Friday, June 28, 2013

SSA Judges Tell Lawmakers They Are Pressured To Pay Down The Back-log




Driven to reduce a huge backlog of disability claims, Social Security is pushing judges to award benefits to people who may not deserve them, several current and former judges told Congress Thursday June 27, 2013.

Judge Larry Butler, an administrative law judge (ALJ) from Fort Myers, Fla., called the system “paying down the backlog.”

 (For a complete explanation of the term "paying down the backlog" see socialNsecurity by Judge L. Steverson, USALJ (Ret.)
The approval rates among ALJs can be quite arbitrary. One ALJ might reverse 9 out of 10 cases and another might deny 9 out of 10 cases. It all depends on the luck of the draw.
There is a practice called “Paying Down The Back Log”. This is where a judge just reverses every case on his docket and grants benefits to the claimant. Some ALJs have been known to do this with no regard at all for the merits of the case. Judges have been known to pay 200 cases or more on-the –record in this manner. Sometimes the Commissioner will take action to stop them. Other times he does not. (Steverson, Judge London, socialNsecurity, p. 19)
http://www.amazon.com/Judge-London-Steverson/e/B006WQKFJM

(AP)
A former Social Security Judge, J.E. Sullivan, said, “The only thing that matters in the adjudication process is signing that final decision.” Sullivan is now an administrative law judge for the Department of Transportation.

The House Oversight and Government Reform Committee is investigating why many judges have high approval rates for claims already rejected twice by field offices or state agencies. Two current and two former judges spoke at a subcommittee hearing.

The number of people receiving Social Security disability benefits has increased by 44 percent over the past decade, pushing the trust fund that supports the program to the brink of insolvency.

Social Security officials say the primary reason for the increase is a surge in baby boomers who are more prone to disability as they age. Deputy Social Security Commissioner Glenn Sklar noted that the vast majority of disability claims are initially denied.

“I think the data kind of speaks for itself,” Sklar told lawmakers.

To qualify for benefits, people are supposed to have disabilities that prevent them from working and are expected to last at least a year or result in death.

According to Social Security data, there were errors in 22 percent of the cases decided in 2011, Sklar said. He said some errors were procedural and did not necessarily result in incorrect decisions.

“The true wrong rate would be less than 10 percent,” Sklar said.

Nearly 11 million disabled workers, spouses and children get Social Security disability benefits. That compares with 7.6 million a decade ago. The average monthly benefit for a disabled worker is $1,130.

An additional 8.3 million people get Supplemental Security Income, a separately funded disability program for low-income people.

Social Security disability claims are first processed through a network of local Social Security Administration field offices and state agencies called Disability Determination Services. About two-thirds of initial claims are rejected, according to agency statistics. If your claim is rejected, you can ask the field office or state agency to reconsider. If your claim is rejected again, you can appeal to an administrative law judge, who is employed by Social Security.

In 2007, the average processing time for a hearing was 512 days. Today it is 375 days, Sklar said. The agency has reduced the wait time even as the number of applications has increased. But the judges who testified Thursday said the quality of their decisions has suffered. So far this budget year, the vast majority of judges have approved benefits in more than half the cases they’ve decided, even though they were reviewing applications typically rejected twice by state agencies, according to Social Security data.

Of the 1,560 judges who have decided at least 50 cases since October, 195 judges approved benefits in at least 75 percent of their cases, according to the data analyzed by congressional investigators.

“The Social Security Administration has failed to take steps to address the problem of rapid disability growth, probably because the agency has failed to recognize many of the problems,” said Rep. James Lankford, R-Okla., the subcommittee chairman.

None of the judges who testified spoke of being specifically ordered to award claims. Three said they had been pressured to decide cases without fully reviewing medical files.

The judges described a system in which there is very little incentive to deny claims, but lots of pressure to approve them. It requires more documentation to deny a claim than to approve one, said Sullivan, the former Social Security judge. Also, rejected claims can be appealed while approved claims are not.

There’s a tremendous amount of pressure to push cases out the door as soon as possible,” Sullivan said in an interview after the hearing. “There’s a push to pay mentality.

Butler, the current judge, told the subcommittee, “I think you need to look at the issue of paying down the backlog. It’s not media hype, its real and for six years it’s been going on.”
                      (AALJ President Randy Frye and Marilyn Zahm)
The Association Of Administrative Law Judges(AALJ), union representing administrative law judges, says judges are required to decide 500 to 700 cases a year in an effort to reduce the hearings backlog. The union says the requirement is an illegal quota that leads judges to sometimes award benefits they might otherwise deny just to keep up with the flow of cases. according to a federal lawsuit filed by the judges’ union in April.

 The Social Security Administration says the agency’s administrative law judges (ALJs) should decide 500 to 700 disability cases a year. The agency calls the standard a productivity goal, but a lawsuit filed in April 2013 by the Social Security Judges against the Commissioner and the Agency claims it is an illegal quota that requires judges to decide an average of more than two cases per workday.
‘‘When the goals are too high, the easy way out is to pay the case,’’ said Randall Frye, president of the Association of Administrative Law Judges (AALJ) and a judge in Charlotte, N.C. ‘‘Paying the case is a decision that might be three pages long. When you deny benefits, it’s usually a 15- or 20-page denial that takes a lot more time and effort.’’

The lawsuit raises serious questions about the integrity of the disability hearing process by the very people in charge of running it. It comes as the disability program faces serious financial problems.
The agency denies there is a case quota for judges and says the standard is a productivity goal.

  “I find it interesting that there is so much wringing of the hands about a judge who pays almost 100% of his cases, as if the agency didn’t know about it, as if the agency wasn’t complicit in it, as if the agency didn’t encourage it,” said Marilyn Zahm, a Social Security judge in Buffalo, NY who is an executive vice president of the Association of Administrative Law Judges (AALJ), the judges’ union.

Judge Zahm had a lot more to say in an interview in October 2009. (Read the entire interview starting at page 430 in my book, socialNsecurity, available at  http://www.amazon.com/SocialNsecurity-ebook/dp/B006VOQIKK

If Congress doesn’t act, the trust fund that supports Social Security disability will run out of money in 2016, according to projections by Social Security’s trustees. At that point, the system will collect only enough money in payroll taxes to pay 80 percent of benefits, triggering an automatic 20 percent cut in benefits.

