Mendez v. Kijakazi

1

HILDA L. VELAZQUEZ MENDEZ ex rel. S.M.R.V., Plaintiff, v. KILOLO KIJAKAZI,^[1] Acting Commissioner of Social Security, Defendant.

Civil Action No. 3:21-cv-00260

United States District Court, M.D. Pennsylvania

October 20, 2022

MEMORANDUM

JOSEPH F. SAPORITO, JR. UNITED STATES MAGISTRATE JUDGE

The plaintiff, Hilda L. Velazquez Mendez, as parent and natural guardian of S.M.R.V., her minor daughter, brought this action under 42 U.S.C. § 1383(c)(3), and, as incorporated by reference, 42 U.S.C. § 405(g), seeking judicial review of the final decision of the Commissioner or Social security denying S.M.R.V.'s claim for supplemental security income benefits under Title XVI of the Social Security Act (the “Act”). The matter has been referred to the undersigned United States magistrate judge on consent of the parties, pursuant to 28 U.S.C. § 636(c) and Fed.R.Civ.P. 73.

I. Background

On February 28, 2018, Velazquez protectively filed an application for supplemental security income (“SSI”) benefits on behalf of her minor daughter S.M.R.V., alleging a disability onset date of January 1, 2014. The claim was initially denied by state agency reviewers on October 30, 2018. The plaintiff then requested an administrative hearing.

A hearing was held on September 19, 2019, before an administrative law judge, Randy Riley (the “ALJ”). Velazquez appeared and testified on behalf of S.M.R.V., with the assistance of a Spanish-language interpreter. The plaintiff was represented by counsel at the hearing.

On May 6, 2020, the ALJ denied S.M.R.V.'s application for benefits in a written decision. The ALJ determined that S.M.R.V. was not entitled to SSI benefits because she was not under a disability as defined by the Act. Specifically, the ALJ found that S.M.R.V. did not have an impairment or combination of impairments that meets, medically equals, or functionally equals the severity of one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1.

The plaintiff sought further administrative review of her claim by the Appeals Council, but her request was denied on December 16, 2020, making the ALJ's May 2020 decision the final decision of the Commissioner subject to judicial review by this court.

The plaintiff timely filed her complaint in this court on February 12, 2021. The Commissioner has filed an answer to the complaint, together with a certified copy of the administrative record. Both parties have filed their briefs, and this matter is now ripe for decision.

II. Standard of Review

When reviewing the denial of disability benefits, the Court's review is limited to determining whether those findings are supported by substantial evidence in the administrative record. See 42 U.S.C. § 405(g) (sentence five); Johnson v. Comm'r of Soc. Sec., 529 F.3d 198, 200 (3d Cir. 2008); Ficca v. Astrue, 901 F.Supp.2d 533, 536 (M.D. Pa. 2012). Substantial evidence “does not mean a large or considerable amount of evidence, but rather such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Pierce v. Underwood, 487 U.S. 552, 565 (1988) (internal quotation marks omitted). Substantial evidence is less than a preponderance of the evidence but more than a mere scintilla. Richardson v. Perales, 402 U.S. 389, 401 (1971). A single piece of evidence is not substantial evidence if the ALJ ignores countervailing evidence or fails to resolve a conflict created by the evidence. Mason v. Shalala, 994 F.2d 1058, 1064 (3d Cir. 1993). But in an adequately developed factual record, substantial evidence may be “something less than the weight of the evidence, and the possibility of drawing two inconsistent conclusions from the evidence does not prevent [the ALJ's decision] from being supported by substantial evidence.” Consolo v. Fed. Maritime Comm'n, 383 U.S. 607, 620 (1966). “In determining if the Commissioner's decision is supported by substantial evidence the court must scrutinize the record as a whole.” Leslie v. Barnhart, 304 F.Supp.2d 623, 627 (M.D. Pa. 2003).

The question before this Court, therefore, is not whether S.M.R.V. is disabled, but whether the Commissioner's finding that she is not disabled is supported by substantial evidence and was reached based upon a correct application of relevant law. See Arnold v. Colvin, No. 3:12-CV-02417, 2014 WL 940205, at *1 (M.D. Pa. Mar. 11, 2014) (“[I]t has been held that an ALJ's errors of law denote a lack of substantial evidence.”)

