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Weaver v. Saul

United States District Court, W.D. Pennsylvania

October 24, 2019

MICHELLE WEAVER, o/b/o R.L.F., Plaintiff,
ANDREW M. SAUL, Defendant.


          Donetta W. Ambrose, United States Senior District Judge.


         Plaintiff 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)[1] 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.


         1. Standard of Review

         Judicial 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 S.Ct. 1420.

         A 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).

         II. The ALJ's Decision

         The 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.

         An impairment functionally equals a listed impairment if the child has “marked” limitations[2] in two domains of functioning or an “extreme” limitation[3] 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. § 416.926a(b)(2)(i)-(iv).

         The ALJ 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)

         III. Discussion

         “When 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 ...

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