Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-4_05-cv-04025/USCOURTS-arwd-4_05-cv-04025-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:405 Review of HHS Decision (SSID)

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 Otitis media is defined as an inflammation of the middle ear. Dorland’s Medical 1

Dictionary, p. 1292 (29th Ed.2000). 

 IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

TEXARKANA DIVISION

LULA CHEATHAM o/b/o

ANDREW CHEATHAM III PLAINTIFF

v. Civil No. 05-4025

JO ANNE B. BARNHART, 

Commissioner, Social 

Security Administration DEFENDANT

MEMORANDUM OPINION

Factual and Procedural Background:

The plaintiff in this case, Lula Cheatham (hereinafter "plaintiff"), has appealed the final

decision of the Commissioner of the Social Security Administration (hereinafter

"Commissioner"), denying her claim on behalf of her minor son, Andrew Cheatham

(hereinafter "claimant"), for supplemental security income benefits (hereinafter "SSI"), under 

§ 1602 of Title XVI, 42 U.S.C. § 1381a. Both parties have filed appeal briefs (Doc. #5 & 6). 

In this judicial review, the court must determine whether there is substantial evidence in the

administrative record to support the Commissioner's decision. 42 U.S.C. § 405(g).

The history of the administrative proceedings is contained in the ALJ’s written decision

and will not be recounted here except as necessary. 

The plaintiff asserts disability due to claimant’s asthma, headaches and otitis media.1

The issue before this Court is whether the Commissioner's decision is supported by substantial

record evidence. Specifically, the plaintiff asserts the ALJ erred in finding less than

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marked/extreme limitations in the areas of attending and completing tasks and overall health

and well being (Doc. #5, pp. 1-2). 

In determining the plaintiff’s claim, the ALJ followed the sequential evaluation process,

set forth in 20 C.F.R. § 416.924. Under this most recent standard, a child must prove that 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 twelve months. 42 U.S.C. §

1382c(a)(3)(c)(i); 20 C.F.R. § 416.906.

When passing the law, as it relates to children seeking SSI disability benefits, Congress

decided that the sequential analysis should be limited to the first three steps. This is made clear

in the House conference report on the law, prior to enactment. Concerning childhood SSI

disability benefits, the report states: 

The conferees intend that only needy children with severe disabilities be eligible

for SSI, and the Listing of Impairments and other current disability

determination regulations as modified by these provisions properly reflect the

severity of disability contemplated by the new statutory definition.... The

conferees are also aware that SSA uses the term "severe" to often mean "other

than minor" in an initial screening procedure for disability determination and in

other places. The conferees, however, use the term "severe " in its common

sense meaning. 

142 Cong. Rec. H8829-92, 8913 (1996 WL 428614), H.R. Conf. Rep. No. 104- 725 (July 30,

1996).

Consequently, under this evaluation process, the analysis ends at step three with the

determination of whether the child's impairments meet or equal any of the listed impairments. 

More specifically, a determination that a child is disabled requires the following three-step

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analysis. See 20 C.F.R. § 416.924(a). First, the ALJ must consider whether the child is

engaged in substantial gainful activity. See 20 C.F.R. § 416.924(b). If the child is so engaged,

he or she will not be awarded SSI benefits. See id. Second, the ALJ must consider whether the

child has a severe impairment. See 20 C.F.R. § 416.924(c). A severe impairment is an

impairment that is more than a slight abnormality. See id. Third, if the impairment is severe,

the ALJ must consider whether the impairment meets or is medically or functionally equal to a

disability listed in the Listing of Impairments, 20 C.F.R. Part 404, Subpart P, Appendix 1 (the

"Listings"). See 20 C.F.R. § 416.924(c). Only if the impairment is severe and meets or is

medically or functionally equal to a disability in the Listings, will it constitute a disability

within the meaning of the Act. See 20 C.F.R. § 416.924(d). Under the third step, a child's

impairment is medically equal to a listed impairment if it is at least equal in severity and

duration to the medical criteria of the listed impairment. 20 C.F.R. § 416.926(a). To determine

whether an impairment is functionally equal to a disability included in the Listings, the ALJ

must assess the child's developmental capacity in six specified domains. See 20 C.F.R. §

416.926a(b)(1). The six domains are: (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. See 20 C.F.R. §

416.926a(b)(1). See also, Moore ex rel. Moore v. Barnhart, 413 F.3d 718, 722 n. 4 (8th

Cir.2005). 

