Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_14-cv-01209/USCOURTS-caed-2_14-cv-01209-2/pdf.json

Parties Involved:
H. B.
Plaintiff
Commissioner of Social Security
Defendant

Document Text:

1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

23 

24 

25 

26 

27 

28 

1

UNITED STATES DISTRICT COURT 

FOR THE EASTERN DISTRICT OF CALIFORNIA 

VALERIE BARTON, on behalf of H.B, a 

minor child, 

Plaintiff, 

v. 

CAROLYN W. COLVIN, Acting 

Commissioner of Social Security, 

Defendant. 

No. 2:14-cv-1209-EFB 

ORDER 

 

Plaintiff seeks judicial review of a final decision of the Commissioner of Social Security 

(“Commissioner”) denying her minor child’s application for Supplemental Security Income 

(“SSI”) child benefits under Title XVI of the Social Security Act. The parties’ cross-motions for 

summary judgment are pending. For the reasons discussed below, plaintiff’s motion is granted, 

the Commissioner’s is denied, and the matter is remanded for further proceedings. 

I. BACKGROUND 

 On July 14, 2011, plaintiff filed an application for SSI on behalf of her minor child, who 

is referred to in this order as H.B or the claimant. Administrative Record (“AR”) 127-135. The 

application was denied initially and upon reconsideration. Id. at 75-79, 83-87. On August 16, 

2012, a hearing was held before administrative law judge (“ALJ”) William Thompson. Id. at 31-

Case 2:14-cv-01209-EFB Document 24 Filed 09/30/15 Page 1 of 9
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

23 

24 

25 

26 

27 

28 

2

54. H.B. was represented by counsel at the hearing, at which he and plaintiff testified. Id. 

On October 31, 2012, the ALJ issued a decision finding that H.B was not disabled under 

section 1614(a)(3)(C) of the Act.1 Id. at 12-25. The ALJ made the following specific findings:

1. The claimant was born on October 12, 2000. Therefore, he was a school-age child on July 

14, 2011, the date application [sic] was filed, and is currently a school-age child (20 CFR 

416.926a(g)(2)). 

2. The claimant has not engaged in substantial gainful activity since July 14, 2011, the 

application date (20 CFR 416.924(b) and 416.971 et seq.). 

3. The claimant has the following severe impairments: Autism vs Asperger’s syndrome 

(Autistic Disorder) and attention deficit hyperactive disorder (20 CFR 416.924(c)). 

* * * 

 

 1

 To qualify for disability child benefits, a child under the age of 18 must have “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)(1). A three-step sequential evaluation governs eligibility for child benefits. 20 

C.F.R. § 416.924. The following summarizes the sequential evaluation: 

 Step one: Is the claimant engaging in substantial gainful 

activity? If so, the claimant is found not disabled. If not, proceed 

to step two. 

 Step two: Does the claimant have a “severe” impairment? 

If so, proceed to step three. If not, then a finding of not disabled is 

appropriate. 

 Step three: Does the claimant’s impairment or combination 

of impairments meet or equal an impairment listed in 20 C.F.R., Pt. 

404, Subpt. P, App.1? If so, the claimant is conclusively presumed 

disabled. If not, the claimant is not disabled. 

 

20 C.F.R. § 416.924. 

 At step three the determination of whether an impairment or combination of impairments 

functionally equals a listing requires the ALJ to assess the claimant in six “broad areas of 

functioning intended to capture all of what a child can or cannot do,” which are referred to as 

“domains”: “(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). To 

functionally equal the listings, the child’s “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.” 20 C.F.R. § 416.926a(a). 

Case 2:14-cv-01209-EFB Document 24 Filed 09/30/15 Page 2 of 9
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

23 

24 

25 

26 

27 

28 

3

4. The claimant does not have an impairment or combination of impairments that meets or 

medically equals the severity of one of the listed impairments in 20 CFR Part 404, Subpart 

P, Appendix 1 (20 CFR 416.924, 416.925, 416.926). 

