The opinion
UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ALABAMA
WESTERN DIVISION
JUANDRITTA NEAL, }
}
}
Plaintiff,
}
} Case No.: 7:24-cv-01583-MHH
v.
}
}
FRANK J. BISIGNANO,
}
Commissioner of the Social Security
}
Administration,1
}
}
Defendant.
MEMORANDUM OPINION
Juandritta Neal, who is proceeding pro se, has asked the Court to review a
final adverse decision of the Social Security Commissioner. The Commissioner
terminated Ms. Neal’s claim for supplemental security income on behalf of her
minor child, K.N., based on an Administrative Law Judge’s finding that K.N.’s
disability ended on February 14, 2023.2 In her complaint, Ms. Neal asserts that the
1 On May 7, 2025, Frank J. Bisignano became the Commissioner of Social Security. Pursuant to
Rule 25(d) of the Federal Rules of Civil Procedure, Frank J. Bisignano should be substituted as
the defendant in this suit. See Fed. R. Civ. P. 25(d) (Although the public officer’s “successor is
automatically substituted as a party” when the predecessor no longer holds officer, the “court may
order substitution at any time. . . .”).
2 Where, as here, an ALJ denies benefits and the Appeals Counsel denies review, the ALJ’s
decision is the Commissioner’s final decision for purposes of this Court’s review. See Samuels v.
Commissioner did not review documents K.N.’s doctor submitted that detail new
diagnoses and kidney problems. (Doc. 1, p. 5).3 Several months after filing her
complaint, Ms. Neal submitted medical records dated July 10, 2024, December 23,
2024, April 22, 2025, and June 11, 2025. (Doc. 9). Because Ms. Neal is proceeding
pro se, the Court construes her complaint liberally. See Curtis v. Comm’r of Soc.
Sec., 856 Fed. Appx. 276, 276 (11th Cir. 2021) (applying the liberal construction
rule to a pro se Social Security appeal). For the reasons described below, the Court
reverses the Commissioner’s decision and remands this matter for further
proceedings.
ADMINISTRATIVE PROCEEDINGS
For a claimant under age 18 to qualify for supplemental security income
benefits, she must have “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 12 months.” 42 U.S.C. § 1382c(a)(3)(C)(i). In a
Acting Comm'r of Soc. Sec., 959 F.3d 1042, 1045 (11th Cir. 2020) (internal quotation and citation
omitted).
3 Ms. Neal did not have to file a brief in support of her challenge to the ALJ and Appeals Council’s
decisions. The briefing notice in this matter states: “Unless the plaintiff is proceeding without
counsel, initial briefs will be required of all parties.” (Doc. 5, p. 1). Because Ms. Neal did not file
a brief, the Court relies on her complaint to understand her position in this appeal.
cessation of benefits case, the issue is whether substantial evidence demonstrates the
claimant’s impairments medically improved to the point that she no longer had
marked and severe functional limitations. See 42 U.S.C. § 1382c(a)(4)(B); 20 C.F.R.
§ 416.994a. Although K.N. previously was found disabled, she was not entitled to
a presumption of continuing disability. See 42 U.S.C. § 1382c(a)(4); 20 C.F.R. §
416.994a(a)(2).
The regulations define the statutory standard of “marked and severe functional
limitations” as “a level of severity that meets, medically equals, or functionally
equals the listings.” 20 C.F.R. § 416.902(h); see 20 C.F.R. §§ 416.906, 416.924(a),
416.926a(a); see also 20 C.F.R. pt. 404, subpt. P, app. 1 (the Listing of Impairments).
To determine if a severe impairment functionally equals a listing, the ALJ must
assess the claimant’s functioning 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)(i)–(vi). An impairment
“is of listing level severity if [the claimant has] ‘marked’ limitations in two of the
domains . . . or an ‘extreme’ limitation in one domain.” 20 C.F.R. § 416.926a(d).
A child’s impairment or combination of impairments constitutes a “marked”
limitation when it interferes “seriously” with her ability to “independently initiate,
sustain, or complete activities.” 20 C.F.R. § 416.926a(e)(2)(i). A child’s
impairment or combination of impairments constitutes an “extreme” limitation when
it interferes “very seriously” with her ability to “independently initiate, sustain, or
complete activities.” 20 C.F.R. § 416.926a(e)(3)(i). “[N]o single piece of
information taken in isolation can establish whether [a claimant has] a ‘marked’ or
‘extreme’ limitation in a domain.” 20 C.F.R. § 416.926a(e)(4).
The Commissioner has established a three-step medical improvement review
process to determine whether a child no longer is disabled. See 20 C.F.R. §
416.994a(a)(1), (b); Social Security Ruling (SSR) 05-03p, 2005 WL 1041037 (Apr.
27, 2005). The Commissioner compares the claimant’s current conditions and
limitations with those identified in the most recent favorable medical decision
finding that the claimant continued to be disabled, known as the “comparison point
decision” or CPD. See 20 C.F.R. § 416.994a(c). In determining whether medical
improvement has occurred since the CPD, the Commissioner must consider:
1) Whether there has been medical improvement in the individual’s condition?
2) Whether the individual’s impairment still meets or equals the severity of the
listed impairment it met or equaled before?
3) Whether the individual currently disabled?
See 20 C.F.R. § 416.994a(b)(1)-(3).
