Ceballos v. Commissioner of Social Security, 1:13-cv-07783

Background

Infant plaintiff A.A.C., born July 26, 2010, suffered an occipital encephalocele (fibrous tissue only) and mild hydrocephalus; surgical closure was performed in April 2011 without complication.
Mother Rose Garcia applied for SSI for A.A.C. on August 15, 2011, alleging disability from birth; initial SSA denial found no marked/severe functional limitations.
ALJ hearing on May 1, 2012 included testimony from Garcia and impartial medical expert Dr. Allan Rothenberg, who opined the child had no marked functional limitations and only "less than marked" health limitations.
Treating pediatric records (Dr. Tenorio) and surgeon Whitehead generally documented age-appropriate development, normal exams, and monitoring of hydrocephalus; MRIs confirmed mild hydrocephalus.
ALJ denied SSI on May 16, 2012, finding no marked or extreme limitations in the six regulatory domains and only a less-than-marked limitation in health/physical well-being; Appeals Council denied review.
District Court (Castel, J.) granted defendant Commissioner’s Rule 12(c) motion, holding the ALJ applied correct legal standards and the denial was supported by substantial evidence.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether A.A.C. received a full and fair hearing / whether ALJ adequately developed the record	Garcia (pro se) implied hearing/record sufficient but sought reversal of denial	Commissioner: ALJ complied with non-adversarial duty, explained rights, considered testimony and records	Court: ALJ afforded a full and fair hearing; record sufficiently developed
Whether A.A.C.’s impairments met or equaled Listing-level severity	Garcia argued encephalocele/hydrocephalus caused disabling limitations	Commissioner relied on medical and expert testimony that impairments did not meet Listings 111.06/111.08	Court: Impairments did not meet or equal listed impairments
Whether A.A.C. had ‘‘marked’’ or ‘‘extreme’’ functional limitations in regulatory domains	Garcia contended child had speech delay, lazy eye, motor/speech issues justifying benefits	Commissioner emphasized treating records and expert testimony showing age-appropriate functioning in five domains and only "less than marked" health limitation	Court: Substantial evidence supports ALJ findings of no limitation in five domains and less-than-marked in health/physical well-being
Standard of review / appropriateness of judgment on the pleadings	Garcia sought review under 42 U.S.C. § 405/1383; no opposition to defendant’s Rule 12(c) motion	Commissioner argued ALJ decision should be affirmed if supported by substantial evidence and correct legal standards	Court: Applied substantial-evidence/administrative-law standards and granted judgment for defendant

Key Cases Cited

Tejada v. Apfel, 167 F.3d 770 (2d Cir. 1999) (two-step review: legal standards then substantial evidence)
Kohler v. Astrue, 546 F.3d 260 (2d Cir. 2008) (deference to Commissioner when regulations followed)
Cage v. Comm’r of Soc. Sec., 692 F.3d 118 (2d Cir. 2012) (no de novo review by courts)
Rosa v. Callahan, 168 F.3d 72 (2d Cir. 1999) (ALJ’s duty to develop the record, especially for pro se claimants)
Echevarria v. Sec’y of Health & Human Servs., 685 F.2d 751 (2d Cir. 1982) (non-adversarial nature of hearings requires a full hearing)
Perez v. Chater, 77 F.3d 41 (2d Cir. 1996) (affirmative duty to develop the record regardless of representation)
Burgess v. Astrue, 537 F.3d 117 (2d Cir. 2008) (medical conflicts are for the Commissioner to resolve)
Snell v. Apfel, 177 F.3d 128 (2d Cir. 1999) (deference to ALJ credibility findings)
Yellow Freight Sys. Inc. v. Reich, 38 F.3d 76 (2d Cir. 1994) (deference to ALJ’s opportunity to observe witness demeanor)
Burns Int’l Sec. Servs. v. Int’l Union, UPGWA, 47 F.3d 14 (2d Cir. 1995) (Rule 12(c) standards)
Coppedge v. United States, 369 U.S. 438 (1962) (good-faith standard for appeals in forma pauperis)