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OP I NI ONA l t hough t he docke t s i n t he Soci al Secur i t yA dm i ni s tr at i on, D i s t r i ctC our tand 1 t hi s cour ts pel l appel l ant ’ s name as J ar ami l l a, the under l y i ng r ecor d s how s hername as J a ra m illo a n d w e u s e th e la tte r h e re . SL O V I T E R , C i r cui tJ udge. M ar i a J ar ami l l o, on behal f of he rs on, G ui l l erm o M es a ( “M es a”) , appea l s the 1 A pr i l 30, 2004 O r derof the U ni t ed St at es D i s t r i ctC our tforthe D i s t r i ctof N ew J er s ey aff i r m i ng t he C om m i s s i onerof Soci al Secur i t y ’ s deni al of M es a’ s appl i cat i on forSoci al S e c u ri ty In c o m e (“ S S I” ) b e n e f its . T h e D is tr ic t C o u rt h a d ju ri s d ic tio n u n d e r 4 2 U .S .C . § 405( g) . W e have j ur i s di ct i on t o r evi ew the fi nal or derof the D i s t r i ctC our tunder28 U. S . C. § 1 2 9 1 . F o rt h e r e a s o n s g i v e n b e l o w, we wi l l a f f i r m. I. B eca us e the part i es ar e fa m i l i arw i t h t he ca s e, w e nee d notpr es enta det ai l ed re c ita tio n o f

th e f a c ts . O n A pr i l 28, 1999, J ar ami l l o fi l ed an a ppl i cat i on forSSI pa ym ent s w i t h t he Soci al Se c ur i t yA dmi ni s t r a t i on ( “ SSA ” ) c l a i mi ng tha tM e s a s uf fe r e d f r om a d i s a bi l i t y . The SSA deni ed hercl ai m on N ovember4, 1999 and aga i n aft err econs i der at i on on Sept ember11, 2 0 0 0 . Ja ra m ill o th e n re q u e ste d a h e a rin g b e f o re a n A d m in istra tiv e L a w Ju d g e (“ A L J” ) to re v ie w h e r a p p lic a tio n . A . E vi dence Pr es ent ed J ar ami l l o pr es ent ed evi dence of M es a’ s m edi cal exami nat i ons and ps y chol ogi cal eval uat i ons s how i ng t hathe s uffe r ed fr om G ui l l ai n- B arr e s yndr om e, tr ans i enthand t r emors , noctur nal enur es i s , A t t ent i on D efi ci tH yper act i vi t yD i s or der( “A D H D ”) , and a3

le a rn in g d is o rd e r. 1 . M e d ica l R e p o rts T he medi cal r eport s s how ed thatM es a w as s i x y ear s ol d w hen he w as di agnos ed w i t h G ui l l ai n- B arr e Syndr om e, “an a cut e pr ogr es s i ve pol y - neur opathychar act er i zed by peri od m uscl e w eakn ess and n um bn ess. ” A -26. R epo rt s fr om M esa’ s treat i ng ph y si ci ans, i s s u e d e a c h y e a rf

r o m 1 9 9 9 t h r o u g h 2 0 0 1 , s t a t e d th a tM e s a s u f f e r e d f r o m a neur ol ogi cal l y - bas ed l earni ng di s abi l i t y , an att ent i on pr obl em, abnorm al r efl exes , and t r emors i n hi s r i ghthand. H e w as di agnos ed w i t h, i nt eral i a, A D H D , enur es i s , and a l earni ng di s abi l i t y . O ne tr eat i ng phy s i ci an r epor t ed thatM es a’ s i m pai r m ent s w er e an

“ e x tr e m e ” lim ita tio n o n h is c o n c e n tr a tio n , p e rs is te n c e , o r p a c e . 2. St at e A gencyE val uat i on O n Sept ember3, 1999, a St at e A gencyPsy chol ogi cal C ons ul t antr evi ew ed the r ecor d and r eport ed thatM es a’ s i m pai r m ent s w er e s ever e bec aus e theycaus ed “mar ked” l i m i t at i on i n hi s conce nt r at i on, per s i s t ence , orpace . H ow ever , the C ons ul t antconcl uded t hatt he i m pai r m ent s di d notm eet , m edi cal l yequal , orfunct i onal l yequal the s ever i t yof a “Li s t i ng, ” pr ovi ded fori n 20 C . F. R . § 404, Subpar tP, A pp. 1. B etw een A ugus t10, 2000 and A ugus t15, 2000, M es a s ubm i t t ed t o a phy s i cal exami nat i on and a ps y chi atr i c eva l uat i on, both atthe r eques tof the SSA . T he phy s i cal exami nat i on r ecor ded norm al gr ow t h par amet er s . T he ps y chi atr i c exa m i nerfound that M es a had A D H D , butw as abl e t o s t ayfocus ed fora l ong per i od of t i m e. O n A ugus t30,4

