Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-6_04-cv-06119/USCOURTS-arwd-6_04-cv-06119-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:405 Review of HHS Decision (DIWC)

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(Rev. 8/82)

IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

HOT SPRINGS DIVISION

JENIFER SMITH PLAINTIFF

v. Civil No. 04-6119

JO ANNE B. BARNHART, 

Commissioner, Social 

Security Administration DEFENDANT

MEMORANDUM OPINION

Factual and Procedural Background:

Plaintiff, Jenifer Smith, appeals from the decision of the Commissioner of the Social

Security Administration (hereinafter “Commissioner”), denying her applications for childhood

disability benefits (hereinafter “CDB”), pursuant to §§ 202 and 223 of Title II of the Social

Security Act (hereinafter "the Act"), 42 U.S.C. §§ 402 and 423. 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 respective appeal

briefs and will not be recounted here except as necessary (Doc. #9 & 10). 

The plaintiff asserts disability due to: panic attacks; inverted left hip; endometriosis;

inability to concentrate; learning disability; cognitive disorder; attention deficit disorder;

schizophrenia; depression; and, fatigue. The issue before this Court is whether the

Commissioner's decision is supported by substantial record evidence. Specifically, the

plaintiff asserts that the ALJ erred: by not giving adequate credence to the opinions of

plaintiff’s treating physicians; and, in ruling that her condition does not meet or equal the

requirements of a listed impairment.

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The Commissioner has established, by regulation, a five-step sequential evaluation for

determining whether an individual is disabled.

The first step involves a determination of whether the claimant is involved in

substantial gainful activity. 20 C.F.R. § 404.1520(b). If the claimant is, benefits are denied;

if not, the evaluation goes to the next step.

Step 2 involves a determination, based solely on the medical evidence, of whether the

claimant has a severe impairment or combination of impairments. Id., § 404.1520©); see 20

C.F.R. § 404.1526. If not, benefits are denied; if so, the evaluation proceeds to the next

step.

Step 3 involves a determination, again based solely on the medical evidence, of

whether the severe impairment(s) meets or equals a listed impairment which is presumed to

be disabling. Id., § 404.1520(d). If so, benefits are awarded; if not, the evaluation

continues.

Step 4 involves a determination of whether the claimant has sufficient residual

functional capacity, despite the impairment(s), to perform past work. Id., § 404.1520(e). If

so, benefits are denied; if not, the evaluation continues.

Step 5 involves a determination of whether the claimant is able to perform other

substantial and gainful work within the economy, given claimant's age, education and work

experience. Id., § 404.1520(f). If so, benefits are denied; if not, benefits are awarded.

In addition, because this case involves a claim for childhood disability benefits, plaintiff

also has to show that she is eligible for those benefits, under the Act. The regulations provide

that a plaintiff seeking CDB must show that she is the insured person’s child, is dependent on

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the insured, is unmarried and, if the plaintiff is over the age of 18, that she has a disability that

began before the age of 22. 20 C.F.R. § 404.350(a). 

Plaintiff’s application was filed on May 23, 2002, alleging an onset date for CDB of

January 31, 1995. Her application was denied initially and upon reconsideration, after which

she requested an administrative hearing. The hearing was held on October 14, 2003, and

plaintiff, her mother and her father each gave testimony (T. 315-352). She attained age 22 on

February 10, 1995, and was 30 years of age at the time of the administrative hearing (T. 51,

318). Plaintiff has an eighth grade formal education, and a Graduate Equivalency Diploma. 

She also attended Garland County Community College for a time, but did not receive a

certificate (T. 320). The ALJ issued an unfavorable decision dated March 25, 2004, which

contained the following findings:

1. Claimant meets the non-disability requirements for Childhood

Disability Benefits set forth in Section 202(d) of the Social

Security Act (with the exceptions noted in 20 CFR §

404.335(b)(2)).

2. Claimant has not engaged in substantial gainful activity since the

alleged onset date.

3. Claimant did not have any impairment that, prior to February 10,

1995, the date she attained age 22, significantly limited her ability

to perform basic work-related activities; therefore, the claimant

did not have a “severe” impairment (20 CFR § 404.1520).

4. Claimant was not under a “disability” as defined in the Social

Security Act, at any time prior to February 10, 1995, the date she

attained age 22 for Social Security benefit purposes (20 CFR §

404.1520(e)).

(T. 18).

 

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Applicable Law:

Our role on review is to determine whether the Commissioner’s findings are supported

by substantial evidence in the record as a whole. See Prosch v. Apfel, 201 F.3d 1010, 1012 (8th

Cir.2000). Substantial evidence is less than a preponderance but is enough that a reasonable

mind would find it adequate to support the Commissioner’s decision. Id. In determining

whether existing evidence is substantial, we consider evidence that detracts from the

Commissioner's decision as well as evidence that supports it. See Craig v. Apfel, 212 F.3d 433,

436 (8th Cir.2000). As long as substantial evidence in the record supports the Commissioner's

decision, we may not reverse it because substantial evidence exists in the record that would

have supported a contrary outcome, see id., or because we would have decided the case

differently. See Woolf v. Shalala, 3 F.3d 1210, 1213 (8th Cir.1993).

