2008 D e c i sion s O p inion s of the U nit e d S t at e s C our t of Appe al s for the Third C irc uit 3-11-2008 

# Morri son v . C omm S o ci al S ecurity P re c e de nt i al or N on-P re c e de nt i al : N on-P re c e de nt i al D ocke t N o . 06-4282

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__________ N o. 06- 4282

__________ S T A C E Y M O R R IS O N , on behal f of D enze l M orr i s on, A ppel l ant

v. CO M M I SS I ON ER O F S OC I AL SECU RI TY

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on J anuary31, 2008 B efore: R E N D E L L and C H A G A R E S , C i rcui tJudg es,

and PO L L A K , * D i s tr i ctJ udge. (F il ed : M arc h 1 1 , 2 0 0 8 )

__________________ * H onor abl e Loui s H . Pol l ak, Seni orJ udge of the U ni t ed St at es D i s tr i ctC ourtforthe E a s te rn D is tr ic t o f

P e n n s y lv a n ia , s ittin g b yd e s ig n a tio n .2 __________ OPI NI ON O F THE COURT

__________ R E N D E L L , C i r cui tJ udge. St ace yM orr i s on, on behal f of he rnow - s event een- y ear - ol d s on, D enze l , appea l s the U ni t ed St at es D i s tr i ctC ourtforthe D i s tr i ctof N ew J er s ey ’ s aff i rm ance of the C om m i s s i onerof Soci al Secur i ty ’ s deni al of D enze l ’ s appl i cat i on forchi l d Suppl ement al S e c u ri ty In c o m e (“ S S I” ) b e n e f its . D e n z e l su f

f e rs f ro m b ro n c h ial a sth m a ; m u lti p le e x o sto se s o n d if f e re n t p a rts o f

h is s k e le to n , in c lu d in g h is le g s , h e a d , a n d ri b s ; a n d re a c tiv e d e p re s s io n /d y s th ym ic d is o rd e r. E xos t os es ar e beni gn bonygr ow ths thatcan c aus e vary i ng degr ees of pai n and di s comfort , can r eappe ari f r emoved t hr ough s ur gery , and ca n gr ow t o the s i ze of a b a se b a ll. D e n z e l w a lk s w ith a lim p , ap p a re n tlyd u e to su rg e ryth a t h e h a d in 1 9 9 6 to exci s e exos t os es . R eac t i ve depr es s i on/ dy s thym i c di s or deri s m arked bydepr es s ed mood, b lu n te d a f

f e c t, p e ri o d s o f

re s tle s s n e s s , a s o f

t- s p o k e n n a tu re , a n d a n g e r e p is o d e s . D enze l ’ s appl i cat i on forbenef i t s , fi l ed i n ear l y2003, w as deni ed i ni t i al l yand upon r econs i der at i on bythe l ocal Soci al Secur i tyA dm i ni s tr at i on offi ce. A ft erM s . M orr i s on s ubs equent l yr eques t ed a he ar i ng, the A dm i ni s tr at i ve Law J udge ( “A L J ”) found that D enzel w as not di sabl ed fo r SS I purposes and thus w as not ent i t l ed to ben efi t s. M s. M orr i s on appea l ed t o the A ppeal s C ounci l , w hi ch r ej ect ed herr eques tt o r evi ew the A L J ’ s deci s i on. She then appe al ed t o the D i s tr i ctC ourt , w hi ch, as not ed above , aff i rm ed3

the deni al of bene fi t s . Forthe r eas ons di s cus s ed bel ow , w e w i l l i n turn aff i rm the ju d g m e n t o f

th e D istric t C o u rt. Th e Di s tr i c tCo u r th a d j u r i s d i c t i o n p u r s u a n tt o 4 2 U. S . C. § 4 0 5 ( g ) a n d 4 2 U. S . C. § 1383( c) ( 3) and w e now have j ur i s di ct i on pur s uantt o 28 U . S. C . § 1291. I n s i tuat i ons l i ke thi s , i n w hi ch the A ppeal s C ounci l has deni ed the appe l l ant ’ s r eques tt o r evi ew the A L J ’s d e n ia l o f

