Balatbat-Light v. Comm'r of Soc. Sec.

ANNELENA BALATBAT-LIGHT, Plaintiff, v. COMMISSIONER OF SOCIAL SECURITY, Defendant.

Case No: 6:16-cv-549-Orl-GJK

UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF FLORIDA ORLANDO DIVISION

April 20, 2017

MEMORANDUM OF DECISION

Annelena Balatbat-Light, on behalf of a minor, L.H.L. (the "Claimant"), appeals to the District Court a final decision of the Commissioner of Social Security (the "Commissioner") finding that Claimant's disability ceased as of April 30, 2012. Doc. No. 1. Claimant argues that the ALJ committed reversible error by: 1) failing to fully and fairly develop the record; 2) relying on the testimony of a child who was not qualified to testify under Florida state law; and 3) failing to consider probative evidence regarding Claimant's lack of medical improvement. Doc. No. 21 at 12-14, 17-19, 22-23. Claimant requests that the Commissioner's decision be reversed and remanded for further proceedings. Id. at 32. For the reasons set forth below, the Commissioner's final decision is AFFIRMED.

I. BACKGROUND

On July 9, 2010, the Commissioner determined that Claimant was disabled as of that date (the "Initial Determination"). R. 24. On April 25, 2012, on periodic review, the Commissioner determined that Claimant was no longer disabled as of April 30, 2012. R. 24, 95. On August 10, 2012, Claimant filed a request for reconsideration. R. 104. On March 29, 2013, the Commissioner upheld the decision upon reconsideration after a hearing by a state agency disability hearing officer. R. 24, 136. On May 7, 2013, Claimant filed a request for hearing before the ALJ. R. 141. On November 1, 2013, Claimant attended a video hearing before the ALJ. 43-94. On June 24, 2014, the ALJ issued an unfavorable decision. R. 24-36. On August 19, 2014, Claimant filed a request for review of the ALJ's decision. R. 18-19. On February 17, 2016, the Appeals Council denied Claimant's request for review. R. 1-7. On March 31, 2016, Claimant filed this appeal. Doc. No. 1.

II. STANDARD OF REVIEW

The Commissioner's findings of fact are conclusive if supported by substantial evidence. 42 U.S.C. § 405(g). Substantial evidence is more than a scintilla — i.e., the evidence must do more than merely create a suspicion of the existence of a fact, and must include such relevant evidence as a reasonable person would accept as adequate to support the conclusion. Foote v. Chater, 67 F.3d 1553, 1560 (11th Cir. 1995) (citing Walden v. Schweiker, 672 F.2d 835, 838 (11th Cir. 1982) and Richardson v. Perales, 402 U.S. 389, 401 (1971)); Edwards v. Sullivan, 937 F.2d 580, 584 n.3 (11th Cir. 1991).

Where the Commissioner's decision is supported by substantial evidence, the District Court will affirm, even if the reviewer would have reached a contrary result as finder of fact, and even if the reviewer finds that the evidence preponderates against the Commissioner's decision. Edwards, 937 F.2d at 584 n.3; Barnes v. Sullivan, 932 F.2d 1356, 1358 (11th Cir. 1991). The District Court must view the evidence as a whole, taking into account evidence favorable as well as unfavorable to the decision. Foote, 67 F.3d at 1560; Lowery v. Sullivan, 979 F.2d 835, 837 (11th Cir. 1992) (the court must scrutinize the entire record to determine reasonableness of factual findings); Parker v. Bowen, 793 F.2d 1177, 1180 (11th Cir. 1986) (the court also must considerevidence detracting from evidence on which Commissioner relied). The District Court "'may not decide the facts anew, reweigh the evidence, or substitute [its] judgment for that of the [Commissioner].'" See Phillips v. Barnhart, 357 F.3d 1232, 1240 n.8 (11th Cir. 2004) (quoting Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir. 1983)).

III. EVALUATION OF A MINOR'S DISABILITY

A. The Three-Step Disability Determination

For a child under the age of eighteen to be entitled to Supplemental Security Income ("SSI"), that child must have "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." Fontanez ex rel. Fontanez v. Barnhart, 195 F.Supp.2d 1333, 1345 (M.D. Fla. 2002) (citing 42 U.S.C. § 1382c(a)(3)(C)(i)). In making such a determination, the Commissioner uses a three-step analysis. Espinoza ex. rel. J.E. v. Astrue, No. 8:07-cv-2003-T-HTS, 2009 WL 331600, at *1 (M.D. Fla. Feb. 10, 2009). A "child is considered disabled if he or she: 1) is not engaged in substantial gainful activity; 2) has a medically determinable impairment that is severe; and 3) the impairment meets, medically equals, or functionally equals a [listed impairment]." Id. When considering whether an impairment functionally meets a listed impairment, the Commissioner considers six domains of a child's functioning: 1) acquiring and using information; 2) attending to 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. (citing 20 C.F.R. § 416.926a (b)(1)). An impairment functionally equals a listed impairment if the child has "'marked' limitations in two domains of functioning or an 'extreme' limitation in one domain." Id. (citing 20 CFR § 416.926a(a)).

