Dana Person For D.P. v. Kijakazi
| Decision Date | 16 September 2021 |
| Docket Number | Civil Action 1:20-CV-01185-AKK |
| Parties | DANA PERSON FOR D.P., A MINOR CHILD, Plaintiff, v. KILOLO KIJAKAZI, Acting Commissioner of Social Security, Defendant. |
| Court | U.S. District Court — Northern District of Alabama |
Dana Person brings this action on behalf of her minor son, D.P pursuant to 42 U.S.C. §§ 1383(c)(3) and 405(g) seeking review of the final adverse decision of the Commissioner of the Social Security Administration under the Social Security Act. After careful review, this court finds that the decision of the Administrative Law Judge, which has become the final decision of the Commissioner, was not predicated on a fully developed record because the ALJ failed to address D.P.'s formal test scores. Thus, for the reasons below, the court reverses the decision denying benefits and remands the case for further proceedings.
Person applied for Social Security benefits on behalf of her then-nine-year-old son, D.P., on July 6, 2018, due to her son's seizures, asthma, and attention- deficit/hyperactivity disorder (“ADHD”). Doc. 19 at 1; R. 166. This claim was denied on October 23, 2018, R 80, and Person requested a hearing thereafter, R. 87. Person, D.P., and their attorney appeared at a hearing before an ALJ, who subsequently rendered a decision denying benefits. See R. 24, 34. Following the ALJ's decision, Person sought review by the SSA Appeals Council, which denied her request and rendered the ALJ's decision the final decision of the Commissioner. R. 1. Person subsequently filed this petition for judicial review.
This court's review is limited to determining whether the record contains substantial evidence to sustain the ALJ's decision and whether the ALJ applied the correct legal standards. See 42 U.S.C. § 405(g); Chester v. Bowen, 792 F.2d 129, 131 (11th Cir. 1986). Specifically, under 42 U.S.C. §§ 405(g) and 1383(c), the Commissioner's “factual findings are conclusive if supported by ‘substantial evidence.'” Martin v. Sullivan, 894 F.2d 1520, 1529 (11th Cir. 1990). In its review, the court may not reconsider the facts, reevaluate the evidence, or substitute its judgment for the Commissioner's. Id. Rather, the court must review the final decision in its entirety to determine whether it is “‘reasonable and supported by substantial evidence.'” Id. (quoting Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983)).
Substantial evidence is “such relevant evidence as a reasonable person would accept as adequate to support a conclusion.” Id. (quoting Bloodsworth, 703 F.2d at 1239). “[T]he threshold for such evidentiary sufficiency is not high.” Biestek v. Berryhill, 139 S.Ct. 1148, 1154 (2019). Rather, substantial evidence falls somewhere between a “scintilla” and a “preponderance of evidence.” Martin, 894 F.2d at 1529. If substantial evidence supports the Commissioner's factual findings, then the court must affirm, even if the evidence preponderates against those findings. See Id. However, this “does not yield automatic affirmance, ” Lamb v. Bowen, 847 F.2d 698, 701 (11th Cir. 1988); reviewing courts are not to act as “automatons, ” Bloodsworth, 703 F.2d at 1239 (internal quotations omitted). Courts review legal conclusions, on the other hand, de novo. Martin, 894 F.2d at 1529.
The SSA considers a claimant under the age of 18 to be disabled if the claimant “[has] a medically determinable physical or mental impairment or combination of impairments that causes marked and severe functional limitations, and that can be expected to cause death or that has lasted or can be expected to last for a continuous period of not less than 12 months.” 20 C.F.R. § 416.906. The regulations define “marked and severe functional limitations” in terms of “listing-level severity.” 20 C.F.R. §§ 416.902, 416.906, 416.924(a), 416.926a(a). The regulations also establish a three-step test to determine whether a child is disabled:
Under the first step, the ALJ considers whether the child has engaged in any substantial gainful activity. At step two, the ALJ considers whether the child has an impairment or combination of impairments that is severe. At step three, the ALJ must decide whether the child's impairment meets, medically equals, or functionally equals a listed impairment.
