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Kientzy v. Colvin

United States District Court, E.D. Missouri, Eastern Division

July 27, 2016

KATIE KIENTZY, on behalf of J.P., Plaintiff
v.
CAROLYN W. COLVIN, Acting Commissioner of Social Security, Defendant.

          ORDER MEMORANDUM AND ORDER [1]

          JOHN M. BODENHAUSEN UNITED STATES MAGISTRATE JUDGE

Katie Kientzy (“Plaintiff”), on behalf of J.P., a minor, appeals the decision of the Commissioner of Social Security (“Defendant”) denying disability benefits under Title XVI of the Social Security Act. Because Defendant’s decision is supported by substantial evidence, as discussed below, it is affirmed. See 42 U.S.C. § 1383(c)(3).

         I. Procedural and Factual Background

         On April 18, 2012, Plaintiff filed an application for disability benefits on behalf of J.P., a child under the age of eighteen. (Tr.[2] 103) Plaintiff’s application alleged that J.P. suffers from: (1) autism; and (2) attention deficit hyperactivity disorder (“ADHD”). (Tr. 55) This application was denied, and Plaintiff then requested a hearing before an Administrative Law Judge (“ALJ”). (Tr. 55, 66-68) Plaintiff appeared (with counsel) at the hearing on January 14, 2014. (Tr. 33-54) In a decision dated February 25, 2014, the ALJ found that J.P. was not disabled. (Tr. 7-32) Plaintiff appealed that decision, but the Appeals Council declined review. (Tr. 1-3) Plaintiff has exhausted her remedies, and the matter is properly before this Court. See 42 U.S.C. § 1383(c).

         J.P. was an 11 year old boy at the time of the administrative hearing in this matter. (Tr. 35) J.P. suffers from an autism-spectrum disorder and ADHD. At the hearing, both Plaintiff and J.P. testified regarding the nature of J.P.’s disabilities and symptomatology. (Tr. 33-54) Among other symptoms, J.P. allegedly fights continuously with his sister, expresses negative thoughts about himself, and has trouble interacting with other children. (Tr. 42, 44, 47) J.P.’s mother testified that J.P. sometimes engages in “self-injurious behavior.” (Tr. 41) J.P. attended an alternative school from August of 2010 until August of 2013, because he “had severe behavioral problems” that the local traditional school “could not accommodate.” (Tr. 41) By August of 2013, however, J.P. transitioned to a regular, mainstream school, where he has been succeeding educationally, including placement on the honor roll. (Tr. 190, 396-99)

         After hearing Plaintiff’s and J.P.’s testimony, and reviewing the objective medical records and other evidence in this case, the ALJ ultimately found J.P. not disabled. (Tr. 27) In arriving at this decision, the ALJ followed the three-step inquiry that applies in child disability cases, as set out in the Commissioner’s regulations. See 20 C.F.R. § 416.924(a).

         At step one, the ALJ found that J.P. was a school-age child on the date of the application, and that he was not engaged in substantial gainful activity. (Tr. 13) At step two, the ALJ found that J.P. had the following severe impairments: (1) Asperger’s syndrome versus oppositional defiant disorder; (2) attention deficit hyperactivity disorder (ADHD); and (3) obesity. (Id.) At step three, the ALJ determined that none of J.P.’s severe impairments: (i) met; (ii) medically equaled; or (iii) functionally equaled a Listing in 20 C.F.R. Part 404, Subpart P, Appendix 1. (Tr. 13-14) In conducting his step three inquiry, the ALJ focused on Listing 112.10 (other pervasive developmental disorders) and Listing 112.11 (ADHD). (Id.) The ALJ held that none of J.P.’s severe impairments “met” or “medically equaled” either of those Listings.

         In analyzing whether J.P.’s severe impairments “functionally” equaled a Listing, the ALJ evaluated J.P.’s functioning within the six required domains.[3] The ALJ found that J.P. had “marked” limitations in the domain of interacting and relating to others; but he found that J.P. had less than “marked” limitations in the remaining five domains.[4] Because J.P. did not suffer “extreme” limitations in one domain, or “marked” limitations in two domains, the ALJ found that there was no functional equivalence between J.P.’s impairments and a Listing. (Tr. 19-27)

         In conducting his analysis, the ALJ made several credibility findings and determinations in which he weighed the evidence. For example, the ALJ found that Plaintiff and J.P. were “not entirely credible” concerning the limiting effects of J.P.’s symptoms. (Tr. 16) Regarding the medical opinion evidence, the ALJ partially credited the opinion evidence of J.P.’s treating psychiatrist, Dr. Lisa Delaney, M.D., agreeing with her that J.P. had marked limitations in interacting and relating with others; but disagreeing with Dr. Delaney’s opinion that J.P. has marked limitations in (1) attending and competing tasks and (2) caring for himself. (Tr. 18)

         Additionally, the ALJ gave “some weight” to Dr. Joan Singer, Ph.D., a state agency non-examining doctor who reviewed the medical files in J.P’s case. (Tr. 18-19) Dr. Singer found that J.P. had marked limitations in interacting and relating to others, but no additional limitations in any other domain. (Tr. 546-52) The ALJ agreed with Dr. Singer’s assessment regarding the domain of interacting and relating to others, but disagreed that J.P. had no other limitations-the ALJ thought it more accurate to find that J.P. had “less than marked” limitations in the remaining domains. (Tr. 18)

         Finally, the ALJ gave “great weight” to the opinion of J.P.’s teacher at the alternative school, Dave Haessig. (Tr. 19) Mr. Haessig thought that J.P. had moderate limitations in the domain of acquiring and using information; mostly moderate limitations in attending and completing tasks; no limitations in moving about and manipulating objects; mostly moderate or no limitations in caring for self, along with mostly no limitations in areas of health and physical well-being. (Tr. 153-159) Taking all of this evidence into account, the ALJ found that Plaintiff had not met her burden in proving that J.P’s impairments functionally equaled a Listing. (Tr. 27) Therefore, the ALJ concluded that J.P. was not disabled under the law. (Id.)

