T. v. ASTRUE

Filing 25

ENTRY ON JUDICIAL REVIEW: In this case, the ALJ satisfied his obligation to articulate the reasons for his decision, and that decision is supported by substantial evidence in the record. Accordingly, the decision of the ALJ is AFFIRMED (see Entry). Signed by Judge William T. Lawrence on 12/11/2013.(SWM)

UNITED STATES DISTRICT COURT
SOUTHERN DISTRICT OF INDIANA
INDIANAPOLIS DIVISION
S. A. T., a minor by her mother,
CONSUELO T. JUAREZ,
Plaintiff,
vs.
CAROLYN W. COLVIN, Acting
Commissioner of Social Security,
Defendant.

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Cause No. 1:12-cv-1697-WTL-TAB

ENTRY ON JUDICIAL REVIEW
Plaintiff’s mother, Consuelo T. Juarez, requests judicial review of the final decision of
the Commissioner of the Social Security Administration (the “Commissioner”), denying her
application for Supplemental Social Security Income (“SSI”) under Title XVI of the Social
Security Act (the “Act”). The Court now rules as follows.
I.

PROCEDURAL HISTORY

Juarez filed an application for SSI on July 20, 2009, alleging that her minor daughter,
S.A.T., became disabled on February 14, 2009. The application was initially denied on October
29, 2009, and again upon reconsideration on January 27, 2010. Thereafter, S.A.T.’s mother
requested a hearing before an Administrative Law Judge (“ALJ”). The hearing was held on May
12, 2011, before ALJ Charles W. Ardery in Indianapolis, Indiana. During the hearing, Georgia
Ann Pitcher, Ph.D., a child clinical and school psychologist, testified as a medical expert. On
August 16, 2011, the ALJ issued a decision denying Jaurez’s application for benefits. The
Appeals Council upheld the ALJ’s decision and denied a request for review on September 18,
2012. This action for judicial review ensued.

II.

EVIDENCE OF RECORD

The relevant medical evidence of record follows.
A. Wishard Cottage Corners Health Center/Midtown Community Mental Health Clinic
In 2008, Dr. Mark Tirtilli, at the Wishard Cottage Corners Health Center, diagnosed
S.A.T. with Attention Deficit Hyperactivity Disorder (“ADHD”) and prescribed her various
drugs, including Ritalin and Concerta, to treat the symptoms. Eventually, Dr. Tirtilli referred
S.A.T. to Midtown Community Mental Health Clinic for a psychiatric consult regarding S.A.T.’s
behavior problems.
On March 17, 2009, Dr. Tirtilli noted that S.A.T. was “doing better at school,” while on
the medication, but still had “impulsivity/mood instability starting at 7 pm.” Tr. at 210. By April
14, 2009, however, Dr. Tirtilli noted that S.A.T. was “doing better both at home and at school.”
Id. at 207.
On March 11, 2010, S.A.T. underwent an initial consultation at the Midtown Community
Mental Health Clinic with Deborah Stamper, a clinical nurse specialist. Stamper noted that
S.A.T. was an honor roll student in the third grade with no behavioral problems at school. She
further reported that S.A.T. “has had irritability since her father left, but [is] more angry when
tormented by her Mother’s boyfriend’s 4 year old son.” Id. at 244.
On March 28, 2010, Jaurez reported to Stamper that S.A.T.’s hyperactivity was in
remission. S.A.T., however, continued to be very angry and irritable. Stamper diagnosed S.A.T.
with anxiety and a depressive disorder combined with ADHD. S.A.T. was also prescribed Zoloft
to treat her depression.
On November 11, 2010, Jaurez reported to Midtown social worker, Pamela O’Brien, that
she was “concerned about inappropriate ‘embarrassing’ behavior, sometimes of a sexual nature,

