Bear Shield v. Barnhart, 2002 DSD 10
ROBERT BEAR SHIELD,
JO ANNE B. BARNHART,
Commissioner, Social Security Administration,
[2002 DSD 10]
United States District Court
District of South Dakota--Western Division
Lisa I. Koehn, Hot Springs, SD
Attorney for Plaintiff:
Diana J. Ryan, Assistant United States Attorney, Rapid City, SD
Attorney for Defendant.
Filed May 6, 2002
Hon. Richard H. Battey, United States District Judge
I. PROCEDURAL HISTORY
[¶1] Pending before the Court is a motion for summary judgment filed by Robert Bear Shield (Bear Shield) on October 10, 2001. (fn1) Bear Shield protectively filed for Supplemental Security Income (SSI) in December, 1998. AR 110-110a. He was initially denied and also denied upon reconsideration. AR 99-101. A hearing was requested which was held on March 30, 2000, and an unfavorable decision was issued on June 30, 2000. AR 23-36, 38-90. The Appeals Council found no basis for review. AR 8-9. Subsequently, Bear Shield filed a complaint with this Court on June 6, 2001.
II. FACTUAL BACKGROUND
[¶2] Bear Shield was born on February 5, 1984, and was sixteen years old at the time of his administrative hearing. AR 86, 111. Bear Shield was found in a ditch as an infant. AR 241. He was eventually placed by Social Services with Edna Apple (grandmother). Id. He was then abducted by his father, Jerry Bear Shield, but was subsequently returned to his grandmother after being physically and sexually abused and neglected. AR 241. He witnessed a friend commit suicide. AR 177.
[¶3] Bear Shield began receiving special education services early in elementary school. Id. He was placed in the Pierre Indian Learning Center in the fourth grade because of inappropriate behavior, academic problems, and his family's inability to provide proper supervision. Id. Bear Shield was eventually placed at the Woodfield Center which is located in Beresford, South Dakota, and is a residential facility which provided Bear Shield a structured setting and special education services. AR 336-38. He had reached the ninth grade and was attending the Woodfield Center at the time of the administrative hearing. AR 86, 337.
[¶4] In 1996, Bear Shield, who was twelve years and nine months old at the time, was given an intelligent quotient (IQ) test. AR 181-82. He scored low average to average, earning a full scale of 88. AR 182. His overall performance, however, ranked him only in the 21st percentile relevant to other children his age. Id. It was Dr. Frank L. Dame's opinion that the full scale IQ was "not meaningful because he displayed a striking discrepancy between his verbal and nonverbal intelligence." Id. His performance IQ was 104 (which placed him in the 61st percentile) while his verbal IQ was 76 (which placed him in the 5th percentile). Id. Thus, Bear Shield scored average on nonverbal activities and borderline on verbal activities. AR 183.
[¶5] Bear Shield underwent a Behavioral/Developmental Pediatric Evaluation on March 5, 1997. AR 174-75. The evaluation found that Bear Shield suffered from the following problems: (1) dysthymia; (2) post-traumatic stress disorder (PTSD) (improving); (3) victim of child abuse; (4) learning disabilities in reading, written language, and math; (5) expressive language disorder; and (6) primary nocturnal enuresis. Id.
[¶6] A mental examination in October of 1998 indicated that Bear Shield was "far behind in academic achievement and [was] severely emotionally disturbed." AR 177. The examination also noted that he fulfilled the criteria for a depression disorder with psychotic features. AR 179.
[¶7] On October 6, 1998, Bear Shield was admitted to Rapid City Regional Hospital because he was experiencing auditory and visual hallucinations and suicidal ideation. AR 186. His diagnosis was as follows: (1) major depression with psychotic features; (2) dysthymia; and (3) PTSD. AR 186. He was given a prescription for Imipramine and Risperdal. AR 187. Counseling was also prescribed. Id. He was discharged on October 16, 1998, but was readmitted to the hospital eight days later "because he had been talking about various ways of dying, such as hanging and the electric chair . . . . The Pierre Indian Learning Center was concerned about his potential for self destructive." AR 208. Paxil was added to his medication regiment and he was discharged on November 18, 1998. AR 210. Dr. Steven Manlove recommended that Bear Shield be placed in a residential treatment facility because he believed that Bear Shield needed structure and therapy. Id. On December 17, 1998, Bear Shield was sent to the Pine Ridge Indian Health Service because he overdosed on his medications. AR 233-236. Finally, in April 1999, Bear Shield was placed in the Woodfield Center for Residential Treatment. AR 336-38.
