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Wigfall v. Berryhill

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

March 22, 2017

NANCY A. BERRYHILL, Acting Commissioner of Social Security, [1]Defendant.



         Plaintiff Gerrisha Wigfall brings this action under 42 U.S.C. § 405(g), seeking judicial review of the Commissioner's denial of her application for child's supplemental security income (SSI) under Title XVI of the Social Security Act, 42 U.S.C. §§ 1381, et seq. Because the Commissioner's final decision is not supported by substantial evidence on the record as a whole, I will reverse the decision and remand for further proceedings.

         I. Procedural History

         An application for child's benefits was filed on Wigfall's behalf on December 18, 2012, claiming that she became disabled on January 1, 2008. Wigfall was 15 years old when her application was filed. The Social Security Administration denied Wigfall's application on March 25, 2013. A hearing was held before an administrative law judge (ALJ) on April 22, 2014, at which Wigfall and her mother testified. On August 13, 2014, the ALJ denied Wigfall's claim for benefits, finding Wigfall's severe impairments of major depressive disorder, post-traumatic stress disorder (PTSD), social anxiety disorder, and anxiety disorder NOS not to meet or medically equal a listed impairment, nor functionally equal a listed impairment. On October 8, 2015, the Appeals Council denied Wigfall's request for review of the ALJ's decision. The ALJ's decision is thus the final decision of the Commissioner. 42 U.S.C. § 405(g).

         In this action seeking judicial review of the Commissioner's final decision, Wigfall, now an adult, argues that the ALJ improperly discounted the opinion of her treating psychiatrist and erred in finding that she did not meet a listed impairment.

         II. Legal Standard

         A claimant under the age of eighteen is considered disabled and eligible for SSI under the Social Security Act if 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 Commissioner is required to undergo a three-step sequential evaluation process when determining whether a child is entitled to SSI benefits. First, the Commissioner must determine whether the child is engaged in substantial gainful activity. If not, the Commissioner must then determine whether the child's impairment, or combination of impairments, is severe. Finally, if the child's impairment(s) is severe, the Commissioner must determine whether it meets, medically equals, or functionally equals the severity of an impairment listed in Appendix 1 of Subpart P of Part 404 of the Regulations. 20 C.F.R. § 416.924(a); Garrett ex rel. Moore v. Barnhart, 366 F.3d 643, 647 (8th Cir. 2004). If the impairment(s) meets or medically equals a Listing, the child is disabled. Garrett, 366 F.3d at 647. If a child's impairment does not meet or medically equal a listed impairment, the Commissioner will assess all functional limitations caused by the child's impairment to determine whether the impairment functionally equals the listings. 20 C.F.R. § 416.926a. If this analysis shows the child not to have an impairment which is functionally equal in severity to a listed impairment, the ALJ must find the child not disabled. Oberts o/b/o Oberts v. Halter, 134 F.Supp.2d 1074, 1082 (E.D. Mo. 2001).

         To functionally equal a listed impairment, the child's condition must result in an “extreme” limitation in one domain of functioning or “marked” limitations in two domains. 20 C.F.R. § 416.926a(a). The domains are “broad areas of functioning intended to capture all of what a child can or cannot do.” 20 C.F.R. § 416.926a(b)(1). The six domains used by the Commissioner in making this determination 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 Oneself; and 6) Health and Physical Well-Being. Id.

A child-claimant has a “marked” limitation in a domain when her impairment(s) interferes seriously with [her] ability to independently initiate, sustain, or complete activities. [Her] day-to-day functioning may be seriously limited when [her] impairment(s) limits only one activity or when the interactive and cumulative effects of [her] impairment(s) limit several activities. “Marked” limitation also means a limitation that is “more than moderate” but “less than extreme.”

20 C.F.R. § 416.926a(e)(2)(i). A child has an “extreme” limitation 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). In determining whether a child-claimant's functioning may be marked or extreme, the Commissioner is to review all the evidence of record and “compare [the child's] functioning to the typical functioning of children [the child's] age who do not have impairments.” 20 C.F.R. § 416.926a(f)(1); see also 20 C.F.R. § 416.926a(b) (in determining child-claimant's functioning, Commissioner looks “at how appropriately, effectively and independently [the child] perform[s] [his] activities compared to the performance of other children [the child's] age who do not have impairments.”); 20 C.F.R. § 416.924a(b)(5).

