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Conway v. Astrue

May 23, 2008

WANDA CONWAY, ON BEHALF OF TYANA TOLEN, PLAINTIFF,
v.
MICHAEL J. ASTRUE, COMMISSIONER OF SOCIAL SECURITY, DEFENDANT.



The opinion of the court was delivered by: Colleen Kollar-kotelly United States District Judge

MEMORANDUM OPINION

Currently pending before the Court are Plaintiff's Motion for Judgment of Reversal and Defendant's Motion for Judgment of Affirmance, respectively, of the decision of an Administrative Law Judge ("ALJ") denying Supplemental Security Income Benefits ("SSIB") to Plaintiff, Tyana Tolen, pursuant to Title XVI of the Social Security Act. After reviewing the parties' briefs, the administrative record, and the relevant case law, the Court shall deny Plaintiff's motion to reverse the judgment and grant Defendant's motion to affirm the judgment.*fn1

I. BACKGROUND

A. Legal Framework and Procedural History

On October 18, 2002, Wanda Conway filed an application for SSIB on behalf of her daughter, Tyana Tolen (born in 1997)*fn2 (hereinafter "Plaintiff"), pursuant to Title XVI of the Social Security Act. Mem. in Support of Pl.'s Mot. for J. of Rev. (hereinafter "Pl.'s Rev. Mot.") at 1-2; Admin. Record ("A.R.") at 53.*fn3 Plaintiff's application for SSIB alleged disability on the basis of a learning disability, a weight problem, and aggressive behavior. A.R. at 62.

After Plaintiff's claims were denied initially and upon reconsideration, she requested a hearing before an ALJ. A.R. at 15, 27-29, 30, 32. That hearing occurred on April 13, 2005, and Plaintiff was represented by counsel. Id. at 156-80. In a decision dated July 26, 2005, the ALJ denied Plaintiff's requested benefits. Id. at 12-24. In order to place the ALJ's opinion in context, the Court sets forth below some of the legal framework relevant to Plaintiff's application for SSIB.

To be eligible for SSIB, a child must be disabled under the meaning of Title XVI of the Social Security Act. 20 C.F.R. § 416.901. The Social Security Administration ("SSA") will consider a child disabled if he or she has "a medically determinable physical or mental impairment or combination of impairments that causes marked and severe functional limitations, and 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. A three-step sequential evaluation is used to determine whether a child is eligible for SSIB on the basis of a disability. 20 C.F.R. § 416.924. This evaluation involves determining: (1) whether the child is engaged in substantial gainful activity; (2) whether the child has an impairment or a combination of impairments that is severe; and (3) whether the child has an impairment(s) that meets, medically equals, or functionally equals the listings included in 20 C.F.R. Part 404, Subpart P, Appendix 1. Id. If the child is engaged in substantial gainful activity or does not have an impairment or combination of impairments that is severe, the child is considered not disabled and the evaluation does not progress to the next step. Id.

In determining whether a child's impairment(s) functionally equal a listed impairment, the SSA considers six separate "domains," or areas, of functioning, which include: (1) Acquiring and using information; (2) Attending and completing tasks; (3) Interacting and relating with others; (4) Moving about and manipulating objects; (5) Caring for yourself; and (6) Health and physical well-being. 20 C.F.R. § 416.924a(b)(1)(i)-(vi). In order to functionally equal a listed impairment, a child's impairment "must be of listing-level severity; i.e., it must result in 'marked' limitations in two domains of functioning or an 'extreme' limitation in one domain." Id. § 416.926a(a). A "marked" limitation exists when a child's impairment "seriously interferes" with his or her "ability to independently initiate, sustain, or complete activities." Id. § 416.926a(e)(2)(i). The SSA describes a "marked" limitation as "more than moderate" but "less than extreme," and will generally find a "marked" limitation when a child has a "valid score that is two standard deviations or more below the mean, but less than three standard deviations, on a comprehensive standardized test designed to measure ability or functioning in that domain, and [the child's] day-to-day functioning in domain-related activities is consistent with that score." Id. § 416.926a(e)(2)(i), (iii). An "extreme" limitation is "more than marked" but "does not necessarily mean a total lack or loss of ability to function." Id. § 416.026a(e)(3)(i). The SSA will generally find an "extreme" limitation when a child has a "valid score that is three standard deviations or more below the mean on a comprehensive standardized test designed to measure ability or functioning in that domain, and [the child's] day-to-day functioning in domain-related activities is consistent with that score." Id. § 416.926a(e)(3)(iii).

In the instant case, at Step One, the ALJ found that Plaintiff had not engaged in substantial gainful activity during any part of the period under adjudication. A.R. at 16. At Step Two, the ALJ found that Plaintiff had "learning disability and obesity, which are 'severe' within the meaning of 20 C.F.R. § 416.924(c) and Social Security Rulings 96-3p and 85-28 because [Plaintiff] has more than slight abnormalities and more than minimal functional limitations." Id. Turning to Step Three, the ALJ found that Plaintiff did not meet or medically equal Section 112.05 ("Mental Retardation") of the SSA' Childhood Listings for disability evaluation under Social Security. Id. at 17.