In this matter, the ALJ determined that K.N.’s comparison point decision is
dated November 24, 2020. (Doc. 4-3, p. 34). The ALJ found that K.N. experienced
medical improvement as of February 14, 2023. (Doc. 4-3, pp. 34–35). The ALJ
determined that K.N.’s CPD impairment, a speech and language disorder, no longer
functionally equaled the Listing of Impairments. (Doc. 4-3, pp. 35–40). The ALJ
determined that K.N. was suffering from a severe impairment of low average
intellectual functioning. (Doc. 4-3, pp. 40–41). The ALJ also determined that K.N.
was suffering from the non-severe impairments of below average receptive language
skills and mild persistent asthma without complication. (Doc. 4-3, p. 40).
Based on a review of the evidence, the ALJ concluded that K.N.’s
impairments, singly and in combination, did not meet or medically equal the severity
of any of the listed impairments in 20 C.F.R. Part 404, Subpart A, Appendix 1. (Doc.
4-3, pp. 41–45). The ALJ found that K.N. had “less than marked” limitations in the
domains of acquiring and using information and health and physical wellbeing and
“no limitation” in the other four domains. (Doc. 4-3, pp. 43–45). Accordingly, the
ALJ determined that K.N. was not disabled between February 14, 2023 and the date
of his decision, May 31, 2024. (Doc. 4-3, p. 45).
EVIDENCE IN THE ADMINISTRATIVE RECORD
2017 Disability Determination
In 2017, when K.N. was 3 years old, an ALJ found that K.N. had the severe
impairments of hearing loss, speech/language delay, adenoid hypertrophy, chronic
otitis media, asthma, and broncho pulmonary dysplasia. (Doc. 4-4, p. 8).4 Because
her severe limitations caused K.N. to have marked limitations in her ability to
acquire and use information and ability to interact and relate to others, the ALJ found
that K.N. was disabled beginning April 25, 2014 and awarded her supplemental
security income benefits. (Doc. 4-4, pp. 9–11).
4 Adenoid hypertrophy occurs when the adenoid, a mass of lymphatic tissue located in the back of
the nose and throat, becomes larger and obstructs the nasal pathways. JOHNS HOPKINS, Adenoid
Hypertrophy Care, https://www.hopkinsmedicine.org/all-childrens-
hospital/services/otolaryngology-cochlear-implant-program/conditions/adenoid-hypertrophy
[https://perma.cc/F7HU-HNF4] (last visited Jan 16, 2026).
Otitis media is an infection in the middle ear. MAYO CLINIC, Ear Infection (Otitis Media) (June 6,
2023), https://my.clevelandclinic.org/health/diseases/8613-ear-infection-otitis-media
[https://perma.cc/4MP9-EU7C].
“Bronchopulmonary dysplasia (BPD) is a form of chronic lung disease that affects newborns, most
often those who are born prematurely.” AM. LUNG ASS’N., Bronchopulmonary Dysplasia,
https://www.lung.org/lung-health-diseases/lung-disease-lookup/bronchopulmonary-
dysplasia/learn-about-bpd [https://perma.cc/KAC7-7BGX] (last visited Jan 16, 2026). “In BPD
the lungs and the airways (bronchi) are damaged, causing tissue destruction (dysplasia) in the tiny
air sacs of the lung (alveoli).” AM. LUNG ASS’N.
2020 Disability Determination
In 2020, a continuing disability review found that K.N. had the severe
impairment of speech and language impairment. and medical improvement had not
occurred. (Doc. 4-3, p. 5).
2023 Disability Determination
On March 22, 2022, when K.N. was 7 years old, Ms. Neal requested a
continuing disability review based on “emotional problems” and “learning
problems.” (Doc. 4-4, p. 13). After reviewing Ms. Neal’s request and available
evidence, the Commissioner found that K.N. no longer was disabled as of February
14, 2023 and issued a cessation of benefits notice. (Doc. 4-4, p. 12).
Speech-Language Pathologist Evaluations
On September 1, 2020, Speech Language Pathologist Monica Franklin at
Franklin Vocals evaluated K.N.’s speech and language skills. (Doc. 4-9, pp. 22–
23). Ms. Franklin described K.N.’s background as follows:
[K.N.], a 6[]-year-old AA female was seen for speech and language
assessment per DDS referral. She was accompanied by her mother,
[Ms. Neal], who served as provider of supplemental information.
Medical history was remarkable for premature delivery at 24-weeks
with subsequent NICU placement for several weeks. History also
included Asthma, sleep apnea, and Sickle Cell disease. Developmental
milestones were reportedly observed within typical time frames with
the exception of independent toileting which was noted around 4.0
years. After aging out of Early Intervention, [K.N.] received therapy
services through the Head Start program. During the 2019-2020 school
year[,] she attended Kindergarten at Reform Elementary School with
Special Education services. [K.N.] lives with her mother and two older
sisters. Continued speech intervention has reportedly been scheduled
for the upcoming school year.
(Doc. 4-9, p. 22).
Ms. Franklin determined that K.N. demonstrated appropriate social
interaction and eye contact and had oral structure and function adequate for normal
speech production. (Doc. 4-9, p. 22). Ms. Franklin reported that a Tuscaloosa
County School System hearing screening indicated that K.N. had normal hearing in
both ears. (Doc. 4-9, p. 22).
To assess K.N.’s articulation skills, Ms. Franklin administered the Goldman-
Fristoe Test of Articulation-3. (Doc. 4-9, p. 41).5 K.N. scored 93 on the GFTA-3.
