Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-alsd-1_03-cv-00884/USCOURTS-alsd-1_03-cv-00884-0/pdf.json

Parties Involved:
Jo Anne B. Barnhart
Defendant
Cynthia Skanes
Plaintiff

Document Text:

IN THE UNITED STATES DISTRICT COURT

FOR THE SOUTHERN DISTRICT OF ALABAMA

SOUTHERN DIVISION

CYNTHIA SKANES, o/b/o, *

JESSICA F. SKANES, *

*

Plaintiff, *

*

vs. * Civil Action No. 03-00884-P-B

*

JO ANNE B. BARNHART, *

Commissioner of * 

Social Security, *

*

Defendant. *

REPORT AND RECOMMENDATION

Plaintiff brings this action under 42 U.S.C.§ 1383 (c)(3)

seeking judicial review of a final decision of the Commissioner

of Social Security denying her claim for supplemental security

income benefits. This action was referred to the undersigned

for report and recommendation pursuant to 28 U.S.C. §

636(b)(1)(B). The parties waived oral argument. Upon careful

consideration of the administrative record and the parties’

argument as raised in their memoranda, the undersigned

respectfully recommends that the decision of the Commissioner be

affirmed.

I. Procedural History 

Plaintiff’s mother, Cynthia Skanes, protectively filed, on

behalf of her daughter, Plaintiff Jessica Skanes, an application

for supplemental security income benefits on June 12, 2000,

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 The reconsideration stage was eliminated from this case pursuant to

testing modifications to the disability determination procedures. 20 C.F.R.

§§ 404.906, 404.966, 416.1406 and 416.1466. 

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alleging that Plaintiff has been disabled since June 1, 1997 due

to a tumor in her left hip and scoliosis of the spine. (Tr. 56-

57, 58, 62-65, 85, 95, 110-111). Plaintiff’s application was

initially denied on December 27, 200, and a Request for Hearing

was filed on February 21, 2001. (Tr. 39-41, 42-43).1

Administrative Law Judge (ALJ) Irwin W, Coleman, Jr. conducted

a hearing on September 26, 2001, which was attended by

Plaintiff, Plaintiff’s mother, Cynthia Skanes, and Plaintiff’s

attorney. (Tr. 199-210). On February 6, 2002, ALJ Coleman

entered an unfavorable decision wherein he found that Plaintiff

has the severe impairments of a femoral neck fibrous dysplasia

on the left side and a six degree levoscoliosis, and that her

impairments, when considered individually, or in combination, do

not meet or medically equal a Listing, or result in a

functionally equivalent level of severity of a listed

impairment. (Tr. 9-19). On October 31, 2003, Plaintiff’s

request for review was denied by the Appeals Council, thus

making the ALJ’s decision the final decision of the Commissioner

of Social Security. (Tr. 4-6). The parties agree that this case

is now ripe for review and is properly before this Court

pursuant to 42 U.S.C. § 1383 (c)(3).

Case 1:03-cv-00884-P-B Document 17 Filed 03/14/05 Page 2 of 25
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II. Background Facts

Plaintiff, Jessica F, Skanes, was born on December 7, 1988,

and was twelve years old at the time of the administrative

hearing on September 26, 2001. (Tr. 202). Plaintiff lives with

her mother, Cynthia Skanes, and was entering the seventh grade

at the time of the administrative hearing. (Tr. 203).

According to Plaintiff’s mother, Plaintiff has problems with her

left hip, and underwent hip surgery three years earlier because

a tumor had deteriorated the bone that joins her hip together.

Id. Plaintiff’s mother testified that Plaintiff was in a body

cast for two or three months after the surgery, and missed a

school term. Plaintiff’s mother further testified that

Plaintiff’s doctor has advised Plaintiff will need to undergo

another surgery, but he is delaying surgery as long as Plaintiff

can tolerate the pain. Id. Plaintiff’s mother testified that

she sought a second opinion from another doctor who agreed that

Plaintiff needs another surgery. (Tr. 203-204, 207-208). 

According to Plaintiff’s mother, as a result of her

condition, Plaintiff has to be very careful, avoid any kind of

activity, and use her crutches when she starts limping really

bad or when her hip starts to hurt. (Tr. 203, 206-207).

