United States District Court, N.D. Indiana, South Bend Division
CONSTANCE H. WAWRZYNIAK, Plaintiff,
NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.
OPINION AND ORDER
Wawrzyniak applied for supplemental security income on behalf
of her son, R.J.W., around the time he began high school.
R.J.W. attended school, held a part-time job, and even played
varsity sports. His mother alleges, though, that his type 1
diabetes and attention deficit hyperactivity disorder
rendered him disabled. An administrative law judge disagreed
and denied the claim. R.J.W. appeals, but he has not
presented any basis for reversal, so the Court affirms the
mother filed an application for supplemental security income
on his behalf in June 2014. At that time, R.J.W. was fourteen
years old and was about to enter high school. She claimed
that R.J.W. was disabled, primarily as a result of his
diabetes and attention deficit hyperactivity disorder. R.J.W.
had been diagnosed with type 1 diabetes in November 2012, and
his diabetes was well-controlled for some time after that by
regular insulin injections. He had also been diagnosed with
attention deficit disorder, for which he took Ritalin. In
2014, R.J.W.'s blood sugar levels began rising, prompting
his doctor to adjust his insulin doses. By 2015, his doctor
wrote that his diabetes was “in suboptimal control,
” (R. 423), and by 2016 his doctor wrote that his
diabetes was “in poor control.” (R. 554).
March 2016, R.J.W. began seeing a new doctor to treat his
diabetes, Dr. Shruti Fadia, an endocrinologist. At the
initial appointment, Dr. Fadia noted that R.J.W.'s
“overall glycemic control is fair, ” but she
suspected that R.J.W. was not complying with his treatment
regimen. (R. 576). Dr. Fadia noted that R.J.W. did not appear
to be checking his blood sugars regularly and was not taking
insulin injections as often as he needed. He was also eating
large snacks without taking any insulin. Dr. Fadia discussed
with R.J.W. the “importance of checking blood sugars
prior to all meals” and administering appropriating
insulin injections to correct his blood sugar levels. (R.
576). At the next appointment in June 2016, though, Dr. Fadia
again noted that R.J.W. was “not compliant with his
regimen.” (R. 568). His testing device showed only 19
entries the previous month, even though R.J.W. was supposed
to be checking his blood sugars before every meal. (R. 567).
R.J.W.'s level of compliance was similar at the next
appointment. In September 2016, Dr. Fadia stated that
R.J.W.'s “poor DM [diabetes mellitus] control is
due to non-compliance with his DM regimen.” (R. 566)
Dr. Fadia explained: “Since he is not checking blood
sugars regularly, he is frequently missing insulin
doses.” (R. 566). And despite Dr. Fadia's
instructions at previous visits, R.J.W. had continued making
the injections in areas of lipohypertrophy (fatty deposits
under the skin that can interfere with the absorption of
insulin), which Dr. Fadia said was contributing to his
elevated blood sugars. (R. 566, 568, 576).
his application for benefits, R.J.W. also underwent a
psychological examination with Dr. Hershberger, an agency
consultant. Dr. Hershberger noted that R.J.W. “was
inattentive” but “was easily brought back to the
examiner's line of questioning.” (R. 458). He
opined that R.J.W.'s “attention and concentration
were questionable, ” as he “had difficulty
maintaining his focus” and “appeared distracted
by even minor external stimuli, ” but was “able
to be redirected with effort.” (R. 460). Dr.
Hershberger diagnosed R.J.W. with attention deficit
hyperactivity disorder, inattentive type. He concluded his
report by stating, “With the support of his parents
[R.J.W.] appears to be functioning well within the normal
parameters for someone of his age.” (R. 462). One of
R.J.W.'s teachers also completed a function report. She
noted that R.J.W. had slight problems acquiring and using
information, and either slight problems or no problems in
various areas relating to attending and completing tasks. (R.
time of the hearing before an administrative law judge,
R.J.W. was halfway through his junior year of high school. He
had missed a significant amount of class due to his
diabetes-he estimated that he had missed about 20 days'
worth of classes the previous year- but he maintained about a
C grade point average and was not receiving special education
services. He also worked a part-time job, working about ten
hours a week as a cook in a restaurant, and he was able to
drive himself to school and to work. He had also played on
his school's varsity soccer team since his freshman year.
