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McClelland v. Commissioner of Social Security

United States District Court, M.D. Florida

May 1, 2017

KERRY MYERS MCCLELLAND, Plaintiff,
v.
COMMISSIONER OF SOCIAL SECURITY, Defendant.

          MEMORANDUM OF DECISION

          GREGORY J. KELLY UNITED STATES MAGISTRATE JUDGE

         Kerry McClelland, on behalf of her minor daughter, V.M. (the “Claimant”), appeals to the District Court a final decision of the Commissioner of Social Security (the “Commissioner”) denying her application for Supplemental Security Income (“SSI”). Doc. No. 8. Claimant argues that the Commissioner erred by: 1) failing to consider new evidence submitted for the first time to the Appeals Council; 2) not considering Claimant's financial limitations when noting her lack of medical treatment; 3) failing to properly consider Ms. McClelland's testimony and Claimant's school records reflecting her mental performance; and 4) failing to develop the record by not ordering a consultative medical examination at any point in the administrative process. Doc. No. 28 at 15-18, 20-22, 27-30, 33-35. Claimant requests that the Commissioner's decision be reversed for an award of benefits as of the alleged onset date or, in the alternative, be reversed and remanded for further proceedings. Id. at 37. For the reasons set forth below, the Commissioner's decision is REVERSED and REMANDED for further proceedings.

         I. PROCEDURAL BACKGROUND

         On October 19, 2012, Claimant filed an application for SSI. R. 168. Claimant alleges a disability onset date of January 30, 2001. Id. On December 26, 2012, Claimant's application was denied. R. 117. On January 16, 2013, Claimant filed a request for reconsideration. R. 124. On March 7, 2013, Claimant's application was denied upon reconsideration. R. 126. On April 30, 2013, Claimant filed a request for a hearing before the Administrative Law Judge (the “ALJ”). R. 132. On September 29, 2014, Claimant attended a hearing before the ALJ. R. 51-88. On January 2, 2015, the ALJ issued an unfavorable decision. R. 31-46. On February 6, 2015, Claimant filed a request for review of the ALJ's decision. R. 27. On April 26, 2016, the Appeals Council denied review. R. 1-5. On June 2, 2016, Claimant filed the operative complaint against the Commissioner and initiated this appeal. Doc. No. 8.

         II. EVALUATION OF A MINOR'S DISABILITY

         For a child under the age of eighteen to be entitled to SSI, that child must have “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 [twelve] months.” Fontanez ex rel. Fontanez v. Barnhart, 195 F.Supp.2d 1333, 1345 (M.D. Fla. 2002) (citing 42 U.S.C. § 1382c(a)(3)(C)(i)). In making such a determination, the ALJ uses a three-step analysis. Espinoza ex rel. J.E. v. Astrue, No. 8:07-cv-2003-T-HTS, 2009 WL 331600, at *1 (M.D. Fla. Feb. 10, 2009). A “child is considered disabled if he or she: 1) is not engaged in substantial gainful activity; 2) has a medically determinable impairment that is severe; and 3) the impairment meets, medically equals, or functionally equals a [listed impairment].” Id. When considering whether an impairment functionally meets a listed impairment at step three, the Commissioner considers six domains of functioning: 1) acquiring and using information; 2) attending to 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. Id. (citing 20 C.F.R. § 416.926a (b)(1)). An impairment functionally equals a listed impairment if the child has “‘marked' limitations in two domains of functioning or an ‘extreme' limitation in one domain.” Id. (citing 20 CFR § 416.926a(a)).

         III. THE ALJ'S DECISION

         At step one, the ALJ found that Claimant has not engaged in substantial gainful activity since the filing of her application. R. 34. At step two, the ALJ found that Claimant has the following severe impairments: ADHD, asthma, mood disorder, psychotic disorder, headaches, and gastroesophageal reflux disease. Id. At step three, the ALJ found that Claimant's impairments (or combination thereof) did not meet or medically equal the severity of any of the listed impairments. R. 34-35. The ALJ also found that Claimant's impairments (or combination thereof) did not functionally equal the severity of any of the listed impairments. R. 35-45. Specifically, the ALJ found that Claimant had less than marked limitations in five of the six domains of functioning. R. 39-45. The ALJ found that Claimant had marked limitations in the domain of health and physical well-being. R. 45. Because the ALJ found that Claimant had marked limitations in only one of the six domains of functioning, the ALJ determined that Claimant was not disabled. R. 46.

         IV. ANALYSIS

         A. Duty to Develop

         Central to Claimant's appeal is the issue of whether the ALJ failed to develop the record. Doc. No. 28 at 33-36. Claimant argues that the ALJ failed to develop the record by not ordering a consultative examination for any of Claimant's alleged impairments. Id. at 34. The Commissioner argues that a consultative examination is not needed because “the ALJ determined [that] the record contained sufficient evidence for him to reach an informed decision on Claimant's claim.” Id. at 35. Thus, the parties agree that no consultative examination was ordered. Id. at 33-36.

         The Supreme Court in Sims v. Apfel, 530 U.S. 103, 110-11, 120 S.Ct. 2080, 2085, 147 L.Ed.2d 80 (2000), held that “[s]ocial security proceedings are inquisitorial rather than adversarial” and that the ALJ has a duty “to investigate the facts and develop the arguments both for and against granting benefits.” Id. (citing Richardson v. Perales, 402 U.S. 389 (1971)). The ALJ's duty includes ordering a consultative examination if one is needed to make an informed decision. Reeves v. Heckler, 734 F.2d 519, 522 n.1 (11th Cir. 1984) (citations omitted). Nevertheless, an ALJ is not required to order a consultative examination provided that the record contains sufficient evidence for the ALJ to make an informed decision. Ingram v. Commissioner of Soc. Sec. Admin., 496 F.3d 1253, 1269 (11th Cir. 2007) (“[t]he administrative law judge has a duty to develop the record where appropriate but is not required to order a consultative examination as long as the record contains sufficient evidence for the administrative law judge to make an informed decision”); Good v. Astrue, 240 Fed.Appx. 399, 404 (11th Cir. 2007) (“the ALJ need not order an additional consultative examination where the record was sufficient for a decision”).[1]

         The Commissioner argues that the ALJ determined the record to be sufficient to make an informed decision on this issue. Doc. No. 28 at 35. The ALJ's own statements, however, prove otherwise. In an exchange with Ms. McClelland (and her ...


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