Leyba ex rel. C.J.L. v. Astrue

803 F. Supp. 2d 1259, 2011 U.S. Dist. LEXIS 34951, 2011 WL 1060437
CourtDistrict Court, D. Colorado
DecidedMarch 21, 2011
DocketCivil Action No. 09-cv-02780-WYD
StatusPublished
Cited by2 cases

This text of 803 F. Supp. 2d 1259 (Leyba ex rel. C.J.L. v. Astrue) is published on Counsel Stack Legal Research, covering District Court, D. Colorado primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Leyba ex rel. C.J.L. v. Astrue, 803 F. Supp. 2d 1259, 2011 U.S. Dist. LEXIS 34951, 2011 WL 1060437 (D. Colo. 2011).

Opinion

ORDER

WILEY Y. DANIEL, Chief Judge.

THIS MATTER is before the Court on review of the Commissioner’s decision that denied a child’s claim, through his mother, for supplemental security income. For the reasons stated below, this case is reversed and remanded for further fact finding.

I. INTRODUCTION AND BACKGROUND

Claimant C.J.L., a minor child, was born on January 21, 1997. (Transcript [“Tr.”] 13, Finding 1.) C.J.L. attends school, although he has been suspended on more than one occasion. (Tr. 181,199, 217.) He was placed in special education at school, and was provided with an Individualized Education Program [“IEP”]. (Id. 144-157.)

Through his mother, C.J.L. applied for supplemental security income in May 2007, alleging disability due to pediatric bipolar disorder and obsessive compulsive disorder. (Tr. 78-84, 101.) After his application was denied, C.J.L. timely requested a hearing. (Id. 49-53, 56.) A hearing was held on July 14, 2009. (Id. 21-48.) C.J.L. was 12 years old and in the sixth grade when he testified at the hearing. (Id. 13.)

On July 28, 2009, the Administrative Law Judge [“ALJ”] issued a decision finding C.J.L. not disabled. (Tr. 7-20.) The ALJ found that C.J.L.’s bipolar disorder, obsessive compulsive behavior, and cognitive disorder were “severe impairments,” but that his impairments did not meet, equal, or functionally equal a listed impairment. (Tr. 13) (citing 20 C.F.R. §§ 416.924(d) and 416.926a.) Specifically, the ALJ found that C.J.L. had no limitations in acquiring and using information, moving about and manipulating objects, or in health and well being. (Id. 16-20). He found that C.J.L. had less than marked limitations in attending and completing tasks, interacting and relating to others, and the ability to care for himself. (Id.) Because C.J.L. did not have an impairment or combination of impairments that resulted in “marked” limitations in two domains of functioning or an “extreme” limitation in one domain of functioning, the ALJ determined that C.J.L. was not disabled. (Id. 20.)

The Appeals Council denied C-J.L.’s request for review. (Id. 1-4). C.J.L. timely requested judicial review, and this appeal followed.

C.J.L., through his mother, makes the following arguments on appeal to this Court: (1) the ALJ failed to properly weigh the opinion of C.J.L.’s treating psychiatrist Salvador Cruz, M.D., (2) the ALJ’s rejection of Dr. Cruz’s opinion was not supported by substantial evidence, and (3) the ALJ failed to properly weigh the opinion of Dr. Wanstrath, a non-examining consultant, and failed to explain why it outweighed Dr. Cruz’s opinion. The Commissioner asserts in response that the ALJ reasonably determined based on all the evidence that C.J.L. was not disabled because he did not meet, equal or functionally equal a listed impairment. I address the arguments below.

II. ANALYSIS

A. Standard of Review

An individual under the age of 18 shall be considered disabled for the purposes of Title XVI of the Act if he 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 (the Duration Requirement). 42 U.S.C. § 1382c(a)(3)(C)(i). The sequential [1262]*1262process of evaluation for a minor child, as set forth at 20 C.F.R. § 416.924, requires the ALJ to determine, in this order, (1) whether the child is not engaged in substantial gainful activity, (2) whether the child has an impairment or combination of impairments that is severe, and (3) whether the child’s impairment meets or equals an impairment listed in appendix 1, sub-part P of 20 C.F.R. Pt. 404 (the listings). Briggs v. Massanari, 248 F.3d 1235, 1237 (10th Cir.2001).

If the child’s impairment does not meet or medically equal a listed impairment, 20 C.F.R. § 416.926a directs an assessment of whether the impairment is functionally equivalent to a listing. Pursuant to 20 C.F.R. § 416.926a(a), functional equivalence will be met if the child has “extreme” limitations in one domain of functioning or “marked” limitations in two domains of functioning. A child will be found to have a “marked” limitation in a domain when an impairment “seriously interferes with [his/ her] ability to independently initiate, sustain, or complete activities.” 20 C.F.R. § 416.926a(e)(2)(i). Day-to-day functioning under a “marked” limitation “may be seriously limited when [the child’s] impairments) limits only one activity or when the interactive and cumulative effects of [the] impairment(s) limit several activities.” Id. An “extreme limitation” is one that “interferes very seriously with [the child’s] ability to independently initiate, sustain, or complete activities.” Id. § 416.926a(e)(3)(i). It “does not necessarily mean a total lack or loss of ability to function.” Id.

A Court’s review of the determination that a child is not disabled is limited to determining whether the Commissioner applied the correct legal standard and whether the decision is supported by substantial evidence. Hamilton v. Sec. of Health and Human Servs., 961 F.2d 1495, 1497-98 (10th Cir.1992). Substantial evidence is evidence a reasonable mind would accept as adequate to support a conclusion. Brown v. Sullivan, 912 F.2d 1194, 1196 (10th Cir.1990). “It requires more than a scintilla of evidence but less than a preponderance of the evidence.” Gossett v. Bowen, 862 F.2d 802, 804 (10th Cir.1988).

“Evidence is not substantial if it is overwhelmed by other evidence in the record or constitutes mere conclusion.” Musgrave v. Sullivan, 966 F.2d 1371, 1374 (10th Cir.1992). Further, “if the ALJ failed to apply the correct legal test, there is a ground for reversal apart from substantial evidence.” Thompson v. Sullivan, 987 F.2d 1482, 1487 (10th Cir.1993).

B. Whether the ALJ’s Decision is Supported by Substantial Evidence

The first issue I address is whether the ALJ failed to properly weigh treating psychiatrist Dr.

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803 F. Supp. 2d 1259, 2011 U.S. Dist. LEXIS 34951, 2011 WL 1060437, Counsel Stack Legal Research, https://law.counselstack.com/opinion/leyba-ex-rel-cjl-v-astrue-cod-2011.