b e n e f its , w e re v ie w th e d e c is io n o f th e A L J . M

at thew s v. Apf

el , 239 F. 3d 5 8 9 , 5 8 2 (3 d C ir. 2 0 0 1 ). In d o in g so , w e a p p lyth e sa m e sta n d a rd a s th e D istric t C o u rt: w e re v ie w a ll le g a l is s u e s d e n o v o a n d a ll f a c tu a l f in d in g s f o r s u b s ta n tia l e v id e n c e . Jones v. B arnh art , 3 6 4 F .3 d 5 0 1 , 5 0 3 (3 d C ir. 2 0 0 4 ); Knepp v. Apf el , 2 0 4 F . 3 d 7 8 , 8 3 (3d C ir . 2000) . Subst ant i al evi dence m eans “s uch r el evantevi dence as a r eas onabl e mi nd m i ght acc eptas adequa t e t o s uppor ta conc l us i on. ” Jones , 364 F. 3d at503. I n or dert o al l ow us t o conductourr evi ew , the A L J m us tgi ve a r eas oned expl anat i on forhi s deci s i on, in c lu d in g h o w h e f

a c to re d in e v id e n c e th a t a rg u a b ly p o in te d to th e o p p o s ite c o n c lu s io n . B u rn ettv. C o m m ’r , 2 2 0 F .3 d 1 1 2 , 1 1 9 -2 0 (3 d C ir. 2 0 0 0 ); C o tterv . H a rr is , 642 F. 2d 700, 705 ( 3d C i r . 1981) . I n Jones , w e m a d e c lea r th a t th e p u rp o se o f th is re q u ire m e n t is “ to e n su re su f

f icie n t d e v e lo p m e n t o f

th e re c o rd a n d e x p lan a tio n o f f in d in g s to p e rm it m eani ngful r evi ew . ” 364 F. 3d at505. T he A L J does notneed “ t o us e part i cul arl anguage oradher e t o a part i cul arform ati n conduct i ng hi s anal y s i s . ” I d. A chi l d underei ght een i s onl yel i gi bl e forSSI be nefi t s i f ( 1) he i s notdoi ng s ubs t ant i al gai nful act i vi ty ; ( 2) he has a medi cal l ydet erm i nabl e i m pai rm entorA “m arked” li m i t at i on “i nter feres s er i ous l y w ith [ th e c h ild ’s] a b ili tyto in d e p e n d e n tly 1 in itia te , s u s ta in , o r c o m p le te a c tiv itie s .” 2 0 C .F .R . § 4 1 6 .9 2 6 a (e )( 2 )( i) (e m p h a s is a d d e d ). A n “ex trem e” l i m i t at i on “i nter feres ver y s er i ous l

y w ith [ th e c h ild ’s] a b ili tyto 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 . ” I d. § 4 1 6 .9 2 6 a (e )(3 )(i) (e m p h a sis ad d ed ). 4 combi nat i on of i m pai rm ent s thati s s ever e; and ( 3) the i m pai rm entorcombi nat i on of i m pai rm ent s m eet s , m edi cal l yequal s , orfunct i onal l yequal s the s ever i tyof one orm or e of th e im p a irm e n ts lis te d in 2 0 C .F .R . P a rt4 0 4 , S u b p a rtP , A p p e n d ix 1 . 2 0 C .F .R § 416. 924. A n i m pai rm entorcombi nat i on of i m pai rm ent s funct i onal l yequal s a l i s t ed i m pai rm enti f i tcaus es a “marked” l i m i t at i on i n tw o of s i x ar eas of func t i oni ng oran “extr em e” l i m i t at i on i n o ne o f tho se si x areas. Id . § 4 1 6 . 9 2 6 a(a ). T h e six are as a re 1 ( 1) acqui r i ng and us i ng i nform at i on, ( 2) att 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 th other s , ( 4) m ovi ng aboutand mani pul at i ng obj ect s , ( 5) car i ng for o n e s e lf , a n d (6 ) h e a lth a n d p h y s ic a l w e ll- b e in g . I d. § 4 1 6 . 9 2 6 a(b )(1). T he A L J found thatD enze l w as notengage d i n s ubs t ant i al gai nful act i vi tyand that hi s thr ee i m pai rm ent s w er e al l s ever e. H ow ever , the A L J al s o found thatnone of the im p a irm e n ts — w h e th e r o n th e ir o w n o r in c o m b in a tio n w ith o n e a n o th e r — m e t, m e d ic a lly e q u a le d , o r f

u n c tio n a lly e q u a le d a lis te d im p a ir m e n t. O f D e n z e l’s th re e im p a irm e n ts, th e re a re o n lylistin g s f o r a sth m a . 2 0 C .F .R . p t. 404, s ubpt . P, app. 1, §§ 3. 03, 103. 03. T he A L J found thatD enze l ’ s condi t i on di d not m eetthes e l i s t i ngs , as ther e w as no evi dence of pul m onary - funct i on t es t i ng, emer gency r oom vi s i t s , i npat i enthos pi t al i zat i on, i ntr avenous ant i bi ot i cs , pr ol onged i nhal at i on5