Ms. Franklin explained that K.N.’s score results indicated that she had average
articulation skills for her age. (Doc. 4-9, p. 22).
To assess K.N.’s language skills, Ms. Franklin administered the Oral and
Written Language Scales-II. (Doc. 4-9, p. 22).6 K.N. scored a 72 in listening
5 The GFTA-3 tests children’s speech sound production in three sections: sounds-in-words,
intelligibility, and stimulability. PEARSON ASSESSMENTS, Goldman-Fristoe Test of Articulation 3,
(last accessed Jan. 22, 2026) https://www.pearsonassessments.com/en-us/Store/Professional-
Assessments/Developmental-Early-Childhood/Goldman-Fristoe-Test-of-Articulation-
3/p/100001202?srsltid=AfmBOoqzQ-ZrycRn5VD-2INbUp-
Z4uzzfvY8VZ5Wn7nViDqWc3w4ECM_ [https://perma.cc/KQ26-P3L9].
6 The OWLS-II tests children’s language comprehension and expression, including oral language,
written language, receptive processing, expressive processing, and overall language processing
skills. PEARSON ASSESSMENTS, Oral Written Language Scales Second Edition, (last accessed Jan.
22, 2026) https://www.pearsonassessments.com/en-us/Store/Professional-Assessments/Speech-
%26-Language/OWLS-II-Oral-and-Written-Language-Scales-%7C-Second-
Edition/p/100000293?srsltid=AfmBOop2-
MGatsOlt8SqrT1Ov7a5JCm8iq4g69E618GTYFdGqku2hRON [https://perma.cc/SPV5-P57F].
comprehension and 88 in oral expression. (Doc. 4-9, p. 22). K.N.’s OWLS-II
composite score was 78. (Doc. 4-9, p. 22). Ms. Franklin explained that these scores
corresponded to below average listening comprehension skills, average oral
expression skills, and a below average composite score. (Doc. 4-9, p. 22). In
addition to the OWLS results, Ms. Franklin reported that K.N.’s comments were
appropriate to the topic and her mean length of utterances were appropriate for her
age. (Doc. 4-9, p. 23).7 Ms. Franklin reported that K.N. attended to and followed
instructions for testing without difficulty. (Doc. 4-9, p. 23).
In the areas of fluency and voice, Ms. Franklin reported that K.N. did not have
abnormal disfluencies and had normal pitch, volume, and resonance. (Doc. 4-9, p.
23).
Based on her evaluation, Ms. Franklin opined that K.N. had a “moderate
overall language impairment” that “put her at risk both academically and socially.”
(Doc. 4-9, p. 23).
Ms. Franklin evaluated K.N.’s speech and language skills two years later on
November 14, 2022. (Doc. 4-9, pp. 41–42). Ms. Franklin described K.N.’s
background as follows:
7 MLU stands for mean length of utterance. This benchmark measures “a child’s progress in the
attainment of adult language.” Rice, et. al., Mean Length of Utterance Levels in 6-month Intervals
for Children 3-9 Years with and without Language Impairments, PUBMED CENTRAL, NATIONAL
INSTITUTE OF HEALTH, https://pmc.ncbi.nlm.nih.gov/articles/PMC2849178/
[https://perma.cc/9JH3-7CNH].
[K.N.] an 8[]-year-old female was seen for speech and language
assessment per DDS referral. She was accompanied by her mother,
[Ms. Neal], who served as provider of supplemental information.
Medical history was remarkable for Asthma that has been managed
with medication. [K.N.] received speech-language intervention
through the school system and was discharged from speech services
after reaching her target goals. She is currently in the third grade and
receives support for reading and math.
(Doc. 4-9, p. 41).
Ms. Franklin determined that K.N. demonstrated appropriate social
interaction and eye contact and had oral structure and function adequate for normal
speech production. (Doc. 4-9, p. 41). Based on K.N.’s response to conversational
speech and a caregiver’s report, Ms. Franklin determined that K.N’s hearing was
“adequate.” (Doc. 4-9, p. 41).
When Ms. Franklin administered the Goldman-Fristoe Test of Articulation-3,
K.N. exhibited one sound error–substituting /f/ for /th/ in the final position–but
“given cues/modeling” correctly pronounced the sound through the phrase level.
(Doc. 4-9, p. 41). Based on K.N.’s GFTA-3 results, Ms. Franklin opined that K.N.’s
articulation was within normal parameters for her age. (Doc. 4-9, p. 41). Ms.
Franklin reported that K.N.’s intelligibility for all listeners was 90% or greater for
single words, phrases, and sentences. (Doc. 4-9, p. 41).8
8 Intelligibility refers to the extent to which a listener can understand a child’s speech. See Hustard,
et al., Development of Speech Intelligibility Between 30 and 47 Months in Typically Developing
Children: A Cross-Sectional Study of Growth, PUBMED CENTRAL, NATIONAL INSTITUTE OF
HEALTH (May 27, 2020), https://pmc.ncbi.nlm.nih.gov/articles/PMC7839034/
[https://perma.cc/D7Z3-SWN5].
When Ms. Franklin administered the OWLS-2, K.N. had a standard score of
83 for listening comprehension and 87 for oral expression. (Doc. 4-9, p. 41). K.N.’s
standard composite score was 83. (Doc. 4-9, p. 41). Ms. Franklin explained that
these scores corresponded to below average listening comprehension skills, average
oral expression skills, and a below average composite score. (Doc. 4-9, p. 41). Ms.
