United States District Court, W.D. Pennsylvania
OPINION AND ORDER
Donetta W. Ambrose, United States Senior District Judge.
Michelle Weaver, o/b/o R.L.F., (“Weaver”) applied
for supplemental security income in February 2015 alleging
disability beginning February 23, 2015. (R. 15) The claimant
testified and was represented by counsel at a hearing before
an Administrative Law Judge (“ALJ). (R. 15) Ultimately,
the ALJ denied benefits and the Appeals Council denied
Weaver's request for review. This appeal followed. The
parties have filed Cross-Motions for Summary Judgment.
See ECF Docket Nos. 11 and 13. For the reasons
below, the ALJ's decision is vacated and this case is
remanded for further consideration.
Standard of Review
review of the Commissioner's final decisions on
disability claims is provided by statute. 42 U.S.C.
§§ 405(g) and 1383(c)(3)(7). Section 405(g) permits
a district court to review the transcripts and records on
which a determination of the Commissioner is based, and the
court will review the record as a whole. See 5 U.S.C. §
706. When reviewing a decision, the district court's role
is limited to determining whether the record contains
substantial evidence to support an ALJ's findings of
fact. Burns v. Barnhart, 312 F.3d 113, 118 (3d Cir.
2002). Substantial evidence has been defined as “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).
Determining whether substantial evidence exists is “not
merely a quantitative exercise.” Gilliland v.
Heckler, 786 F.2d 178, 183 (3d Cir. 1986)
(citing Kent v. Schweiker, 710 F.2d 110,
114 (3d Cir. 1983)). “A single piece of evidence will
not satisfy the substantiality test if the secretary ignores,
or fails to resolve, a conflict created by countervailing
evidence. Nor is evidence substantial if it is overwhelmed by
other evidence - particularly certain types of evidence
(e.g., that offered by treating physicians).”
Id. The Commissioner's findings of fact, if
supported by substantial evidence, are conclusive. 42 U.S.C.
§405(g); Dobrowolsky v. Califano, 606 F.2d 403,
406 (3d Cir. 1979); Richardson, 402 U.S. at 390, 91
district court cannot conduct a de novo review of
the Commissioner's decision, or re-weigh the evidence;
the court can only judge the propriety of the decision with
reference to the grounds invoked by the Commissioner when the
decision was rendered. Palmer v. Apfel, 995 F.Supp.
549, 552 (E.D. Pa. 1998); S.E.C. v. Chenery Corp.,
332 U.S. 194, 196-7, 67 S.Ct. 1575, 91 L.Ed. 1995 (1947).
Otherwise stated, “I may not weigh the evidence or
substitute my own conclusion for that of the ALJ. I must
defer to the ALJ's evaluation of evidence, assessment of
the credibility of witnesses, and reconciliation of
conflicting expert opinions. If the ALJ's findings of
fact are supported by substantial evidence, I am bound by
those findings, even if I would have decided the factual
inquiry differently.” Brunson v. Astrue, 2011
WL 2036692, 2011 U.S. Dist. LEXIS 55457 (E.D. Pa. Apr. 14,
2011) (citations omitted).
The ALJ's Decision
Social Security Act provides that a child under 18 is
“disabled” for purposes of SSI eligibility if he
or she “has a medically determinable physical or mental
impairment, which results in a marked and severe functional
limitation(s), 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). The Commissioner follows a
three-step sequential process in determining childhood
disability: (1) whether the child is doing substantial
gainful activity; (2) if not, whether he or she has a
medically determinable severe impairment; (3) if so, whether
the child's severe impairment meets, medically equals, or
functionally equals the severity of a set of criteria for an
impairment listed in 20 C.F.R. § 416.924.
impairment 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. §
416.926(a). The six domains are: acquiring and using
information; attending and completing tasks; interacting and
relating with others; moving about and manipulating objects;
caring for yourself; and health and physical well-being. 20
C.F.R. § 416.926a(b)(1)(i)-(iv). When evaluating the
ability to function in each domain, the ALJ considers
information that will help answer the following questions
“about whether your impairment(s) affect your
functioning and whether your activities are typical of other
children your age who do not have impairments: What
activities are you able to perform; What activities are you
not able to perform; Which of your activities are limited or
restricted compared to other children your age who do not
have impairments; Where do you have difficulty with your
activities - at home, in childcare, at school, or in the
community; Do you have difficulty independently initiating,
sustaining, or completing activities; and What kind of help
do you need to do your activities, how much help do you need,
and how often do you need it.” 20 C.F.R. §
denied the claim for benefits. More specifically, at step
one, the ALJ found that the claimant has not engaged in
substantial gainful activity since the application date. (R.
18) At step two, the ALJ concluded that the claimant suffers
from the following severe impairments: asthma and attention
deficit hyperactivity disorder (ADHD). (R. 18) At step three,
the ALJ determined that the claimant does not have an
impairment or combination thereof that meets, equals, or
functionally equals the severity of one of the listed
impairments. (R. 19-31)
evaluating how a child's impairments affect his ability
to function, the ALJ is required to consider how well the
child can initiate, sustain, and complete his activities,
including the amount of help or adaptations he needs, and the
effects of structured or supportive settings.” A.B.
on Behalf of Y.F. v. Colvin, 166 F.Supp.3d 512, 520
(D.N.J. Feb. 16, 2016), citing, 20 C.F.R. §
416.924a(b)(5). “Because a structured setting often
masks the symptoms of a disability and improves the
child's ability to function within that supportive
environment, the ALJ is instructed to consider the degree of
limitation in functioning the child has or would have outside
the structured setting.” A.B. on Behalf of
Y.F., 166 F.Supp.3d at 520, citing, 20 C.F.R.
§ 416.924a(b)(5)(iv)(C). “That is, an ALJ cannot
appropriately evaluate the effects of [a claimant's]
structured setting on his ability to function without
identifying the nature of his structured ...