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as well as mood swings.” Id. at 247. She wanted advice on “how to deal with [S.A.T.’s] behavior
without yelling at her.” Id.
S.A.T. and her mother met with O’Brien on November 19, 2010. After the visit, O’Brien
opined as follows:
[S.A.T.] is reacting aggressively to what she perceives as a chaotic family that
does not meet her emotional needs. She is able to express her feelings verbally
and states that she wants to have more control over herself so that she can feel
better about herself and so that her siblings will want to take her places.
Id.
On December 16, 2010, after noting that S.A.T. continued to be irritable and
argumentative, Stamper increased S.A.T.’s Concerta dosage and continued her prescription for
Zoloft.
On February 19, 2011, Stamper reported that S.A.T. was not doing well in school. S.A.T.
was sad that she may have to repeat the 4th grade. A report from her teacher indicated that she
talked too much and was not completing her assignments on time. Stamper recommended that
the family begin consistent counseling with O’Brien.
Less than a month later, on March 6, 2011, Stamper noted that S.A.T.’s grades had
improved and she was making a “much greater effort at school.” Id. at 249. She was, however,
“having peer ridicule and peer troubles.” Id.
Over the next several weeks, Jaurez continued to complain about S.A.T.’s behavior; she
reported that S.A.T. threw temper tantrums, had screaming fits, and talked out of turn at school.
After several medication and dosage changes, however, S.A.T.’s mother reported on April 11,
2011, that “[S.A.T. was] doing very well and receiving excellent reports from school. She [was]
not irritable or oppositional.” Id. at 252. S.A.T.’s mother attributed the improvement to the
Concerta.
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B. Mental Status Examination/State-Agency Reviews
On October 8, 2009, S.A.T. underwent a mental status examination with Greg Lynch,
Ph.D. Dr. Lynch opined that S.A.T. suffered from ADHD and assigned her a Global Assessment
of Functioning (“GAF”) Score of 51-53. Dr. Lynch further concluded that S.A.T.’s medication
was “beneficial,” and “[t]he prognosis for [S.A.T.’s] improvement seem[ed] fair to good with
appropriate mental health intervention.” Id. at 228.
On October 27, 2009, Randal Horton, Psy.D., reviewed S.A.T.’s records and completed a
Childhood Disability Evaluation Form. He opined that S.A.T. had no limitations in acquiring and
using information, interacting and relating with others, moving about and manipulating objects,
caring for herself, and with regard to her health and physical well-being. Due to S.A.T.’s ADHD,
however, she had less than marked limitations in attending and completing tasks.
On January 27, 2010, state-agency doctor, Joelle Larsen, Ph.D., also completed a
Childhood Disability Evaluation Form and opined that S.A.T. had no limitations in acquiring and
using information, moving about and manipulating objects, caring for herself, and with regard to
her health and physical well-being. S.A.T., however, had less than marked limitations in
attending and completing tasks and interacting and relating with others.
C. Teacher/School Reports
In September 2009, while S.A.T. was in third grade, S.A.T.’s second grade teacher
completed a Teacher Questionnaire and reported that S.A.T. “struggled with working
independently in the classroom. She worked well with the teacher’s guidance, yet was
challenged with comprehending verbal directions and following.” Id. at 144. The teacher further
reported that S.A.T. “demands much of the teacher’s attention. Recess has been taken away and
[she has been removed] from the classroom. [She requires c]onstant verbal reminders to keep her

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focused.” Id. at 146. S.A.T. however, “is able to focus and complete tasks much quicker and
completely when medicated.” Id. at 149.
That same month, the school social worker indicated that S.A.T.
is a very intelligent child who is at grade level in all areas of functioning. Her
attention span and concentration are good with the aid of mediation and she can
focus without any problem. She is a self motivated child who does her work
independently and to date has had perfect attendance. Furthermore, she is NOT a
behavior problem at all! Her mother told the teacher . . . that the reason that she
applied for SSI is so she can get the money to send her to Catholic School!
Id. at 151 (emphasis in original). The school resource teacher further indicated that S.A.T. was
“in a regular [education] classroom with no behavior problems.” Id. at 223.
The following year, in August 2010, S.A.T.’s fourth grade teacher noted that S.A.T.
talked too much during class and often failed to complete her assignments on time. The teacher
reported in November 2010, that S.A.T. was reprimanded for chewing gum and playing with
pencils. S.A.T. was also earning below-average grades. On her November 29, 2010 midterm
report, her grades were as follows:
Reading

D

English

C

Spelling

C

Social Studies

F

Handwriting

B

Science

A

Math

D

As the year progressed, S.A.T.’s teacher continued to complain about S.A.T.’s excessive
talking during class. Additionally, S.A.T.’s grades remained low. On February 16, 2011,
S.A.T.’s midterm report listed the following grades:
Reading