Franklin noted that the language testing revealed errors with antonyms, adjectives,
present progressive tense, and singular person pronouns. (Doc. 4-9, p. 41). Ms.
Franklin reported that K.N. was “challenged by tasks that called for correcting
grammatical errors, explaining idioms, and requesting information.” (Doc. 4-9, p.
42).
In the areas of fluency and voice, Ms. Franklin reported that K.N. did not have
abnormal disfluencies and had normal pitch, volume, and resonance. (Doc. 4-9, p.
2).
Based on her evaluation, Ms. Franklin concluded that K.N. had normal
articulation skills, average expressive language skills, and below average receptive
language skills. (Doc. 4-9, p. 42). Ms. Franklin opined that K.N.’s receptive
language deficits “put her at risk both academically and socially” and recommended
continued school enrollment, continued academic support, and monitoring for the
need of additional language intervention to address the deficits. (Doc. 4-9, p. 42).
Dr. Kline’s Evaluation
On February 6, 2023, PhD/LPC Robert J. Kline evaluated K.N.’s mental
status and administered the Wechster Intelligence Scale for Children. (Doc. 4-9, pp.
43–47).9 Dr. Kline noted that K.N. was in the third grade, did not have a behavioral
intervention plan, and did not have a history of psychiatric treatment or mental
illness in her family. (Doc. 4-9, p. 44).
When Dr. Kline asked what issues were causing K.N.’s disability, Ms. Neal
reported that K.N. had difficulty reading, “g[ot] emotional sometimes,” and had
“some speech difficulty.” (Doc. 4-9, p. 44). In response to further inquiry about
K.N.’s “emotional problems,” Ms. Neal reported that K.N. recently had become
quieter and shyer after losing a grandfather and grandmother. (Doc. 4-9, p. 44). Dr.
Kline reported that Ms. Neal did not identify “significant” emotional or behavioral
problems. (Doc. 4-9, p. 44).
Dr. Kline evaluated whether K.N. experienced symptoms of depression.
(Doc. 4-9, p. 44). He noted that K.N. slept about eight hours each night, had a good
appetite, had an estimated energy level of four out of ten, and did not show
9 The Wechsler Intelligence Scale for Children “is an intelligence test that measures a child’s
intellectual ability and 5 cognitive domains that impact performance.” PERSON ASSESSMENTS,
Wechsler Intelligence Scale for Children Fifth Edition, (last accessed Jan. 22, 2026)
https://www.pearsonassessments.com/en-us/Store/Professional-Assessments/Cognition-%26-
Neuro/Wechsler-Intelligence-Scale-for-Children-%7C-Fifth-Edition-
/p/100000771?srsltid=AfmBOorJoHj0b9d8Gw7-eV-
IQP7iVy4KC81AMw10nEOqzEwrGBDtDHKY&tab=overview [https://perma.cc/3MCL-
Z9EB].
“psychomotor retardation.” (Doc. 4-9, p. 44). According to Dr. Kline, K.N.
“enumerate[d] several pleasures in life,” denied crying spells, and did not express
feelings of guilt, helplessness, or hopelessness. (Doc. 4-9, p. 44).
Dr. Kline observed that K.N. was appropriately dressed, had average
grooming and personal hygiene, and did not have an unusual physical appearance,
mannerisms, or motor abilities. (Doc. 4-9, p. 45). Dr. Kline reported that K.N.’s
mood was euthymic, that her range of affect was normal, and that she did not display
signs of anxiousness. (Doc. 4-9, p. 45).
Dr. Kline reported that K.N. was adequately oriented to time, place, person,
and situation for her age. (Doc. 4-9, p. 45). When asked, K.N. subtracted serial
sevens from 100, determined how much she would have left if she spent $7.50 of
$18,10 and counted backwards from 20. (Doc. 4-9, p. 45). K.N. could not spell the
word “world” backwards. (Doc. 4-9, p. 45).
When Dr. Kline evaluated K.N.’s memory, K.N. repeated seven digits
forward and four digits in reverse. (Doc. 4-9, p. 45). She recalled three of three
objects after five minutes. (Doc. 4-9, p. 45). She remembered what she had for her
last meal, what she had done the day before, something she saw on her way to the
appointment, her mother’s birthday, the name of her first-grade teacher, and
something she had done two years before. (Doc. 4-9, p. 45).
10 Ms. Neal responded “$10,” omitting the change. (Doc. 4-9, p. 45).
When Dr. Kline evaluated K.N.’s “fund of information,” K.N. recognized the
names Taylor Swift and Kim Kardashian but not Lebron James. (Doc. 4-9, p. 45).
K.N. knew that Joe Biden was the United States president but did not know that Kay
Ivey was the governor of Alabama. (Doc. 4-9, p. 45). K.N. did not know that
Montgomery was the state capital or that there were 52 weeks in the year. (Doc. 4-
9, p. 45).
When Dr. Kline assessed K.N.’s abstracting abilities, K.N. identified how two
objects were alike. (Doc. 4-9, p. 45). She could not interpret the phrases “don’t cry
over spilled milk” and “strike while the iron is hot.” (Doc. 4-9, p. 45).
Dr. Kline observed that K.N. did not show loose or tangential thinking,
confusion, or pressured, mumbled, or slurred speech. (Doc. 4-9, p. 45). Dr. Kline
reported that he understood 100% of K.N.’s speech without difficulty. (Doc. 4-9, p.
