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Wawrzyniak v. Berryhill

United States District Court, N.D. Indiana, South Bend Division

March 25, 2019

NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.



         Constance 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 Commissioner's decision.


         R.J.W.'s 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).

         In 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).

         After 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. 227-28).

         By the 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.

         In a 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.


         Because 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).

         It is 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).


         Under 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. Id.

         To 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). ...

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