written decision issued following the hearing, the ALJ
concluded that R.J.W. did not qualify as disabled. He found
that R.J.W.'s severe impairments included diabetes and
attention deficit hyperactivity disorder, but that R.J.W. did
not meet or medically equal any of the listings. Accordingly,
he evaluated R.J.W.'s degree of limitations in six
different domains in order to determine whether R.J.W.
functionally equaled a listing. As relevant here, he
concluded that R.J.W. had “less than marked”
limitations in the domains of Attending and Completing Tasks
and Health and Physical Well-Being. Because R.J.W. did not
have “marked” or “extreme”
limitations in any domain, the ALJ found that R.J.W. did not
qualify as disabled. The Appeals Council denied review of
that decision, so R.J.W.'s mother, by counsel, filed this
action on his behalf.
STANDARD OF REVIEW
the Appeals Council denied review, the Court evaluates the
ALJ's decision as the final word of the Commissioner of
Social Security. Schomas v. Colvin, 732 F.3d 702,
707 (7th Cir. 2013). This Court will affirm the
Commissioner's findings of fact and denial of disability
benefits if they are supported by substantial evidence.
Craft v. Astrue, 539 F.3d 668, 673 (7th Cir. 2008).
Substantial evidence consists of “such relevant
evidence as a reasonable mind might accept as adequate to
support a conclusion.” Richardson v. Perales,
402 U.S. 389, 401 (1971). This evidence must be “more
than a scintilla but may be less than a preponderance.”
Skinner v. Astrue, 478 F.3d 836, 841 (7th Cir.
2007). Thus, even if “reasonable minds could
differ” about the disability status of the claimant,
the Court must affirm the Commissioner's decision as long
as it is adequately supported. Elder v. Astrue, 529
F.3d 408, 413 (7th Cir. 2008).
the duty of the ALJ to weigh the evidence, resolve material
conflicts, make independent findings of fact, and dispose of
the case accordingly. Perales, 402 U.S. at 399-400.
In this substantial-evidence determination, the Court
considers the entire administrative record but does not
reweigh evidence, resolve conflicts, decide questions of
credibility, or substitute the Court's own judgment for
that of the Commissioner. Lopez ex rel. Lopez v.
Barnhart, 336 F.3d 535, 539 (7th Cir. 2003).
Nevertheless, the Court conducts a “critical review of
the evidence” before affirming the Commissioner's
decision. Id. An ALJ must evaluate both the evidence
favoring the claimant as well as the evidence favoring the
claim's rejection and may not ignore an entire line of
evidence that is contrary to his or her findings.
Zurawski v. Halter, 245 F.3d 881, 887 (7th Cir.
2001). Consequently, an ALJ's decision cannot stand if it
lacks evidentiary support or an adequate discussion of the
issues. Lopez, 336 F.3d at 539. Ultimately, while
the ALJ is not required to address every piece of evidence or
testimony presented, the ALJ must provide a “logical
bridge” between the evidence and the conclusions.
Terry v. Astrue, 580 F.3d 471, 475 (7th Cir. 2009).
STANDARD FOR DISABILITY
Supplemental Security Income rules, a child is disabled if he
has a “medically determinable physical or mental
impairment, which results in marked and severe functional
limitations” that “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). This
assessment requires a three-step analysis. 20 C.F.R. §
416.924(a); Jelinek v. Astrue, 662 F.3d 805, 809-10
(7th Cir. 2011). At step one, if the child is engaged in
substantial gainful activity, then he is not disabled.
Id. At step two, if the child does not have a severe
medical impairment or combination of impairments, then he is
not disabled. Id. At step three, a child will
qualify as disabled only if his impairments “meet,
” “medically equal, ” or
“functionally equal” any of the listings
contained in 20 C.F.R. Pt. 404, Subpt. P, App. 1.
determine if a child's impairments are
“functionally equivalent” to a listing, an ALJ
analyzes their severity in 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); see Murphy v. Astrue, 496 F.3d 630,
634 (7th Cir. 2007); Sanchez v. Barnhart, 467 F.3d
1081, 1082 (7th Cir. 2006) (since children do not generally
have work history, the structure of the disability program
for them necessarily differs from that for adults, and
focuses on the functioning of the child in specified areas of
life activity). ...