45). Dr. Kline reported that K.N. did not demonstrate symptoms of hallucinations,
delusions, ideas of reference, phobias, obsessions, compulsions, indecision,
grandiosity, helplessness, hopelessness, homicidal ideation, or suicidal ideation.
(Doc. 4-9, p. 45). Dr. Kline opined that “overall, [K.N.’s] insight into [her]self and
her social situation [was] good.” (Doc. 4-9, p. 45).
Dr. Kline administered the Wechster Intelligence Scale for Children in a quiet,
well-lit room that was free from distractions. (Doc. 4-9, p. 46). Dr. Kline noted that
K.N. appeared to be “putting forth a good effort” and explained that “there [was]
every reason to believe that the[] results [were] a true reflection of her present
functioning capacity.” (Doc. 4-9, p. 46). On the verbal comprehension section, K.N.
scored 10 for similarities and 9 for vocabulary, yielding a VCI of 98.11 On the fluid
reasoning section, K.N. scored 9 for matrix reasoning and 7 for figure weights,
yielding an FRI of 88.12 On the processing speed section, K.N. scored 6 for coding
and 8 for symbol search, yielding a PSI of 83.13 On the visual special section, K.N.
scored 12 for block design and 8 for visual puzzles, yielding a VSI of 100.14 On the
working memory section, K.N. scored 10 on digit span and 9 on picture span,
yielding a WMI of 97.15 K.N.’s overall FSIQ was 93. (Doc. 4-9, p. 46). 16
When Dr. Kline inquired about K.N.’s daily activities, it was reported that
K.N. spent most of her time at home on her cell phone or watching YouTube, that
her chores included helping with housecleaning and putting her clothing away, and
11 VCI stands for “Verbal Comprehension Index.” PEARSON ASSESSMENTS, WISC-V INTERPRETIVE
REPORT 2 (Oct. 20, 2020)
https://www.pearsonassessments.com/content/dam/school/global/clinical/us/assets/wisc-v/wisc-
v-interpretive-report.pdf?srsltid=AfmBOoqOfAEV4AB6KvkUDWuosiIZfERpH2FmwxTkl-
a1q2agh9CRuNou [https://perma.cc/T7UG-N8BQ].
12 FRI stands for “Fluid Reasoning Index.” WISC-V INTERPRETIVE REPORT at 2.
13 PSI stands for “Processing Speed Index.” WISC-V INTERPRETIVE REPORT at 2.
14 VSI stands for “Visual Spatial Index.” WISC-V INTERPRETIVE REPORT at 2.
15 WMI stands for “Working Memory Index.” WISC-V INTERPRETIVE REPORT at 2.
16 FSIQ stands for “Full Scale IQ.” FSIQ scores ranging from 90 to 109 are considered average.
WISC-V INTERPRETIVE REPORT at 2.
that she had not been sent to the principal’s office for trouble that school year. (Doc.
4-9, p. 47). It was reported that K.N. got along “fairly well” with her teachers,
classmates, and others her age and would receive a B grade for her overall behavior
and cooperation at home. (Doc. 4-9, p. 47).
Based on K.N.’s mental status examination and WISC results, Dr. Kline
concluded that K.N. had no restrictions of activities, constriction of interests, or
restriction in her ability to relate with others. (Doc. 4-9, p. 47). Dr. Kline noted that
K.N. did not have a history of “mental slowness” and that her presentation was
“relatively normal.” (Doc. 4-9, p. 47). Dr. Kline opined that, compared to other
children of her age, K.N. had adequate ability to function independently for her age
and did not have impairments in the domains of acquiring and using information,
attending to and completing tasks, interacting and relating with others, moving about
and manipulating objects, caring for one’s self, or health and physical wellbeing.
(Doc. 4-9, p. 47). Dr. Kline reported that K.N.’s abilities to concentrate and persist
during the exam, relate to others, interact and communicate with family and
community members, understand, remember, and carry out simple one or two-step
job instructions, maintain concentration and attention, and tolerate work stress
appeared to be adequate. (Doc. 4-9, p. 47).
Educational Records
On January 13, 2017, Ms. Neal attended a meeting to plan for K.N.’s transition
from early intervention to preschool. (Doc. 4-7, pp. 38–42). The transition planning
team indicated that K.N. was receiving early intervention speech therapy at home
and at daycare and was prescribed albuterol for asthma. (Doc. 4-7, p. 38). The team
reported that K.N. played well and had good social, cognitive, and motor skills.
(Doc. 4-7, p. 38). The team reported that K.N.’s speech was difficult to understand.
(Doc. 4-7, p. 38). Ms. Neal permitted the team to refer K.N. to the Local Education
Agency for evaluation. (Doc. 4-7, p. 38).17
The team referred K.N. for an IEP evaluation based on her “poor progress in
acquiring communication skills” and “easy frustration.” (Doc. 4-7, p. 39).18 The
referral listed the following signs of “health, orthopedic, and medical problems”:
asthma, sickle cell trait, and tubes in her ears. (Doc. 4-7, p. 39). Additionally, the
referral identified “hearing problems” and “limited talking” as classroom behaviors
that might indicate vision or hearing problems. (Doc. 4-7, p. 39).
17 A Local Educational Agency, or LEA, is “a public board of education or other public authority
legally constituted within a State for either administrative control or direction of, or to perform a
service function for, public elementary schools or secondary schools in a city, county, township,
school district, or other political subdivision of a State.” 34 C.F.R. § 303.23(a).