Congress could redirect money from Social Security’s much bigger retirement program to shore up the disability program, as it did in 1994. But that would worsen the finances of the retirement program, which is facing its own long-term financial problems. (AP)

Several current and former Administrative Law Judges (“ALJs”) testified before Congress that the Social Security Administration is purportedly pushing ALJs to award benefits (or grant benefits) in an effort to reduce the rather large backlog of disability claims in the system. This further feeds the misperception that ALJs are approving claims willy-nilly left and right. Just as there are Judges who have high approval rates or grant rates (the percentage of claims approved out of all claims disposed), there are Judges who have extremely low grant rates and deny the vast majority of claims that they decide.

Nick A. Ortiz, Esq. crunched the data from all Social Security disability claims decided in Fiscal Year 2012. The data was found here: http://www.socialsecurity.gov/appeals/DataSets/Archive/archive_data_reports.html. [Update: the raw, unedited data can be found here in the archives for 2012: http://www.ssa.gov/appeals/DataSets/archive/archive_data_reports.html#ht=1].

 http://www.nickortizlaw.com/the-50-social-security-administrative-law-judges-with-the-worst-grant-rates-in-2012/

Tuesday, June 25, 2013

Silence Is Not Golden Anymore

On Monday, in a case called Salinas v. Texas the Supreme Court held that you remain silent at your peril. The court said that this is true even before you’re arrested, when the police are just informally asking questions. The court’s move to cut off the right to remain silent is wrong and also dangerous — because it encourages the kind of high-pressure questioning that can elicit false confessions.
This case has not gotten the attention it deserves.  Here are the facts from Salinas: Two brothers were shot at home in Houston. There were no witnesses — only shotgun shell casings left at the scene. Genovevo Salinas had been at a party at that house the night before the shooting, and police invited him down to the station, where they talked for an hour. They did not arrest him or read him his Miranda warnings. Salinas agreed to give the police his shotgun for testing. Then the cops asked whether the gun would match the shells from the scene of the murder. According to the police, Salinas stopped talking, shuffled his feet, bit his lip, and started to tighten up.
At trial, Salinas did not testify, but prosecutors described his reportedly uncomfortable reaction to the question about his shotgun. Salinas argued this violated his Fifth Amendment rights: He had remained silent, and the Supreme Court had previously made clear that prosecutors can’t bring up a defendant’s refusal to answer the state’s questions. This time around, however, Justice Samuel Alito blithely responded that Salinas was “free to leave” and did not assert his right to remain silent. He was silent. But somehow, without a lawyer, and without being told his rights, he should have affirmatively “invoked” his right to not answer questions. Two other justices signed on to Alito’s opinion. Justice Clarence Thomas and Justice Antonin Scalia joined the judgment, but for a different reason; they think Salinas had no rights at all to invoke before his arrest (they also object to Miranda itself). The upshot is another terrible Roberts Court ruling on confessions.
 In 2010 the court held that a suspect did not sufficiently invoke the right to remain silent when he stubbornly refused to talk, after receiving his Miranda warnings, during two hours of questioning. Now people have to somehow invoke the right to remain silent even when they’re not formal suspects and they haven’t been heard the Miranda warnings. As Orin Kerr points out on the Volokh Conspiracy, this just isn’t realistic.

The court’s ruling in Salinas is all the more troubling because during such informal, undocumented, and unregulated questioning, there are special dangers that police may, intentionally or not, coax false confessions from innocent suspects. I have spent years studying cases of people exonerated by DNA testing. A large group of those innocent people falsely confessed — and many supposedly admitted their guilt even before any formal interrogation. The Supreme Court’s decision in Salinas encourages loosey-goosey, and easily contaminated, police questioning that can lead to wrongful convictions. Salinas may very well have been guilty of the two murders. But in many cases, as in this one, there are no eyewitnesses and not much other evidence of guilt: That is why the police may desperately need a confession. And that makes it crucial for them to handle interrogations and confessions with the utmost care. The court appreciated none of the pressures police face, and how they can squeeze an innocent suspect.Questions first, rights later is the approach the court’s majority now endorses. And by giving the police more incentive to ask questions informally, the new ruling will also undermine the key reform that police have adopted to prevent false confessions: videotaping entire interrogations. Why not try to trap a suspect before the camera starts rolling? In only a few cases like Yarris’ will there be DNA to test. The likely result of the court’s embrace of shoddy interrogation tactics: more wrongful convictions.

Saturday, June 15, 2013

Is Snowden Really A Double Agent Sent By USA To China To Assess Chinese Hacking Capabilities?


