United States District Court, N.D. New York
MARY MARTHA WITHINGTON, ESQ., LEGAL AID SOCIETY OF NORTHEASTERN, NY - SARATOGA SPRINGS, Saratoga Springs, NY, Attorneys for Plaintiff.
MARIA P. FRAGASSI, SANTANGELO, ESQ., DAVID L. BROWN, ESQ., OFFICE OF REGIONAL GENERAL COUNSEL SOCIAL SECURITY ADMINISTRATION REGION II, New York, NY, Attorneys for Defendant.
MEMORANDUM-DECISION and ORDER
DAVID N. HURD, District Judge.
Tammie Ovitt brings this action on behalf of her minor granddaughter, A.C. ("A.C." or "plaintiff"), pursuant to 42 U.S.C. §§ 405(g) of the Social Security Act (the "Act") seeking review of the defendant Commissioner of Social Security's ("Commissioner" or "defendant") decision to deny plaintiff's application for Supplemental Security Income ("SSI"). The parties have filed their briefs, including the Administrative Record on Appeal, and the matter has been submitted for decision without oral argument.
A.C. filed an application for SSI on February 25, 2009, claiming a period of disability beginning on October 1, 2008. Her application was denied on July 21, 2009. At plaintiff's request, a hearing was held before an Administrative Law Judge ("ALJ") on August 11, 2010. The ALJ rendered a written decision on September 24, 2010, concluding that plaintiff was not disabled.
On October 29, 2010, A.C. appealed the ALJ's decision to the Appeals Council. On August 1, 2012, the ALJ's decision became the final decision of the Commissioner when the Appeals Council denied plaintiff's request for review. On October 5, 2012, plaintiff filed this action seeking judicial review of the Commissioner's denial of benefits. Because the parties are familiar with the underlying facts, they are discussed only to the extent necessary to address plaintiff's appeal.
A. Standard of Review
A court's review of the Commissioner's final decision is limited to determining whether the decision is supported by substantial evidence and the correct legal standards were applied. Poupore v. Astrue , 566 F.3d 303, 305 (2d Cir. 2009) (per curiam). "Substantial evidence means more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'" Id . (quoting Consol. Edison Co. v. NLRB , 305 U.S. 197, 229 (1938)).
"To determine on appeal whether an ALJ's findings are supported by substantial evidence, a reviewing court considers the whole record, examining the evidence from both sides, because an analysis of the substantiality of the evidence must also include that which detracts from its weight." Williams v. Bowen , 859 F.2d 255, 258 (2d Cir. 1988) (citing Universal Camera Corp. v. NLRB , 340 U.S. 474, 488 (1951)). If the Commissioner's disability determination is supported by substantial evidence, that determination is conclusive. See id. Where evidence is deemed susceptible to more than one rational interpretation, the Commissioner's decision must be upheld-even if the court's independent review of the evidence may differ from the Commissioner's. See Rutherford v. Schweiker , 685 F.2d 60, 62 (2d Cir. 1982); Rosado v. Sullivan , 805 F.Supp. 147, 153 (S.D.N.Y. 1992).
However, "where there is a reasonable basis for doubting whether the Commissioner applied the appropriate legal standards, " the decision should not be affirmed even though the ultimate conclusion reached is arguably supported by substantial evidence. Martone v. Apfel , 70 F.Supp.2d 145, 148 (N.D.N.Y. 1999) (citing Johnson v. Bowen , 817 F.2d 983, 986 (2d Cir. 1987)).
B. Child Disability Determination-The Three-Step Evaluation Process
An individual under the age of eighteen (the "child") is disabled if he or she has "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). The ALJ follows a three-step sequential evaluation process to determine whether the child is disabled. See 20 C.F.R. § 416.924. At step one, the ALJ determines whether the child is engaged in substantial gainful activity. § 416.924(b). If the child is not engaged in substantial gainful activity, then step two requires the ALJ to determine whether the child has a medically determinable "severe" impairment or a combination of impairments that is "severe." § 416.924(c). If the impairment or combination of impairments is severe, then step three requires the ALJ to determine whether that severe impairment or combination of impairments meets or equals one of the conditions identified in the listing of impairments set forth in 20 C.F.R. Pt. 404, Subpt. P., App. 1 (the "Listings").
Equivalence to one of the Listings can be either "medical" or "functional." 20 C.F.R. § 416.924(d). If an impairment is found to meet or medically equal a listed disability, and the twelve-month durational requirement is satisfied, the child will be deemed disabled. § 416.924(d)(1). If no such impairment is found, an ALJ examines the child's "functional" equivalence to determine whether he or she "functionally" equals a disability. 20 C.F.R. § 416.926a(a). This analysis is conducted by considering how the child performs in six "broad areas of functioning intended to capture all of what a child can or cannot do." § 416.926a(b)(1).
These six "domains" are: (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 yourself; and (6) health and physical well-being. § 416.926a(b)(1)(i)-(vi). A finding of disability is warranted if a "marked" limitation, defined as when the impairment "interferes seriously with [the child's] ability to independently initiate, sustain, or complete activities, " is found in two of the listed domains. § 416.926a(d), (e)(2)(I). A finding of disability is also warranted if an "extreme" limitation, defined as when the impairment "interferes very seriously with [the child's] ability to independently initiate, sustain, or complete activities, " is found in one of the listed domains. § 416.926a(d), (e)(3)(I). This rating is only "give[n] to the worst limitations." 20 C.F.R. § 416.926a(e)(3)(I); see also Pollard v. Halter , 377 F.3d 183, 190 (2d Cir. 2004).
C. The ALJ's Decision
The ALJ first determined that A.C. was a "school-age child" during the relevant time period. R. at 28. At step one, the ALJ found plaintiff had not engaged in substantial gainful activity since February 25, 2009, the alleged onset date. Id . At step two, the ALJ determined plaintiff's attention deficit hyperactivity disorder ("ADHD"), adjustment disorder, and oppositional defiant disorder ("ODD") were severe impairments. Id.
At step three, the ALJ found A.C. did not have an impairment or combination of impairments that met or medically equaled any of the Listings. Id . The ALJ then evaluated plaintiff's impairments in accordance with the six domains of functional equivalence. R. 28-38. He found that she had "no limitations" in: (1) acquiring and using information; (4) moving about and manipulating objects; (5) her ability to care for herself; and (6) her health and physical well-being. Id . He also found that plaintiff had "less than marked limitations" in: (2) attending and completing tasks; and (3) interacting and relating with others. Id.
Based on these findings, the ALJ determined that plaintiff did not have an impairment or combination of impairments that functionally equaled any of the Listings. Id. at 28. Accordingly, the ALJ concluded that plaintiff was not disabled within the meaning of the Act. Id. at 38.
D. Plaintiff's Appeal
A.C. contends that the ALJ erred by: (1) summarily concluding that she did not meet or medically equal any of the Listings; (2) failing to find that she suffered "marked" impairments in several functional domains; and (3) ...