Adams v. Social Security Administration, Commissioner

Filing 10

MEMORANDUM OPINION. Signed by Judge L Scott Coogler on 7/16/2012. (KAM, )

FILED
2012 Jul-16 PM 03:28
U.S. DISTRICT COURT
N.D. OF ALABAMA

UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF ALABAMA
SOUTHERN DIVISION
LASHONDA ADAMS,
o/b/o A.M.P.,
Plaintiff,
vs.
MICHAEL J. ASTRUE,
Commissioner of Social Security
Defendant.

]
]
]
]
]
]
]
]
]
]

2:11-CV-1132-LSC

MEMORANDUM OF OPINION
I.

Introduction
The plaintiff, LaShonda Adams, on behalf of her son, Airimis M. Porter,

appeals from the decision of the Commissioner of the Social Security Administration
(“Commissioner”) denying her application for Child’s Supplemental Security
Income (“SSI”). Ms. Adams timely pursued and exhausted her administrative
remedies and the decision of the Commissioner is ripe for review pursuant to 42
U.S.C. §§ 405(g), 1383(c)(3).
Airimis was twelve years old at the time of the Administrative Law Judge’s
(“ALJ’s”) decision, and he was in the seventh grade. (Tr. at 58, 62.) Ms. Adams

Page 1 of 15

claims that her son became disabled on March 27, 2003, due to asthma, Oppositional
Defiant Disorder (ODD), and ADHD. (Tr. at 18, 286.)
When evaluating the disability of a child, the regulations prescribe a three-step
sequential evaluation process. See 20 C.F.R. § 416.924(a). The first step requires a
determination of whether the child is “doing substantial gainful activity.” Id. If he or
she is, the child is not disabled and the evaluation stops. Id. If he or she is not, the
Commissioner will consider the child’s physical or mental impairments to see if there
is an impairment or combination of impairments that is “severe.” Id. If the
impairments are not severe, the analysis stops. Id. However, if the impairments are
severe, the Commissioner will look to see if one of the impairments meets or equals
an impairment listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. Id. If the child has
such an impairment and it meets the durational requirement, the Commissioner will
find that he or she is disabled. Id.
In step number three of the sequential evaluation, the ALJ initially evaluates the
evidence and determines whether the child’s severe impairment or combination of
impairments found in step two meets or medically equals a listed impairment. If they
do not meet each of the criteria enumerated in the listings, the ALJ must decide
whether the impairment or combination of impairments “functionally equals” the

Page 2 of 15

severity of any listed impairment. See 20 C.F.R. § 416.924(d). When assessing
functional limitations, the Commissioner considers all the relevant factors, such as
how well the child can initiate and sustain activities, how much extra help he or she
requires, the effects of structures or supportive settings, how the child functions in
school, and the effects of medications or other treatments on the child’s health. 20
C.F.R. § 416.926a. To determine functional equivalence, the child’s limitations must
be evaluated in the following six functional areas, called domains: (1) acquiring and
using information; (2) attending and completing tasks; (3) interacting and relating
with others; (4) moving about and manipulating objects; (5) the ability to care for
himself; and (6) health and physical well-being. See 20 C.F.R. § 416.926a(b)(1)(i-vi).
An impairment or combination of impairments functionally equals a listed impairment
if it results in either “marked” limitations in two of the previously mentioned domains
or an “extreme” limitation in one domain. See 20 C.F.R. § 416.926a(a).
Applying this sequential evaluation, the ALJ found that Claimant has not
engaged in substantial gainful activity at any time relevant to the decision. (Tr. at 24.)
Based on the evidence presented, the ALJ concluded that his asthma, ADHD, and
Disruptive Disorder are considered “severe” according to 20 C.F.R. § 416.924(c).
Id. Nonetheless, the ALJ determined that these impairments, when considered

