Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_05-cv-01316/USCOURTS-azd-2_05-cv-01316-0/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

FOR THE DISTRICT OF ARIZONA

Catherine C., a minor, 

by Connie Brown, 

Plaintiff, 

vs.

Jo Anne B. Barnhart, 

Commissioner of the Social 

Security Administration, 

Defendant. 

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No. CV-05-1316-PHX-JAT

ORDER

Pending before the Court are the Plaintiff’s Motion for Summary Judgment and the

Defendant’s Cross-Motion for Summary Judgment. (Docs. 11, 18). The Court now rules on

the motions. 

I. BACKGROUND

On July 24, 2000, the Plaintiff, Connie Brown, applied for disability insurance

benefits on behalf of her minor child, Catherine Cutter, (the “Claimant”). The alleged

disability onset date was January 10, 2000. The Plaintiff timely requested a hearing on

February 22, 2001. The hearing was held on January 17, 2002. The hearing officer denied

the Plaintiff’s claim in a decision dated April 25, 2002. The Plaintiff requested review on

May 14, 2002. On December 17, 2002, the Appeals Council denied review. The Plaintiff

subsequently filed suit in Federal District Court appealing the April 25, 2002, denial of

benefits. 

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On May 20, 2004, the Honorable Susan Bolton remanded the case for further

administrative proceedings to develop the administrative record. The hearing officer was

directed to obtain medical expert testimony from a qualified pediatrician or other specialist

qualified to evaluate the case. The hearing officer was also ordered to obtain and consider

any material testimony reasonably necessary to evaluate the combined effect of the

Claimant’s alleged impairments in light of the evidence as a whole. 

On June 2, 2004, the Appeals Council vacated the April 25, 2002, unfavorable

decision and remanded the matter for further proceedings consistent with the May 20, 2004,

district court ruling.

On remand, a supplemental administrative hearing was held on October 21, 2004.

John Kerr, M.D., a medical expert on contract with the Office of Hearings and Appeals,

appeared telephonically. On January 3, 2005, the hearing officer issued a “partially

favorable” decision finding that the Claimant was entitled to Children’s Supplemental

Security Income (“CSSI”) benefits, but only for the period of July 24, 2000, through August

1, 2003. 

The Plaintiff requested review of the January 3, 2005, decision. On June 20, 2005,

the Appeals Council declined to review the determination. As a result, the hearing officer’s

January 3, 2005, decision became the final decision of the Commissioner of Social Security

for purposes of judicial review. 

On May 3, 2005, the Plaintiff filed a Complaint pursuant to 42 U.S.C.A § 405(g)

(West 1997). The Complaint seeks judicial review of the Commissioner of Social Security’s

denial of benefits. On February 13, 2006, the Plaintiff filed a Motion for Summary

Judgment. On May 19, 2006, the Defendant filed a Cross-Motion for Summary Judgment.

II. LEGAL STANDARD AND ANALYSIS

Because the Social Security Act confines the scope of judicial review to evidence

within the administrative record, the Court will treat the Plaintiff’s Motion for Summary

Judgment as a motion for reversal of the Commissioner’s decision and the Defendant’s

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Cross-Motion for Summary Judgment as a motion for affirmance. 42 U.S.C.A § 405;

Higgins v. Shalala, 876 F. Supp. 1224, 1226 (D. Utah 1994) (collecting cases and discussing

the appropriate treatment of summary judgment motions requesting review of administrative

decisions). Concerning such motions, the appropriate standard of review is whether the

hearing officer’s findings of fact are supported by substantial evidence and whether the

denial of benefits was free from legal error. Smolen v. Chater, 80 F.3d 1273, 1279 (9th Cir.

1996); Flaten v. Sec’y of Health & Human Servs., 44 F.3d 1453, 1457 (9th Cir. 1995).

