Janice Collins, on Behalf of Tyrone Williams v. Jo Anne B. Barnhart, Commissioner of Social Security
Docket: 02-3420MN
Court: Court of Appeals for the Eighth Circuit; July 8, 2003; Federal Appellate Court
Janice Collins sought Social Security disability benefits for her son, Tyrone Williams, who was diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) in July 1998. Following the diagnosis, Tyrone was prescribed Ritalin, which significantly improved his behavior and ability to function. Despite this, the Social Security Administration (SSA) rejected Collins' application for benefits, leading to an Administrative Law Judge (ALJ) hearing, where the claim was denied on the grounds that Tyrone could function adequately with his medication.
Collins documented fluctuations in Tyrone's behavior linked to his medication intake, noting that he exhibited disruptive behavior when unmedicated but was calm and engaged while on Ritalin. His teacher corroborated these observations, indicating that Tyrone's behavior and academic performance improved markedly with medication. A psychological evaluation by Dr. Craig Barron in December 1998 also indicated that Tyrone, while diagnosed with ADHD, was articulate and likely had a learning disability rather than a low IQ, suggesting that his academic struggles were not solely due to ADHD.
The District Court upheld the ALJ's decision, affirming that the evidence did not support Collins' claim for disability benefits. The Eighth Circuit Court of Appeals, in reviewing the case, confirmed the District Court's ruling.
Physicians from two state agencies confirmed Dr. Overby's ADHD diagnosis for Tyrone in early 1999, noting that medication had reduced the severity of his condition. Reports filed by Ms. Hall and Bill Deno indicated that while Tyrone's behavior was generally acceptable, the effectiveness of Ritalin seemed to be diminishing. Ms. Collins filed a third report indicating a decline in Tyrone's behavior, prompting Dr. Overby to increase his medication. In her final evaluation, Ms. Collins reiterated that Tyrone struggled with concentration and social conflicts when off medication, but performed well when medicated. His new fourth-grade teacher, Richard Willegalle, described him as occasionally hyperactive but capable of average social interactions and task transitions.
In November 1999, an administrative hearing took place where testimony was presented regarding Tyrone's functionality. Dr. Jones Adkins, a neutral medical expert, testified that with medication, Tyrone exhibited less than marked limitations in cognitive/communicative, social, and personal functioning, although he faced greater challenges in concentration, persistence, and pace. Dr. Adkins noted no limitations in motor functioning and stated that even without medication, Tyrone's functioning was still less than markedly limited. The ALJ, relying on this testimony, determined that Tyrone was not disabled. Ms. Collins appealed the findings, which a Magistrate Judge recommended affirming, and the District Court adopted.
The appeal focuses on whether Tyrone had marked impairments in the disputed areas necessary for disability benefits, as defined by 20 C.F.R. 416.926a(b). Ms. Collins did not contest the ALJ's conclusions regarding personal and motor functioning, narrowing the appeal to cognitive/communicative, social functioning, and concentration. The review emphasizes that substantial evidence must support the ALJ's conclusions, particularly that impairments manageable by medication do not constitute total disability, as supported by evidence indicating Tyrone's adequate functioning when medicated.
Cognitive and communicative functioning encompasses a person's ability to think, solve problems, recall information, and interact with others, as defined by 20 C.F.R. 416.926a(c)(5)(iv)(A). Evidence indicates that Tyrone, after starting Ritalin, was able to engage in conversations, tell jokes, and interact effectively with teachers, achieving average scores on the Weschler Intelligence Scale for Children by December 1998, leading to his promotion to fourth grade. While there is some contrary evidence, it is substantial enough to support the ALJ's conclusion that Tyrone's cognitive functioning was not markedly impaired.
Regarding social development, as per 20 C.F.R. 416.926a(c)(5)(iv)(C), Tyrone's social interactions improved significantly while on medication, allowing him to maintain normal relationships and receive average evaluations from his teacher. Ms. Collins contends that the ALJ overlooked Tyrone's lack of continuous medication, but even considering his worst behavior, his social development does not appear markedly impaired, as he has never faced legal troubles or severe disciplinary actions.
In terms of concentration, persistence, and pace, outlined in 20 C.F.R. 416.926a(c)(5)(iv)(E), Tyrone demonstrated a fair ability to concentrate and follow instructions while medicated, though he was disruptive and disorganized when off medication. There is sufficient evidence supporting the ALJ's finding that Tyrone's concentration was impaired but not markedly so.
Ms. Collins challenges the ALJ's reliance on Dr. Adkins' testimony regarding Tyrone's ADHD diagnosis, claiming it undermines the decision. However, it was Dr. Barron who diagnosed "undifferentiated-type ADHD," and Dr. Adkins merely referenced this without asserting it as his own diagnosis. The significance of the specific label is minimal, as the key issue is whether Tyrone's functioning is markedly impaired, not the exact terminology used.
Overall, the evidence supports the ALJ's determination that Tyrone's functioning was not markedly impaired in any relevant area due to his ADHD, leading to the affirmation of the District Court’s decision.
