Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-almd-2_13-cv-00527/USCOURTS-almd-2_13-cv-00527-0/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 DISTRICT COURT OF THE UNITED STATES

FOR THE MIDDLE DISTRICT OF ALABAMA

NORTHERN DIVISION

PAMELA MONTEZ MOORE, )

on behalf of L.J.H., Jr., a minor, )

)

Plaintiff, )

)

v. ) CIVIL ACTION NO. 2:13cv527-TFM

) (WO)

CAROLYN W. COLVIN, Acting )

Commissioner of Social Security, )

)

Defendant. )

OPINION

I. PROCEDURAL HISTORY

The plaintiff, Pamela Montez Moore (“Moore” or “Plaintiff”), filed this lawsuit on

behalf of her child, L.J.H., Jr. (“L.J.H.”), challenging a final judgment by Defendant Carolyn

W. Colvin, Acting Commissioner of Social Security, in which she determined that L.J.H. is

not “disabled” and, therefore, not entitled to child supplemental security income benefits. 

On May 17, 2010, Moore filed on behalf of L.J.H. an application for supplemental security

income benefits. Moore’s application was denied at the initial administrative level. Plaintiff

then requested and received a hearing before an Administrative Law Judge (“ALJ”). 

Following the hearing, the ALJ determined that L.J.H. is not disabled. The Appeals Council

rejected a subsequent request for review. The ALJ’s decision consequently became the final

decision of the Commissioner of Social Security (“Commissioner”).1

 See Chester v. Bowen,

1

 Pursuant to the Social Security Independence and Program Improvements Act of 1994, Pub.L. No.

103-296, 108 Stat. 1464, the functions of the Secretary of Health and Human Services with respect to Social

Case 2:13-cv-00527-TFM Document 19 Filed 05/20/14 Page 1 of 12
792 F.2d 129, 131 (11th Cir. 1986). The parties have consented to the undersigned United

States Magistrate Judge rendering a final judgment in this lawsuit. The court has jurisdiction

over this lawsuit under 42 U.S.C. §§ 405(g) and 1383(c)(3).2

 Based on the court’s review

of the record in this case and the briefs of the parties, the court concludes that the decision

of the Commissioner is due to be AFFIRMED.

II. STANDARD OF REVIEW

An individual under 18 is considered disabled “if that individual 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) (1999). The sequential analysis for determining whether a child claimant

is disabled is as follows:

1. If the claimant is engaged in substantial gainful activity, [s]he is not

disabled.

2. If the claimant is not engaged in substantial gainful activity, the

Commissioner determines whether the claimant has a physical or

mental impairment which, whether individually or in combination with

one or more other impairments, is a severe impairment. If the

claimant’s impairment is not severe, [s]he is not disabled.

3. If the impairment is severe, the Commissioner determines whether the

impairment meets the durational requirement and meets, medically

equals, or functionally equals in severity an impairment listed in 20

Security matters were transferred to the Commissioner of Social Security.

2

 Title 42 U.S.C. §§ 405(g) and 1383(c)(3) allow a plaintiff to appeal a final decision of the

Commissioner to the district court in the district in which the plaintiff resides.

2

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C.F.R. Part 404, Subpart P, Appendix 1. If the impairment satisfies this

requirement, the claimant is presumed disabled.

See 20 C.F.R. § 416.924(a)-(d) (1997).

The Commissioner’s regulations provide that if a child’s impairment or impairments

are not medically equal, or functionally equivalent in severity to a listed impairment, the

child is not disabled. See 20 C.F.R. § 416.924(d)(2) (1997). In determining whether a child's

impairment functionally equals a listed impairment, an ALJ must consider the extent to

which the impairment limits the child’s ability to function in the following six “domains” of

life: (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 oneself;

and (6) health and physical well-being. Shinn ex rel. Shinn v. Comm'r of Soc. Sec., 391 F.3d

1276, 1279 (11th Cir. 2004); 20 C.F.R. § 416.926a(b)(1). A child’s impairment functionally

equals a listed impairment, and thus constitutes a disability, if the child’s limitations are

“marked” in two of the six life domains, or if the child's limitations are “extreme” in one of

the six domains. Shinn, 391 F.3d at 1279; 20 C.F.R. § 416.926a(d).

