WILLIAM M. SKRETNY, District Judge.
1. Plaintiff, on behalf of her minor child, J.J.S., challenges an Administrative Law Judge's ("ALJ") determination that J.J.S. is not entitled to Supplemental Security Income ("SSI") under the Social Security Act ("the Act"). Plaintiff alleges a disability onset date of February 1, 2010, due to Attention-deficit/hyperactivity disorder (ADHD), Oppositional Defiant Disorder (ODD), and Pervasive Developmental Disorder (PDD).
2. Plaintiff filed an application for SSI on May 24, 2011. The application was initially denied on September 19, 2011. Pursuant to Plaintiff's request, an administrative hearing was held before ALJ David Lewandowski on January 22, 2013, at which time J.J.S., Plaintiff, and their attorney appeared. The ALJ considered the case de novo, and on March 4, 2013, issued a decision finding that J.J.S. was not disabled. On September 12, 2014, the Appeals Council denied Plaintiff's request for review. Plaintiff filed the current civil action on November 11, 2014, challenging the Commissioner's final decision.
3. On March 16, 2015, the Plaintiff filed a motion for judgment on the pleadings pursuant to Rule 12(c) of the Federal Rules of Civil Procedure. (Docket No. 6). The Commissioner followed suit with her own motion on April 23, 2015. (Docket No. 10). For the following reasons, the Plaintiff's motion is granted and the Commissioner's motion is denied.
4. A court reviewing a denial of disability benefits may not determine de novo whether an individual is disabled.
5. "To determine on appeal whether the ALJ's findings are supported by substantial evidence, a reviewing court considers the whole record, examining the evidence from both sides, because an analysis of the substantiality of the evidence must also include that which detracts from its weight."
6. An individual under the age of 18 is considered disabled when he or she "has a medically determinable physical or mental impairment, which results in marked and severe functional limitations, and 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 twelve months." 42 U.S.C. § 1382c(a)(3)(C)(i). The Commissioner has established a three-step sequential evaluation process to determine whether a child is disabled as defined under the Act.
Where an impairment medically meets or equals a listed impairment, the child will be found disabled. 20 C.F.R. §§ 416.924(d)(1), 416.925. If a child's impairment or combination thereof does not meet or equal a listed impairment, the ALJ must assess all functional limitations caused by the child's impairments in terms of six domains: (1) acquiring and using information; (2) attending and completing tasks; (3) interacting and relating to others; (4) moving about and manipulating objects; (5) caring for self; and (6) health and physical well-being. 20 C.F.R. §§ 416.926(a),(b)(1). A child is classified as disabled if he or she has an "extreme" limitation in one domain of functioning or a "marked" limitation in two domains. 20 C.F.R. § 416.926a(d). A "marked" limitation exists when an impairment or the cumulative effect of impairments "interferes seriously with [the child's] ability to independently initiate, sustain, or complete activities." 20 C.F.R. § 416.926a(e)(2)(i). An "extreme" limitation "interferes very seriously" with that ability. 20 C.F.R. § 414.926a(e)(3)(i). A child's "day-to-day functioning may be seriously limited when [his] impairment(s) limits only one activity or when the interactive and cumulative effects of [his] impairment(s) limit several activities." 20 C.F.R. § 416.926a(e)(2)(i).
7. In this case, J.J.S. was a pre-schooler (age 5) on the application date and a school-aged child (age 7) at the time of the decision. (R. 17).
8. Plaintiff argues that the ALJ failed to adequately explain his finding that J.J.S. had a "less than marked" impairment in the domain of attending and completing tasks. In support of this contention, Plaintiff maintains: three teachers opined to "serious" problems in this domain, the record largely supports a finding of marked impairment, and the ALJ improperly relied on the finding of consultative psychologist, Dr. Baskin, that J.J.S.'s "attention and concentration were intact." (
9. With respect to the domain of attending and completing tasks, the Commissioner considers the claimant's ability to "focus and maintain [his] attention, and how well [he can] begin, carry through, and finish . . . activities, including the pace at which [he] perform[s] activities and the ease with which [he] change[s] them." 20 C.F.R. § 416.926a(h).
The Court finds that the ALJ's conclusion was not supported by substantial evidence or explained with adequate clarity. The ALJ purportedly gave "great" or "greatest" weight to the various teacher opinions (R. 20), which, along with the other educational evidence, reasonably demonstrate that J.J.S. has a marked impairment in this domain. On the other hand, the ALJ failed to assign any weight to Dr. Baskin's opinion but still relied on her finding that J.J.S.'s "attention and concentration were intact" at the consultative examination to undermine the evidence of J.J.S.'s difficulties in this domain. (R. 24).
