K.L.B., III v. Social Security Administration
Filing
20
REPORT AND RECOMMENDATIONS re 18 MOTION for Summary Judgment filed by Social Security Administration. Signed by Magistrate Judge Stephanie A Gallagher on 4/12/2019. (cm 04/12/2019 - jf3s, Deputy Clerk)
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF MARYLAND
ANISA E., as Parent and
Guardian of K.L.B., III, a minor child
*
*
*
v.
*
Civil Case No. GJH-18-1771
*
COMMISSIONER, SOCIAL SECURITY
*
*
*************
REPORT AND RECOMMENDATIONS
Pursuant to Standing Order 2014-01, the above-referenced case has been referred to me for
review of the parties’ dispositive motions and to make recommendations pursuant to 28 U.S.C. §
636(b)(1)(B) and Local Rule 301.5(b)(ix). I have considered the Commissioner’s motion for
summary judgment.1 ECF 18. This Court must uphold the Commissioner’s decision if it is
supported by substantial evidence and if proper legal standards were employed. 42 U.S.C. §§
405(g), 1383(c)(3); Craig v. Chater, 76 F.3d 585, 589 (4th Cir. 1996); Coffman v. Bowen, 829
F.2d 514, 517 (4th Cir. 1987). I find that no hearing is necessary. See Loc. R. 105.6 (D. Md.
2018). For the reasons set forth below, I recommend that the Commissioner’s motion be granted.
Plaintiff applied for and received Children’s Supplemental Security Income (“SSI”)
benefits on behalf of her minor child, K.L.B., III, in 2009. Tr. 81-96. On November 9, 2015, the
Commissioner determined that K.L.B., III was no longer disabled as of November 1, 2015. Tr.
97-100. Plaintiff sought reconsideration, but the original determination was upheld by a Disability
Hearing Officer. Tr. 122-30. After a hearing on November 21, 2016, an Administrative Law
Judge (“ALJ”) issued an opinion on March 8, 2017, affirming the determination that K.L.B., III’s
1
Plaintiff, who proceeds pro se, did not file a Motion for Summary Judgment in accordance with the
scheduling order. After the Commissioner filed her Motion for Summary Judgment on February 11, 2019,
ECF 18, a Rule 12/56 letter was mailed to Plaintiff, advising her of the potential consequences of failure to
oppose the Commissioner’s motion. ECF 19. Plaintiff still did not file a response.
disability had ended as of November 1, 2015, and finding that K.L.B., III had not become disabled
again since that date. Tr. 30-43. The Appeals Council denied review, making the ALJ’s decision
the final, reviewable decision of the Agency. Tr. 1-7.
The ALJ evaluated Plaintiff’s claim using the appropriate sequential process for
determining whether a child’s disability has ended, as set forth in 20 C.F.R. § 416.994a. The ALJ
determined that the “comparison point decision” was the decision finding K.L.B., III disabled on
April 29, 2009, as a result of hypoplastic left heart syndrome. Tr. 33. The ALJ found that, although
K.L.B., III continued to suffer from the same cardiac condition through the date of the ALJ’s
opinion, medical improvement had occurred as of November 1, 2015. Tr. 34. In finding medical
improvement, the ALJ relied on several facts, including that K.LB., III “has not required further
surgical intervention in the past four years,” “his treatment notes indicate that he has been doing
relatively well and that his symptoms have improved,” and a state agency medical examiner’s
opinion supported a finding of medical improvement. Tr. 34. At step three, the ALJ concluded
that K.L.B., III’s condition after November 1, 2015 did not meet the listings within Section 104.00.
Tr. 34, 42. The ALJ further found, by considering K.L.B., III’s degree of limitation in six domains
of functioning, that after November 1, 2015, K.L.B., III did not have an impairment or combination
of impairments that were functionally equivalent to any listing. Tr. 34-43. Therefore, the ALJ
determined that K.L.B., III’s disability ended as of November 1, 2015, and that he had not become
disabled again between that date and the date of the ALJ’s opinion. Tr. 43.
My review of the ALJ’s decision is confined to whether substantial evidence, in the record
as it was reviewed by the ALJ, supports the decision and whether correct legal standards were
applied. See Richardson v. Perales, 402 U.S. 389, 390 (1971). Even if there is other evidence that
may support Plaintiff’s position, I am not permitted to reweigh the evidence or to substitute my
2
own judgment for that of the ALJ. See Hays v. Sullivan, 907 F.2d 1453, 1456 (4th Cir. 1990). In
considering the entire record, I find that the ALJ’s RFC determination was supported by substantial
evidence.
The ALJ accurately summarized the medical evidence of record throughout her opinion,
and appropriately referred to evidence, with record citations, to support her conclusions in
evaluating whether K.L.B., III’s condition met or medically equaled or was functionally equivalent
to any listing. Tr. 34-42. The ALJ specifically considered Listings 104.05 and 104.06, and
identified which criteria had not been met with discussion of the relevant medical evidence. Tr.
34, 42. Functional equivalence is determined by rating a child’s abilities in six “domains.”