In reviewing the Commissioner’s decision, the court asks only whether his findings

concerning the steps are supported by substantial evidence. Dyer v. Barnhart, 395 F.3d

1206, 1210 (11th Cir. 2005). Substantial evidence is “more than a scintilla,” but less than

a preponderance: it “is such relevant evidence as a reasonable person would accept as

adequate to support a conclusion.” Crawford v. Comm'r of Soc. Sec., 363 F.3d 1155,

1158–59 (11th Cir. 2004) (quotation marks omitted). The court “may not decide the facts

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anew, reweigh the evidence, or substitute . . . [its] judgment for that of the [Commissioner].”

Phillips v. Barnhart, 357 F.3d 1232, 1240 n. 8 (11th Cir. 2004) (alteration in original)

(quotation marks omitted). The court must, however, conduct an “exacting examination of

the [Commissioner's] conclusions of law.” Martin v. Sullivan, 894 F.2d 1520, 1529 (11th 

Cir. 1990).

III. INTRODUCTION

A. The Commissioner’s Decision

L.J.H. was 2 years and 8 months of age at the hearing before the ALJ. (R. 15, 43). 

Moore alleges that, on November 1, 2009, L.J.H. became disabled due to a seizure disorder. 

(R. 139). The ALJ, in his opinion, followed the regulations’ three steps listed above when

he analyzed L.J.H.’s claim. After doing so, he concluded that L.J.H. is not disabled and,

therefore, denied his claim for supplemental social security benefits. Under the first step, the

ALJ found that L.J.H. is not engaged in substantial gainful activity. (R. 15.) At the second

step, the ALJ found that L.J.H. suffers from a seizure disorder as a severe impairment. (Id.). 

At step three, the ALJ found that L.J.H.’s impairments, when considered singularly or in

combination, do not meet or medically equal in severity the criteria for any impairment listed

at 20 CFR, part 404, Subpart P, Appendix 1. (Id.). 

In addition, the ALJ concluded that L.J.H.’s impairments do not functionally equal

a Listing. (R. 16-24.) Specifically, the ALJ found that L.J.H. has less than marked

limitations in the domains of acquiring and using information, attending and completing

tasks, moving and manipulating objects, interacting with others, caring for himself, and

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health and physical well-being. (R. 18-24). The ALJ concluded that L.J.H. does not have an

extreme limitation in one area of functioning, nor does he have a marked limitation in two

areas of functioning. (R. 24.) Consequently, the ALJ determined that L.J.H. is not disabled. 

(R. 24-25.) 

B. The Plaintiff’s Claim

The sole issue presented by Moore is whether “the ALJ’s finding that [L.J.H.] has less

than a marked limitation in the domain of health and physical well being is not supported by

substantial evidence.” (Doc. No. 13, Pl’s Br., p. 5.) 

IV. DISCUSSION

Moore asserts the ALJ improperly relied on the opinions of two non-examining

physicians when determining L.J.H.’s seizure disorder does not functionally equal Listing

111.02. 

Social Security regulations provide a three-step sequential analysis for

determining whether a child is disabled. 20 C.F.R. § 416.924(a). First, the

Commissioner must determine whether the child is engaged in substantial

gainful activity. Id. If yes, the child is not disabled, but if not, the

Commissioner must then proceed to the second question, which is whether the

claimant has a severe impairment. Id. If not, the child is not disabled. Id. If

yes, the Commissioner then must consider the third step, whether the child has

an impairment that meets, medically equally, or functionally equals the Listing

of impairments. Id. If the child satisfied a listing, the child is conclusively

disabled. Id.

Gibbs v. Barnhart, 130 Fed. Appx. 426, 428-29 (11th Cir. 2005) (emphasis added); Henry

v. Barnhart, 156 Fed. Appx. 171, 173 (11th Cir. 2005) (emphasis added).

The ALJ found that L.J.H. has not engaged in substantial gainful activity and that his

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seizure disorder is a severe impairment. Step three requires a three-tiered approach to

determine whether the child has an impairment that meets, medically equals, or functionally

equals the Listing of impairments. First, the ALJ must consider whether L.J.H. meets a

Listing. 20 C.F.R. § 416.924(a); Johnson, 148 Fed. Appx. at 840. “To ‘meet’ a Listing, a

claimant must have a diagnosis included in the Listings and must provide medical reports

documenting that the conditions meet the specific criteria of the Listings and the duration

requirement.” Wilson v. Barnhart, 284 F.3d 1219, 1224 (11th Cir. 2002). Next, the ALJ

must consider whether L.J.H.’s impairments medically equal the Listings. 20 C.F.R. §

416.924(a). To medically equal a listing, there must be in the record “medical findings that

are at least equal in severity and duration.” Johnson, 148 Fed. Appx. at 841-42. Finally, if

the ALJ concludes that L.J.H. does not meet or medically equal a Listing, the ALJ must

determine whether L.J.H. functionally equals a Listing by considering the six domains of

functional limitations set forth in the regulations. See Henry, 156 Fed. Appx. at 173-74. 