If the child claiming SSI benefits has marked limitations in two categories or an

extreme limitation in one category, the child's impairment is functionally equal to an

impairment in the Listings. See 20 C.F.R. § 416.926a(d). A marked limitation is defined as an

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impairment that is "more than moderate" and "less than extreme." A marked limitation is one

which seriously interferes with a child’s ability to independently initiate, sustain, or complete

activities. See 20 C.F.R. § 416.926a(e)(2). An extreme limitation is defined as “more than

marked”, and exists when a child’s impairment(s) interferes very seriously with his or her

ability to independently initiate, sustain or complete activities. Day-to-day functioning may be

very seriously limited when an impairment(s) limits only one activity or when the interactive

and cumulative effects of the impairment(s) limit several activities. See 20 C.F.R. §

416.926a(e)(3).

Discussion:

This court reviews a decision by an ALJ "to determine whether it is supported by

substantial evidence on the record as a whole." Ellis v. Barnhart, 392 F.3d 988, 993 (8th

Cir.2005); Bailey v. Apfel, 230 F.3d 1063, 1065 (8th Cir.2000); 42 U.S.C. § 405(g). Our scope

of review is narrow; we must affirm the Commissioner's decision so long as it conforms to the

law and is supported by substantial evidence on the record as a whole. Collins ex rel. Williams

v. Barnhart 335 F.3d 726, 729 (8th Cir.2003); Qualls v. Apfel, 158 F.3d 425, 427 (8th

Cir.1998). Substantial evidence is relevant evidence that reasonable minds might accept as

adequate to support the decision. Hunt v. Massanari, 250 F.3d 622, 623 (8th Cir.2001). The

issue on appeal is whether there is substantial evidence to support the ALJ's determinations

under the three-step sequential test. The undersigned employs the same three-step sequential

process as the ALJ to evaluate the evidence and the alleged disability. Because plaintiff does

not contest the ALJ's finding regarding substantial gainful activity, we bypass the first step. 

Under the second step, the ALJ found that the claimant has asthma, a “severe impairment” as

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that term in contemplated in the regulations (T. 12). Consequently, the pivotal issue remains

the third step, namely, whether there is substantial evidence in the record to support the finding

that claimant’s impairment does not rise to the medical or functional level of severity necessary

to equal a disability listed in Appendix 1 of 20 C.F.R. § 404, Subpart P. See Pepper ex rel.

Gardner v. Barnhart 342 F.3d 853, 855 (8th Cir.2003). 

The regulations provide:

(a) Basic considerations. We consider all relevant information (i.e., evidence)

in your case record. The evidence [] may include information from medical

sources, such as your pediatrician, other physicians, psychologist, or qualified

speech-language pathologist; other medical sources not listed in § 416.913(a),

such as physical, occupational, and rehabilitation therapists; and nonmedical

sources, such as your parents, teachers, and other people who know you. 

(1) Medical evidence -- (i) General. Medical evidence of your

impairment(s) must describe symptoms, signs, and laboratory findings. The

medical evidence may include, but is not limited to, formal testing that provides

information about your development or functioning in terms of standard

deviations, percentiles, percentages of delay, or age or grade equivalents. It may

also include opinions from medical sources about the nature and severity of your

impairments. (See § 416.927).

(ii) Test scores. We consider all of the relevant information in your case

record and will not consider any single piece of evidence in isolation. Therefore,

we will not rely on test scores alone when we decide whether you are disabled. 

(See § 416.926a(e)) for more information about how we consider test scores.

20 C.F.R. § 416.924a(a)(1)(i)-(ii). 

At the time of the administrative due process hearing, the claimant was 12 years old and

in the seventh grade, in regular classes (T. 297, 298, 109). Both the plaintiff and the claimant’s

grandmother, testified at the hearing, and plaintiff was represented by counsel (T. 296-311).

The administrative hearing was conducted on July 20, 2004 (T. 296), after which the ALJ

issued his written decision, dated August 20, 2004 (T. 11-17). 

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As has been noted, there are several ways to demonstrate that a child is disabled. 20

C.F.R. § 416.926a(b). If the ALJ had found that the claimant had an extreme impairment in

one functional area or marked impairments in two functional areas, then he would have been

entitled to benefits. 20 C.F.R. § 416.926a(d). Plaintiff challenges whether there was sufficient

evidence to support the ALJ’s conclusions that claimant suffered: a less than marked limitation

in the two domains of attending and completing tasks and health and physical well-being (Doc.

#5, p. 3). 

With respect to these two domains, the ALJ found:

The claimant has a less than marked limitation in attending and completing

tasks. The claimant’s teacher indicated that the claimant had some difficulty

with concentration, persistence and pace unless he was interested in the subject. 

