S. THOMAS ANDERSON, District Judge.
Plaintiff Wanda Kelley, as guardian of B.F., a minor, filed this action to obtain judicial review of Defendant Commissioner's final decision denying the application of B.F. for childhood Supplemental Security Income ("SSI") benefits under Title XVI of the Social Security Act ("Act"). The application was denied initially and upon reconsideration by the Social Security Administration. Plaintiff then requested a hearing before an administrative law judge ("ALJ"), which was held on September 19, 2012. On October 18, 2012, the ALJ issued a decision, finding that B.F. was not entitled to benefits. The Appeals Council denied Plaintiff's request for review, and, thus, the decision of the ALJ became the Commissioner's final decision. For the reasons set forth below, the decision of the Commissioner is
Under 42 U.S.C. § 405(g), a claimant may obtain judicial review of any final decision made by the Commissioner after a hearing to which he was a party. "The court shall have the power to enter, upon the pleadings and transcript of the record, a judgment affirming, modifying, or reversing the decision of the Commissioner of Social Security, with or without remanding the cause for a rehearing."
Substantial evidence is "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion."
As a preliminary matter, the Court notes that the original record did not contain a transcript of the hearing held on September 12, 2012. Therefore, the Court ordered the Commissioner to file a statement clarifying whether a transcript of the hearing existed and, if it did exist, to supplement the record with a copy of that transcript. (ECF No. 19.) The Commissioner subsequently filed the supplemental transcript. (ECF No. 20.) Plaintiff then moved to either strike the supplemental transcript or for additional time to file a reply brief. (ECF No. 21.) The Court granted Plaintiff's motion to file a reply (ECF No. 22), and Plaintiff filed a reply on October 10, 2016. (ECF No. 23.) The matter is now ready for the Court's decision.
B.F. was born on September 4, 2002, and was a special education student in elementary school at all relevant times.
The Welfare Reform Act amended certain provisions of the Social Security Act relating to SSI applications by children as follows:
The Social Security Administration ("SSA") promulgated final rules implementing this provision. The rules establish a three step sequential evaluation for determining childhood disability such that the SSA considers (1) whether the child is working; (2) whether the child has a medically determinable severe impairment which is expected to result in death, has lasted or is expected to last for a continuous period of not less than twelve months and, if so, (3) whether the impairment or combination of impairments meets, medically equals, or functionally equals the severity of any impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1 (the "Listings").
Methods that may be used to determine whether an impairment is functionally equivalent to a listing include consideration of whether the child's impairment affects "broad areas of development or functioning" set forth in the regulations.
Determination of functional equivalence to a listing entails determination as to whether a child meets the criteria for "marked" limitation in any two of the six domains, without comparison to any specific childhood listing or an "extreme" limitation in one domain.
The burden of proof at the listing level of the sequential evaluation is on the claimant. In order for a claimant to show that her impairment matches a listing, the impairment must meet all specified medical criteria.
In the present case, the ALJ determined that B.F. has severe impairments of attention deficit hyperactivity disorder ("ADHD") and oppositional defiance disorder ("ODD") but does not have an impairment or combination of impairments that meet or medically equal one of the listed impairments, and she does not functionally equal the listings. Therefore, B.F. was not disabled as defined in the Act since the date of the application. In reaching his decision, the ALJ considered all of B.F.'s medically determinably impairments, including any that were not found to be severe in all of the affected domains.
Plaintiff contends that the ALJ erred (1) in finding that B.F.'s mental impairments were not disabling; (2) in dismissing the examining specialist reports, teacher statements, and psychological treatment records; (3) in failing to properly evaluate and set forth good reasons for the weight attributed to the opinion evidence, including dismissing B.F.'s guardian's testimony for improper reasons; (4) in finding that B.F.'s mental impairments failed to meet or equal a listing; and (5) in denying the claim without requiring substantial evidence to support the denial of benefits. Plaintiff's arguments are not persuasive.
As for her first argument that the ALJ should have found B.F.'s mental impairments to be disabling, Plaintiff points to the report of Dr. David Pickering, which she contends supports a finding that B.F. satisfies the criteria of Listing 112.04 (mood disorder) and 112.11 (ADHD).
The criteria for Listing 112.04 are as follows:
112.04 Mood Disorders: Characterized by a disturbance of mood (referring to a prolonged emotion that colors the whole psychic life, generally involving either depression or elation), accompanied by a full or partial manic or depressive syndrome. The required level of severity for these disorders is met when the requirements in both A and B are satisfied.
A. Medically documented persistence, either continuous or intermittent, of one of the following:
1. Major depressive syndrome, characterized by at least five of the following, which must include either depressed or irritable mood or markedly diminished interest or pleasure:
2. Manic syndrome, characterized by elevated, expansive, or irritable mood, and at least three of the following:
or
3. Bipolar or cyclothymic syndrome with a history of episodic periods manifested by the full symptomatic picture of both manic and depressive syndromes (and currently or most recently characterized by the full or partial symptomatic picture of either or both syndromes); and
B. For older infants and toddlers (age 1 to attainment of age 3), resulting in at least one of the appropriate age-group criteria in paragraph B1 of 112.02; or, for children (age 3 to attainment of age 18), resulting in at least two of the appropriate age-group criteria in paragraph B2 of 112.02.