The required level of severity for Listing 111.02, Major Motor Seizure Disorder, is 

as follows:

A. Convulsive epilepsy. In a child with an established diagnosis of

epilepsy, the occurrence of more than one major motor seizure

per month despite at least three months of prescribed treatment. 

With:

1. Daytime episodes (loss of consciousness and convulsive

seizures); or

2. Nocturnal episodes manifesting residuals which interfere

with activity during the day.

B. Convulsive epilepsy syndrome. In a child with an established diagnosis

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of epilepsy, the occurrence of at least one major motor seizure in the

year prior to application despite at least three months of prescribed

treatment. And one of the following:

1. IQ of 70 or less; or

2. Significant interference with communication due to

speech, hearing, or visual defect; or 

3. Significant mental disorder; or

4. Where significant adverse effects of medication interfere

with major daily activities.

20 C.F.R. Pt. 404, Subpt. P App. 1, Listing 111.02. 

Plaintiff does not challenge the ALJ’s finding that L.J.H. does not meet or medically

equal the Listing. She does, however, assert that the ALJ erred in determining that L.J.H.

does not functionally equal the Listing. Specifically, she argues that the opinion of Dr. Leah

Sanchez, L.J.H.’s pediatric neurologist, establishes that L.J.H. has an extreme limitation in

the domain of health and well being. 

The law in this Circuit is well-settled that the ALJ must accord “substantial weight”

or “considerable weight” to the opinion, diagnosis, and medical evidence of the claimant’s

treating physician unless good cause exists for not doing so. Jones v. Bowen, 810 F.2d 1001,

1005 (11th Cir. 1986); Broughton v. Heckler, 776 F.2d 960, 961 (11th Cir. 1985). The

Commissioner, as reflected in his regulations, also demonstrates a similar preference for the

opinion of treating physicians.

Generally, we give more weight to opinions from your treating sources, since

these sources are likely to be the medical professionals most able to provide

a detailed, longitudinal picture of your medical impairment(s) and may bring

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a unique perspective to the medical evidence that cannot be obtained from the

objective medical findings alone or from reports of individual examinations,

such as consultive examinations or brief hospitalizations.

Lewis v. Callahan, 125 F.3d 1436, 1440 (11th Cir. 1997) (citing 20 CFR § 404.1527 (d)(2)). 

It is not only legally relevant but unquestionably logical that the opinions, diagnosis, and

medical evidence of a treating physician whose familiarity with the patient’s injuries, course

of treatment, and responses over a considerable length of time, should be given considerable

weight. Smith v. Schweiker, 646 F.2d 1075, 1081 (5th Cir. 1981). 

The ALJ may reject the opinion of any physician when the evidence supports a

contrary conclusion. Bloodsworth v. Heckler, 703 F.2d 1233, 1240 (11th Cir. 1983). 

However, the ALJ must articulate the weight given to a treating physician’s opinion and must

articulate any reasons for discounting the opinion. Schnorr v. Bowen, 816 F.2d 578, 581

(11th Cir. 1987). 

Plaintiff argues that the ALJ’s opinion is “based almost entirely on the opinions of Dr.

Doris S. Phillips, a non-examining medical doctor, and the medical expert, Dr. Anderson.” 

(Pl’s Br., p. 6). She contends that Drs. Phillips and Anderson are not medical specialists and,

therefore, the ALJ should have assigned “extra weight” to the opinion of Dr. Sanchez,

L.J.H.’s neurologist. This court’s review of the record, however, indicates that the ALJ

assigned great weight to the opinion of the treating pediatric neurologist, as well as to the

opinions of the non-examining physicians. (R. 17). Specifically, the ALJ assigned

. . . great weight to the opinions of Drs. Anderson, Phillips, and Sanchez. The

expert evaluations find the claimant to be somewhat less impaired than I do but

fully support the decision reached. 

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(R. 17). 

The opinion of reviewing, non-examining physicians, when contrary to those of

examining physicians, are entitled to little weight. Broughton v. Heckler, 776 F.2d 960, 962

(11th Cir. 1985); Ortega v. Chater, 933 F. Supp. 1071, 1074 (S.D. Fla. 1996) (citing Lamb

v. Bowen, 847 F.2d 698 (11th Cir. 1988) and Sharfarz v. Bowen, 825 F.2d 278 (11th Cir.

