E.S. v. Commissioner of Social Security

Background

E.S. applied for Child Supplemental Security Income benefits on behalf of D.A.M.S., alleging disability beginning October 1, 2013. The application was denied initially and on reconsideration. After hearings, Administrative Law Judge Lynn Neugebauer found D.A.M.S. not disabled. The Appeals Council denied review.

In an earlier round of this case, the parties stipulated to a remand for further administrative proceedings. After another hearing, Administrative Law Judge Kimberly Schiro again denied the application on December 5, 2019. The Appeals Council denied review on November 15, 2021, making that decision the Commissioner’s final decision. E.S., represented by counsel, then filed this action for judicial review. The parties submitted a joint stipulation instead of separate motions for judgment on the pleadings.

Issues and Governing Standards

The court reviewed whether the Commissioner applied the correct legal standards and whether substantial evidence supported the decision. “Substantial evidence” means relevant evidence that a reasonable person could accept as adequate to support a conclusion.

For a child to qualify for Supplemental Security Income, the child must have an impairment causing marked and severe functional limitations that has lasted, or is expected to last, at least 12 months. A child can establish functional equivalence to a listed impairment by showing a marked limitation in two of six functional areas or an extreme limitation in one area.

E.S. argued that the Administrative Law Judge improperly evaluated the medical opinions concerning D.A.M.S.’s functional limitations and did not properly assess E.S.’s testimony.

Functional-Equivalence Analysis

The Administrative Law Judge found a marked limitation in interacting and relating with others, but less-than-marked limitations in acquiring and using information, attending and completing tasks, and caring for himself. The Administrative Law Judge found no limitation in moving about and manipulating objects or in health and physical well-being.

Several treating providers assessed more serious limitations. Dr. Salvador Castells assessed marked limitations in acquiring and using information and some aspects of caring for himself and health and physical well-being. Seth Dressekie, a psychiatric-mental health nurse practitioner, assessed marked limitations in acquiring and using information, attending and completing tasks, interacting and relating with others, and caring for himself. Pedro Vazquez, a licensed clinical social worker, assessed marked limitations in acquiring and using information, attending and completing tasks, and interacting and relating with others.

The court upheld the Administrative Law Judge’s evaluation of these opinions. The court found that the record showed significant improvement with medication, generally proficient academic performance, and better behavior at home and school. The court also noted that Dr. Castells’s treatment notes did not support the most restrictive limitations, that Dr. Castells later assessed only moderate developmental, mental, and behavioral impairment, and that non-examining pediatrician Dr. Alan Meyers assessed less-than-marked limitations in all functional areas.

Because the application was filed before March 27, 2017, the treating-physician rule applied. Under that rule, a treating physician’s opinion receives controlling weight when it is well supported by accepted medical techniques and is not inconsistent with the other substantial evidence. The court concluded that the Administrative Law Judge gave sufficient reasons for discounting parts of Dr. Castells’s opinion. The court also found that the Administrative Law Judge properly considered the opinions of Dressekie and Vazquez, even though they were not considered acceptable medical sources under the rules applicable to this case.

Testimony

E.S. argued that the Administrative Law Judge did not adequately consider testimony about D.A.M.S.’s difficulties at home and school. The court disagreed. It found that the Administrative Law Judge summarized the testimony, considered reported inattention and aggressive behavior, recognized reported improvement with medication, and referred to the testimony when discussing each functional area. The court concluded that the treatment records, improved school performance, reported symptom improvement, and Dr. Meyers’s opinion provided sufficient reasons for rejecting a finding of marked limitations in two areas or an extreme limitation in one area.

Disposition

The court found no error in the functional-equivalence analysis or the assessment of E.S.’s credibility. Judge Gary R. Jones granted the Commissioner judgment on the pleadings, dismissed the case, directed the Clerk to enter final judgment, and directed the Clerk to close the file.