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Amaya v. Colvin

United States District Court, C.D. California, Eastern Division

February 22, 2017

DEBORAH AMAYA on behalf of D.V.A., a minor, Plaintiff,
CAROLYN W. COLVIN, Commissioner of Social Security, Defendant.


          ANDREW J. WISTRICH United States Magistrate Judge.

         Plaintiff's mother and guardian ad litem filed this action on plaintiff's behalf seeking reversal of the decision of defendant, the Commissioner of Social Security (the “Commissioner”), denying plaintiff's application for child's supplemental security income (“SSI”) benefits. The parties have filed a Joint Stipulation (“JS”) setting forth their contentions with respect to each disputed issue.

         Administrative Proceedings

         The procedural facts are summarized in the Joint Stipulation. [JS 2-3]. Plaintiff began receiving child's SSI benefits in 2005 following the Commissioner's decision that plaintiff was disabled under section 111.09A of the Listing of Impairments (the “listing”). See 20 C.F.R. Pt. 404, Subpt. P, App. 1. [JS 2; see Administrative Record (“AR”) 21, 546].

         On February 19, 2010, the Commissioner reviewed plaintiff's disability status and found that he was no longer disabled as of February 1, 2010. [JS 2]. Plaintiff requested a hearing before an Administrative Law Judge (“ALJ”), who terminated benefits on the ground that plaintiff's disability ended due to medical improvement as of February 1, 2010. [JS 2; AR 15-32]. The Appeals Council denied plaintiff's request for review. [AR 1-4]. Plaintiff filed an action for judicial review, which resulted in a stipulated order for voluntary remand for further administrative proceedings . [JS 2; see AR 643-648]. On remand, a different ALJ conducted three new hearings. On March 30, 2015, the ALJ issued a final written hearing decision finding plaintiff not disabled as of February 1, 2010. [AR 542-559]. This action followed.

         Standard of Review

         The Commissioner's denial of benefits should be disturbed only if it is not supported by substantial evidence or is based on legal error. Brown-Hunter v. Colvin, 806 F.3d 487, 492 (9th Cir. 2015); Thomas v. Barnhart, 278 F.3d 947, 954 (9th Cir. 2002). “Substantial evidence” means “more than a mere scintilla, but less than a preponderance.” Bayliss v. Barnhart, 427 F.3d 1211, 1214 n.1 (9th Cir. 2005). “It is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005) (internal quotation marks omitted). The court is required to review the record as a whole and to consider evidence detracting from the decision as well as evidence supporting the decision. Robbins v. Social Sec. Admin, 466 F.3d 880, 882 (9th Cir. 2006); Verduzco v. Apfel, 188 F.3d 1087, 1089 (9th Cir. 1999). “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) (citing Morgan v. Comm'r of Soc. Sec. Admin., 169 F.3d 595, 599 (9th Cir. 1999)).


         A child under the age of 18 is disabled within the meaning of the Social Security Act “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) (as amended); see 20 C.F.R. § 416.906; see Merrill ex rel. Merrill v. Apfel, 224 F.3d 1083, 1085 (9th Cir. 2000) (citing section 1382c(a)(3)(C)(i)). The regulations governing the evaluation of childhood disability provide that “if the child's impairment or impairments do not meet, medically equal, or functionally equal in severity a listed impairment, the child is not disabled.” Brown v. Callahan, 120 F.3d 1133, 1135 (10th Cir. 1997) (citing 20 C.F.R. § 416.928 (a)); see 20 C.F.R. §§ 416.902, 416.906, 416.924-416.926a (regulations concerning childhood disability standards).

         To meet a listed impairment, a claimant must show that his or her impairment “meet[s] all of the specified medical criteria. An impairment that manifests only some of those criteria, no matter how severely, does not qualify.” Sullivan v. Zebley, 493 U.S. 521, 530 (1990); see Tackett v. Apfel, 180 F.3d 1094, 1099 (9th Cir. 1999). To medically “equal” a listed impairment, a claimant must present medical findings at least equal in severity and duration to all of the criteria for the most similar listed impairment. See Sullivan, 493 U.S. at 531; Tackett, 180 F.3d at 1099-1100; 20 C.F.R. § 416.926 (discussing medical equivalence for adults and children).

         If a child disability claimant does not have an impairment or combination of impairments that meets or medically equals any listing, the ALJ must consider whether it “functionally equals” a listed impairment. 20 C.F.R. §§ 416.924(a), 416.926a. “Functional equivalence” is determined not by reference to the criteria for any particular listed impairment, but by reviewing all relevant information in the case record, including information from a broad range of medical sources and nonmedical sources, to assess the child's functioning in six areas, which are referred to as “domains.” See 20 C.F.R. § 416.926a. The six domains are: (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). An impairment or combination of impairments functionally equals the listing if, applying criteria detailed in the Commissioner's regulations, it results in “marked” limitations in two domains or an “extreme” limitation in one domain. 20 C.F.R. § 416.926a(a), (e)(1).

         In determining whether a child's disability continues or has ended, the Commissioner employs a three-step evaluation process. The first step asks whether there has been medical improvement, as the Commissioner defines that term, in the impairment or combination of impairments that formed the basis of the most recent favorable determination or decision.[1] If there has been no medical improvement in the CPD impairment(s), the child's disability continues, unless a specified exception applies. If there has been medical improvement in the CPD impairment(s), the Commissioner considers whether the CPD impairment(s) still meets, medically equals, or functionally equals the severity of the listed impairment that it met or equaled at the time of the CPD. If so, the child is still disabled, unless a specified exception applies; if not, the inquiry proceeds to the third step, which asks whether the child's current impairment or combination of impairments is disabling under the childhood disability standard, that is, whether the child currently has a severe impairment or combination of impairments that meets, medically equals, or functionally equals a listed impairment. See 20 C.F.R. § 416.994a(a)-(b); SSR 05-03p, 2005 WL 6491605; Marquez ex rel. A.N.M. v. Astrue, 2012 WL 5457472, at *2 (C.D. Cal. Nov. 8, 2012).

         The ALJ found that the CPD was the Commissioner's July 11, 2005 decision finding plaintiff disabled on the grounds that he met section 111.09A of the listing due to the severe, medically determinable impairments of “mental retardation” and “speech/hearing delay.” [AR 546]. Section 111.09 concerns a “[c]ommunication impairment, associated with documented neurological disorder and one of the following:”

A. Documented speech deficit that significantly affects (see 111.00K1) the clarity and content of the speech; or
B. Documented comprehension deficit resulting in ineffective verbal communication (see ...

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