Coleman ex rel. J.K.C. v. Comm'r of Soc. Sec., 454 Fed.Appx. 751, 752 (11th Cir. 2011) (internal citations omitted); see 20 C.F.R. § 416.924.[1]
If the child has a severe impairment or combination of impairments that does not meet or medically equal any listing, the ALJ determines whether the impairment or combination of impairments “functionally equals” the listings. 20 C.F.R. § 416.926a(a). To do this, the ALJ considers the child's functioning 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. 20 C.F.R. § 416.926a(b)(1). If the ALJ determines that the child has “marked” limitations in two of these domains or an “extreme” limitation in one domain, the child's impairment or impairments are of listing-level severity. Id. § 416.926a(d). “An ‘extreme' rating is reserved for ‘the worst limitations,' ones that interfere ‘very seriously' with the child's ability to independently initiate, sustain, or complete activities.” Beavers v. Comm'r of Soc. Sec., 601 Fed.Appx. 818, 821 (11th Cir. 2015) (citing 20 C.F.R. § 416.926(a)). “A child's limitation is ‘marked' if it is ‘less than extreme,' but ‘more than moderate' and ‘interferes seriously with [the child's] ability to independently initiate, sustain, or complete activities.'” Id.
To render these conclusions, the ALJ considers “all evidence in [the child's] case record, ” including “information from medical sources (such as [the child's] pediatrician or other physician; psychologist; qualified speech-language pathologist; and physical, occupational, and rehabilitation therapists) and nonmedical sources (such as [the child's] parents, teachers, and other people who know [the child]).” 20 C.F.R. § 416.924a(a). Medical evidence may include “formal testing that provides information about [the child's] development or functioning in terms of percentiles, percentages of delay, or age or grade equivalents, ” and the ALJ evaluates these scores together with information like reports of classroom performance and observations by teachers. Id. § 416.926a(e). The ALJ also considers whether the child does activities that other children that age typically do, how much assistance the child requires from family members or teachers, and the combined effects of multiple impairments on the child's day-to-day functioning. Id. § 416.924a(b).
Finally, the ALJ considers symptoms, including pain, and the extent to which the child's symptoms can “reasonably be accepted as consistent with the objective medical evidence and other evidence.” Id. § 416.929(a). The regulations require that there be “objective medical evidence from an acceptable medical source that shows [the child has] a medical impairment(s) which could reasonably be expected to produce the pain or other symptoms alleged” and that the ALJ consider statements about the intensity and persistence of [the child's] pain or other symptoms “which may reasonably be accepted as consistent with the medical signs and laboratory findings.” Id. The ALJ uses this evidence to decide how symptoms affect the child's functioning. Id. If the impairments do not meet, medically equal, or functionally equal one of the listings, a finding of not disabled is reached, and the claim is denied.
In this case, the ALJ determined at Step One that D.P., a school-aged child, had not engaged in substantial gainful activity since the date his mother filed his application for benefits. R. 14. At Step Two, the ALJ found that D.P. suffered from seizures, asthma, and ADHD, all constituting severe impairments. Id. (citing 20 C.F.R. § 416.924(c)). In particular, the ALJ stated that D.P.'s impairments “constitute[d] more than a slight abnormality and have caused [D.P.] more than a minimal functional limitation for a continuous period of 12 months.” Id. At Step Three, the ALJ determined that D.P. did not have an impairment or combination of impairments that met or medically equaled the severity of any listing. Id. In reaching this conclusion, the ALJ reviewed the listings for neurodevelopmental disorders, asthma, and epilepsy and found that D.P.'s impairments did not satisfy the required elements for severity of these conditions. R. 14-15.[2]
Thus, the ALJ assessed whether D.P. had an impairment or impairments that functionally equaled the severity of the listings. R. 15. The ALJ began by reviewing function reports of D.P. prepared by D.P.'s parents. R. 16.[3] Next, the ALJ discussed some of D.P.'s treatment, including transportation to school in a special-needs bus due to seizures; tutoring; and medication for seizures, ADHD, and asthma. Id. The ALJ then turned to the hearing testimony. See Id. At the hearing, D.P. acknowledged that he “[did] not like school [] and perform[ed] poorly” and that he fought with classmates. Id.; see also R. 39, 45-46. D.P.'s mother testified that he had absences caused by his seizures every other day, experienced daily headaches due to his seizure medication, and struggled with tasks in class and at home, and that his school “seldom” provided the extra help he was supposed to receive. R. 45-51.
In light of this evidence, the ALJ concluded that D.P.'s “medically determinable impairments could reasonably be expected to produce some of the alleged symptoms.” R 17. However, the ALJ stated that “the...
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