Baker ex rel. Baker v. Barnhart

• Decision Date: 30 December 2005
• Docket Number: No. 05 C 0652.,05 C 0652.
• Citation: Baker ex rel. Baker v. Barnhart, 410 F.Supp.2d 757 (E.D. Wis. 2005)
• Parties: Milo BAKER, a minor, by Michelle BAKER, his mother and natural guardian Plaintiff, v. Jo Anne B. BARNHART Defendant.
• Court: U.S. District Court — Eastern District of Wisconsin

410 F.Supp.2d 757

Milo BAKER, a minor, by Michelle BAKER, his mother and natural guardian Plaintiff, v. Jo Anne B. BARNHART Defendant.

No. 05 C 0652.

United States District Court, E.D. Wisconsin.

December 30, 2005.

COPYRIGHT MATERIAL OMITTED

Lynn M. Zuehlsdorf-Mack, Mack Law Offices, Milwaukee, WI, for Plaintiff.

Matthew V. Richmond, Nora Sheehan Barry, United States Department of Justice, Office of the US Attorney, Milwaukee WI, Danielle A. Pedderson, United States Social Security Administration, Office of the General Counsel, Chicago, IL, for Defendant.

DECISION AND ORDER

ADELMAN, District Judge.

Despite the deferential standard of review applicable to social security appeals, district courts reverse or remand more than fifty percent of the time, a rate that has been increasing. Paul Verkuil & Jeffery Lubbers, Alternative Approaches to Judicial Review of Social Security Disability Cases: A Report to the Social Security Board, at 31 (Mar. 1, 2002), available at http://www.ssab.gov (last visited Dec. 23, 2005). One reason for this trend is that Administrative Law Judges ("ALJs") too often fail to explain the reasoning underlying their decisions. Of course, ALJs need not discuss their reasoning in microscopic detail, but they must explain their "analysis of the evidence with enough detail and clarity to permit meaningful appellate review." Briscoe v. Barnhart, 425 F.3d 345, 351 (7th Cir.2005).

In the present case, the ALJ's analysis of the two primary issues consisted of recitations of some of the evidence followed by bald conclusions. He failed to provide a bridge from the evidence to the result. Therefore, although the Commissioner creditably attempts to salvage the decision by providing the rationale the ALJ omitted, I must reverse and remand. See Blakes v. Barnhart, 331 F.3d 565, 569 (7th Cir.2003) (holding that the ALJ must rationally articulate the grounds for his decision, and the court must confine its review to the reasons he provided).

I. BACKGROUND

On May 29, 1995, Milo Baker was born prematurely, weighing just two pounds, six ounces. In July 1995, based on his low birth weight and prematurity, he was awarded supplemental security income ("SSI"). In April 2002, the Social Security Administration ("SSA") reviewed his case and determined that his condition had improved such that he was no longer entitled to benefits. His mother, Michelle Baker ("plaintiff"), appealed the decision, contending that Milo continued to have significant problems in understanding and concentrating, but the ALJ found that he was no longer disabled. The Appeals Council denied review, making the ALJ's decision the final decision of the SSA. Haynes v. Barnhart, 416 F.3d 621, 626 (7th Cir.2005). Plaintiff then commenced the present action on Milo's behalf seeking judicial review of the ALJ's decision. 42 U.S.C. § 405(g).

II. APPLICABLE LEGAL STANDARDS

A. Disability Standard for Children

The SSA has adopted a sequential three-step test for determining whether a child-claimant is disabled. Under this test, the ALJ must determine: (1) whether the claimant is engaged in substantial gainful activity; (2) if not, whether the claimant has a severe impairment; and (3) if so, whether the impairment meets, equals or functionally equals an impairment listed in SSA regulations as being presumptively disabling. See 20 C.F.R. § 416.924. In determining whether an impairment, meets or equals a Listed impairment, the evaluation for a child is much the same as for an adult: the claimant must satisfy all of the specific criteria of the particular Listing. See Keys v. Barnhart, 347 F.3d 990, 992 (7th Cir.2003); Maggard v. Apfel, 167 F.3d 376, 380 (7th Cir.1999). If the child-claimant does not meet or equal a Listing, the ALJ must determine whether his impairment "results in limitations that functionally equal the listings." 20 C.F.R. § 416.926a(a). The ALJ does this by evaluating the claimant's degree of limitation (i.e., extreme, marked, less than marked, or no limitation) in six "domains": (1) acquiring and using information; (2) attending and completing tasks; (3) interacting and relating with others; (4) moving about and manipulating objects; (5) caring for oneself; and (6) health and physical well-being. § 416.926a(b)(1). If the ALJ determines that the claimant has "marked" limitations in two domains or an "extreme" limitation in one domain, he must find the child disabled. § 416.926a(a).