18 An IEP, or Individual Education Plan, provides special education services for eligible children
with disabilities. ALABAMA DISABILITIES ADVOCACY PROGRAM, A RIGHT NOT TO FAVOR (2014)
at 5, accessible at https://bpb-us-e2.wpmucdn.com/sites.ua.edu/dist/a/74/files/2025/02/Special-
Education-ARightNotAFavorFinal.pdf [https://perma.cc/RKS3-RUWV].
On March 13, 2017, the Local Education Agency evaluated K.N.’s eligibility
for special education services. (Doc. 4-7, pp. 43–46). K.N. passed functional
hearing and vision screenings. (Doc. 4-7, p. 43). An examination of K.N.’s oral
structure and functioning revealed that K.N. had adequate structures for speech
production. (Doc. 4-7, p. 43). K.N. received a standard score of 98 on the fifth
edition Preschool Language Scales. (Doc. 4-7, p. 43).19 She scored 115 in auditory
comprehension and 82 in expressive communication. (Doc. 4-7, p. 43). Based on
these results, the examiner concluded that K.N. did not have a speech delay that
adversely affected her communication. (Doc. 4-7, pp. 43–44).
On April 11, 2017, Ms. Neal attended an IEP eligibility determination
meeting. (Doc. 4-7, p. 46). The IEP team determined that K.N. did not meet the
criteria for the suspected area of disability, have a disability that adversely affected
educational performance, or need specially designed instruction to access and
participate in the general education curriculum. (Doc. 4-7, p. 46). Accordingly, the
IEP team determined that K.N. was not eligible for special education services. (Doc.
4-7, p. 46).
19 The 5th edition Preschool Language Scales, or PLS-5, “offer[] a comprehensive developmental
language assessment.” PEARSON ASSESSMENTS, Preschool Language Scales Fifth Edition
https://www.pearsonassessments.com/en-us/Store/Professional-Assessments/Speech-%26-
Language/Preschool-Language-Scales-%7C-Fifth-
Edition/p/100000233?srsltid=AfmBOooGeTiI2JeVubpUrl9WqfENT8Hz1vYV6ocWkQruc-
Fo9xTOSW3Z [https://perma.cc/AE8H-QBFY] (last accessed Jan. 21, 2026). Results in the range
of 85-115 are average on the PLS-5. (Doc. 4-7, p. 43).
The administrative record does not include educational records from between
April 2017 and January 2022. During the 2017–18 and 2018–19 school years, K.N.
attended preschool and received services through HeadStart. (Doc. 4-9, pp. 6, 15).
During the 2019–20 school year, K.N. attended kindergarten at Reform Elementary
School and received special education services. (Doc. 4-9, p. 22). The record does
not identify where K.N. began first grade in Fall 2020, but K.N. began attending
Faucett Vestavia Elementary School in Spring 2021. (See Doc. 4-7, p. 34). That
year, K.N. received a grade of “proficient” or “outstanding” in every subject on her
third- and fourth-quarter report cards. (See Doc. 4-7, p. 99).
The next fall, K.N. received a grade of “proficient” on most subjects;
“emerging” in completing classroom assignments, language, and reading
informational texts; and “needs improvement” in operations and algebraic thinking
in the first quarter. (Doc. 4-7, p. 100). In the second quarter, K.N. received a grade
of “proficient” on most subjects; “emerging” in language and in number and
operations; and “needs improvement” in language, operations and algebraic
thinking, and reading literature and informal texts. (Doc. 4-7, p. 100).
In January 2022, Faucett Vestavia implemented a Student Intervention Plan
for K.N. (Doc. 4-7, pp. 150–151).20 The intervention plan provided that K.N. would
20 The fax cover page for this document indicates that it is “a copy of [K.N.]’s IEP plan.” (Doc.
4-7, p. 148). The record does not include documents from an IEP referral, evaluation, or eligibility
determination at Faucett Vestavia Elementary. Accordingly, it is not clear whether the intervention
solve 2-digit addition problems with 80% accuracy. (Doc. 4-7, p. 150). K.N.
achieved this goal on February 4 and February 11, 2022. (Doc. 4-7, p. 150). In the
third quarter of the school year, K.N. received a grade of “proficient” in most
subjects and “emerging” in language and operations and algebraic thinking. (Doc.
4-7, p. 100). In the fourth quarter, K.N. received a grade of “proficient” in most
subjects and “emerging” in measurements and data, operations and algebraic
thinking, and foundational reading skills. (Doc. 4-7, p. 100).
That spring, K.N. scored a 502 in English language arts and a 508 in math on
the Alabama Comprehensive Assessments for second grade. (Doc. 4-8, p. 14).
These scores placed K.N. in the 49th percentile for language arts, the 47th percentile
for math, and performance level two for both subjects. (Doc. 4-8, p. 14).21
In August 2022, the Tuscaloosa County School System notified Ms. Neal that
K.N. was consistently showing a deficiency in reading and implemented a Student
Reading Improvement Plan for the 2022–23 school year. (Doc. 4-7, p. 72). K.N.’s
SRIP provided that she would “decode and encode open and closed syllables with
blends and diagraphs with 80% accuracy.” (Doc. 4-7, p. 72). The record does not
indicate whether K.N. met this goal.
plan was developed under the formal process prescribed by the Individuals with Disabilities
Education Act. See generally ALABAMA DISABILITIES ADVOCACY PROGRAM, at 4–32.