* * * 

5. The claimant does not have an impairment or combination of impairments that 

functionally equals the severity of the listings (20 CFR 416.924(d) and 416.926a). 

* * * 

6. The claimant has not been disabled, as defined in the Social Security Act, since July 14, 

2011, the date the application was filed (20 CFR 416.924(a)). 

Id. at 15-25. 

Plaintiff’s request for Appeals Council review of the ALJ’s decision was denied on March 

24, 2014, leaving the ALJ’s decision as the final decision of the Commissioner. Id. at 1-6. 

II. LEGAL STANDARDS 

The Commissioner’s decision that a claimant is not disabled will be upheld if the findings 

of fact are supported by substantial evidence in the record and the proper legal standards were 

applied. Schneider v. Comm’r of the Soc. Sec. Admin., 223 F.3d 968, 973 (9th Cir. 2000); 

Morgan v. Comm’r of the Soc. Sec. Admin., 169 F.3d 595, 599 (9th Cir. 1999); Tackett v. Apfel,

180 F.3d 1094, 1097 (9th Cir. 1999). 

 The findings of the Commissioner as to any fact, if supported by substantial evidence, are 

conclusive. See Miller v. Heckler, 770 F.2d 845, 847 (9th Cir. 1985). Substantial evidence is 

more than a mere scintilla, but less than a preponderance. Saelee v. Chater, 94 F.3d 520, 521 (9th 

Cir. 1996). “‘It means such evidence as a reasonable mind might accept as adequate to support a 

conclusion.’” Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting Consol. Edison Co. v. 

N.L.R.B., 305 U.S. 197, 229 (1938)). 

“The ALJ is responsible for determining credibility, resolving conflicts in medical 

testimony, and resolving ambiguities.” Edlund v. Massanari, 253 F.3d 1152, 1156 (9th Cir. 

2001) (citations omitted). “Where the evidence is susceptible to more than one rational 

interpretation, one of which supports the ALJ’s decision, the ALJ’s conclusion must be upheld.” 

Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002). 

Case 2:14-cv-01209-EFB Document 24 Filed 09/30/15 Page 3 of 9
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

23 

24 

25 

26 

27 

28 

4

III. ANALYSIS 

Plaintiff argues that the ALJ erred by (1) discrediting the statement from H.B.’s teacher; 

(2) weighing the medical opinion evidence; and (3) finding that H.B.’s impairments did not meet 

or medically equal the listings. ECF No. 18-1. 

A. The ALJ Properly Rejected the Opinion of the Claimant’s Teacher 

As found by the ALJ, plaintiff’s mental and social functioning is impaired by Autism vs 

Asperger’s syndrome (Autistic Disorder) and attention deficit hyperactive disorder. Plaintiff first 

contends that the ALJ failed to give adequate reasons for rejecting the opinion provided by H.B.’s 

sixth grade teacher, Constance Dixon-Sorogane. Id. at 20-23. 

Ms. Dixon-Sorogane completed a teacher questionnaire, which required her to rate the 

claimant’s ability to function in a number of broad areas, which are often referred to as domains. 

AR 161-168; see 20 C.F.R. § 416.926a(a). She indicated that the claimant was reading at a fifth 

grade level, writing below a second grade level, and performing math between a first and second 

grade level. Id. at 161. She reported her observations that the claimant had “very serious” 

problems in acquiring and using information and attending and completing tasks. Id. at 132-163. 

Although she generally noted that he had less problems in interacting and relating with others, 

moving about and manipulating objects, and caring for himself, Ms. Dixon-Sorogane still 

assessed “very severe” problems in a number of tasks identified under these domains. 

“[I]n the evaluation of child disability cases, the opinions of a child’s teachers are highly 

probative.” Meredith ex. Rel. D.H. v. Astrue, 2011 WL 1303308, at *5 (E.D. Wash. Apr. 5, 

2011). Under the applicable regulations, teachers are considered “other sources,” see 20 C.F.R. 

§ 416.913(d), and their opinions must be considered and cannot be disregarded without comment. 

