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Estrada v. Astrue

September 29, 2010

TIFFANY ESTRADA, O/B/O, E.E., PRO SE, PLAINTIFF,
v.
MICHAEL J. ASTRUE, COMMISSIONER OF SOCIAL SECURITY, DEFENDANT.



The opinion of the court was delivered by: Dora L. Irizarry, U. S. District Judge

MEMORANDUM & ORDER

Plaintiff Tiffany Estrada brought this action pro se, seeking judicial review of the Social Security Administration's denial of supplemental security income ("SSI") benefits for her thirteen-year-old daughter, E.E.*fn1 The Commissioner moves for judgment on the pleadings pursuant to Fed. R. Civ. P. 12(c), seeking affirmation of the denial of benefits. Plaintiff opposes the Commissioner's motion and requests that the case be remanded for further proceedings. Plaintiff also filed a request for the appointment of counsel. For the reasons set forth below, the Commissioner's motion is denied, and this case is remanded for further proceedings consistent with this Order. Plaintiff's motion for the appointment of counsel is denied as moot.

BACKGROUND

On July 19, 2006, plaintiff filed an application for SSI benefits on behalf of her minor daughter, E.E., claiming that E.E. was disabled due to speech and language delays, asthma, and a learning disability. (A.R. 51, 56.) The Social Security Administration denied plaintiff's application initially on November 21, 2006, and she subsequently requested a hearing before an administrative law judge ("ALJ"). (A.R. 40-47.) After holding a hearing on July 10, 2007, at which plaintiff and E.E. appeared pro se, ALJ Miriam L. Shire issued an opinion on December 21, 2007, concluding that E.E. was not disabled within the meaning of the Social Security Act ("SSA"). (A.R. 14-24.) In making that determination, the ALJ first found that E.E. had not engaged in substantial gainful employment. (A.R. 17.) Second, the ALJ found that E.E. suffered from the severe impairments of depression, insomnia, asthma, a learning disability, and speech and language delays, and outlined the evidence supporting those conclusions, focusing on the reports of state agency consultative examining physicians. (Id.) Third, the ALJ concluded that E.E. did not have an impairment or combination of impairments that met or medically equaled one of the listing impairments. (A.R. 18.) The ALJ then concluded that E.E. did not have an impairment or combination of impairments that functionally equaled the listings. (Id.) On July 25, 2008, the ALJ's decision became the Commissioner's final decision when the Appeals Council denied plaintiff's request for review. (A.R. 3-5.) On August 18, 2008, plaintiff filed the instant action on E.E.'s behalf. On January 16, 2009, the Commissioner moved for judgment on the pleadings.

DISCUSSION

A. Standard of Review

A district court reviewing the final determination of the Commissioner must determine whether the correct legal standards were applied and whether substantial evidence supports the decision. See Schaal v. Apfel, 134 F.3d 496, 504 (2d Cir. 1998). The court must ask whether "the claimant has had a full hearing under the [Commissioner's] regulations and in accordance with the beneficent purposes of the Act." Echevarria v. Sec'y of Health & Human Servs., 685 F.2d 751, 755 (2d Cir. 1982) (internal quotation marks omitted). The court must also ask whether the decision is supported by "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting Consol. Edison Co. v. N.L.R.B., 305 U.S. 197, 229 (1938)). As a pro se litigant, plaintiff's pleadings are held to "less stringent standards than formal pleadings drafted by lawyers." Haines v. Kerner, 404 U.S. 519, 520 (1972). Accordingly, the court will construe plaintiff's pleadings and papers "to raise the strongest arguments that they suggest." Triestman v. Fed. Bureau of Prisons, 470 F.3d 471, 474 (2d Cir. 2006) (original emphasis, internal quotation marks and citation omitted).

B. Governing SSA Regulations for Defining Childhood Disability

To qualify for SSI 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. § 1382c(a)(3)(C)(i); see Pollard v. Halter, 377 F.3d 183, 189 (2d Cir. 2004). The SSA has provided a three-step sequential analysis to determine whether a child is eligible for SSI benefits on the basis of disability. 20 C.F.R. § 416.924(a); see also Pollard, 377 F.3d at 189. First, the ALJ must consider whether the child is engaged in "substantial gainful activity." 20 C.F.R. § 416.924(b). If so, the child's claim will be denied. Id. "Second, the ALJ considers whether the child has a 'medically determinable impairment that is severe,' which is defined as an impairment that causes 'more than minimal functional limitations.'" Pollard, 377 F.3d at 189 (quoting 20 C.F.R. § 416.924(c)). Third, if the impairment is severe, the ALJ must determine whether the impairment meets or is medically or functionally equal to a disability in the listings. Johnson v. Astrue, 563 F. Supp. 2d 444, 454 (S.D.N.Y. 2008) (quoting 20 C.F.R. § 416.924(c), (d)).

In order to demonstrate functional equivalence to a listing impairment, the child must exhibit "marked" limitations in two of six domains, or an "extreme" limitation in one domain. 20 C.F.R. § 416.926a(a). These six domains consider a child's: (1) ability to acquire and use information; (2) ability to attend and complete tasks; (3) ability to interact and relate with others; (4) ability to move about and manipulate objects; (5) ability to care for oneself; and (6) health and physical well-being. 20 C.F.R. §§ 416.926a(a)-(b). A "marked" limitation "interferes seriously with [the child's] ability to independently initiate, sustain, or complete activities." Johnson, 563 F. Supp. 2d at 454 (quoting 20 C.F.R. § 416.926a(e)(2)(i)). In addition, a limitation is "marked" when standardized testing shows functioning two standard deviations below mean levels. Id.; see also Pacheco v. Barnhart, 2004 WL 1345030, at * 4 (E.D.N.Y. June 14, 2004). An "extreme" limitation exists when the impairment "interferes very seriously with [the child's] ability to independently initiate, sustain, or complete activities." 20 C.F.R. § 416.926a(e)(3)(i). Such a limitation would be found in a domain where the child scores at least three standard deviations below average. Id.

C. Analysis

The Commissioner moves for judgment on the pleadings, seeking affirmation of the denial of benefits on grounds that the ALJ applied the correct legal standards to determine that E.E. was not disabled, and that the ALJ's factual findings are supported by substantial evidence. Plaintiff opposes the motion and urges the court to remand the case, arguing that the ALJ failed to apply the medical facts in the record to the appropriate listing criteria.

This court finds the ALJ's decision insufficient in several respects. First, the ALJ provided insufficient rationale for her conclusion that E.E.'s impairments did not meet or medically equal listing impairments. Second, the ALJ provided insufficient rationale to enable this court to conclude that her findings regarding the incredibility of statements related to the severity and duration of E.E.'s symptoms was supported by substantial evidence. Finally, the ALJ also failed to provide a sufficient rationale for her findings that E.E.'s impairments did not functionally equal the listings.

1. The ALJ Failed to Provide Sufficient Rationale to Support a Finding That E.E.'s Impairments Did Not Meet or Medically Equal Listing Impairments

Plaintiff alleges that E.E. suffers from several impairments which satisfy the listing criteria, including asthma, anxiety disorders, personality ...


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