2000, t he St at e A gencyPsy chol ogi cal C ons ul t antcompl et ed a s econd e val uat i on. T he C o n su ltan t co n c lu d e d th a t M e sa ’s A D H D w a s s e v e re , b u t th a t itf a iled to m e e t, m e d ica lly e q u a l, o r f

u n c tio n a lly e q u a l a L is tin g . O n M ay17, 2001, M es a’ s cas e managerr epor t ed thatM es a w as at t endi ng a s peci al cl as s forbi l i ngual , m ul t i - di s abl ed i ndi vi dual s . T he ca s e manageral s o r epor t ed that M es a’ s G ui l l ai n- B arr e Syndr om e, w hi ch had oc curr ed af t eran i nfec t i on, br oughtabout s t r ong fat i gue and pa i n i n hi s l ow erextr emi t i es . M es a r emai ned bel ow gr ade l evel , and e x h ib ite d s ym p to m s o f

A D H D , in c lu d in g h yp e ra c tiv ity a n d a s h o rt a tte n tio n s p a n . 3. Jer seyC i t yP sy cho m et ri c and L earni ng D i sabi l i t yT est O n A pr i l 26, 1999, t he J er s eyC i t ySchool Sy s t em per form ed a norm at i ve ps y chomet r i c and l earni ng di s abi l i t yt es ton M es a. I tfound thatM es a exhi bi t ed a p p ro p ria te s o c ial s k ill s, a p lea sa n t d e m e a n o r, se n sitiv ityto w a rd h is p e rf o rm a n c e in s c h o o l, s o m e w h a t r e a lis tic g o a ls f o r t h e f u tu re , a n d a g o o d v e rb a l c o m m a n d o f S p a n is h . Ho we v e r , i tn o t e d a d e l a yi n t h e d e v e l o p me n to f M e s a ’ s a d a p t i v e / s e l f

- h e l p s k i l l s . On M ay26, 1999, M es a t ook an I Q t es t , w hi ch pl ace d hi m i n t he bor der l i ne r ange of i nt el l ectual funct i oni ng and he w as det erm i ned t o be el i gi bl e fors peci al educa t i on. 4. T eac herE val uat i ons M es a’ s t eac hercompl et ed a que s t i onnai r e on J une 11, 1999, and r epor t ed that M es a w as notw or ki ng atgr ade l evel , w or ki ng i ndepende nt l y , appl y i ng know l edge, or f o l l o wi n g i n s t ru c t i o n s . Ho we v e r , t h e t e a c h e rn o t e d th a tM e s a d i d n o th a v e p r o b l e ms5

comm uni cat i ng w i t h hi s peer s orpart i ci pat i ng i n s chool phy s i cal act i vi t i es ( butnot ed that M es a t i r ed ea r l y ) . Fi nal l y , t he t eac hernot ed thatM es a’ s behavi orw as s at i s fac t orybut th a t h is a tten tio n sp a n w a s v e ryp o o r a n d h e w a s u n a b le to c o n c e n tra te a n d c o m p lete t asks. O n M ay25, 2000, a s econd t eac herques t i onnai r e r epor t ed thatM es a per form ed poor l y , fai l ed t o compl et e as s i gnm ent s , and s uffe r ed fr om a l anguage barr i er . T he t eac her al s o r epor t ed thatM es a coul d notcontr ol hi s behavi or , conce ntr at e, payat t ent i on, or c o m p le te ta s k s . B . T he A L J ’ s D eci s i on A ft eran or al hear i ng conduct ed on Sept ember12, 2001, the A L J found thatM es a w as not ent i t l ed to So ci al S ecuri t yben efi t s, and sum m ari zed h i s fi nd i ng s as fol l ow s: 1 ) T h e c laim a n t h a s n o t en g a g e d in su b sta n tial g a in f u l ac tiv itysin c e h is appl i cat i on dat e of A pr i l 28, 1999. 2) T he medi cal evi dence es t abl i s hes thatthe cl ai m anthas the fol l ow i ng s ever e i m pai r m ent : hi s t or yof G ui l l ai n- B arr e s yndr om e, tr ans i enthand tr em o rs, n o cturn al en u resis, A D H D , an d a lea rnin g d isord er. 3 ) T h e c laim a n t h a s n o im p a irm e n t th a t m e e ts o r m e d ica llyo r f u n c tio n a lly e qu a l s t he c r i t e r i a of

