United States District Court, M.D. Florida
MEMORANDUM OF DECISION
GREGORY J. KELLY UNITED STATES MAGISTRATE JUDGE
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.
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.
EVALUATION OF A MINOR'S DISABILITY
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 §
THE ALJ'S DECISION
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.
Duty to Develop
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.
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”).
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