Andrea Holland v. Commissioner of Social Security

[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
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No. 20-10201
Non-Argument Calendar
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D.C. Docket No. 1:18-cv-25248-FAM
ANDREA HOLLAND,
on behalf of Amina West,
Plaintiff-Appellant,
versus
COMMISSIONER OF SOCIAL SECURITY,
Defendant-Appellee.
________________________
Appeal from the United States District Court
for the Southern District of Florida
________________________
(January 6, 2021)
Before JORDAN, BRANCH, and ED CARNES, Circuit Judges.
PER CURIAM:
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Andrea Holland, on behalf of her daughter, Amina West, appeals the district
court’s order affirming the Administrative Law Judge’s decision denying her
application for Child’s Insurance and Supplemental Security Income (SSI).
Holland presents several arguments on appeal that we distill into two issues:
(i) whether substantial evidence supports the ALJ’s determination that Amina’s
impairments did not meet, medically equal, or functionally equal the severity of a
listed impairment, and (ii) whether the ALJ properly assessed the medical and non-
medical opinion evidence of record.
I.
In November 2015 Holland applied for SSI on behalf of Amina, alleging a
disability onset date of January 1, 2015, when Amina was four years old. In the
disability report, Holland stated that Amina suffered from attention deficit
hyperactivity disorder (ADHD) and impulsive behavior. She noted that Amina
was in kindergarten and was not receiving special education.
The Social Security Administration denied Holland’s claim initially and
again on reconsideration. Holland requested a hearing before an ALJ, who issued
a decision denying her claim. The Administration’s Appeals Council, which
manages the agency’s internal appeals process, denied Holland’s request for
review. Holland then filed an action in the district court. A magistrate judge
issued a report recommending that the district court affirm the ALJ’s decision.
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Holland objected, the Commissioner responded, and the district court issued an
order and judgment adopting the magistrate judge’s report and affirming the ALJ’s
decision.
II.
We review de novo the legal principles on which the ALJ’s decision is
based, but we review the resulting decision only to determine if it is supported by
substantial evidence. Moore v. Barnhart, 405 F.3d 1208, 1211 (11th Cir. 2005).
Substantial evidence is “less than a preponderance,” id., but “more than a
scintilla,” Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176, 1178 (11th Cir. 2011).
It is “such relevant evidence as a reasonable person would accept as sufficient to
support a conclusion.” Id. “We may not decide the facts anew, reweigh the
evidence, or substitute our own judgment for that of the [ALJ].” Id. Taken
together, those principles mean that we defer to the ALJ’s decision so long as it is
supported by substantial evidence, even if other evidence may preponderate against
it. See Crawford v. Comm’r of Soc. Sec., 363 F.3d 1155, 1158–59 (11th Cir.
2004).
III.
Holland contends that substantial evidence does not support the ALJ’s
determination that Amina’s impairments did not meet, medically equal, or
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functionally equal the severity of a listed impairment. That contention calls into
play the legal framework needed to assess the propriety of the ALJ’s decision.
A child under the age of 18 is disabled if she has a medically determinable
impairment that results in marked and severe functional limitations and is expected
to last for at least one year. 42 U.S.C. § 1382c(a)(3)(C)(i); 20 C.F.R. § 416.906.
To determine whether a child is disabled, the ALJ must apply a three-step analysis:
(1) whether the child is working; (2) whether the child has a severe impairment or
combination of impairments; and (3) whether that impairment or combination of
impairments meet, medically equal, or functionally equal the severity of an
impairment in the Administration’s “Listing of Impairments.” See 20 C.F.R.
§ 416.924(a)-(d). The parties agree that Amina is not working and that her ADHD
is a severe impairment, so the question is whether there is substantial evidence to
support a conclusion that her impairment does not meet, medically equal, or
functionally equal the severity of an impairment in the Listing.
A.