a nyi mpai r mentl i s t e d i n Appe nd i x 1 , Sub pa r tP, R egul at i ons N o. 4. 4 ) T h e c laim a n t h a s n o t b e e n “ d isa b led ” a t an ytim e th ro u g h th e d a te o f th is d ec isi o n (20 C . F . R . § 4 1 6 . 9 2 4 (d)). A - 32. T he Soci al Secur i t yA ppeal s C ounci l deni ed r evi ew , the D i s t r i ctC our taff i r m ed,§ 1382c( a) ( 3) ( C ) ( I ) pr ovi des thata cl ai m antunderthe age of 18 i s cons i der ed 2 d isa b led if

“ th a t in d iv id u a l h a s a m e d ica llyd e ter m in a b le p h y sic a l o r m e n tal im p a irm e n t, w h ich re su lts in m a rk e d a n d se v e re f u n c tio n a l li m itatio n s, a n d w h ich c a n b e e x p e c ted to r es ul ti n death orw hi ch has l as t ed orcan be expec t ed t o l as tfora cont i nuous per i od of n o t le s s th a n 1 2 m o n th s .” Id . 6 a n d M e sa h a s f

iled a tim e lya p p e a l. I I . W e “r evi ew t he A L J ’ s deci s i on underthe s ame st andar d of r evi ew as the D i s t r i ct C our t , t o det erm i ne w hethert her e i s s ubs t ant i al evi dence on t he r ecor d t o s uppor tthe A L J’s d ec isi o n . ” B u rne ttv . C o m m ’r of S o c. S ec . A d m in., 2 2 0 F . 3 d 1 1 2 , 1 1 8 (3d C ir . 20 00 ); see al so 42 U . S . C . § 4 05 (g) . S ub st anti al evidence is “such rel evan tevidence as a r eas onabl e mi nd m i ghtacc eptas adequa t e t o s uppor ta conc l us i on. ” Pi er ce v. U n d e rw o o d , 4 8 7 U .S . 5 2 2 , 5 6 4 -6 5 (1 9 8 8 ). T o q u a lifyf

o r S S I b e n e f

its u n d e r th e S o c ial S e c u rityA c t, M e sa m u st d e m o n stra te t hathe i s “di s abl ed” w i t hi n t he meani ng of 42 U . S. C . § 1382. A n exami nerm akes the 2 fol l ow i ng t hr ee- s t ep eva l uat i on, found i n 20 C . F. R . §§ 416. 924, 416. 926a, t o det erm i ne w h e th e r a c laim a n t u n d e r th e a g e o f 1 8 is d isa b led , an d th e re f o re e n tit led to S S I b e n e f its: A t s te p o n e , if

th e c la im a n t is e n g a g e d in s u b s ta n tia l g a in f u l a c tiv ity, s/h e is n o t d is a b le d . A ts t ep tw o, i f the cl ai m anti s notengage d i n s ubs t ant i al gai nful act i vi t y , then the exami nerw i l l det erm i ne w hethert he phy s i cal orm ent al i m pai r m enti s “s ever e. ” A ts t ep t hr ee, i f the i m pai r m enti s s ever e, t he exa m i nerw i l l det erm i ne w hetherthe i m pai r m ent me e t s , me d i c a l l ye q u a l s o rf u n c t i o n a l l ye q u a l s a n I mp a i r me n tLi s t i n g f o u n d i n 2 0 C. F . R.“M arked” Li m i t at i on i n a part i cul ardom ai n i s defi ned as : “[W ] hen y our 3 i m pai rm ent ( s ) i nt er fer es s er i ous l yw i t h y ourabi l i t yt o i ndepende nt l yi ni t i at e, s us t ai n, or compl et e ac t i vi t i es . . . . ‘ M arked’ l i m i t at i on al s o m eans a l i m i t at i on thati s ‘ m or e than m oder at e’ but‘ l es s t han extr eme. ’ I ti s the equi val entof the func t i oni ng w e w oul d expec t t o fi nd on s t andar di zed t es t i ng w i t h s cor es thatar e atl eas t , tw o, butl es s than thr ee, stan d ard d ev iat ion s b elow the m ea n . ” 2 0 C . F . R . § 4 1 6 . 9 2 6 a(e )(2)(i ). “Ext r eme” L i m i t at i on i n a part i cul ardom ai n i s defi ned as : “[W ] hen y our 4 i m pai rm ent ( s ) i nt er fer es verys er i ous l yw i t h y ourabi l i t yt o i ndepende nt l yi ni t i at e, s us t ai n, orcompl et e ac t i vi t i es . Y ourday - t o- dayfunct i oni ng m aybe verys er i ous l yl i m i t ed w hen y o u ri mp a i r me n t ( s ) l i mi ts e v e r a l a c t i v i t i e s . . . . I ti s th e e q u i v a l e n to f th e f u n c t i o n i n g we w oul d expec tt o fi nd on s t andar di zed t es t i ng w i t h s cor es thatar e atl eas tthr ee de vi at i ons b elow the m ea n . ” 2 0 C . F . R . § 4 1 6 . 9 2 6 a(e )(3)(i ). 7 § 404, Subpar tP, A pp. 1. If th e c h ild ’s im p a ir m e n t d o e s n o t m e d ic a lly m e e t a lis tin g u n d e r 2 0 C .F .R . § 41 6. 90 2, t he ex am i ner m ustdeterm i ne w hetherthe im pairm ent functi on al l yequ al s a l i s t i ng byeval uat i ng t he chi l d’ s s i x dom ai ns of func t i oni ng: 1) acqui r i ng and us i ng i nform at i on; 2) at t endi ng and compl et i ng t as ks ; 3) i nt er act i ng and r el at i ng w i t h other s ; 4) m ovi ng aboutand mani pul at i ng obj ect s ; 5) car i ng fory our s el f; and 6) heal t h and phy s i cal w el l bei ng. See 20 C . F. R . § 416. 926a( b) ( 1) . A n i m pai r m entfunct i onal l yequal s a l i s t i ng i f the chi l d has “mar ked” l i m i t at i ons i n atl eas ttw o dom ai ns , oran “e xtr eme” 3 l i m i t at i on i n atl eas tone domai n.

