Does age of onset in legal contexts mean chronological or developmental age? This is a live issue in the death penalty context because in Atkins v. Virginia, the United States Supreme Court found it cruel and unusual punishment under the Eighth Amendment to execute mentally retarded offenders. While the Atkins Court cited favorably to clinical definitions of mental retardation, it left open to the states to define what mental retardation means for purposes of the death penalty.
In my article Cruel and Unequal Punishments, I argue that a legal definition of mental retardation should not be defined by the medical definition of the same. Law defines “insanity” by the purpose it serves, not by a medical construct. Likewise, legislatures and courts should define “mental retardation” in law according to its purpose and not its diagnostic criteria. The DSM-IV and each revision since explains that clinical definitions of mental illness are designed for diagnostic purposes, not legal ones. A legal definition of mental retardation should reflect the purpose it serves — to exempt those less culpable from punishment. In Cruel and Unequal Punishments, I argue that the Equal Protection Clause interacts with the Eighth Amendment in a way that makes this medical-definition line-drawing unconstitutional.
In the case today, the Nevada Supreme Court cites to my article but for the exact opposite claim that I make. The Nevada Court holds that it makes sense to import the age of onset requirement from the medical definition of mental retardation in the legal context. In the article, I argue the exact opposite. Age of onset is meant to help with differential diagnosis, not to determine which offenders are the less culpable ones.
As a bonus, I’ve included a second case today that deals with age of onset in a different context — Child Disability Benefits under the Social Security Administration. Whether in the disability context or the death penalty context, even if diagnosis doesn’t occur until after age eighteen, the relevant inquiry is whether the impairments were present before eighteen and not whether the condition was diagnosed before then.
Age of Onset, Mental Retardation, Death Penalty
Ybarra v. State, 2011 WL 743214 (Nev. 2011)
A jury found the defendant guilty of first-degree murder, first-degree kidnapping, battery with intent to commit sexual assault, and sexual assault. After finding four circumstances aggravated the murder and no mitigating circumstances sufficient to outweigh them, the jury imposed death for the first-degree murder and consecutive terms of life in prison without the possibility of parole for the remaining offenses. As matters of first impression, the Nevada Supreme Court addressed the three components of the mental retardation definition and, in particular, held that the “developmental period” referenced in the statute includes the period before a person reaches 18 years of age. Relying upon the clinical definitions of mental retardation, the court distinguished between the evidence of brain injury that the defendant suffered and mental retardation, which for differential diagnosis purposes requires an age of onset before 18. It held that the age-of-onset requirement ensures “that the mental retardation developed during the developmental period, as opposed to forms of brain damage that occur later in life,” and, precludes a defendant from feigning mental retardation once charged with a capital crime. Because the defendant failed to prove by a preponderance of the evidence that he suffered from significant subaverage intellectual functioning and adaptive behavior deficits during the developmental period, which extends to 18 years of age, he was not mentally retarded for purposes of categorical exemption from the death penalty.
Age of Onset, Social Security Benefits
Miller v. Astrue, 2011 WL 284643 (D. Oregon 2011)
The plaintiff here is seeking judicial review of final decision by the Social Security Administration denying his application for Child’s Insurance Benefits. In the agency hearing, plaintiff introduced a “psychodiagnostic evaluation” stating that he had an IQ score of 74 and “borderline intellectual function,” making it very unlikely that he can consistently work in any job-related capacity. Another medical expert testified that the plaintiff had “never functioned in an adult fashion” and suffered from “chronic, phobic, or agoraphobic kind of behavior” and “inability to socialize.” The medical expert also testified that the plaintiff has a “life history” of “operat[ing] at a very very primitive level,” but could provide no medical reason for his conclusion. The agency denied the plaintiff’s request for Child’s Insurance Benefits. The Commissioner of the Social Security Administration agreed that the plaintiff suffered from the “severe impairment of organic brain syndrome” but concluded that there was no evidence establishing that this severe impairment began before the age of 22. Here, the district court finds that the agency’s decision denying the plaintiff benefits was not supported by substantial evidence. The court holds that the agency failed to recognize that the medical expert testimony “reached backward and provided evidence as to [the plaintiff’s] inability to function for most of his life.” The court also pointed to the plaintiff’s school records as other evidence showing his limitations at an early age. His records showed poor grades, poor attendance, inability to use class time effectively, being unprepared for class, not participating in class, and being uncooperative. Therefore, the court remands the case back to the agency to perform a new hearing on the issue.