Stout v. Comm’r of Soc. Sec. Admin., 454 F.3d 1050, 1053 (9th Cir. 2006). However, in rejecting 

testimony from an “other source,” the ALJ need only give germane reasons for doing so. Molina 

v. Astrue, 674 F.3d 1104, 1111 (9th Cir. 2012). 

Plaintiff contends that the ALJ failed to explicitly explain the weight he assigned to Ms. 

Dixon-Sorogane’s statement. ECF No. 18-1 at 21. Although the ALJ did not assign a specific 

weight to Ms. Dixon-Sorogane’s statement, he did specifically state that “it seems that the 

Case 2:14-cv-01209-EFB Document 24 Filed 09/30/15 Page 4 of 9
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

23 

24 

25 

26 

27 

28 

5

claimant is perceived by . . . his teacher as functioning much lower than his actual capabilities 

suggest.” AR 18. It is clear from this statement that the ALJ rejected the functional limitations 

suggested by Ms. Dixon-Sorogane. 

In finding that Ms. Dixon-Sorogane overstated H.B.’s limitations, the ALJ relied on a 

speech and language report completed by Sara Sauseda, a speech and language pathologist. Id. 

Ms. Sauseda tested and evaluated the claimant’s social skills. Id. at 582. She found that the 

claimant’s social and emotional awareness was average to above average when compared to 

typically-developed children. Id. at 583. She found that the claimant’s speech was ageappropriate in terms of articulation, language, fluency, vocal quality, and pitch. Id. at 585. She 

also found that plaintiff had average receptive social skills (ability to identify facial expressions 

and body language), and above average expressive social skills (ability to identify and correct 

social gaffes and recognize conflicts of interpersonal communications). Id. Significantly, she 

also noted that while the results indicated that the claimant tested at the average to above average 

level, his teacher assessed him in the low range. Id. 

Thus, the speech and language report supports the ALJ’s finding that the claimant was not 

as limited as Ms. Dixon-Sorogane perceived him to be. Marci v. Chater, 93 F.3d 540, 543 (9th 

Cir. 1996) (“[T]he ALJ is entitled to draw inferences logically flowing from the evidence.”) 

(quotation omitted). The ALJ was permitted to rely on the inconsistency between Ms. DixonSorogane’s opinion and the results of Ms. Sauseda’s evaluation in rejecting this lay opinion. See 

Harris v. Colvin, 584 F. App’x 526, 528 (9th Cit.2014) (“The agency gave sufficiently ‘germane’ 

reasons for discounting the statements of various lay witnesses because they were inconsistent 

with the record . . . .”). Therefore, the ALJ provided a germane reasons for rejecting Ms. DixonSorogane’s opinion. 

Plaintiff’s motion for summary judgment does not specifically address the ALJ’s finding 

that the limitations assessed by Ms. Dixon-Sorogane were at odds with the speech and language 

report completed by Ms. Sauseda. Instead, plaintiff cites to other evidence in the record that 

purportedly supports Ms. Dixon-Sorogane’s assessment. Although the record clearly does 

contain evidence supporting plaintiff’s position, it is the ALJ’s duty to resolve any conflict in the 

Case 2:14-cv-01209-EFB Document 24 Filed 09/30/15 Page 5 of 9
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

23 

24 

25 

26 

27 

28 

6

evidence, and this court is not permitted to reweigh the evidence. Rather, the focus is on whether 

there is substantial evidence in the record that can support the ALJ’s finding. See Matney v. 

Sullivan, 981 F.2d 1016, 1019 (9th Cir. 1992) (“The trier of fact and not the reviewing court must 

resolve conflicts in the evidence, and if the evidence can support either outcome, the court may 

not substitute its judgment for that of the ALJ”). Because the ALJ provided a germane reason 

that is supported by the evidence in the record, the court will not disturb the ALJ’s finding. 

