United States District Court, C.D. California
LINA AL ZIADAT, Guardian Ad Litem of A.S.A, a minor, Plaintiff,
CAROLYN W. COLVIN, Acting Commissioner of Social Security,  Defendant.
MEMORANDUM OPINION AND ORDER AFFIRMING COMMISSIONER
JEAN ROSENBLUTH, Magistrate Judge.
Plaintiff Lina Al Ziadat seeks review of the Commissioner's final decision denying minor Claimant A.S.A.'s application for supplemental security income ("SSI"). The parties consented to the jurisdiction of the undersigned U.S. Magistrate Judge under 28 U.S.C. 636(c). This matter is before the Court on the parties' Joint Stipulation, filed May 8, 2014, which the Court has taken under submission without oral argument. For the reasons stated below, the Commissioner's decision is affirmed and this action is dismissed.
Claimant was born on March 18, 2007. (AR 19, 65.) On March 25, 2007, her mother, Plaintiff, filed an application for SSI on her behalf. (AR 65-70.) Plaintiff alleged that Claimant had been disabled from birth because of "[c]ongenital diaphragmatic hernia" and "lung damage." (AR 91.) A hearing was held on September 29, 2008, at which Claimant was represented by counsel and Plaintiff and an internist appeared and testified. (See AR 270, 288.) In a written decision issued June 2, 2009, an administrative law judge determined that Claimant was not disabled. (AR 270-85.)
On June 30, 2009, Plaintiff filed a new application on Claimant's behalf. (AR 594-97.) Plaintiff alleged that Claimant's impairments caused her difficulty in understanding and learning and adversely affected her physical abilities, her behavior with others, and her ability to take care of her personal needs. (AR 608-10; see also AR 642 (alleging "[s]peech delays and physical delays").) Plaintiff also noted Claimant's "hole on her heart [and] mild mitral valve prolapse." (AR 642.)
On February 26, 2010, the Appeals Council vacated the June 2009 decision and remanded for further proceedings. (AR 288-90.) The council directed the ALJ to make reasonable efforts to secure a qualified pediatrician or appropriate medical specialist to evaluate Claimant's case. (AR 288.) The council further directed him to enter into the record new evidence from the June 2009 application and a treating source. (Id.)
On October 12, 2011, a second hearing was held, at which pediatrician Perry Grossman appeared and testified as a medical expert. (AR 519-47.) In a written decision issued November 14, 2011, the ALJ again determined that Claimant was not disabled. (AR 15-34.) On January 17, 2013, the Appeals Council denied Plaintiff's request for review. (AR 7-9.) This action followed.
III. STANDARD OF REVIEW
Under 42 U.S.C. § 405(g), a district court may review the Commissioner's decision to deny benefits. The ALJ's findings and decision should be upheld if they are free of legal error and supported by substantial evidence based on the record as a whole. Id .; Richardson v. Perales, 402 U.S. 389, 401 (1971); Parra v. Astrue, 481 F.3d 742, 746 (9th Cir. 2007). Substantial evidence means such evidence as a reasonable person might accept as adequate to support a conclusion. Richardson, 402 U.S. at 401; Lincrenfelter v. Astrue, 504 F.3d 1028, 1035 (9th Cir. 2007). It is more than a scintilla but less than a preponderance. Lincrenfelter, 504 F.3d at 1035 (citing Robbins v. Soc. Sec. Admin., 466 F.3d 880, 882 (9th Cir. 2006)). To determine whether substantial evidence supports a finding, the reviewing court "must review the administrative record as a whole, weighing both the evidence that supports and the evidence that detracts from the Commissioner's conclusion." Reddick v. Chater, 157 F.3d 715, 720 (9th Cir. 1996). "If the evidence can reasonably support either affirming or reversing, " the reviewing court "may not substitute its judgment" for that of the Commissioner. Id. at 720-21.
IV. THE EVALUATION OF CHILDHOOD DISABILITY
"An individual under the age of 18 shall be considered disabled... if that individual 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); see also Howard ex rel. Wolff v. Barnhart, 341 F.3d 1006, 1013 (9th Cir. 2003).
A. The Three-Step Evaluation Process
In determining eligibility for SSI based on a childhood disability, the Commissioner follows a three-step evaluation process. 20 C.F.R. § 416.924(a).
In the first step, the Commissioner considers whether the child has engaged in substantial gainful activity; if so, the child is not disabled and the claim must be denied. § 416.924(b). If the child is not engaged in substantial gainful activity, the second step requires the Commissioner to consider whether she has a "severe" impairment or combination of impairments; if not, a finding of not disabled is made and the claim must be denied. § 416.924(c). If the child has a "severe" impairment or combination of impairments, the third step requires the Commissioner to determine whether the impairment meets, medically equals, or functionally equals an impairment in the Listing of Impairments ("Listing") set forth at 20 C.F.R., Part 404, Subpart P, Appendix 1. 416.924(d). If so and the impairment also meets the duration requirement, the child is disabled and benefits are awarded. Id.
An impairment "meets" a listed impairment if it satisfies all of the criteria described in the Listing. § 416.925(c) (3). An impairment "medically equals" a listed impairment "if it is at least equal in severity and duration to the criteria of any listed impairment." § 416.926(a). An impairment "functionally equals" a listed impairment if it results in marked limitations in at least two of six functional domains or an extreme limitation in at least one domain. § 416.926a(a). The six functional domains are (1) acquiring and using information; (2) attending to and completing tasks; (3) interacting with and relating to others; (4) moving about and manipulating objects; (5) caring for oneself; and (6) health and physical well-being. § 416.926a(b) (1) (i)-(vi). A marked limitation "interferes seriously with [the child's] ability to independently initiate, sustain, or complete activities." § 416.926a(e) (2). An extreme limitation "interferes very seriously" with those things. § 416.926a(e) (3).