D

Health

A

Spelling

C

English

B

Math

F

Social Studies

F

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The teacher also reported that S.A.T. was
having trouble staying focused on her work in the classroom. She often talks to
classmates or plays with objects in her desk . . . This draws attention away from
the skills being taught, and then she has difficulty with the written lessons related
to the skill. . . . During lessons I remind [S.A.T.] numerous times each day to
listen and pay attention and focus on her work or the lesson. Her response is
usually positive and cooperative, but she sometimes makes excuses or gives
reasons to support what she is doing. . . . Often when I give instructions to the
entire class [S.A.T.] does not hear me and asks me later what she is supposed to
be doing. These behaviors are contributing to lower grades for [S.A.T.] and slow
progress toward academic goals.
Id. at 281.
On April 13, 2011, an inclusion teacher1 at S.A.T.’s school reported that S.A.T. had
extreme limitations in attending and completing tasks, marked limitations in interacting and
relating to others, and less than marked limitations in acquiring and using information, moving
about and manipulating objections, caring for herself, and with regard to her health and wellbeing. The teacher did, however, note that S.A.T. exhibited “noticeable improvement” over the
last several weeks. Id. at 284.
On April 14, 2011, S.A.T.’s fourth grade teacher reported that S.A.T. had less than
marked limitations in acquiring and using information, attending and completing tasks,
interacting and relating to others, and moving about and manipulating objections. She had no
limitations in caring for herself or with regard to her health and well-being. S.A.T.’s fourth grade
teacher also noted that S.A.T.’s behavior had “changed drastically during the past two weeks.”
Id. at 285. She was “calm and more attentive in class” and “no longer disruptive.” Id.

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S.A.T. stated during the hearing that the inclusion teacher did not regularly work with
her and was in the classroom to help the special education students.
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D. Hearing Testimony
1. Jaurez
Jaurez testified that she applied for social security on behalf of her daughter because
“she’s very hyper. She was diddling in school and talking and screaming and arguing at home
and at school.” Id. at 39. She also stated that S.A.T. had trouble sleeping through the night and
was often worried that someone would break into the house. She further reported that S.A.T. was
defiant when asked to do chores and had problems controlling her anger, especially when her
brothers and sisters bothered her and her things.
2. Dr. Pitcher
Dr. Pitcher testified that she reviewed Listings 112.11, ADHD, and 112.04, Mood
Disorders in Children, but that S.A.T. did not suffer from a severe impairment or combination of
impairments. Dr. Pitcher clarified, however, that S.A.T. would have a severe impairment without
treatment, but that her ailments were under control with medication.
III.

APPLICABLE STANDARD

To be eligible for SSI, a claimant must meet the requirements of 42 U.S.C. § 423.
Pursuant to that statute, “disability” means the inability to engage in any substantial gainful
activity by reason of any medically determinable physical or mental impairment that has lasted
or can be expected to last for a continuous period of not less than twelve months. 42 U.S.C. §
423(d)(1)(A). The standard is a stringent one. The Act does not contemplate degrees of disability
or allow for an award based on partial disability. See Stephens v. Heckler, 766 F.2d 284, 285 (7th
Cir. 1985).
In determining whether a claimant under the age of eighteen is disabled, the
Commissioner employs a three-step sequential analysis. 20 C.F.R. § 416.924(a). At step one, if