B. The ALJ Erred in Relying on the State Agency Reviewing Physician’s Opinion 

Plaintiff next argues that the ALJ failed to apply the proper legal standard in evaluating 

the medical opinion evidence. ECF No. 18-1 at 24-30. First, plaintiff argues that the ALJ failed 

to give legally sufficient reasons for rejecting the opinion of Dr. Asaikar, the claimant’s treating 

physician. Id. at 25-27. Second, plaintiff argues that in relying on the opinion of Dr. O’Brien to 

find that claimant did not meet the listings, the ALJ failed to comply with the requirements of 42 

U.S.C. § 1382c(a)(3)(I). ECF No. 18-1 at 27-30. The court declines to address plaintiff’s first 

argument because, as explained below, even assuming that the ALJ properly rejected Dr. 

Asaikar’s opinion, the ALJ failed to comply with 42 U.S.C. § 1382c(a)(3)(I) and therefore this 

matter must be remanded for further proceedings. 

42 U.S.C. § 1382c(a)(3)(I) provides, in relevant part: 

In making any determination under this subchapter with respect to 

the disability of an individual who has not attained the age of 18 

years..., the Commissioner of Social Security shall make reasonable 

efforts to ensure that a qualified pediatrician or other individual 

who specializes in a field of medicine appropriate to the disability 

of the individual (as determined by the Commissioner of Social 

Security) evaluates the case of such individual. 

In Howard ex rel. Wolff v. Barnhart, a case reviewing the denial of SSI benefits to a 

minor, the Ninth Circuit interpreted section 1382c(a)(3)(I) “to mean that the ALJ is required to 

make a reasonable effort to obtain a case evaluation, based on the record in its entirety, from a 

pediatrician or other appropriate specialist, rather than simply constructing his own case 

evaluation from the evidence in the record.” 341 F.3d 1006, 1014 (9th Cir. 2003). The court 

noted that the administrative record contained numerous reports from various experts, but 

explained that “[t]here is a distinction, however, between having an expert evaluate a claimant 

Case 2:14-cv-01209-EFB Document 24 Filed 09/30/15 Page 6 of 9
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

23 

24 

25 

26 

27 

28 

7

with respect to that expert’s particular specialty, and having an expert evaluate a claimant’s case 

in its entirety, considering all of the medical records and determining whether those indicate that 

the claimant is disabled within the meaning of the Social Security Act.” Id. at 1014 n. 2. 

Ultimately, the Ninth Circuit found that “[d]espite the various reports of doctors and specialists 

indicating their independent views of [the minor’s] situation, at no point did the ALJ have her 

case evaluated as a whole, nor did he indicate that there was a ‘case’ evaluation in the record.” 

Id. at 1014. 

In response to Howard, the Social Security Administration issued Acquiescence Ruling 

04-1(9). 69 FR 22578-03, 2014 WL 875081 (Apr. 26, 2004). That ruling provides that: 

For cases that are subject to this Ruling, ALJs and AAJs (when the 

Appeals Council makes a decision) must make reasonable efforts to 

ensure that a qualified pediatrician or other individual who 

specializes in a field of medicine appropriate to the disability of the 

individual (as identified by the ALJ or AAJ) evaluates the case of 

the individual. To satisfy this requirement, the ALJ or AAJ may 

rely on case evaluation made by a State agency medical or 

psychological consultant that is already in the record, or the ALJ or 

AAJ may rely on the testimony of a medical expert. When the ALJ 

relies on the case evaluation made by a State agency medical or 

psychological consultant, the record must include the evidence of 

the qualifications of the State agency medical or psychological 

consultant. In any case, the ALJ or AAJ must ensure that the 

decision explains how the State agency medical or psychological 

consultant's evaluation was considered. 

69 Fed. Reg. at 22,580. 

Plaintiff argues that the ALJ was not permitted to rely on Dr. O’Brien’s opinion because it 

was rendered in February 2012, before all the evidence of record was submitted, and therefore he 

did not conduct a case assessment based on all the evidence in the record. ECF No. 18-1 at 28. 