4 A ppl y i ng t he above t es t , t he A L J found thatM es a w as notdi s abl ed. A l t hough M esa sat i sfi ed the r equ i rem ents atst ep o ne an d st ep tw o, the A L J det erm i ned that M esa coul d notm eett he r equi r ement s ats t ep thr ee be caus e he di d “nothave a n i m pai r m entor combi nat i on of i m pai r m ent s t hatm eet s orm edi cal l yequal s i n s ever i t ythe cr i t er i a of a ny8

im p a ir m e n t in s e c tio n 1 1 1 .0 0 , 1 1 2 .0 0 , o r a n yo th e r i m p a ir m e n t in th e L is tin g s .” A -2 9 . F u rth e rm o re , the A L J d e ter m in e d th a t M e sa ’s im p a irm e n ts d id n o t “f u n c tio n a llye q u a l” o n e o f th e listin g s b e c a u se h e d id n o t su f f e r “ e x tre m e ” lim itatio n s in a n yo f th e six funct i onal dom ai ns and onl ys uffe r ed “mar ked” l i m i t at i ons i n one ( hi s abi l i t yt o att end an d co m p let e task s). O n a p p e a l, Ja ra m ill o a rg u e s th a t th e A L J f a iled to a rticu late a n e v id e n tiary ba sis to s uppor thi s fi ndi ng t hatM es a’ s i m pai r m ent s w er e not“medi cal l yequi val ent ” t o any L i s t ed I m pai r m entats t ep thr ee. See C ot t erv. H arr i s , 642 F. 2d 700, 704 ( 3d C i r . 1981) ( s t at i ng t hatt he A L J s houl d m ake “ a cl earand s at i s fac t oryexpl i cat i on of the bas i s on w hi ch [hi s orherconcl us i on] r es t s . ”) . She r el i es on ourr ece nthol di ng i n B urnet tv. C o m m issi o n er, 22 0 F . 3 d 1 1 2 , 1 1 9 -20 (3d C ir . 2 0 0 0 ), w h ere w e h eld th at an A L J’s expl anat i on ats t ep 3- - - s t at i ng i n t ot o, that“[a ] l t hough [the appl i cant ] has es t abl i s hed that s he s uffe r s fr om a s ever e muscul os kel et al [i m pai r m ent ] , s ai d i m pai r m entfai l ed t o equal t he l evel of s ever i t yof anydi s abl i ng condi t i on cont ai ned i n A ppendi x I , Subpar tP of S o c ial S e c u rityR e g u latio n N o . 4 ” ---w a s “ h o p e les slyin a d e q u a te” b e c a u se it “m e re ly s t at ed a s um m aryconcl us i on, ” ther ebypr ecl udi ng “meani ngful j udi ci al r evi ew . ” I d. at 1 1 9 (i n te rn a l q u o ta tio n s o m itte d ). B ur netti s di s t i ngui s habl e. I n B urnet t , the A L J fai l ed t o i dent i fyw hatL i s t i ng he w a s re f e rrin g to o r w h a t ev id e n c e h e re lied o n to c o m e to h is c o n c lu sio n . B yc o n tra st, in t he pr es entcas e, t he A L J cl ear l yi dent i fi ed the s peci fi c Li s t i ngs t o w hi ch he w as r efe rr i ng,9

