Opinion
01 Civ. 4057 (SAS)
December 4, 2002
Attorney for Plaintiff: (Pro Se) Mareanela Morales, Bronx, New York
Attorney for Defendant: Susan D. Baird, Assistant United States Attorney, New York, New York
OPINION AND ORDER
I. INTRODUCTION
Pro se plaintiff Marianela Morales, suing on behalf of her child, Flexina Morales, brings this action pursuant to Section 205(g) of the Social Security Act (the "Act"), 42 U.S.C. § 405(g), seeking judicial review of a final decision by the Commissioner of the Social Security Administration (the "Commissioner") denying her daughter's claim for Supplemental Security Income ("SSI") benefits. The Commissioner moves for judgment on the pleadings under Rule 12(c) of the Federal Rules of Civil Procedure. Plaintiff failed to timely respond to an Order directing her to submit opposition papers. See Order dated August 22, 2002. As a result, this motion is decided solely on the papers filed by the Commissioner.
For the reasons set forth below, the Commissioner's motion is granted and her determination is affirmed.
II. BACKGROUND
A. procedural Background
Flexina Morales (the "claimant" or "child") applied for SSI benefits on March 11, 1998. See Transcript of Administrative Record filed as part of the Commissioner's Answer ("Tr.") at 67-70. This application was denied initially, see id. at 35-40, and on reconsideration. See id. at 43-46. Pursuant to plaintiff's request, a hearing was held on October 26, 1999 before an Administrative Law Judge ("ALJ"). See id. at 20-34. On December 16, 1999, after considering the case de novo, the ALJ found that the child was not disabled and therefore issued a decision denying plaintiff's application for benefits. See Tr. at 6-19. Hence, the period of disability at issue is March 11, 1998, through December 16, 1999. See id. at 6. The ALJ's decision became the final decision of the Commissioner after the Appeals Council denied plaintiff's request for review on March 2, 2001. See id. at 3-4.
See 20 C.F.R. § 416.335 (SSI benefits available only after application filed).
B. Factual Background
The claimant was born on June 2, 1987 and was 10 years old when Ms. Morales filed an SSI application on her behalf. See Tr. at 67. Claimant alleged that she was disabled due to distractibility, impulsivity, poor performance in school, an excess of lead in her system, anemia, a low blood-sugar level, and problems with her ankles. See id. at 74, 88.
1. Hearing Testimony
Claimant testified at the administrative law hearing on October 26, 1999, when she was twelve years old. See Tr. at 23. Claimant testified that she was in regular classes in school and was doing "fine." Id. The child also stated that she did not have many friends in school, but she liked her teacher. See id. at 24. She further testified that she enjoyed watching baseball and basketball on television, and listening to music.See id. at 24-25, 32-33. Claimant also stated that she helped her mother clean at home, and sometimes played with her sisters. See id. at 32-33. Marianela Morales testified that her daughter was "in her own, little world," and that she fought with her sisters. See id. at 26-27. Ms. Morales also stated that the claimant spent time with a five-year old child, and that she was trying to get her daughter to spend more time with children her own age. Ms. Morales stated that her daughter took medication to help her sleep. See id. at 31.
2. Prior Medical History
In July 1994, the child was seen by Ms. Yacobacci-Tam, an evaluator from the Children Evaluation Rehabilitation Center, who conducted a speech and language evaluation. Ms. yacobacci-Tam reported that claimant had severe expressive and receptive language disorder. See Tr. at 205-09.
In August 1994, a social worker, Mary DeVivo, conducted a psychosocial evaluation of the child, and reported that she was unmotivated and had low energy. See id. at 202-04.
In September 1994, claimant underwent a psychological evaluation by Dr. John Florea, a psychologist. See id. at 166-69. Intelligence testing revealed a verbal I.Q. of 73, a performance I.Q. of 78 and a full-scale I.Q. of 73, placing claimant's overall intellectual functioning in the borderline range. See id. at 167. Significant attention deficit problems were also noted. See id. at 168. Dr. Florea concluded that the child was in a need of a full-time, self-contained class with intensive language therapy. See id. at 169.