Specifically, plaintiff contends that Dr. O’Brien did not have an opportunity to review updated 

school records, Dr. Asaikar’s treating assessment, and a letter detailing the claimant’s history of 

counseling, which described the claimant’s “struggles with social phobia and anxiety . . . , 

difficulty with interpersonal relationship and inappropriate expressions of emotions . . . .” Id. 

Plaintiff also argues that the ALJ’s reliance on Dr. O’Brien’s opinion was inappropriate because 

the record does not include evidence of his qualifications. Id. at 29. 

///// 

Case 2:14-cv-01209-EFB Document 24 Filed 09/30/15 Page 7 of 9
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

23 

24 

25 

26 

27 

28 

8

The Commissioner does not dispute that Dr. O’Brien did not review the entire record, nor 

does she contend that his opinion constitutes a “case” evaluation. See Howard, 341 F.3d at 1014. 

The Commissioner also does not dispute that the record fails to include Dr. O’Brien’s 

qualifications or any evidence demonstrating that this non-examining physician “specializes in a 

field of medicine appropriate to the disability of the claimant.” See 69 Fed. Reg. at 22, 580. 

Instead, the Commissioner argues that plaintiff overlooks the fact that the claimant’s primary care 

physician, Dr. Sherman, is a pediatrician. ECF No. 22 at 15-16. The Commissioner contends 

that in light of the medical records from Dr. Sherman, plaintiff’s “allegation that the record is 

missing a comprehensive evaluation by a relevant specialist is simply untenable.” Id. at 16. The 

court disagrees. 

The record contains treatment notes from Dr. Jamie Sherman. AR 611-618. While these 

notes do not specifically identify Dr. Sherman’s medical specialty, they do suggest that she is a 

pediatrician. See id. at 611 (identifying the physician’s department as “Sssa Peds Elk Laguna”).2 

However, even assuming Dr. Sherman is a pediatrician, that fact alone does not establish 

compliance with 42 U.S.C. § 1382c(a)(3)(I). The statute does not simply require the record to 

contain evidence demonstrating the child was evaluated or treated by a pediatrician. Instead, “the 

ALJ is required to make a reasonable effort to obtain a case evaluation, based on the record in its 

entirety, from a pediatrician or other appropriate specialist.” Howard, 341 F.3d at 1014. The 

eight pages of treatment notes from Dr. Sherman do not indicate that he conducted a case 

evaluation based on all the evidence in the record. Nor do they establish that Dr. Sherman 

reviewed the numerous education records or all of the claimant’s medical records. Rather, they 

simply document Dr. Sherman’s treatment of the claimant, including his medical findings and 

prescribed course of treatment. AR 611-618. 

Thus, the record does not establish that the ALJ made a reasonable effort to obtain a case 

evaluation by an appropriate specialist based on the entire record. Accordingly, the court finds 

 2

 The Commission cites a Sutter Health website, which indicates that there is a 

pediatrician by the name of Dr. Jamie Sherman that works at a Sutter Health facility off Laguna 

Blvd. in Elk Grove, California. See http://sutterhealth.org/dr-jamie-sherman.html 

Case 2:14-cv-01209-EFB Document 24 Filed 09/30/15 Page 8 of 9
1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

22 

23 

24 

25 

26 

27 

28 

9

that the ALJ failed to comply with the requirements of 42 U.S.C. § 1382c(a)(3)(I), and therefore 

this matter must be remanded for further proceedings.3 

IV. CONCLUSION 

 Accordingly, it is hereby ORDERED that: 

 1. Plaintiff’s motion for summary judgment is granted; 

 2. The Commissioner’s cross-motion for summary judgment is denied; 

 3. The matter is remanded for further proceedings consistent with this order; and 

 4. The Clerk is directed to enter judgment in the plaintiff’s favor. 

DATED: September 30, 2015. 

 

3

 Because the matter must be remanded to permit the ALJ to acquire the necessary case 

evaluation, the court declines to address plaintiff’s remaining argument. 

Case 2:14-cv-01209-EFB Document 24 Filed 09/30/15 Page 9 of 9