Edward Snowden, a former contractor for the U.S. National Security Agency, said he believed there had been more than 61,000 NSA hacking operations globally, including hundreds in Hong Kong and on the Chinese mainland. Those claims followed intelligence leaks Mr. Snowden made earlier this month to British newspaper the Guardian about U.S. surveillance, which prompted a political furor in the U.S.
When it comes to Hong Kong politics, activists typically see Beijing as the main source of meddling in local affairs. Although the former British colony returned to mainland rule in 1997 and continues to operate with its own distinctive political systems and rule of law, pro-democracy activists fear Beijing is encroaching on the city.
“Usually we hear from Western media that Chinese government is the one hacking,” said Oiwan Lam of Hong Kong In-media, which supports citizen journalism and is helping organize  a rally Saturday in support of Mr. Snowden. “But apparently it’s a double standard, and when the U.S. hacks we are just in the dark,” said Ms. Lam.
Supporters plan to march Saturday on Hong Kong’s government and the U.S. consulate.
“What are we going to say to fight our battles now [against Chinese hacking] if the U.S. is doing the same?” she said.
While some Hong Kong lawmakers called on the government to ask for clarifications from Washington about what activities were carried out, others said the allegations so far didn’t seem to amount to much. “We all know Hong Kong is a city where lots of spying has been carried out. If the U.S. government has been spying in Hong Kong, that’s not surprising at all,” said lawyer Martin Lee, who helped establish the city’s Democratic Party. Compared with Chinese spying activities in Hong Kong, he said, the U.S.’s activities so far revealed by Mr. Snowden are “nothing.”
Mr. Lee said he already assumes his phone line is bugged and his office computers regularly the target of Chinese hackers. “At least if I know that there’s more than one government is spying on me I might feel safer, that way it’s not just the Chinese,” said Mr. Lee, who doesn’t expect the local movement supporting Mr. Snowden to gain much traction.
“People think it’s really a matter between a U.S. citizen and his government. I doubt if that [issue] would raise too much enthusiasm from Hong Kong citizens,” he said.
On Thursday, a spokeswoman for China’s Foreign Ministry said she had no information on Mr. Snowden’s claims and reiterated China’s stance that it is a victim rather than a perpetrator of hacking. The Chinese University in Hong Kong, which Mr. Snowden named as one target of American hacking and is home to the Hong Kong Internet Exchange—an Internet hub for the Asia-Pacific region—said it hadn’t detected any form of hacking on its network.
While China’s state-controlled media at first paid minimal attention Mr. Snowden’s case, his latest allegations spurred various outlets to become more vocal. On Thursday, CCTV highlighted Mr. Snowden’s claims in its widely watched evening news broadcast. On Friday, Hong Kong’s Communist Party-sympathizing Chinese-language newspaper Wen Wei Po ran a photo illustration of Mr. Snowden’s head imposed on the body of a man wearing a long trenchcoat, frozen in a “Matrix”-style pose, under the headline “The U.S. Breaches Hong Kong Computers, Meddles in Hong Kong Affairs.”
Mr. Snowden has said that he wants to stay in Hong Kong, where he has been hiding out since May 20. He told the South China Morning Post that he ultimately plans to fight the U.S. in its courts. While Hong Kong has an extradition treaty with the U.S. government, if he chooses to apply for asylum or contest any potential extradition, Mr. Snowden could prolong his stay in Hong Kong for potentially years, lawyers say.
Still, Hong Kong-based lawyer Kevin Egan said it wasn’t likely Mr. Snowden would be able to escape extradition if the U.S. issues a request. “If I was his legal adviser, I’d be telling him to get out of town,” said Mr. Egan, citing the numerous occasions on which Hong Kong has surrendered suspects back to the U.S. “He says he has a great deal of faith in Hong Kong’s legal system and he’s going to stay and fight? Good luck to him.”
Lawyer Ronny Tong said that Hong Kong could be a good base for Mr. Snowden if his goal is to get his message out, given its international media presence and independent judicial system. But he cautioned that top-notch legal representation in Hong Kong for Mr. Snowden will be expensive, particularly if it ends up involving a protracted yearslong battle. In such a case, Mr. Snowden could wind up with a bill for up to $650,000 in legal fees, Mr. Tong said.
In addition to the attention Mr. Snowden’s allegations have received in Hong Kong and in state media, they’ve also been the object of some amusement—as well as outrage—on China’s voluble social media network.
“Chinese exiles used to run to America,” posted one user of the popular Sina Weibo microblogging service Thursday. “Now Americans start running to China.”
– Te-Ping Chen and Brian Spegele

Saturday, June 8, 2013

Man Who Shot And Killed Thief Found Not Guilty


A Bexar County Texas jury on Wednesday acquitted Ezekiel Gilbert of murder in the death of a 23-year-old Craigslist escort.
Gilbert, 30, embraced defense attorneys Bobby Barrera and Roy Barrera Sr. with tears in his eyes after the not guilty verdict was read aloud by state District Judge Mary Román.
Outside the courtroom, Gilbert thanked God, the Barrera family and the jury for being able to “see what wasn't the truth” and for the “second chance.”
Had he been convicted, he could have faced up to life in prison for the slaying of Lenora Ivie Frago who died about seven months after she was shot in the neck and paralyzed on Christmas Eve 2009. Gilbert admitted shooting Frago.
“I sincerely regret the loss of the life of Ms. Frago,” Gilbert said Wednesday. “I've been in a mental prison the past four years of my life. I have nightmares. If I see guns on TV where people are getting killed, I change the channel.”
The verdict came after almost 11 hours of deliberations that stretched over two days. The trial began May 17 but had a long hiatus after a juror unexpectedly had to leave town for a funeral.
During closing arguments Tuesday, Gilbert's defense team conceded the shooting did occur but said the intent wasn't to kill. Gilbert's actions were justified, they argued, because he was trying to retrieve stolen property: the $150 he paid Frago. It became theft when she refused to have sex with him or give the money back, they said.
Gilbert testified earlier Tuesday that he had found Frago's escort ad on Craigslist and believed sex was included in her $150 fee. But instead, Frago walked around his apartment and after about 20 minutes left, saying she had to give the money to her driver, he said.
That driver, the defense contended, was Frago's pimp and her partner in the theft scheme.
The Texas law that allows people to use deadly force to recover property during a nighttime theft was put in place for “law-abiding” citizens, prosecutors Matt Lovell and Jessica Schulze countered. It's not intended for someone trying to force another person into an illegal act such as prostitution, they argued.