Paragraph B(2) of 112.02 provides:
Dr. Pickering's report identified manic syndrome, characterized by hyperactivity, pressure, of speech, flight of ideas, inflated self-esteem, decreased need for sleep, easy distractibility, and involvement in dangerous activities. The ALJ declined to adopt Dr. Pickering's findings because they were inconsistent with treatment records from Pathways and B.F.'s activities and were more restrictive than shown in the other evidence of record. Additionally, as the ALJ noted, there is no evidence showing that B.F.'s impairments meet all of the specific listing requirements for mood disorder or ADHD. Thus, the ALJ gave Dr. Pickering's report partial weight only.
Although B.F. has diagnoses of ADHD and occasional hyperactivity, there is minimal evidence to support a finding of mania. Dr. Pickering thought B.F. was "a little too happy," but B.F.'s guardian and her treating nurse practitioner, Jeanne Egan, never expressed such a concern.
As the ALJ determined, the evidence does not establish marked impairment in two or more of the areas described in 112.02(B)(2). B.F. was an avid reader and able to communicate with others, which is inconsistent with a finding of marked impairment in communication and cognitive function.
Next, Plaintiff contends that B.F. meets Listing 112.11. The criteria for Listing 112.11 are:
A. Medically documented findings of all three of the following:
As discussed above, although the evidence establishes some hyperactivity, the ALJ could properly find that the record does not contain evidence of marked inattention or impulsivity or that B.F.'s impairments result in at least two of the criteria in paragraph B2 of 112.02. Thus, Plaintiff has failed to demonstrate that B.F. meets the requirements of any listing.
Plaintiff also argues that the ALJ erred in failing to find that her impairments functionally equal a listed impairment. To determine whether an impairment is functionally equivalent to a listing and, therefore, severe enough to entitle a child to benefits, the ALJ must consider whether the child's impairment affects "broad areas of development of functioning."
Dr. Pickering found that B.F. had marked impairments in two domains — acquiring and using information and attending and completing tasks.
The domain of acquiring and using information includes the ability to acquire and learn information, and use the information learned.
In finding that B.F. had less than marked limitation in this domain, the ALJ pointed to the following evidence. B.F. has a full scale IQ of 81, placing her in the low average range of intelligence, and there was a significant difference between her verbal and performance capabilities.
The domain of attending and completing tasks considers how well a child is able to focus and maintain attention and how well the child begins, carries through, and finishes activities, including the pace at which she performs.
Dr. Pickering opined that B.F. had marked limitations in this domain, again with no narrative explanation on the form to support his finding.
The ALJ's finding that B.F. had less than marked limitations in acquiring and using information and attending and completing tasks is supported by state agency psychologist Victor O'Bryan, Ph.D., who reviewed the file in April 2011 and opined that B.F. had less than marked limitations in these two domains.
Also supporting the decision of the ALJ are the records from B.F.'s treating clinician, Nurse Egan, which show that, during the relevant time period, B.F. was oriented, with an intact memory, appropriate thought contact, neat appearance, pleasant affect, cooperative behavior, and appropriate speech.
Plaintiff contends that the ALJ should have considered evidence showing that B.F. was the victim of prenatal drug abuse.
"In assessing the medical evidence supplied in support of a claim, there are certain governing standards to which an ALJ must adhere."
The ALJ gave Dr. Pickering's opinions partial weight because they were not fully consistent with treatment records from Pathways or B.F.'s daily activities and abilities. The ALJ gave significant weight to the opinion of Dr. O'Bryan, explaining that his opinion was based on evidence that included B.F.'s test scores, teacher questionnaires, and daily activities. He gave less weight to Dr. O'Bryan's finding that B.F. had no limitation in health and physical well-being because it was not supported by the record. The ALJ gave significant weight to the opinions of state agency consultants Dr. Gulbenk, Dr. Schoup, and Ms. Allen regarding B.F.'s limitations in the domains of acquiring and using information and attending and completing tasks. The ALJ gave little weight to Dr. Smith's opinion because it was vague and uncertain. Thus, Plaintiff's contention that the ALJ failed to specify the weight given to opinion evidence of record or explain the basis of weight given is without merit.
Social Security Ruling 96-7p requires the ALJ explain his credibility determinations such that it "must be sufficiently specific to make clear to the individual and to any subsequent reviewers the weight the adjudicator gave to the individual's statements and the reasons for that weight."
Here, the ALJ considered the statements of Plaintiff in finding that B.F. was not disabled. The ALJ noted that Plaintiff was not medically trained and, because of her relationship with B.F. and financial interest in seeing B.F. obtain benefits, she could not be considered a disinterested third party. Additionally, Plaintiff's statements were not consistent with the opinions and observations by clinicians. For example, Plaintiff asserted that medication was ineffective in addressing B.F.'s mental issues even though treatment records showed that B.F. benefitted from medication.
Finally, Plaintiff argues that the ALJ did not develop the record. When the record contains a sufficient amount of evidence pertaining to an impairment, as in this case, an ALJ has no obligation to obtain an additional assessment.
Because substantial evidence supports the ALJ's findings and the correct legal standards were applied, the decision of the Commissioner is