to provide a

comprehensive psychiatric profile and formally diagnosed him with

PTSD. See CR at 154-57.3 Jenkerson “complains about depression,

nightmares, flashbacks and easy irritability with temper

outbursts and social isolation.” Id. At that visit Jenkerson

reported having suicidal thoughts frequently, but his

responsibility for his daughter stopped him from acting on them.

Dr. Standow found “there [was] certainly a great deal of evidence

of anxiety and depression. . . . All in all, however, M r .

Jenkerson has shown not only evidence of anxiety and depression,

3 Jenkerson described his tour of duty to D r . Standow: [He] spent 1967 in heavy combat. He saw people, including friends, being killed; handled severely wounded comrades; flew on numerous helicopter missions and almost constantly feared for his life.

CR at 154.

16 but certainly all the classical and characteristic symptoms of

PTSD.” CR at 156.

Dr. Standow’s diagnosis was confirmed in April 1998 by an

SSA consulting physician, D r . Craig Stenslie. D r . Stenslie

reviewed Jenkerson’s VA records and D r . Standow’s report and

found the records showed Jenkerson suffered from a generalized

anxiety disorder and PTSD, which had been treated on an

outpatient basis by the VA. CR at 158-59. D r . Stenslie gave D r .

Standow’s report the greatest weight because it was “the most

complete and recent report, although it [was] more or less

consistent with the rather sketchy records from the VA.” Id.

These two opinions are also consistent with D r . Carvalho’s

diagnosis of Jenkerson. The record contains many treatment notes

from D r . Carvalho, beginning in 1997 through 2005. CR at 365-83;

390-407. D r . Carvalho noted as early as August 1 9 , 1997 that

Jenkerson suffered from a generalized anxiety disorder. See id.

at 405. The record is replete with notes that Jenkerson suffered

from an anxious affect and depressed mood, and was being treated

by D r . Carvalho with medications and therapy, in varying amounts

at different times over the years, to help his mental health. In

January 2001, D r . Carvalho notes:

17 Has not been seen by this clinician x over 2 years; attempted to resume therapy last March and did not seem to reconnect at that time. Long standing hx of generalized anxiety disorder with anger and irritability most prominent; this is getting worse x past year despite buspirone rx which seemed to work at the beginning of therapy. He also had developed some depressive sxs of mood depression, decreased interest in activities, sleep is disturbed, concentration poor. No active suicidal thoughts but has some passive death wishes.

CR at 379. At that time, D r . Carvalho again described a

generalized anxiety disorder. Id. These notes reflect a

consistent diagnosis of trouble with anxiety, depression, and

stress, that was being treated by D r . Carvalho during the sixty

day period, and much longer, following the April 2 3 , 1998 denial.

As this record demonstrates, the ALJ erred in finding that

Dr. Carvalho first diagnosed Jenkerson with PTSD on September 1 9 ,

2005. See id. at 1 7 . While D r . Carvalho may not have previously

used the term PTSD, he repeatedly described Jenkerson’s condition

consistently with the characteristics of PTSD identified by Drs.

Standow and Stenslie.4 The ALJ found “a recent diagnosis change

from dysphasia to PTSD despite no prior diagnosis of the same at

4 The ALJ stated that D r . Carvalho actually ruled out PTSD in contemporaneous treatment notes; however, my review of the record does not support this finding.

18 any relevant time.” Id.5 That conclusion simply is not

supported by substantial evidence in the record, which reflects

that Jenkerson had no difficulty with speaking but had great

difficulty coping with stress and anxiety. In September 2005,

Dr. Carvalho provided an historical opinion of Jenkerson’s mental

health problems, see CR at 459-63, concluding that his PTSD was a

“major factor in preventing him for pursuing his Social Security

Disability appeal in May and June of 1998.” Id. at 459. D r .

Carvalho explained his VA treatment had been fractionalized

because of staffing problems, which frustrated Jenkerson and

exacerbated his anxiety problems. Id. D r . Carvalho’s opinion

should have been accorded controlling weight, as he was

Jenkerson’s long-standing treating physician and his opinion is

consistent with the other evidence in the record. See 20 C.F.R.