Monday, June 3, 2013

Military Wakes Up To Broad Reach Of Civilian Reformers Of UCMJ



WASHINGTON (AP) — The Uniform Code Of Military Justice (UCMJ) gives American military commanders  substantial power to discipline the troops they lead. However an epidemic of sexual assaults in the armed forces has Congress considering changes to that well established authority.
The big question is by how far and how wide?
Army Gen. Martin Dempsey, chairman of the Joint Chiefs of Staff, and the four-star officers atop each service are scheduled to testify June 4th at a Senate hearing on congressional proposals to modify theUCMJ with the aim of staunching the escalating number of sexual assaults that have outraged the military and the public.
Dempsey and other military leaders say they are open to legislative solutions to the problem. But, they are deeply concerned that too drastic an overhaul by Congress will lead to unintended and alarming consequences.
Curbing too sharply a commander's ability to decide how and when to punish or pardon service members will send a message there is lack of faith in the officer corps, and that in turn will undermine the efficiency and effectiveness of the military in peacetime and war, Dempsey warned in a recent letter to Sen. Carl Levin, D-Mich., chairman of the Senate Armed Services Committee.
Paradoxically, the Defense Department's failure so far to change the military's male-dominated culture is driving a vocal group of mainly female lawmakers led by Sen. Kirsten Gillibrand, D-N.Y., to advocate aggressive reforms.
Tinkering at the edges, they argue, won't produce the seismic shift needed to send the message that sexist attitudes and behaviors will no longer be tolerated. Victims need to be confident that if they report a crime their allegations won't be discounted and they won't face retaliation.
The latest in a string of allegations came May 31, 2013.
The Pentagon said the U.S. Naval Academy is investigating allegations that three football team members sexually assaulted a female midshipman at an off-campus house more than a year ago, and a lawyer for the woman says she was "ostracized" on campus after she reported it.
The Naval Academy investigation follows several recent arrests: A soldier at the U.S. Military Academy at West Point was charged with secretly photographing women, including in a bathroom. The Air Force officer who led the service's Sexual Assault Prevention and Response unit was arrested on charges of groping a woman. And the manager of the Army's sexual assault response program at Fort Campbell, Ky., was relieved of his post after his arrest in a domestic dispute with his ex-wife.
The Pentagon estimated in a report last month that up to 26,000 military members may have been sexually assaulted last year, up from an estimated 19,000 assaults in 2012, based on an anonymous survey of military personnel. While the number of sexual assaults members of the military actually reported rose 6 percent to 3,374 in 2012, thousands of victims are still unwilling to come forward despite new oversight and assistance programs aimed at curbing the crimes, the report said.
Those numbers and outrage over two recent decisions by Air Force generals overturning juries' guilty verdicts in sexual assault cases are generating support for Gillibrand's proposal to largely strip commanding officers of the power to toss out a verdict, a change initially recommended in April by Defense Secretary Chuck Hagel and backed by Dempsey, the service chiefs and many members of Congress.
But Gillibrand's bill goes much farthertoo far, according to Dempsey. It would remove commanders from the process of deciding whether serious crimes, including sexual misconduct cases, go to trial. That judgment would rest with seasoned trial counsels who have prosecutorial experience and hold the rank of colonel or above.
Her legislation, which has 18 cosponsors that include four Republicans, also would take away a commander's authority to convene a court-martial. That responsibility would be given to new and separate offices outside the victim's chain of command.
"The current system allowing commanders to have sole discretion in the disposition of legal matters is clearly broken and has a chilling effect on reporting," said Gillibrand, who chairs the Armed Services Committee's personnel subcommittee. "We must ... increase accountability within the system by removing the influence of the chain of command in the prosecution of intolerable crimes."
In a May 20 letter to Levin, Dempsey said taking away a commander's ability to convene a court-martial would "radically" alter a principal tenet of military law dating back two centuries and merged more than 60 years ago into a single Uniform Code of Military Justice.
"While Congress has modified the UCMJ from time to time, it has never removed commanders from the military justice system," Dempsey wrote. "The consequences of such a decision would be far-reaching and extraordinarily damaging to the nation's security."
Whether all or parts of Gillibrand's Military Justice Improvement Act are added to the defense policy bill for the 2014 fiscal year remains to be seen.
But changes are coming. The GOP-led House Armed Services military personnel subcommittee used Hagel's April recommendation as a starting point and then went further in a bill it approved two weeks ago.
In addition to taking away the authority to reverse courts-martial rulings, the subcommittee voted to establish dismissal or dishonorable discharge as the mandatory minimum sentence under military law for service members found guilty of rape, sexual assault, forcible sodomy or an attempt to commit those offenses. Commanders also would be barred from reducing or commuting the minimum sentence except in situations where the accused substantially aided the government in the investigation or prosecution of another assailant.
The House bill, however, stops short of taking those cases outside the chain of command, as Gillibrand's bill proposes. Rep. Michael Turner, R-Ohio, who co-chairs the House Military Sexual Assault Prevention Caucus, said the focus should be on preventing sexual assaults, not scrapping central elements of the current military justice system.
The hearing June 4 may indicate how far the Senate Armed Services Committee is willing to go. A final plan will eventually be produced after any differences between the House and Senate are resolved.
Levin has not publicly stated his position on Gillibrand's proposal but has made clear he is dissatisfied with the Pentagon's efforts to eradicate what he has described as the "plague of sexual assaults in the military."
And Sen. Claire McCaskill, D-Mo., an Armed Services Committee member and critic of the Pentagon's handling of sexual assault cases, isn't co-sponsoring Gillibrand's bill, backing instead many of the changes the House panel approved.
McCaskill told reporters last month that she's not opposed to Gillibrand's legislation but wants to be sure Congress doesn't squander a chance to pass a bill because of partisan differences over its scope. "I am tired of trying to legislate around the gridlock in Congress," she said.
___

Thursday, May 30, 2013

Former Social Security Medical Expert Sentenced To Years In Federal Prison For Fraudulently Bilking SSA Of $1.5 Million In Benefits





( Wed, 29 May 2013 10:46:43 PST)
SAN DIEGO (CNS) - Doctor  Roberto J. Velasquez, a clinical psychologist, from National City,CA was sentenced Wednesday, May 29th, to nearly two years in federal prison for fraudulently obtaining government disability benefits via a scheme in which the Social Security Administration was swindled out of at least $1.5 million.

While handing down the 21-month custody term in federal court in downtown San Diego, Chief District Judge Barry Ted Moskowitz also ordered Doctor Velasquez, 55, to repay the funds he illicitly obtained.

Over a six-year period beginning in 2006, Velasquez falsely certified that dozens of able-bodied patients were disabled, according to court documents.

To further the fraud, Velasquez made up patient histories, fabricated test results, suggested symptoms and complaints that did not exist, and intentionally underestimated patient scores on standardized tests, prosecutors said.

In exchange for each false report, Velasquez charged his patients a $200 kickback, according to the government.

In his plea agreement, the defendant, who was arrested in the case 13 months ago, admitted that he faked disability-exception forms used by the Department of Homeland Security during naturalization processes.

Doctor Velasquez's false certifications allowed immigrants to avoid taking civics and English-language portions of the U.S. citizenship exam, prompting the Department of Homeland Security to grant exemptions to about 50 applicants who were not actually disabled.

According to court documents, Doctor Velasquez coached his patients to skirt the citizenship requirements by instructing them to use poor English during interviews and avoid mentioning that they had college educations.

He also lied, prosecutors said, about the length of time he had been treating his patients, in order to falsify a record that would satisfy reviewers at the Social Security Administration, where he previously had worked as a consultant. (He was probably an expert medical witness.)
In addition, Doctor Velasquez conceded that he submitted phony medical reports to the Social Security Administration, falsely certifying that certain patients were eligible for disability benefits when he knew they were not, and admitted that roughly one-third of his patient files contained false statements and bogus certifications of disability.

The fraud was uncovered through an undercover operation conducted by the Department of Homeland Security, Immigration and Customs Enforcement/Homeland Security Investigations and the Office of Inspector General in the Social Security Administration.

The prosecution was part of the U.S. Attorney's Health Care Fraud Initiative.

Wednesday, May 29, 2013

Being Born A Man Does Not Render A Woman Disabled

French v. Commissioner of Social Security (USA)

April 23, 2013
 ESPER FRENCH, Plaintiff, v. COMMISSIONER OF SOCIAL SECURITY, Defendant.



