ROBERT M. ILLMAN, Magistrate Judge.
Pending before the court is Defendant's Motion, filed pursuant to Fed. R. Civ. P. 59(e), to alter or amend the final order and judgment previously entered in this case. (Doc. 35).
On February 7, 2018, the court entered its Order (hereafter, "the Order") granting Plaintiff's motion for summary judgment and denying Defendant's cross-motion for summary judgment, while remanding the case to the Commissioner for further proceedings. (Doc. 31). Judgment was entered in accordance with the Order on the same day. (Doc. 32). In ruling on the summary judgment motions, the court noted that Plaintiff had argued that the ALJ erred at Step Three by failing to consider Listing 12.05C (Intellectual Disability), and at Step Two by failing to develop the record as to Plaintiff's cognitive dysfunction. (Doc. 31 at 5). Having found that the ALJ's failure to address the medical evidence of Plaintiff's cognitive dysfunction at Step Two was reversible error, the case was remanded for further proceedings. (Id. at 9-10).
On March 3, 2018, Defendant filed the instant Motion and argued that the Order contained "manifest errors of law and fact upon which it based the judgment." (Doc. 35 at 2). Thereafter, due to counsel's health issues, the court granted two stipulations for extra time for Plaintiff to file a response. The second of which extended the time for the filing of Plaintiff's responsive brief to May 16, 2018. (Docs. 37, 39). In April of 2018, Plaintiff's counsel untimely passed away, and the process of transitioning his law practice and client files was initiated.
Defendant's Motion begins by taking issue with the notion that while "[t]he Order repeatedly asserts that the ALJ ignored substantial evidence that Plaintiff had a cognitive impairment," that no such impairment was identified by the Order or by the record. (Doc. 35 at 2). Defendant also suggests that the Step Two determination "involves a number of statutory and regulatory standards that the Order does not acknowledge or appear to comprehend." (Id.). In essence, Defendant suggests that the court "mischaracterizes and improperly reevaluates medical evidence that actually supports the relevant findings in the ALJ's decision." (Id.).
Defendant argues that a "deficit[] in cognitive functioning is not a medically determinable impairment," and that "[a]t best, a deficit in cognitive functioning would be a limitation." (Id. at 3) (internal quotation marks omitted). Thus, Defendant contends that "[t]he record does not contain any evidence from an acceptable medical source indicating that Plaintiff had an impairment related to a cognitive disorder." (Id.). Defendant also takes issue with the Order's reliance on the mental status findings and prognosis outlined in the report of Dr. Anne Khalifeh, Psy.D., a clinical psychologist and state agency consultative examiner. (Id. at 4) (suggesting that "Dr. Khalifeh did not diagnose any medical condition related to Plaintiff's cognitive abilities."). Defendant submits that the court "reinterprets" Dr. Khalifeh's findings, and that "the Order improperly elevates Dr. Khalifeh's observations and/or test results — rather than her conclusions — to the status of a medically determinable impairment." (Id.). Defendant also contends that "none of Dr. Khalifeh's conclusions included a `cognitive impairment.'" (Id. at 5). In short, Defendant claims that "the Order misunderstands what an impairment is under the regulatory disability framework, misunderstands and then mischaracterizes the evidence it relies upon to find ALJ error, and misapprehends the nature of Plaintiff's primary argument and the Commissioner's response to that argument." (Id. at 6).
Notwithstanding the strident manner in which they have been presented, the court is unpersuaded by Defendant's arguments. Defendant suggests that diminished cognitive functioning is not a medically determinable impairment, and that such a "deficit" would be a "limitation" and not an "impairment." For this proposition, Defendant cites only to a seemingly unrelated regulatory provision that merely explains that impairments and related symptoms may cause physical or mental limitations that may affect what one could do in a work setting. (Doc. 35 at 3) (citing 20 C.F.R. § 416.945). On the other hand, the Oxford English Dictionary defines "impairment" as a deterioration, an injurious lessening or weakening.
Additionally, there is a wealth of authority undercutting Defendant's unusual argument that sub-normal intellectual functioning is merely a limitation rather than an impairment under the Social Security Act. In numerous cases, other ALJs, as well as federal courts, have found claimants to suffer from a mild, moderate, or severe cognitive impairment at Step Two on the basis of valid IQ scores.