B. The ALJ's Application of the Three-Step Process
At step one, the ALJ found that Claimant had never engaged in substantial gainful activity. (AR 20, 33.) At step two, he found that she had the severe impairment of Simpson-Golabi-Behmel syndrome ("SGBS"). (AR 20, 33.) At step three, he found that she did not have an impairment or combination of impairments that met or medically or functionally equaled a Listing. (AR 20, 34.) Specifically, the ALJ found that Claimant's SGBS did not meet Listings 112.12, 112.10, 12.02 B1, or 112.02 B2 (AR 20) and that she had "less than marked limitation" in each of the six functional domains (AR 20-34). He therefore found she was not disabled. (AR 34.)
The ALJ Did Not Err in Assessing the Opinion Evidence
Plaintiff contends that the ALJ erred in rejecting the findings and opinions of Claimant's treating physicians and Los Angeles Unified School District ("LAUSD") examiners concerning her functional limitations in favor of the opinion of the medical expert. (J. Stip. at 3.)
1. Relevant background
On May 18, 2007, Claimant and her twin brother were born at 34 weeks. (AR 107.) Her twin was diagnosed with SGBS, from which the twins' older brother also suffered. (Id.; see also AR 173.) Claimant was successfully treated for left-lung alectasis. (See AR 121, 124.) On May 24, 2007, she underwent left diaphragmatic hernia repair. (AR 182-83.) The procedure was successful and she suffered no complications. (Id.; see also AR 140-57.)
On October 10, 2007, examining consultant Scott Kopoian performed a psychological evaluation of Claimant, who was then four months and 22 days old. (AR 228-32.) He reported that her infant-development scores, when adjusted for premature birth, showed her mental development to be "Within Normal Limits" and her motor development to be "Mildly Delayed." (AR 230.) He estimated her developmental age in both areas to be two months. (Id.) Dr. Kopoian reported that Claimant's scores on the Vineland Adaptive Behavior Scales, which were based upon Plaintiff's reports of Claimant's behavior, were adequate in all categories. (AR 230-31.)
On October 19, 2007, registered play therapist Rita Snell of Kolchins/Thomas Infant Development Services ("KIDS") performed a developmental assessment of Claimant, who was then five months old but had a prematurity-adjusted age of four months. (AR 462-65.) Snell reported the following developmental scores: gross motor skills, eight to 12 weeks; adaptive skills, eight to 16 weeks; fine motor skills, four weeks; language skills, 16 weeks; personal/social skills, eight to 16 weeks. (AR 464.) Snell noted concern with "motor delays and limited mobility" and recommended weekly physical and occupational therapy and biweekly child-development appointments. (AR 465.) Treatment was intended to "facilitate age appropriate motor skills, " "[e]ncourage improved upper extremity use, " and "improve overall play, learning and interaction skills." (Id.)
On April 18, 2008, child-development specialist Michelle Livolsi of KIDS reported that Claimant, whose adjusted age was then nine and a half months, was social and excited to play but not very mobile. (AR 458; see also AR 459 (noting parents' concern with gross motor skills).) Livolsi reported the following developmental scores: cognitive skills, 40 to 44 weeks; receptive language skills, 36 weeks; expressive language skills, 28 to 36 weeks; fine motor skills, 32 to 40 weeks; gross motor skills, 32 to 36 weeks; social/self-help skills, 32 weeks. (AR 460.) She recommended continued physical and occupational therapy and increased child-development services. (AR 459.)
On May 19, 2008, Livolsi completed a developmental progress report. (AR 236.) Claimant's adjusted age was then 10.75 months. (Id.) Based on reports from her parents and counselor, Livolsi assessed the following developmental levels: cognitive development, 10 to 11 months; communicative development, seven to nine months; receptive development, nine months; gross motor skills, eight to nine months; fine motor skills, eight to 10 months; social/emotional development, eight months; adaptive development, eight months. (Id.) Livolsi established a plan for in-home physical therapy to help Claimant develop the skills necessary for walking; in-home instruction from a childdevelopment specialist to improve her understanding of abstract concepts and develop her problem-solving skills and personalsocial play; weekly in-home occupational therapy to improve eyehand coordination; and in-home visits from a respite worker to afford Claimant's mother relief. (See AR 239-45.)
On June 14, 2008, Claimant was seen by cardiologist Jay Pruetz. (AR 356.) He noted that she had no chronic medications, good appetite, and appropriate weight gain. (Id.) Her parents reported nonsevere developmental delays. (Id.) Claimant was able to crawl and stand, had four or five words, and could hold a bottle. (Id.) Claimant "appear[ed] to be doing quite well with no evidence of heart failure or pulmonary over-circulation." (AR 357.) Dr. Pruetz recommended reevaluation in six months. (AR 358.)
In treatment notes, pediatrician Michelle Thompson consistently noted that Claimant suffered general developmental delay. (See AR 421 (on June 19, 2008, noting "dev[elopmental] delay, progressing slowly"); AR 423 (on Apr. 10, 2008, noting "Dev Delay"); AR 425 (on Mar. 13, 2008, noting "Global dev delay"); AR 427 (on May 22, 2008, noting "Global dev delay").) In a letter dated June 20, 2008, Dr. Thompson reported that "[f]rom a developmental standpoint, [Claimant] is delayed (especially in gross motor skills)." (AR 250.)
In an August 21, 2008 report, geneticist Shoji Yano reported that Claimant's gene-mutation analysis was positive for SGBS. (AR 247-48.) Based on this result and Claimant's "developmental delay, early over growth, " and other clinical symptoms, Dr. Yano diagnosed SGBS. (Id.) He noted that females often present milder traits than males ...