Plaintiff’s mother further testified that Plaintiff can only

take Tylenol for her pain because she has to avoid medication

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 Plaintiff’s mother testified that when Plaintiff was in fifth grade,

the cold weather caused Plaintiff’s hip to hurt so bad that she was unable to

go to school the last two or three weeks, and the pain caused her back to

start hurting. (Tr. 208). She further testified that Plaintiff is unable to

stretch her leg when it is cold, and stays in bed most of the time. (208-

209). 

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that may upset her bone. She also testified that she does not

allow Plaintiff to ride the bus to school when she starts

limping a lot, and that when Plaintiff is in pain, she sometimes

cuts the hair off her dolls’ heads. (Tr. 207). She further

testified that at one time Plaintiff was irritated because she

could not participate in any school activities; however, she is

adjusting better, and Plaintiff’s school has really worked with

her by allowing Plaintiff extra time to get to class. (Tr. 204,

207). 

Plaintiff testified that her hip causes her a lot of pain,

and that the pain is exacerbated by cold weather.2 (Tr. 205).

Plaintiff further testified that she has to use crutches once a

week because of the pain. According to Plaintiff, before her

surgery, she was a cheerleader, played with her classmates

during physical education class and played in her neighborhood.

Plaintiff testified that she misses being able to participate in

activities and that her inability to participate has caused

problems with her friends. (Tr. 205-206). 

The ALJ determined that Plaintiff has not engaged in

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substantial gainful activity since her alleged onset of

disability. (Tr. 13, 18). The ALJ further determined that

Plaintiff has the severe impairments of a femoral neck fibrous

dysplasia on the left side and a six degree levoscoliosis. Id.

Next, the ALJ concluded that Plaintiff does not have an

impairment or combination of impairments which meet or medically

equal the criteria for any of the impairments listed in 20

C.F.R. Pt. 404, App. 1., Subpt. P. (Tr. 13-14, 19). The ALJ

also found Plaintiff’s subjective complaints of pain and

allegations of disability, as well as the testimony of

Plaintiff’s mother regarding the severity of Plaintiff’s

condition, are not fully credible nor supported by objective

medical evidence. (Tr. 18-19). The ALJ then determined that

Plaintiff’s impairments, when considered individually or in

combination, are not functionally equivalent to a listed

impairment, and Plaintiff is not disabled. Id. 

III. Issues on Appeal

1. Whether the ALJ erred in finding that Plaintiff’s

impairments do not meet or medically equal a Listing, or result

in severity that is functionally equivalent to a Listing?

2. Whether the ALJ erred in finding that Plaintiff had

marked limitations in only one domain of functioning?

3. Whether the ALJ erred by finding Plaintiff’s subjective

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 This court’s review of the Commissioner’s application of legal

principles is plenary. Walker v. Bowen, 826 F.2d 996, 999 (11th Cir. 1987).

6

complaints and the testimony of Plaintiff’s mother were not

credible without providing any viable reasoning or explanation.

IV. Analysis

A. Standard of Review

In reviewing claims brought under the Act, this court’s role

is a limited one. The court’s review is limited to determining:

1) whether the decision of the Secretary is supported by

substantial evidence, and 2) whether the correct legal standards

were applied. Martin v. Sullivan, 894 F.2d 1520, 1529 (11th Cir.

1990).3 A court may not decide the facts anew, reweigh the

evidence, or substitute its judgment for that of the

Commissioner. Sewell v. Bowen, 792 F.2d 1065, 1067 (11th Cir.

1986). The Commissioner’s findings of fact must be affirmed if

they are based upon substantial evidence. Brown v. Sullivan,

921 F.2d 1233, 1235 (11th Cir. 1991); Bloodsworth v. Heckler, 703

F.2d 1233, 1239 (11th Cir. 1983)(Substantial evidence is defined

as “more than a scintilla but less than a preponderance,” and

consists of “such relevant evidence as a reasonable person would

accept as adequate to support a conclusion.”). In determining

whether substantial evidence exists, the court must view the

record as a whole, taking into account evidence favorable as

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 First, a determination must be made as to whether the claimant is

engaging in substantial gainful activity. If so, a determination will be made

that the claimant is not disabled and the claim will not be reviewed further.