UNITED STATES DISTRICT COURT

March 12, 2013, Decided

OPINION

Plaintiff Esper French appeals Defendant Commissioner of Social Security’s (“Commissioner”) denial of her applications for disability insurance benefits and supplemental security income.
 For the reasons set forth below, this Court finds that substantial evidence supports the Commissioner’s decision.
The Court therefore RECOMMENDS that Plaintiff’s Motion for Summary Judgment be DENIED , that Defendant’s Motion for Summary Judgment be GRANTED , and that the decision of the Commissioner of Social Security be AFFIRMED .
I. BACKGROUND
Plaintiff was 52 years old on the date she alleges she became disabled.  Plaintiff graduated from high school and completed some college work She previously worked as a computer-aided drafter (CAD), a general laborer, and as a care giver.  She alleges that she cannot work due to her depression,  gender dysphoria and deafness.
A. Procedural History
On November 5, 2008, Plaintiff applied for disability insurance benefits (“DIB”) and supplemental security income (“SSI”) asserting that she became unable to work on January 2, 2006.  The Commissioner initially denied Plaintiff’s disability application on May 16, 2009.
 Plaintiff then requested an ALJ administrative hearing, and on September 27, 2010, she appeared with counsel before Administrative Law Judge Timothy C. Scallen, who considered her case de novo  Vocational expert Elizabeth A. Pasikowski also appeared at the hearing.
In an October 20, 2010 decision, ALJ Scallen found that Plaintiff was not disabled.
 The ALJ’s decision became the final decision of the Commissioner on April 26, 2012, when the Social Security Administration’s Appeals Council denied Plaintiff’s request for review.
 Plaintiff filed this suit on June 27, 2012.
B. Medical Evidence
In November 1997, records from Foote Hospital show that Plaintiff was hospitalized for psychiatric issues. An assessment at that time indicated depression, suicidal  ideation,
In or around 2001, Plaintiff underwent a trans-gender surgery to become female.
Plaintiff is referred to herein as “she” when referring to evidence post-dating the gender change.
An earlier hearing on April 26, 2010 was adjourned so that Plaintiff could obtain representation.
 ALJ Scallen also presided over the first, abbreviated hearing,
and trans-sexual disorder/gender identity disorder.
On February 19, 1998, Plaintiff was admitted to the hospital after a self-castration attempt.  Hospital notes indicate that Plaintiff wanted a sex change operation, but was unable to find a physician to perform it.  Plaintiff was taking Premarin – a hormone replacement therapy most commonly used in post-menopausal women.  Plaintiff underwent a surgical procedure to debride his scrotum, evacuate the clot, and properly close the wound.
On May 2, 1998, Plaintiff was admitted to the hospital after attempting to amputate his left testicle.  Emergency room notes from May 29, 1998 indicate that Plaintiff had undergone a sexual reassignment surgery and continued to undergo hormonal therapy. Plaintiff wanted to speak to someone in the psychiatric unit regarding his mood swings, volatile moods, and fears of hurting himself. Emergency room notes state that Plaintiff’s symptoms were partly due to the hormone therapy, and also to the adjustment to his new female role.
 Plaintiff was diagnosed with adjustment disorder and was instructed to continue outpatient therapy and to return if symptoms worsened.
On August 27, 2000, Plaintiff was admitted to the hospital for depression. Plaintiff reported feeling depressed and frustrated with the way his coworkers were treating him because of changing his identity to a woman.  Plaintiff denied suicidal or homicidal ideation. Plaintiff was diagnosed with adjustment disorder, depressed mood and gender identity disorder and was advised to follow-up with counseling.) Plaintiff was also given instructions to return if symptoms worsened or persisted.
These notes likely reflect Plaintiff’s self-castration attempts, as formal trans-gender surgery occurred in or around 2001.
3
On September 30, 2000, a bone density test of Plaintiff’s lumbar spine  and left hip was performed.  Testing indicated osteopenia of the lumbar spine with a slightly increased risk of pathological fracture.  Results also showed osteopenia of the left hip with a slightly increased risk for pathological fracture.
In February 2001, emergency room records indicate that Plaintiff continued to pursue a sex change – from male to female.  Plaintiff made comments indicating that she believed that she was a “joke” and that “no one care[d] if [she was] dead or alive.”  The emergency room physician indicated that Plaintiff also had suicidal ideation.
On April 8, 2009, Dr. Eugene Rontal examined Plaintiff’s hearing capacity.  Dr. Rontal reported that Plaintiff had worn hearing aids, but had lost them.  The examination revealed normal tympanic membranes and ear canals.  An audiogram demonstrated a moderate sensorineural hearing loss in both ears.  With a hearing aid, Plaintiff had 96% discrimination at 50dB. Dr. Rontal opined that Plaintiff had bilateral sensorineural hearing loss of a hereditary origin.  Dr. Rontal further believed that a hearing aid was the only  treatment available.
On April 24, 2009, Michele Bridges prepared a case analysis for the State concluding that Plaintiff would be able to perform some type of low skilled work that did not heavily rely on hearing.  Ms. Bridges also concluded that working with the public, working in a fast food setting that relies heavily on hearing, or work requiring phone use would be difficult.
On April 27, 2009, Dr. Donald Kuiper completed a physical residual functional capacity assessment. In it, Dr. Kuiper opined that Plaintiff could occasionally lift and/or carry 50 pounds, frequently lift and/or carry 25 pounds, stand and/or walk about 6 hours in an 8-hour workday, sit for
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a total of about 6 hours in an 8-hour workday, and was unlimited in her ability to push and/or pull.  Dr. Kuiper noted no postural, manipulative, visual, communicative or environmental limitations.  After indicating that Plaintiff had no communication limitations, Dr. Kupier concluded that Plaintiff “retains sufficient hearing to be able to avoid normal workplace hazards and understand occasional oral instructions.”  Dr. Kuiper noted an audiogram and ENT exam dated April  8, 2009 which demonstrated a non-listing level hearing and discrimination limitation.  Further, Dr. Kupier reported that an audiogram performed in 2006 confirmed the same level of limitation.
On August 23, 2010, clinical therapist Bernadine McClung evaluated Plaintiff and determined that Plaintiff had gender identity disorder together with dysthymic disorder depressed mood. Ms. McClung assessed Plaintiff’s Global Assessment Functional (GAF) Scale score at 30.  Moreover, Ms. McClung concluded that Plaintiff exhibited “[s]erious impairment in judgment, preoccupation with becoming and looking like a female, suicidal ideation, [and an] inability to function in almost all areas.”  Ms. McClung further noted that Plaintiff, “[l]ack[ed] motivation to get out of bed, [and was] unable to obtain and keep a job.
On September 23, 2010, Jennifer Turecki-Kaiser, MA, prepared an initial vocational assessment (IVA) to determine Plaintiff’s ability to participate in vocational rehabilitation as it related to Plaintiff’s ability to return to gainful employment. Ms. Turecki indicated that Plaintiff was teaching herself to read lips.  Despite this, Ms. Turecki had to repeat and rephrase herself numerous times throughout the interview.  Ms. Turecki noted that Plaintiff had been diagnosed with moderate, bilateral hearing loss.  Ms. Tuercki also noted that in 2006, Plaintiff’s hearing loss rose to the level of disability.  Ms. Turecki pointed out Plaintiff’s
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numerous unskilled labor positions and that Plaintiff was “let go” from numerous positions due to her hearing loss and gender modification issues.  Ms. Turecki also noted that Plaintiff was “harassed, ridiculed and at times, felt threatened by others due to her gender reassignment.”  Ms. Turecki concluded that Plaintiff’s past work was at the unskilled or semi-skilled level with the highest specific vocational preparation of 3. She noted no transferrable skills from Plaintiff’s past work.  As such, based on education and skill level, Ms. Turecki concluded that Plaintiff was a candidate for unskilled work only. With Plaintiff’s hearing loss, Ms. Turecki also concluded that only jobs that did not require hearing should be considered.  After reviewing Dr. Gray’s September 20, 2010 RFC assessment, Ms. McClung’s report, Ms. Bridges’ assessment, and taking into account Plaintiff’s hearing loss and trans-gender issues, Ms. Turecki concluded that “her impairments and symptoms [] would make gainful competitive employment a non-realistic goal.”