Disability is established if the child has an “extreme” degree of limitation in one domain, or a
“marked” limitation in two domains. See 20 C.F.R. § 416.926a. The ALJ found that, between
November 1, 2015 and March 8, 2017, K.L.B., III was attending school and keeping up with his
peers, and accordingly had “no limitation” in the four functional domains of “acquiring and using
information,” “attending and completing tasks,” “interacting and relating with others,” and “caring
for yourself.” Tr. 36-41. The ALJ found that, during that same time frame, K.L.B., III had “less
than marked limitation in moving about and manipulating objects,” Tr. 39, citing somewhat
contradictory testimony from Plaintiff regarding K.L.B., III’s ability to run and play, and the
reports from his physicians indicating that he could start “karate or any sports he would enjoy,”
and had no cardiac restrictions on his activities. Tr. 40. Finally, the ALJ determined that K.L.B.,
III had marked limitation in the domain of “health and physical well-being,” citing “Holter
monitoring, which showed evidence of increased bradycardia, which may eventually result in the
claimant requiring a pacemaker.” Tr. 41. However, the ALJ determined that “extreme” limitations
were not warranted, because “the claimant has not been restricted from participating in any
3
activities, despite the fact that [Plaintiff] reported his alleged symptoms to his treating physician.”
Id. Because the ALJ did not find either “marked” limitation in two functional domains or
“extreme” limitation in one, the ALJ properly concluded that K.L.B., III’s condition did not
functionally equal a listing. I therefore recommend that the ALJ’s opinion be affirmed.
Although Plaintiff did not file a motion for summary judgment, and did not address, in her
Complaint, specific deficiencies in the ALJ’s opinion, she raised two other issues that merit
attention here. ECF 1. First, she alleged that K.L.B., III’s health has worsened since the time of
the ALJ’s opinion. ECF 1 at 5 (“[S]ince we have been denied by a law judge [K.L.B., III] has
received a pace maker, therefore I requested his S.S.I. be reinstated, or at least reviewed.”). The
record contains some very limited documentation suggesting that K.L.B., III was hospitalized in
May, 2017, about two months after the ALJ’s decision, and was scheduled to have a pacemaker
implanted in October, 2017. Tr. 378-79. While the limited records regarding those developments
were presented to the Appeals Council, the records do not demonstrate or suggest that K.L.B., III’s
worsening condition relates back to a date preceding the ALJ’s opinion. The Appeals Council
must review additional evidence only if it is “(a) new, (b) material, and (c) relates to the period on
or before the date of the ALJ’s decision.” Wilkins v. Sec’y, Dep’t of Health & Human Servs., 953
F.2d 93, 95–96 (4th Cir.1991) (quoting Williams v. Sullivan, 905 F.2d 214, 216 (8th Cir. 1990));
see also 20 C.F.R. § 416.1470. The burden of proving that evidence is new and material rests with
the claimant. See Taylor v. Astrue, Civil No. 5:09CV7–RLV, 2012 WL 909506, at *4 (W.D.N.C.
Mar. 16, 2012) (citing Allen v. Comm’r of Soc. Sec., 561 F.3d 646, 653 (6th Cir. 2009)) (finding
plaintiff did not satisfy her burden of demonstrating that new evidence was relevant to period on
or before ALJ hearing decision); Fagg v. Chater, 106 F.3d 390, 1997 WL 39146, at *2 (4th
Cir.1997) (unpublished table decision) (outlining the three prerequisites a plaintiff must satisfy to
4
merit remand on the basis of newly discovered evidence). Because, with the limited records
presented to the Appeals Council regarding the medical developments after the ALJ’s opinion,
Plaintiff did not satisfy her burden to prove that the evidence was relevant to the period predating
the ALJ’s opinion, the evidence of K.L.B., III’s condition after the date of the ALJ’s opinion must
be raised first to the Commissioner by way of a new application for benefits. The only issue
presented to the Court in this case is whether the ALJ provided substantial evidence to support her
conclusions, based on K.L.B., III’s medical condition between November 1, 2015 and March 8,
2017.
Second, in her Complaint, Plaintiff seems to suggest that the SSA is attempting to collect
a significant overpayment from her. ECF 1 at 6 (“I ask that the funds allocated $11,460.00, be
waived, from myself having to be paid.”). Any assessment of an overpayment, however, is not
included in the record in this case, and is not presented to this Court by way of a final decision
from the Commissioner. Accordingly, it is not yet ripe for judicial review, absent exhaustion of
proceedings seeking waiver at the agency level. See 42 U.S.C. § 405(g) (restricting judicial review
to “any final decision of the Commissioner of Social Security made after a hearing to which [the
claimant] was a party”).
CONCLUSION
For the reasons set forth above, I respectfully recommend that the Court GRANT
Defendant’s Motion for Summary Judgment, ECF 18; AFFIRM the decision of the Commissioner
pursuant to sentence four of 42 U.S.C. § 405(g); and order the Clerk to CLOSE this case.
Any objections to this Report and Recommendations must be served and filed within
fourteen (14) days, pursuant to Federal Rule of Civil Procedure 72(b)(2) and Local Rule 301.5(b).
5
NOTICE TO PARTIES
Failure to file written objections to the proposed findings, conclusions, and
recommendations of the Magistrate Judge contained in the foregoing report within fourteen (14)
days after being served with a copy of this report may result in the waiver of any right to a de novo
review of the determinations contained in the report and such failure shall bar you from challenging
on appeal the findings and conclusions accepted and adopted by the District Judge, except upon
grounds of plain error.
Dated: April 12, 2019
/s/
Stephanie A. Gallagher
United States Magistrate Judge
6
Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.
Why Is My Information Online?