         On appeal to this Court, the parties dispute: (1) whether the ALJ properly considered the effects of a structured setting on J.P.’s level of functioning; and (2) whether the ALJ properly considered the opinion evidence in the record. After the initial briefing in this case, the Court ordered oral argument on the first question disputed by the parties, in an effort to ensure that the Court applied the correct legal standards and properly addressed the relevant facts. The Court also gave the parties the option of submitting additional briefing. Defendants submitted additional briefing, and both parties appeared for oral argument on July 7, 2016. After hearing from the parties, the Court took the matter under submission.[5]

         II. Legal Framework and Standard of Review

         Children from low income families may receive Title XVI benefits if certain income and asset requirements are met, and if the child qualifies as “disabled.” See 42 U.S.C. § 1382(a)(1). A child under the age of eighteen 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. See 42 U.S.C. § 1382c(a)(3)(C)(i). As noted above, the Commissioner employs a three-step sequential evaluation process to determine whether a child meets this definition. See 20 C.F.R. § 416.924.

         At step one, the Commissioner determines whether the child is engaged in “substantial gainful activity.” If so, the claim is denied; if not, the Commissioner moves on to step two. See 20 C.F.R. §§ 416.924(a), (b). At step two, the Commissioner determines whether or not the child suffers from any impairments or combination of impairments that are “severe.” 20 C.F.R. § 416.924(a). Under these rules, an impairment is not severe if it “causes no more than minimal functional limitations.” See 20 C.F.R. § 416.924(c). If the child suffers from an impairment or combination of impairments that qualifies as “severe, ” the analysis moves to step three. At step three, the Commissioner determines whether the child has a severe impairment or combination of impairments that: (1) meets; (2) medically equals; or (3) functionally equals a listed impairment set forth in Appendix 1 of 20 C.F.R. pt. 404, subpart P. See 20 C.F.R. § 416.924(d).

         To “meet” or “medically equal” a Listing, a child’s severe impairment must meet the severity criteria for an individual Listing impairment. See id. But if a child has a severe impairment or combination of impairments that does not “meet” or “medically equal” any Listing, the Commissioner will analyze whether the child has limitations that “functionally equal” the Listings of disabling conditions. See 20 C.F.R. § 416.926a(a).

         In considering functional equivalence, the Commissioner looks at how the child’s impairment(s) affect “broad areas of functioning, ” known as “domains.” See 20 C.F.R. § 416.926a(b)(1). To equal a Listing functionally, the impairment(s) must result in “marked limitations”[6] in two domains of functioning, or an “extreme”[7] limitation in one domain. There are six domains:

(i) acquiring and using information; (ii) attending and completing tasks; (iii) interacting and relating to others; (iv) moving about and manipulating objects; (v) caring for yourself; and (vi) health and physical well-being.

See 20 C.F.R. § 416.926a(d). If a claimant fails to meet the burden at any of these three steps, the ALJ must find the child not disabled. See 20 C.F.R. § 416.924(a).

         The Eighth Circuit has repeatedly emphasized that a district court’s review of an ALJ’s disability determination is intended to be narrow and that courts should “defer heavily to the findings and conclusions of the Social Security Administration.” Hurd v. Astrue, 621 F.3d 734, 738 (8th Cir. 2010) (quoting Howard v. Massanari, 255 F.3d 577, 581 (8th Cir. 2001)). The ALJ’s findings should be affirmed if they are supported by “substantial evidence” on the record as a whole. See Finch v. Astrue, 547 F.3d 933, 935 (8th Cir. 2008). Substantial evidence is “less than a preponderance, but enough that a reasonable mind might accept it as adequate to support a decision.” Juszczyk v. Astrue, 542 F.3d 626, 631 (8th Cir. 2008); see also Wildman v. Astrue, 596 F.3d 959, 963 (8th Cir. 2010) (same).

         Despite this deferential stance, a district court’s review must be “more than an examination of the record for the existence of substantial evidence in support of the Commissioner’s decision.” Beckley v. Apfel, 152 F.3d 1056, 1059 (8th Cir. 1998). The district court must “also take into account whatever in the record fairly detracts from that decision.” Id.

         Finally, a reviewing court should not disturb the ALJ’s decision unless it falls outside the available “zone of choice” defined by the evidence of record. Buckner v. Astrue, 646 F.3d 549, 556 (8th Cir. 2011). A decision does not fall outside that zone simply because the reviewing court might have reached a different conclusion had it been the finder of fact in the first instance. Id.; see also McNamara v. Astrue, 590 F.3d 607, 610 (8th Cir. 2010) (explaining that if substantial evidence supports the Commissioner’s decision, the court “may not reverse, even if inconsistent conclusions may be drawn from the evidence, and [the court] may have reached a different outcome”).

         III. Discussion

         As noted above, the parties dispute whether the ALJ properly considered the effects of a structured setting on J.P.’s level of functioning, and whether the ALJ properly considered the opinion evidence in the record. The Court concludes that the ALJ properly considered both of those issues, and that the decision of the ALJ in this matter is supported by substantial evidence.[8]

         A. ALJ’s Consideration of J.P.’s “Structured Environment”

         Plaintiff’s first argument is that the ALJ failed to consider the effects of a structured environment on J.P.’s ability to function. (ECF No. 16 at 3) As Plaintiff points out, the ALJ must consider the effect ...


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