(alterations omitted); Burton v. Schweiker, 512 F.Supp. 913, 914 (W.D. Pa. 1981) (“The Secretary's determination as to the status of a claim requires the correct application of the law to the facts.”); see also Wright v. Sullivan, 900 F.2d 675, 678 (3d Cir. 1990) (noting that the scope of review on legal matters is plenary); Ficca, 901 F.Supp.2d at 536 (“[T]he court has plenary review of all legal issues ....”).

With respect to children under the age of 18, the Social Security regulations consider an individual to be “disabled” if he or she has “a medically determinable physical or mental impairment^[2] or combination of impairments that causes marked and severe functional limitation, and that can be expected to cause death or that has lasted or can be expected to last for a continuous period of not less than 12 months.” 20 C.F.R. § 416.906; see also 42 U.S.C. § 1382c(a)(3)(C)(i). A child has “marked and severe functional limitations” if he or she has an impairment or combination of impairments that “meets, medically equals, or functionally equals” the listings found at 20 C.F.R., Part 404, Subpart P, Appendix 1. Id. § 416.902; see also id. § 416.911(b). However, “no individual under the age of 18 who engages in substantial gainful activity^[3] . . . may be considered to be disabled.” 42 U.S.C. § 1382c(a)(3)(C)(ii); see also 20 C.F.R. § 416.906.

The Commissioner follows a three-step sequential analysis to ascertain whether a child is disabled and therefore eligible to receive SSI benefits. See 20 C.F.R. § 416.924(a). Under this process, the ALJ must determine in sequence: (1) whether the child is engaged in substantial gainful activity (i.e., whether the child is working), id. § 416.924(b); (2) whether the child has a medically determinable impairment or combination of impairments that is severe (i.e., whether the child has an impairment or combination of impairments that cause “more than minimal functional limitations”), id. § 416.924(c); and (3) whether the impairment or combination of impairments meets or medically equals the severity of a listing, or functionally equals the listings, in 20 C.F.R., Part 404, Subpart P, Appendix 1, which describes impairments that cause marked and severe functional limitations, id. § 416.924(d).

Within each of the individual listings considered at step three, the regulations specify the objective medical and other findings needed to satisfy the criteria of that listing. An impairment or combination of impairments meets a listing when it satisfies all of the criteria of that specified listing, and it meets the duration requirement (i.e., it is expected to cause death or has lasted or is expected to last for a continuous period of not less than 12 months). Id. § 416.925(c)(3); see also id. § 416.909 (duration requirement). An impairment or combination of impairments medically equals a listing when it is at least equal in severity and duration to the criteria of any listed impairment (e.g., the child exhibits all but one of the findings specified in a particular listing, but other related findings are at least of equal medical significance to the required criteria). Id. § 416.926(a),(b). An impairment or combination of impairments functionally equals the listings when it “result[s] in ‘marked' limitations in two domains of functioning or an ‘extreme' limitation in one domain.” Id. § 416.926a(a).

In assessing functional equivalence, the Commissioner considers how the child functions in terms of six “domains” or broad areas of functioning intended to capture all that a child can or cannot do:

(1) acquiring and using information; (2) attending and completing tasks; (3) interacting and relating with other children; (4) moving about and manipulating objects; (5) caring for yourself; and (6) health and physical well-being. Id. § 416.926a(b)(1). A child has a “marked limitation” in a domain when his impairment or combination of impairments interferes seriously with his ability to independently initiate, sustain, or complete activities; a “marked limitation” is more than moderate but less than extreme. Id. § 416.926a(e)(2). A child has an “extreme limitation” in a domain when his impairment or combination of impairments interferes very seriously with his ability to independently initiate, sustain, or complete activities; an “extreme limitation” is more than marked. Id. § 416.926a(e)(3). “Extreme limitation” is the rating given to the worst limitations, but it does not necessarily mean a total lack or loss of ability to function. Id.

III. The ALJ's Decision

In this case, the ALJ reached the third step of the sequence, at which point he determined that S.M.R.V. was not disabled. The ALJ first determined that S.M.R.V. had not engaged in substantial gainful activity since February 28, 2018, the date when her application for SSI benefits was filed. The ALJ next found that the medical evidence of record established that S.M.R.V. had severe impairments of: ADHD; unspecified disruptive, impulse-control, and conduct disorder; anxiety; and adjustment disorder.

At step three, the ALJ evaluated S.M.R.V.'s impairments under listings 112.04 (depressive, bipolar, and related disorders) 112.06 (anxiety and obsessive-compulsive disorders), 112.08 (personality and impulse-control disorders), and 112.11 ...