10. Here, the record contains various teacher evaluations, school records, and three Teacher Questionnaires,
11. In addition to other activities in this domain, the record reflects J.J.S.'s problems with paying attention and his nearly complete inability to make an effective and undisruptive transition to a new activity during the school day.
12. At the end of the 2010-2011 school year, kindergarten teachers Ms. Maslowski (special education) and Ms. Madden (general education) stated on J.J.S.'s report card that despite "consistent improvement in his academic ability and his behavior this year," J.J.S. "remains unable to focus his attention for more than a short amount of time and prefers to be `tuned out' of many of the classroom discussions." (R. 177). On June 22, 2011, at the request of the State Agency, the teachers also completed a Teacher Questionnaire. (R. 152-159). Regarding the domain of attending and completing tasks, they indicated that J.J.S. had a "serious problem" with "changing from one activity to another without being disruptive," as well as with "working without distracting self or others." (R. 154). They specifically observed "[J.J.S.] has a tough time with transitions or a change in schedule. He is easily distracted. [He] must complete a task until it is done — he has a difficult time stopping a task when asked." (
13. The record also contains a June 2011 Teacher Questionnaire completed by J.J.S.'s caregivers at his day care center, which he attended daily for 4-8 hours from July 2007 — June 2010, and then for 8 hours per day during school vacations and holidays beginning July 2010 through the date of the report. (R. 138-145). With respect to attending and completing tasks, Ms. Gothard (school age teacher) and Ms. Serveiss (2 yr old teacher) indicated "serious problems" in seven of the thirteen activities, and "very serious problems" in three activities, including waiting to take turns, changing from one activity to another without being disruptive, and working at a reasonable pace/finishing on time. (R. 140). Their narrative indicates "J.J.S. requires a great deal of extra structure and support in any organized activity. The basis of the support is guidance in understanding the activity, the structure to complete the activity and monitoring his behavior and interaction with himself and others." (
In other domains, the teachers commented on related limitations. It was noted that J.J.S. "[o]ften requires a constant demonstration and repetition of directives," "[o]ften projects [are] begun and then abandoned by other interest, [he] prematurely states `I'm done' and `don't want to do that' (to do this anymore) while peers stay engaged and most complete projects and [are] able to follow simple step by step instructions." (R. 139). In addition, they observed J.J.S. has "great difficulty with patience with self and others and transitioning from one activity to the next if not self-directed" (
14. An October 2011 report card from the beginning of first grade states that J.J.S. is a "very sweet young boy," and that he "tries very hard to stay on task." (R. 207). The teacher specifically noted, however, that he "has difficulty working independently and can only follow one step directions," and that he "also has difficulty with the numerous transitions" throughout the day, which "have a tendency to cause [him] to become frustrated and sometimes angry." (R. 207). Shortly after this report card was issued, J.J.S. switched to a different school; his mother testified that the first school could not accommodate his needs or manage his behaviors, and that J.J.S. "wasn't staying in the classroom" and "he was interrupting." (R. 57).
15. In April 2012, near the end of first grade, school psychologist, Ms. Carey, noted that "[h]igh activity levels, distractibility, and emotional outbursts have been documented in school and at home" along with "[d]ifficulties with transitions, sitting still, overstimulation, and verbal aggression." (R. 219). She also opined that J.J.S.'s behaviors related to ADHD and PDD "continue to be exhibited in school on a frequent basis" and "markedly interfere with [his] daily classroom performance, in addition to the learning and safety of self and others." (R. 222).
Also near the end of 1st grade, May 2012 IEP documents indicate that J.J.S. retained certain goals for the following school year, including "needs to increase his ability to maintain attention to task and participate appropriately in all classroom activities. He also needs to transition appropriately within the classroom." (R. 348). In the same report, the Occupational Therapist's progress note includes, among other comments, "poor spelling and difficulty with transitions are evident", that J.J.S. "is fast, impulsive and displays decreased organizational skills affecting the quality of his work", his "poor visual attention and decreased control of writing tools affect overall quality of written work", and his "sensory processing skills are delayed as he has difficulty attending and requires increased cues to stay on task and follow directions." (R. 349).