In October 1994, Ms. Phyllis Ruttenberg, a psychoeducational specialist, performed a psychoeducational evaluation. See id. at 194-97. Ms. Ruttenberg reported that claimant had various academic delays, and weaknesses in a number of areas, with attention difficulties. Id.
Audiological testing in 1994 indicated that claimant had no hearing problems. See id. at 210. Hearing was described as mildly elevated in low frequency, and within normal limits in higher frequency. Id.
In the 1993-1994 school year, a visual acuity test indicated that the child had 20/50 vision in both eyes without glasses. See id. at 143, 158.
Subsequent intelligence tests conducted in April 1995 revealed that claimant was functioning within the borderline to low average range, with perceptual development within age expectancy. See id. at 114, 124. Claimant's power of concentration was described as adequate, and she was responsive to praise. See id. at 130. In a form signed by Ms. Morales and claimant's teacher, the child's vision was described as "extremely poor even with glasses." Id. at 135, 149.
In February 1995, the child was noted to have various limitation in certain areas, including following oral and written directions, poor studying skills and poor response to questions. Moreover, claimant was noted to have some behavior problems, such as reluctance to attempt new tasks and. little responsiveness to classroom activity. See id. at 135-38. However, her teacher indicted that claimant's general knowledge was appropriate to her age/peer group. See Id. at 138, 151.
In May 1995, a report from the New York City Board of Education described claimant as functioning "very well" in the classroom. See id. at 163-64. The child had the ability to work on her own initiative, follow instructions, relate to others and complete a written task. See id.
An individualized Education Program report dated June 1995 classified claimant as learning disabled. See id. at 110. The child was placed in a general education setting with supplemental instructional services. See id. at 110, 119-20.
3. Medical Evidence Relating to the Period at Issue
A report from the New York City Board of Education revealed that in 1997 claimant scored at the thirty-second national percentile in reading and scored at the twentieth percentile in mathematics. See Tr. at 172. In 1998, the child scored at the thirty-sixth percentile in reading and scored in the ninth percentile in mathematics. See id.
During the period April 1998 through May 1999, claimant was treated at the Fordham-Tremont Community Mental Health Center (the "Center"). See id. at 212-20, 261-307. In April 1998, a mental status evaluation reported that the child had become increasingly angry, demanding and sensitive since her father left home in 1997. The examining clinician reported that claimant had poor eye contact and a sad or angry facial expression. Claimant was oriented to person, place and time, and was aware of her surroundings. Claimant had good attention. See id. at 212, 248. Claimant's speech was fairly clear and soft-spoken. The child's ability to comprehend and respond was described as good, and there were no problems with receptive or expressive language. The child's emotions were considered to be age and content appropriate. Productivity of thought processes were described as low. The child reported seeing ghosts and white things. Intelligence was estimated to be average to low average. Claimant denied suicidal or homicidal ideation. While social judgment was described as poor to fair, and insight was described as poor, impulse control was good. Claimant was diagnosed with a disruptive behavior disorder. See id. at 213-14, 249-50.
From April 6 through June 22, 1998, the child had therapy sessions at the Center once or twice a month. On April 6, 1998, the child reported no behavioral problems at home or in class unless she became angry. Claimant reportedly often fought with her siblings. In a group session on April 27, 1998, the child did not interact much with peers, but was pleasant. The child focused on her task and completed it with good results. On May 4, 1998, claimant showed a notable increase in group involvement, speaking to peers, participating and smiling. See id. at 285-94. On May 11, 1998, progress notes indicated that the child had shown "vast improvement," speaking openly to group members. Id. at 290. On May 18, 1998, progress notes from the Center indicated that claimant showed increasing enthusiasm, participation and communication. See id. at 289. In a one-on-one session on June 8, 1998, the child was quiet and somewhat withdrawn. Claimant reported conflict with a peer, but decreased sibling conflict. The child described feeling frightened by loud noises and often felt as if she was being watched. See id. at 287. Claimant reported difficulty falling asleep and nightmares. On July 22, 1998, during a group session, claimant showed a "remarkable ability" to converse at ease in the group situation. Id. at 285. The child addressed peers appropriately and took responsibility for younger group members' actions.See id.
From July through November 1998, claimant was not treated at the Center. On December 11, 1998, claimant resumed treatment at the Center with a new therapist. The child was cooperative and slightly anxious. On December 17, 1998, claimant appeared happy, smiled throughout the session and engaged in discussion. See id. at 281-82.