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the claimant is engaged in substantial gainful activity, she is not disabled, despite her medical
condition. 20 C.F.R. § 416.924(b). At step two, if the claimant does not have a “severe”
impairment or a combination of impairments that is “severe,” she is not disabled. 20 C.F.R. §
416.924(c). At step three, the Commissioner determines whether the claimant’s impairment or
combination of impairments meets, medically equals, or functionally equals any impairment that
appears in the Listing of Impairments, codified at 20 C.F.R. pt. 404, subpt. P, App. 1. 20 C.F.R.
§ 416.924(d). If the claimant has an impairment or combination of impairments that meets,
medically equals, or functionally equals the listings, and meets the twelve-month duration
requirement, the claimant is deemed disabled. 20 C.F.R. § 416.906.
In determining whether an impairment functionally equals the listings, the ALJ must
examine the following 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 oneself; and (6) health and physical well-being. 20 C.F.R. §
416.926a(b)(1)(i)-(vi). The claimant’s impairment or combination of impairments must result in
“marked” limitations in two or more domains or an “extreme” limitation in one domain. 20
C.F.R. § 416.926a(a). A “marked” limitation is one that seriously interferes with the claimant’s
ability to sustain and complete activities. 20 C.F.R. § 416.926a(e)(2)(i). An “extreme” limitation
is one that very seriously interferes with the claimant’s ability to sustain and complete activities.
20 C.F.R. § 416.924a(e)(3)(i).
On review, the ALJ’s findings of fact are conclusive and must be upheld by this Court
“so long as substantial evidence supports them and no error of law occurred.” Dixon v.
Massanari, 270 F.3d 1171, 1176 (7th Cir. 2001). “Substantial evidence means such relevant
evidence as a reasonable mind might accept as adequate to support a conclusion,” id., and the

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Court may not reweigh the evidence or substitute its judgment for that of the ALJ. Overman v.
Astrue, 546 F.3d 456, 462 (7th Cir. 2008). The ALJ “need not evaluate in writing every piece of
testimony and evidence submitted.” Carlson v. Shalala, 999 F.2d 180, 181 (7th Cir. 1993).
Rather, the ALJ is required to articulate only a minimal, but legitimate, justification for his
acceptance or rejection of specific evidence of disability. Scheck v. Barnhart, 357 F.3d 697, 700
(7th Cir. 2004). In order to be affirmed, the ALJ must articulate his analysis of the evidence in
his decision; while “[he] is not required to address every piece of evidence or testimony,” [he]
must “provide some glimpse into [his] reasoning . . . [and] build an accurate and logical bridge
from the evidence to [his] conclusion.” Dixon, 270 F.3d at 1177.
IV.

THE ALJ’S DECISION

At step one, the ALJ found that S.A.T. had not engaged in substantial gainful activity
since June 22, 2009, the application date. At step two, the ALJ concluded that S.A.T. suffered
from the following severe impairments: ADHD and depression. At step three, the ALJ
determined that S.A.T. did not have an impairment or combination of impairments that met,
medically equaled, or functionally equaled the listings. Accordingly, the ALJ concluded that
S.A.T. was not disabled as defined by the Act from June 22, 2009, through the date of his
decision.
V.

DISCUSSION

Juarez advances two objections to the ALJ’s decision; both arguments are addressed
below.
A. Lack of Substantial Evidence to Support ALJ’s Decision
Jaurez argues that “substantial evidence fails to support the ALJ’s Step 2 determination
that the claimant was not disabled because her combined [ADHD] and depression was not a

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severe impairment.” Pet.’s Br. at 12, Dkt. No. 16. Jaurez maintains that the ALJ ignored or
mischaracterized various items in the record. This argument, however, is without merit. Indeed,
an ALJ need not discuss every piece of evidence in his disability decision. See Diaz v. Chater, 55
F.3d 300, 307-08 (7th Cir. 1995). Rather, as noted above, the ALJ must simply “provide some
glimpse into [his] reasoning . . . [and] build an accurate and logical bridge from the evidence to
[his] conclusion.” Scheck, 357 F.3d at 700. In this case, the ALJ did just that.
The ALJ noted that S.A.T. suffered from ADHD and depression, and that these ailments
caused various behavioral issues, including excessive talking and irritability. However, as of
April 2011, S.A.T.’s teachers and treatment providers indicated that S.A.T. had improved
“drastically,” and her symptoms were under control with medication. Dr. Pitcher also testified to
this fact during the hearing. Because S.A.T.’s symptoms were controlled by medication, the ALJ
concluded that S.A.T.’s ADHD and depression were not severe impairments.
Jaurez implies that Dr. Lynch’s Mental Status Evaluation, assessing S.A.T. with a GAF
Score of 51-53, belies this fact, and the ALJ’s failure to note his conclusion requires reversal. Dr.
Lynch’s report, however, is consistent with the ALJ’s decision. In this regard, Dr. Lynch opined
in October 2009, that S.A.T.’s medication was “beneficial,” and “[t]he prognosis for [S.A.T.’s]
improvement seem[ed] fair to good with appropriate mental health intervention.” Tr. at 228.
Thus, Dr. Lynch’s report does not contain evidence that is contrary to the ALJ’s decision such
that the ALJ’s failure to specifically discuss the report was improper.
Jaurez further argues that S.A.T.’s ADHD and depression symptoms do, in fact, meet or
functionally equal Listing 112.04, Mood Disorders, and Listing 112.11, ADHD.2 Both Listings
require “medically documented” evidence. See Listings 112.04 and 112.11. Jaurez, however,

