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Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 

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United States Court of Appeals

FOR THE EIGHTH CIRCUIT

___________

No. 04-1358

___________

Tawanna Neal, by her next * 

friend, Evelyn M. Walker, * 

* 

Appellants, * 

* Appeal from the United States

v. * District Court for the 

* Southern District of Iowa.

Jo Anne B. Barnhart, Commissioner * 

of Social Security, * 

* 

Appellee. *

___________

Submitted: November 19, 2004

Filed: April 27, 2005

___________

Before SMITH, BEAM, and BENTON, Circuit Judges.

___________

SMITH, Circuit Judge.

I. Introduction

Evelyn Walker ("Walker"), on behalf of her daughter, Tawanna Neal ("Neal"),

appeals the Commissioner's denial of supplemental security income ("SSI") benefits

made under Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq., after Neal

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The Honorable Charles R. Wolle, United States District Judge for the Southern

District of Iowa.

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was found to be no longer disabled. The district court1

 found that substantial evidence

supported the decision of the Commissioner. We affirm.

II. Background

Walker filed an initial application for SSI benefits for Neal under Title XVI on

September 5, 1995, and alleged a disability onset date of October 10, 1989. Neal

alleged disability due to a mental impairment that resulted in an inability to follow

directions, slow learning, and slow developmental skills. The medical record

supported a finding of disability. Dr. Stana J. Michael ("Dr. Michael"), Ed.D.,

administered the Wechsler Intelligence Scale for Children-Third Edition (WISC-III)

in November 1995. Neal obtained a verbal intelligence quotient (IQ) score of 76, a

performance IQ score of 58, and a full scale IQ score of 65. Dr. Michael diagnosed

Neal with mild mental retardation based on those scores. However, Dr. Michael

opined that Neal's scores were low indications of her abilities and noted that Neal's

verbal IQ score was within the borderline intellectual functioning range. Dr. Michael

also observed that Neal's "performance score was much weaker and in this area she

tended to give up rather easily." 

The Commissioner reviewed Neal's continued eligibility for benefits in 1997

following enactment of 42 U.S.C. § 1382c(a)(3)(C)(i) which created new standards

describing qualifying disabling conditions. Neal missed an assigned consultative

examination and the Commissioner terminated her benefits. After filing requests for

reconsideration, a hearing was held with a disability hearing officer, who determined

that Neal's disability had ceased. Following a hearing, an administrative law judge

("ALJ") ruled that Neal was not under a "disability" as defined in the Social Security

Act and the Appeals Council denied a request for review. 

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During the administrative hearing, Walker testified that Neal went to bed and

arose on her own and ate breakfast without assistance. While Neal sometimes

required help buttoning her clothing and styling her hair, Neal showered and dressed

herself without assistance. Neal also rode the bus both to and from school on her own.

Walker testified that Neal earned an "A" in her regular physical education class,

enjoyed art, and performed well at drawing–which she spent a considerable amount

of time doing. However, Neal was unable to ride a bicycle or cook when unattended.

Neal's grandmother, Bessie Johnson ("Johnson"), also testified on Neal's behalf.

Johnson testified that Neal had once jumped into the deep end of a pool and required

assistance due to her inability to swim.

Dr. Roger L. Parks ("Dr. Parks"), Psy.D., administered the WISC-III to Neal

on December 12, 1997. Neal obtained a verbal IQ score of 46, a performance IQ score

of 49, and a full scale IQ score of 45. Dr. Parks opined that those scores did not

accurately reflect Neal's cognitive abilities. Dr. Parks stated that Neal was

cooperative, but not sufficiently motivated during the administration of the WISC-III.

According to Dr. Parks, Neal gave up easily on difficult items and may have

intentionally given up on more simple items. Dr. Parks also diagnosed Neal with mild

mental retardation because, based on the statements of Neal's mother, he suspected

that Neal's cognitive abilities fell within the mentally deficient range.

Neal's special education teacher, Jeanie Wade ("Wade"), completed a school

activities questionnaire on September 30, 1998. Wade stated Neal had good motor

and communication skills, although Neal sometimes did not understand directions or

ask for help. Neal's school psychologist, Sally Hartman ("Hartman"), performed a

psychological assessment of Neal in April 1999, which included another WISC-III

examination. The results of the WISC-III showed a full scale IQ score of 72, a verbal

IQ score of 82, and a performance IQ score of 66. Hartman opined that Neal

functioned within the low average range intellectually. 

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At the request of Neal's attorney, Dr. James A. Stehbens ("Dr. Stehbens"),

Ph.D., a pediatric psychologist, performed a consultative psychological evaluation on

February 26, 2001. The results of that evaluation revealed verbal and nonverbal IQ

scores within the borderline range of intelligence. Dr. Stehbens diagnosed Neal with

borderline intelligence and school learning delays. 

On April 12, 2001, Dianne McBrien ("Dr. McBrien"), M.D., diagnosed Neal

as a healthy child with borderline intelligence and learning disabilities. Dr. McBrien

recommended that Neal continue with educational and psychological assistance.