[¶8] An Individualized Education Plan (IEP), dated May 17, 1999, summarized Bear Shield's academic performance. AR 333-35. At the time, he was in the eighth grade, albeit in a special education program. Id. The IEP provided a summary of the Woodcock-Johnson Achievement Battery which Bear Shield had taken on April 12, 1999. The results were summarized as follows:
|Standard Score||Grade Equivalent||Percentile Rank|
His scores were in the borderline to low average range and he appeared to have a weakness in the area of written expression. Id. On August 4, 2000, Bear Shield's IEP summarized updated results from the Woodcock-Johnson Achievement Battery. AR 462. The results were from tests taken on April 12, 1999, and March 27, 2000. From April 12, 1999, to March 27, 1999, Bear Shield's scores dropped in six subtests and raised in three. Id. His grade equivalent ranged from 7.6 to 2.0, with an average of 5.2, even though he was in the tenth grade in a special education program. Id.
[¶9] Bear Shield's behavior problems are summarized by the Woodfield Center on a chart which covers the time period from April 13, 1999, to March 12, 2000. AR 441-42. The notation for the period of February 28, 2000, to March 12, 2000, which is the last period noted in the chart, stated that Bear Shield displayed "serious inappropriate behavior." Id. The information provided by the chart reveals an individual with anger, trust, and behavior problems, even in a structured environment. See id. The information in the chart also shows that Bear Shield has been placed in an isolation room, physically restrained once, and has restrictions placed upon him in regards to several people. Id. The chart is consistent with and supported by Bear Shield's therapy notes and reports. See AR 443-521.
[¶10] The record indicates that Bear Shield cannot function outside a structured environment. Lory LaPointe, the Education Director of the Woodfield Center School, stated on December 13, 1999, that Bear Shield's "emotional/behavioral difficulties which are significantly affecting [Bear Shield's] progress in school and in his daily life to the degree that he is unable to function independently and effectively in a mainstream setting." AR 151. She did note, however, that he can maintain fairly appropriate behaviors in a structured school environment where the student-teacher ratio is about six-to-one. Id.
[¶11] A progress report for the period of January 24, 2000, to May 8, 2000, stated that the Woodfield staff was considering moving Bear Shield from Woodfield to an even more structured environment. AR 448. Furthermore, on March 21, 2000, Dr. W. Vail Williams stated that "[i]t would be the recommendation of this therapist for additional consideration of placement outside of Woodfield. Robert is going to need a much more structured male setting as opposed to a co-ed setting where he is in a more locked unit to deal with issues of anger and intimidation . . . ." AR 480. Bear Shield was still at the Woodfield Center as of January 14, 2001. AR 510.
[¶12] On October 19, 2000, Dr. Timothy Soundy diagnosed Bear Shield as suffering from: (1) PTSD; (2) poly-substance abuse; (3) conduct disorder or oppositional defiant disorder; and (3) enuresis. AR 521. The doctor noted that Bear Shield was pleasant and cooperative and had no suicidal or homicidal thinking. Id. Bear Shield was taken off Paxil but after having had several problems he was put back on Paxil on February 3, 2000. AR 516. Dr. Soundy stated that he was to continue using Paxil, Imipramine for the enuresis, and Risperdal. AR 521.
III. THE DECISION OF THE ALJ
[¶13] The ALJ determined that Bear Shield was not engaged in substantial gainful activity at step one of the three-step sequential evaluation process. (fn2) AR 27. At step two, the ALJ determined that Bear Shield had the following severe impairments: (1) PTSD; (2) affective disorder; (3) learning disabilities; and (4) a history of drug and alcohol abuse. Id. At step three, however, the ALJ determined that Bear Shield's severe impairments did not meet or medically equal or functionally equal an impairment listed in Appendix 1 of Subpart P of Social Security Administration Regulation No. Four. Id. The ALJ determined that Bear Shield had no limitations of specific function and no limitations relating to a chronic illness or limitations relating to treatment or medication. AR 35-36. The ALJ determined that Bear Shield had the following broad functional limitations: "less than marked limitations in cognition/communication, personal functioning, and concentration, persistence or pace and a marked limitation in social functioning." AR 36. The ALJ concluded that Bear Shield's severe impairments did not functionally equal any listing and thus he was not eligible for supplemental security income. AR 36.