To establish entitlement to benefits, the plaintiff must show that she had been unable to

engage in any substantial gainful activity by reason of a medically determinable impairment

which had lasted or could have been expected to last for not less than 12 months. See 42

U.S.C. §§ 423(d)(1)(A) and 1382c(a)(3)(A). 

In order to qualify for disability benefits, “[a] physical or mental impairment must be

established by medical evidence consisting of signs, symptoms and laboratory findings, not

only by [a claimant’s] statement of symptoms.” 20 C.F.R. § 404.1508. Signs are

“anatomical, physiological or psychological abnormalities which can be observed apart from

[a claimant’s] statements (symptoms). Signs must be shown by medically acceptable clinical

diagnostic techniques.” 20 C.F.R. § 404.1528(b). “Laboratory findings are anatomical,

physiological, or psychological phenomena which can be shown by the use of medically

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 The ability to do most work activities encompasses "the abilities and aptitudes 1

necessary to do most jobs." Williams v. Sullivan, 960 F.2d 86, 88 (8th Cir.1992). Examples

include physical functions such as walking, sitting, standing, lifting, pushing, pulling, reaching, 

carrying, or handling; capacities for seeing, hearing, and speaking; understanding, carrying out

and remembering simple instructions; use of judgment; responding appropriately to supervision,

co-workers and usual work situations; and dealing with changes in a routine work situation. Id.

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acceptable laboratory diagnostic techniques." 20 C.F.R. § 404.1528©). 

In evaluating the plaintiff’s subjective complaints, the ALJ must consider the

plaintiff’s allegations of pain, but also has a statutory duty to assess the credibility of plaintiff

and other witnesses. Nelson v. Sullivan, 966 F.2d 363, 366 (8th Cir.1992). The ALJ may

discredit subjective complaints inconsistent with the record as a whole. Ownbey v. Shalala,

5 F.3d 342, 344 (8th Cir.1993). The law on this issue is clear. Under Polaski v. Heckler,

739 F.2d 1320, 1321-22 (8th Cir.1984) (subsequent history omitted), “an ALJ must look at

five factors when determining the credibility of a claimant’s subjective allegations of pain:

(1) the claimant’s daily activities; (2) the duration, frequency and intensity of the pain; (3)

aggravating and precipitating factors; (4) dosage, effectiveness and side effects of

medication; and (5) functional restrictions.” Harris v. Shalala, 45 F.3d 1190, 1193 (8th

Cir.1995); see also Baker v. Sec. of HHS, 955 F.2d 552, 555 (8th Cir.1992).

Notwithstanding, it is recognized that the ALJ, in the instant matter, made his

decision at step two of the sequential process, which decision is made based solely upon the

medical evidence. 

At step 2 of the sequential evaluation process, the ALJ concluded that, prior to

February 10, 1995, the plaintiff had no impairment which significantly limited her ability to

perform work-related activities , and therefore, concluded that she had no severe impairment, 1

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at 88-89; 20 C.F.R. § 1521(b).

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and was not disabled. 

The United States Supreme Court has recognized that this severity regulation

increases efficiency by identifying at an early stage those claimants whose medical

impairments are so slight that it is unlikely they would be found disabled even if their age,

education and work experience were taken into account. Bowen v. Yuckert, 482 U.S. 137,

153 (1987). 

However, a majority of the Court adopted a standard allowing a denial of benefits at

step 2 for “[o]nly those claimants with slight abnormalities that do no significantly limit ‘any

work activity.’” Bowen v. Yuckert, 482 U.S. at 158. 

Thus, the sequential evaluation process can be terminated at step 2 only in cases

where there is “no more than a minimal effect on the claimant’s ability to work.” Hudson v.

Bowen, 870 F.2d 1392, 1396 (8th Cir.1989). While the plaintiff did have the burden of

showing a severe impairment that significantly limited her physical or mental ability to

perform basic work activities, the burden of a plaintiff at this stage of the analysis is not

great. Caviness v. Massanari, 250 F.3d 603, 605 (8th Cir.2001). 

Further, the Social Security Administration has published a ruling on the issue of

severe impairments which cautions:

Great care should be exercised in applying the not severe impairment concept.

If an adjudicator is unable to determine clearly the effect of an

impairment or combination of impairments on the individual's ability to

do basic work activities, the sequential evaluation process should not end

with the not severe evaluation step. Rather, it should be continued....

[S]equential evaluation requires that the adjudicator evaluate the individual's

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ability to do past work, or to do other work based on the consideration of age,

education, and prior work experience.