Page 3 of 15

singularly or in combination, did not medically meet or equal the severity of any
impairments listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. (Tr. at 25.) In
evaluating functional equivalence, the ALJ found that Claimant does not have an
impairment that meets or medically equals the listings in 20 CFR § 416.924(d) and
416.926(a). Id. In the domains of acquiring and using information and attending and
completing tasks, the ALJ found Claimant’s impairments caused a “less than marked
limitation.” (Tr. at 28.) In the domains of interacting and relating with others,
moving about and manipulating objects, caring for himself, and health and physical
well-being, the ALJ found “no limitation.” (Tr. at 29-32.) The ALJ concluded by
finding that “[b]ased on the application for supplemental security income filed on
March 21, 2003, Claimant has not been disabled, under Section 1614(a)(3)(c) of the
Act, at any time since that day.” (Tr. at 33.)
II.

Standard of Review
This Court’s role in reviewing claims brought under the Social Security Act is

a narrow one. The scope of its review is limited to determining (1) whether there is
substantial evidence in the record as a whole to support the findings of the
Commissioner, and (2) whether the correct legal standards were applied. See
Richardson v. Perales, 402 U.S. 389, 390, 401 (1971); Wilson v. Barnhart, 284 F.3d

Page 4 of 15

1219, 1221 (11th Cir. 2002). The Court approaches the factual findings of the
Commissioner with deference, but applies close scrutiny to the legal conclusions. See
Miles v. Chater, 84 F.3d 1397, 1400 (11th Cir. 1996). The Court may not decide facts,
weigh evidence, or substitute its judgment for that of the Commissioner. Id. “The
substantial evidence standard permits administrative decision makers to act with
considerable latitude, and ‘the possibility of drawing two inconsistent conclusions
from the evidence does not prevent an administrative agency’s finding from being
supported by substantial evidence.’” Parker v. Bowen, 793 F.2d 1177, 1181 (11th Cir.
1986) (Gibson, J., dissenting) (quoting Consolo v. Fed. Mar. Comm’n, 383 U.S. 607,
620 (1966)). Indeed, even if this Court finds that the evidence preponderates against
the Commissioner’s decision, the Court must affirm if the decision is supported by
substantial evidence. Miles, 84 F.3d at 1400. No decision is automatic, however, for
“despite this deferential standard [for review of claims] it is imperative that the Court
scrutinize the record in its entirety to determine the reasonableness of the decision
reached.” Bridges v. Bowen, 815 F.2d 622, 624 (11th Cir. 1987). Moreover, failure to
apply the correct legal standards is grounds for reversal. See Bowen v. Heckler, 748
F.2d 629, 635 (11th Cir. 1984).

Page 5 of 15

III.

Discussion
Plaintiff alleges that the ALJ’s decision should be reversed or remanded because

(1) the ALJ improperly accorded minimal weight to the opinions of Dr. Arista Rayfield
and Dr. S. Khan; and (2) the ALJ improperly accorded minimal weight to the opinion
of Ms. Brenda Poellnitz, Claimant’s first-grade teacher. (Doc. 8 at 9-10.)
Plaintiff argues that the ALJ improperly accorded minimal weight to the
opinions of Dr. Rayfield and Dr. Khan. (Doc. 8 at 10.) Plaintiff contends that “the
ALJ’s reasoning for finding Dr. Rayfield, Dr. Khan, and Ms. Poellnitz to all be not
credible was conclusory” and not based on substantial evidence. (Doc. 8 at 9.)
Under the regulations, the medical opinions of non-treating sources do not
enjoy a deferential status. See 20 C.F.R. § 416.927(d). Instead, the weight the ALJ
affords them varies depending on several factors, including the sources’ examining
and treatment relationship with the claimant, as well as the opinions’ supportability
and consistency with the other evidence of record. Id.
A.

