Caseflicks

Court of Appeals for the Second Circuit • 2012

Talavera v. Comm’r of Social Security

697 F.3d 145 | 2012 U.S. App. LEXIS 21092

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Takeaway

In short, this case holds that a qualifying adult IQ score presumptively shows pre-age-twenty-two intellectual deficits, but SSI claimants must still separately prove cognitive deficits in adaptive functioning—and Talavera did not do so.

Background

Christina Talavera applied for Supplemental Security Income in 1999, principally alleging disabling back pain and related physical conditions. On appeal, however, she argued that her 2004 IQ testing independently established disability under the Social Security Administration’s listed impairment for intellectual disability. The testing produced a verbal IQ of 66, performance IQ of 68, and full-scale IQ of 64.

Talavera had attended regular, rather than special-education, classes through the tenth grade; later attempted a GED; and attended business school for about one year. Before her 1996 back injury, she held short-term jobs as a receptionist, telemarketer, and cashier, and testified that neither cognitive nor physical problems had interfered with her ability to perform those jobs. Several earlier medical examinations described her intelligence, memory, judgment, cognition, or capacity to follow instructions as average or normal.

Her later psychological evaluation also reflected substantial everyday abilities. Talavera reported that she could groom herself, use public transportation alone, manage her own finances, use computers, and maintain family relationships. She participated in caring for her children, though her mother performed much of the lifting, cleaning, cooking, and shopping because of Talavera’s physical pain. The psychologist concluded that Talavera could understand and follow simple instructions, perform simple tasks independently, make simple decisions, and relate adequately to others.

The ALJ found that Talavera had severe impairments but retained the residual capacity for certain low-stress light and sedentary work. The ALJ rejected her intellectual-disability claim, relying on her regular schooling, business training, work history, child care, and medical evidence. The Appeals Council denied review. The Eastern District of New York affirmed, reasoning that the record did not establish onset of adaptive-functioning deficits before age twenty-two. Talavera appealed to the Second Circuit.

Issues

Issue #1

Whether an adult claimant’s qualifying IQ score may serve as prima facie evidence that significantly subaverage intellectual functioning began before age twenty-two under Listing § 12.05.

Holding

Yes. Absent evidence that a later event such as trauma or disease caused the cognitive limitation, a qualifying adult IQ score is prima facie evidence that the claimant’s qualifying intellectual deficits existed before age twenty-two.

Reasoning

Listing § 12.05 requires that intellectual disability initially manifest during the developmental period, before age twenty-two. The court joined the majority view among the circuits that intellectual functioning is generally stable over time. Thus, unless contrary evidence suggests that an adult-onset event reduced the claimant’s cognitive capacity, an adult IQ score in the qualifying range supports an inference that the same intellectual limitation existed before age twenty-two.

This presumption fits the regulation’s purpose. The age-of-onset requirement distinguishes an innate intellectual disability from cognitive limitations caused by disease, injury, or another event in adulthood. Treating adult IQ evidence as prima facie evidence of earlier deficits respects that distinction while allowing contrary evidence to rebut the inference.

The rule also avoids an unreasonable evidentiary barrier. Many adults with genuine intellectual disabilities will never have received IQ testing as children, and requiring a contemporaneous childhood test would make proof exceptionally difficult. Talavera’s qualifying adult IQ scores therefore met her initial burden on the onset of significantly subaverage intellectual functioning.

Issue #2

Whether a claimant who has a qualifying IQ score and another significant physical impairment automatically satisfies Listing § 12.05, or must also establish cognitive deficits in adaptive functioning that began before age twenty-two.

Holding

No. A qualifying IQ score does not by itself establish intellectual disability under § 12.05; the claimant must separately prove deficits in adaptive functioning attributable to cognitive limitations and initially manifested before age twenty-two.

Reasoning

The text of § 12.05 defines intellectual disability as significantly subaverage general intellectual functioning with deficits in adaptive functioning. The IQ requirement in the particular severity criterion does not replace that threshold diagnostic requirement. A claimant must establish both low intellectual functioning and inadequate adaptive functioning.

Adaptive functioning concerns a person’s ability to cope with ordinary demands of daily life. The court explained that the relevant deficits must stem from cognitive limitations, rather than from a physical condition or some other infirmity. The listing also requires that the adaptive deficits, like the cognitive deficits, initially manifest before age twenty-two.

There is no necessary connection between a low IQ score and deficient adaptive functioning. A person with an IQ in the 60s may nevertheless function well enough in daily life to sustain full-time work and thus may not be disabled under the listing. The claimant therefore retains the burden to demonstrate the required adaptive deficits.

Issue #3

Whether substantial evidence supported the Commissioner’s finding that Talavera lacked the required deficits in adaptive functioning.

Holding

Yes. Substantial evidence supported the conclusion that Talavera did not establish qualifying adaptive-functioning deficits, so she was not per se disabled under § 12.05.

Reasoning

Talavera’s educational and work history supported the agency’s finding. She completed ten years of regular education, attended business training, and performed her prior jobs without reported cognitive difficulty until physical back problems ended her employment. Those facts supported an inference that she could manage ordinary work and life demands despite her later IQ scores.

Her daily activities also indicated adequate adaptive functioning. She meaningfully participated in caring for her children, traveled on public transportation by herself, managed her own finances, used computers, maintained close family relationships, and presented with fluent speech, appropriate affect, and coherent, goal-directed thought processes. The psychologist further found that she could carry out simple instructions and tasks independently, keep a regular schedule involving noncomplex work, make simple decisions, and relate adequately to others.

Although Talavera needed assistance with household and child-care tasks, the record linked those restrictions to her physical pain and other physical ailments rather than to cognitive limitations. Earlier medical professionals had likewise found average or normal cognitive functioning and no material impairment in her ability to navigate everyday life. Considering the entire record, a reasonable factfinder could conclude that she had not proved the adaptive deficits required by § 12.05.