Holland argues that substantial evidence does not support the ALJ’s
determination that Amina’s impairments did not meet or medically equal the
impairments in the Listing. A child’s impairments “meet” an impairment in the
Listing if she actually suffers from the limitations specified by it for her severe
impairment. Wilson v. Barnhart, 284 F.3d 1219, 1224 (11th Cir. 2002). And
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limitations “medically equal” an impairment in the Listing if they “are at least of
equal medical significance to those of a listed impairment.” 20 C.F.R. §
416.926(a)(2). Applicable here, Listing 112.11 governs neurological disorders for
children age 3 to 18. To prove a disability the claimant must establish, among
other things:
Extreme limitation of one, or marked limitation of two, of the following
areas of mental functioning:
1. Understand, remember, or apply information.
2. Interact with others.
3. Concentrate, persist, or maintain pace.
4. Adapt or manage oneself.
20 C.F.R. pt. 404, subpt. P., app. 1, § 112.11 (“Listing 112.11”).
The ALJ determined that Amina’s impairments did not meet or medically
equal those limitations. After reciting the elements of Listing 112.11,1 the ALJ
ruled that Amina’s ADHD did not rise to the level of a listed impairment because,
among other things, Amina earns average grades in school without special
education or other educational allowances, and she is able to complete homework
and household chores. The ALJ recognized that Amina’s impairments limited her
ability to interact with others but ruled that this limitation was “less than marked”
1 The ALJ cited Listing 112.14, which governs neurological disorders for infants and
toddlers, instead of Listing 112.11, which governs neurological disorders for children 3 to 18.
But that error is harmless because the ALJ’s decision makes clear that he considered the
elements of Listing 112.11 and compared to them Amina’s limitations. See Diorio v. Heckler,
721 F.2d 726, 728 (11th Cir. 1983).
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because she has no trouble communicating with others, demonstrates no difficulty
relating to medical professionals, and shows no difficulty sustaining friendships.
The ALJ’s findings are consistent with the conclusions of two agency consultants,
Drs. Plasay and Rudmann, who are both acquainted with the evidentiary standards
of the disability program, and who both found that the medical evidence indicated
that Amina’s limitations in interacting with others were “less than marked.” The
ALJ’s determination that Amina’s ADHD did not meet or medically equal Listing
112.11 is supported by substantial evidence. See Winschel, 631 F.3d at 1178.
B.
Holland argues that the ALJ erred in determining that Amina’s impairments
do not “functionally equal” an impairment in the Listing of Impairments. To
functionally equal a listed impairment, a claimant must have marked limitations in
two or an extreme limitation in one of the following six 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), (d). A child’s
limitation is “marked” where it is “more than moderate” but “less than extreme”
and “interferes seriously with [the child’s] ability to independently initiate, sustain,
or complete activities.” Id. § 416.926a(e)(2)(i).
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The ALJ determined that Amina had marked limitations in the fifth domain,
caring for oneself, but no limitations or “less than marked” limitations in the other
domains. As a result, he determined that Amina’s impairments did not
functionally equal an impairment on the Listing of Impairments. Holland asserts
that “there is ample evidence to support a finding that Amina has at least ‘marked’
limitation in the domains of ‘attending and completing tasks’ and ‘interacting with
others.’” But the standard is not whether there is “ample evidence” to support
Holland’s argument; it is whether there is “substantial evidence” to support the
ALJ’s decision to the contrary. There is.
As to “attending and completing tasks,” the analysis looks at how well a
child can focus and maintain attention; begin, carry through, and finish activities;
avoid impulsive thinking; and manage her time. See 20 C.F.R. § 416.926a(h). The
ALJ acknowledged that difficulties in this domain are inherent with ADHD and
noted that Amina’s difficulties manifested as fidgeting, difficulty concentrating,
and disruptive behaviors at school. But he noted that despite those challenges,
Amina achieved passing grades without special education services and was able to
complete school assignments and household chores, albeit with prompts.