Substantial evidence is relevant evidence that a reasonable mind “might accept as

adequate to support a conclusion.” Smolen, 80 F.3d at 1457 (quoting Richardson v. Perales,

402 U.S. 389, 401 (1971)); Magallanes v. Bowen, 881 F.2d 747, 750 (9th Cir. 1989) (internal

quotation omitted). To determine whether an administrative decision is supported by

substantial evidence, the reviewing court must “review the administrative record as a whole,

weighing both the evidence that supports and detracts from the [hearing officer]’s

conclusion.” Magallanes, 881 F.2d at 750 (internal citations omitted). If the evidence can

support either affirming or reversing the hearing officer’s decision, the court must uphold the

decision. Moncada v. Chater, 60 F.3d 521, 523 (9th Cir. 1995). Reviewing courts cannot

accept post-hoc rationalizations for agency action. See, e.g., NLRB v. Metro. Life Ins. Co.,

380 U.S. 438, 441, 85 S.Ct. 1061, 1063 (1965); Pinto v. Massanari, 249 F.3d 840, 847 (9th

Cir. 2001). Thus, the decision must be upheld, if at all, on the grounds articulated in the

order by the hearing officer. Pinto, 249 F.3d at 847. 

A child is entitled to CSSI benefits if his impairment is as severe as one that would

prevent an adult from working. 42 U.S.C.A. § 1614(a)(3)(A & B), as amended, 42 U.S.C.A.

§ 1382c(a)(3)(A & B) (West 1993); Sullivan v. Zebley, 493 U.S. 521, 529, 110 S.Ct. 885, 890

(1990). The test for determining whether a child claimant is disabled is a three-step

sequential evaluation process that is an abbreviated version of the adult test. 20 C.F.R. §

416.924 (2004). A child will qualify for SSI benefits if: (1) the child is not engaged in

substantial gainful activity; (2) the child has a medically determinable severe impairment;

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and (3) the impairment meets, medically equals, or functionally equals the severity of an

impairment listed at 20 C.F.R. Pt. 404, Subpt. P, App. 1, and that impairment meets the

durational requirement, 20 C.F.R. § 416.924(b)(1) (2004).

The hearing officer in this case concluded that the medical evidence established that

the Claimant had the following severe impairment: (1) diabetes mellitus with episodes of

recurrent otitis media. (Tr. 260). The hearing officer concluded that the impairment met the

definition of a disability during the period of January 10, 2000, through July 31, 2003. Id.

However, the hearing officer held that due to medical improvement, after July 31, 2003, the

Claimant’s diabetes no longer meets or equals a listed impairment. Id. Further, the hearing

officer found that the Claimant does not have a severe mental impairment. Id. 

The Plaintiff argues that with respect to the claimed psychological and psychiatric

impairments, the hearing officer improperly accepted a Global Assessment of Functioning

(“GAF”) rating of 60 by Dr. Kerr, a non-psychiatrist, while rejecting a much lower GAF

rating of 42 by a qualified evaluating psychiatrist, Dr. Buckner. As a result, the Plaintiff

argues, the hearing officer’s findings are insufficient to support his conclusion that the

Claimant is not disabled. 

A. Juvenile Diabetes

The Plaintiff argues that with respect to the Claimant’s disability resulting from

juvenile diabetes mellitus, the hearing officer improperly discounted the blood sugar journals

kept by the Claimant’s mother which demonstrated recent and recurring episodes of

hypoglycemia. 

To justify his denial of benefits, the hearing officer must adequately support his

determination that the Claimant’s condition does not meet or medically equal the applicable

listing. 20 C.F.R. § 416.926(a) (2004); Monroe v. Barnhart, 2006 WL 839367, 6 (D. Del.

2006). The hearing officer acknowledged that the medical expert in this case testified that

the claimant has type I brittle diabetes. (Tr. 261). The listing of impairments is set forth in

20 C.F.R. Pt. 404, Subpt. P, App. 1. The listing for juvenile diabetes states:

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 The documentation required by 109.00C is as follows: 

Documentation. Description of characteristic history, physical

findings, and diagnostic laboratory data must be included.

Results of laboratory tests will be considered abnormal if

outside the normal range or greater than two standard deviations

from the mean of the testing laboratory. Reports in the file

should contain the information provided by the testing

laboratory as to their normal values for that test. 

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109.08 Juvenile diabetes mellitus (as documented in 109.00C)1

 requiring

parenteral insulin. And one of the following, despite prescribed therapy:

A. Recent, recurrent hospitalizations with acidosis; or

B. Recent, recurrent episodes of hypoglycemia; or

C. Growth retardation as described under the criteria in 100.02

A or B; or

D. Impaired renal function as described under the criteria in

106.00ff.

(emphasis added). 

