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Kyle W. v. Saul

United States District Court, D. Kansas

July 19, 2019

KYLE W., [1]o.b.o. T.D.W. Plaintiff,
ANDREW M. SAUL, [2]Commissioner of Social Security, Defendant.



         Plaintiff seeks review of a decision of the Commissioner of Social Security denying Supplemental Security Income (SSI) benefits to his minor son pursuant to sections 1602, and 1614(a) of the Social Security Act, 42 U.S.C. §§ 1381a, and 1382c(a) (hereinafter the Act). Finding no error in the Administrative Law Judge's (ALJ) decision, the court ORDERS that judgment shall be entered pursuant to the fourth sentence of 42 U.S.C. § 405(g) AFFIRMING the Commissioner's final decision.

         I. Background

         An application for SSI was filed for Plaintiff's minor son on December 16, 2014. (R. 13, 182-86). After exhausting administrative remedies before the Social Security Administration (SSA), Plaintiff filed this case seeking judicial review of the Commissioner's decision pursuant to 42 U.S.C. § 405(g). Plaintiff argues that the ALJ erroneously concluded that his son has “less than marked limitations” in the functional equivalence domains of interacting and relating with others and of caring for himself, and that she should have found at least a marked limitation in both of these areas. (Pl. Br. 5-6).

         The court's review is guided by the Act. Wall v. Astrue, 561 F.3d 1048, 1052 (10th Cir. 2009). Section 405(g) of the Act provides that in judicial review “[t]he findings of the Commissioner as to any fact, if supported by substantial evidence, shall be conclusive.” 42 U.S.C. § 405(g). The court must determine whether the ALJ's factual findings are supported by substantial evidence in the record and whether she applied the correct legal standard. Lax v. Astrue, 489 F.3d 1080, 1084 (10th Cir. 2007); accord, White v. Barnhart, 287 F.3d 903, 905 (10th Cir. 2001). “Substantial evidence” refers to the weight of the evidence. It is more than a scintilla, but it is less than a preponderance; it is “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971); see also, Wall, 561 F.3d at 1052; Gossett v. Bowen, 862 F.2d 802, 804 (10th Cir. 1988).

         The court may “neither reweigh the evidence nor substitute [its] judgment for that of the agency.” Bowman v. Astrue, 511 F.3d 1270, 1272 (10th Cir. 2008) (quoting Casias v. Sec'y of Health & Human Servs., 933 F.2d 799, 800 (10th Cir. 1991)); accord, Hackett v. Barnhart, 395 F.3d 1168, 1172 (10th Cir. 2005); see also, Bowling v. Shalala, 36 F.3d 431, 434 (5th Cir. 1994) (The court “may not reweigh the evidence in the record, nor try the issues de novo, nor substitute [the Court's] judgment for the [Commissioner's], even if the evidence preponderates against the [Commissioner's] decision.”) (quoting Harrell v. Bowen, 862 F.2d 471, 475 (5th Cir. 1988)). Nonetheless, the determination whether substantial evidence supports the Commissioner's decision is not simply a quantitative exercise, for evidence is not substantial if it is overwhelmed by other evidence or if it constitutes mere conclusion. Gossett, 862 F.2d at 804-05; Ray v. Bowen, 865 F.2d 222, 224 (10th Cir. 1989).

         The Commissioner uses a three-step sequential process to evaluate a minor's claim for disability. 20 C.F.R. §§ 416.924, 416.924a, 416.924b, 416.926a; Briggs, ex rel. Briggs v. Massanari, 248 F.3d 1235, 1237 (10th Cir. 2001). “If a determination can be made at any of the steps that a claimant is or is not disabled, evaluation under a subsequent step is not necessary.” Wilson v. Astrue, 602 F.3d 1136, 1139 (10th Cir. 2010) (quoting Lax, 489 F.3d at 1084). In these three steps, the Commissioner determines whether the minor claimant is engaged in substantial gainful activity, whether he has a severe impairment or combination of impairments, and whether the severity of his impairment(s) meets, medically equals, or functionally equals the Listings (20 C.F.R., Pt. 404, Subpt. P, App. 1). Briggs, 248 F.3d at 1237 (citing 20 C.F.R. § 416.924(a)). As relevant here, in considering functional equivalence, the ALJ considers how the claimant “functions in his activities in terms of six domains: ‘(i) Acquiring and using information; (ii) Attending and completing tasks; (iii) Interacting and relating with others; (iv) Moving about and manipulating objects; (v) Caring for yourself; and, (vi) Health and physical well-being.'” Briggs, 248 F.3d at 1238 (quoting 20 C.F.R. § 416.926a(b)(1)(i)-(vi)). The Commissioner will determine that a child's condition functionally equals the listings if he has marked limitations in two domains or an extreme limitation in one domain. 20 C.F.R. § 416.926a(d).

