United States District Court, N.D. Indiana, Fort Wayne Division
OPINION AND ORDER
Collins, United States Magistrate Judge
Tara Sanders, on behalf of K.S., a minor, appeals to the
district court from a final decision of the Commissioner of
Social Security (“Commissioner”) denying
K.S.'s application for Supplemental Security Income
(“SSI”). (DE 1). For the following reasons, the
Commissioner's decision will be AFFIRMED.
applied on K.S.'s behalf for SSI in April 2012, alleging
disability as of March 30, 2012 (DE 9 Administrative Record
(“AR”) 24, 121-29); the Commissioner denied the
application initially and upon reconsideration (AR 70-73,
77-82). A hearing was held on September 18, 2013, before
Administrative Law Judge Maryann S. Bright (“the
ALJ”), at which K.S. and Sanders, who were represented
by counsel, testified. (AR 45-67). On February 18, 2014, the
ALJ rendered an unfavorable decision, concluding that K.S.
was not disabled. (AR 24-39). The Appeals Council denied
Sanders's request for review, at which point the
ALJ's decision became the final decision of the
Commissioner. (AR 1-6).
on behalf of K.S. filed a complaint with this Court on August
24, 2015, seeking relief from the Commissioner's final
decision. (DE 1). Sanders advances just one argument in this
appeal-that the ALJ improperly found that K.S. did not meet
or equal Listing 114.02(A), the listing for Systemic Lupus
Erythematosus (“SLE”). (DE 19 at 7-9).
K.S's Testimony at the Hearing
alleges that K.S. is disabled due to SLE with resulting
arthritis and kidney disease. (DE 19 at 2). At the time of
the hearing, K.S. was 11 years old and in the sixth grade; he
rode the bus to school. (AR 49, 55-56). He stated that he had
no problems with using a computer, writing, or completing his
homework. (AR 50, 53). After school, he watches television or
plays with his siblings. (AR 51). He helps with household
tasks, such as using a knife to cut vegetables. (AR 53-54).
K.S. stated that he can run and jump, but that his legs start
hurting afterward. (AR 51-52). He reported that he is good at
throwing and catching a ball, but his arm sometimes
“locks up sideways, ” though this had never
happened at school. (AR 52). He enjoys playing laser tag and
has no problems with kicking. (AR 53). He was planning on
trying out for the school basketball team; he also wanted to
participate in cross country, but thought that he probably
would not be able to do that. (AR 52-53).
Sanders's Testimony at the Hearing
reported that K.S. was diagnosed with SLE in March 2012. (AR
56). When asked how K.S. is different from other children his
age, Sanders responded that he cannot play contact sports
such as football. (AR 56). She added that while he can play
and have a good time during the day, by the end of the day
she might have to carry him upstairs because he cannot walk
(AR 56, 62); she also said that some mornings he wakes up and
cannot walk. (AR 56). Sanders acknowledged that K.S. was
“doing well” with his medications (prednisone,
methotrexate, naproxen, and plaquenil) without any report of
side effects, but stated that he still has some bad days when
he complains of aches and pains or swelling. (AR 56-58). She
had taken him to the emergency room on several occasions for
various complaints. (AR 57).
stated that K.S. is able to perform his own self care; help
with household chores; and walk, run, jump, and climb. (AR
59). But she tries to not let him do too much, concerned that
if he does, “he's going to be hurting” later.
(AR 59). She clarified, however, that there are times that he
goes for walks and does not experience pain later. (AR 59).
She estimated that he has two to four “flare-ups”
a week, where he doesn't feel well, has a reduced
appetite, and has pain and swollen joints. (AR 60). However,
he had missed just one day of school in the sixth grade and
“a few days” in the fifth grade. (AR 57, 63). She
stated that sometimes he has swelling in his fingers, but
then conceded that “he ha[d]n't really had too much
of that.” (AR 60). He was not receiving any special
services at school, other than that Sanders had requested one
of his teachers keep K.S.'s books in the classroom so
that he did not have to carry them. (AR 60-61). Sanders
agreed that K.S. has no learning problems, that he gets along
well with others, and that he completes his homework. (AR
Summary of the Relevant Medical Evidence
March 13, 2012, K.S. was seen at the St. Joseph Medical Group
for a rash and swelling. (AR 215-23). He complained of chest
pain and congestion; he did not have a fever. (AR 215-17).
