Shinn ex rel. Shinn v. Commissioner, No. 03-14229 (11th Cir. Nov. 30, 2004)

The Eleventh Circuit, in an opinion by Circuit Judge Gerald B. Tjoflat, holds that testimony of a nonmedical source "concerning the repeated onset of what, to all outward appearances, seem to be pain crises or vaso-occlusive crises" should have been considered by the ALJ in determining whether a child's SSI claimant met the listing for sickle cell disease (listing 107.05). Nonmedical evidence is permissible under 20 C.F.R. § 416.928 to prove the existence of symptoms, and the Court holds that vaso-occlusive crises are a symptom of sickle cell disease. While the regulations regarding nonmedical source testimony are "intricate, confusing, and fail to provide a clear answer . . ."

The ALJ erred in failing to consider the testimony of Yvonne’s mother. . . . [Her] testimony suggests that Yvonne suffered episodes that closely resemble those Dr. Wall specifically warned “could” happen, fit the description of vaso-occlusive episodes, were treated as vaso-occlusive episodes, and resemble other crises for which Yvonne was hospitalized that were expressly declared vaso-occlusive episodes by medical personnel. Once the testimony of Yvonne’s mother is considered, it builds a persuasive case that Yvonne suffered from "recent, frequent severe vaso-occlusive crises."

The case is remanded for a new hearing.

Note:  For more on Judge Tjoflat, read Howard Bashman's 20 Questions published August 4, 2003.