IV. STANDARD OF REVIEW
IV. STANDARD OF REVIEW
[¶14] The decision of the ALJ must be upheld if it is supported by substantial evidence in the record as a whole. See 42 USC § 405(g); Metz v. Shalala, 49 F3d 374, 376 (8th Cir. 1995) (citing Sullins v. Shalala, 25 F3d 601, 603 (8th Cir. 1994), cert. denied, 573 US 1076, 115 S. Ct. 722, 130 L. Ed. 2d 627 (1995)); Smith v. Shalala, 987 F2d 1371, 1373 (8th Cir. 1993). Substantial evidence is less than a preponderance, but enough evidence that a reasonable mind might find it adequate to support the conclusion. See Fines v. Apfel, 149 F3d 893 (8th Cir. 1998) (citing Oberst v. Shalala, 2 F3d 249, 250 (8th Cir. 1993)). See also Shannon v. Chater, 54 F3d 484, 486 (8th Cir. 1995) (citing Richardson v. Perales, 402 US 389, 401, 91 S. Ct. 1420, 1427, 28 L. Ed. 2d 842 (1971)); Onstead v. Sullivan, 962 F2d 803 (8th Cir. 1992) (quoting Whitehouse v. Sullivan, 949 F2d 1005, 1007 (8th Cir. 1991)). Review by this Court extends beyond a limited search for the existence of evidence supporting the Commissioner's decision to include giving consideration to evidence in the record which fairly detracts from the decision. See Brockman v. Sullivan, 987 F2d 1344, 1346 (8th Cir. 1993); Locher v. Sullivan, 968 F2d 725, 727 (8th Cir. 1992); Turley v. Sullivan, 939 F2d 524, 528 (8th Cir. 1991).
[¶15] The Court's role is to determine whether there is substantial evidence in the record as a whole to support the decision of the Commissioner and not to reweigh the evidence or try the issues de novo. See Murphy v. Sullivan, 953 F2d 383, 384 (8th Cir. 1992). Furthermore, a reviewing court may not reverse the Commissioner's decision "merely because substantial evidence would have supported an opposite decision." Woolf v. Shalala, 3 F3d 1210, 1213 (8th Cir. 1993); Smith v. Shalala, 987 F2d at 1374 (citing Locher, 986 F2d at 727 (quoting Baker v. Heckler, 730 F2d 1147, 1150 (8th Cir. 1984))). The Court must review the Commissioner's decision to determine if an error of law has been committed. See Smith v. Sullivan, 982 F2d 308, 311 (8th Cir. 1992); Nettles v. Schweiker, 714 F2d 833, 836 (8th Cir. 1983). The Commissioner's conclusions of law are only persuasive, not binding, on the reviewing court. See Smith v. Sullivan, 982 F2d at 311; Satterfield v. Mathews, 483 F. Supp. 20, 22 (E.D. Ark. 1979), aff'd per curiam, 615 F2d 1288, 1289 (8th Cir. 1980). As long as the ALJ's decision is supported by substantial evidence, then this Court cannot reverse the decision of the ALJ even if the Court would have decided it differently. See Smith v. Shalala, 987 F2d at 1374. In other words, '"[i]f, after review, [the Court] find[s] it possible to draw two inconsistent positions from the evidence and one of those positions represents the Commissioner's findings, [the Court] must affirm the denial of benefits."' Howard v. Massanari, 255 F3d 577, 581 (8th Cir. 2001) (quoting Mapes v. Chater, 82 F3d 259, 262 (8th Cir. 1996) (citing Siemers v. Shalala, 47 F3d 299, 301 (8th Cir. 1995)).
[¶16] Bear Shield raises the following issues: (1) whether the ALJ erred in evaluating Bear Shield's medical impairments; (2) whether substantial evidence supports a finding that Bear Shield has a less than marked limitation in cognition/communication; (3) whether substantial evidence supports a finding that Bear Shield has only a marked limitation in social functioning; and (4) whether substantial evidence supports a finding that Bear Shield has a less than marked limitation in personal functioning.
