Source: http://ks.findacase.com/research/wfrmDocViewer.aspx/xq/fac.20180705_0000961.DKS.htm/qx
Timestamp: 2019-04-25 18:31:24+00:00

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Plaintiff seeks review of a decision of the Acting Commissioner of Social Security (hereinafter Commissioner) denying child's insurance benefits, Disability Insurance Benefits (DIB), and Supplemental Security Income (SSI) benefits pursuant to sections 216(i), 223, 1602, and 1614(a)(3)(A) of the Social Security Act, 42 U.S.C. §§ 416(i), 423, 1381a, and 1382c(a)(3)(A) (hereinafter the Act). Finding no error, the court ORDERS that judgment shall be entered pursuant to the fourth sentence of 42 U.S.C. § 405(g) AFFIRMING the Commissioner's final decision.
Plaintiff argues that the Administrative Law Judge (ALJ) erred by failing to consider whether Plaintiff's condition medically equals § 12.05C of the listing for mental disorders and by accepting vocational expert testimony which is inconsistent with the Dictionary of Occupational Titles (DOT) and the policies of the Social Security Administration (SSA). Finally, she argues that the ALJ's residual functional capacity (RFC) assessment is not supported by the evidence because he erred in evaluating the opinion evidence. She seeks reversal and remand “with directions to grant her claims for disability insurance benefits and supplemental security income benefits.” (Pl. Br. 37).
Plaintiff argues that the ALJ erred because he did not consider whether Plaintiff's mental impairment medically equals Listing 12.05C of the listing of mental disorders. (Pl. Br. 28). Plaintiff cites two cases from the Eighth Circuit for the proposition that a case should be remanded where the ALJ fails to mention, or disregards, the Program Operations Manual System (POMS) guideline for determining medical equivalence to Listing 12.05C. Id. at 29 (citing Hesseltine v. Colvin, 800 F.3d 461, 466 (8th Cir. 2015); and Shontos v. Barnhart, 328 F.3d 418, 425 (8th Cir. 2003); and POMS DI 24515.056, available online at: https://secure.ssa.gov/apps10/poms.nsf/lnx/0424515056; effective 9/13/12-present) (last visited July 2, 2018). The Commissioner argues that the Eighth Circuit “cases have no authority in the Tenth Circuit, ” and that contrary to Plaintiff's argument, the ALJ specifically determined Plaintiff's mental impairments did not meet or medically equal any Listed mental disorder. (Comm'r Br. 5-6). In her Reply Brief, Plaintiff argues that “the ALJ did not consider Listing 12.05C except to the extent he mentioned the B criteria and C criteria of 12.04 or 12.06.” (Reply 2) (citing R. 928-29).
The Commissioner has provided a “Listing of Impairments” which describes certain impairments that she considers disabling. 20 C.F.R. §§ 404.1525(a), 416.925(a); see also, Pt. 404, Subpt. P, App. 1 (Listing of Impairments). If Plaintiff's condition meets or equals the severity of a listed impairment, that impairment is conclusively presumed disabling. Williams, 844 F.2d at 751; see Bowen v. Yuckert, 482 U.S. 137, 141 (1987) (if claimant's impairment “meets or equals one of the listed impairments, the claimant is conclusively presumed to be disabled”). However, Plaintiff “has the burden at step three of demonstrating, through medical evidence, that h[er] impairments ‘meet all of the specified medical criteria' contained in a particular listing.” Riddle v. Halter, No. 00-7043, 2001 WL 282344 at *1 (10th Cir. Mar. 22, 2001) (quoting Sullivan v. Zebley, 493 U.S. 521, 530 (1990) (emphasis in Zebley)); see also, Thompson v. Sullivan, 987 F.2d 1482, 1487 (10th Cir. 1993) (burden shifts to Commissioner only at step five). “An impairment that manifests only some of [the listing] criteria, no matter how severely, does not qualify” to meet or equal the listing. Zebley, 493 U.S. at 530.
“The [Commissioner] explicitly has set the medical criteria defining the listed impairments at a higher level of severity than the statutory standard. The listings define impairments that would prevent an adult, regardless of h[er] age, education, or work experience, from performing any gainful activity, not just ‘substantial gainful activity.'” Zebley, 493 U.S. at 532-33 (emphasis in original) (citing 20 C.F.R. § 416.925(a) (1989)). The listings “streamlin[e] the decision process by identifying those claimants whose medical impairments are so severe that it is likely they would be found disabled regardless of their vocational background.” Yuckert, 482 U.S. at 153. “Because the Listings, if met, operate to cut off further detailed inquiry, they should not be read expansively.” Caviness v. Apfel, 4 F.Supp.2d 813, 818 (S.D. Ind. 1998).