C. Testimony at the Hearing Before the ALJ
1. Plaintiff’s Testimony
Plaintiff is trans-gendered female. She lives with two roommates.  Plaintiff reported that she did most of the housework, although one of her roommates was a hoarder and did not allow Plaintiff to pick up any of her belongings. Plaintiff also reported that she cooked all of the meals. Plaintiff reported that she watched television; however, because of her hearing loss, she directed the sound through a walkman as high as she can get it.  Plaintiff reported being active socially with her roommates, going to movies, parks, coffee houses, and open microphone
Dr. Gray’s RFC assessment, while noted in Ms. McClung’s report, was not included in the administrative record.
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nights.  Plaintiff also reported reading science fiction and collecting Star Trek memorabilia.
Plaintiff reported that her hearing  aids were stolen from her purse and that she had not replaced them.  Plaintiff reported having no insurance to pay for replacement hearing aids.  Without the assistance of her hearing aids, Plaintiff testified that she communicated through reading lips and by using some sign language. Plaintiff testified that she was only able to understand about 40 to 50 percent of what is going on around her due to her lack of hearing. Plaintiff reported that she was afraid to drive because she cannot hear a car horn and felt she was a hazard to people on the road.  Plaintiff reported that the last time she drove was in 2008.  Plaintiff testified that the last time she worked was in 2008 as a care giver for an autistic child. She testified that she only worked for three or four weeks before quitting because she felt as though she was more of a burden than a help.  Before that, Plaintiff reported that she worked for a temporary service at a factory.  However, despite typically making a good first impression on temporary employers, Plaintiff testified that soon employers would realize that she could not pay attention   and her supervisors would get very upset with her and would ask her to leave the building.
Plaintiff also reported upsetting experiences associated with her gender change from 1998 until 2006.  Plaintiff testified that people would make comments like: “it might be better off if [she would] just put the gun to [her] own head and save some heterosexual the need to go to prison for the rest of his life.”  Plaintiff reported that she got to a point in her gender dysphoria, that she castrated herself. ) Due to the lack of understanding of the subject, Plaintiff reported that this is not uncommon within the trans-gender community. Plaintiff
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reported that she became disabled on January 2, 2006.  Despite this, Plaintiff attempted
to continue working; however, she reported that her hearing remained compromised.
Plaintiff testified that the buzzing she experienced in her ears affects her concentration.
Plaintiff did not take any medications for her depression.  Plaintiff did, however, report
taking hormone therapy medication.
2. The Vocational Expert’s Testimony
The ALJ solicited testimony from a vocational  xpert (“VE”) about job availability for a
hypothetical individual of Plaintiff’s age, education, and work experience who was capable of
performing all exertional demands, but has the following non-exertional limitations: first of all, avoiding concentrated exposure to excessive noise I’m going to say simple, routine, repetitive tasks for the reason that her concentration is interrupted by not only the constant buzzing the way you’ve said it in your ear which interferes with concentration, but also the psychological problems as well, no interaction with the public, occasional interaction with coworkers, which requires only communication at close distances, and limit to occasional oral instructions.
The VE testified that the general laborer position would apply. However, if there
was a restriction of not being able to interact at all with co-workers, then the general laborer position
would not apply.  The ALJ then asked if the position could allow for using headphones to
drown out noise. The VE responded that it would not.
II. THE ALJ’S APPLICATION OF THE DISABILITY FRAMEWORK
Under the Social Security Act (the “Act”), Disability Insurance Benefits  (for qualifying wage
earners who become disabled prior to expiration of their insured status) and Supplemental Security
Income “are available only for those who have a ‘disability.’” See Colvin v. Barnhart , 475 F.3d 727,
730 (6th Cir. 2007). The Act defines “disability,” in relevant part, as the:
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inability 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), 1382c(a)(3)(A) (DIB); 20 C.F.R. § 416.905(a) (SSI).
The Social Security regulations provide that disability is to be determined through the
application of a five-step sequential analysis:
Step One: If the claimant is currently engaged in substantial gainful activity, benefits are denied without further analysis.
Step Two: If the claimant does not have a severe impairment or combination of impairments that “significantly limits . . . physical or mental ability to do basic work activities,” benefits are denied without further analysis.
Step Three: If the claimant is not performing substantial gainful activity, has a severe impairment that is expected to last for at least twelve months, and the severe impairment meets or equals one of the impairments listed in the regulations, the claimant is conclusively presumed to be disabled regardless of age, education, or work experience.
Step Four: If the claimant is able to perform his or her past relevant work, benefits are denied without further analysis.
Step Five: Even if the claimant is unable to perform his or her past relevant work, if other work exists in the national economy that plaintiff can perform, in view of his or her age, education, and work experience, benefits are denied.
See 20 C.F.R. §§ 404.1520, 416.920; see also Heston v. Comm’r of Soc. Sec. , 245 F.3d 528, 534 (6th
Cir. 2001). “The burden of proof is on the claimant throughout the first four steps . . . . If the
analysis reaches the fifth step without a finding that the claimant is not disabled, the burden transfers
to the [Commissioner].” Preslar v. Sec’y of Health and Human Servs. , 14 F.3d 1107, 1110 (6th
Cir. 1994).
At step one, ALJ Scallen found that Plaintiff had not engaged in substantial gainful activity
since the alleged disability onset date of January 2, 2006. (Tr. 24.) At step  two, he found that
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Plaintiff had the following severe impairment: deafness. Next, the ALJ concluded that this impairment did not meet or medically equal a listed impairment.  Between steps three and four, the ALJ determined that Plaintiff had the residual functional capacity to perform “a full range of work at all exertional levels but with the following nonexertional limitations: avoid concentrated exposure to excessive noise; simple, routine, repetitive tasks; no interaction with the public; occasional interaction with co-workers; tasks which only require communication at close contact.” At step four, the ALJ found that Plaintiff was able to perform her past work as a general laborer.  The ALJ therefore concluded that Plaintiff was not disabled as defined by the Social Security Act.
III. STANDARD OF REVIEW
This Court has jurisdiction to review the Commissioner’s final administrative decision pursuant to 42 U.S.C. § 405(g). Judicial review under this statute is limited: the Court “must affirm the Commissioner’s conclusions absent a determination that the Commissioner has failed to apply the correct legal standard or has made findings of fact  unsupported by substantial evidence in the record.” Longworth v. Comm’r of Soc. Sec. , 402 F.3d 591, 595 (6th Cir. 2005) (internal quotation marks omitted).
Substantial evidence is “more than a scintilla of evidence but less than a preponderance; it is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.”
Rogers v. Comm’r of Soc. Sec. , 486 F.3d 234, 241 (6th Cir. 2007). If the Commissioner’s decision is supported by substantial evidence, “it must be affirmed even if the reviewing court would decide the matter differently and even if substantial evidence also supports the opposite conclusion.” Cutlip v. Sec’y of Health & Human Servs. , 25 F.3d 284, 286 (6th
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Cir. 1994); see also Mullen v. Bowen , 800 F.2d 535, 545 (6th Cir. 1986) (en banc) (noting that the substantial evidence standard “presupposes . . . a zone of choice within which the decisionmakers can go either way, without interference by the courts” ).