th e ra p y , o r c h ro n ic w h e e z in g . See i d. S ince there is no li sti n g fo r ex o stose s, the A L J an aly ze d w h ethe r D en ze l’ s condi t i on w as m edi cal l yequi val entt o w hathe thoughtw er e the mostanal ogous l i s t ed i m pai rm ent s — “maj ordy s funct i on of a j oi nt , ” “f r actur e of the fe m ur , t i bi a, pel vi s , orone orm or e of the t ar s al bones , ” and “ fr actur e of a n upperextr emi ty . ” 20 C . F. R . pt . 404, s ubpt . P, app. 1, §§ 1. 02, 1. 06, 1. 07, 101. 02, 101. 06, 101. 07. T he A L J concl uded that D e n z e l’ s c o n d itio n w a s n o t m e d ic a lly e q u iv a le n t to a n yo f th e s e b e c a u s e , in tera lia , he d id n o t h a v e th e “ in a b ili tyto a m b u late e f f e c tiv e ly ,” w h ich is a b a sic re q u ire m e n t f o r a ll lis te d m u s c u lo s k e le ta l im p a irm e n ts . See 20 C . F. R . pt . 404, s ubpt . P, app. 1, § § 1 .0 0 (B )(2 ), 1 0 1 .0 0 (B )(2 ). A s th e re g u latio n s e x p lain , the “ in a b ili tyto a m b u late e f f e c tiv e ly ” c o m p rise s “ a n e x tre m e lim itatio n o f th e a b ili tyto w a lk ” a n d is g e n e ra lly defi ned as “havi ng i ns uffi ci entl ow erextr emi tyfunct i oni ng t o perm i ti ndepende nt ambul at i on w i thoutthe us e of ahand- hel d as s i s t i ve devi ce( s ) thatl i m i t s the func t i on of both upperextr emi t i es . ” I d. T he A L J acknow l edged thatD enze l “expe r i ence d per i ods of d if f icu ltyw a lk in g o f

v a ry in g len g th s, d id re c e iv e h o m e tu to rin g f o r a c o u p le o f

m o n th s in 2003 as a r es ul t , has been pr ovi ded w i th handi cappe d bus tr ans port at i on fors chool , has been gi ven a ke yt o oper at e the el evat orats chool , and has r ece i ved a s peci al acc om m odat i on ats chool forfi r e dr i l l evac uat i ons . ” ( A pp. 25. ) H ow ever , the A L J found thatthes e fa ct or s w er e outw ei ghed bythe fa ctthatD enze l w al ked home fr om s chool (e v e n th o u g h h e h a d th e o p tio n to tak e th e h a n d ica p p e d b u s) a n d g e n e ra llyp a rticip a ted in6

g ym , inc lu d in g p layi n g b a sk e tb a ll, v o lleyb a ll, a n d b a se b a ll. T he A L J al s o compar ed D enze l ’ s condi t i on t o the l i s t i ngs form ood and af fec t i ve d iso rd e rs, w h ich h e th o u g h t w e re th e m o st a n a lo g o u s to re a c tiv e d e p re ss io n /d y sth ym ic di s or der . 20 C . F. R . pt . 404, s ubpt . P, app. 1, §§ 12. 04, 102. 04. T he A L J pr ovi ded an ext ens i ve expl anat i on forw hyD enze l ’ s condi t i on w as notm edi cal l yequi val entt o ei ther l i s t i ng, i ncl udi ng a cr i t er i on- by - cr i t er i on anal y s i s of w hyD enze l does nothave am aj or depr es s i ve s yndr om e and w hyhi s depr es s i on does notl i m i thi s m ent al funct i oni ng t o the d e g re e re q u ire d b y§ 1 2 .0 4 a n d § 1 0 2 .0 4 . A m o n g o th e r th in g s, th e A L J f o u n d it s i gni fi cantthatD enze l enj oy ed pl ay i ng games, w as i nt er es t ed i n hi s s chool w ork and g e n e ra llyre c e iv e d g o o d g ra d e s, h a d a f e w f rie n d s, w a s o n stu d e n t co u n c il, c a re d f o r h is gr oom i ng and hy gi ene the s ame as otherchi l dr en hi s age, w as gener al l ycooper at i ve d u rin g h is p e rio d ic p sy c h o th e ra p yse ss io n s, w a s a b le to se lf -c o p e , an d h a d n o d if