The Center's progress notes from February 1999 through September 1999 indicated that claimant was seen thirteen times in a combination of individual and group sessions. See id. at 263-78. In these sessions, the child reported continuing difficulties falling asleep, irritability and fighting with siblings. See id. After frequently missing appointments, the child's therapist reviewed the rules of attendance with Ms. Morales due to the child's "chronic non-compliance" with appointments. Id. at 264.
On September 20, 1999, the child was evaluated by a psychiatrist at the Center. See id. at 300-02. Claimant was noted to be in a sixth grade regular education class. Claimant's mother reported that the child had improved in her schoolwork, but still isolated herself at school. On examination, the child was friendly overall, and had adequate orientation, attention and memory. Speech and language were described as "ok." Id. at 301. The child reported feeling sad and depressed. Productivity of thought processes was evaluated as fair to low. Delusions, hallucinations and other cognitive abnormalities were not evident. Intelligence was described as average. See id. at 302. Although relatedness was described as poor, impulse control and social judgment were considered to be fair. The child was diagnosed with depression, not otherwise specified, and with an oppositional-defiant disorder. Medication was prescribed. See id.
Zyprexa, an anti-psychotic medication, and Paxil, an anti-depressant medication were prescribed.
The Center's final progress note, dated October 14, 1999, indicated that claimant was noted to have increased appetite, only mild difficulty falling asleep, and had no complaints from teachers. At home, the child was noted to have decreased hyperactivity, decreased fighting and decreased oppositional behavior. The therapist also praised and reinforced claimant's positive behavior. See id. at 262.
On May 11, 1998, Regina Burke, claimant's fourth grade teacher, remarked on her behavior and performance. See id. at 179-80. Ms. Burke noted that the child occasionally, but "not often," became withdrawn in class, and that she became disruptive due to talking too much "every once in a while." Id. at 179. Ms. Burke stated, however, that this was normal for the child's age in comparison to her peers. According to Ms. Burke, the child did not have problems with the effective completion of tasks in a timely manner. Ms. Burke described claimant as a "sweet, respectful child that always tries to do her best." Id. at 180. Although the child was considered to be below grade level, Ms. Burke stated that she was slowly making progress. See id.
Claimant's report card for the 1997-1998 academic year revealed that she needed improvement in reading, written language, mathematics and science. See id. at 171. However, the child performed satisfactorily in oral language and social studies. Claimant got a grade of "good" in music, art, health education, physical education, and work habits. Id. All areas of personal and social development, such as getting along well with others and showing self-control, were described as "satisfactory" or "good" in the first marking period, and as "excellent" in the second and final marking periods. Id.
On October 28, 1998, Ms. Fernandez, claimant's fifth grade teacher, reported that the child did not exhibit poor frustration tolerance behaviors, or inappropriate social interaction behavior such as fighting, tantrums, withdrawal episodes or peer relationship problems.See id. at 173-74. Although the child was described as soft-spoken and a slow learner, she was conscientious in all that she did, with no behavioral problems. See id. at 175-76.
On January 9, 1999, Dr. Edward Hoffman, a psychologist, performed an intelligence evaluation on the child. See id. at 221-23. Dr. Hoffman described claimant's health as adequate and reported that she was not taking any medication on a regular basis. The child was reportedly able to dress herself, answer the phone adequately, and tell time correctly. Claimant had friends and liked to play video games with them. On testing, the child attained a verbal I.Q. of 59, a performance I.Q. of 65 and a full scale I.Q. of 59. However, Dr. Hoffman reported that claimant's score was "definitely not believed to be an accurate indicator of her current cognitive functioning" due to the fact that she became increasingly anxious and withdrawn during the evaluation. Id.
On January 13, 1999, Ms. Caryl-Robin Dresher, a language pathologist, performed a speech and language evaluation. See id. at 224-27. Ms. Dresher reported that the child had auditory memory difficulties, auditory imperception, a need for repetition of stimuli and prolonged processing time. Prescription glasses were not reported or observed. Testing revealed moderate to severe delays across all parameters of language processing and expression. Narrative and discourse skills were described as moderately to severely delayed. Speech intelligibility was good, and vocal intensity was adequate. It was noted that claimant inconsistently cooperated in certain tasks and presented with a sullen, depressed affect.
