Supplemental Security Income • Disability Determination • Medical Source Statements • Functional Equivalence Findings

Alicea v. Colvin, PICS Case No. 14-0284 (E.D. Pa. Feb. 7, 2014) Robreno, J. (15 pages).

Where, in a disability determination hearing, an administrative law judge had a “voluminous and clear” medical record for consideration, the judge need not seek additional information in the form of medical source statements; and where substantial evidence supported the administrative law judge’s determination that a disability applicant only had a “marked” limitation in one domain of functioning, a denial of disability determination was proper. Denied.

Plaintiff Margarita Alicea, on behalf of minor child J.I.P., brought this action seeking judicial review of denial of plaintiff’s application for child’s supplemental security income. Plaintiff’s SSI application alleged that J.I.P. was disabled from birth as a result of spina bifida.

Plaintiff alleged that the magistrate judge erred in finding that the administrative law judge did not commit error by failing to obtain a medical source statement from J.I.P.’s physicians, and in accepting the ALJ’s findings in the determination of no disability.

The court rejected plaintiff’s argument that the ALJ erred in not obtaining MSSs from J.I.P.’s pediatrician and surgeon, and that this error had a “detrimental effect” in the disability determination. The court noted that the ALJ may seek a MSS from an applicant’s physician if there is insufficient evidence in the record. However, the court found that the ALJ had collected a significant medical history, including testimony from J.I.P.’s mother, surgical, hospital, and physician records, the opinion of a state medical agency consultant, and a letter from J.I.P.’s surgeon detailing potential developmental problems. The court found that these records constituted sufficient evidence for the record, and accordingly the ALJ was not obligated to seek additional information.

The court also accepted the functional equivalence findings of the ALJ. The court noted that of the six domains considered in assessing an applicant’s functioning, only two were at issue in the instant case; the court further noted that a disability finding required an assessment of “marked” limitation in two domains or “extreme” limitation in one domain. The court held that there was sufficient evidence in the record to support the ALJ’s determination of “less than marked” limitation in one domain at issue and “marked” limitation in the other domain at issue; consequently, the court ruled that, as it could not reweigh the evidence, it concurred in the ALJ’s findings.