§ 404.1527(d)(1-6) (listing how medical opinions are evaluated);

see also Pariseau v . Astrue, N o . CA 07-268 M L , 2008 WL 2414851,

at *4-5 (D.R.I. June 1 3 , 2008) (discussing weight of treating

5 It is unclear where the ALJ got the term “dysphasia,” because he does not support that finding with a cite to the record. The term dysphasia means difficulty with speech, see www.webmd.com, or “any aphasia which does not produce complete abolition of the facility to use language.” Blakiston’s Gould Medical Dictionary at 419 (4th ed. 1979). D r . Carvalho did describe Jenkerson as suffering from dysthymia, which is a despondent mood or depressive tendency. See id. at 420.

19 physician’s opinion); SSR 96-2p (weighing treating physician’s

opinions).

Nothing in the record contradicts this consistent pattern of

PTSD-related symptoms. Despite these medical records, the ALJ

concluded that Jenkerson had the mental capacity to understand

the review procedures because D r . Standow had found that he

retained the ability to follow complex instructions, was well-

oriented with conventional thought and average intelligence.

See CR at 156-57. While those mental faculties may have resulted

in Jenkerson having a residual functional capacity to do some

type of work, see e.g. id. at 158-59, they do not necessarily

indicate he had the mental capacity to pursue the administrative

review procedures. As discussed above, the record contains

overwhelming evidence that Jenkerson could not handle stress, was

easily frustrated and abnormally irritable. See id. (Dr.

Stenslie’s opinion on the limited work environment he would

need). At a minimum, his PTSD raises doubts about how he would

have handled a second denial for benefits. SSR 91-5p requires

that any reasonable doubt be resolved in favor of the claimant.

Though this case may present a close call, given the record

evidence of PTSD and Jenkerson’s pro se status during his second

20 application, the ALJ was required to give him the benefit of the

doubt and simply reconsider whether the denial was appropriate.

See Udd 245 F.3d at 1100 (reversing ALJ who “applied an incorrect

legal standard and failed to resolve doubts in favor of the

claimant”).

c. Demonstrated Knowledge of Procedures

Finally, the ALJ determined that Jenkerson’s testimony at

the 91-5p hearing and the multiple records of his benefits

applications filed with both the SSA and the VA were evidence

that he had the mental capacity to pursue the administrative

review procedures. While I agree with the ALJ that the record

contains ample evidence of Jenkerson’s attempts to seek benefits

from the VA and the SSA, his repeated efforts demonstrate his

misunderstanding of the system more than they reflect his

knowledge of how it worked. If he actually understood the effect

of not seeking review of a denial, then he would not have pursued

either the second or the third benefits applications. Again, the

record raises doubts about what he understood when, and SSR 91-5p

requires that all reasonable doubts be resolved in Jenkerson’s

favor.

The ALJ found persuasive Jenkerson’s admission that he was

21 angered by the system and thought he would be better off out of

i t , because “the bureaucracy” does not take care of veterans.

See CR at 16-17. The ALJ concluded that Jenkerson’s statement

combined with the multiple records of medical care he had

received from the VA evinced a deliberate choice on Jenkerson’s

part to walk away from the rights he had to obtain review of the

benefits decisions. Although I am not persuaded by Jenkerson’s

current argument that his testimony reflects delusional thinking,

I am also not convinced that the ALJ fairly interpreted the

testimony in the context of Jenkerson’s medical history.

The record is replete with evidence that Jenkerson was

frustrated by “the system” and his perceived unsuccessful efforts

to get help. The progress notes from the VA indicate he was

concerned about his therapist leaving him and not wanting to

continue with someone new.6 In the summer of 1997, between his

first and second SSA applications, Jenkerson applied for

“Compensation and Pension” benefits from the VA because of the

“unusual stress disorder” caused by the tension from his combat

service that he believed contributed to his heart condition. See

CR at 173. After D r . Standow diagnosed Jenkerson with PTSD,

6 That concern is legitimized by D r . Stenslie’s observation that the VA records were “sketchy.”

22 Jenkerson notified the Department of Veterans Affairs seeking

verification of the combat experience he remembered from his

service in Vietnam. See id. at 160-61. He was notified on April

2 8 , 1998 that his request for documentary proof of his combat

experience would take approximately six months to process. It is

entirely reasonable that Jenkerson believed he could not

challenge the April 2 3 , 1998 benefits denial without some

documentary proof of the PTSD, which he learned on April 2 8 , 1998

that he would have to wait six months to receive.