21 A student with a performance level of two has a “partial understanding of grade-level standards
and is likely to need some additional support at this level of learning.” (Doc. 4-8, p. 14).
In September 2022, Faucett Vestavia updated K.N.’s Student Intervention
Plan to provide that K.N. would solve three-digit addition and subtraction problems
with 80% accuracy. (Doc. 4-7, p. 151). K.N. achieved 66% accuracy on December
7, 2022, and the interventionist recommended dismissal. (Doc. 4-7, p. 151).
Teacher Questionnaires
K.N.’s second grade teacher, Johnna Drummond, completed a questionnaire
on K.N.’s speech and language skills on May 2, 2022. (Doc. 4-7, pp. 32–34).22 Ms.
Drummond wrote: “[K.N.] is able to communicate on a normal second grade level.
She has been at our school just over a year and does not receive speech services.”
(Doc. 4-7, p. 34). Ms. Drummond reported that K.N.’s speech or language disorder
did not affect her social skills and academic development. (Doc. 4-7, p. 34).
Ms. Drummond indicated that K.N. never or rarely had difficulty saying
single words, producing conversational speech that was easily understood,
maintaining articulatory control as utterance length increases, and producing error
sounds correctly in isolation given a model. (Doc. 4-7, p. 32). Ms. Drummond
indicated that a familiar listener would understand about 97% of K.N.’s speech on a
first attempt and an unfamiliar listener would understand 3% of K.N.’s speech on a
first attempt. (Doc. 4-7, p. 32). Ms. Drummond reported that K.N. did not exhibit
22 The questionnaire should have been completed by a speech language pathologist. (Doc. 4-7, p.
32). Because Ms. Drummond was not qualified to answer the questionnaire, her responses are not
persuasive.
sound errors or phonological patterns that were not typical for her age, speak with a
monotone voice, demonstrate consistently abnormal voice quality, exhibit speech
fluency patterns that were not typical for age in most situations, or exhibit secondary
behaviors. (Doc. 4-7, pp. 32–33).
Ms. Drummond indicated that K.N. frequently had difficulty following single-
step and multi-step instructions, following classroom discussions, using complete
sentences, talking about past events, producing narratives, and following verbal
instructions completely without looking to see what others are doing. (Doc. 4-7, p.
33). Ms. Drummond indicated that K.N. sometimes had difficulty understanding
frequently used vocabulary words, answering questions about a read-aloud story,
repeating a sentence accurately, answering a question appropriately, understanding
humor, and asking for repetition or clarification when she was obviously confused.
(Doc. 4-7, p. 33). Ms. Drummond indicated that K.N. rarely or never had difficulty
expressing wants and needs, taking turns in a conversation, and initiating and
maintaining conversations with friends. (Doc. 4-7, p. 33). Ms. Drummond indicated
that K.N. did not exhibit receptive or expressive vocabulary below expectations for
her age, use incorrect word order, speak only in simple sentences, have difficulty
understanding sarcasm or figurative language, or have difficulty interpreting body
language and facial expressions. (Doc. 4-7, p. 33).
On May 13, 2022, Ms. Drummond and Millie Harrow, a school speech
language pathologist, responded to a request for administrative information. They
reported that K.N. recently had had a vision and hearing screening and a language
evaluation. (Doc. 4-7, p. 58). When asked whether K.N. had been referred for
evaluation or services, they listed K.N.’s January 2017 referral for language
assessment and IEP evaluation. (See Doc. 4-7, p. 58). Ms. Harrow and Ms.
Drummond indicated that K.N. participated in regular education and did not receive
special education or therapeutic services through the school. (Doc. 4-7, p. 58).
A few days later, Ms. Harrow and Ms. Drummond completed a teacher
questionnaire. (Doc. 4-7, pp. 62–69). In the acquiring and using information
domain, they indicated that K.N. had no problem understanding school and content
vocabulary; slight problems reading and comprehending written material, providing
oral explanations and adequate descriptions, learning new material, recalling and
applying previously learned material, and applying problem-solving skills in class
discussions; obvious problems comprehending and doing math problems,
understanding and participating in class discussions, and expressing ideas in written
form; and a serious problem comprehending oral instructions. (Doc. 4-7, p. 63). Ms.
Drummond noted that K.N. “often misses directions given in class due to not paying
attention” and “often times is not focused during class, discussions, and instruction.”
(Doc. 4-7, p. 63). They reported that K.N. performed below grade level and saw a
school interventionist for 30 minutes in math and reading each day. (Doc. 4-7, p.
63).
In the attending and completing tasks domain, Ms. Harrow and Ms.
Drummond reported that K.N. had no problem sustaining attention during play/sport
activities, waiting to take turns, and changing from one activity to another without
being disruptive; a slight problem weekly with competing work accurately without
careless mistakes; an obvious problem weekly with working with others without
distracting self or others; an obvious problem daily with focusing long enough to
finish an assigned activity or task, carrying out single-step instructions, and
organizing her own things or school materials; an obvious problem hourly with
paying attention when spoken to directly and refocusing to a task when necessary; a
serious problem weekly with completing class/homework assignments; a serious
problem daily with working at a reasonable pace/finishing on time; and a serious
problem hourly with carrying out multi-step instructions. (Doc. 4-7, p. 64). They
noted that K.N. “ha[d] a difficult time focusing on her work” and “struggle[d] to
complete assignments[] due to being easily distracted.” (Doc. 4-7, p. 64).