Finally, Kris Baldwin ("Baldwin"), M.P.T., a physical therapist, evaluated Neal

on April 12, 2001. Baldwin conducted an assessment of Neal's motor status, and

opined that Neal had delays in her gross motor skills, but that she was functional in

her environment and had good leg strength and normal range of leg motion. Baldwin

stated that Neal's strongest area was bilateral coordination and that she was most

challenged by activities that required balance and spatial awareness of her body.

Baldwin stated Neal's gross motor skills could be improved with specific activities

that challenged her balance, such as riding a bicycle and roller skating, although she

would require large amounts of practice to learn how to do these activities. Neal was

found to have very legible writing and it was suggested that an adjustment of her

pencil grip would reduce pressure in her hand from writing. Neal was able to use a

computer keyboard for her school work. 

The ALJ found Neal had borderline intellectual functioning and a learning

disability. However, the ALJ further found that Neal's limited mental functioning did

not meet or medically or functionally equal the requirements for the Listing of

Impairments. According to the ALJ, Neal had neither subaverage general intellectual

functioning nor deficits in adaptive functioning. While the ALJ found that Neal had

a marked impairment in acquiring and using information, Neal showed less than a

marked impairment in moving about and manipulating objects, and had no limitation

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in attending and completing tasks, interacting and relating with others, caring for

herself, her health or her well-being. The district court found that substantial evidence

supported this decision and affirmed the ALJ.

III. Discussion

We review decisions of the Commissioner using the same standard as the

district court. Howard v. Massanari, 255 F.3d 577, 580–81 (8th Cir. 2001). By

statute, "[t]he findings of the Commissioner of Social Security as to any fact, if

supported by substantial evidence, shall be conclusive." 42 U.S.C. § 405(g). We have

stated that

the Commissioner's determinations [will be upheld] if they are supported

by substantial evidence on the record as a whole. Substantial evidence

is relevant evidence which a reasonable mind would accept as adequate

to support the Commissioner's conclusion. In assessing the substantiality

of the evidence, we must consider evidence that detracts from the

Commissioner's decision as well as evidence that supports it. We may

not reverse the Commissioner merely because substantial evidence

exists supporting a different outcome.

Black v. Apfel, 143 F.3d 383, 385 (8th Cir. 1998) (internal quotations and citations

omitted). Substantial evidence is more than a scintilla of evidence. Nelson v. Sullivan,

966 F.2d 363, 366 n.6 (8th Cir. 1992). It is "such relevant evidence as a reasonable

mind might accept as adequate to support a conclusion." Richardson v. Perales, 402

U.S. 389, 401 (1971) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197

(1938)). Under this standard, we do not reverse the Secretary even if we, sitting as

finder of fact, would have reached a contrary result; "[a]n administrative decision is

not subject to reversal merely because substantial evidence would have supported an

opposite decision." Baker v. Heckler, 730 F.2d 1147, 1150–51 (8th Cir. 1984). We

defer heavily to the findings and conclusions of the Social Security Administration.

Howard, 255 F.3d at 580–581. We may also reverse the Commissioner's findings if

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the Secretary applies an erroneous legal standard. Ingram v. Chater, 107 F.3d 598,

601 (8th Cir. 1997). 

We apply a three-step analysis to childhood disability determinations. Pepper

ex rel. Gardner v. Barnhart, 342 F.3d 853, 854 (8th Cir. 2003). See also 20 C.F.R.

§ 416.924(a). We first determine whether the child is engaged in substantial gainful

activity. 20 C.F.R. § 416.924(b). The second step requires a determination of whether

the child's impairments are "severe." 20 C.F.R. § 416.924(c). Under this step, if the

impairments result in no more than minimal functional limitations, the impairments

are not severe and the child is not disabled. The third step requires a determination

of whether the child's impairments meet, are medically equal, or are functionally

equal in severity to the listed impairments set forth in the Commissioner's disability

regulations, 20 C.F.R. § 404, Subpart P, Appendix 1. 20 C.F.R. § 416.924(d). 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). A child's impairment is functionally equal to a listed impairment if there

is an "extreme" limitation in one of six specific functional domains, or a "marked"

limitation in at least two domains. 20 C.F.R. § 416.926a. Domain analysis considers

the child's age-appropriate functioning in relation to: (1) acquiring and using

information; (2) attending and completing tasks; (3) interacting and relating with

others; (4) moving around and manipulating objects; (5) caring for oneself; and (6)

health and physical well being. 20 C.F.R. § 416.926a(a)(1)(i)–(vi). 

Here, the ALJ determined that Neal met the requirements of steps one and two.