"Marked" and "extreme" limitations in a given domain can be established by standardized test scores that are two or three standard deviations, respectively, below the mean — that is, either in the lowest 2.5 percent of the distribution or the lowest 1 percent — provided, however, that the scores are representative of day-to-day functioning. 20 C.F.R. §§ 416.926a(e)(2)(iii), 416.926a(e)(3)(iii). Test scores are not conclusive, therefore, and the bulk of 20 C.F.R. § 416.926a is devoted to "general descriptions of each domain" against which a claimant's functioning may be compared; and so when the dust settles, the agency retains substantial discretion[.]

Keys, 347 F.3d at 994.

B. Medical Improvement/Cessation of Benefits

After a claimant is found disabled, the SSA periodically evaluates his impairments to determine whether he is still eligible for benefits. See 20 C.F.R. §§ 404.1589 & 416.994a. The agency refers to this as a "continuing disability review." § 404.1589. The review is comprised of three steps. First, the SSA considers whether the claimant has experienced "medical improvement" since the previous determination.¹ § 404.994(a)(1). If not, the SSA will, subject to a few exceptions, find that the claimant is still disabled. Second, if the SSA finds medical improvement, it considers whether the claimant's impairment now meets or medically or functionally equals the severity of the Listing it met or equaled at the time of the previous determination. If so, the SSA will find the claimant still disabled, unless an exception applies. Third, if the impairment no longer meets or equals the Listing it previously met or equaled, the SSA considers whether the claimant is currently disabled under the three-step test described above. See § 404.994(a)(1). If not, it terminates the claimant's benefits.

C. Review of ALJ's Decision

In social security appeals, the district court's review is limited to determining whether the ALJ's decision is supported by "substantial evidence" and based on the proper legal criteria. Scheck v. Barnhart, 357 F.3d 697, 699 (7th Cir.2004). Substantial evidence is such relevant evidence as a reasonable person could accept as adequate to support a conclusion. Cannon v. Apfel, 213 F.3d 970, 974 (7th Cir. 2000). Thus, where conflicting evidence would allow reasonable minds to differ as to whether a claimant is entitled to benefits, the responsibility for that decision falls on the ALJ. Binion v. Chater, 108 F.3d 780, 782 (7th Cir.1997). However, if the ALJ commits an error of law, the district court must reverse regardless of the volume of evidence in support of the factual findings. Id. The ALJ's decision must also demonstrate the path of his reasoning, and the evidence must lead logically to his conclusion. Rohan v. Chater, 98 F.3d 966, 971 (7th Cir.1996). Even if the evidence in the record supports the decision, the court cannot uphold it if the ALJ's reasoning does not build an accurate and logical bridge between the evidence and the result. Sarchet v. Chater, 78 F.3d 305, 307 (7th Cir.1996).

III. FACTS

A. Administrative History

In June 1995, the SSA determined that Milo equaled Listing 100.02 based on low birth weight. (Tr. at 44). In January 1997, the SSA commenced a continuing disability review (Tr. at 45) and in April 1997 found Milo no longer disabled (Tr. at 49). Plaintiff requested reconsideration (Tr. at 59) and on March 3, 1998, appeared before a disability hearing officer ("DHO") (Tr. at 63). The DHO found medical improvement, i.e., that Milo had good growth and no signs of physical impairment or motor deficits related to his premature birth (Tr. at 67-68); that his impairment no longer met the Listing from the CPD (Tr. at 68-69); but that he remained disabled based on a "marked" limitation in the area of cognition and an "extreme" limitation in communication, which functionally equaled Listing 111.09 (Tr. at 69-70). Therefore, the DHO reinstated Milo's benefits. (Tr. at 71-73.)

In September 2001, the SSA commenced another continuing disability review and on April 11, 2002 again discontinued benefits. (Tr. at 77.) Plaintiff requested reconsideration (Tr. at 81), but this time the DHO found Milo not disabled (Tr. at 97). The DHO concluded that since the March 1998 CPD Milo had made significant gains in his overall functioning, including in communication and cognition, and thus no longer functionally equaled Listing 111.09. (Tr. at 93-94.) The DHO found Milo limited to "less than a marked" degree in the domain of acquiring and using information, with no significant limitations in the other domains. (Tr. at 92-93.)

Plaintiff requested a hearing before an ALJ (Tr. at 101), and on January 21, 2004 she appeared with counsel before ALJ Dale Garwal. (Tr. at 653).

B. Hearing Testimony

Plaintiff testified that Milo was eight years old, in the third grade and not doing well in school. On a recent report card, he received mostly zeroes. (Tr. at 659; see also Tr. at 621.) Plaintiff testified that Milo's teachers said that he sat in the classroom staring like he did not know what to do and that he did not complete his assignments. (Tr. at 660.) Although Milo was enrolled in special speech and language classes and tutored three days a week after school, it did not seem to help. (Tr. at 662.) Plaintiff stated that she tried to help Milo with his homework, but she could not read his writing and he was too hyper to sit down and do the work. (Tr. at 660-61.)

Plaintiff testified that Milo had friends, but they bossed him...