United States District Court, N.D. Illinois, Eastern Division
For Antoinette Wilson, Plaintiff: Patricia K. Best, LEAD ATTORNEY, Beth A. Alpert, Beth A. Alpert & Associates, Chicago, IL.
For Acting Commissioner Carolyn W. Colvin, Defendant: David R Lidow, LEAD ATTORNEY, AUSA-SSA, United States Attorney's Office (NDIL), Chicago, IL.
MEMORANDUM OPINION AND ORDER
Milton I. Shadur, Senior United States District Judge.
Antonette Wilson (" Wilson" ), on behalf of her daughter J.D., seeks judicial review pursuant to Social Security Act (" Act" ) § 405(g) of the final decision of Commissioner of Social Security Carolyn Colvin (" Commissioner" ) denying J.D.'s claim for supplemental security income (" SSI" ) disability benefits. Both parties have moved for summary judgment under Fed.R.Civ.P. (" Rule" ) 56, and Wilson has alternatively moved to remand for further proceedings. For the reasons stated here, both Rule 56 motions are denied, but Wilson's alternative motion to remand is granted.
Standard of Review and Applicable Law
This Court reviews the ALJ's decision as Commissioner's final decision, reviewing the legal conclusions de novo and factual determinations with deference (Haynes v. Barnhart, 416 F.3d 621, 626 (7th Cir.2005)). Because factual determinations receive deferential review, courts may not " reweigh the evidence or substitute [their] own judgment for that of the ALJ" and will affirm Commissioner's decision " if it is supported by substantial evidence" (id.). But as Haynes further explains, " the ALJ must build a logical bridge from the evidence to his conclusion" (id.). Hence " [i]f the Commissioner's decision lacks adequate discussion of the issues, it will be remanded" (Villano v. Astrue, 556 F.3d 558, 562 (7th Cir.2009)).
To be found disabled, a child must meet or equal (either medically or functionally) the elements of an impairment listed in Appendix (" App'x" ) 1 to the Act's implementing regulations (see Reg. § 416.924). Those regulations create a multistep analysis for determining disability:
1. Commissioner must find that the child was not performing substantial gainful activity (Reg. § 416.924(b)).
2. Commissioner must then determine that the child has a severe medically determinable impairment or combination of impairments (Reg. § 416.924(c)).
3. With a " yes" answer at step 2, the next step is to determine whether the impairment meets or equals an impairment listed in App'x 1 (Reg. § 416.924(d)).
If all three steps have produced " yes" answers, that spells disability. But if the answer at step 3 is " no," Commissioner must then consider whether the child's limitations are functionally equal in severity to any listed impairment (Reg. § 416.924(d)) by analyzing the child's limitations in six domains of functioning: (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 (Reg. § 416.926a(b)(1)). Under that functional equivalence test, a child is disabled if she suffers from two " marked" limitations or one " extreme" limitation (Reg. § 416.926a(a)).
" Marked" limitations " interfere[ ] seriously" and " extreme" limitations " interfere[ ] very seriously" with the " ability to independently initiate, sustain, or complete activities" (Reg. § § 416.926a(e)(2)(i), 416.926a(e)(3)(i)). More quantitatively, the regulations define those terms this way: Where standardized test results are available, performance " at least two" standard deviations below the mean implies a " marked" limitation, while performance " at least three standard deviations" below the mean implies an " extreme" limitation (id.). For children under age 3 such as J.D., if there are no standardized test scores available in the record, functioning at a level " not more than two-thirds" of her chronological age implies a " marked limitation," while functioning at a level " one-half of [her] chronological age or less" implies an " extreme" limitation (Reg. § § 416.926a(e)(2)(ii), 416.926a(e)(3)(ii)).
On November 18, 2010 Wilson filed an application for SSI disability benefits on behalf of her daughter J.D. (R. 115-23). That application was denied both initially and on reconsideration (R. 58, 63). Wilson then requested and received a hearing (the " Hearing" ), which took place before Administrative Law Judge (" ALJ" ) Jose Anglada on March 26, 2012. Represented by counsel, Wilson testified during the hearing (R. 34-35). ALJ Anglada issued a decision denying SSI disability benefits on April 26, 2012 (R. 14). Although the ALJ concluded that J.D. did indeed have severe medical impairments -- developmental delay, left metatarsus adductus and asthma -- those impairments were held neither to have met nor to have equaled (medically or functionally) a listed impairment, so that J.D. was held not to be disabled (R. 20). That decision became Commissioner's once the Appeals Council denied Wilson's request for review (R. 1). On December 13, 2013 Wilson filed a timely complaint for judicial review (Compl. 1, ECF No. 8).
Wilson gave birth to J.D. prematurely (at 32 weeks old on November 22, 2009, weighing just 3-1/2 pounds (R. 218). At the time of the hearing, J.D. was 2 years
and 4 months old (see R. 17, 20). Wilson's application for SSI disability benefits cited four health problems: asthma, a left foot metatarsus adductus, acid reflux and developmental delay (R. 57). But the crux of Wilson's appeal concerns J.D.'s developmental delay. Wilson argues that after the agency's experts completed their review of the medical evidence in June 2011 (when J.D. was about 1-1/2 years old), new evidence came to light that indicated more severe ...