Neal never engaged in substantial gainful activity and her borderline intellectual

functioning and learning disability were severe impairments. However, at step three,

the ALJ found that Neal's impairments neither met nor were medically or functionally

equal to the requirements of the Listing of Impairments as described in 20 C.F.R. §

404, Subpart P, Appendix 1. Neal argued that her disabilities either met or were

medically or functionally equal to mental retardation as listed in § 112.05, specifically

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subsection F. The ALJ ruled that Neal did not meet or medically equal § 112.05

because the most recent test results indicated that she had borderline intelligence, not

mental retardation. Moreover, the ALJ ruled that Neal's test scores did not satisfy any

of the subsections of § 112.05.

The mental retardation listing contained in § 112.05 describes mental

retardation as "characterized by significantly subaverage general intellectual

functioning with deficits in adaptive function." The required level of severity for this

disorder is satisfied when the requirements of any one of the six subsections are met.

While several of the six subsections have a specific IQ requirement, the applicable

subsection in this case, § 112.05F, does not. Instead, § 112.05F requires, for children

aged 3 to 18, "satisfaction of [§] 112.02B(2)(a), and a physical or other mental

impairment imposing an additional and significant limitation of function." Section

112.02B(2)(a) sets forth a requirement of

[m]arked impairment in age-appropriate cognitive/communicative

function, documented by medical findings (including consideration of

historical and other information from parents or other individuals who

have knowledge of the child, when such information is needed and

available) and including, if necessary, the results of appropriate

standardized psychological tests, or for children under age 6, by

appropriate tests of language and communication.

Neal's intelligence ranged between borderline intellectual functioning and mild

mental retardation. When tested by Dr. Michael in 1995, Neal obtained a verbal IQ

score of 76, a performance IQ score of 58, and a full scale IQ score of 65. Based on

Neal's overall score, Dr. Michael's actual diagnosis was mild mental retardation.

However, Dr. Michael opined that Neal's scores were low indications of her ability.

In 1997, Dr. Parks also diagnosed Neal with mild mental retardation. During that

examination, Neal obtained a verbal IQ score of 46, a performance IQ score of 49,

and a full scale IQ score of 45. Dr. Parks agreed with Dr. Michael's analysis that the

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scores "underestimate her cognitive functioning" and "do not reflect an accurate

appraisal of Neal's abilities." Both Dr. Stehbens and Dr. McBrien examined Neal in

2001 and both diagnosed her with borderline intelligence and learning disabilities or

delays. Neal's latest IQ was administered in April 1999. The results of that exam

showed a full scale IQ score of 72, a verbal IQ score of 82, and a performance IQ

score of 66.

Neal argues that the ALJ heavily relied upon the April 1999 IQ scores and the

diagnoses of borderline intelligence made by Dr. Stehbens and Dr. McBrien. In doing

so, argues Neal, the ALJ improperly disregarded the earlier diagnoses of mental

retardation made by Dr. Michael and Dr. Parks and, in effect, gave Neal credit for

more than what she was able to do. Neal ignores that both Dr. Parks's and Dr.

Michael's diagnoses of mild mental retardation were only based on her IQ scores.

Both doctors opined that those scores were not accurate reflections of her intelligence

level or cognitive ability. Substantial evidence supports the ALJ's finding that Neal's

impairments did not medically equal § 112.05F.

Substantial evidence also supports the ALJ's finding that Neal's impairments

did not functionally equal § 112.05F. The ALJ ruled that Neal did not have any

extreme limitations and only a marked limitation in acquiring and using information.

Neal argues that she also has marked limitations in moving around and in

manipulating objects and caring for herself. In 2000, Neal was assigned to regular

physical education classes, in which she earned an A grade. Moreover, a physical

therapist examined Neal's motor skills in 2001 and concluded that although there

were delays in Neal's gross motor skills, Neal had good leg strength, a normal range

of leg motion, and was functional in her environment. While Neal had been having

some difficulty in learning to ride a bicycle, specialists have suggested that she is

capable of learning to ride a bicycle and roller skate with practice. There was also

substantial evidence in the record that Neal was able to draw, sketch, write legibly,

and use a computer keyboard. Neal's mother testified that Neal had no personal

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mobility problems and that teachers observed Neal to have good motor skills. While

Neal could not cook or swim without supervision, those inabilities alone do not

establish that Neal was markedly limited in caring for herself. School records did not

indicate that Neal had put herself at risk for physical injury. Neal is able to bathe and

dress herself, although her mother does help her style her hair and selects her

wardrobe. 

The record reflects that Neal had difficulty comprehending certain information

and verbal instructions. Testing in April 1999 indicated that Neal, then age eleven,

functioned at a second grade level in reading and mathematics and at a first grade

level in written language. Neal scored significantly below average on a visualperceptual skill test. Neal's written language skills were also well below average. This

evidence establishes, as found by the ALJ, that Neal had a marked limitation in

acquiring and using information. However, one marked limitation is insufficient to

show that Neal was functionally equal to § 112.05F. When the whole record is

considered, we are left with the conclusion that the findings of the Commissioner are

supported by substantial evidence. We must therefore affirm.

______________________________

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