United States District Court, N.D. Illinois, Eastern Division
MEMORANDUM OPINION AND ORDER
R. Harjani United States Magistrate Judge
Sierra G., on behalf of her son, D.D.M, seeks
reversal or alternatively, a remand of the final decision of
the Commissioner of Social Security denying D.D.M's
application for Supplemental Security Income
(“SSI”). The Commissioner asks the Court to
affirm the denial of benefits. For the reasons that follow,
the Court concludes that the ALJ's decision denying
D.D.M.'s application was supported by substantial
evidence. Accordingly, Sierra's Motion for Summary
Judgment  is denied, and the Commissioner's Motion
for Summary Judgment  is granted.
29, 2014, Sierra filed an application for SSI on behalf of
D.D.M., alleging that D.D.M. had been disabled since he was
born on April 7, 2014 due to left upper extremity brachial
plexus injury and an inability to use his left
D.D.M's father testified that he heard D.D.M's left
arm “snap” when he was delivered. (R. 51). On
December 5, 2014, when he was almost eight months old, D.D.M.
underwent left brachial plexus exploration and left
intercostal to left ulnar nerve neurotization surgery.
Approximately six months post-surgery on June 10, 2015,
D.D.M. had significant improvement in terms of shoulder and
bicep movement. Id. at 1423. He was able to lift his
shoulder up to 90 degrees and flex his biceps but still had
no movement in his left wrist and held it in a neural
position. Id. In January 2017, D.D.M's
pediatrician reported that he had decreased range of motion
in his left arm, wore a splint at all times, and had no
feeling from his left elbow down his arm through his hand.
Id. at 1291. D.D.M. has full use of his right
application was initially denied on November 5, 2014 and upon
reconsideration on July 9, 2015. (R. 62-93). Sierra then
requested a hearing before an ALJ. Id. at 95-97. On
January 3, 2017, Sierra and D.D.M's father appeared
without an attorney and testified at a hearing before ALJ
Jordan Garelick. Id. at 32-61. On August 23, 2017,
the ALJ issued a decision denying D.D.M's application for
SSI. Id. at 12-24. Applying the three step
sequential evaluation process for evaluating whether a child
is disabled, the ALJ found at step one that D.D.M. had not
engaged in substantial gainful activity since the date of his
application. Id. at 15. At step two, the ALJ found
that D.D.M. has the following severe impairments: motor
dysfunction, spinal cord or nerve root lesions, and spina
bifida brachial plexus birth palsy with left arm involvement.
Id. At step three, the ALJ determined that D.D.M.
does not have an impairment or combination of impairments
that meet or medically equal the severity of any of the
listed impairments. Id. The ALJ next determined that
D.D.M. does not have an impairment or combination of
impairments that functionally equals the severity of any
listing. Id. at 15-24. In making the functional
equivalence determination, the ALJ found that D.D.M. has a
marked limitation in moving about and manipulating objects;
less than a marked limitation in health and physical
well-being; and no limitations in acquiring and using
information, attending and completing tasks, interacting and
relating with others, and caring for himself. Id.
Based on these findings, the ALJ concluded that D.D.M has not
been disabled since the date of his application. Id.
at 24. The Appeals Council denied D.D.M's request for
review on June 21, 2018. Id. at 1-6. D.D.M. now
seeks judicial review of the ALJ's decision, which is the
final decision of the Commissioner. Jozefyk v.
Berryhill, 923 F.3d 492, 396 (7th Cir. 2019).
the Social Security Act, a “child qualifies as disabled
and therefore may be eligible for SSI if he has a
‘medically determinable physical or mental impairment,
which results in marked and severe functional
limitations' and the impairment ‘has lasted or can
be expected to last for a continuous period of not less than
12 months.'” Hopgood ex rel. L.G. v.
Astrue, 578 F.3d 696, 699 (7th Cir. 2009). When
determining whether a child meets this definition, the ALJ
applies a three-step sequential evaluation process: (1) has
the child engaged in substantial gainful activity; (2) does
the child have “a medically determinable impairment (or
combination of impairments) that is ‘severe'”
and (3) does the severe impairment (or combination of
impairments) meet, medically equal, or functionally equal the
severity of a listing. L.D.R. by Wagner v.
Berryhill, 920 F.3d 1146, 1150 (7th Cir. 2019). To
determine whether a child's impairment functionally
equals a listing, “the ALJ considers six
‘domains' of functioning: (1) acquiring and using
information; (2) attending to and completing tasks; (3)
interacting with and relating to other people; (4) moving
about and manipulating objects; (5) caring for oneself; and
(6) health and physical well-being.” Id. at
1150-51. “Functional equivalence exists, and a child
qualifies for benefits, if the ALJ finds a marked difficulty
in two domains of functioning or an extreme limitation in
one.” Murphy v. Astrue, 496 F.3d 630, 633 (7th
Cir. 2007). A “marked” limitation is one which
interferes seriously with the child's ability to
independently initiate, sustain, or complete activities. 20
C.F.R. § 416.926a(e)(2)(i). An “extreme”
limitation occurs when the impairment very seriously
interferes with the child's ability to independently
initiate, sustain, or complete activities. 20 C.F.R. §
review of the ALJ's decision is limited to determining
whether it adequately discusses the issues and is based upon
substantial evidence and the proper legal criteria. See
Villano v. Astrue, 556 F.3d 558, 562 (7th Cir. 2009);
Scheck v. Barnhart, 357 F.3d 697, 699 (7th Cir.
