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BARRETO v. BARNHART

July 26, 2004.

MARILU BARRETO o/b/o ANGEL RIVAS, Plaintiff,
v.
JO ANNE B. BARNHART, Commissioner of Social Security, Defendant.



The opinion of the court was delivered by: LAURA TAYLOR SWAIN, District Judge

MEMORANDUM OPINION AND ORDER

Plaintiff Marilu Barreto, suing on behalf of her minor son, Angel Rivas ("Angel"), moves for a judgment pursuant to Rule 12(c) of the Federal Rules of Civil Procedure reversing the determination of Defendant Commissioner of Social Security that Angel does not qualify for Supplemental Security Income ("SSI") under the Social Security Act, and ordering the granting of benefit payments, or, alternatively, remanding the matter for a new hearing and decision. Defendant cross-moves for a judgment on the pleadings affirming her decision.

The Court has considered thoroughly all submissions in connection with this motion. For the following reasons, Defendant's determination that Angel is not eligible for SSI is reversed and Plaintiff's claim is remanded to the Commissioner for a new hearing and decision.

  I. The Legal Standard For Determining Disability Of A Child

  The SSI program is a federal program providing benefits to needy, aged, blind or disabled individuals who meet the statutory requirements. 42 U.S.C.A. § 1381 (West 2003). To qualify for disability benefits, a child under the age of eighteen must have "a medically determinable physical or mental impairment, which results in marked and severe functional limitations, and which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C.A. § 1382c(a)(3)(C)(i) (West 2003).

  To determine whether a child is disabled, the ALJ engages in a three-step analysis. 20 C.F.R. § 416.924(a). First, the ALJ must consider whether the child is engaged in "substantial gainful activity." 20 C.F.R. § 416.924(b). If the child is so engaged, he or she will not be awarded SSI benefits. Id. Second, the ALJ must consider whether the child has a severe impairment. 20 C.F.R. § 416.924(c). A severe impairment is an impairment that is more than a slight abnormality. Id. Third, if the impairment is severe, the ALJ must consider whether the impairment meets or is medically or functionally equal to a disability listed in the designated "Listing of Impairments." 20 C.F.R. § 416.924(c); see 20 C.F.R. Pt. 404, Subpt. P, App. 1 (the "Listing").

  In making the third determination — whether a child's impairment meets or equals a listed impairment — the ALJ must consider whether the impairment, alone or in combination with another impairment, "medically equals, or functionally equals the listings." Encarnacion v. Barnhart, 331 F.3d 78, 84 (2d Cir. 2003). Functional equivalency means that the impairment is of "listing-level severity; i.e., it must result in `marked' limitations in two domains of functioning or an `extreme limitation' in one domain. . . ." 20 C.F.R. § 416.926a(a). A marked limitation is one that interferes seriously with the child's "ability to independently initiate, sustain, or complete activities." Id. § 416.926a(e)(2)(i). The ALJ considers how a child functions in his activities "in terms of six domains": "(i) Acquiring and using information; (ii) Attending and completing tasks; (iii) Interacting and relating with others; (iv) Moving about and manipulating objects; (v) Caring for yourself; and, (vi) Health and physical well-being." Id. 416.926a(b)(1). The regulations provide that a child must be found to be disabled if he or she has an impairment or impairments of "listing-level severity," that is, an "extreme" limitation in one of these domains, or "marked" limitations in two or more domains. 20 C.F.R. § 416.926a(a).

  II. Background

  The Claimant, Angel J. Rivas, is a child who, at the time of his application for benefits, was nine years old, enrolled in elementary school, and attending regular classes. (Record of Social Security Proceedings ("R.") at 12.) Angel was initially diagnosed with asthma when he was eight months old. (R. at 114.) In February, 2001, Angel was also diagnosed with diabetes. (R. at 181). Angel also suffers from Type I von Willebrand Disease (R. at 114), a hemorrhagic condition causing frequent nosebleeds.

  On February 27, 2001, Marilu Barreto filed an application for Supplemental Security Income payments based on disability on behalf of Angel, alleging disability due to asthma. (R. at 62-64.) The claim was denied initially and on reconsideration, and a request for hearing was timely filed. (R. at 37). A hearing was held on September 20, 2001. (R. at 20-30.) The claimant and his mother appeared and testified. The administrative law judge (the "ALJ") issued a decision denying the claim, concluding that claimant was not disabled within the meaning of the Social Security Act. (R. at 8-18.) The ALJ based his findings upon his analysis of Plaintiff's testimony at the hearing regarding Angel's impairments and functional abilities, the medical records submitted by Plaintiff, the questionnaire submitted by Angel's teacher, and reports of the state agency medical consultants. (R. at 8-18).

  The ALJ found that Angel has never engaged in substantial gainful activity. (R. at 12). The ALJ also found that Angel suffered from "mild, intermittent asthma that is controlled with medication," first diagnosed when he was eight months old. (R. at 12, 15). The ALJ further found that Angel was diagnosed with diabetes on February 21, 2001, but that this impairment did not reach the degree of disability defined by section 109.08 of the Listings. (R. at 13). He found that both impairments were "severe" within the meaning of Social Security Regulations. (R. at 12.)

  The ALJ listed the numerous occasions on which Angel sought treatment at the Montefiore Medical Center between 1999 and 2001, along with the medical notes indicating Angel's condition. The ALJ also found claimant did not have any marked or extreme limitations in the six domains required to meet functional equivalence of the Listings. (R. at 15-17). The ALJ also evaluated Plaintiff Marilu Barreto's testimony and did not find it "entirely credible in light of the medical evidence cited above." The ALJ did not explain why Plaintiff's testimony contradicted the medical evidence, and furthermore failed to explore several statements made by plaintiff regarding Angel's impairments.

  The ALJ devoted less than one page of his written decision to a summary of the evidence, and only one paragraph to his findings. On the basis of this evidence, the ALJ concluded that Angel's asthma was a severe impairment but that it did not meet, medically equal nor functionally equal the impairments listed in Appendix 1. Accordingly, he found that Angel was not disabled as defined by the Social Security Act. (R. at 17). On April 12, 2002, the Social Security Administration's Appeals Council ...


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