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Sierra G. v. Saul

United States District Court, N.D. Illinois, Eastern Division

December 9, 2019

SIERRA G., on behalf of D.D.M., a minor, Plaintiff,
v.
ANDREW M. SAUL, Commissioner of Social Security, Defendant.

          MEMORANDUM OPINION AND ORDER

          Sunil R. Harjani United States Magistrate Judge

         Plaintiff Sierra G.[1], 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 [12] is denied, and the Commissioner's Motion for Summary Judgment [18] is granted.

         BACKGROUND

         On May 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 arm.[2] 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 dominant hand.

         D.D.M.'s 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).

         DISCUSSION

         Under 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. § 416.926a(e)(3)(i).

         Judicial 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.

         Sierra 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.

         A. Moving About and Manipulating Objects

         The ALJ 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 this area.

         The 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. § 416.926a(e)(3)(ii).

         The 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.

         The ALJ 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 ...


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