Physicians’ Diagnoses

Plaintiff contends that the ALJ improperly afforded minimal weight to the
opinion testimony of Dr. Rayfield. (Doc. 8 at 10.) Dr. Rayfield performed a
psychological examination on Claimant pursuant to a referral from Dr. Wall, a primary

Page 6 of 15

care physician. (Tr. at 19.) Dr. Rayfield examined the Claimant only once, in January
2003. She assessed a Global Assessment of Functioning (GAF) score of 50, indicating
serious symptoms or impairment in his day-to-day functioning. (Tr. at 27, 139.)
However, Dr. Rayfield observed that Claimant was cooperative, in a good mood, and
interacted well with his brother. (Tr. at 140.) She recommended a psychiatric
consultation, family intervention, and behavior intervention, but indicated that his
prognosis was fair and estimated treatment length at one year. (Tr. at 139.) The ALJ
considered Dr. Rayfield’s opinion, but gave it minimal weight. (Tr. at 27.) Because
Dr. Rayfield had examined Claimant only once, she had limited opportunity to assess
his limitations. Further, the ALJ noted that Dr. Rayfield’s assessment relied on
information from the Claimant’s mother, who had been shown to be a “less than fully
credible informant.” (Tr. at 27.) Claimant had not received any treatment or
counseling at the time of the evaluation, and was not on any medication. (Tr. at 27.)
This treatment history is evidence supporting the ALJ’s decision. See 20 C.F.R. §
416.929(c)(3)(v). An individual’s statements may be less credible if the level or
frequency of treatment is inconsistent with the level of complaints. See SSR 96-7p,
1996 WL 374186. Accordingly, substantial evidence supports the ALJ’s decision to
give minimal weight to Dr. Rayfield’s opinion.

Page 7 of 15

Plaintiff also contends that the ALJ essentially discarded all of the evidence that
supported disability when he improperly accorded minimal weight to the opinion of
Dr. Khan. (Doc. 8 at 10.) Dr. Khan is not a treating source under the regulations. 20
C.F.R. § 416.927(d). He saw Claimant only once or twice when he completed his
evaluation. (Tr. at 27.) The record reflects evidence of a single visit, on December
19, 2008. (Tr. at 266.) Dr. Khan completed an evaluation form provided by
Claimant’s representation on February 20, 2009, but it is unclear whether he actually
examined Claimant at that time. (Tr. at 270-73.) There is a drastic contrast between
the limitations alleged by Claimant at the January 2009 hearing and the limitations
reported by Dr. Khan on the evaluation form just 30 days later. (Tr. at 27.) Dr. Khan
indicated a marked or extreme limitation in each of the six domains. (Tr. at 271-272.)
In five of the domains, Dr. Khan found limitations more severe than those alleged at
hearing. (Tr. at 27, 353.) In fact, in two domains, Dr. Khan found limitations that
Claimant did not allege at all. (Tr. at 27.)
In Domain 1, Dr. Khan found an extreme limitation in acquiring and using
information. (Tr. at 271.) However, the record fails to support an extreme limitation
of function in this area. Examples of limited functioning in this domain are listed in
20 C.F.R. § 416.926a(g)(3) and include difficulty understanding words about space,

Page 8 of 15

size, or time; difficulty recalling important things learned in school yesterday; and
talking in only short, simple sentences. Claimant has not exhibited such problems.
Rather, Claimant’s mother testified that he is “very smart,” and makes A’s, B’s, and
C’s in school. (Tr. at 307.) School records at the time of the hearing indicate that
Claimant was maintaining a C average and was not in special education classes. (Tr.
at 234.) Ms. Poellnitz, Claimant’s first-grade teacher, indicated that he has less than
marked limitations in this domain. (Tr. at 157.) Ms. Garrison, his kindergarten
teacher, noted that he had no more than a “slight problem.” (Tr. at 217.) Even Dr.
Khan, despite his indication of an extreme limitation, initially assessed Claimant as
having an average fund of knowledge. (Tr. at 267.)
Dr. Khan’s opinion that Claimant has extreme limitations in Domain 2 is also
unsupported by the record. This domain measures how well a child is able to focus
and maintain his attention and how well he begins, carries through, and finishes his
activities, including the pace at which he performs activities and the ease with which
he changes them. 20 C.F.R. § 416.926a(h). As the ALJ noted, Claimant would be
expected to have some limitations in this area, given his diagnosis of ADHD. (Tr. at
28.) However, Claimant’s limited treatment suggests that his problems in this domain
are not as severe as alleged. The ALJ noted that Claimant has not taken his ADHD