f icu lty co n ce n tr ati n g , n o fa ti g u e, an d n o su ici d al th o u g h ts. M o reo v er, i n M arc h 2 0 0 3 , D en ze l’ s tea c h e r c o u ld n o t id e n tifya n ylim itatio n in th e a re a s o f in ter a c tin g a n d re latin g w ith other s orcar i ng forones el f. F in a lly , the A L J d e ter m in e d th a t D e n z e l’s im p a irm e n ts w e re n o t f u n c tio n a lly e q u iv a len t to a n ylisted im p a irm e n t. S p e c if ica lly , h e f

o u n d th a t D e n z e l’s im p a irm e n ts caus ed no l i m i t at i on i n the domai ns of ac qui r i ng and us i ng i nform at i on, att endi ng and compl et i ng t as ks , and ca r i ng forones el f, and ca us ed l es s - than- m arked l i m i t at i ons i n the do m ai ns of int eract i ng and rel at i ng w i th o thers, m ov i ng abo ut and m anipul at i ng obj ect s,T h e D D S d o c to rs d id n o t h a v e b e f o re th e m d o c u m e n ta tio n a b o u t D e n z e l’ s d e p re s s io n . 2 7 and hea l th and phy s i cal w el l - bei ng. O nce a gai n, the A L J pr ovi ded a s i gni fi cant expl anat i on forhi s concl us i on, s om e of w hi ch r efe rr ed bac k t o hi s anal y s i s of w hy D e n z e l’ s c o n d itio n d id n o t m e e t o r m e d ic a lly e q u a l a n ylis te d im p a ir m e n t. T hr oughout , the A L J gave s ubs t ant i al w ei ghtt o the opi ni ons of the doct or s fr om the s tat e’s D isab il ityD eterm ination S erv ice (“D D S ”), w h o tho u g h t th at D en ze l’ s exos t os es and as thm a di d notm eet , m edi cal l yequal , orfunct i onal l yequal a l i s t ed im p a irm e n t. See 2 0 C . F . R . § 4 1 6 . 9 2 7 (f). 2 M s. M o rriso n m a k e s a n u m b e r o f a rg u m e n ts o n a p p e a l. F irst, sh e c o n ten d s th a t, i n conduct i ng hi s m edi cal equi val ence anal y s i s , the A L J compar ed D enze l ’ s exos t os es t o the w r ong condi t i on. She m ai nt ai ns thatthe mosts i m i l arl i s t i ng w as for“def i ci tof m us cul os kel et al funct i on due t o deform i tyorm us cul os kel et al di s eas e, ” ent ai l i ng

“ w a lk in g [ th a t] is m a rk e d lyre d u c e d in sp e e d o r d ista n c e d e sp ite o rth o tic o r p ro sth e tic d e v ice s,” a n d th a t D e n z e l’s c o n d iti o n is m e d ica llye q u iv a len t to it. H o w e v e r, th is is f orm er lis tin g 1 0 1 .0 3 , w h ic h w a s e lim in a te d w h e n th e lis tin g s w e re a m e n d e d in 2 0 0 1 . See R evi s ed M edi cal C r i t er i a forD et erm i nat i on of D i s abi l i ty , M us cul os kel et al Sy s t em a n d R e late d C riter ia, 6 6 F e d R e g . 5 8 ,0 1 0 , 5 8 ,0 2 1 (2 0 0 1 ). A s d isc u ss e d a b o v e , “in a b ili ty t o ambul at e ef

fec t i vel y ” i s now r equi r ed foranym us cul os kel et al i m pai rm ent . G i ven the f a c t th a t D e n z e l g e n e ra llyp a rticip a ted in g ym a n d w a lk e d h o m e f ro m sc h o o l, a re a so n a b le8

m in d c o u ld c o n c lu d e th a t, d e s p ite h is c o n d itio n , D e n z e l d id n o t m e e t th is re q u ir e m e n t. T h e re f o re , su b sta n tial e v id e n c e su p p o rts th e A L J’s c o n c lu sio n th a t D e n z e l w a s n o t u n a b le to a m b u la te e f