i . e. , 111. 00 ( pert ai ni ng t o neur ol ogi cal i m pai r m ent s ) and 112. 00 ( per t ai ni ng t o m ent al di s or der s ) , and di s cus s ed the evi dence pr es ent ed atl ength. W e ther efor e conc l ude thatt he A L J’s re a so n in g a t th e “ m e d ica l eq u iv a len t” le v e l o f S tep 3 w a s s u f

f icie n t an d p e rm its m eani ngful r evi ew . See J ones v. B arnhar t , 364 F. 3d 501, 505 ( 3d C i r . 2004) ( s t at i ng t hat par t i cul arl anguage orform ati s notr equi r ed; r atherthe A L J m us tonl ypr ovi de a “s uffi ci entdevel opm entof the r ecor d and expl anat i on of fi ndi ngs t o perm i tm eani ngful re v ie w ” ). W e l i kew i s e hol d t hatt he A L J ’ s expl anat i on atthe “f unct i onal l i m i t at i ons ” l evel of s t ep 3 w as bot h s at i s fac t or yand s uppor t ed bys uffi ci entevi dence . T he A L J ’ s deci s i on expl i ci t l yl i s t ed the evi dence he r el i ed upon foreac h of the s i x funct i onal dom ai ns and adequa t el yar t i cul at ed a s uffi ci entevi dent i arybas i s forhi s deci s i on. W e r ej ect J ar ami l l o’ s ar gum entt hatt he A L J comm i t t ed r ever s i bl e err orbynotgi vi ng contr ol l i ng w ei ghtt o M es a’ s t r eat i ng phy s i ci an’ s opi ni on thathe had a n “extr eme l i m i t at i on i n t he ar ea of conce nt r at i on, per s i s t ance , orpace . ” A - 28. A s not ed bythe A L J , the opi ni ons of t h e t r e a t i n g p h y s i c i a n a n d t h e S t a t e Ag e n c yP s y c h o l o g i c a l Co n s u l t a n td i f f e r e d . As we hel d i n K entv. Schw ei ker , 710 F. 2d 110, 115 n. 5 ( 3d C i r . 1983) , a r efe r ee mayr ej ectt he concl us i ons of the tr eat i ng phy s i ci an i f he “ w ei gh[s ] [thos e conc l us i ons ] agai ns tthe other r el evantevi dence and expl ai n[s ] w hycert ai n evi dence has been a cce pt ed and w hyot her evi dence has been r ej ect ed. ” See a l s o A l l en v. B ow en, 881 F. 2d 37, 41 ( 3d C i r . 1989) ( hol di ng t hatw her e a tr eat i ng phy s i ci an’ s opi ni on i s contr adi ct ed bya cons ul t i ngphy s i ci an, “the A L J m us texpl ai n on t he r ecor d t he r eas ons forr ej ect i ng the opi ni on of the

tre a tin g p h y sic ian ” ). T h e A L J h a s a d e q u a telyd o n e so in th e p re se n t ca se , an d h is concl us i on i s s uppor t ed bys ubs t ant i al evi dence . Fi nal l y , w e r ej ectJ ar ami l l o’ s ar gum entthatthe A L J fai l ed t o gi ve hert es t i m ony reg ard ing M esa ’s su b

jecti v e c o m p lai n ts of

p ain th e re q u ir ed co n side rati o n . A claim an t’ s s ubj ect i ve s t at ement s aboutpai n orot hers ym pt om s , w i t houtm or e, cannotbe the bas i s for a d isab il ity . S ee 4 2 U . S . C . § 1 3 8 2 c(3 )(A ). T h e A L J ad eq u atelyex p lai n ed that Jara m il lo’s t es t i m onyw as i ncons i s t entw i t h t he medi cal evi dence as w el l as the r epor t s s ubm i t t ed by M esa’ s t eache rs and otherexam i ners. III . Fort he above r eas ons , w e hol d t hatthe A L J ’ s deci s i on i s s uppor t ed bys uffi ci ent e v id e n c e in th e re c o rd , an d th a t h e a rticu late d a su f f icie n t ev id e n tiary ba sis f o r h is deci s i on. T he dec i s i on of the D i s t r i ctC our ti s aff i r m ed.