Hesseltine v. Colvin

800 F.3d 461

Tammy HESSELTINE, Plaintiff–Appellant

v.Carolyn W. COLVIN, Acting Commissioner of Social Security, Defendant–Appellee.

No. 14–2780.

United States Court of Appeals, Eighth Circuit.

Submitted: April 17, 2015.

Filed: Aug. 26, 2015.

Thomas A. Krause, argued, Des Moines, IA, Plaintiff–Appellant.

Emily J. Kirk, argued, Kansas City, MO, (William C. Purdy, AUSA, Des Moines, IA, Bert W. Coleman, AUSA, Kansas City, MO, on the brief), Defendant–Appellee.

Before MURPHY, COLLOTON, and KELLY, Circuit Judges.

Opinion

KELLY, Circuit Judge.

Tammy Hesseltine applied for disability insurance benefits under Title II of the Social Security Act. An administrative law judge (ALJ) found Hesseltine was not disabled because the combination of her mental and physical impairments did not meet the listed impairment under 20 C.F.R. § 404, Subp. P.App. 1, § 12.05C. The Social Security Appeals Council denied Hesseltine's request for review, and the district court affirmed. On appeal, Hesseltine argues the ALJ failed to sufficiently address whether her impairments medically equal Listing 12.05C. We agree, and remand the case for further proceedings.

I. Background

In 1993, when Hesseltine was eight years old, she was given IQ testing by a school psychologist.¹ Under the Wechsler Intelligence Scale for Children, she obtained a full scale IQ score of 70, a 72 in processing, and a 73 in verbal. The psychologist noted that Hesseltine was “within the Borderline range of mental functioning.” The psychologist also found that Hesseltine's “adaptive behavior composite score” was a 71, which placed her in the third percentile of her peers. When Hesseltine graduated from high school in 2003, she read at a sixth grade level.

Hesseltine underwent several surgeries as a child to treat an impairment in her left leg caused by Perthes disease, a disorder that cuts off blood flow to the hip. In 2004, when Hesseltine was age 18, David Speigel, M.D., noted that there had been no changes in her hip since 2001 and that her Perthes disease was asymptomatic. Her left leg was 1.5 centimeters shorter than her right leg, and her mobility was limited by the condition.

In 2005, Roger Mraz, Ph.D., a licensed psychologist, administered a Wechsler Adult Intelligence Scale and determined that Hesseltine had a full scale IQ score of 71, a processing score of 73, and a verbal score of 74. Dr. Mraz noted that “[o]verall, the results of the intellectual assessment suggests [sic] that Tammy is functioning near the lower end of the Borderline Range, at the 3rd percentile.” Dr. Mraz additionally assessed Hesseltine's adaptive behavior, based on consultations with her aunt. Her daily living skills were low-average, in the 25th percentile, but her communication skills were “below the 0.1 percentile” due to her “low academic skills” and “borderline adaptive functioning.” The assessment concluded that “Tammy should have no difficulty following simple instructions, and would probably do better on repetitive type tasks.”

From 2004 to 2005, Hesseltine worked irregularly as a cook's helper in a school cafeteria. From 2005 to 2007, Hesseltine worked part-time at a laundry business with the help of a job coach. Her supervisor at the laundry indicated that Hesseltine “works better than most in the same position,” that she required little supervision and sometimes had “a lot of independence,” and that he “would hire her again.” In 2009, Hesseltine worked briefly as a housekeeper in a casino.

In 2006, Hesseltine was diagnosed with polycystic ovarian syndrome, but after several months her symptoms resolved and she was able to manage her syndrome with medication. In 2007, C.W. Huang, M.D., gave Hesseltine a physical examination and observed limitation in flexion of her left hip and knee, “probably due to obesity.” He noted that left hip pain would occur if she stood for more than one hour.

Hesseltine twisted her hip while at work in July 2009. She sought treatment, and an X-ray revealed “extensive changes consistent with Perthes disease.” Her treating physician, Gregory Bell, M.D., diagnosed “acute exacerbation of left hip pain” but indicated that no MRIs or other follow up was necessary and that Hesseltine “can go back to work in a week like she is planning to do.”

Hesseltine completed a function report form in 2007, and again in 2012. She indicated that she lived with her husband, that she “prepare[d] food all the time daily,” as well as “small amounts of cleaning, laundry, [and] mowing” with breaks. She reported that she went shopping for household items and food, but that she had trouble counting change and got confused. She stated that she followed cooking recipes “Ok.” She also reported that she could not walk more than a block without needing to rest and could lift a gallon of milk at a maximum.