If it is determined that the claimant is not engaging in substantial gainful

activity, next the claimant’s physical or mental impairment(s) will be

considered first to see if the claimant has an impairment or combination of

impairments that is severe. If the claimant’s impairment(s) is not severe, a

determination will be made that the claimant is not disabled and the claim

will not be reviewed further. Finally, if the claimant’s impairment(s) is

severe, the claim will be reviewed further to determine if the claimant has an

impairment(s) that meets, medically equals, or functionally equals the

listings. If the claimant has such an impairment(s), and it meets the duration

requirement, the claimant will be found disabled. If the claimant does not

have such an impairment(s), or if it does not meet the duration requirement,

the claimant will be found not disabled. 20 C.F.R. § 416.924(a)(2005); see

also Shinn v. Comm’r of Soc. Sec., 391 F.3d 1276, 1278-1279 (11th Cir. 2004). 

7

well as unfavorable to the Commissioner’s decision. Chester v.

Bowen, 792 F.2d 129, 131 (11th Cir. 1986); Short v. Apfel, 1999

U.S. Dist. Lexis 10163 (S.D. Ala.).

B. Discussion

The definition of “disabled” for children under 18 is:

An individual under the age of 18 shall be

considered disabled for the purposes of this

subchapter 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)(2004); see also 20 C.F.R. §

416.906 (2005). The Social Security regulations provide a

three-step sequential evaluation process for determining

childhood disability claims. See 20 C.F.R. § 416.924(a)(2005).4

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At step one, a plaintiff’s age and work activity, if any,

are identified. At step two, the severity of the impairments is

identified. Under the regulations a severe impairment is one

that is more than “a slight abnormality or a combination of

slight abnormalities that causes no more than minimal functional

limitations.” 20 C.F.R. § 416.924(c)(2005). If it is determined

that a plaintiff has a severe impairment, the plaintiff must

then establish that the impairment results in marked and severe

functional limitations. 42 U.S.C. § 1382c(a)(3)(C)(i)(2004).

The regulations set forth that an “impairment(s) causes marked

and severe functional limitations if it meets or medically

equals the severity of a set of criteria for an impairment in

the listings, or if it functionally equals the listings.” 20

C.F.R. § 416.924(d) (2005). 

If the functional limitations caused by a plaintiff’s

impairment do not meet or medically equal any listing, then the

Commissioner must determine whether the impairment or

combination of impairments results in limitations which

functionally equal the criteria for a listing. 20 C.F.R.

§416.926a(a)(2005) (“If you have a severe impairment or

combination of impairments that does not meet or medically equal

any listing, we will decide whether it results in limitations

that functionally equal the listings. By ‘functionally equal

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 The regulation sets forth the methods for using each domain to

evaluate functional equivalence to a listing. 20 C.F.R. § 416.926a(f)(2005). 

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the listings,’ we mean that your impairment(s) must be of

listing-level severity; i.e., it must result in ‘marked’

limitations in two domains of functioning or an ‘extreme’

limitation in one domain, as explained in this section.”). 

To make this determination, the Commissioner must address

six domains of development or functioning: (i) Acquiring and

using information; (ii) Attending and completing tasks; (iii)

Interacting and relating with others; (iv) Moving about and

manipulating objects; (v) Caring for yourself; and, (vi) Health

and physical well-being. 20 C.F.R. § 416.926a(b)(1)(i-vi)(2005).

If a plaintiff has an extreme limitation in one domain or marked

limitation in two domains, a finding of functional equivalence

will be made. 20 C.F.R. § 416.926a(d),(e),(f) (2005).5

An extreme limitation of function occurs when the impairment

“interferes very seriously with [plaintiff’s] ability to

independently initiate, sustain or complete activities”. 20

C.F.R. § 416.926(e)(3)(i)(2005). This limitation may occur

whether the impairment limits one activity or the cumulative

effect of plaintiff’s impairments limit several activities, and

is given to the “worst limitations.” Id. Also, the regulations

state that an extreme limitation is “the equivalent of the

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The regulations further discuss this standard in terms of functioning

according to chronological age, the use of standardized test scores to measure

functioning in a domain, and for the sixth domain of functioning, health and

physical well-being, the frequency of exacerbation of the impairment. 20

C.F.R. § 416.926(e)(3)(i)-(iv)(2005). Additionally, 20 C.F.R. § 416.926(e)(4)

explains the method for consideration of standardized test scores. 

