United States District Court, D. Arizona
Douglas L. Rayes United States District Judge
is a minor with rheumatoid arthritis. (AR 14, 17.) In
February 2013, Plaintiff's mother, Kifa Elia, filed an
application for Supplemental Security Income (SSI) benefits
on Plaintiff's behalf, alleging that Plaintiff's
rheumatoid arthritis became disabling on February 20, 2013.
(AR 14.) After state agency denials, Plaintiff and Elia
appeared and testified at a hearing before an Administrative
Law Judge (ALJ). (AR 32, 73, 83.) At the ALJ's request,
pediatrician Daniel Weisman appeared and testified as a
medical expert. (AR 32.) On January 13, 2014, the ALJ issued
a decision finding that Plaintiff is not disabled within the
meaning of the Social Security Act. (AR 27.) The ALJ's
decision became the agency's final decision when the
Appeals Council denied Plaintiff's request for review,
(AR 1), and this appeal followed. For the following reasons,
the agency's decision is affirmed.
Standard of Review
district court reviews only those issues raised by the party
challenging the agency's decision. See Lewis v.
Apfel, 236 F.3d 503, 517 n.13 (9th Cir. 2001). The
agency's decision must be upheld unless it is not
supported by substantial evidence or is tainted by harmful
legal error. Garrison v. Colvin, 759 F.3d 995, 1009
(9th Cir. 2014). Substantial evidence is more than a
scintilla, less than a preponderance, and relevant evidence
that a reasonable person might accept as adequate to support
a conclusion considering the record as a whole. Orn v.
Astrue, 495 F.3d 625, 630 (9th Cir. 2007). “Where
the evidence is susceptible to more than one rational
interpretation, one of which supports the ALJ's decision,
the ALJ's conclusion must be upheld.” Thomas v.
Barnhart, 278 F.3d 947, 954 (9th Cir. 2002). The court,
however, reviews “only the reasons provided by the ALJ
in the disability determination and may not affirm the ALJ on
a ground upon which he did not rely.”
Garrison, 759 F.3d at 1010.
Procedure for Evaluating Childhood SSI Cases
is considered disabled under the Social Security Act if she
“has 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 12 months.” 42 U.S.C. §
1382c(a)(3)(C)(i). When evaluating a minor claimant's
disability application, the agency follows a three-step
process. 20 C.F.R. § 416.924. First, the ALJ determines
whether the claimant is engaged in “substantial gainful
activity.” Id. § 416.924(a). If so, the
inquiry ends and the claimant is not disabled. Id.
§ 416.924(b). If, however, the claimant is not engaged
in substantial gainful activity, the ALJ proceeds to step two
and determines whether the claimant has a severe medically
determinable impairment or combination of impairments.
Id. § 416.924(a). If the claimant is not
severely impaired, she is not disabled. Id. §
416.924(c). If the claimant has a severe impairment or
combination of impairments, the ALJ proceeds to the final
step and determines whether the claimant's impairment(s)
meets, medically equals, or functionally equals an impairment
listed in Appendix 1 (Part B) to Subpart P of 20 C.F.R. Pt.
404. Id. § 416.924(a), (d). In determining
whether the claimant's condition functional equals a
listed impairment, the ALJ assesses the claimant's
functioning in six domains: (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 yourself; and (6) health
and physical well-being. Id. § 416.926a(b). A
claimant's condition functionally equals a listed
impairment if it results in marked limitations in at least
two domains or an extreme limitation in one. Id.
§ 416.926a(d). If a claimant's condition does not
meet, medically equal, or functionally equal a listed
impairment, she is not disabled.
steps one and two, the ALJ determined that Plaintiff has not
engaged in substantial gainful activity since her alleged
disability onset date and that her rheumatoid arthritis is a
severe impairment. (AR 17.) At step three, however, the ALJ
determined that Plaintiff's condition neither meets,
medically equals, nor functionally equals a listed
impairment. (AR 17.) In so doing, the ALJ found that
Plaintiff was not markedly limited in any of the six domains
of functioning. (AR 21-27.) The ALJ therefore concluded that
that she was not disabled. (AR 27.)
does not challenge the ALJ's conclusion that her
rheumatoid arthritis does not meet or medically equal a
listed impairment, nor does she challenge the ALJ's
assessment of her functioning in domains one, two, three, and
five. She challenges only the ALJ's findings that she has
less than marked functional limitations in domains four
(moving about and manipulating objects) and six (health and
four considers a minor claimant's ability to use motor
skills freely and to travel around school and the community.
20 C.F.R. § 416.926a(j)(2)(v). Minors “should be
able to participate in a full range of individual and group
physical activities, ” “show mature skills in
activities requiring eye-hand coordination, ” and
“have the fine motor skills needed to write efficiently
or type on a keyboard.” Id. Domain six
considers “the cumulative physical effects of physical
or mental impairments and their associated treatments or
therapies on [a claimant's] functioning[.]” §
Unlike the other five domains of functional equivalence
(which address a child's abilities), this domain does not
address typical development and functioning. Rather, the . .
. domain addresses how such things as recurrent illness, the
side effects of medication, and the need for ongoing
treatment affect a child's body; that is, the child's
health and sense of physical well-being.
Social Security Ruling (SSR) 09-8p, 2009 WL 396030, at *2. A
claimant's impairment(s) result in marked limitations if
it “interferes seriously” with the claimant's
“ability to independently initiate, sustain, or
complete activities.” 20 C.F.R. § 416.926a(2)(i).
the ALJ found that Plaintiff has less than marked limitations
in moving about and manipulating objects:
This finding is supported by the claimant's testimony
during the hearing. For instance, the claimant indicated she
was able to ride a bicycle, swim, dress herself, bathe, tie
her shoes, and prepare simple meals, like cereal or toast. As
well, the claimant indicated she can do dishes. She has
played three soccer games with the most recent one occurring
approximately one month prior to the hearing. Findings upon
physical examinations show of minimal abnormal findings
(Exhibits 1F & 6F). Moreover, the claimant frequently
denied any symptoms to treating physicians. This conclusion
is further supported by the opinion of the claimant's
teacher (Exhibit 5E).
(AR 25.) Likewise, the ALJ found that Plaintiff has less than
marked limitations in health and physical well-being:
The claimant is currently treated with medication and
occasional injections for juvenile arthritis (Exhibits 1F
& 6F). She is seen approximately every 2-3 months for
medication management and follow up. The claimant rarely
offers complaints and clinical findings are somewhat minimal.
Thus, treatment has been fairly conservative in nature. The
claimant is doing well in school and she testified to
maintaining general normal activities of daily living
(Exhibits 5E and Claimant's Testimony). Finally the
conclusion reached herein is consistent with that of the
reviewing physicians for the State agency (Exhibits 2A &
(AR 26-27.) In making these findings, Plaintiff contends that
the ALJ erred by: (1) rejecting the opinion of Dr. Wiseman;
(2) giving greater weight to the opinions of the state agency
reviewers than to the opinion of Dr. Wiseman; (3) giving
greater weight to the lay opinion of Plaintiff's teacher
than to the medical opinions in the record; and (4)
discounting Plaintiff's testimony concerning the
intensity, persistence, and limiting effects of her symptoms.
(Docs. 24, 29.) The Court addresses each issue in turn.