16. Most recently, on December 19, 2012, J.J.S.'s second grade teacher, Ms. Miles, and school psychologist, Ms. Carey completed a Teacher Questionnaire. (R. 233-240). In the domain of attending and completing tasks, the report indicates that J.J.S. had "serious problems" in 8 of 13 areas, including paying attention when spoken to directly, changing from one activity to another without being disruptive, and working without distracting self or others. (R. 235). The narrative states: "(1) highly impulsive, blurts out, never in seat, crawling on floor in hallway" and "(2) refocus and redirection constantly." (R. 235). In addition, Ms. Miles noted on J.J.S.'s first quarter report card that he is "a pleasure to have in class," but he "continues to need a high level of teacher support to organize his personal locker and desk space" and that she must "frequently refocus/redirect his attention to the task and remind him what a learner looks and sounds like," that "[h]e frequently disrupts others right to learn," and "[t]ransitioning from one task to another is an area for improvement." (R. 226). Another teacher advised on the same report card: "[J.J.S.], focus on being a respectful listener and speaker, as well as organizing yourself in the class room." (R. 226).
17. Regarding the opinion evidence, the ALJ noted that "several teacher questionnaires vary in their descriptions of the claimant's problems." (R. 20). Still, he purported to give "great weight" to the opinions of J.J.S.'s teachers, and, in particular, "greatest weight" to the combined opinion of kindergarten teachers Ms. Madden and Ms. Maslowski. (
18. To be sure, the Court finds the record contains some support for J.J.S.'s ability to maintain attention and concentration at times, and that he improved his behavior and skills in certain areas. For example, in the May 2012 IEP report, J.J.S.'s speech therapist noted his "ability to respond favorably to verbal prompts and signals to wait or end his turn, and attend to task has improved considerably" during first grade. (R. 348). The report also states J.J.S.'s mother (Plaintiff) noticed improvement in math and reading (R. 349). Nevertheless, as discussed, the record demonstrates consistent difficulties in this domain. Moreover, the Court notes that J.J.S. educational goals and teacher comments consistently refer to his difficulties with transitions and paying attention, among other relevant activities.
19. Thus, while it is apparent the ALJ reviewed the entire record and purported to give great weight to those who had a "substantial longitudinal picture" of J.J.S.'s limitations, (
Although not raised by Plaintiff, the Court finds the ALJ's reliance on this finding and the lack of explanation perplexing in light of the Commissioner's acknowledgement that "children with some impairments (for example, AD/HD) may be calmer, less inattentive, or less out-of-control in a novel or one-to-one setting, such as a CE." SSR 09-2p, citing 20 CFR 416.924a(b)(6);
20. Indeed, J.J.S.'s treating psychiatrist documented his reported behavior problems at home and at school, and specifically noted that his ability to focus was better in individual sessions or around fewer people, as compared with his ability to focus in family sessions, "due to lack of people in the room." (R. 330, 332). Although the ALJ noted J.J.S.'s improved behavior at treatment sessions, (R. 19; citing 330, 332), he failed to acknowledge the treating psychiatrist's caveat that the improvement was mentioned in comparison to J.J.S.'s behavior in a larger group setting. (
21. Finally, the Court notes that the ALJ also generally gave "great weight" to the opinion of agency reviewing physician, Dr. Meyer (pediatrics). (R. 21). In finding a less than marked impairment in the domain of attending and completing tasks, Dr. Meyer noted that J.J.S. stopped taking Concerta, an ADHD medication, due to hallucinations, and that "his teacher reports that he has difficulty with transitions and is easily distracted," but also stated that J.J.S.'s "attention and concentration were intact at the [mental status exam]." (R. 299). Thus, to the extent the ALJ implicitly incorporated Dr. Meyer's opinion in this domain, it also rested on Dr. Baskin's one-time evaluation, and, therefore, does not constitute substantial evidence in support of the ALJ's determination.
22. For the reasons stated above, the Court finds that the ALJ's discussion fails to elucidate why he did not find a marked limitation in the domain of attending and completing tasks, despite crediting evidence in favor of such a finding. Further, the ALJ failed to assign weight to consultative examiner Dr. Baskin's opinion, which reflected J.S.S's behavior in a "one-to-one", "unusual" situation. SSR 09-2p;
23. After carefully examining the record, this Court finds cause to remand this case to the ALJ for further administrative proceedings consistent with this decision. Plaintiff's Motion for Judgment on the Pleadings is therefore granted. Defendant's Motion for Judgment on the Pleadings is denied.
IT HEREBY IS ORDERED, that Defendant's Motion for Judgment on the Pleadings (Docket No. 10) is DENIED;
FURTHER, that Plaintiff's Motion for Judgment on the Pleadings (Docket No. 6) is GRANTED;
FURTHER, that this case is REMANDED to the Commissioner of Social Security for further proceedings consistent with this Decision and Order;
FURTHER, that the Clerk of the Court is directed to close this case.
SO ORDERED.