7

 The regulations further discuss this standard in terms of functioning

according to chronological age, the use of standardized test scores to measure

functioning in a domain, and for the sixth domain of functioning, health and

physical well-being, the frequency of exacerbation of the impairment. 20

C.F.R. § 416.926(e)(2)(i)-(iv)(2005). Additionally, 20 C.F.R. §

416.926(e)(4) explains the method for consideration of standardized test

scores. 

10

functioning we would expect to find on standardized testing with

scores that are at least three standard deviations below the

mean.” Id. 6 

A marked limitation of function occurs when the impairment

“interferes seriously with [plaintiff’s] ability to

independently initiate, sustain or complete activities”. 20

C.F.R. § 416.926(e)(2)(i)(2005). This limitation may occur

whether the impairment limits one activity or the cumulative

effect of plaintiff’s impairments limit several activities. Id.

Also, the regulations state that a marked limitation is “the

equivalent of the functioning we would expect to find on

standardized testing with scores that are at least two, but less

than three, standard deviations below the mean.” Id. 7 

In the case sub judice, the ALJ applied the above standards

for evaluating child supplemental security income disability

claims, and found that Plaintiff has not engaged in substantial

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 In assessing a child’s functional limitations, relevant factors

outlined in 20 C.F.R. §§ 416.924a, 416.924b and 416.929 are considered. See

20 C.F.R. 416.926a(a). The factors include, and the ALJ considered: (1) how

the Plaintiff’s functioning compares to the functioning of children the same

age who do not have impairments; (2) the combined effects of Plaintiff’s

multiple impairments; (3) how well Plaintiff can sustain and complete

activities, including the amount of help or adaption she needs, and the

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gainful activity since her alleged onset of disability, and that

she suffers from the severe impairments of a femoral neck

fibrous dysplasia on the left side and a six degree

levoscoliosis. (Tr. 13, 18). Then, as noted supra, proceeding

to the next step, the ALJ found that these impairments, when

considered individually, or in combination, do not meet or

medically equal a criteria listed in 20 C.F.R. Pt. 404, Subpt.

P., App. 1. (Tr. 13-14, 19). The ALJ further determined that

Plaintiff’s impairments, when considered individually or in

combination, are not functionally equivalent to a listed

impairment, and Plaintiff is not disabled. (Tr. 18-19). 

Plaintiff argues, without discussion or elaboration, that

the ALJ erred in finding that her impairments do not meet or

medically equal a listed impairment. Plaintiff also attacks the

ALJ’s finding that her impairments are not functionally

equivalent to a Listing. Specifically, Plaintiff argues that

the ALJ failed to take into account all the facts as they relate

to factors considered in determining whether Plaintiff’s

impairments are functional equivalent to a Listing.8 In

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effects of structured or supportive settings; (4) functioning in unfamiliar

settings, such as a one-on-one examination conducted by a consulting

psychologist or physician; (5) early intervention and school programs; the

impact of illness and limitations that interfere with Plaintiff’s activities

over time; and the effects of treatment (including medications and other

treatment). 

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considering the relevant factors, Plaintiff argues that the ALJ

should have found she has extreme limitations in the domain of

moving about and manipulating objects since Plaintiff has such

difficulty walking. Plaintiff further argues, assuming

arguendo, that the ALJ was correct in finding that Plaintiff has

only marked limitations in the functional domain of moving and

manipulating objects, the ALJ should have also found marked

limitations in the functional domains of interacting and

relating with others, or health and physical well-being. 

In support of her contentions, Plaintiff notes that she is

no longer able to participate in school events, physical

education class, cheerleading, or any other type similar

activity, and that this has had an extreme effect on her social

activities, her interaction with others, and her overall wellbeing. Plaintiff further contends that her mother’s testimony,

the questionnaires completed by her school, and the medical

records provide further support and corroboration regarding the

severity of her impairments and pain. 