On February 1, 1999, a periodic evaluation was performed by Dr. Tomasito Virey, a pediatrician. See id. at 228-30. On examination, the child was fairly developed, fairly nourished, alert and active. Claimant ambulated "on slight tippy-toes". Id. at 229. The child wore eyeglasses. There was a slight stiffness and slight limitation on range of motion of the Achilles' tendon areas on the right and left lower extremities. In his neurologic evaluation, Dr. Virey indicated that there was a "highly possible involvement of the optic nerve," while "the other cranial nerves appeared to be intact." Id. at 230. Dr. Virey described the child's ability to do age-related activities and to behave in an age-appropriate manner as moderately affected.
On February 11, 1999, a state agency medical consultant, Dr. Baum, indicated in a child disability evaluation form that claimant had a speech/language delay, but that it did not meet, medically equal, or functionally equal the severity of any listing in the listing of impairments in the Commissioner's regulations, 20 C.F.R. Part 404, Subpart P, Appendix 1 (the "Listings"). See id. at 231-33. Specifically, Dr. Baum opined that the child did not have limitations of specific function(s), limitations related to episodic impairment(s), or limitations related to treatment or medication effects. Dr. Baum also opined that the child had marked limitations in cognitive/communicative functioning, less than marked limitation in concentration, persistence or pace, and no evidence of limitation in motor, social, or personal functioning.
State agency medical experts are highly qualified physicians and psychologists who are experts in Social Security disability evaluations.See 20 C.F.R. § 416.927(f)(2)(i). A state agency consultant's opinion can be given controlling weight if it is "well supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with other substantial evidence." 20 C.F.R. § 404.1527(d)(2); Diaz v. Shalala, 59 F.3d 307, 313 (2d Cir. 1995); Schisler v. Sullivan, 3 F.3d 563, 568 (2d Cir. 1993).
The ALJ noted, however, that his decision is based on additional medical evidence, including updated therapy reports, that were submitted later and therefore were not available and not considered by the state agency consultants. See Tr. at 13.
A report from the New York City Board of Education in the Spring of 1999 indicated that the child scored "low" on a Performance Assistance in Mathematics (PAM) test. See id. at 181. Claimant's report card for the 1998-1999 school year showed "satisfactory" scores in reading, written language, mathematics, social studies and science. Id. at 186. The child received a grade of "good" in oral language, music, art, health education and physical education. Id. Claimant also received a grade of "good" in work habits, and personal and social development. Id.
III. LEGAL STANDARD
A. Substantial Evidence
A final determination by the Commissioner must be affirmed if it is based on substantial evidence. See 42 U.S.C. § 405(g). "Substantial evidence" has been interpreted as "'more than a mere scintilla [and] such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'" Shaw v. Chater, 221 F.3d 126, 131 (2d Cir. 2000) (quoting Richardson v. Perales, 402 U.S. 389, 401 (1971)). "[F]actual issues need not have been resolved by the [Commissioner] in accordance with what we conceive to be the preponderance of the evidence."Rutherford v. Schweiker, 685 F.2d 60, 62 (2d Cir. 1982). The substantial evidence test applies not only to findings on basic evidentiary facts, but also to inferences and conclusions drawn from such facts. See Filkins v. Commissioner of Soc. Sec., No. 00 Civ. 3873, 2001 WL 798006, at *4 (S.D.N.Y. July 5, 2001). "[I]n examining the ALJ's decision, "[i]t is not our function to determine de novo whether [plaintiff] is disabled,' rather, we must determine whether the Commissioner' s conclusions "are supported by substantial evidence in the record as a whole or are based on an erroneous legal standard.'" Schaal v. Apfel, 134 F.3d 496, 501 (2d Cir. 1998) (quoting Beauvoir v. Chater, 104 F.3d 1432, 1433 (2d Cir. 1997)). The Second Circuit has held that "[w]here an administrative record supports disparate findings, we must accept the ALJ'S factual determinations." Schauer v. Schweiker, 675 F.2d 55, 57 (2d Cir. 1982). The substantial evidence standard also governs judicial review of children's SSI benefits claims. See Brown on Behalf of Brown v. Chater, 932 F. Supp. 71, 74 (S.D.N.Y. 1996).
