Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-4_04-cv-04138/USCOURTS-arwd-4_04-cv-04138-0/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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IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

TEXARKANA DIVISION

SANDRA WOODS o/b/o

MARLON TOWERY PLAINTIFF

v. Civil No. 04-4138

JO ANNE B. BARNHART, 

Commissioner, Social 

Security Administration DEFENDANT

MEMORANDUM OPINION

Factual and Procedural Background:

The plaintiff, Sandra Woods, appeals from the decision of the Commissioner of the

Social Security Administration (hereinafter “Commissioner”), denying her claim on behalf of

her minor son, Marlon Towery (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 & 7,8). In this judicial review, the court must determine whether

there is substantial evidence in the administrative record to support the Commissioner's

decision. 

The history of the administrative proceedings is contained in the appeals briefs and in

the ALJ’s written decision and will not be recounted here except as necessary. However, it

should be noted that the plaintiff submitted additional medical evidence to the undersigned in

conjunction with her Supplemental Appeal Brief (Doc. #6). This evidence was not submitted to

the ALJ, and was not submitted to the Appeals Council, but was appended to the plaintiff’s

Supplemental Appeal Brief. Plaintiff requests:

Plaintiffs pray review of [their] claim for [SSI] benefits for a child to be awarded

from September 17, 2002, the filing date, to an indefinite date in the future, or,

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in the alternative, that the case be remanded to the Defendant for the taking of

supplemental evidence pertaining to Plaintiffs’ claim. It is to be duly noted that

the Plaintiffs appeared without an attorney before the [ALJ].

(Doc. #6, p. 1). Accordingly, the undersigned finds that the plaintiff’s Supplemental Appeal

Brief should and will be construed as a motion to consider additional evidence.

Section 405(g) generally precludes consideration on review of evidence outside the

record before the Commissioner during the administrative proceedings. See Delrosa v.

Sullivan, 922 F.2d 480, 483 (8th Cir.1991). Remand is appropriate only upon a showing by the

claimant "that there is new evidence which is material and that there is good cause for the

failure to incorporate such evidence into the record in a prior proceeding." 42 U.S.C. § 405(g);

see also Thomas v. Sullivan, 928 F.2d 255, 260 (8th Cir.1991). To be considered material, the

new evidence must be "non-cumulative, relevant, and probative of the claimant's condition for

the time period for which benefits were denied." See Woolf v. Shalala, 3 F.3d 1210, 1215 (8th

Cir.1993). Furthermore, it must be reasonably likely that the Commissioner's consideration of

this new evidence would have resulted in an award of benefits. See id.

An implicit requirement is that the new evidence pertain to the time period for which

benefits are sought, and that it not concern later-acquired disabilities or subsequent

deterioration of a previously non-disabling condition. See Goad v. Shalala, 7 F.3d 1397, 1398

(8th Cir.1993) (per curiam); Thomas v. Sullivan, 928 F.2d at 260-61. Additional evidence

showing a deterioration in a claimant's condition significantly after the date of the

Commissioner's final decision is not a material basis for remand, although it may be grounds

for a new application for benefits. Jones v. Callahan 122 F.3d 1148,1154 (8th Cir.1997).

 Here, plaintiff seeks remand to the ALJ for consideration of medical evidence dated June 7,

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2004 through January 13, 2005 (Doc. #6, attachments). As has been noted, the plaintiff’s

administrative hearing was held on May 13, 2004, written decision was rendered on June 30,

2004 and the Appeals Council entered its Order on August 27, 2004. 

While it is noted that the undersigned may “at any time order additional evidence to be

taken before the Commissioner”, there must first be a “showing that there is new evidence

which is material and that there is good cause for the failure to incorporate such evidence into

the record in a prior proceeding.” 42 U.S.C. § 405(g). 

Much of the new evidence was generated some five (5) months after the date the

Appeals Council entered its order making the ALJ’s decision the final decision for purposes of

this appeal. Because this evidence was not in existence at the time of the administrative

hearing, it is new evidence, and it could not be made a part of the record at the prior proceeding. 