Page 9 of 15

medications consistently or received consistent treatment. (Tr. at 29.) Claimant
stopped seeing Dr. Elrefai, who treated him for ADHD in 2004, and did not initiate
treatment with any other pediatric psychiatrist until December 2008. (Tr. at 29, 247,
332.) The ALJ reasoned that because Adderall requires a new prescription each
month, Claimant could not have taken the medication since 2004. (Tr. at 29.) This
lack of treatment is an indication that Claimant’s problems in this domain were not
debilitating. The ALJ did consider Dr. Khan’s assessment. However, substantial
evidence supports the ALJ’s finding of a less-than-marked limitation in Domain 2.
Dr. Khan also found an extreme limitation in Domain 3, which measures
Claimant’s ability to interact and relate with others. (Tr. at 272.) However,
substantial evidence supports the ALJ’s decision that Claimant has no limitation in
this domain. Dr. Khan assessed an extreme limitation in this domain after examining
Claimant only once. (Tr. at 266.) His fifth grade teacher, who would have observed
him daily, indicated the opposite. (Tr. at 239.) At the May 2005 hearing, Claimant
did not allege any limitations in this domain. (Tr. at 289.) In fact, he testified that he
has many friends, and enjoys playing sports with other children. (Tr. at 309-310.) In
October 2004, Dr. Mark Ticola, a primary care physician at Primary Care Clinic,
reported that Claimant had mostly younger friends. (Tr. at 264.) But, in October

Page 10 of 15

2006, Dr. Ticola reported “good” peer relations. (Tr. at 252.) In September 2008,
when Claimant was ten years old, Dr. Kierstin Leslie also indicated good peer
relations, noting that Claimant “gets along well with others.” (Tr. at 250.) Dr. Khan
gave no explanation for his conclusions, and his assessment is not supported by the
record. The ALJ properly discounted his opinion.
Dr. Khan’s assessment of a marked limitation in Domain 4 is also unsupported
by the record, and was properly discredited. Domain 4 measures a child’s ability to
move about and manipulate objects. (Tr. at 30.) Claimant never alleged a limitation
in this domain. In fact, Claimant reported playing football and kickball, wrestling, and
riding his bike — all of which are activities that would not be possible with a limitation
in Domain 4. (Tr. at 250, 252, 316.) None of Claimant’s teachers noted any limitation
in this domain. Furthermore, Dr. Khan is a psychiatrist and did not treat Claimant for
any physical condition. The ALJ correctly afforded no credit to Dr. Khan’s opinion
that Claimant has a marked limitation in this domain.
Dr. Khan indicated a marked limitation of function in Domain 5, but once again
provided no explanation for that level of severity. (Tr. at 272.) Domain 5 measures
Claimant’s ability to care for himself. (Tr. at 31.) In the May 2005 hearing, Claimant
alleged no limitation in this domain. (Tr. at 289.) However, in the January 2009