In determining that Plaintiff’s impairments, when considered

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 Listing § 101.03 requires: 

Reconstructive surgery or surgical arthrodesis of a major weightbearing joint, with inability to ambulate effectively, as defined

in 101.00B2b, and return to effective ambulation did not occur, or

is not expected to occur, within 12 months of onset.

§ 101.00B2b provides as follows:

(1) Definition. Inability to ambulate effectively means an

extreme limitation of the ability to walk; i.e., an impairment

that interferes very seriously with the child’s ability to

independently initiate, sustain, or complete activities. 

Ineffective ambulation is defined generally as having insufficient

lower extremity function (see 101.00J) to permit independent

ambulation without the use of a hand-held assistive device(s) that

limits the functioning of both upper extremities. . . .

. . .

(3) How we assess inability to ambulate effectively for older

children. Older children, who would be expected to be able to

walk when compared to other children the same age who do not have

impairments, must be capable of sustaining a reasonable walking

pace over a sufficient distance to be able to carry out ageappropriate activities. They must have the ability to travel ageappropriately without extraordinary assistance to and from school

or a place of employment. Therefore, examples of ineffective

ambulation for older children include, but are not limited to, the

inability to walk without the use of a walker, two crutches or two

canes, the inability to walk a block at a reasonable pace on rough

or uneven surfaces, the inability to use standard public

transportation, the inability to carry out age-appropriate school

activities independently, and the inability to climb a few steps

at a reasonable pace with the use of a single hand rail. The

ability to walk independently about the child’s home or a short

distance at school without the use of assistive devices does not,

in and of itself, constitute effective ambulation.

13

individually or in combination, do not meet or medically equal

a Listing, the ALJ considered listed impairments related to the

musculoskeletal system at listing 101.02 through 101.08, and

specifically found that Plaintiff’s impairments do not meet or

medically equal the requirements of § 101.03.9 Then, in

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determining that Plaintiff’s impairments are not functionally

equivalent to a listed impairment, the ALJ found that Plaintiff

has no functional limitations in the domains of acquiring and

using information, attending to and completing tasks,

interacting and relating with others, and health and physical

well-being. The ALJ further determined that, considering the

combined effects of Plaintiff’s impairments, Plaintiff has

marked limitations in the domain of moving about and

manipulating objects. (Tr. 15-16). As the ALJ found marked

limitations in only one domain of functioning, he determined

that Plaintiff’s impairments are not functionally equivalent to

a listed impairment, and therefore, Plaintiff is not disabled.

In making his determination, the ALJ considered, and relied

upon, records submitted by Plaintiff’s school. (Tr. 16-17,

112-126). One of Plaintiff’s teachers described Plaintiff as

being a typical student and reported that Plaintiff’s

functioning compares favorably with the functioning of other

children her age and that absenteeism was not a problem. (Tr.

18, 112-114). The report further indicated that Plaintiff:

functions academically with average ability and performs as most

other normal children; works well independently and responds

appropriately to teachers; has no problems with social skills;

has no problems with any age-appropriate self-help skills; is

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unable to participate in physical education as a result of her

limp; does not require any special devices to accommodate her

physical needs; and has not exhibited any sudden worsening in

functioning or behavior. (Tr. 17, 112-114). 

The ALJ determined that Plaintiff’s subjective complaints

of pain and allegations of disability, as well as the testimony

of Plaintiff’s mother regarding the severity of Plaintiff’s

condition, are not fully credible nor supported by objective

medical evidence. (Tr. 18-19). The ALJ found that the record

established that frequent visits to a physician or health care

provider are not required. (Tr. 16). To that end, the ALJ

observed that Plaintiff underwent surgery on August 12, 1997,

for an incisional biopsy with fibular allograft because of a

lytic lesion of the left femoral neck, which Plaintiff tolerated

well and resulted in Plaintiff being in a Spica cast for four

weeks. (Tr. 16, 130-138, 184, 185). Follow-up examinations in

September and October of 1997 indicate that Plaintiff was doing

well and her wound was healing appropriately. (Tr. 183-184).

The ALJ determined that the medical records substantiate that

Plaintiff made a slow, but good recovery following surgery, and

that upon examination on numerous subsequent occasions,

treatment notes indicate that Plaintiff was doing well and

experienced only occasional pain. (Tr. 16, 144-167, 170-187,

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195-198). 