f e c tiv e ly. M s . M orr i s on al s o ar gues thatthe A L J fai l ed t o cons i derD enze l ’ s thr ee im p a irm e n ts in c o m b in a tio n w ith o n e a n o th e r a n d th a t w e sh o u ld th e re f o re re m a n d w ith i ns truct i ons forhi m t o do s o. T he A L J , how ever , expl i ci t l yi ndi cat ed a numberof t i m es thathe w as cons i der i ng the i m pai rm ent s i n combi nat i on. ( A pp. 25, 27, 28. ) W e s ee no re a s o n n o t to b e lie v e h im . Fi nal l y , M s . M orr i s on cont ends thatthe A L J ’ s funct i onal equi val ence anal y s i s w as concl us oryand mai nt ai ns thatD enze l ’ s condi t i on i s i n fac tfunct i onal l yequi val entt o the l i s t i ngs . Speci fi cal l y , s he as s ert s thatD enze l s uffe r s fr om m arked l i m i t at i ons i n four d o m ains : r elati n g w ith o thers, m o v ing ab o u t and m an ipu lat ing o b jects, ca ri n g fo r on e’s s e lf , a n d h e a lth a n d w e ll- b e in g . W e conc l ude thatthe A L J ’ s expl anat i on of w hyD enze l had ei therno l i m i t at i on or a les s-th a n -m a rk e d lim itatio n in e a c h o f th e se f o u r d o m a in s w a s s u f

f icie n t “to p e rm it m eani ngful r evi ew , ” s ee J ones , 364 F. 3d at505, and, m or eover , thathi s ul t i m at e fi ndi ngs ar e s upport ed bys ubs t ant i al evi dence . R egar di ng the domai n of i nt er act i ng and r el at i ng w i th other s , the A L J r efe rr ed bac k t o hi s thor ough anal y s i s of w hyD enze l ’ s condi t i on w as notm edi cal l yequi val entt o the l i s t i ngs form ood and af fec t i ve di s or der s . R egar di ng the domai n of m ovi ng aboutand mani pul at i ng obj ect s , the A L J r efe rr ed bac k t o hi s m or e-9

th a n - s u f f i c i e n ta n a l y s e s o f

wh yDe n z e l ’ s c o n d i t i o n d i d n o tme e tth e l i s t i n g s f o ra s th ma a n d w a s n o t m e d ic a lly e q u iv a le n t to a n a lo g o u s lis tin g s f o r m u s c u lo s k e le ta l im p a ir m e n ts . R e g a rd in g th e d o m a in o f c a rin g f o r o n e se lf

, the A L J re f

e rre d b a c k a g a in to h is in -d e p th c o m p a r i s o n o f

D e n z e l ’ s c o n d i t i o n t o th e l i s t i n g s f o rm o o d a n d a f

f e c t i v e d i s o r d e r s . L a s t l y, the domai n of hea l th and phy s i cal w el l - bei ng cont empl at es “the cumul at i ve phy s i cal eff ect s of phy s i cal orm ent al i m pai rm ent s and thei ras s oci at ed tr eatm ent s orther api es on [the chi l d’ s ] funct i oni ng” thatw er e notcons i der ed underthe domai n of m ovi ng aboutand m ani pul at i ng obj ect s . 20 C . F. R . § 416. 926a( l). H e re , the A L J re f e rre d o n c e m o re to h is pr i ordi s cus s i on of w hyD enze l ’ s condi t i on nei therm etthe l i s t i ngs foras thm a nor m edi cal l yequal ed the l i s t i ngs form us cul os kel et al i m pai rm ent s and, agai n, gave s u b s t a n t i a l wei g h tt o th e DD S d o c t o r s ’ o p i n i o n s . I n e x p l a i n i n g h i s c o n c l u s i o n , th e ALJ acknow l edged thatpai n caus ed byD enze l ’ s exos t os es s om et i m es w akes hi m up atni ght and has caus ed hi m t o be abs entfr om s chool fors i gni fi cantper i ods of t i m e; how ever , the A L J al s o hi ghl i ght ed the fa ctthats peci al acc om m odat i ons , i ncl udi ng hom e- tut or i ng, have been pr ovi ded t o al l ow D enze l t o cont i nue t o att end s chool and thatthe tr eatm enthe has recei ved si nce F ebruary20 03 — a com binat i on of p hy si cal therapy , res t , al coh ol rub s, and occ as i onal non- nar cot i c pr es cr i pt i on m edi cat i on — pr ovi de hi m w i th s om e r el i ef fr om hi s pai n. Forthe r eas ons di s cus s ed above , w e w i l l A FFIRM the D i s tr i ctC ourt ’ s j udgm ent a f f irm in g th e C o m m is s io n e r’ s d e n ia l o f b e n e f its .