United States Court of Appeals

FOR THE EIGHTH CIRCUIT

_____________

No. 02-3420MN

_____________

Janice Collins, on behalf of *

Tyrone Williams, *

*

Appellant, *

* On Appeal from the United

v. * States District Court

* for the District of

* Minnesota.

Jo Anne B. Barnhart, Commissioner *

of Social Security, *

*

Appellee. *

___________

Submitted: March 11, 2003

Filed: July 8, 2003

___________

Before WOLLMAN, RICHARD S. ARNOLD, and MURPHY, Circuit Judges.

___________

RICHARD S. ARNOLD, Circuit Judge.

Janice Collins applied to the Social Security Administration for benefits on

behalf of her allegedly disabled eleven-year-old son, Tyrone Williams. Her

application was rejected, and she requested a hearing before an Administrative Law

Judge. The ALJ rejected her claim, finding that Tyrone’s medication allowed him to
1

The Hon. Joan E. Lancaster, United States District Judge for the District of

Minnesota, accepting the Report and Recommendation of the Hon. Raymond L.

Erickson, United States Magistrate Judge. 

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function adequately. Ms. Collins filed the appropriate appeals. Her claim was

ultimately denied by the District Court1

 on August 23, 2002. For the reasons given

below, we affirm the decision of the District Court.

I.

Tyrone Williams’s mother had him evaluated because she was concerned about

his disruptive behavior at school and at home, which had started the year before. A

specialist, Richard Auger, diagnosed Tyrone with Attention Deficit Hyperactivity

Disorder (ADHD) in July 1998. Tyrone’s doctor, Philip Overby, put Tyrone on

Ritalin, a common medication for ADHD. In September of that year, Ms. Collins

applied, on Tyrone’s behalf, for disability benefits. 

Ms. Collins filled out four SSA reports from September 1998 through the fall

of 1999, which recorded swings in Tyrone’s behavior depending on whether he was

taking Ritalin or not. For example, in September of 1998, Ms. Collins reported that

Tyrone was hard to control when he did not take his medication. He hit other

children, he threw things, and he did not pay attention in class. While on medication,

however, he did his homework and played well with other children. In November,

Ms. Collins reported that her son’s behavior had improved considerably. He played

team sports, had no physical problems, helped around the house, obeyed safety rules,

and did what he was told. Tyrone’s third-grade teacher, Dawn Hall, echoed these

observations in a report she completed around the same time. Ms. Hall noted that

when Tyrone was on his medication he was calm, friendly, and hardworking. When

he was not on medication he became loud and belligerent, and did not do as he was

told. Ms. Hall also observed that Tyrone was performing at a first-grade level.
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Dr. Craig Barron, a licensed psychologist, evaluated Tyrone in December of

1998. Ms. Collins told him that Tyrone did his chores around the house, took care

of his own physical needs like bathing and dressing, and enjoyed going to the park.

Ms. Collins attributed this improved behavior to the Ritalin. Dr. Barron described

Tyrone as being an articulate speaker with logical thoughts. Dr. Barron tested Tyrone

and believed that Tyrone’s IQ was much closer to average than Dr. Overby had

suggested. Dr. Barron thought that a learning disability rather than a low IQ might

be the cause of Tyrone’s poor academic performance. Dr. Barron confirmed that

Tyrone had ADHD, but he described it as “undifferentiated type” ADHD, a diagnosis

not in the Diagnostic Statistical Manual of Mental Disorders (DSM-IV). 

Physicians from two state agencies reaffirmed Dr. Overby’s diagnosis of

ADHD in January and April of 1999. They stated that Tyrone’s condition had been

rendered non-severe by medication. Also in April of 1999, both Ms. Hall and Bill

Deno, an instructional integration specialist, filed reports on Tyrone suggesting that

while his behavior remained decent, it appeared that the Ritalin’s effect was

lessening. Ms. Collins again filed a report, her third, which also suggested that

Tyrone’s behavior was degenerating. Dr. Overby responded by increasing Tyrone’s

medication. That fall, Ms. Collins filled out her final evaluation, in which she

basically restated what she had said in November of 1998: Tyrone could not

concentrate and had conflicts with others when off his medication, but when on his

new dosage of medicine, he got along well with others and did what he was told.

Tyrone’s new fourth-grade teacher, Richard Willegalle, described Tyrone as being

hyperactive at times but as having an average ability to interact with others and go

from one task to another.

An administrative hearing was held in November of 1999. Both sides

presented testimony regarding Tyrone’s functioning. Of special relevance to this

appeal is the testimony of Dr. Jones Adkins, a psychologist, who testified as a neutral

medical expert about how Tyrone’s ability to manage in five different functional areas
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was affected by ADHD. Dr. Adkins testified that, with medication, Tyrone showed

less than marked limitation in the areas of cognitive/communicative functioning,

social functioning, and personal functioning. The doctor thought Tyrone had greater

trouble in the area of concentration, persistence, and pace, but still thought that

Tyrone’s limitation was less than marked. Dr. Adkins testified that Tyrone had no

limitations in his motor functioning. The doctor further testified that even without

medication, Tyrone’s functioning in these areas was still less than markedly limited.

Relying heavily on this testimony, the ALJ concluded that Tyrone was not disabled.

Ms. Collins appealed the adequacy of the evidence to support these findings. A

Magistrate Judge issued a Report and Recommendation suggesting the affirmance of

the ALJ’s decision, and the District Court adopted that Magistrate’s report in full.

This appeal followed.

II.

There are many ways to demonstrate that a child is disabled. 20 C.F.R.