[¶17] Bear Shield's Medical Impairments
[¶18] Bear Shield argues that the ALJ erred in failing to adress his enuresis in analyzing his functioning. See Plaintiff's Opening Memorandum (Plaintiff's Memorandum) at 10. Section 416.929(d)(4) of the regulations provide, in pertinent part, as follows:
If you have a medically determinable severe physical or mental impairment(s), but your impairment(s) does not meet or equal an impairment listed in appendix 1 of Subpart P of part 404 of this chapter, we will consider the impact of your impairment(s) and any related symptoms . . . on your functioning if you are a child.
20 CFR § 416.929(d)(4) (emphasis added). The ALJ did not classify Bear Shield's enuresis as severe. Consequently, § 416.929(d)(4) is not applicable.
[¶19] The ALJ, however, did not list Bear Shield's enuresis as an impairment at all in his discussion at step one. See AR 27. Section 416.924(a) states:
We consider all relevant evidence in your case record when we make a determination or decision whether you are disabled. If you allege more than one impairment, we will evaluate all the impairments for which we have evidence. Thus, we will consider the combined effects of all your impairments upon your overall health and functioning.
20 CFR § 416.924(a). The ALJ merely notes the condition in his discussion and that the condition was being treated. AR 31. There is, however, evidence in the record that the problem was being successfully treated with medication. See AR 520. The Eighth Circuit has held that "[i]mpairments that are controllable or amenable to treatment do not support a finding of total disability." Hutton v. Apfel, 175 F3d 651, 655 (8th Cir. 1999) (citations omitted). The Court finds that the ALJ's omission of Bear Shield's enuresis in his analysis was harmless error.
[¶20] Cognition/Communication Functioning
[¶21] Bear Shield next argues that the ALJ erred in finding he had only a less than marked limitation in cognition/communication. See Plaintiff's Memorandum at 10-12. The regulations define a "marked limitation" as follows:
(A) When standardized tests are used as the measure of functional abilities, a valid score that is two standard deviations or more below the norm for the test (but less than three standard deviations); or
(C) For children from age 3 to attainment of 18, "more than moderate" and "less than extreme." Marked limitation may arise when several activities or functions are limited or even when only one is limited as long as the degree of limitation is such as to interfere seriously with the child's functioning.
20 CFR § 416.926a(c)(3)(i) (1999). The regulations describe cognitive/communicative functioning in the following manner for Bear Shield's age group:
(A) Cognitive/communicative functioning (age 12 to attainment of age 18): Your ability or inability to learn, understand, and solve problems through intuition, perception, verbal and nonverbal reasoning, and the application of acquired knowledge; the ability or inability to retain and recall information, images, events, and procedures during the process of thinking, as in formal learning situations (e.g., composition, classroom discussion) and in daily living (e.g., using the post office, using public transportation). Your ability or inability to comprehend and produce language (e.g., vocabulary, grammar) in order to communicate in conversation (e.g., to express feelings, meet needs, seek information, describe events, tell stories), and in learning situations (e.g., to obtain and convey information and ideas) both spontaneously and interactively, in all communication environments (e.g., home, classroom, game fields, extra-curricular activities, job), and with all communication partners (e.g., parents, siblings, peers, school classes, teachers, employers).
20 CFR § 416.926a(c)(5)(v)(A) (1999).
[¶22] The ALJ based his finding of a less than marked limitation in cognition/communcative functioning on Bear Shield's IQ results, grades, a disability determination services opinion, and statements made in treatment notes. See AR 31-32. Bear Shield's IQ results, however, were taken in November 1996 when he was twelve years and nine months old. AR 181-82. Appendix 1 of Part 404, Subpart P states that "IQ test results obtained between ages seven and sixteen should be considered current . . . for 2 years when the IQ is 40 or above." See 20 CFR Pt. 404, Subpt. P, App.1, § 112.00D(10). Furthermore, Dr. Frank L. Dame's opinion was that the full scale IQ was "not meaningful because he displayed a striking discrepancy between his verbal and nonverbal intelligence." AR 182. Hence, the ALJ relied on evidence which was not valid.