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This argument appears to relate to the ALJ’s determination at Step 3 rather than Step 2.
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fails to cite any medical evidence in the record suggesting that these Listings are indeed met.
Rather, Jaurez points to the report issued by an inclusion teacher at S.A.T.’s school indicating
that S.A.T. does, in fact, have various extreme and marked limitations. Such a report, however, is
not an appropriate indicator that the listings are met.
In sum, the ALJ properly articulated his reasoning for finding S.A.T.’s ADHD and
depression to be non-severe impairments, and his determination is substantially supported by the
medical evidence of record.
B. Credibility Determination
Additionally, Jaurez argues that the ALJ’s credibility determination was “patently
erroneous” because it was “contrary to the evidence and contrary to Social Security Ruling 967p.” Pet.’s Br. at 18. The Court does not agree.
In determining credibility, an ALJ must consider several factors, including the claimant’s
daily activities, level of pain or symptoms, aggravating factors, medication, treatment, and
limitations, see 20 C.F.R. § 404.1529(c); S.S.R. 96–7p, and justify his finding with specific
reasons. Villano v. Astrue, 556 F.3d 558, 562 (7th Cir. 2009). “Furthermore, the ALJ may not
discredit a claimant’s testimony . . . solely because there is no objective medical evidence
supporting it.” Id. (citations omitted). District courts “afford a credibility finding ‘considerable
deference,’ and overturn [a finding] only if ‘patently wrong.’” Prochaska v. Barnhart, 454 F.3d
731, 738 (7th Cir. 2006) (quoting Carradine v. Barnhart, 36 F.3d 751, 758 (7th Cir. 2004)).
In this case, the AJL opined as follows:
After considering the evidence of record, the undersigned finds that the claimant’s
medically determinable impairments could reasonably be expected to produce the
alleged symptoms; however, the allegations concerning the intensity, persistence
and limiting effects of these symptoms are not credible to the extent they are
inconsistent with finding that the claimant has no severe impairment or
combination of impairments . . .
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Tr. at 17.
Jaurez faults the ALJ for using boilerplate language to explain his rejection of S.A.T.’s
reported symptoms. The Court shares in the sentiments expressed in several recent Seventh
Circuit opinions regarding the meaninglessness of certain Social Security “templates,” similar to
the one used here. See, e.g., Bjornson v. Astrue, 671 F.3d 640, 645-46 (7th Cir. 2012). That being
said, the ALJ listed S.A.T.’s reported symptoms and limitations and discussed the relevant
medical evidence in the record. The ALJ also noted that S.A.T. had shown significant
improvements while on medication, and focused on the recent non-medical reports issued by
S.A.T.’s teachers. After considering this evidence, the ALJ concluded that S.A.T.’s symptoms
were not as severe as Jaurez alleged. In light of the foregoing, the Court does not find the ALJ’s
credibility determination to be patently wrong.3
VI.

CONCLUSION

In this case, the ALJ satisfied his obligation to articulate the reasons for his decision, and
that decision is supported by substantial evidence in the record. Accordingly, the decision of the
ALJ is AFFIRMED.
SO ORDERED: 12/11/2013

_______________________________
Hon. William T. Lawrence, Judge
United States District Court
Southern District of Indiana

Copies to all counsel of record via electronic communication.

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Jaurez also argues that that the ALJ’s failure to consider S.A.T.’s GAF score of 51-53 in
relation to the credibility determination was “contrary to his duty.” Pet. Br. at 18. Again,
however, Dr. Lynch’s report is not contrary to the ALJ’s decision. Moreover, the ALJ was under
no specific duty to consider Dr. Lynch’s report in relation to his credibility determination.
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