B. Requirements for Eligibility
The SSI program is a federal program that provides benefits to needy, aged, blind or disabled individuals who meet statutory requirements. See 42 U.S.C. § 1381. The eligibility standard for a child's disability benefits was amended in 1996 by the Responsibility and Work Opportunity Reconciliation Act of 1996, Pub.L. 104-193, 1996 U.S.C.C.A.N. (110 Stat.) 2105. It was the intent of Congress to tighten the eligibility standards. See Cotis v. Massanari, No. 00 Civ. 4693, 2001 WL 527471, at *3 (S.D.N.Y. May 17, 2001) (citing Nelson v. Apfel, 131 F.3d 1228, 1234-35 (7th Cir. 1997)). Accordingly, the Commissioner published "interim final" regulations which govern Morales's case.
On September 11, 2000, the Commissioner published revised final rules for determining disability for children under eighteen, which became effective on January 2, 2001. See 65 Fed. Reg. 54, 546 (Sept. 11, 2000) (codified at 20 C.F.R. pt. 404, 416). Nevertheless, the Commissioner "expect[s] that the court's review . . . would be made in accordance with the rules in effect at the time of the [Commissioner's] final decision." See id. at 54, 751; see also Robles o/b/o Padilla v. Commissioner of Soc. Sec., No 99 Civ. 4248, 2001 WL 194888, at *2 (S.D.N.Y. Feb. 27, 2001). In this case, the Commissioner's final decision was rendered on December 19, 1999. See Tr. at 10-19. Therefore, the following "C.F.R." references are to the interim regulations in effect from February 11, 1997 through December 31, 2000.
A child under eighteen years of age is disabled if the child has "a medically determinable physical or mental impairment, which results in marked and severe functional limitations, and which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than twelve months." 42 U.S.C. § 1382c(a)(3)(c)(i); Cotis, 2001 WL 527471, at *3 A determination that a child is disabled requires a three-step analysis.See 20 C.F.R. § 416.924(a). First, the ALJ must consider whether the child is engaged in substantial gainful activity. See 20 C.F.R. § 416.924(b). If the child is so engaged, he or she will not be awarded SSI benefits. See id. Second, the ALJ must consider whether the child has a severe impairment. See 20 C.F.R. § 416.924(c). A severe impairment is an impairment that is more than a slight abnormality. See id. Third, if the impairment is severe, the ALJ must consider whether the impairment meets or is medically or functionally equal to a disability in the Listings. See 20 C.F.R. § 416.925. Only if the impairment is severe and meets or is medically or functionally equal to a disability in the Listings will it constitute a disability within the meaning of the Act. See 20 C.F.R. § 416.924(d);Cotis, 2001 WL 527471, at *3; Salomon o/b/o Jenkins v. Apfel, No. 99 Civ. 4250, 2000 WL 776924, at *3 (S.D.N.Y. June 15, 2000).
If a child's impairment or combination of impairments does not meet or equal any impairment stated in the Listings, the Commissioner assesses all functional limitations caused by the child's impairment(s). See 20 C.F.R. § 416.926a(a). If the functional limitations caused by the impairment(s) are the same as the disabling functional limitations caused by an impairment stated in the Listings, the Commissioner will find that the impairment(s) is functionally equivalent in severity to an impairment in the Listings. See id.
In determining whether a child's limitation(s) is functionally equivalent, the Commissioner uses four methods. See 20 C.F.R. § 416.926a(b); Morris v. Barnhardt, No. 02 Civ. 377, 2002 WL 1733804, at *8 (S.D.N.Y. July 26, 2002); Tucker v. Massanari, No. 99 Civ. 12037, 2001 WL 868031, at *7 (S.D.N.Y. Aug. 1, 2001). The ALJ considers all four methods before determining whether a child's impairment is functionally equivalent to a disability in the Listings. There is no set order in which these methods must be considered. See 20 C.F.R. § 416.926a(b). Under the first method — "limitation of specific functions" — the Commissioner will find that a child's impairment(s) is functionally equivalent in severity to a disability in the Listings if there is extreme limitation in one specific function, such as walking or talking. See 20 C.F.R. § 416.926a(b)(1).