Hesseltine's insured status expired on September 30, 2009. She applied for disability insurance benefits on July 28, 2010. At the request of the ALJ and Hesseltine's attorney, on January 31, 2012, Dr. Mraz met Hesseltine for a second IQ evaluation. This time her results included: a full scale IQ of 72, a processing score of 79, and a verbal score of 76. Dr. Mraz noted that “the results of the intellectual assessment indicate that Tammy is functioning near the lower end of the Borderline range.” Her Global Assessment of Functioning (GAF) was assessed at 65.

Following an administrative hearing, the ALJ denied Hesseltine's claim for insurance benefits in February 2012. In reaching her decision the ALJ engaged in the familiar five step analysis outlined in 20 C.F.R. § 416.920(a)(4). At the first step she found that Hesseltine had not engaged in substantial gainful activity after January 1, 2007, the alleged onset date. Next, she found that Hesseltine suffered from the following severe impairments: borderline intellectual functioning, Perthes disease of the left hip, polycystic ovarian syndrome, and obesity. Third, she found that this combination of impairments did not meet or medically equal one of the listed impairments in 20 C.F.R. § 404, Subp. P.App. 1, including Listing 12.05C.

The ALJ then evaluated Hesseltine's residual functional capacity and concluded that through the last insured date Hesseltine could lift and carry twenty pounds occasionally and ten pounds frequently; could push and pull within the same weight restrictions; could stand or walk for two hours in an eight hour workday; could sit for six hours in an eight hour workday; could occasionally climb ramps and stairs, but never ladders, ropes, or scaffolds; could occasionally balance and stoop, but never kneel; could occasionally crouch, but never crawl; should avoid concentrated exposure to hazards such as heights and machinery; and could perform only simple, routine tasks with a specific vocational preparation level of one or two. At the hearing a vocational expert testified that a hypothetical person with these limitations could perform work as an ampoule sealer, lens gauger, or final assembler. The ALJ therefore concluded that there were jobs in the national economy that Hesseltine could perform and denied her application for disability benefits.

The Appeals Council denied review of the ALJ's decision and the district court affirmed. On appeal, Hesseltine argues that her impairments “medically equal” Listing 12.05C. She maintains that the ALJ failed to provide a reviewable decision as to her equivalence findings.

II. Discussion

“We review de novo a district court's denial of social security benefits.” Halverson v. Astrue, 600 F.3d 922, 929 (8th Cir.2010). We must “determine whether the ALJ's decision complies with the relevant legal requirements and is supported by substantial evidence in the record as a whole.” Id. (quotation omitted). We have defined substantial evidence as “such relevant evidence that a reasonable mind might accept as adequate to support a conclusion.” Id. (citing Heino v. Astrue, 578 F.3d 873, 878 (8th Cir.2009) ).

Hesseltine argues that the ALJ erred in step three of the sequential evaluation by finding that her impairments did not satisfy the requirements of Listing 12.05C. Hesseltine was required to establish: “(1) a valid verbal, performance, or full scale IQ score of 60 through 70, (2) an onset of the impairment before age 22, and (3) a physical or other mental impairment imposing an additional and significant work-related limitation of function.” Phillips v. Colvin, 721 F.3d 623, 625 (8th Cir.2013) (quoting McNamara v. Astrue, 590 F.3d 607, 610–11 (8th Cir.2010) ); see also 20 C.F.R. § 404, Subp. P, App. 1, § 12.05C. Because Hesseltine had received IQ scores of 71 and 72, above the range of 60–70, the ALJ determined that she failed to meet the first element of Listing 12.05C.²

However, a finding that a claimant does not meet a given listing “does not end the inquiry.” Shontos v. Barnhart, 328 F.3d 418, 424 (8th Cir.2003). “The regulations provide that if a claimant has more than one impairment, the combined effect of the impairments will be considered.” Id. The medical equivalence regulation provides:

If you have a combination of impairments, no one of which meets a listing ..., we will compare your findings with those for closely analogous listed impairments. If the findings related to your impairments are at least of equal medical significance to those of a listed impairment, we will find that your combination of impairments is medically equivalent to that listing.

20 C.F.R. § 404.1526(b)(3).

Instructions for determining whether a person's combination of impairments is medically equal to a given listing are outlined in the Program Operations Manual System (POMS). “Although POMS guidelines do not have legal force, and do not bind the Commissioner, this court has instructed that an ALJ should consider the POMS guidelines.” Shontos, 328 F.3d at 424. The applicable POMS guideline for Listing 12.05C provides:

D. Determining Medical Equivalence in Particular Situations

1. MEDICAL EQUIVALENCE AND MENTAL RETARDATION Listing

...