Box v. Astrue
| Decision Date | 27 September 2011 |
| Docket Number | No. 2:10CV28 FRB,2:10CV28 FRB |
| Parties | LORI BOX, o/b/o P.B.P., Plaintiff, v. MICHAEL J. ASTRUE, Commissioner of Social Security, Defendant. |
| Court | U.S. District Court — Eastern District of Missouri |
This cause is before the Court on appeal of an adverse decision of the Social Security Administration. All matters are pending before the undersigned United States Magistrate Judge, with consent of the parties, pursuant to 28 U.S.C. § 636(c).
On October 3, 2007, plaintiff Lori Box filed an application for Supplemental Security Income (SSI) pursuant to Title XVI, 42 U.S.C. §§ 1381, et seq., on behalf of her son, P.B.P, in which she claimed P.B.P. became disabled on September 1, 2007. (Tr. 86-88.) On initial consideration, the Social Security Administration denied plaintiff's claim for benefits. (Tr. 35, 4852.) On May 15, 2009, a hearing was held before an Administrative Law Judge (ALJ). (Tr. 1-27.) Plaintiff and P.B.P. testified and were represented by counsel. On June 12, 2009, the ALJ issued a decision denying plaintiff's claim for benefits. (Tr. 36-47.) On February 22, 2010, the Appeals Council denied plaintiff's requestfor review of the ALJ's decision. (Tr. 28-32.) The ALJ's decision is thus the final decision of the Commissioner. 42 U.S.C. § 405(g).
At the hearing on May 15, 2009, P.B.P. testified in response to questions posed by the ALJ and counsel.
At the time of the hearing, P.B.P. was eight years old. P.B.P. had just completed second grade. P.B.P. testified that he attended a special class at school for reading, but for no other subjects. (Tr. 5-6.) P.B.P. testified that another teacher helped and stayed with him throughout the school day. (Tr. 7.)
P.B.P. testified that he has meltdowns at school when he loses his temper. (Tr. 9.) P.B.P. testified that he has meltdowns every day at school at which time he leaves the school and walks around the building to "get the anger out" and calm down. (Tr. 11.) P.B.P. testified that the most recent meltdown occurred when he thought he got an answer wrong. P.B.P. testified that he stuck his head in a toilet and then ran out of the school and hid behind a tree. (Tr. 9-10.)
P.B.P. testified that he plays sports and plays at recess at school with friends. P.B.P. testified that he has a best friend. (Tr. 6-7.) P.B.P. testified that he used to go to church where he would play games, but that he no longer goes. (Tr. 7-8.)
P.B.P. testified that he takes out the trash every day at home, but that he sometimes forgets and his mom reminds him. P.B.P. testified that he takes the trash to a dumpster that is next to his neighbor's house. (Tr. 8.)
Plaintiff testified in response to questions posed by the ALJ and counsel.
Plaintiff testified that P.B.P. was disabled on account of attention deficit hyperactivity disorder (ADHD), impulsive explosive disorder, and oppositional defiant disorder (ODD). (Tr. 3.)
Plaintiff testified that P.B.P. has experienced meltdowns since the second half of kindergarten, but that she does not get as many calls from the school as she used to because the school is now better able to handle them. Plaintiff testified that P.B.P.'s previous school frequently called and asked plaintiff to pick up P.B.P. from school. Plaintiff testified that she would get such a call at least once a week. (Tr. 13.) Plaintiff testified that at P.B.P.'s current school, she was called to pick him up from school only five to seven times during the recent school year. (Tr. 17.)
Plaintiff testified that other than the recent episode where P.B.P. ran from the school building, she was unaware of the school allowing P.B.P. to go outside to work through his anger. Plaintiff testified that during the recent episode, the police werecalled to help locate P.B.P. Plaintiff testified that the teachers usually try to remove P.B.P. or the other children from the classroom during P.B.P.'s episodes because they do not want the other children to see his behavior. (Tr. 16.) Plaintiff testified that she does not believe that P.B.P. has had in-school suspensions imposed because of his behavior. (Tr. 17.)
Plaintiff testified that P.B.P. sees a counselor at school as well as another teacher who helps him with reading and speech. Plaintiff testified that P.B.P. currently does not have a teacher that stays with him throughout the day, as P.B.P. testified, although such an arrangement was made at P.B.P.'s previous school. (Tr. 16.)
Plaintiff testified that P.B.P. experiences a meltdown when things are not perfect, such as when he makes a small error or when he believes his work is not good enough. Plaintiff testified that playing board games with P.B.P. is difficult because he wants to start over if he is losing and will knock the pieces off of the board. (Tr. 17-18.)
