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Rosas v. Commissioner of Social Security

United States District Court, D. Oregon

December 3, 2014

LEISA ROSAS, o/b/o I.M.B. Plaintiff,
v.
COMMISSIONER OF SOCIAL SECURITY, Defendant.

ORDER

THOMAS M. COFFIN, Magistrate Judge.

Plaintiff I.M.B., a minor, through his mother, Leisa Rosas, brings this proceeding to obtain judicial review of the Commissioner's final decision denying plaintiffs application for supplemental security income benefits.

Plaintiff alleges disability beginning June 1, 2010 due to asthma, attention deficit hyperactivity disorder (ADHD), febrile seizures, and mental/emotional difficulties. After a hearing, an administrative law judge (ALJ) determined that plaintiff is not disabled.

An individual under the age of 18 is considered disabled if he "has 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." 42 U.S.C. § 1382c(a)(3)(C)(I). Similar to the usual five-step process for evaluating disability claims, the determination of childhood disability follows a three-step sequential analysis:

(1) Is the child engaged in substantial gainful activity? If so, the child is not disabled, regardless of his medical condition, age, education, or work experience. If not, the analysis proceeds to step two. 20 C.F.R. § 416.924(a), (b).

2) Does the child have a medically determinable impairment or combination of impairments that is severe, i.e., that causes more than minimal functional limitations? If not, the child is not disabled. If so, the analysis proceeds to step three. 20 C.F.R. § 416.924(a), (c).

(3) Does the child's impairment or combination of impairments meet, medically equal, or functionally equal a listing? If not, the child is not disabled. If so, and the duration requirement is satisfied, the child is disabled. 20 C.F.R.§ 416.924(a), (d).

To meet or medically equal a listing, the child's impairments must meet or medically equal a set of criteria for the particular impairment as outlined in the Listings, 20 C.F.R. Part 404, Subpart P, App. 1. See 20 C.F.R. § 416.924(d); Sullivan v. Zebley, 493 U.S. 521, 530 (1990) (impairment must meet all of the specified medical criteria).

To determine whether a child's impairments functionally equals a listing, the ALJ must assess the functional limitations caused by the child's impairments in 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. 20 C.F.R. § 416.926a(a), (b)(1). A child's impairments functionally equals a listing when it is of listing-level severity, i.e., if it results in "marked" limitations (limitations that interfere seriously with the childis ability to independently initiate, sustain, or complete activities) in at least two domains of functioning, or "extreme" limitations (limitations that interfere very seriously with the child's ability to independently initiate, sustain, or complete activities) in at least one domain of functioning. 20 C.F.R. § 416.926a(a), (d) (e).

The ALJ determined that plaintiff has not engaged in substantial gainful activity since June 24, 2010, that he has the sever impairments of adjustment disorder and ADHD, but that his impairments did not meet or medically equal the severity of one of the listed impairments. Plaintiff contends that the ALJ erred in: (1) rejecting the opinion of a treating physician; (2) rejecting plaintiffs mother's testimony and reports; and (3) failing to have the case evaluated by an expert.

Dr. Lyn Jacobs completed a form in which she found plaintiff to be markedly limited in the area of acquiring and using information and extremely limited in the areas of attending and completing tasks, interacting and relating with others, and health and physical well-being. Tr. 467-68. The ALJ rejected this opinion because the form[1]on which the opinion was made did not adequately delineate the requirements in each domain. Tr. 22. In addition, the ALJ noted that Dr. Jacobs's findings, if correct, would likely require institutionalization.[2]The ALJ also found the opinion inconsistent with Dr. Jacobs's underlying treatment notes and noted it appeared to be based more on subjective complaints rather than objective findings. Tr. 22. Accordingly, the ALJ gave greater weight to medical consultants who opined plaintiff had limitations in the domains inconsistent with disability. Tr. 22. Finally, the ALJ found Dr. Jacobs's opinion inconsistent with the report of plaintiffs teacher, Ashley Krill. Tr. 22-23.

The ALJ did not determining that Dr. Jacobs's definitions of "extreme" limitations with respect to the domains were inconsistent with the social security regulations. For instance, the regulations provide the following examples of functionally equivalent limitations in health and physical well-being:

(1) Documented need for major organ transplant (e.g., liver).
(2) Any condition that is disabling at the time of onset, requiring continuing surgical management within 12 months after onset as a life-saving measure or for salvage or restoration of function, and such major function is not restored or is not ...

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