KAREN E. SCOTT, Magistrate Judge.
Plaintiff Robert Anaya ("Plaintiff") was awarded Supplemental Security Income ("SSI") as a child. Administrative Record ("AR") 20. He now appeals the final decision of the Administrative Law Judge ("ALJ") who determined that he was no longer disabled as of February 1, 2013.
Plaintiff began receiving SSI due to autism when he was four years old. AR 43, 56. Plaintiff turned eighteen in June of 2012.
On March 31, 2014, an ALJ conducted a hearing, at which Plaintiff, who was represented by counsel, appeared and testified. AR 39-54. On April 25, 2014, the ALJ issued a written decision finding that Plaintiff was no longer disabled as of February 1, 2013, per 20 C.F.R. § 416.987. AR 20-28.
The ALJ found that Plaintiff has the severe impairment of autism, but his autism did not meet or equal a listed impairment. AR 22-23. Notwithstanding his autism, the ALJ concluded that Plaintiff had the residual functional capacity ("RFC") to perform a full range of work with non-exertional restrictions to "simple repetitive tasks requiring only incidental interaction with others, i.e., tasks not requiring verbal collaboration as a primary component." AR 23.
Based on this RFC and the testimony of a vocational expert ("VE"), the ALJ found that Plaintiff would be able to work as a laborer/stores (DOT 922.687-057), laborer/salvage (DOT 929.687-022) and laundry worker (DOT 361.684-014). AR 27. The ALJ therefore concluded that Plaintiff is no longer disabled. AR 28.
A person receiving childhood disability benefits may continue to receive benefits even after his/her disability has ended if the following three conditions are met:
20 CFR § 416.1338(a).
The regulations define a qualifying program of vocational rehabilitation services, employment services, or other support services. 20 CFR § 416.1338(c). Generally, a qualifying program is carried out under an individualized work plan administered by a government agency or a private organization "with expertise" in providing such services.
The regulations explain that a program will increase the likelihood that participants will not return to the disability benefit rolls if that program provides participants with "work experience ... so that would more likely be able to do past relevant work" or "education ... and/or skilled or semi-skilled work experience so that you would more likely be able to adjust to other work ...." 20 CFR § 416.1338(e)(i)-(ii). The regulations further provide that if "you are a student age 18 through age 21 participating in an individualized education program ["IEP"] ..., we will find that your completion of or continuation in the program will increase the likelihood that you will not have to return to the disability ... benefit rolls." 20 CFR § 416.1338(e)(2).
Plaintiff initially argued that he participated in qualifying services "through both the Regional Center as well as the ARC of Ventura." JS 3. When the Court requested supplemental briefing on this issue, Plaintiff added an argument that his participation in special education services after his eighteen birthday but before he graduated from high school also triggered the application of 20 C.F.R. § 416.1338(d)(2). Dkt. 20 at 2, 5. The Commissioner declined to provide supplemental briefing. Dkt. 18.
Plaintiff was referred for potential participation in two ARC programs: a "day program ... to assist him in acquiring vocational skills" and "the Training for Independent Living ["TIL"] program" which would involve living in an on-site apartment. AR 338. The TIL program only accepts individuals who receive SSI benefits to ensure they have sufficient funds to pay their monthly rent and other expenses.
In September 2013, Plaintiff was notified that he was accepted into the TIL program, but placed on a waiting list until an opening became available. AR 313. Plaintiff testified at the March 31, 2014 hearing that he was "going to soon start this program ..." referring to the TIL program. AR 43. He also testified, "I think it's so I can get a job or something ...."
With regard to his participation in Regional Center programs, Plaintiff points to records at AR 531-42. JS 4. These records consist of the following:
(1) A March 20, 2014, evaluation by psychologist Victor Sanchez. AR 531-536. Dr. Sanchez reports that Plaintiff was referred to him by the "Tri-Counties Regional Center for the purpose of diagnostic clarification and to aid in program planning." AR 531. Dr. Sanchez summarized information provided by Plaintiff's mother explaining that Plaintiff has "been a consumer of the Regional Center System since approximately age four as a result of an early diagnosis of Autism."
(2) A March 26, 2014, one-page "psychological ID note" written by Dr. Brand, a staff psychologist at the Tri-Counties Regional Center. AR 537. Dr. Brand reported that Plaintiff "has been receiving Regional Center services based on a diagnosis of autism since 1988."
(3) AR 538 is a blank page. Neither the Court's electronic nor paper copy of the Administrate Record contains pages marked AR 539-42.
Plaintiff's other medical records include progress reports from 1998-2012 from the Tri-Counties Regional Center. AR 190-212. These records refer to Plaintiff's IPP [Individual Program Plan]. For example, in March 2012 (when Plaintiff was in 11th grade), his IPP objective was to obtain a high school diploma and continue to live with his family. AR 196-97.
As of the date when the ALJ determined that Plaintiff was no longer disabled (i.e., February 1, 2013), Plaintiff was 18 years old. He was still attending high school and he had an IEP plan. AR 529 (October 2012 IEP plan noting that Plaintiff was "on track" to graduate); AR 343-44 (IPP records dated June 20, 2013, noting that Plaintiff is currently attending high school, will graduate "next week" and then his "employment plan" is to "attend Ventura College in Graphic Arts."). Plaintiff enjoys drawing and wants to be a cartoonist. AR 148, 347.
With regard to ARC of Ventura, the record demonstrates that Plaintiff's participation in this program did not fall within 20 C.F.R. § 416.1338, given the ending date of his disability. Per § 416.1338(a)(2), a claimant must have begun participating in the program before the date his/her disability ended. Here, Plaintiff's disability was determined to have ended as of February 2013, but as of the hearing date in March 2014, Plaintiff was not yet participating in the TIL program. Even if one considers the date when he was accepted into the program but waitlisted as the date when he began participating (i.e., September 2013), that date is still after February 2013. There is no evidence in the record that Plaintiff ever participated in ARC's day program. Thus, neither of these two ARC of Ventura programs fall within 20 C.F.R. § 416.1338, such that the ALJ did not err in failing to address them. If, after remand, the ALJ sets a different ending date for Plaintiff's disability, then the ALJ should consider whether § 416.1338(a)(2) would still prevent Plaintiff's participation in ARC of Ventura programs (if any) from falling within 20 C.F.R. § 416.1338.
With regard to the Regional Center and special education services, evidence in the record concerning Plaintiff's participation in an IPP and IEP shows that his participation might fall within 20 C.F.R. § 416.1338. The ALJ, therefore, erred by not considering this regulation before terminating Plaintiff's disability benefits.
When an ALJ errs in denying benefits, the Court generally has discretion to remand for further proceedings.
For the reasons stated above, the decision of the Social Security Commissioner is REVERSED and the matter is REMANDED for further proceedings consistent with this opinion.
LET JUDGMENT BE ENTERED ACCORDINGLY.