The claimant has not been diagnosed or received treatment for emotional

problems.

* * *

The claimant has a less than marked limitation in his health and physical wellbeing. The claimant carries a diagnosis of asthma and takes prescribed

medications. The medical evidence shows the claimant was hospitalized in

November 2002 and January 2004.

(T. 14-15). 

Plaintiff contends:

This is a minor [claimant] who has asthma to the extent that it affects his ability

to attempt and complete tasks and affects his overall health and physical well

being if not on the marked level in both categories at least in the extreme level

and particularly in regard to affecting his overall health and physical well being. 

The testimony of the minor [claimant], of his mother Lula Cheatham, and of his

grandmother Betty Jean Wilkerson all support the facts that the minor [claimant]

is markedly (if not extreme) (sic) unable to attempt and complete tasks and that

his overall health and physical well being is at least in the marked category if not

the extreme category. To ignore the evidence of disability of the minor

[claimant] from asthma is to ignore the substantial evidence in this case.

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(Doc. #5, p. 3). To support her contentions, the plaintiff cites the undersigned to diagnoses of

asthma and otitis media, in the administrative record (Doc. #5, pp. 2-3). 

However, the plaintiff testified at the hearing that claimant has “not too much trouble

with his ears since he got his ears – the little things in his ears.” She testified further that the

placement of tubes “kind of helped with his ears.” (T. 306-307) While plaintiff testified that

the claimant has one or two headaches per week, they require only children’s over the counter

aspirin (T. 306). 

With respect to the claimant’s asthma, the record clearly documents that his medications

and treatments help the condition (T. 302, 133, 132, 280, 309, 134, 280, 281). The plaintiff

testified that claimant’s doctors opined that he “will grow out of it.” (T. 302). Plaintiff also

appeared to state that the claimant, on an average, required treatment either by a doctor or at a

hospital every three (3) months (T. 303). However, the testimony on this issue could also be

construed to reflect that the claimant required treatment by a doctor or at a hospital two (2) to

three (3) times, every three (3) months (T. 303). Notwithstanding, the record documents

hospital visits lasting longer than 24 hours, due to asthma, on November 1, 2002 (T. 126, 186)

and January 1, 2004 (T. 154-199), only. Further, the plaintiff clearly testified that the claimant

has a “bad asthma attack” “probably once every three months” and a “regular” asthma attack

once a month” (T. 301). Both the plaintiff and claimant’s grandmother testified that the

claimant’ medications help to control claimant’s attacks (T. 302, 309). Plaintiff also stated at

the July hearing that claimant had not been to see his doctor since February (T. 304).

With respect to asthma, the regulations state:

103.03 Asthma. With:

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A. FEV equal to o less than the value specified in table I or 103.02A; 1

Or

B. Attacks (as defined in 3.00C), in spite of prescribed treatment and requiring

physician intervention, occurring at least once every 2 months or at least six

times a year. Each inpatient hospitalization for longer than 24 hours for control

of asthma control counts as two attacks, and an evaluation period of at least 12

consecutive months must be used to determine the frequency of attacks;

Or

C. Persistent low-grade wheezing between acute attacks or absence of extended

symptom-free periods requiring daytime and nocturnal use of sympathomimetic

bronchodilators with one of the following:

1. Persistent prolonged expiration with radiographic or other appropriate

imaging techniques evidence of pulmonary hyperinflation or peribronchial

disease: or

2. Short courses of corticosteriods that average more than 5 days per

month for at least 3 months during a 12-month period;

D. Growth impairment as described under the criteria in 100.00.

20 C.F.R. Part 404, Subpart P, Appendix 1, § 103.03

The undersigned’s careful review of the administrative record demonstrates that the

ALJ’s findings are supported by substantial evidence. The claimant’s medical records do not

support a finding that he meets the listing for asthma. Further, the evidence, as a whole,

substantially supports the ALJ’s determination that claimant’s only “severe” impairment, as

contemplated by the regulations, is asthma; it also supports the ALJ’s finding that the

claimant’s asthma does not medically or functionally equal a listing.

Conclusion:

Accordingly, we conclude that the decision of the ALJ, denying benefits to the plaintiff

on behalf of the claimant, is supported by substantial evidence of record and should be

affirmed. The undersigned finds further that the plaintiff’s Complaint should be dismissed

with prejudice. 

ENTERED this 3 day of May, 2006. rd

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/s/ Bobby E. Shepherd 

HONORABLE BOBBY E. SHEPHERD 

 UNITED STATES MAGISTRATE JUDGE

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