Defendant also contends that Dr. Khalifeh did not diagnose any medical condition related to Plaintiff's cognitive abilities. However, this argument has no basis in the record as Dr. Khalifeh's report unmistakably sates that, "the following diagnostic and clinical impressions and disability considerations are offered. The overall clinical presentation is that of an individual with borderline to impaired cognitive abilities." (Doc. 13, Administrative Record "AR" at 294). Describing the results from the battery of IQ testing she administered, Dr. Khalifeh noted that Plaintiff's Full Scale IQ score of 63 placed her within "the extremely low range of cognitive functioning." (Id. at 292). Thus, there was substantial evidence in the record that Plaintiff operates in the "extreme low range of cognitive functioning," and it was error for the ALJ to fail to address this evidence at Step Two, such that the evidence and record could then have been properly developed for a Step Three determination as to meeting or equaling the intellectual disability listing.
Defendant's suggestion that this court "reinterprets Dr. Khalifeh's findings" is wholly without merit. IQ testing was performed by a trained professional, the validity of the results of which has never been questioned, and the ALJ failed to even address this evidence of serious cognitive dysfunction at Step Two. Thus, Defendant has failed to make any showing that the court has "misunderstood the evidence." Nor is the court persuaded by Defendant's suggestion that the court "misunderstands what an impairment is under the regulatory disability framework." Based on the cases cited above, if there is any such "misunderstanding," it is widespread indeed. Furthermore, the court finds little value in addressing or discussing Defendant's suggestion that the court has not only misunderstood the evidence in this case, but that the court has mischaracterized it. Instead, the court will simply remind counsel to avoid using intemperate language in pleadings.
As to Defendant's suggestion that the court has misapprehended Plaintiff's "primary" argument, the court is likewise unpersuaded. While Plaintiff argued that the ALJ committed harmful legal error at Step Three by failing to consider the intellectual disability listing (Listing 12.05C), Plaintiff also argued that "[t]he [ALJ] decision did not evaluate deficits in cognitive functioning as either severe or nonsevere impairments." (Doc. 21 at 3). Plaintiff has maintained that the ALJ failed to adequately develop the record as to her cognitive dysfunction at Step Two, such that it could be determined at Step Three whether or not she met or equaled the listing for intellectual disability. (Id. at 5-7). Thus, Defendant is incorrect when arguing that Plaintiff never took exception to the ALJ's error at Step Two as Plaintiff's pleading in this court unambiguously took issue with the ALJ's failure to "evaluate deficits in cognitive functioning as either severe or nonsevere impairments" — this is a clear assignment of Step Two error and Defendant's contention to the contrary is meritless. Additionally, it should be noted that in articulating the suggestion that Plaintiff never even raised a Step Two issue, Defendant uses interesting terminology. Despite spending much energy attempting to make the case that a deficit in cognitive functioning is not so much of an "impairment" as it is a "limitation," Defendant's contention that a Step Two issue was never raised shows the flaw in this logic. Defendant submits that "Plaintiff's primary argument, however, was not that the ALJ erred at step two, but that, at step three, she was so cognitively impaired that she was presumptively disabled by mental retardation (intellectual disability)." (Doc. 35 at 6) (emphasis in original). Putting aside Defendant's factually incorrect statement that Plaintiff never raised a Step Two issue, Defendant's use of the term "cognitively impaired" in the same document that argues that deficits in cognitive functioning are not impairments but limitations is curious. Either a deficit in cognitive functioning is an impairment, or it is not, Defendant cannot have it both ways. Of course, as discussed above, it is.
The Step Three evaluation for intellectual disability requires a showing of "(1) Significantly sub-average general intellectual functioning with deficits in adaptive functioning initially manifested during the developmental period; i.e., the evidence demonstrates or supports onset of impairment before age 22; (2) A valid verbal, performance, or full scale IQ score of 60 to 70; and (3) A physical or other mental impairment imposing an additional and significant work-related limitation of function." 20 C.F.R. pt. 404, subpt. P, app. 1 § 12.05C. Thus, as the above-cited cases make clear, the Step Two precursor to a Step Three evaluation for intellectual disability is an evaluation for deficits in cognitive functioning, or put another way, an evaluation of any substantial evidence of a claimant's cognitive dysfunction. Notwithstanding Defendant couching Plaintiff's "primary" argument as focusing on the ALJ's failure to consider the intellectual disability listing at Step Three, Plaintiff clearly also took exception to the ALJ's failure to consider her sub-normal intellectual functioning and develop the record at Step Two.
Accordingly, Defendant's Motion to Alter or Amend (Doc. 35) the judgment in this case is DENIED.