The Claimant in this case has “difficult to control” insulin dependant juvenile

diabetes. (Tr. 261). Thus, in order to be entitled to benefits, the Claimant only had to show

that she experienced one of the criteria set forth in subsections A through D, despite

prescribed therapy. If the evidence in record establishes, as the Plaintiff contends, that the

Claimant experienced “recent, recurrent episodes of hypoglycemia,” despite prescribed

treatment, the Claimant’s medical condition meets or equals listing 109.08 and she is entitled

to an award of benefits. 

The hearing officer found that “the claimant has a history of treatment for Insulin

dependant diabetes mellitus with episodes of hyperglycemia and hypoglycemia” and that the

Claimant underwent treatment for “recurrent otitis media during the time period beginning

January 10, 2000, through July 31, 2003.” (Tr. 260). These findings formed the basis of the

hearing officer’s conclusion that the Claimant was disabled during the time period from

January 10, 2000, through July 31, 2003. (Tr. 262). 

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The Social Security Commission’s medical expert, Dr. Kerr, agreed that a reading

below 70 mg/dl constitutes an “episode of hypoglycemia.” The Plaintiff in this case provided

the hearing officer with a journal of the Claimant’s daily blood sugar levels. (Tr. 575).

According to the journal, the Claimant experienced 30 episodes of blood sugar levels at or

below 50 mg/dl, and another 116 episodes of blood sugar levels at or below 70 mg/dl

between August 1, 2003, and September 16, 2004. (Tr. 490-93, 494-98, 500, 502, 504-07,

509-10, 512-13, 515-28, 531-38, 540, 542-43, 548, 551, 553). Thus, the Claimant

experienced a total of 146 hypoglycemic episodes during this same time frame. (Tr. 490-93,

494-98, 500, 502, 504-07, 509-10, 512-13, 515-28, 531-38, 540, 542-43, 548, 551, 553).

This meets the listing’s requirement that the Claimant experience “recent, recurring episodes

of hypoglycemia.” 

The medical expert testified that the Claimant did not meet or equal the listing for

juvenile diabetes because she did not experience complications related to her episodes of

hypoglycemia and hyperglycemia. (Tr. 262). The hearing officer properly rejected this

conclusion after noting that 109.08 does not require evidence of complications. Id. 

Nevertheless, the hearing officer found, without citing to any medical evidence or

testimony, that the “claimant has experienced significant improvement since July 31, 2003.”

Id. The hearing officer’s holding relies exclusively on the fact that there are no medical

records that show that the Claimant has low blood sugar readings. Specifically, the hearing

officer states: 

no medical practitioner or provider mentions findings indicating that the

claimant has a listing level or equivalent impairment after July 31, 2003.

Therefore, based on the totality of the evidence, and with particular emphasis

on the ongoing medical evidence, the undersigned finds the claimant’s diabetes

mellitus does not meet or medically equal the criteria of a specific impairment

as published in the Childhood listings, with particular consideration of Listing

109.08B...

Id. 

In fact, there is evidence to the contrary, the blood sugar journal kept by the

Claimant’s mother. Because minors are often unable to unable to adequately describe their

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symptoms, a hearing officer is directed to accept as a statement of these symptoms the

“description given by the person most familiar with the individual, such as a parent, other

relative, or guardian.” 20 C.F.R. § 416.928(a). In this case, the Plaintiff is the Claimant’s

primary care-giver and her testimony, including her journal of the Claimant’s blood sugar

levels, comprised a significant portion of the record created at the administrative hearing. 

Ultimately, the hearing officer must consider the extent to which Claimant’s alleged

symptoms, as described at the hearing, can reasonably be accepted as consistent with

objective medical and other evidence. 20 C.F.R. §§ 404.1529, 416.929. However, the

medical expert testified that the Plaintiff did a good job taking records and even stated that

“I should compliment the mother on the records. She has done an excellent job in taking care

of this child and recording her medication and recording her blood sugar findings...” (Tr.

572). When asked by the hearing officer if there are any conflicts with the medical evidence

in record, Dr. Kerr stated “no.” (Tr. 572). 

The hearing officer did not discredit the Plaintiff’s testimony, or her journal of the

Claimant’s blood sugar levels. In fact, the journal was applauded by the expert as extremely

well kept. Moreover, the medical records reflect only the brief period of time when the

Claimant was hospitalized. The journal, which has already been accepted by the expert and

the hearing officer as reliable evidence in this case, provides a daily picture of the Claimant’s

blood sugar levels over a much longer and highly relevant period of time. 