1987)). The opinions of Drs. Phillips and Anderson do not conflict with Dr. Sanchez’s

findings. Thus, the ALJ did not inappropriately rely on the opinions of the non-examining

physicians. See Bailey v. Soc. Sec. Admin. Comm’r, 444 Fed. Appx 365 (11th Cir. 2011)

(noting 20 C.F.R. § 404.1527(f)(2)(I) and SSR 96-6p require consideration of such opinions).

Plaintiff also incorrectly argues that “the ALJ characterized and considered Dr.

Sanchez’s opinion as referring to Listing 111.02 for a seizure disorder due to an extreme

limitation in health and physical well being.” (Pl’s Br., p. 5). Nothing in the medical records

indicates that Dr. Sanchez, at any time, found that L.J.H. suffers from any “extreme

limitation” in health and physical well being. 

The opinion of the ALJ shows that he carefully considered the evidence in this case

and was extremely familiar with it. A remand is not required. In this case, the ALJ

concluded that although L.J.H. has deficits in health and physical well being, none of his

limitations rise to the level of marked or extreme. Substantial evidence supports the ALJ’s

determination.

The medical records indicate L.J.H. has suffered two documented seizures. The first

seizure occurred on November 1, 2009, and the second seizure occurred on April 16, 2010. 

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(R. 41, 320-27, 351-55.) On July 8, 2010, Dr. Sanchez examined L.J.H. (R. 293, 313). Dr. 

Sanchez’s clinical impression was as follows:

(1) Two recent unprovoked grand mal type seizures, the second one

suggestive of status epilepticus in an otherwise healthy 20-

month-old who [has] a normal EEG, nonfocal exam and has a

positive maternal family history for epilepsy. Clinically, this

patient appears to meet criteria for a seizure[] disorder or

epilepsy.

(2) Suboptimal sleep habits.

(R. 294, 314). Dr. Sanchez recommended increasing L.J.H.’s dosage of Keppra and

prescribed Diastat. (R. 314-15). L.J.H. continued to receive treatment from Dr. Sanchez on

a routine basis through June 10, 2011. (R. 304-12). During this treatment period, Dr.

Sanchez found no additional seizure activity and that L.J.H.’s condition was “controlled on

current meds.” (Id.)

In July 2010, Dr. Doris S. Phillips, a state consultative physician, reviewed L.J.H.’s

medical records and completed a Childhood Disability Evaluation Form. (R. 296-302). The

non-examining physician found “less than marked functional impairment” in the domain of

health and physical well-being. (R. 299). 

During the hearing on March 12, 2012, Dr. James Noble Anderson, a medical expert,

testified that the medical records indicate a three-year-old child with a history of complex

seizure disorder, a normal EEG, and no seizures after beginning medication. (R. 33). Dr.

Anderson acknowledged that L.J.H. clinically meets the criteria for a seizure disorder and

has less than a marked functional impairment in the domain of health and physical well10

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being. (R. 34). 

It is clear from a review of the record that the ALJ considered L.J.H.’s functional

limitations and concluded that any limitations were less than marked. Furthermore, the ALJ

properly considered all of L.J.H.’s impairments and concluded that L.J.H. “does not have an

impairment or combination of impairments that result in either ‘marked’ limitations in two

domains of functioning or ‘extreme’ limitation in one domain of functioning.” (R. 24). 

L.J.H.’s treating physician noted that L.J.H.’s seizure condition is controlled with medication

and that no additional seizures have occurred. (R. 304, 307, 309, 311-12). In addition,

Plaintiff testified that L.J.H. has not suffered a seizure since April 2010. (R. 45).

Pursuant to the substantial evidence standard, this court’s review is a limited one; the

entire record must be scrutinized to determine the reasonableness of the ALJ’s factual

findings. Lowery v. Sullivan, 979 F.2d 835, 837 (11th Cir. 1992). Given this standard of

review, the court finds that the ALJ’s detailed explanation of L.J.H.’s limitations, coupled

with his analysis of L.J.H.’s complete medical history, was reasonable and consequently, is

supported by substantial evidence.

IV. CONCLUSION

In short, this court has carefully and independently reviewed the record and concludes

that the ALJ’s conclusion that L.J.H. is not disabled is supported by substantial evidence. 

Thus, the decision of the Commissioner is due to be AFFIRMED.

A separate order shall accompany this Opinion.

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Done this 20th day of May, 2014.

 /s/Terry F. Moorer 

TERRY F. MOORER

UNITED STATES MAGISTRATE JUDGE

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