March 23, 2012, K.S. saw Dr. Susan Ballinger, a pediatric
rheumatologist at Riley Hospital for Children
(“Riley”), for a two-month history of joint pain
and swelling. (AR 234). He had also complained of increased
fatigue and a recent fever of 103 degrees. (AR 234). His
symptoms included progressive swelling throughout the day,
mostly around his knees. (AR 234). He was hospitalized for
one week. (AR 234, 367). Laboratory testing revealed that his
ANA was high and that his C3 and C4 were both low. (AR 235).
Dr. Ballinger suspected SLE. (AR 234).
follow-up examination on April 4, 2012, Dr. Ballinger noted
that K.S. had stiff fingers, pain on wrist flexion and
extension, right elbow swelling, and ankle swelling
bilaterally with decreased subtalar motion. (AR 275).
Otherwise, he had a normal gait, full range of motion, no
swelling or tenderness, normal strength, and no rash or
lesions. (AR 275). Dr. Ballinger's impression was SLE,
and she prescribed prednisone. (AR 275). Two weeks later, on
April 19, 2012, Dr. Ballinger indicated that K.S. had
“been doing great since his last visit.” (AR
271). He was without new complaints, other than some nausea
in the morning. (AR 271). On exam, K.S. had trace swelling in
his knees bilaterally, but otherwise he had full range of
motion, a normal gait, and no swelling or tenderness. (AR
272). A physical therapy evaluation that same day revealed no
functional limitations, though he did have some swelling in
his middle fingers and left knee, poor hand strength,
decreased grip, and reduced finger flexion. (AR 261). He told
his physical therapist that he had been doing better since
taking medications. (AR 261).
2012, K.S. was seen by Dr. Kathleen O'Neil, chief
pediatric rheumotologist at Riley. (AR 257). She noted that
K.S. had developed nausea and diarrhea in the last week but
that it had resolved within 48 hours. (AR 257). He was
feeling much better and was “nearly back to normal,
” although his mother worried that he was sleeping more
and not playing quite as much as usual; his mother suspected,
however, that K.S.'s decreased interest in playing was
related to their recent move. (AR 257). He had no fevers but
did have some night sweats; he had experienced some weight
gain since starting on prednisone. (AR 257). His only joint
complaint was intermittent anterior knee pain when playing on
his knees with his baby brother; otherwise, all of his joint
complaints had resolved. (AR 257). On exam, K.S. showed no
abnormalities other than skin irritation. (AR 257-58). Dr.
O'Neil's impression was SLE with probable early renal
involvement. (AR 258). She noted that he was on a very high
dose of prednisone, which she hoped to taper somewhat. (AR
May 2012, Dr. Steven Roush, a state agency physician,
reviewed K.S.'s record and completed a childhood
disability evaluation form. (AR 237-42). Dr. Roush concluded
that K.S. had a severe impairment but that it did not meet or
equal a listing. (AR 237). Dr. Roush found a “Less Than
Marked” limitation in the domain of health and physical
well-being, but no limitation in any of the other five
domains of acquiring and using information, attending and
completing tasks, interacting and relating with others,
moving about and manipulating objects, and caring for
yourself. (AR 237-40). He noted that K.S. was responding to
medications and had been doing great since April 19, 2012.
early June 2012, K.S. saw his pediatrician, reporting that he
had “lots of pain.” (AR 330). His prednisone
dosage was being weaned down. (AR 330).
June 2012, K.S. saw Dr. Sharon Andreoli, a pediatric
nephrologist at Indiana University. (AR 367-68). K.S.
reported fatigue, back pain, leg pains, and nosebleeds. (AR
367). His mother stated that his activity level had been
significantly decreased since being diagnosed with SLE. (AR
367). A physical exam was unremarkable. (AR 367). Laboratory
testing revealed a normal protein-creatinine ratio, normal
renal function, normal blood pressure, and no hematuria. (AR
2, 2012, K.S. returned to Dr. Ballinger, reporting that he
had been doing well in terms of his joint pain and swelling.
(AR 264). He had no fever, weight loss, or similar symptoms.
(AR 264). He had been weaning from his prednisone pursuant to
the doctor's weaning schedule. (AR 264). He had been
complaining of some low back pain in the past few days,
mostly at night. (AR 264). His mother thought that his knees
looked a little swollen, but he had no joint pain and no
significant medication side effects. (AR 264). Dr. Ballinger
found that he was “doing well overall.” (AR 265).
11, 2012, Dr. Ballinger wrote a letter to the state agency
noting K.S.'s diagnosis of SLE and his two major symptoms
of SLE-arthritis and kidney disease. (AR 304). She indicated
that he had “some limitations of his activity because
of back pain from his arthritis, ” and that he
“missed days of school last school year” due to
his SLE. (AR 304). Due to concerns ...