Thomas v. Sullivan, 928 F.2d at 260. This evidence is not merely cumulative, but instead

presents more specific findings and conclusions of mental health personnel treating the

plaintiff. Williams v. Sullivan, 905 F.2d 214, 216 (8th Cir.1990). The question then becomes

whether the evidence is material. We find that it is. 

The plaintiff asserts disability due to claimant’s depression, attention deficit

hyperactivity disorder (hereinafter “ADHD”), adjustment disorder and mood disorder. The

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

record evidence. 

The ALJ followed the sequential evaluation process, set forth in 20 C.F.R. § 416.924.

Under this standard, a child must prove that she has a medically determinable physical or

mental impairment, which results in marked and severe functional limitations, and which can

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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 the law, 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 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

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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).

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 a disability in

the Listings. See 20 C.F.R. § 416.926a(b)(2). A marked limitation is an 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 “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).

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Discussion:

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

substantial evidence on the record as a whole." 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 test 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, we agree

that claimant’s impairments of adjustment disorder and ADHD are severe. Consequently, the

pivotal issue remains the third step, namely, whether there is substantial evidence in the record

to support the finding that claimant’s impairments do 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

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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 hearing, the claimant was 14 years old and was in the

eighth grade (T. 28, 63). The plaintiff, claimant’s mother, and claimant testified at the hearing,

however, the plaintiff was not represented by counsel (T. 26). The administrative hearing was

conducted on May 13, 2004, after which the ALJ issued his written decision, dated June 30,

2004 (T. 12-18). On August 27, 2004, the Appeals Council denied the plaintiff’s request for

review of the hearing decision (T. 5-7), making the ALJ’s decision the Commissioner’s final

decision. 

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 she would have been

entitled to benefits. 20 C.F.R. § 416.926a(d). 

Here, the ALJ assessed that the claimant has: less than a marked limitation in the

domain of acquiring and using information; less than a marked limitation in the domain of

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attending and completing tasks; no limitation in the domain of interacting and relating to others;

no limitation in the domain of moving about and manipulating objects; no limitation in the area

of caring for herself; and, less than a marked limitation in the area of health and physical well

being (T. 16-17). 

However, after carefully examining the record, including the additional evidence

submitted for consideration, the undersigned concludes that we do not reach the issue of

whether the ALJ’s decision is supported by substantial evidence. Instead, it appears clear that

the plaintiff’s motion to consider additional evidence should be granted and this matter

remanded to the Commissioner for the consideration of the evidence appended to the plaintiff’s

supplemental appeal brief. 

As has been stated, an individual is "disabled" under the Act if she is unable "to engage

in any substantial gainful activity by reason of any medically determinable physical or mental

impairment 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. §§ 423(d)(1)(A) and

1382c(a)(3)(A). The burden of establishing a compensable disability under the Act is initially

on the claimant. See Kerns v. Apfel, 160 F.3d 464, 466 (8th Cir.1998); Riley v. Shalala, 18

F.3d at 621 (quoting Bowen v. Yuckert, 482 U.S. 137, 146 n. 5, 107 S.Ct. 2287, 96 L.Ed.2d 119

(1987)). However, the submission of the additional evidence, and our finding with respect to

that evidence, complicates the analysis and thus, this matter should be remanded. 

Conclusion:

Accordingly, the undersigned finds that the plaintiff’s Supplemental Appeal Brief, with

appended new and material evidence, is construed as a motion to submit additional evidence

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(Doc. #6). Finding further, it is determined that the motion should be and hereby is granted. 

Thus, this matter is remanded to the Commissioner pursuant to sentence six, 42 U.S.C. 405(g),

for the consideration of any and all relevant additional evidence.

ENTERED this 7 day of November, 2005. th

/s/ Bobby E. Shepherd 

HONORABLE BOBBY E. SHEPHERD 

 UNITED STATES MAGISTRATE JUDGE

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