When reviewing the Commissioner’s factual findings for substantial evidence, the Court is limited to an examination of the record and must consider that record as a whole. Bass v. McMahon , 499 F.3d 506, 512-13 (6th Cir. 2007); Wyatt v. Sec’y of Health & Human Servs. , 974 F.2d 680, 683 (6th Cir. 1992). The Court “may look to any evidence in the record, regardless of whether it has been cited by the Appeals Council.” Heston v. Comm’r of Soc. Sec. , 245 F.3d 528, 535 (6th Cir. 2001). There is no requirement, however, that either the ALJ or this Court discuss every piece of evidence in the administrative record. Kornecky v. Comm’r of Soc. Sec. , 167 F. App’x 496, 508 (6th Cir. 2006). Further, this Court does “not try the case de novo, resolve conflicts in evidence, or decide questions of credibility.” Bass , 499 F.3d at 509; Rogers , 486 F.3d at 247.
IV. ANALYSIS
Plaintiff raises two claims of error – first, that the ALJ failed to properly determine the effects of her hearing loss on her ability to work; and second, that the ALJ improperly omitted depression and gender identity disorder from the list of severe impairments at step two.
A.  The ALJ Properly Determined The Effects Of Plaintiff’s Hearing Loss On Her Ability To Work
Plaintiff argues that the ALJ failed to properly determine the effects of her hearing loss on her ability  to work. This Court disagrees and concludes that the ALJ’s determination that Plaintiff could return to work as a general laborer is supported by substantial evidence.
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The ALJ accommodated Plaintiff’s hearing problems by including limitations in the RFC including avoidance of concentrated exposure to excessive noise, communication at close range (presumably to accommodate her need to read lips), no interaction with the public, and only occasional interaction with co-workers. Moreover, ALJ Scallen accommodated the “buzzing” in Plaintiff’s ears which reportedly affected her concentration by limiting Plaintiff to jobs with “simple, routine, repetitive tasks . . .”
To support these limitations, the ALJ noted the April 8, 2009 consultative examination by ENT specialist Dr. Eugene Rontal, who observed no reports of tinnitus, aural discharge, or dizziness. The ALJ also noted that the examination revealed normal tympanic membranes and ear canals, and that an audiogram demonstrated moderate sensorineural hearing loss in both ears.  ALJ Scallen further noted that although a hearing aid brought the Plaintiff’s hearing  discrimination to 96% at 50dB, Plaintiff reported losing her hearing aids and has not replaced them.  The ALJ noted that a 2006 audiogram confirmed the same level of limitation.  These objective findings, the ALJ concluded, demonstrated that Plaintiff had a non-listing level hearing and discrimination limitation.
Plaintiff claims that it was error for the ALJ to consider a lack of treatment for her hearing loss; however, SSR 96-7p instructs that “the individual’s statements may be less credible if the level or frequency of treatment is inconsistent with the level of complaints.” See also Gwizdala v. Comm’r of Soc. Sec ., No. 98-1525, 1999 WL 777534, at *5 (6th Cir. Sept. 16, 1999) (ALJ may consider claimant’s refusal to adhere to medical recommendations, including the use of hearing aids).
Plaintiff also complains that the ALJ failed to consider evidence that she lacked the insurance
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to replace the allegedly stolen hearing aids. However, Plaintiff brings forth no evidence establishing that she could not have afforded replacement hearing aids through insurance or other means. On this point, this Court has recently concluded that it is proper for an ALJ to consider a claimant’s failure to seek emergency room treatment or low cost health care options. See Hashemi v. Comm’r of Soc. Sec. , No. 11-13629, 2012 WL 3759033, at  (E.D. Mich. Aug. 6 2012).
The ALJ also noted that Plaintiff sought no other treatment or monitoring for her hearing loss, even on an emergency basis, which suggests that her hearing loss was not as severe as alleged. Further, the ALJ noted that Plaintiff was able to effectively communicate by lip reading – and did so during the administrative hearing in this case – without the need for any kind of interpretative assistance.
Relatedly, Plaintiff claims that substantial evidence does not support the ALJ’s conclusion that she can return to work as a general laborer. Plaintiff argues that the RFC limitation that she “avoid concentrated exposure to excessive noise” coupled with her testimony at the hearing regarding the noise in the factory in which she worked, preclude a return to her prior work as a general laborer.
But Plaintiff’s argument has been rejected by the Sixth Circuit. In Studaway v. Sec’y of Health & Human Servs. , 815 F.2d 1074, 1076 (6th Cir. 1987),  the Sixth Circuit held that the Act requires that a plaintiff show his impairments are “so severe that he is ‘unable to do his previous work. . . .’” The Court specified: “[h]e must prove an inability to return to his former type of work and not just to his former job.” Id. (emphasis in original) (internal quotation marks omitted); accord Clendening v. Comm’r of Soc. Sec. , 482 F. App’x 93, *7 (6th Cir. 2012) (“The relevant inquiry is
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whether [the claimant] could still perform that type of work and not necessarily the specific job that he had in the past.”); see also Villa v. Heckler , 797 F.2d 794, 798 (9th Cir. 1986); Gray v. Heckler , 760 F.2d 369, 372 (1st Cir. 1985); De Loathe v. Heckler , 715 F.2d 148, 151 (4th Cir. 1983); Jock v. Harris , 651 F.2d 133, 135 (2d Cir. 1981). Because the VE testified that general laborer work existed at a level consistent with Plaintiff’s RFC, this Court is compelled to affirm. See Studaway , 815 F.2d at 1076.
B.  Severe Impairments
At step two the ALJ determined that Plaintiff had one severe impairment, deafness. (Tr. 24.) Plaintiff contends that the ALJ improperly omitted depression and gender identity disorder from the list of severe impairments. However, Plaintiff fails to recognize that once step two is “cleared” by finding that some severe impairment exists – in this case, deafness
- the ALJ must then consider a plaintiff’s “severe and nonsevere impairments in the remaining steps of the sequential analysis.” Anthony v. Astrue , 266 Fed. App’x 451, 457 (6th Cir. 2008) “The fact that some of [a plaintiff's] impairments were not deemed to be severe at step two is therefore legally irrelevant.” Id. Consequently, any alleged omission of Plaintiff’s depression and/or gender identity disorder from the list of severe impairments does not necessarily undermine the ALJ’s decision. See Anthony , 266 Fed. App’x at 457; Talos v. Comm’r of Soc. Sec ., No. 11-13207, 2012 WL 1392156, at *8 (E.D. Mich. Mar. 26, 2012); Maziarz v. Sec. of Health & Human Servs. , 837 F.2d 240, 244 (6th Cir. 1987).
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The Court has reviewed the ALJ’s decision and concludes that he properly considered Plaintiff’s depression and gender identity disorder in the remaining steps of the sequential analysis.
Specifically, the ALJ discussed Plaintiff’s mental health treatment during 1997 for depression and suicidal ideation.  Next, the ALJ discussed, in detail, Plaintiff’s emergency room visits during February and May 1998 after he attempted to remove his testicles. ALJ Scallen noted Plaintiff’s history of gender dysphoria, identifying as a transgender while seeking a sex change operation.  ALJ Scallen noted a break in treatment until August 2000, at which time Plaintiff presented to the emergency room exhibiting symptoms of depression regarding his sexual identity, but denied suicidal ideation.  ALJ Scallen noted Plaintiff’s return to the emergency room in February 2001 with suicidal ideation, but was discharged. ALJ Scallen also noted that Plaintiff worked for years with the noted conditions. And, importantly, ALJ Scallen identified no records of treatment for Plaintiff’s mental health conditions since the alleged onset date of disability.
This Court concludes that the ALJ properly considered Plaintiff’s mental health impairments and a failure to find that Plaintiff’s depression or gender identity disorder constituted a severe impairment at step two does not constitute reversible error.
V. CONCLUSION AND RECOMMENDATION
For the reasons set forth above, this Court finds substantial evidence supports the Commissioner’s decision. The Court therefore RECOMMENDS that Plaintiff’s Motion for Summary Judgment (Dkt. 12) be DENIED , that Defendant’s Motion for Summary Judgment.  The ALJ rated the severity of Plaintiff’s mental impairments and the RFC reflects the degree of limitation the ALJ found in the “paragraph B” mental function analysis.
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14) be GRANTED , and that, pursuant to 42 U.S.C. § 405(g), the decision of the Commissioner of Social Security be AFFIRMED .