[¶23] Additionally, the ALJ and the Appeals Council failed to consider the Woodcock-Johnson Achievement Battery test results. The results indicate a severe learning disability. See AR 462. The ALJ is required to consider all relevant evidence in a claimant's case record. See 20 CFR § 416.924a(a) ("We consider all relevant information (i.e., evidence) in your case record). Medical evidence includes formal testing. See 20 CFR § 416.924a(a)(1)(i) ("medical evidence may include . . . formal testing that provides information about your development or functioning in terms of standard deviations, percentiles, percentages of delay, or age or grade equivalents."). Test scores, however, are not to be considered in isolation. See 20 CFR § 416.924a(a)(1)(ii). Further, the ALJ is to consider how a claimant's function compares with functioning of children of the claimant's age. 20 CFR § 416.924a(b)(3). The ALJ did not properly address the Woodcock-Johnson test results which indicated that Bear Shield scored no better than the 25th percentile in one subtest and as low as below the 1st percentile in another subtest-all while undergoing a special education program. AR 68-69. These tests provide very substantial evidence that Bear Shield's cognitive/communicative functioning is severely below that of other children his age.
[¶24] Additionally, the ALJ's reliance on Bear Shield's grades is weak. Bear Shield is in a special education program. An ALJ is required to consider the fact that a claimant is participating in a special education program. See 20 CFR § 416.924a(b)(7)(iv) ("We will consider the fact that you attend school, that you may be placed in a special education setting, or that you receive accommodations because of your impairments . . . "). There is no indication in the ALJ's decision that he considered Bear Shield's special education program in his analysis.
[¶25] Furthermore, Bear Shield, at the time of the hearing, was in a structured residential program. AR 336-38. Section 416.924a of the regulations, in pertinent part, provides as follows:
(C) [W]e will consider your need for a structured setting and the degree of limitation in functioning you have or would have outside the structured setting. Even if you are able to function adequately in the structured or supportive setting, we must consider how you function in other settings and whether you would continue to function at an adequate level without the structured or supportive setting.
(E) Therefore, if your symptoms or signs are controlled or reduced in a structured setting, we will consider how well you are functioning in the setting and the nature of the setting in which you are functioning (e.g., home or a special class); the amount of help you need from your parents, teachers, or others to function as well as you do; adjustments you make to structure your environment; and how you would function without the structured or supportive setting.
20 CFR § 416.924a(b)(5)(iv)(C) and (E). It is not clear from the record that the ALJ considered Bear Shield's structured setting and special education program and what, if any, changes in his function would result if either was terminated. The ALJ has a duty to develop the record. See Reeder v. Apfel, 214 F3d 984, 987 (8th Cir. 2000) (stating that "the ALJ has a duty to develop facts fully and fairly, especially in a case where the claimant is not represented by counsel.") (citation omitted).
[¶26] The ALJ also considered several positive comments concerning Bear Shield's attitude and demeanor concerning class, see AR 32, 151, but there are substantially more comments indicating problems. See e.g., AR 151, 267, 448-51, 455,462-64, 469-70. On balance, the comments made are weighed against the ALJ's conclusion. See id.
[¶27] Finally, the ALJ also relied on a disability determination service (DDS) expert opinion which indicated Bear Shield had less than marked limitations in cognition/communication. AR 32, 163. The defendant concedes that the DDS examiner was a non-examining advisor. See Defendant's Memorandum at 11. Nevertheless, defendant argues that the Ninth Circuit Court of Appeals has held that reports of nonexamining advisors may serve as substantial evidence if their opinions are supported by other evidence in the record consistent with their opinions. Id. (citing Jamerson v. Chater, 112 F3d 1064, 1067 (9th Cir. 1997)). Ninth Circuit case law, however, is not binding upon this Court. Additionally, the only other evidence cited by the ALJ was an invalid IQ test, grades received in a special education program, and some comments made in therapy notes and reports, all of which have been already addressed by the Court. The Court finds that the ALJ's findings are not supported by substantial evidence and his analysis did not comply with the relevant legal standards. See Locher v. Sullivan, 968 F2d 725, 727 (8th Cir. 1992) ("In assessing the substantiality of the evidence, [a court] must consider evidence that detracts from the Secretary's decision as well as evidence that supports it."); Nettles v. Schweiker, 714 F2d 833, 835-36 (8th Cir. 1983) (holding that "it is the court's duty to review the disability benefit decision to determine if it is based on legal error (i.e., erroneous legal standards, incorrect application of the law.") (citations omitted); Smith v. Sullivan, 982 F2d 308, 311 (8th Cir. 1992); Smith v. Sullivan, 982 F2d at 311; Satterfield v. Mathews, 483 F. Supp. 20, 22 (E.D. Ark. 1979), aff'd per curiam, 615 F2d 1288, 1289 (8th Cir. 1980) (stating that the Commissioner's conclusions of law are only persuasive, not binding).