Page 11 of 15

hearing, he alleged a marked limitation. (Tr. at 354.) Dr. Khan’s assessment may
have been based on reports from Claimant’s mother that Claimant soils himself on a
regular basis, and has done so for years. (Tr. at 354.) However, as the ALJ noted,
there is no indication in the record that this conduct was ever reported to any medical
professional, and none of Claimant’s teachers noted such conduct on their
questionnaires. (Tr. at 25, 31.) Dr. Khan gave no explanation for his assessment, and
there is no evidence of behavior that would be consistent with a marked limitation of
function in this domain. The ALJ was not required to adopt Dr. Khan’s opinion.
Finally, in Domain 6, Dr. Khan indicated that Claimant has extreme limitations
in health and physical well-being. (Tr. at 271.) Claimant did not allege a limitation in
this domain, and the ALJ likewise found no limitation. (Tr. at 32.) Claimant’s
medical records support such a finding. The evidence reflects that Claimant received
only sporadic treatment for asthma, and that he did not take medication for ADHD
from 2004 until 2008. (Tr. at 32-33.) There is no medical evidence supporting an
extreme limitation of function in this domain. The ALJ was correct in discounting Dr.
Khan’s opinion.

Page 12 of 15

B.

Weight of Teacher’s Opinion

Plaintiff argues that the ALJ failed to give proper weight to the opinion of
Claimant’s first grade teacher, Ms. Poellnitz. Plaintiff argues that the ALJ went to
“great lengths” to find Ms. Poellnitz not credible, and that the ALJ’s reasoning for
finding her not credible was conclusory and not based on substantial evidence. (Doc.
8 at 9.)
In determining disability, the ALJ considers evidence from “acceptable medical
sources,” which include licensed physicians and licensed or certified psychologists.
20 C.F.R. § 416.913(a). A teacher is not an “acceptable medical source” under the
regulations. While the ALJ weighs such an opinion in the same manner as those from
a medical source, they are not entitled to any particular deference. 20 C.F.R.
§ 416.927(d). The ALJ can consider evidence not only from medical sources, but also
“evidence from other sources to show the severity of your impairment(s) and how it
affects your ability to work or, if you are a child, how you typically function compared
to children your age who do not have impairments.” 20 C.F.R. § 416.913(d). These
“other sources” can include school teachers, counselors, developmental center
workers, and parents. Id. “The better an explanation a source provides for an
opinion, the more weight we will give that opinion.” 20 C.F.R. § 416.927(d)(3). The

Page 13 of 15

weight given to opinions of non-examining sources “will depend on the degree to
which they provide supporting explanations for their opinions.” Id.
Ms. Poellnitz filled out a teacher questionnaire in May 2005. The questionnaire
was formulated by Claimant’s representative, and included no basis for the responses
given. (Tr. at 27, 157-158.) Ms. Poellnitz indicated a marked limitation in Domain 3,
Interacting and Relating to Others, as well as a marked limitation in Domain 5, Caring
for Self. (Tr. at 158.) She noted that Claimant “likes to daydream in class and
sometimes has a problem staying on task.” (Tr. at 158.)
As discussed above, substantial evidence supports the ALJ’s finding of no
limitation in Domain 3. At the time of Ms. Poellnitz’s assessment, Claimant was only
seven years old and known to have separation anxiety issues. (Tr. at 27). As the ALJ
noted, age and immaturity likely played a role in Ms. Poellnitz’s assessment of
limitations in this domain. (Tr. at 27.) Claimant alleged no limitation in this domain
at his 2005 hearing, which occurred just two days before Ms. Poellnitz completed the
questionnaire. (Tr. at 289.) Testimony from Claimant himself, as well as from other
teachers, provide substantial evidence for a finding of no limitation in Domain 3. The
ALJ properly discounted Ms. Poellnitz’s opinion.

Page 14 of 15

Ms. Poellnitz also provided no explanation for her assessment of a marked
limitation in Domain 5. As discussed above, however, such an opinion is unsupported
by the evidence on record. The ALJ properly afforded limited weight to her
assessment.
IV.

Conclusion.

Upon review of the administrative record, and considering all of Ms. Adams’
arguments, the Court finds the Commissioner’s decision is supported by substantial
evidence and in accord with the applicable law. A separate order will be entered.
Done this 16th day of July 2012.

L. Scott Coogler
United States District Judge
167458

Page 15 of 15