In January 1999, D r . Valdez examined Jenkerson as part of

his VA Compensation and Pension benefit application. See CR at

178-80. D r . Valdez also concluded Jenkerson suffered from PTSD,

opining: “this patient has been suffering from PTSD for some

time now. He just did not know how to get help for it nor did he

know that he could get Compensation and Pension for it.” Id. at

180. 7 Despite that opinion, the VA denied Jenkerson’s

7 Dr. Valdez observed and noted several problems consistent with Drs. Standow and Stenslie, about Jenkerson’s anxiety levels, irritability, inability to succeed in social relationships, and significant fear stemming from his experience in Vietnam, which haunted him to that day. D r . Valdez gave Jenkerson a “Global Assessment of Functioning” (“GAF”) score of 5 0 . See Tindal v . Astrue, N o . 3:06-cv-1095-J-TEM, slip op., 2008 WL 725552, at *4 n.4 (M.D.Fla. Mar. 1 7 , 2008) (describing GAF score ranges that rate a person’s psychological, social and occupational functioning level, with 50 falling in the ‘serious symptoms’

23 application on February 3 , 1999 because the army’s records could

not establish the March 1967 night-time ambush Jenkerson

identified as the “inservice stressor” that caused his PTSD. Id.

at 147-49. The record indicates that Jenkerson disagreed with

that decision and obtained a second consideration, but was again

denied benefits on June 1 1 , 1999 because of the “absence of

verified stressful events.” Id. at 138-43. He did not pursue

any further appeal. Id. at 138.

While this evidence shows Jenkerson was capable of applying

for benefits, it also suggests why Jenkerson would have felt

frustrated and defeated by the system. Despite his reported

upset from his combat experience in Vietnam, the army’s response

was that his “stressor” was unverifiable.8 He did not appeal the

VA denial, as he had not appealed the SSA denials. That he had

the mental capacity to persevere with his benefits claims but

simply elected not to do so is not supported by substantial

evidence in the record. He was as likely to have had the mental

range). 8 The record contains a report on the 129th Assault Helicopter Company in An Son, Vietnam during 1967, which is the unit and location where Jenkerson served while in the army. CR at 176-88. That report details the unit’s assault missions and substantiates Jenkerson’s reported combat experience.

24 capacity as he was not, and in such equivocal circumstances, SSR

91-5p requires that doubt should be resolved in Jenkerson’s

Conclusion

For all the reasons set forth above, I find that Jenkerson

had good cause for not timely seeking review of his June 1996 and

April 1998 disability benefits application denials and that due

process requires those prior two applications be reopened. I

recommend, therefore, that Jenkerson’s motion to remand (document

n o . 14) be granted. On remand, the Commissioner shall reopen

Jenkerson’s prior applications and consider the merits of the

April 1996 and November 1997 benefits applications to determine

whether or not Jenkerson’s disability onset date is July 1 2 , 1995

as he has alleged. After such further review, the Commissioner

shall recalculate what, if any, additional benefits are due

Jenkerson, which decision shall be subject to further

administrative or judicial review as provided by law. See Udd,

245 F.3d at 1102 (explaining procedures for reviewing reopened

SSD benefits applications); Boothby, 1997 WL 727535 at *2

(addressing the merits of the application after the due process

violation is decided).

25 Any objections to this report and recommendation must be

filed within ten (10) days of receipt of this notice. Failure to

file objections within the specified time waives the right to

appeal the district court’s order. See Unauthorized Practice of

Law Comm. v . Gordon, 979 F.2d 1 1 , 13-14 (1st Cir. 1992);

United States v . Valencia-Copete, 792 F.2d 4 , 6 (1st Cir. 1986).

Jame ___ R. Muirhead States Magistrate Judge

Date: May 2 6 , 2009

cc: Jeffry A . Schapira, Esq. Gretchen Leah Witt, Esq.