The ALJ then continued to consider "whether [Plaintiff] has an impairment (or combination of impairments) that is 'functionally equal' to the listings and satisfies the 12-month duration requirement." Id. The ALJ detailed all of the evidence contained in the Administrative Record in this case, including the testimony during the administrative hearing, and found that Plaintiff had "marked" limitation in the domain of Acquiring and Using Information "but based upon current evidence has improved and is doing better" in that domain. A.R. at 18. As to the remaining domains, the ALJ found that Plaintiff had either "less than 'marked' limitation" or no limitation." Id. at 18-20. Ultimately, the ALJ concluded that "[b]ecause [Plaintiff] does not have an 'extreme' limitation in one area of functioning or a 'marked' limitation in two areas, [Plaintiff] does not functionally equal, singly or in combination, any listed impairment." Id. at 17-22. Finally, having determined that Plaintiff "does not have an impairment or combination of impairments which meets [or] medically equals any listing, or functionally equals any listing," the ALJ concluded that Plaintiff is not "disabled" for purposes of eligibility for SSIB. Id. at 22-23.

Plaintiff appealed the ALJ's decision, but on January 26, 2006, the Appeals Council determined there was no basis for granting review. A.R. at 4-6. Having fully exhausted her administrative remedies, Plaintiff filed suit in this Court seeking relief on March 28, 2006. Plaintiff filed her Motion for Judgment of Reversal on September 25, 2006, and Defendant filed its Motion for Judgment of Affirmance on November 13, 2006. Neither party has filed an opposition to the other party's motion.

B. Evidence Contained in the Administrative Record The ALJ evaluated Plaintiff's condition based on evidence including various medical records (both physical and mental health records), District of Columbia Public Schools ("DCPS") records, and the testimony of Plaintiff and her mother during the administrative hearing in this case. The Court recounts below the most relevant portions of the administrative record.

1. Medical Records

Dr. Alberta M. Vallis conducted a psychological examination of Plaintiff on June 18, 2002. A.R. at 114-16. At the outset of her report, Dr. Vallis noted that Plaintiff's pre-kindergarten teacher was concerned about Plaintiff's slow ability to learn, and that Plaintiff's mother was concerned with Plaintiff's behavior, including cursing, disrespectful, disobedient, and aggressive behavior. Id. at 114. Dr. Vallis, however, reported that Plaintiff was pleasant and co-operative, and that her attitude toward Dr. Vallis was appropriate. Id. at 114-15. Among other things, Dr. Vallis noted that Plaintiff's speech had some sound errors, including poor articulation of Ts and Ys, that her thought process was intact, but aggressive and immature, and that she had poor insight and was unable to judge situations well. Id. at 115-16. Dr. Vallis diagnosed Plaintiff with Child Adjustment Disorder and Oppositional Defiant Disorder, and described her as obese. Id. at 116. Dr. Vallis rated Plaintiff's Global Assessment of Functioning at 40, id., which Plaintiff notes is described as some impairment in reality testing or communication, or major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood. Pl.'s Rev. Mot. at 7-8 n.6 (citing Diagnostic and Statistical Manual of Mental Disorders, Fourth Ed., Am. Psych. Assoc., p. 32). Dr. Vallis recommended that Plaintiff undergo weekly individual therapy and a work-up for special education. A.R. at 116.

On December 19, 2002, Neil P. Schiff, Ph. D., conducted a psychological examination of Plaintiff in connection with her application for SSIB. Id. at 117-20. Dr. Schiff interviewed Plaintiff, and also administered the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R) and Vineland Adaptive Behavior Scales (VABS) tests. Id. at 117. On the WPPSI-R, Plaintiff attained a verbal IQ score of 84, a performance IQ score of 60, and a full scale IQ of 69. Id. Interpreting these test results, Dr. Schiff noted that Plaintiff's "current overall functioning (Full Scale IQ) falls in the Deficient range of intelligence, with estimated potential likely to be considerably higher than that range." Id. at 119. Dr. Schiff continued to explain that Plaintiff's "verbal abilities (Low Average range) were more strongly developed than her non-verbal abilities (Deficient range of functioning)." Id. As for the VABS, Plaintiff attained an adaptive behavior composite of 76 (moderately low), id. at 117, a score that Dr. Schiff described as commensurate with Plaintiff's WPPSI-R scores, id. at 119.

Significantly, Dr. Schiff's report noted that Plaintiff had not yet been scheduled for an Individualized Education Plan ("IEP") evaluation and was still placed in a regular classroom. Id. at 118. Dr. Schiff also stated that "it is important to note that while intelligence test scores at this young age are fairly predictive of early school performance, their stability over time can be limited. As such, it may be informative to re-test [Plaintiff] after another year or two of maturation." Id. at 119. This statement is consistent with the SSA's approach of relying on standardized test scores; in the Childhood Listings, the SSA notes that "IQ test results must also be sufficiently current for accurate assessment under [Listing] 112.05. Generally, the results of IQ tests tend to stabilize by the age of 16 . . . IQ test results obtained before age 7 are current for 2 years if the tested IQ is less than 40 and 1 year if at 40 or above." 20 C.F.R. Part 404, Subpart P, Appx. 1, ยง ...


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