s/Laurie J. Michelson
LAURIE J. MICHELSON
UNITED STATES MAGISTRATE JUDGE
Dated: March 12, 2013


                                            Even Man's-men May Turn Out To Be She-men

A former member of the elite U.S. Navy SEALs has come out to say she's now a woman.
Kristin Beck, formerly Chris, served 20 years as a SEAL and fought on some of the most dangerous battlefields in the world, but after she left the service she realized she wasn't living the life she wanted.
"Chris really wanted to be a girl and felt that she was a girl and consolidated that identity very early on in childhood," said Anne Speckhard, co-author of Beck's biography "Warrior Princess," which was published over the weekend of May 31 to June 2, 2013. Speckhard told ABC News Beck suppressed that secret for decades, however, through the trials of SEAL training and the harrowing missions that followed, growing a burly beard as she fought on the front lines of American special operations.
Brandon Webb, a former SEAL who served on a different SEAL team than Beck, said that Beck's reputation in the SEALs was a good one and said she was, by all appearances, the "consummate guy's guy."
But the book says that Chris "had considered living as the woman he felt himself to be for a very long time, but while he was serving as a SEAL he couldn't do it."
"For years Chris had turned off his sexuality like a light switch and lived as a warrior, consumed with the battle -- living basically asexual. For Chris the other SEALs were brothers and in the man's man warrior lifestyle, even if he had wanted to entertain sexual thoughts, there really was never any time to be thinking too much about sexuality," the book says.
After her retirement in 2011, however, "Now seemed the right time to go for it -- to make his body match his identity -- or at least start by dressing like a woman in his regular life."
Speckhard said Beck first announced her decision to friends online with the declaration "No more disguises" and the book describes her going out to gay bars in Florida as a woman.
Beck is currently on hormone therapy in preparation for sexual reassignment surgery and generally wears long hair, make-up and women's clothes, Speckhard said.
In the book's Preface, Beck said she wrote the book "to reach out to all of the younger generation and encourage you to live your life fully and to treat each other with compassion, be good to each other, especially in your own backyard (whether it be high school or your community)."