The journal reflects that the Claimant experienced over 146 hypoglycemic episodes

during the 12-month period after July 31, 2003 – the date that the hearing officer determined

that the Claimant no longer met listing 109.08B. (Tr. 490-93, 494-98, 500, 502, 504-07, 509-

10, 512-13, 515-28, 531-38, 540, 542-43, 548, 551, 553). The hearing officer’s findings of

facts are not supported by the evidence. Likewise, the Court finds that the hearing officer’s

holding that the Claimant failed to meet or equal a listed impairment due to medical

improvement after July 31, 2003, is not free from legal error. The Court, therefore, reverses

and vacates that portion of the January 3, 2005, decision of the Commissioner of Social

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Security.

To the extent that it is inconsistent with this opinion, the hearing officer’s January 3,

2005, opinion is vacated. This case is remanded for payment of benefits. 

Despite the Defendant’s contention, this Court need not engage in a functional

equivalency analysis. The Court has determined that the evidence in record establishes that

the Claimant experienced “recent, recurrent episodes of hypoglycemia,” despite prescribed

treatment. Thus, the Claimant’s medical condition meets or equals 109.08. The Claimant

has already met her burden of showing that she has a listed impairment. She is not also

required to show that she has other conditions that are the functional equivalent of a listed

impairment. The Claimant in this case is entitled to an award of benefits. No further analysis

is necessary. Alternatively, the Court finds as follows.

B. Other Alleged Impairments

The Plaintiff argues that the hearing officer made the same mistake at the hearing on

remand that it did at the initial hearing. Specifically, the Plaintiff contends that the hearing

officer failed to obtain a report from an expert that was qualified to analyze the significance

of the Claimant’s psychological difficulties. 

The Plaintiff contends that with respect to the claimed psychological and psychiatric

impairments, the hearing officer improperly accepted a GAF rating of 60 by Dr. Kerr, a

pediatrician appointed by the Commission, while rejecting a much lower GAF rating of 42

by the Claimant’s evaluating psychiatrist, Dr. Buckner. As a result, the Plaintiff argues, the

hearing officer’s findings are insufficient to support his conclusion that the Claimant is not

disabled.

The Court agrees. The hearing officer engages in a lengthy discussion of some the

evidence, including evidence provided by the Claimant’s teachers and Dr. Kerr, the

pediatrician assigned by the Commission to evaluate the Claimant. However, the hearing

officer completely fails to discuss the low 42 GAF score assigned to the Claimant by her

psychiatrist, Dr. Buckner. The scores differ by at least 20 points, and yet the hearing officer

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ignores the psychiatrist’s much lower GAF rating. Although the issues being scored were

psychological or psychiatric in nature, the hearing officer provides no explanation as to why

the score assigned by the pediatrician was accepted over the score given by the psychiatrist.

Because the hearing officer did not discuss the 42 GAF score at all, or Dr. Buckner’s

evaluation in any meaningful detail, it is impossible for this Court to determine whether the

hearing officer considered the entirety of Dr. Buckner’s evaluation and found legitimate

reasons to discredit portions of the evidence, or perhaps failed to consider the 42 GAF score

altogether. 

Given the above considerations, the Court vacates the hearing officer’s January 3,

2005, denial of benefits based on a finding that the Claimant is not mentally impaired for the

reason that it is not supported by substantial evidence and is not free from legal error.

Ordinarily, the Court would remand this case for further proceedings with respect to her

alleged mental impairment. However, because the Court has already determined that the

Claimant is disabled due to her diabetes mellitus and entitled to an award of benefits, it

would cause unnecessary delay to require the hearing officer to write another reasoned

opinion in this matter regarding the Claimant’s possible mental impairments. 

Accordingly, this case is remanded solely for the payment of benefits.

/ / /

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IT IS ORDERED GRANTING the Plaintiff’s Motion for Summary Judgment (doc.

11).

IT IS FURTHER ORDERED DENYING the Defendant’s Cross-Motion for

Summary-Judgment (doc. 18). 

IT IS FURTHER ORDERED the Commissioner of Social Security’s denial of benefits

is OVERRULED. 

IT IS FURTHER ORDERED to the limited extent that it is inconsistent with this

opinion, the hearing officer’s January 3, 2005, opinion is VACATED. 

IT IS FURTHER ORDERED this case is REMANDED for payment of benefits.

DATED this 24th day of August, 2006.

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