Specifically, the ALJ observed that Plaintiff’s treating

physician, Dr. Prasit Nimityongskul, M.D., opined that Plaintiff

was doing well when examined on January 8, 1998, and indicated

that “[e]verything seem[ed] to be growing well, and the graft

seem[ed] to be giving support. It seem[ed] like the superior

cortex of the femoral neck [was] also thickening.” (Tr. 182).

Plaintiff only complained of occasional aches and pain, and her

physical examination revealed that her wounds were healed and

dry; she had good range of motion; no instability; and she was

neurologically intact. Id. In fact, Dr. Nimityongskul’s

treatment notes for March 5, 1998 reflect that Plaintiff’s “mom

and dad say she is really not limiting her activities. She is

riding a bike, running around, and is being pretty active.”

(Tr. 181). Dr. Nimityongskul’s physical examination of

Plaintiff revealed that she had full range of motion; all her

wounds were healed; she had no signs of trauma or swelling; she

was neurologically in tact; and x-rays of her hip showed no

expansion of the lesion, maybe some subtle decrease in size.

Id. 

Plaintiff was described as doing “quite well” upon

examination by Dr. Nimityongskul on June 9, 1998, and her

examination revealed that her wound was well healed, she had

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good range of motion, and x-rays of Plaintiff’s hip, pelvis and

lateral showed good incorporation of the graft. (Tr. 180). Dr.

Nimityongskul again opined, based on an October 1998

examination, that Plaintiff was improving and healing; although,

she reported having occasional pain with limping. (Tr. 179). 

Plaintiff’s examination on February 4, 1999 revealed that

the allograft was amalgamating with the bone, the lesion

appeared to be healing satisfactorily, Plaintiff had no symptoms

at that point and was advised to refrain from any contact

sports. (Tr. 178). Upon examination on August 31, 1999, Dr.

Nimityongskul’s treatment records indicate that Plaintiff was

slowly healing, and x-rays revealed progressive consolidation of

the graft area. Although Plaintiff reported having a few

occasional episodes of sharp pain, no such episodes were

experienced upon examination on August 31, 1999. During the

examination, Plaintiff was ambulatory without a walking aid and

found to have no limits; Plaintiff’s Trendelenburg test was

negative; and her spine was clinically straight. (Tr. 176).

Similarly, the ALJ observed that Dr. Nimityongskul opined that

Plaintiff was doing well on November 4, 1999, and his

examination of her revealed that Plaintiff had good range of

motion, and ambulated well at the clinic without problems.

Plaintiff reported experiencing hip pain “off and on at times”,

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and was prescribed Vioxx as a result. (Tr. 175).

When Plaintiff presented for examination on May 18, 2000,

her mother reported that Plaintiff’s hip was barely tender, “but

the main problem is her lower lumbar spine. This does not slow

her down at all though and is mostly musculoskeletal in origin.”

(Tr. 171). The physical examination revealed that Plaintiff

had: excellent rotation, flexion and extension of her back and

good forward flexion of her hips at 90 degrees, internal

rotation to 20, and external rotation to 45 degrees; evidence of

gentle lumbar curve of about 10 to 15 degrees and some

hyperlordosis; weak rectus spine muscles; and x-rays of the

spine were normal. (Tr. 171-172). Dr. Nimityongskul prescribed

physical therapy for back exercises and abdominal strengthening

and lumbar-sacral corset. (Tr. 171, 173). Upon his examination

of Plaintiff on August 24, 2000, Dr. Nimityongskul reported that

Plaintiff was doing well, had no increased pain in her hip, and

her x-rays showed no active progress change or any active

radiolucency in the femoral neck. (Tr. 170). Dr. Nimityongskul

felt mature bone was slowly filing in, and recommended that

Plaintiff continue to refrain from physical education class,

contact sports and strenuous activities and that she return for

a follow-up exam in six (6) months. Id.

Plaintiff’s Trendelenburg test was again negative upon

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examination on February 22, 2001, and according to Dr.