§ 416.926a(b) (1999). Only one of them is at issue in this appeal. If the ALJ had

found that Tyrone had an extreme impairment in one functional area or marked

impairments in two functional areas, then he would have been entitled to benefits.

20 C.F.R. § 416.926a(b)(2) (1999). The five relevant functional areas are: (1)

cognitive/communicative functioning; (2) social functioning; (3) concentration,

persistence, and pace; (4) personal functioning; and (5) motor functioning. Ms.

Collins does not challenge the ALJ’s conclusions about (4) personal functioning, or

(5) motor functioning, so we need not address them. 

She does challenge whether there was sufficient evidence to support the ALJ’s

conclusions that Tyrone did not suffer marked limitations in the three disputed areas.

A marked limitation is a serious limitation that interferes with a person’s ability to

function in an area. 20 C.F.R. § 416.926a(c)(3)(i)(C) (1999). Our scope of review

is narrow; we must affirm the Commissioner’s decision so long as it conforms to the
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law and is supported by substantial evidence on the record as a whole. Qualls v.

Apfel, 158 F.3d 425, 427 (8th Cir. 1998). Substantial evidence is less than a

preponderance, but enough that a reasonable mind might find adequate to support the

ALJ’s conclusion. Johnson v. Apfel, 240 F.3d 1144, 1147 (8th Cir. 2001). 

After examining each disputed area in turn, we conclude that the ALJ’s

determinations were supported by substantial evidence in the record. We reach this

result primarily because impairments that are controllable by medication do not

support a finding of total disability. See Johnson, 240 F.3d at 1148. As will be

illustrated below, there is evidence, much of it from Ms. Collins herself, that suggests

that when Tyrone took his medication, his functioning, in all contested categories,

was adequate. 

Cognitive/communicative functioning refers to a person’s ability to think, solve

problems, recall information, and interact with the world. 20 C.F.R.

§ 416.926a(c)(5)(iv)(A) (1999). Whatever his condition before starting Ritalin, after

taking the medication, it is clear that Tyrone was able to hold conversations with

others, tell jokes, explain his actions, and interact with his teachers. By December of

1998, he was scoring in the average range on the Weschler Intelligence Scale for

Children. He was promoted to the fourth grade. He was able to communicate with

his teachers and with experts interviewing him. There is some evidence to the

contrary. However, there is substantial evidence here to support the ALJ’s conclusion

that Tyrone’s cognitive/communicative functioning was not markedly impaired.

With regard to social development, 20 C.F.R. § 416.926a(c)(5)(iv)(C) (1999),

it is evident that Tyrone’s functioning depended on whether he was on his medication

or not. When taking Ritalin, he enjoyed normal relationships with his classmates,

siblings, and adults. His fourth-grade teacher described his ability to interact with

others as average. Ms. Collins argues that the ALJ did not take into consideration

that Tyrone is not continually medicated. Even looking at his worst behavior, it is
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arguable whether his social development was markedly impaired. Tyrone has never

had any trouble with the police. Despite discipline problems, he has not been

removed from normal classes or expelled. He has never threatened extreme violence.

In short, his behavior has been disruptive — not incapacitating. There is significant

evidence in the record that supports the ALJ’s determination that Tyrone did not

suffer limitations that markedly impaired his ability to function socially.

The final area of contention regards Tyrone’s concentration, persistence, and

pace. 20 C.F.R. § 416.926a(c)(5)(iv)(E) (1999). The same facts mentioned above are

equally relevant here. According to his teacher, Tyrone was hardworking, could

follow multi-step instructions, and had a fair ability to concentrate and remain on

task, when on medication. Off his medication, he was disruptive in class,

disorganized, and able to follow only basic instructions. Again, there is adequate

evidence in the record to support the ALJ’s conclusion that, because of his

medication, Tyrone’s concentration, persistence, and pace, while impaired, were not

markedly impaired.

As a final point, Ms. Collins argues that the ALJ’s decision was fatally flawed

because it relied on the testimony of Dr. Adkins, who, in her mind, did not understand

Tyrone’s condition because he diagnosed Tyrone with “undifferentiated-type

ADHD,” a diagnosis of ADHD not in the DSM-IV. She alleges that his testimony,

therefore, is inherently unreliable and inadequate to support the ALJ’s decision.

We disagree for two reasons. First, Dr. Adkins never claimed that Tyrone had

undifferentiated-type ADHD; that was Dr. Barron’s diagnosis. Dr. Adkins merely

referred to this diagnosis and admitted that he was not sure what was meant by

undifferentiated-type ADHD. Second, the diagnosis has minor significance one way

or the other. Grebenick v. Chater, 121 F.3d 1193, 1199 (8th Cir. 1997) (“A treating

physician's opinion is generally entitled to substantial weight; however, such an

opinion is not conclusive in determining disability status.”). The regulations say,
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“[w]e will not consider your impairment to be [disabling] solely because it has the

diagnosis of a listed impairment. It must also have the findings shown in the Listing

for that impairment,” 20 C.F.R. § 416.925(d). Thus, the dispositive question remains

whether Tyrone’s functioning in various areas is markedly impaired, not what one

doctor or another labels his disorder. 

There was adequate evidence in the record to support the ALJ’s decision that

Tyrone’s functioning in all of the areas laid out in the regulations was not markedly

impaired because of his ADHD. For that reason, the decision of the District Court is

affirmed. 

A true copy.

Attest:

CLERK, U.S. COURT OF APPEALS, EIGHTH CIRCUIT.