         The Commissioner's findings are conclusive upon this Court if they are supported by substantial evidence. 42 U.S.C. § 405(g); Young v. Shalala, 52 F.3d 200 (8th Cir. 1995) (citing Woolf v. Shalala, 3 F.3d 1210, 1213 (8th Cir. 1993)). Substantial evidence is less than a preponderance but enough that a reasonable person would find it adequate to support the conclusion. Briggs v. Callahan, 139 F.3d 606, 608 (8th Cir. 1998). In evaluating the substantiality of the evidence, I must consider evidence which supports the Commissioner's decision as well as any evidence which fairly detracts from the decision. McNamara v. Astrue, 590 F.3d 607, 610 (8th Cir. 2010). Where substantial evidence supports the Commissioner's decision, I must affirm, even if a different conclusion may be drawn from the evidence. Id.

         III. Evidence Before the ALJ

         A. Testimonial Evidence

         At the hearing on April 22, 2014, Wigfall and her mother testified in response to questions posed by counsel and the ALJ. Wigfall was 17 years old and in the eleventh grade at the time of the hearing. She weighed 308 pounds. She failed English the year before but took it again on credit recovery and passed. She has trouble staying focused and awake. Wigfall was suspended from school twice during the school year for arguing with other students. She is irritable and gets angry easily. Since her grandmother died, she has daily mood swings, anxiety, and depression. Wigfall has been hospitalized twice for depression, most recently in November of 2013, when she was hospitalized at Center Pointe for suicidal thoughts. She has been on different medications for depression without noticing much improvement, but she cannot currently afford medication or counseling. She has a treating psychiatrist and has problems with posttraumatic stress disorder. She has never had a job. (Tr. 32-43).

         Wigfall's mother testified that Wigfall cannot get along with others and that she sits in her room in the dark all the time. Wigfall was sexually molested as a five year old and as a school-aged child. Wigfall was given medication for her irritability, but it did not help much and caused side effects. Wigfall went to live with her father because her mood swings made her too difficult for her mother to handle. (Tr. 43-52).

         B. Medical Evidence

         1. Hospitalizations

         Wigfall was hospitalized for four days in November of 2012 for depression, anxiety, anger, flashbacks, and suicidal ideation. She was reluctant to talk but admitted being sexually abused by a family friend about five years prior and as a very young child. She was also removed from her mother's care at one point because her mother physically abused her. She was diagnosed with mood disorder, not otherwise specified, depression with much repressed trauma, possible temporal lobe hyperfunction aggravating the anger problems, obesity, and sexual abuse as a child. Her GAF score was 40 during her stay and 55 upon discharge. Wigfall was prescribed Paxil, Terileptal, and Trazodone. Her prognosis was “cautiously optimistic.” (Tr. 161-83).

         Wigfall was hospitalized a second time for suicidal ideation between November 19, 2013 and November 27, 2013, upon the request of her treating psychiatrist, Laura Huffman, M.D. Wigfall reported increased depression and persistent thoughts of killing herself. She cut her left wrist and burned her right hand with a cigarette lighter. She was feeling down, sad, and overwhelmed, with feelings of hopelessness and worthlessness. Her diagnosis upon discharge was suicidal ideation, acute depression, and PTSD. Her GAF score upon admission was 30 and 75 at discharge. Wigfall's mood at the time of her discharge was noted to be “excited.” She was prescribed Wellbutrin. (Tr. 221-28).

         2. Treatment with Therapist Hunter

         After her first hospitalization, Wigfall began treatment with therapist Joe Hunter, M.A., L.P.C., L.C.S.W. in November of 2012. Wigfall reported being sexually molested by a family friend at age five and then later by one of her sister's friends. She also reported being removed from her mother's care because her mother physically abused her with telephone and electrical cords. She reported “going off on” her sister. Wigfall admitted that she likes to remember her abuse during these times because it makes her angrier. Her mood was “up and down” and she liked to be alone. (Tr. 194, 197-200).

         In December, Wigfall told Hunter that she “lost it” with another student and that she likes “losing it” because people “back off and leave her alone.” (Tr. 193). In January of 2013, Wigfall admitted having a “battle controlling her temper.” She talked about being sexually and physically abused and stated her anger “helped her to survive” and “became her friend and the one thing she could count on.” (Tr. 188).

         During her February 2013 visit, Wigfall reported having issues with her choir teacher and her mom. (Tr. 217). In May, Wigfall told Hunter that “a lot” had happened over the last month and that it was “all bad.” She said that she was raped by a nineteen year old boy while at a friend's house. She reported the rape to her school counselor, who called Wigall's mother to come to the school. When Wigfall's mother arrived, she and Wigfall got into an argument. Hunter noted that Wigfall had poor eye contact and her mood was depressed. Wigfall said she was hurt, angry, and depressed, with thoughts of ...

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