Social Security Ruling 85-28, quoted in Yuckert, 482U.S. at 158, 107 S.Ct. 2287 (emphasis

supplied). Applying this cautious standard to the evidence in the administrative record, we

conclude that substantial evidence does not support the ALJ's decision to stop the sequential

analysis of the plaintiff’s claim with a step two finding that she has no severe impairment.

See Gilbert v. Apfel, 175 F.3d 602, 604-05 (8th Cir.1999). 

In addition, it should be noted that whenever adult claimants allege mental impairment,

the application of a special technique must be followed at each level of the administrative

review process. See 20 C.F.R. § 416.920a(a).

The Commissioner is then charged with rating the degree of functional limitation, and

applying the technique to evaluate mental impairments. See 20 C.F.R. § 416.920a(d). 

Application of the technique must be documented by the Commissioner at the ALJ hearing and

Appeals Council levels. See 20 C.F.R. § 416.920a(e). 

Finally, in cases involving the submission of supplemental evidence subsequent to the

ALJ's decision, the record includes that evidence submitted after the hearing and considered by

the Appeals Council. See Jenkins v. Apfel, 196 F.3d 922, 924 (8th Cir.1999) (citing Riley v.

Shalala, 18 F.3d 619, 622 (8th Cir.1994)). Thus, in situations such as the present, this court's

role is to determine whether the ALJ's decision "is supported by substantial evidence on the

record as a whole, including the new evidence submitted after the determination was made."

Riley v. Shalala, 18 F.3d at 622. In practice, this requires a decision as to how the ALJ would

have weighed the new evidence had it existed at the initial hearing. See id. As the United

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States Court of Appeals for the Eighth Circuit has often noted, "this [is] a peculiar task for a

reviewing court." Id. Critically, however, this court may not reverse the decision of the ALJ

merely because substantial evidence may allow for a contrary decision. See Woolf v. Shalala, 3

F.3d 1210, 1213 (8th Cir.1993).

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 to the Appeals Council

complicates the analysis; thus, this court now turns to that additional evidence. 

Discussion:

In his decision, the ALJ stated:

There is no doubt that at a later date claimant did develop a limiting mental

health condition. However, claimant’s allegations concerning the onset date of

severe impairments is not credible. Although claimant and family have alleged

rather marked functional limitations, the true extent of claimant’s functional

limitations on and before February 9, 1995 was significantly less than that

alleged.

(T. 17). However, the following letter was submitted to, and considered by the Appeals

Council approximately three (3) months after the ALJ’s decision. Written by Dr. James Davis,

who was plaintiff’s treating physician during much of the relevant time period, it states:

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Re: Jenifer S. Smith

d.o.b.: February 11, 1973

I am a retired family practice physician who cared for Jenifer from 1979 to 1995

at Mount Ida, Arkansas.

Jenifer was always a verbal youngster but it was obvious she always had severe

personality, character, and intellectual disabilities.

She has a wonderfully supportive family and the small community knew and

sustained Jenifer during her childhood.

However, Jenifer had a severe learning disability and reads and performs at

about the 3rd grade level. She never successfully completed a single middle

school or high school credit.

Her behavior when I knew her was not psychotic but always slightly in

appropriate.

When I last saw her she had not been able to hold any job.

In retrospect we should have realized that Jenifer was disabled from birth and

should have sought disability status early in her life. However, the support of

her family and her verbal nature lulled us into an unreasonable optimization

about her ability to cope in society. (i.e.) It is now obvious Jenifer has been

disabled all her life. 

(T. 310-312). 

In his opinion, the ALJ determined:

Other than the family/group counseling records, there is no evidence of “mental

health treatment” on or prior to February 9, 1995. The earlier records of detailed

evaluation only date to October 1995, or more than six months after claimant

attained age 22 (Exhibit 1F, 2F, 3F, 4F). Moreover, there is no evidence of

psychosis prior to late 1999/early 2000 when claimant first required psychiatric

treatment (Exhibits 6F-9F, 13F, 15F).

(T. 17). Clearly, Dr. Davis’ opinion belies this statement. Unfortunately, this letter was not

before the ALJ when he rendered his decision. Nonetheless, it was considered by the Appeals

Council and therefore, it is a part of the administrative record. 

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Based on the foregoing, we find that there is a reasonable likelihood that this evidence

would have, at the very least, changed the ALJ’s decision with respect to his termination of the

sequential evaluation process at step two. Likewise, this evidence leads the undersigned to the

determination that the ALJ’s conclusion, to the effect that plaintiff’s impairments did not

significantly limit her ability to perform basic work-related activities, is not supported by

substantial evidence of record.

Conclusion:

Thus, the undersigned concludes that the ALJ’s decision denying benefits to the plaintiff

is not supported by substantial evidence and should be reversed. This matter should be

remanded to the Commissioner for the reasons set forth above. 

ENTERED this 16 day of September, 2005. th

/s/ Bobby E. Shepherd 

HONORABLE BOBBY E. SHEPHERD 

 UNITED STATES MAGISTRATE JUDGE

 

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