Medical equivalence to a listing may be established by showing that the claimant's impairment(s) “is at least equal in severity and duration to the criteria of any listed impairment.” 20 C.F.R. §§ 404.1526(a), 416.926(a). The determination of medical equivalence is made without consideration of vocational factors of age, education, or work experience, but the ALJ will “consider the opinion given by one or more medical or psychological consultants designated by the Commissioner. 20 C.F.R. §§ 404.1526(c), 416.926(c).
The severity of the claimant's mental impairments, considered singly and in combination, do not meet or medically equal the criteria of any impairment listed in section 12.00 of Appendix 1. In making this finding, the undersigned has considered whether the paragraph B criteria are satisfied. To satisfy the paragraph B criteria, the mental impairments must result in extreme limitation of one, or marked limitation of two, of the four areas of mental functioning. The four areas of mental functioning are: understand, remember, or apply information; interact with others; concentrate, persist, or maintain pace; and adapt or manage oneself. An extreme limitation is an inability to function in the area independently, appropriately, effectively, and on a sustained basis. A marked limitation is a seriously limited ability to function in the area independently, appropriately, effectively, and on a sustained basis.
The ALJ went on to explain that he found Plaintiff has a moderate limitation in understanding, remembering, or applying information; a moderate limitation in interacting with others; a moderate limitation in concentrating, persisting, or maintaining pace; and a mild limitation in adapting, or managing oneself. (R. 928-29). He found that the paragraph B criteria of the mental listings are not satisfied because there is neither one extreme limitation nor two marked limitations, and the paragraph C criteria are not satisfied because the evidence does not establish that Plaintiff has only marginal adjustment. Id. at 929. Finally, he noted “that no State agency psychological consultant concluded that a mental listing is medically equaled.” Id.
The Listings for Mental Disorders were changed effective January 17, 2017. 81 Fed. Reg. 66, 138 (Sept. 26, 2016); see also 20 C.F.R., Pt. 404, Subpt. P, App. 1, § 12.00 (2017). As relevant here, Plaintiff's borderline intellectual functioning is evaluated under Listing 12.11, “neurodevelopmental disorder, ” 20 C.F.R., Pt. 404, Subpt. P, App. 1, § 12.00B9b (“Examples of disorders that we evaluate in this category include … borderline intellectual functioning”); and Plaintiff's anxiety disorder is evaluated under Listing 12.06, “anxiety and obsessive-compulsive disorders.” 20 C.F.R., Pt. 404, Subpt. P, App. 1, § 12.00B5b. Listing 12.05, “intellectual disorder, ” on the other hand “may be described in the evidence as intellectual disability, intellectual developmental disorder, or historically used terms such as ‘mental retardation.'” 20 C.F.R., Pt. 404, Subpt. P, App. 1, § 12.00B4b. The regulations specifically note that “[t]his category [(Listing 12.05)] does not include the mental disorders that we evaluate under … neurodevelopmental disorders (12.11).” 20 C.F.R., Pt. 404, Subpt. P, App. 1, § 12.00B4c.
Listing 12.11 has two paragraphs--A and B--and to meet or equal that Listing, the mental impairment “must satisfy the requirements of both paragraphs A and B.” 20 C.F.R., Pt. 404, Subpt. P, App. 1, § 12.00A2. Listing 12.06 has three paragraphs--A, B, and C--and the mental impairment “must satisfy the requirements of both paragraphs A and B, or the requirements of both paragraphs A and C.” 20 C.F.R., Pt. 404, Subpt. P, App. 1, § 12.00A2. Paragraph B of both Listing 12.06 and Listing 12.11 require evaluation of each of the four mental functional areas: understand, remember, or apply information; interact with others; concentrate, persist, or maintain pace; and adapt or manage oneself, and the paragraph B criteria are only met, as the ALJ explained when Plaintiff's mental impairments “result in ‘extreme' limitation of one, or ‘marked' limitation of two, of the four areas of mental functioning.” 20 C.F.R., Pt. 404, Subpt. P, App. 1, § 12.00A2b.
The paragraph C criteria of Listing 12.06 require a mental disorder that is “serious and persistent, ” “medical treatment, mental health therapy, psychosocial support(s) or a highly structured setting(s)” that diminishes the symptoms and signs of the claimant's mental disorder, and “only marginal adjustment.” 20 C.F.R., Pt. 404, Subpt. P, App. 1, § 12.00G2a, b, and c.
Th e explanation above illuminates the ALJ's consideration of Plaintiff's mental impairments. His explanation that the paragraph B criteria are not met demonstrates that Listing 12.11 cannot be met and that one possible combination of criteria in Listing 12.06 cannot be met. His explanation that the Paragraph C criteria are not met eliminates the other possible combination of criteria for Listing 12.06, and confirms that Listing 12.06 cannot be met.
3. The evidence about your current intellectual and adaptive functioning and about the history of your disorder demonstrates or supports the conclusion that the disorder began prior to your attainment of age 22.

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