United States District Court, M.D. Pennsylvania
RICHARD P. CONABOY UNITED STATES DISTRICT COURT.
consider here the appeal of Christina Barlet, on behalf of
her minor daughter, Elizabeth Barlet, from a decision of the
Social Security Administration (“SSA”) or
(“Agency”) that denied her application for
Supplemental Security Income (“SSI”)benefits. The
application was denied administratively on December 12, 2013.
After a hearing before the Administrative Law Judge
(“ALJ”), the claim was denied by a written
decision dated August 25, 2015. The Appeals Council affirmed
the ALJ's decision by letter dated December 15, 2016. The
Appeals Council's affirmance constitutes a “final
decision” by the Agency from which Plaintiff timely
appeals. This Court has jurisdiction over this matter
pursuant to 42 U.S.C. § 1383(c)(3). The parties have
briefed the issues (Docs. 12, 13 and 14) and this case is now
ripe for dispostion.
Testimony Before the ALJ.
hearing before the AlJ occurred on May 19, 2015. Plaintiff
testified as did Christina Marie Barlet (claimant's
mother), Rick Barlet (claimant's father), John Kowalski
of Luzerne County Children and Youth Services, and Jane
Miller, also of Luzerne County Children and Youth Services.
Plaintiff's testimony may be summarized as follows. She
was eleven years of age at the time of the hearing and a
student in the fifth grade at the Lake Lehman School
District. Her favorite subject is math. Her least favorite
subject is reading. She gets extra help in school with both
math and reading. The extra help consists of allowing her
extra time to complete her assignments. She also is allowed
time to snack to help control her diabetic condition. Her
mother helps her with her homework. (R.42-43).
stated that she participates in gym class but is restricted
in that regard because she cannot touch latex balls or gym
mats. She gets along well with her fellow students and her
teachers in her own estimation. She states that she has not
been subjected to any disciplinary measures in school.
takes insulin at least twice daily and administers it
herself. She also takes Levothyroxine and allergy
medications. These medications can make her tired and, at
times, hyperactive. She lives at home with her mother,
father, and two younger brothers. She has three cats at home
and takes care of them personally. She also cleans her
bedroom and bathroom and does not experience any physical
problems when doing so. She no longer has the assistance of a
mobile therapist and has less help from a TSS worker than had
formerly been the case. (R.45-47).
Christina Marie Barlet.
testimony of Christina Marie Barlet, Plaintiff's mother,
may be summarized as follows. Her daughter takes multiple
medications including: Lantus, Novolog, insulin syringes and
test strips, Lancet, Ketostix, Levothyroxine, Ventolin,
Albuterol, Econazole cream, Flonase, and Benadryl. These
medications are basically for control of Plaintiff's
diabetes and asthmatic/hyperallergic conditions. In addition,
Plaintiff's blood sugar level must be frequently
monitored and her diet frequently adjusted to address
fluctuations in her blood sugar level. (R.47-50).
treating physician was Dr. Stone until October of 2014 when
he stopped practicing medicine. Dr. Cook assumed her care in
November of 2014. She also saw several doctors at Northeast
Counseling Services, but, because of changes in government
reimbursement practices, she can no longer go there. Dr. Cook
and a Dr. Long, who also sees the Plaintiff, are affiliated
with Geisinger Medical Center. She sees one or the other
every two months or more often if she gets sick. She also
sees Dr. Delregno for vision problems and Dr. Trovitch, a
pediatric endocrinologist. (R.50-51).
grades fluctuate. Her mother attributes this in part to the
fact that she misses a lot of school due to her illnesses. At
the time of the hearing, Plaintiff had already missed more
than 20 days in the current school year. Plaintiff is
identified as a special needs student and her schooling is
governed by an individualized educational program.
