Cummings v. Commissioner of Social Security
1:20-cv-00885
W.D.N.Y.Jan 18, 2022Background
- Plaintiff (mother) applied for SSI for her minor son M.C. on Feb. 16, 2017 (alleged onset Feb. 7, 2016); ALJ denied benefits May 30, 2019 and Appeals Council denied review May 15, 2020.
- ALJ found severe impairments of ADHD and impulse control disorder and evaluated the six child-functioning domains under the child disability rules.
- ALJ concluded M.C. had "less than marked" limitations in five domains and "no limitation" in health/physical well-being, and therefore was not disabled.
- M.C. had an IEP providing daily resource room, biweekly small-group occupational therapy, extra classroom refocusing, medication management, and biweekly therapy outside school.
- Kindergarten teacher questionnaires rated "serious" or "very serious" problems in many areas (acquiring/using information; attending/completing tasks; interacting when unmedicated); a state reviewer opined a marked limitation in attending/completing tasks.
- The district court held the ALJ erred by failing to assess how M.C. would function outside his structured/supportive setting and remanded for further proceedings.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether ALJ failed to evaluate claimant's functioning outside of a structured/supportive setting | ALJ relied on improvements but ignored that gains depended on IEP, classroom supports, and medication; must assess functioning without those supports | ALJ permissibly relied on evidence of improvement and credited classroom/school reports showing gains | Court: ALJ committed legal error by not analyzing how M.C. would function without supports; remand required |
| Weight given to teacher questionnaires and state agency reviewer | Teachers reported "serious/very serious" problems that could indicate marked limitations; state reviewer found marked limitation in attending/tasks | ALJ assigned "some" weight to teachers and implicitly declined the state reviewer, treating the overall record as showing improvement | Court: ALJ's treatment of these opinions, without the required analysis of structured-setting dependence, may be outcome-determinative; remand for reassessment |
| Whether error was harmless / whether record supports substantial evidence of non-disability | Error not harmless because reevaluation could yield two marked domains or one extreme domain and change the result | Commissioner contends decision is supported by substantial evidence | Court: Error not harmless; substantial-evidence review requires correct legal analysis first; remand ordered |
Key Cases Cited
- Machadio v. Apfel, 276 F.3d 103 (2d Cir. 2002) (standard that Commissioner’s denial must be upheld only if supported by substantial evidence and correct legal standards applied)
- Brown v. Colvin, 193 F. Supp. 3d 460 (E.D. Pa. 2016) (a child’s functioning that depends on a structured or supportive setting still constitutes a limitation and must be assessed by the ALJ)