As to “interacting and relating with others,” the analysis focuses on how
well a child can initiate and sustain emotional connections with others; develop
and use the language of the community; cooperate with others; comply with rules;
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respond to criticism; and respect and take care of the possessions of others. See 20
C.F.R. § 416.926a(i). The ALJ found Amina’s limitations in this domain were less
than marked because, despite incidents of aggressive behavior toward herself and
her peers, she had no difficulty relating to medical professionals, had no difficulty
communicating with others, and had no difficulty sustaining friendships, trying
new experiences, or playing sports. Moreover, Holland herself stated in a function
report that Amina enjoyed being with other children her own age, showed affection
toward other children, and played games like tag and hide-and-seek. The ALJ’s
determination is consistent with the opinions of Drs. Plasay and Rudmann, which it
gave great weight; both doctors found that Amina had “less than marked”
limitations in this domain.
We conclude that substantial evidence supports the ALJ’s determination that
Amina’s impairments did not functionally equal an impairment in the Listing of
Impairments. The existence of evidence that is arguably inconsistent with the
ALJ’s conclusion is not grounds for reversal. See Crawford, 363 F.3d at 1158–59.
Even if the evidence were to predominate against the ALJ’s findings, we must not
disturb them unless there is nothing more than a scintilla of evidence to support
them. Id. There is much more than a scintilla of evidence to support the ALJ’s
decision.
IV.
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Holland contends that the ALJ “erred as a matter of law” by failing to
properly consider both medical and non-medical opinion evidence of record. She
argues that the ALJ downplayed the seriousness of treating psychiatric records,
which she asserts are medical opinions, and cursorily summarized Amina’s school
records, which indicated that she had a history of behavioral problems, including
physical aggression toward her peers.
Holland cites cases for the proposition that an ALJ must consider medical
opinions of record and “state with particularity the weight he gave to different
medical opinions and the reasons therefor.” Sharfarz v. Bowen, 825 F.3d 278, 279
(11th Cir. 1987); see also Winschel, 631 F.3d at 1178–79. She is correct that an
ALJ’s failure to state the weight he gave to a medical opinion is reversible error.
See Winschel, 631 F.3d at 1179. But she is incorrect about what counts as a
“medical opinion.” A medical opinion, in this context, must provide judgments
about Amina’s functional limitations or the severity of her impairments. See 20
C.F.R. 416.927(a)(2) (“Medical opinions are statements from acceptable medical
sources that reflect judgments about . . . what you can still do despite
impairment(s), and your physical or mental restrictions.”); see also Winschel, 631
F.3d at 1178–79 (“Medical opinions . . . reflect judgments about the nature and
severity of the claimant’s impairment(s), including . . . what the claimant can still
do despite the impairment . . . .”) (alterations adopted). But the evidence about
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which Holland complains — records of psychiatric treatment by Drs. Bernadotte
and Salgado — did not provide those judgments, so they were not medical
opinions. In any event, the record indicates that the ALJ did consider the medical
records from those two doctors; he simply did not draw from them the conclusion
that Holland asserts here.
Finally, Holland argues that the ALJ erred by discounting educational and
disciplinary records from Amina’s school, which reflected a number of behavioral
problems. But the ALJ explicitly stated that he “reviewed the various educational
evidence submitted into the record.” Although Holland asserts that the ALJ should
have provided a more detailed accounting of that evidence, he was not required to
do that. See Dyer v. Barnhart, 395 F.3d 1206, 1211 (11th Cir. 2005) (“[T]here is
no rigid requirement that the ALJ specifically refer to every piece of evidence in
his decision, so long as the ALJ’s decision . . . is not a broad rejection which is not
enough to enable the district court or this Court to conclude that the ALJ
considered her medical condition as a whole.”). Moreover, although he was not
required to, the ALJ did acknowledge the behavioral issues cited in Amina’s
school records but stated that he gave that evidence little probative weight because
they comprised the opinions of educators as opposed to medical professionals.
AFFIRMED.
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