SSA Releases AR 15-1(4): Changing the Standard for Meeting Listing 1.04A

Posted March 18, 2016 by Premier Disability Services, LLC® Our office has begun receiving correspondence from the Social Security Administration (SSA) regarding a Fourth Circuit Court of Appeals Case called Radford v. Colvin that may impact the determination made on a claimant’s prior claim. The issue involved in this case was whether the clinical signs and symptoms detailed in listing 1.04A for disorders of the spine had to be present simultaneously or merely needed to be present at some point during the disability period. The Appeals Court held that the listing requires a more, “free-form, contextual inquiry that makes 12 months the relevant metric for assessment of the claimant’s duration of disability.” Ultimately, the court determined that a claimant does not need to show that all clinical signs or symptoms are present at the same time, or even in a particular proximity.

SSA released Acquiescence Ruling (AR) 15-1(4) based on the determination in this case. AR 15-1(4) clarifies how SSA will apply the Radford ruling. To be clear, this ruling will only be applied to claims in which the claimant resides in Maryland, North Carolina, South Carolina, Virginia, or West Virginia. In these states, a claim that qualifies for a listing 1.04 analysis will be reviewed using the “free form, contextual inquiry” that is contemplated by the Court of Appeals. In other words, they will look at whether all of the required clinical signs and symptoms have been present within a 12 month period. The adjudicator will then look at whether the spinal condition caused, or is expected to cause, nerve root compression continuously for at least 12 months.

What Does this Mean for Claimants?
The correspondence our office received from SSA states that their agency will review an earlier claim to determine whether this Acquiescence ruling could change the prior decision. If you were denied on a prior claim in which you alleged a spinal impairment and you reside in one of the states listed above, it is certainly worth contacting your local SSA office to request a review. The directions from SSA are merely that you reference the court case (Radford) or the Acquiescence ruling (AR 15-1(4)) when you request review.

Our office will be reviewing the implications of this ruling with our current and former clients. SSA reiterates in their correspondence that you have the right to hire a representative to assist with this process. If you are seeking representation and would like a free evaluation of your claim, please contact us.

By: Devon Brady of Premier Disability Services, LLC®

[1] Full Citation: Radford v. Colvin, 734 F.3d 288 (4th Cir. 2013).
[2] 734 F.3d at 293.
[3] States that compile the Fourth Circuit