For a child of plaintiff's age, extreme limitation means that there is no meaningful functioning in a given area. See 20 C.F.R. § 416.926a(c)(3)(ii)(C); see also Morris, 2002 WL 1733804, at *9; DeLeon v. Apfel, No. 00 Civ. 3701, 2000 WL 1873851, at *89 (S.D.N.Y. Dec. 21, 2000); De Medina v. Apfel, No. 99 Civ. 4149, 2000 WL 964937, at *5-6 (S.D.N.Y. July 10, 2000).
The second method — "broad areas of development or functioning" — evaluates the effect of the child's impairment(s) in broad areas of development or functioning. See 20 C.F.R. § 416.926a(b)(2). Children between the age of three and eighteen are evaluated in five categories of functioning: (1) cognitive/communicative functioning, (2) motor functioning, (3) social functioning, (4) personal functioning, and (5) concentration, persistence or pace. See 20 C.F.R. § 416.926a(c)(4). The regulations define cognitive function as a child's "ability or inability to learn, understand, and solve problems . . .; the ability to retain and recall information. [and] the ability or inability to comprehend and produce language in order to communicate." 20 C.F.R. § 416.926a(c)(4)(i). The regulations define motor function as a child's "ability or inability to use gross and fine motor skills. . . . It involves general mobility, balance and the ability to perform age-appropriate physical activities." 20 C.F.R. § 416.926a(c)(4)(ii). The area of social development includes a child's "ability or inability to form and maintain relationships with other individuals and with groups." 20 C.F.R. § 416.926a(c)(4)(iii). The area of personal functioning includes "[t]he ability or inability to help yourself and to cooperate with others in taking care of your personal needs, health and safety." 20 C.F.R. § 416.926a(c)(4)(v). The regulations define the area of concentration, persistence and pace as the child's "ability or inability to attend to, and sustain concentration on, an activity or task, such as playing, reading, or practicing a sport, and the ability to perform the activity or complete the task at a reasonable pace." 20 C.F.R. § 416.926a(c)(4)(vi). If a child claiming SSI benefits has marked limitations in two categories or an extreme limitation in one category, the child's impairment is functionally equal in severity to a disability in the Listings. See 20 C.F.R. § 416.926a(b)(2).
A marked limitation is an impairment that is "more than moderate" and "less that extreme." A marked limitation may arise when several activities or functions are limited, or when only one activity is limited as long as the degree of limitation is such as to interfere seriously with the child's functioning. See 20 C.F.R. § 416.926a(c)(3)(i)(C).
The third method — "episodic impairments" — evaluates chronic impairments that are characterized by frequent illnesses or attacks or by exacerbations and remissions. The functional limitations caused by an episodic impairment(s) are evaluated in the same manner as the first and second methods. See 20 C.F.R. § 416.926a(b)(1) and (b)(2). Alternatively, the Commissioner may compare the child's functional limitations to those in any Listing for a chronic impairment with similar episodic criteria to determine if the child's impairment(s) has such serious impact on his functioning over time that it is functionally equivalent in severity to a disability in the Listings. See 20 C.F.R. § 416.926a(b)(3)
The fourth method involves "limitations related to treatment or medication effects." 20 C.F.R. § 416.926a(b)(4). Some impairments require treatment over a long period of time (i.e., at least a year) where the treatment itself (including the side effects of medication) causes marked and severe functional limitations. Marked and severe functional limitations may also result from the combined effects of limitations caused by ongoing treatment. In many cases, these limitations are evaluated by using the first and the second methods. See 20 C.F.R. § 416.926a(b)(1) and (b)(2). The Commissioner may also compare the child's limitations to a disability in the Listings based on treatment that is itself disabling, or that contributes to functional limitations. See 20 C.F.R. § 416.926a(b)(4). If treatment of the child's impairment(s) produces functional limitations that are the same as the disabling functional limitations in the Listings, the Commissioner will find the child's impairment(s) to be functionally equivalent in severity to a disability in the Listings. See id.
