Opinion ID: 785992
Heading Depth: 3
Heading Rank: 1

Heading: Medically equal to a listed impairment

Text: 15 First, Myron contends that his impairments medically equal a listed impairment and that substantial evidence does not exist to support the ALJ's conclusion to the contrary. Under the third step of the sequential analysis, a child's impairment is medically equal to a listed impairment if it is at least equal in severity and duration to the medical criteria of the listed impairment. 20 C.F.R. § 416.926(a) (2003). 1 The ALJ's decision reflects his recognition that Myron suffers from attention deficit hyperactivity disorder, depression and a cognitive disorder. (Admin. Tr. at 17.) However, after considering the listings for mental problems at 112.02 through 112.12, the ALJ found that Myron's impairments do not meet or equal in severity the criteria for a listed impairment. 16 Myron submits that his impairments meet or medically equal in severity the mood disorder listing, 112.04. To meet or medically equal the mood disorder listing, a claimant must satisfy two separate prongs. Id. Part 404, Subpt. P, App. 1, § 112.04. The first prong demands [m]edically documented persistence, either continuous or intermittent, of a major depressive syndrome that is characterized by at least five of the following ten symptoms: 17
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19 c. Appetite or weight increase or decrease, or failure to make expected weight gains; or 20 d. Sleep disturbance; or 21 e. Psychomotor agitation or retardation; or 22 f. Fatigue or loss of energy; or 23 g. Feelings of worthlessness or guilt; or 24 h. Difficulty thinking or concentrating; or 25
26 j. Hallucinations, delusions, or paranoid thinking[.] 27 Id. Pt. 404, Subpt. P, App. 1, § 112.04(a)(1)(a)-(j) (hereinafter sometimes referred to as the A criteria). The second prong, pertinent to a child Myron's age, requires a showing of marked impairment in at least two of four specified areas of functioning, which we will discuss in greater detail later. 28 Myron argues that his impairments meet the A criteria for listing 112.04 because he has been diagnosed with both major depression and bipolar disorder, which have persisted for several years. He contends that the medical evidence shows depressed mood, suicidal thoughts and acts, decreased sleep, increased anhedonia, decreased energy, decreased concentration, and mild psychomotor retardation. The ALJ did not explain his reasoning underlying his finding that Myron's impairments did not meet nor medically equal a listed impairment, thus making judicial review difficult. He stated, however, that he considered listed impairments related to mental problems at listings 112.02 through 112.12. His failure to elaborate is not reversible error so long as substantial evidence in the record supports his conclusion. See Dunahoo v. Apfel, 241 F.3d 1033, 1037 (8th Cir.2001) (holding a failure to explain why the claimant did not meet the listing for rheumatoid arthritis was not error); Briggs v. Callahan, 139 F.3d 606, 609 (8th Cir.1998) (stating that [a]lthough the ALJ did not specifically discuss [the] condition in the context of listing 112.05(D), the record supported the conclusion). 29 On review to the district court, the court rejected Myron's contention that he met listing 112.04. The court noted that some of Myron's medical records supported his argument that he experienced at least five of the ten A criteria symptoms. Still, the court determined that the documentation did not support the medically documented persistence requirement and that, in any event, the second prong of listing 112.04 was not satisfied. 30 In the application for SSI benefits, Myron's mother indicated an onset date of April 1998, which is the date on which Myron's treating psychiatrist, Dr. Millicent Dudley, first diagnosed Myron as suffering from major depressive disorder and attention deficit hyperactivity disorder. Myron saw Dr. Dudley one to two times per month during the time period of April 7, 1998 through June 2, 1999 — more than ten visits in total. All of Dr. Dudley's progress notes were in evidence at Myron's hearing. Moreover, Myron submitted the treatment notes of the attending psychiatrists and counselors from each of his several hospital and treatment center admissions. None of any doctors' or therapists' notes indicates that Myron's symptoms had subsided or had been cured. 31 Although we apply a de novo standard of review to the district court's decision affirming the ALJ's decision, Depover v. Barnhart, 349 F.3d 563, 565 (8th Cir.2003), we address the medically documented persistence of Myron's impairments primarily because the Commissioner contends on appeal that the lack of evidence in this regard supports denial of benefits. However, we disagree that substantial evidence in the record supports a finding that Myron's claim of disability fails for lack of medically documented persistence. Not only has Myron adduced substantial evidence that he satisfies the A criteria of listing 112.04(A)(1), major depressive syndrome, our thorough review of Myron's medical and scholastic records convinces us that the record does not contain relevant evidence that reasonable minds might consider as adequate to support a conclusion that Myron's symptoms were not either continuous or intermittent. Medication at times adequately controls Myron's symptoms, but the record shows that the symptoms regularly recur. For example, one discharge summary notes: 32 The patient has a history of acting out in a self-destructive fashion with a history of overdose in the past. The patient was found by his grandmother, playing Russian Roulette with a gun, and was admitted to [St. Bernard's Behavioral Health] due to imminent risk for harm to self. The patient has been treated with a combination of Depakote, Zoloft and Trazodone in an outpatient setting, and this appears not to have had an effect as yet. 33 It should be noted that present neurovegetative signs and symptoms have been reported off and on for the past 3 years. Most notable are decreased sleep, with initial insomnia, not restful, increased anhedonia, with no ruminations reported, decreased energy, decreased concentration, no change in appetite, mild psychomotor retardation and history of suicidal behaviors and actions. 34 (Admin. Tr. at 276) (Discharge Summary, St. Bernard's Behavioral Health, dated Sept. 17, 1999.) In short, substantial evidence does not support a finding that Myron has not satisfied the A criteria of meeting or medically equaling listing 112.04.