Plaintiff testified that P.B.P. does well staying on task and wants to finish whatever project he is working on. (Tr. 20.) Plaintiff testified, however, that P.B.P. has difficulty moving from one task to another. Plaintiff also testified that P.B.P. has difficulty completing his chores at home because he feels that someone else should do them. Plaintiff testified that P.B.P.accepts her redirection pretty well. (Tr. 17-18.)
Plaintiff testified that P.B.P. has been diagnosed with ADHD but that she disagrees with the diagnosis. Plaintiff testified that P.B.P.'s doctor finally ruled out ADHD and recently diagnosed P.B.P. with attention deficit disorder (ADD) for which he was prescribed new medication. Plaintiff testified that P.B.P.'s medications now include Risperdal, Depakote, Metadate, and Zoloft. Plaintiff testified that P.B.P. has recently gained significant weight but she does not know whether to attribute it to side effects from the medications. (Tr. 20-21.) Plaintiff testified that P.B.P. is able to take care of himself and his personal hygiene, although he wets the bed at night. Plaintiff testified that the doctors are aware of this problem but have not addressed it. (Tr. 25-26.)
Plaintiff testified that P.B.P. sees a psychiatrist as well as a school counselor, but that she has seen no real change since he began treatment. Plaintiff testified that P.B.P. has an upcoming appointment to be tested for Asperger's Syndrome, but that P.B.P. had not yet been formally diagnosed. (Tr. 18-19.)
Plaintiff testified that P.B.P. plays and interacts well with children his own age and shows no aggression toward them. Plaintiff testified that P.B.P. can be mean when he loses control and that he once kicked and struck a trash can during one of his episodes. Plaintiff testified that P.B.P. cannot be redirectedwhen he is in the middle of a meltdown. (Tr. 19.) Plaintiff testified that P.B.P.'s episodes are not as extreme at home because he knows plaintiff can spank him and because he does not have to look good for someone else. Plaintiff testified that P.B.P. feels he has to be the best while at school. (Tr. 20.) Plaintiff testified that P.B.P. appears to be happy for the most part but does not really show much emotion. (Tr. 26.)
In an Evaluation Report dated March 14, 2005, the Center School District noted that P.B.P. was in the early childhood education program. Areas of concern identified in the evaluation included P.B.P.'s speech and language, and screening resulted in a diagnosis of "sound system disorder." Suggestions were made to help P.B.P. progress in the general curriculum, including reading to P.B.P., repeating sounds correctly, and playing rhyming games. It was also noted that plaintiff had reported that P.B.P. had temper tantrums when he does not get his way and that such tantrums last from ten to thirty minutes. (Tr. 217-21.)
On September 6, 2007, P.B.P. was admitted to the Research Psychiatric Center for evaluation following an anger outburst. It was noted that P.B.P. was six years of age and that his school recommended that he undergo such evaluation on account of daily temper tantrums during which he yells, bangs his head, and vocalizes his wish that he were dead. It was noted that P.B.P. hadto be restrained at school several times during the previous week. It was noted that P.B.P. had previously received therapeutic services but was never psychiatrically hospitalized nor had taken psychotropic medications. Mental status examination showed P.B.P. to be very distracted and markedly hyperkinetic with noted difficulty sitting still. P.B.P.'s mood was noted to be good and he was observed to be comfortable in the hospital setting. P.B.P. appeared to be of average intelligence but with impaired insight and judgment. P.B.P. was initially diagnosed with intermittent explosive disorder and ADHD, and was assigned a Global Assessment of Functioning (GAF) score of 43.1 P.B.P. was placed on Ritalin2 during his hospitalization. On September 10, 2007, it was noted that P.B.P. had not displayed explosive behavior and had positive interactions with his peers. P.B.P. was discharged home that date with instruction to follow up with a psychiatrist for medication management. (Tr. 211-14.)
P.B.P. was readmitted to the Research Psychiatric Centeron September 18, 2007, after having had a severe episode of explosive behavior. P.B.P. responded well to medication and was discharged home on September 19, 2007, with instruction to follow up. (Tr. 215.)
P.B.P. visited Dr. Lee T. Weng, a psychiatrist, on September 26, 2007. It was noted that P.B.P. had problems in school and had been hospitalized for four days after which he was given a diagnosis of ADD. P.B.P.'s current medications were noted to be Ritalin and Risperdal.3 Plaintiff reported that P.B.P. was doing okay but continued to be hyper. Dr. Weng noted that P.B.P. had low grades in first grade. Mental status examination showed P.B.P. to be hyper. Plaintiff was instructed to increase P.B.P.'s dosage of Ritalin and Risperdal. (Tr. 256.)
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