Nimityongskul, Plaintiff was able to one leg stand on either

side; squat very well; had good motor strength throughout; range

of motion was forward flexion to 100 degrees, 10 degrees of

internal rotation and 30 degrees of external rotation on the

hip; x-rays showed excellent incorporation of the fibular graft;

and she had a little bit of lucency on the inferior portion of

her femoral neck, and some reconstitution of her tension lines

in the femoral neck. (Tr. 195). Treatment notes indicate that

Plaintiff’s mother reported that Plaintiff had been doing okay,

had refrained from participating in any contact sports or

running, did not complain of any groin pain, and had only

occasionally complained of thigh tenderness. Id. Based on his

examination of Plaintiff, Dr. Nimityongskul recommended yearly

follow-up visits to make sure Plaintiff was doing well. Id. 

Upon a follow-up examination on June 14, 2001, Plaintiff

reported that she had experienced pain with activities during

the prior several weeks, and Dr. Nimityongskul decided to

monitor Plaintiff’s condition and recommended that Plaintiff do

limited activities and perform protective weight bearing. (Tr.

198). However, the ALJ observed that treatment notes dated

October 8, 2001 again indicated that Plaintiff experienced only

occasional pain, and had in fact been asymptomatic over the

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prior three months. Further, the notes reflect that Dr.

Nimityongskul specifically noted that no surgery was recommended

at that point. (Tr. 197).

Moreover, like Dr. Nimityongskul, physicians at the Barial

Clinic opined that Plaintiff was doing well upon examination on

January 11, 2000. (Tr. 17, 153). To that end, the ALJ observed

that since Plaintiff’s alleged onset of disability, follow-up

examinations repeatedly indicate that Plaintiff was doing well

and only suffered from occasional pain, and that she had in fact

made an excellent recovery from her surgery by the time she

sought disability benefits.

Based on the above, the undersigned finds that the ALJ did

not err in finding that Plaintiff does not have an impairment,

or combination of impairments, that meet or medically equal a

Listing or result in severity functionally equivalent to a

listed impairment, and the decision is supported by substantial

evidence. As correctly observed by the ALJ, the report

submitted by Plaintiff’s teacher, as well as record medical

evidence, undermine Plaintiff’s contention that her impairments

are functionally equivalent to a listed impairment. As noted

supra, one of Plaintiff’s teachers described Plaintiff as being

a typical student and reported that Plaintiff’s functioning

compares favorably with the functioning of other children her

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21

age and that absenteeism was not a problems. (Tr. 112-114).

The teacher further indicated that Plaintiff: functions

academically with average ability and performs as most other

normal children; works well independently and responds

appropriately to teachers; has no problems with social skills;

has no problems with any age-appropriate self-help skills; does

not require any special devices to accommodate her physical

needs; and has not exhibited any sudden worsening in functioning

or behavior. (Tr. 17, 112-114). While Plaintiff argues that

the ALJ provided no basis for finding Plaintiff’s and her

mother’s testimony not credible regarding the degree of pain and

functional limitations experienced by Plaintiff, the undersigned

disagrees. Indeed, in affording little weight to the proffered

testimony, the ALJ observed:

On numerous occasions, the claimant’s treating

physician reported that the minor child is doing well,

and he also indicated that the claimant experiences

only occasional pain. For example, the minor child

experienced several weeks of pain in June 2001,

however, the record indicates that this pain subsided.

The treating physician reported, in October 2001, that

the minor child experiences only occasional pain and

that she had been basically asymptomatic for a threemonth period of time.

(Tr. 18). As correctly observed by the ALJ, record medical

evidence reveals Plaintiff’s examinations repeatedly indicate

that Plaintiff was doing well and only suffered from occasional

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22

pain. (Tr. 153, 170, 175, 179-184, 195). To that end, the ALJ

opined:

By October 2001, the treating physician reported that

the claimant experienced only occasional pain. He

indicated that the minor child has been basically

asymptomatic over the prior three months. He

indicated, at that time, that he did not recommend

further surgery. The Administrative Law Judge notes

that this entry tends to contradict the testimony

received into evidence at the hearing.

