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Castilloveitia v. Berryhill

United States District Court, D. New Jersey, Camden Vicinage

December 28, 2018

LIZ CASTILLOVEITIA O/B/O B.O.M., Plaintiff,
v.
NANCY A. BERRYHILL, ACTING COMMISSIONER OF THE SOCIAL SECURITY ADMINISTRATION, Defendant.

          MEMORANDUM OPINION AND ORDER

          RENÉE MARIE BUMB, UNITED STATES DISTRICT JUDGE

         This matter comes before the Court upon an appeal filed by Plaintiff Liz Castilloveitia (“Plaintiff”) on behalf of her minor son, B.O.M. (“Claimant”), seeking judicial review of the determination denying Plaintiff's application for Supplemental Security Income (“SSI”) benefits.

         For the reasons set forth below, the Court vacates the decision of the Administrative Law Judge (the “ALJ”) and remands for proceedings consistent with this Memorandum Opinion and Order.

         I. PROCEDURAL HISTORY

         On June 19, 2013, Plaintiff protectively filed an application for childhood supplemental security income, under Title XVI of the Social Security Act, on behalf of Claimant, alleging disability due to asthma and autisim spectrum disorder, with an onset date of June 3, 2013. The claim was initially denied on September 17, 2013, and again upon reconsideration on January 31, 2014. Record of Proceedings (“R.P.”) at 20. Thereafter, Plaintiff requested a hearing, which was held before the Honorable Daniel N. Shellhamer, ALJ, on January 7, 2016. Plaintiff appeared at the hearing, on behalf of Claimant, and was represented by counsel, David S. Bross.

         Following the formal hearing, the ALJ issued a decision on May 20, 2016, which denied Plaintiff's claim based on the ALJ's determination that Claimant did not suffer from “an impairment or combination of impairments” that result in “marked” limitations in two domains of functioning or “extreme” limitations in one domain of function. [R.P., p. 35]. The Appeals Council denied Plaintiff's request for review, thus rendering the ALJ's decision as final. [R.P., p. 1-4]. Plaintiff now seeks this Court's review.

         II. STANDARD OF REVIEW

         In social security appeals, the district court must uphold the Commissioner's decision if it is supported by substantial evidence. Allen v. Bowen, 881 F.2d 37, 39 (3d Cir.1989). Substantial evidence exists when there is “more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate.” Ventura v. Shalala, 55 F.3d 900, 901 (3d Cir.1995)(quoting Richardson v. Perales, 402 U.S. 389, 401 (1971)). If the ALJ's findings of fact are supported by substantial evidence, then those findings are conclusive. 42 U.S.C. § 405(g); Dobrowolsky v. Califano, 606 F.2d 403, 406 (3d Cir.1979). A district court cannot “weigh the evidence or substitute its conclusions for those of the fact-finder.” Williams v. Sullivan, 970 F.2d 1178, 1182 (3d Cir.1992) (citation omitted). Thus, a district court is bound by the findings of the ALJ that are supported by substantial evidence, “even if [it] would have decided the factual inquiry differently.” Hartranft v. Apfel, 181 F.3d 358, 360 (3d Cir.1999)(citations omitted). To determine if such substantial evidence exists, the district court must review the record as a whole. See 5 U.S.C. § 706.

         In addition to the “substantial evidence” inquiry, the court must also determine whether the ALJ applied the correct legal standards. See Friedberg v. Schweiker, 721 F.2d 445, 447 (3d Cir. 1983); Sykes v. Apfel, 228 F.3d 259, 262 (3d Cir. 2000). The Court's review of legal issues is plenary. Sykes, 228 F.3d at 262 (citing Schaudeck v. Comm'r of Soc. Sec., 181 F.3d 429, 431 (3d Cir. 1999)).

         Under the Social Security Act, a child under 18 years old is eligible for SSI if he or she is “disabled, ” meaning he or she “has a medically determinable physical or mental impairment, which results in marked and severe functional limitations, and which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” 42 U.S.C. § 1382c(a)(3)(C)(i). To determine whether a child is disabled, the regulations establish a three-step sequential process. See T.C. ex rel. Z.C. v. Comm'r of Soc. Sec., 497 Fed.Appx. 158, 160 (3d Cir. 2012)(citing 20 C.F.R. § 416.924(a)).

         At step one, the ALJ considers whether the child is engaging in substantial gainful activity. Id. If so, the child is not disabled. If not, the ALJ proceeds to step two, determining whether the child has a medically determinable severe impairment or combination of impairments. Id. If not, the child is not disabled. If so, the ALJ proceeds to step three. Id.

         At step three, the ALJ assesses whether the child has an impairment or combination of impairments that meets, medically equals, or functionally equals a listed impairment set forth in 20 C.F.R. § 416.924(d). An impairment or combination of medical impairments “medically equals” a listed impairment “if it is at least equal in severity and duration to the criteria of any listed impairment.” 20 C.F.R. § 416.926(a). An impairment or combination of impairments “functionally equals” a listed impairment if the child has “marked” limitations in two domains of functioning or an “extreme” limitation in one domain. 20 C.F.R. § 416.926a(a).

         The six domains of functioning are: (1) acquiring and using information; (2) attending and completing tasks; (3) interacting and relating with others; (4) moving about and manipulating objects; (5) caring for oneself; and (6) health and physical well-being. 20 C.F.R. § 416.926a(b)(1)(i)-(vi). A “marked” limitation exists when it “interferes seriously with [the child's] ability to independently initiate, sustain, or complete activities, ” and is considered “‘more than moderate' but ‘less than extreme.'” 20 C.F.R. § 416.926a(e)(2). An “extreme” limitation exists when it “interferes very seriously with [the child's] ability to independently initiate, sustain, or complete activities, ” and is considered “more than marked” but not necessarily equivalent to “a total lack or loss of ability to function.” 20 C.F.R. § 416. 926a (e)(3).

         The ALJ determines the child's ability to function in each domain based on “all the relevant factors, ” including the effectiveness of medication on the child, the ability of the child to function in school, and the effects of structured settings on the performance of the child. 20 C.F.R. § 416.926a(a)(1)-(3). If the ALJ finds that the requirements of the third step are met, the ...


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