United States District Court, N.D. New York
KIMBERLY ST. LOUIS, on behalf of D.H., Plaintiff,
COMMISSIONER OF SOCIAL SECURITY, Defendant
For Plaintiff: Louise M. Tarantino, Esq., Empire Justice Center, Albany, New York.
Hon. Richard S. Hartunian, United States Attorney; John M. Kelly, Esq., Special Assistant United States Attorney, Social Security Administration, Office of Regional General Counsel, Region II, New York, New York.
MEMORANDUM-DECISION AND ORDER
Norman A. Mordue, Senior U.S. District Judge.
On April 30, 2008, plaintiff filed an application for supplemental security income (" SSI" ) on behalf of her son, D.H, who was then seven years old. T.12. Plaintiff claimed that D.H. suffered from attention deficit hyperactivity disorder (" ADHD" ) and borderline intellectual functioning. T.15. On October 14, 2010, a hearing was held before Administrative Law Judge (" ALJ" ) Elizabeth W. Koennecke; plaintiff
and D.H. testified. T. 26-42. On December 17, 2010, the ALJ issued a decision denying plaintiff's claim for benefits. T.12. The Appeals Council denied plaintiff's request for review. Plaintiff, on D.H.'s behalf, brought this action pursuant to 42 U.S.C. § 405(g) of the Social Security Act, and asks the Court to reverse the Commissioner's decision to deny disability benefits and remand for a calculation of benefits. Presently before the Court are the parties' cross-motions for judgment on the pleadings. Dkt. Nos. 12, 16.
Plaintiff argues: (1) that the ALJ erred in finding that D.H. has less than marked limitations in the domains of acquiring and using information and interacting and relating with others; (2) that the ALJ erred when weighing the opinion evidence; and (3) that the legal standard the ALJ employed when considering the " effects of medication and structured or supportive settings" on D.H.'s limitations, was incorrect.
A Commissioner's determination that a claimant is not disabled will be set aside when the factual findings are not supported by " substantial evidence." 42 U.S.C. § 405(g); see also Shaw v. Chater, 221 F.3d 126, 131 (2d Cir. 2000). Substantial evidence has been interpreted to mean " such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Id. The Court may also set aside the Commissioner's decision when it is based upon legal error. Rosa v. Callahan, 168 F.3d 72, 77 (2d Cir. 1999).
The Social Security Act defines a child, an individual under the age of eighteen, as disabled and eligible for SSI benefits: " if he 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). There is a three-step evaluative process to determine whether a child can meet the statutory definition of disability. 20 C.F.R. § 416.924; Kittles ex rel. Lawton v. Barnhart, 245 F.Supp.2d 479, 487-88 (E.D.N.Y. 2003); Ramos v. Barnhart, No. 02Civ.3127, 2003 WL 21032012, at *7 (S.D.N.Y. May 6, 2003). The first step of the test, which bears some similarity to the familiar, five-step analysis employed in adult disability cases, requires a determination of whether the child has engaged in substantial gainful activity. 20 C.F.R. § 416.924(b); Kittles, 245 F.Supp.2d at 488. If so, then both statutorily and by regulation the child is ineligible for SSI benefits. 42 U.S.C. § 1382c(a)(3)(C)(ii); 20 C.F.R. § 416.924(b).
If the child has not engaged in substantial gainful activity, then the second step requires examination of whether the child suffers from one or more medically determinable impairments that, either singly or in combination, are severe -- that is, which causes more than a minimal functional limitation. 20 C.F.R. § 416.924(c); Kittles, 245 F.Supp.2d at 488; Ramos, 2003 WL 21032012, at *7. If the existence of a severe impairment is discerned, the agency must next determine whether it meets or equals a presumptively disabling condition identified in the listing of impairments set forth by regulation, 20 C.F.R. Pt. 404, Subpt. P, App. 1 (the " Listings" ). Id. Equivalence to a Listing can be either medical or functional. 20 C.F.R. § 416.924(d); Kittles, 245 F.Supp.2d at 488; Ramos, 2003 WL 21032012, at *7. If an impairment is found to meet, or qualify as medically or functionally equivalent to, a listed disability, and the twelve month durational requirement is satisfied, the
child will be deemed disabled. 20 C.F.R. § 416.924(d)(1); Ramos, 2003 WL 21032012, at *8.
Under the Social Security Regulations (the " Regulations" ), analysis of functionality is performed by consideration of how a claimant functions in six areas which are denominated as " domains," and described as " broad areas of functioning intended to capture all of what a child can or cannot do." 20 C.F.R. § 416.926a(b)(1); Ramos, 2003 WL 21032012, at *8. The functional domains include:
(I) [a]cquiring and using information;
(ii) [a]ttending and completing tasks;
(iii) [i]nteracting and relating with others;
(iv) [m]oving about and manipulating objects;
(v) [c]aring for [oneself]; and
(vii) [h]ealth and physical well-being.
20 C.F.R. § 416.926a(b)(1). A finding of disability is warranted if a " marked" limitation, defined as when the impairment " interferes seriously with [the claimant's] ability to independently initiate, sustain, or complete activities," 20 C.F.R. § 416.926a(e)(2)(i), is found in two of the listed domains. 20 C.F.R. § 416.926a(a); Ramos, 2003 WL 21032012, at *8. Functional equivalence also exists in the event of a finding of an " extreme" limitation, meaning " more than marked," representing an impairment which " interferes very seriously with [the claimant's] ability to independently initiate, sustain, or complete activities," and this rating is only " give[n] to the worst limitations" . 20 C.F.R. ...