B. The Three-Step Medical Improvement Review Standard

After a child is found to be eligible for SSI, the Commissioner performs a periodic review of the case to determine whether the child is still eligible to receive SSI due to any medical improvements. Verdecia v. Colvin, CASE NO. 12-21057-CIV-MARTINEZ/SIMONTON, 2015 WL 12556299, at * 2 (S.D. Fla. Mar. 31, 2015). When making such a determination, the Commissioner implements a three-step Medical Improvement Review Standard Sequential Evaluation Process. Id. (citing 20 C.F.R. § 416.994a(b)). "At step one, the [Commissioner] first considers whether there has been a medical improvement in the claimant's condition." Id. At step one, the Commissioner "examines if medical improvement has occurred in the impairment(s) that the claimant had at the time of the most recent medical determination that he [or she] was disabled, which is known as the 'comparison point decision' ('CPD')."¹ Id. at * 3. If there are no improvements in a claimant's CPD impairments, then the claimant is considered disabled unless an exception found in 20 C.F.R. § 1994(e)-(f) applies. Id.

At step two, the Commissioner considers whether the impairments the child had at CPD still meet (or medically or functionally equal) the severity of any of the listed impairments. Id. When the Commissioner finds that a claimant's impairments did not meet or medically equal the listed impairments at CPD (but functionally equaled the listed impairments at CPD), the Commissioner must consider whether the claimant's CPD impairments now functionally equal the listed impairments. Id. "If there is a functional equivalence, the child is disabled; if it does not, the Commissioner moves to step three." Id.

At step three, the Commissioner "decides if the child is currently disabled...by considering all the impairments the claimant has now, including any not present or not considered at the CPD." Id. When making a determination at step three, the [Commissioner] must make three separate findings. Id. "First, the [Commissioner] must determine whether the child has a severe impairment or combination of impairments."² Id. Second, if the child has a severe impairment or a combination of impairments, the Commissioner then determines if such impairments meet or medically equal the severity of any of the listed impairments. Id. Third, "if the child's impairments do not meet or medically equal a [listed impairment], the [Commissioner] must determine if the claimant's impairments functionally equal the [listed impairments]."³ Id.

IV. THE ALJ'S DECISION

A. Step One

At step one, the ALJ determined that there has been medical improvement in the impairments Clamant had at CPD. R. 28. In making this determination, the ALJ made three central findings. First, the ALJ found the Initial Determination to be the CPD. R. 27. Second, the ALJ found that at CPD, Claimant had the following severe impairments: ADHD, speech and language delay, and affective disorder. Id. Third, the ALJ found that at CPD, Claimant's impairments functionally equaled the listed impairments. Id. In making such a finding, the ALJ found marked limitations in interacting and relating with others and marked limitations in caring for herself. R. 28. Finally, the ALJ determined that there has been medical improvement in Claimant's CPD impairments since April 30, 2012:

Since [April 30, 2012], the objective evidence of record shows medical improvement, particularly when [Claimant] is compliant on medications as discussed in detail below.

Id. Thus, the ALJ found that the objective record evidence (which the ALJ discusses at step three) shows medical improvement of Claimant's impairments, particularly when Claimant is compliant with medication. Id. See also R. 29-34 (the ALJ's summary of the medical evidence).⁴

B. Step Three

After finding that Claimant's CPD impairments have improved since April 30, 2012, the ALJ proceeded to step three.⁵ At step three, the ALJ found that as of April 30, 2012, Claimant has the following severe impairments: ADHD; Autism Spectrum Disorder; speech and language delay (borderline to below average); Intermittent Explosive Disorder; Oppositional Defiant Disorder; and Mood Disorder. R. 28. The ALJ also found that such impairments (or combination thereof) do not meet or medically equal any of the listed impairments. R. 29. In the final part of step three, the ALJ found that none of Claimant's current impairments (or combination thereof) functionally equals any of the listed impairments. R. 29-35. The ALJ found that Claimant had less than marked limitations in five of the six domains of a child's functioning. R. 34-35. See also supra n. 2, 3. The ALJ...