In making these determination, the ALJ is required to consider "all of the relevant evidence in the record, including: (1) the objective medical facts; (2) the medical opinions of the examining or treating physicians; (3) the subjective evidence of the claimant's symptoms submitted by the claimant, [her] family, and others; and (4) the claimant's educational background, age, and . . . experience." Tucker, 2001 WL 868031, at *7 (quoting DeLeon, 2000 WL 1873851, at *8). See also e.g., Williams v. Bowen, 859 F.2d 255, 259 (2d Cir. 1988).
IV. DISCUSSION
The ALJ concluded, after applying the sequential analysis set forth at 20 C.F.R. § 416.926a(a)-(d), that claimant was not disabled within the meaning of the Act and thus not entitled to SSI benefits. Based on the complete record before him, the ALJ reasonably found that although the child had speech, learning, and emotional problems, these impairments did not meet or equal a disability in the Listings. See Tr. at 18. The ALJ then evaluated the child's impairments to determine whether they were functionally equivalent to a disability in the Listings. See id. at 17. The record indicated that claimant did not suffer from any extreme limitation in a specific function. Claimant's speech was clear, although she was soft spoken, and her ability to comprehend and respond was good.See id. at 14, 213, 249. In addition, claimant was not prone to frequent illness and did not receive medical treatment which resulted in severe functional limitations. See id. at 232. Although the record indicated that claimant took medication for her depression at one point, see id. at 302, there is no indication that the treatment itself caused marked and severe limitations. See id. at 17. Thus, the ALJ's inquiry focused on whether the child suffered from marked limitations in at least two broad areas of functioning. The ALJ determined that claimant had a marked limitation in the area of social functioning, a less than marked limitations in the areas of cognitive/communicative functioning and motor functioning, and no limitation in the areas of personal functioning and concentration, persistence or pace. See id. at 18. The ALJ therefore concluded that the child's impairments were not functionally equivalent to a disability in the Listings. See id. at 19.
Substantial evidence in the record supports the ALJ'S decision that claimant was not disabled under the Act.
A. Cognitive/Communicative Functioning
The ALJ determination that claimant had a less than marked limitation in the area of cognition/communicative functioning is supported by substantial evidence. The ALJ found that the child had some cognitive and language deficits, but that these limitations were not marked or extreme. Although a speech/language evaluation revealed significant delays in 1994, subsequent evidence during the period at issue indicates that claimant's functioning in this area improved. See id. at 166-69, 202-04, 205-09, 212-23, 248-60, 262, 284-99.
B. Motor Functioning
Substantial evidence supports the ALJ'S finding that claimant had a less than marked limitation in the area of motor functioning. Although the child has had problems with her Achilles' tendons, Dr. Virey noted only slight stiffness and slight limitation in range of motion. See id. at 110. Moreover, there is no evidence in the record of any physical therapy, surgery of other treatment. See id. at 17.
C. Social Functioning
The ALJ reasonably found that claimant had a marked limitation in the area of social functioning, based upon the fact that she was receiving therapy and medication for depression and behavioral problems from the Center. See id. at 17, 300-02. The record supports the finding that this limitation was marked, or "seriously interfered" with the child's functioning, but was not extreme. See id. at 14-16, 212-23, 248-62, 284-99.
D. Personal Functioning
There is no evidence in the record of a limitation in the area of personal functioning. The record demonstrates that the child was able to take care of her personal needs, as indicated by claimant's teachers and the state agency medical consultant. See id. at 171, 175, 180, 186, 233.
E. Concentration, Persistence or Pace
The ALJ reasonably found that there is no evidence in the record of a limitation in the area of concentration, persistence or pace. Treatment notes from April 1998 indicated that claimant focused on her tasks and completed them with "good results." Id. at 14, 292-99. Moreover, a mental status evaluation from April 1998 described the child's attention as "good," id. at 212-14, and a record from her psychiatrist dated September 30, 1999, indicated that her attention was adequate. See id. at 16, 262, 300-02.
In sum, there is substantial evidence in the record to support the ALJ'S conclusion that claimant did not suffer either from an extreme limitation in one area of functioning, or from marked limitations in two of the five broad areas of functioning.
V. CONCLUSION
Because the ALJ'S decision is supported by substantial evidence and reflects a thoughtful and thorough consideration of the record, the Commissioner's motion is granted and her decision is affirmed. The Clerk of the Court is directed to close this case.