         II. Discussion

         Plaintiff argues the level of handholding T.D.W. requires “to understand, navigate, and get through social situations poses much more than a less than marked limitation.” (Pl. Br. 8). He argues that in 2016 T.D.W. was re-evaluated by the Kansas Department for Aging and Disability Services and found “eligible for placement in an immediate care facility based on his developmental delay, ” and that, “The State of Kansas would not have found T.D.W. eligible for essentially institutional care if he only suffered less than marked limitations.” Id. (citing R. 398). Plaintiff recites record evidence including observations of Alex Bruce, [3] “a social worker, ” id., and argues that:

A less than marked limitation is inconsistent with the high degree of supervision T.D.W. requires and his inability to be alone at home or in the community more than briefly. As an adolescent, he shouldn't need his parents to remind him regularly to address his hygiene. And, he shouldn't need a case worker to come to his home and convince him to go out or teach him basic life skills.

Id. at 9.

         He argues that in evaluating the area of caring for yourself, “the ALJ's analysis was simply wrong.” (Pl. Br. 9). He argues that “the ALJ underrepresented T.D.W.'s hygiene deficits, ” id., and that “T.D.W., an adolescent, is unable to even manage being asked to do a chore without absconding.” Id. at 10. He argues it was error for the ALJ to rely on the opinion of the state agency psychologists because their opinions are not accompanied by thorough written reports or supported by the record and did not recognize T.D.W.'s eligibility for an immediate care facility or his need for daily caseworker support. Id. at 11. Moreover, he points out it is the ALJ's responsibility, not the psychologist's, to assess T.D.W.'s limitations.

         The Commissioner argues that the evidence supports the ALJ's findings. (Comm'r Br. 8). He argues that the ALJ considered the evidence appealed to by Plaintiff and reasonably reached a different conclusion, noting that T.D.W. “interacted with friends and family, was not noted to be a behavioral problem at school, and his case worker recognized that some of his issues were merely typical of an adolescent boy of his age.” Id. at 9 (citing R. 18-19, 24-25, 454, 466, 478). He argues, “Even if the record could support a conclusion that T.D.W. had marked limitations in this domain, that is still an insufficient basis to reject the ALJ's finding where-as here-she supported it with substantial evidence.” Id. (citing Lax, 489 F.3d at 1084).

         Similarly, the Commissioner argues the ALJ's findings regarding the domain of caring for yourself are reasonable and supported by the record. He argues the ALJ recognized T.D.W. had deficits in this domain but explained the reasons he found them not to result in marked limitations. Id. at 10. He argues that the ALJ considered the evidence to which Plaintiff appeals, again directs the court to Lax, and argues that even if the court found one of the domains to result in marked limitation that would not change the result of the decision below because the regulations require marked limitations in two domains before a claimant's condition may be found functionally equal to the Listings. (Comm'r Br. 10).

         In his Reply Brief, Plaintiff reiterates his earlier arguments and citation to certain evidence in the record and argues that these facts carry the day rather than the ALJ's “citation to isolated statements” which have resulted in her “missing the forest for the trees.” (Reply 1). He argues, “The average adolescent does not require two case managers to ensure he does not run off, ensure he showers, and ensures [sic] he learns basic life skills, ” and “is able to be along by himself and around younger siblings without supervision. To suggest that these facts only constitute a less than marked limitation is simply not reasonable.” Id. 2-3 (citations omitted). He argues that the opinion of the state agency psychologist, Dr. Bergman-Harms is deficient because he did not address the evidence mentioned in Plaintiff's reply brief, he did not cite to the need for daily case management and for assisted living, and his discussion of interacting and relating with others focused on speech issues rather than T.D.W.'s inability to develop friends and need to become more independent and be more vocal without assistance. Id. at 2. He concludes his argument, “This is not a matter of asking the Court to reweigh the facts. The issue is that the ALJ's interpretation of the evidence is such an outlier that no reasonable factfinder would have reached a similar conclusion.” Id.

         A. The ...

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