2004). “Substantial evidence means ‘such relevant
evidence as a reasonable mind might accept as adequate to
support a conclusion.'” Zurawski v.
Halter, 245 F.3d 881, 887 (7th Cir. 2001) (quoting
Richardson v. Perales, 402 U.S. 389, 401 (1971)). In
reviewing an ALJ's decision, the Court may “not
reweigh the evidence, resolve conflicts, decide questions of
credibility, or substitute [its] own judgment for that of
the” ALJ. Clifford v. Apfel, 227 F.3d 863, 869
(7th Cir. 2000). Although the Court reviews the ALJ's
decision deferentially, the ALJ must nevertheless
“build an accurate and logical bridge” between
the evidence and his conclusions. See Steele v.
Barnhart, 290 F.3d 936, 938, 941 (7th Cir. 2002)
(internal citation and quotations omitted); see also
Fisher v. Berryhill, 760 Fed.Appx. 471, 476 (7th Cir.
2019) (explaining that the “substantial evidence”
standard requires the building of “a logical and
accurate bridge between the evidence and conclusion”).
Moreover, when the ALJ's “decision lacks
evidentiary support or is so poorly articulated as to prevent
meaningful review, the case must be remanded.”
Steele, 290 F.3d at 940.
challenges two of the ALJ's findings. Sierra first
contends that the ALJ should have found that D.D.M. has an
extreme limitation in the domain of moving about and
manipulating objects. Second, Sierra argues that the ALJ
should have found that D.D.M. experienced greater limitation
than “less than marked” in the domain of health
and physical well-being. Sierra does not object to the
ALJ's findings that D.D.M. had no limitation in the other
four domains of acquiring and using information, attending
and completing tasks, interacting and relating with others,
and caring for himself. The Court concludes that substantial
evidence the ALJ's findings that D.D.M. had a marked
limitation in moving about and manipulating objects and less
than a marked limitation in health and physical well-being.
Moving About and Manipulating Objects
determined that D.D.M. had a marked limitation in the domain
of moving about and manipulating objects. Without citation to
relevant case law or any medical evidence from the record,
Sierra argues that the ALJ erred in failing to find that
D.D.M. had an extreme-rather than merely marked-limitation in
domain of moving about and manipulating objects relates to a
child's gross and fine motor skills. 20 C.F.R. §
416.926a(j). In this domain, the ALJ considers how a child
moves his body from one place to another and how a child
moves and manipulates things. Id. For newborns and
young infants (birth to age 1), examples of typical
functioning include: exploring immediate environment by
moving body and using limbs, learning to hold head up, sit,
crawl, and stand, trying to hold onto a stable object and
stand actively for brief periods, and beginning to practice
developing eye-hand control by reaching for objects or
picking up small objects and dropping them into containers.
SSR 09-6p, 2009 WL 396028 at *4 (Feb. 17, 2009). Older
infants and toddlers (age 1 to age 3) should explore a wider
area of the physical environment with steadily increasing
body control and independence from others, begin to walk and
run without assistance and climb with increasing skill, try
frequently to manipulate small objects and to use hands to do
or get something wanted or needed, and use improving motor
skills to play with small blocks, scribble with crayons, and
feed self. Id. For children not yet three years old,
an “extreme” limitation is demonstrated by
“functioning at a level that is one-half of [one's]
chronological age or less.” 20 C.F.R. §
ALJ's determination that D.D.M. has a marked limitation
in the domain of moving about and manipulating objects is
supported by substantial evidence. In reaching this
conclusion, the ALJ noted that despite his left brachial
plexus injury, D.D.M was developmentally appropriate and
meeting all milestones at 11 months old, including pulling to
standing and taking a couple of steps with assistance. (R.
17, 1224); see also id. at 1176 (at nine months old,
D.D.M's functional level was “age
appropriate.”). At one year old, D.D.M. was walking
with good balance and his mobility was “age
appropriate.” Id. at 1257-58. At age 14 months
and six months after his surgery, D.D.M. had improvement in
terms of his left shoulder and bicep movement; he was able to
lift his shoulder up to 90 degrees and flex his biceps. (R.
22; 1423). The ALJ acknowledged, however, that D.D.M still
had significant left arm limitations as he was unable to move
his left wrist and held it at a neutral position.
Id. As the ALJ indicated, a complete review of all
other systems was normal at that time. Id.
also referenced the April 8, 2014 evaluation of Dr. Loris
Rayner, D.D.M's pediatrician, when D.D.M. was two years
old. (R. 22, 1303-06). The ALJ noted that D.D.M.'s
general health was described as good, he had no sleep issues
and no behavior issues, his mother expressed no concerns
regarding his development, and he had normal gait and no
coordination deficits. Id. at 22, 1303, 1305;
see also Id. at 1303 (at two years old, despite
limited use of his left arm, D.D.M could color with crayons,
put on ...