(“IEP”). A special education teacher helps
Plaintiff in reading and math and assists her when she takes
tests. Also, Mrs. Barlet must meet with cafeteria staff at
the beginning of the year to make them aware of her
child's dietary restrictions and to find out what she
must personally supply to meet her child's needs. Every
time there is a field trip Mrs. Barlet must attend because
the school will not furnish a nurse for that purpose. She
must also meet frequently with the principal, guidance
counselors, and her child's teachers regarding her
child's special problems. These problems include
attention deficit disorder. Plaintiff cannot take the
medications normally prescribed for attention deficit
disorder because of her allergy to gluten (Celiac disease).
As a result, she is at times “hyped up” and
“antsy” and this results in behavioral problems.
At other times, if her blood sugar level gets too low or her
asthma flares, she must be monitored in the nurse's
mother states that she is physically capable of dressing
herself but that she often needs help with her personal
hygiene. She must often be reminded to shower and her mother
must monitor her in the shower to make sure she showers
effectively. Plaintiff is very aggressive in her interactions
with her younger brothers and is very inconsiderate at times.
Mrs. Barlet attributes these behaviors to her child's
diabetes and attention deficit disorder. When her child had
access to the TSS worker her behavior improved. Because
medical assistance no longer pays for the services of a TSS
worker, she has been unable to provide for these services.
Barlet testified further that she had brought John Kowalski
and Jane Miller from Luzerne County's Office of Children
and Youth Services for purposes of securing their testimony.
She stated that they were instrumental in forcing her
child's school to develop a more comprehensive IEP to
meet her needs. Before Mr. Kowalski and Ms. Miller became
involved, the school was largely unresponsive to her
child's special needs. Mrs. Barlet also noted that the
school has been habitually resistant to supplying her child
with things she requires such as certain food items, glucose
tests, alcohol wipes to test her sugar, latex-free erasers,
special art supplies, and latex-free gloves. She also
testified that she must constantly educate school personnel
regarding her daughter's numerous special needs.
Barlet, Plaintiff's father, also testified regarding the
difficulties they have experienced getting cooperation from
school authorities to adapt to their daughter's special
needs. He emphasized particularly their struggle with the
cafeteria staff's inattention to the problems caused by
even lightly touching any of the foods served to their
daughter with latex gloves. When such cross-contamination
occurs, their daughter experiences a severe allergic reaction
secondary to her Celiac disease that often results in her
missing school. He stated that his wife is often on the phone
with the school nutritionist to find out what was served for
lunch on days when their daughter comes home sick. On these
occasions, it is often the case that her daughter was served
food containing gluten, a substance she cannot tolerate.
Luzerne County Children's Services.
final two witnesses were John Kowalski and Jane Miller, both
employees of the Luzerne County Bureau of Children Services.
Mr. Kowalski testified that he had been assigned to
Plaintiff's case in December of 2012 due to her diabetic
condition. He is a life-long diabetic himself and has lost he
eyesight as a result of the disease. He stated that his task
was to help Plaintiff “as much as I possibly could in
terms of diabetic control, diet, education, and her situation
at school for accommodations...”. He explained further
that Plaintiff is a very brittle diabetic whose health is
further complicated by her latex allergy and Celiac disease.
He stated that Plaintiff's eyesight had already been
affected by the disease and her struggle with the disease
will be something that will go on for as long as she lives.
He has tried to teach her to make better dietary choices and
to be strictly compliant with her insulin regimen. He stated
further that Plaintiff's parents have gone beyond what
would be expected of the parents of a diabetic but that doing
so has been very costly to them. He urged the AlJ to find in
Plaintiff's favor because that result “would help
her and her parents in the long run, and in the short run as
Miller was the final witness. She stated that she was
employed by Luzerne County Children and Youth Services as a
“special education advocate”. She helps the
families of students with special problems with issues
involving their schooling. She corroborated Mr.
Kowalski's assessment that Plaintiff's brittle
diabetes, Celiac disease, and latex allergy pose very
complicated problems both at school and in the home. She
stated that she was instrumental in helping Plaintiff's
parents persuade her school to provide an IEP that is more
truly reflective of the child's needs. She stated that
since the IEP had been created she had not heard from either
the school or the family. For this reason she assumed that
the accommodations were proving to be beneficial. (R.69-70).