[¶28] Social Functioning
[¶29] Bear Shield next argues that the ALJ erred in finding he had only a marked limitation in social function rather than an extreme limitation. See Plaintiff's Memorandum at 12-13. The pertinent regulation defines an extreme limitation as follows:
(A) When standardized tests are used as the measure of functional abilities, a valid score that is three standard deviations or more below the norm for the test; or
(C) For children from birth to attainment of age 18, no meaningful functioning in a given area. There may be extreme limitation when several activities or functions are limited or even when only one is limited.
20 CFR § 416.926a(c)(3)(ii) (1999). The regulations define social function for Bear Shield's age group as "[his] ability or inability to initiate and develop friendships, to relate appropriately to individual peers and adults and to peer and adult groups, and to reconcile conflicts between [himself] and peers or family members or other adults outside [his] family." 20 CFR § 416.26a(c)(5)(v)(C) (1999).
[¶30] In determining Bear Shield's limitation in social functioning was marked, the ALJ acknowledged that Bear Shield had problems with his social functioning. AR 34. The ALJ considered Bear Shield's structured environment on his social functioning. Id. Although the record indicates that Bear Shield has a history of being restricted from associating with peers and staff members at the Woodfield Center, the record does show some improvement. AR 443-521. Additionally, the record also indicates that medication is aiding Bear Shield. AR 516-17. While there is evidence that Bear Shield may require a more structured setting, see AR 448, 480, the ALJ has considered Bear Shield's structured setting in his analysis of Bear Shield's social functioning. AR 34. The Court finds that the ALJ's determination of a marked limitation in social functioning is supported by substantial evidence.
[¶31] Personal Functioning
[¶32] Finally, Bear Shield argues that the ALJ erred in finding less than a marked limitation in his personal functioning. See Plaintiff's Memorandum at 13. The regulations define personal function for Bear Shield's age group as "[his] ability or inability to help [himself] in taking care of [his] personal needs, health, and safety (e.g., dressing, bathing, doing laundry, adhering to medication or therapy regimens)." 20 CFR § 416.926a(c)(5)(v)(D) (1999).
[¶33] In his analysis, the ALJ notes, "[c]laimant is able to care for his personal needs and has not demonstrated significant problems in activities of daily living. Claimant takes medicine and reports no adverse side-effects." AR 35. He also cites a childhood disability evaluation indicating a less than marked limitation in personal function. AR 162. Additionally, and contradictorily, the ALJ rejects the conclusions of Lory LaPointe (LaPointe), the Education Director at the Woodfield Center School, that Bear Shield was "unable to function independently and effectively in a mainstream setting" while at the same time admitting that he can succeed in school and care for himself with structure and assistance. AR 32. Thus, the ALJ rejects the statement of LaPointe that Bear Shield cannot function independently while finding that he can function well with assistance and structure which in effect means he cannot function independently. It should be noted, that this was the extent of the ALJ's discussion of Bear Shield's structured environment and its effect on his personal functioning, which in fact cuts against the ALJ's conclusions. The record does not indicate that the ALJ performed the required analysis of the effect of the structured environment on Bear Shield's functioning. See 20 CFR § 416.924a(b)(6)(iv)(C) and (E). Additionally, a childhood disability evaluation form, dated July 13, 1999, indicating a less than marked limitation in personal functioning was cited by the ALJ. AR 32, 162. But a childhood disability evaluation form, which is dated approximately four months earlier (March 11, 1999) indicated that Bear Shield had a marked limitation in personal function. AR 154. Regardless, as the ALJ failed to apply relevant regulations, the Court finds that the ALJ's decision is not supported by substantial evidence in the record.
[¶34] In light of the fact that the ALJ's decision was not supported by substantial evidence, the Court awards Bear Shield SSI benefits.
[¶35] Pursuant to the forgoing, it is hereby
ORDERED that plaintiff's motion for summary judgment is granted. The plaintiff is to be awarded benefits.
1. Bear Shield only filed a memorandum, but the Court will construe the memorandum as a motion.
2. The three-step sequential evaluation process for evaluating the disability of children is as follows:
See 20 CFR 416.924(b)-(d).