United States District Court, N.D. New York
VICTORIA M. ESPOSITO, ESQ., LEGAL AID SOCIETY OF NORTHEASTERN NEW YORK, INC. - CANTON, Canton, New York, Attorneys for Plaintiff.
TOMASINA DIGRIGOLI, ESQ., SOCIAL SECURITY ADMINISTRATION, Office of Regional General Counsel Region II New York, New York, Attorneys for Defendant.
MEMORANDUM-DECISION AND ORDER
MAE A. D'AGOSTINO, District Judge.
Plaintiff ("T.F.") commenced this action on August 28, 2013, pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3), seeking review of a decision by the Commissioner of Social Security ("the Commissioner") denying T.F.'s application for Supplemental Security Income ("SSI"). See Dkt. No. 1.
On June 8, 2010, T.F. filed an application for SSI, alleging a disability onset date of January 1, 2000. See Dkt. No. 9, Administrative Transcript ("T") at 133. This application was denied on October 5, 2010. Id. at 25. T.F. then requested a hearing and appeared with her counsel before Administrative Law Judge ("ALJ") F. Patrick Flanagan on August 11, 2011. See id. at 46-78. On October 13, 2011, ALJ Flanagan issued a decision denying T.F.'s application. See id. at 22-45. T.F. subsequently requested review by the Appeals Council and was denied such review on June 28, 2013, making the ALJ's decision the final decision of the Commissioner. See id. at 1-6.
Presently before the Court are the parties' cross motions for judgment on the pleadings. See Dkt. Nos. 13, 17.
T.F. was fourteen years old at the time of the hearing, held on August 11, 2011. See T. at 48. A "Child Disability Report Form" completed for T.F. by her mother in connection with T.F.'s application for SSI benefits alleges that T.F.'s disabling illnesses and conditions include learning, social, emotional, and behavioral limitations and schizophrenia. T. at 165. The record evidence in this case is undisputed, and the Court adopts the parties' factual recitations. See Dkt. No. 13 at 2-16; Dkt. No. 17 at 4 ("The Commissioner incorporates by reference Plaintiff's recitation of the facts, except for any legal inferences or conclusions, made in Plaintiff's Brief (Pl. Br.) at 2-16.").
A. Standard of Review
The Social Security Act (the "Act") authorizes payment of SSI benefits to individuals with "disabilities." An individual under the age of eighteen is disabled, and thus 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). The definitional provision excludes from coverage any "individual under the age of 18 who engages in substantial gainful activity." Id. § 1382c(a)(3)(C)(ii).
Regulations enacted by the Social Security Administration set forth a three-step analysis for evaluating whether a child's impairment meets this definition of disability: First, the ALJ considers whether the child is engaged in "substantial gainful activity." 20 C.F.R. § 416.924(b). 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." Id. § 416.924(c). Finally, if the ALJ finds a severe impairment, he or she must then consider whether the impairment "medically equals" or, as is most pertinent here, "functionally equals" a disability listed in the regulatory "Listing of Impairments." Id. § 416.924(c)-(d).
Miller v. Comm'r of Soc. Sec., 409 F.Appx. 384, 386 (2d Cir. 2010).
Equivalence to a listing can be either medical or functional. 20 C.F.R. § 416.924(d); Kittles ex rel. Lawton v. Barnhart, 245 F.Supp.2d 479, 488 (E.D.N.Y. 2003). 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); see also Pollard v. Halter, 377 F.3d 183, 189 (2d Cir. 2004).
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). Those prescribed 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 (vi) [h]ealth and physical well-being." Id. A finding of disability is warranted if a "marked" limitation, defined as an impairment that "interferes seriously with [the claimant's] ability to independently initiate, sustain, or complete activities, " id. § 416.926a(e)(2)(i), is found in two of the listed domains, id. § 416.926a(a). Functional equivalence also exists in the event of a finding of an "extreme" limitation, meaning "more than marked" and representing an impairment which "interferes very seriously with [the claimant's] ability to independently initiate, sustain, or complete activities." Id. § 416.926a(e)(3)(i). This rating is only "give[n] to the worst limitations." Id .; see also Pollard, 377 F.3d at 190.
The 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 ALJ must set forth the crucial factors supporting the decision with sufficient specificity to enable the court to decide whether the decision is supported by substantial evidence. Ferraris v. Heckler, 728 F.2d 582, 587 (2d Cir. 1984). Where the weight of the evidence does not meet the requirement for substantial evidence or a reasonable basis for doubt exists as to whether correct legal principles were applied, the ALJ's decision may not be affirmed. Johnson v. Bowen, 817 F.2d 983, 986 (2d Cir. 1987).
B. The ALJ's Decision
At the first step of the sequential analysis, the ALJ found that T.F. had not engaged in substantial gainful activity since May 18, 2010, the application date. T. at 28. At step two, the ALJ concluded that T.F. had the following severe impairments: speech/language disorder, borderline intellectual functioning, and adjustment disorder. Id. At the third step of the analysis, the ALJ determined that T.F. did not have an impairment or combination of impairments that meets or medically equals the severity of any of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. Id. Finally, the ALJ found that T.F. did not have an impairment or combination of impairments that functionally equals the severity of the listings. Id. at 29. Specifically, the ALJ found that T.F. had only one marked limitation, in the domain of interacting and relating with others. Id. at 38. In all other domains, the ALJ found that T.F. had less than marked limitations or no limitation. See id. at 35-40. Therefore, the ALJ made a determination that T.F. was not disabled as defined by the Act. Id. at 41.
1. Functional domains
The ALJ must analyze whether a claimant has an impairment or combination of impairments that functionally equals a listing based upon an analysis of six domains: (1) attending and completing tasks; (2) acquiring and using information; (3) interacting and relating with others; (4) moving about and manipulating objects; (5) ...