(Tr. 17). Additionally, upon examination on March 5, 1998,

treatment notes indicate that Plaintiff’s parents reported that

Plaintiff was not limiting her activities, and was riding a

bike, running around, and being pretty active. (Tr. 181). The

medical evidence, coupled with the school records, clearly

support the ALJ’s finding Plaintiff’s and her mother’s testimony

regarding the degree of pain and functional limitations

experienced by Plaintiff was not entirely credible. 

Moreover, while Plaintiff contends that her condition

adversely affected her relationship with her friends and overall

interaction with others, the record reveals that Plaintiff’s

mother reported that Plaintiff: talks with family and friends;

has friends her own age; can make friends; generally gets along

with her mother, school teachers and other adults; keeps out of

trouble; and obeys rules. (Tr. 77, 80, 103, 105-106).

Plaintiff’s mother also testified that Plaintiff was adjusting

better to her condition. (Tr. 204). As Plaintiff’s impairments

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23

do not meet or medically equal a Listing, and record evidence

does not reflect marked impairments in at least two areas of

functioning, or extreme impairment in at least one area of

functioning, the undersigned finds that the ALJ did not err in

concluding that Plaintiff is not disabled. See 20 C.F.R. §

416.926a(d),(e),(f) (2005). 

V. Conclusion

For the reasons set forth, and upon careful consideration

of the administrative record and memoranda of the parties, it is

recommended that the decision of the Commissioner of Social

Security denying Plaintiff’s claim for supplemental security

income benefits be AFFIRMED.

The attached sheet contains important information regarding

objections to this report and recommendation.

DONE this 14th day of March, 2005.

 s/ SONJA F. BIVINS 

UNITED STATES MAGISTRATE JUDGE

Case 1:03-cv-00884-P-B Document 17 Filed 03/14/05 Page 23 of 25
MAGISTRATE JUDGE’S EXPLANATION OF PROCEDURAL RIGHTS

AND RESPONSIBILITIES FOLLOWING RECOMMENDATION

AND FINDINGS CONCERNING NEED FOR TRANSCRIPT

1. Objection. Any party who objects to this recommendation or

anything in it must, within ten days of the date of service of

this document, file specific written objections with the clerk

of court. Failure to do so will bar a de novo determination by

the district judge of anything in the recommendation and will

bar an attack, on appeal, of the factual findings of the

magistrate judge. See 28 U.S.C. § 636(b)(1)(c); Lewis v. Smith,

855 F.2d 736, 738 (11th Cir. 1988). The procedure for

challenging the findings and recommendations of the magistrate

judge is set out in more detail in SD ALA LR 72.4 (June 1,

1997), which provides, in part, that:

A party may object to a recommendation entered by a

magistrate judge in a dispositive matter, that is, a

matter excepted by 28 U.S.C. § 636(b)(1)(A), by filing

a “Statement of Objection to Magistrate Judge’s

Recommendation” within ten days after being served

with a copy of the recommendation, unless a different

time is established by order. The statement of

objection shall specify those portions of the

recommendation to which objection is made and the

basis for the objection. The objecting party shall

submit to the district judge, at the time of filing

the objection, a brief setting forth the party’s

arguments that the magistrate judge’s recommendation

should be reviewed de novo and a different disposition

made. It is insufficient to submit only a copy of the

original brief submitted to the magistrate judge,

although a copy of the original brief may be submitted

or referred to and incorporated into the brief in

support of the objection. Failure to submit a brief

in support of the objection may be deemed an

abandonment of the objection.

A magistrate judge’s recommendation cannot be appealed to a

Court of Appeals; only the district judge’s order or judgment

can be appealed.

2. Opposing party’s response to the objection. Any opposing

party may submit a brief opposing the objection within ten (10)

days of being served with a copy of the statement of objection.

Fed. R. Civ. P. 72; SD ALA LR 72.4(b). 

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3. Transcript (applicable where proceedings tape recorded).

Pursuant to 28 U.S.C. § 1915 and Fed.R.Civ.P. 72(b), the

magistrate judge finds that the tapes and original records in

this action are adequate for purposes of review. Any party

planning to object to this recommendation, but unable to pay the

fee for a transcript, is advised that a judicial determination

that transcription is necessary is required before the United

States will pay the cost of the transcript.

 s / SONJA F. BIVINS

UNITED STATES MAGISTRATE JUDGE

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