Ms. Harrow and Ms. Drummond reported that K.N. had no problems in the
interacting and relating with others, moving and manipulating objects, and caring
for herself domains. (Doc. 4-7, pp. 65–67). In the health and physical wellness
domain, they noted that K.N. had asthma, sickle cell trait, and tubes in her ears; that
K.N. did not use glasses, hearing aids, or other disability aids at school; and that they
did not know whether K.N. was taking medication. (Doc. 4-7, p. 68). They checked
a box indicating that K.N. frequently missed school because of illness but noted that
her absences were unexcused because there was no documentation of illness. (Doc.
4-7, p. 68).
On October 21, 2022, K.N.’s third grade teacher, Maranda McMillan,
completed a teacher questionnaire. (Doc. 4-7, pp. 88–96). In the domain of
acquiring and using information, Ms. McMillan reported that K.N. had no problems
comprehending oral instructions, understanding and participating in class
discussions, providing oral explanations and adequate descriptions, expressing ideas
in written form, learning new material, or recalling and applying previously learned
material; slight problems in understanding school and content vocabulary, reading
and comprehending written material, and applying problem-solving skills in class
discussions; and an obvious problem in comprehending and doing math problems.
(Doc. 4-7, p. 90). Ms. McMillan noted that K.N. saw an intervention teacher for
math for 30 minutes daily. (Doc. 4-7, p. 90).
In the domain of moving about and manipulating objects, Ms. McMillan
reported that K.N. had no problem moving and manipulating things, demonstrating
strength, coordination, and dexterity in activities or tasks, managing the pace of
physical activities or tasks, showing a sense of her body’s location and movement in
space, integrating sensory input with motor output, and planning, remembering, and
executing controlled motor movements. (Doc. 4-7, p. 93). Ms. McMillan indicated
that K.N. had a slight problem with moving her body from one place to another and
noted that K.N. “seem[ed] to drag one foot when walking.” (Doc. 4-7, p. 93).
Ms. McMillan reported that K.N. had no problem in the attending and
completing tasks, interacting and relating with others, caring for herself, and health
and physical wellbeing domains. (Doc. 4-7, pp. 91–92, 94–95).
Ms. McMillan also completed a speech and language questionnaire. (Doc. 4-
9, p. 34–36).23 Ms. McMillan reported that K.N. frequently had difficulty saying
single words clearly, producing conversational speech that is easily understood,
maintaining articulatory control as utterance length increases, and producing error
sounds correctly in isolation, given a model. (Doc. 4-9, p. 34). Ms. McMillan
estimated that a familiar listener would understand 95% of K.N.’s speech on a first
attempt and 100% of K.N.’s speech with repetition. (Doc. 4-9, p. 34). Ms. McMillan
estimated that an unfamiliar listener could understand 5% of K.N.’s speech on a first
attempt. Ms. McMillan reported that K.N. did not exhibit sound errors or
phonological patterns not typical for her age, speak with a monotone voice,
demonstrate abnormal vocal quality, exhibit speech fluency patterns that were
23 The questionnaire should have been completed by a speech language pathologist. (Doc. 4-7,
p. 32). Thus, Ms. McMillan was not qualified to answer the questionnaire, and her responses are
not persuasive.
atypical for her age in most situations, or exhibit secondary behaviors. (Doc. 4-9,
pp. 34–35). Ms. McMillan reported that K.N.’s speech was audible at conversational
distances on first attempt half or more of the time. (Doc. 4-9, p. 35).
Ms. McMillan reported that K.N. never or rarely had difficulty following
single and multi-step verbal instructions, understanding frequently used vocabulary
words, answering questions about a read-aloud story, following a classroom
discussion, repeating a sentence accurately, answering a question appropriately,
understanding humor, expressing needs and wants, using complete sentences,
talking about past events, describing a picture/object, producing narratives, taking
turns in conversation, and initiating and maintaining conversations with friends.
(Doc. 4-9, p. 35). Ms. McMillan reported that K.N. did not exhibit expressive or
receptive vocabulary below expectation for age, use incorrect word order, have
difficulty understanding sarcasm or figurative language, or have difficulty
interpreting body language and facial expressions. (Doc. 4-9, p. 35). Ms. McMillan
reported that K.N. spoke only in simple sentences. (Doc. 4-9, p. 35). Ms. McMillan
noted that K.N. was not receiving services and did not have a diagnosis of speech or
language impairment and indicated that K.N.’s speech and language did not
adversely affect her social skills and academics. (Doc. 4-9, p. 36).
Ms. McMillan responded to a request for administrative information and
completed another teacher questionnaire on March 30, 2023. (Doc. 4-7, pp. 123–
131). Ms. McMillan reported that K.N. did not have an educational disability and
participated in regular education. (Doc. 4-7, p. 123). In the accompanying teacher
questionnaire, Ms. McMillan reported that K.N. had no problems in the domains of
acquiring and using information, attending and completing tasks, interacting and
relating with others, moving about and manipulating objects, caring for herself, and
health and physical wellness. (Doc. 4-7, pp. 124–130).
Parent Questionnaires
Ms. Neal completed functional reports on January 25, 2022 and October 20,
2022. (Doc. 4-7, pp. 4–12, 74 –84). In January and October 2022, Ms. Neal reported
that K.N. did not have problems seeing or hearing. (Doc. 4-7, p. 4; Doc. 4-7, p. 75).
On January 25, 2022, Ms. Neal reported that K.N. was “totally unable to talk.”
(Doc. 4-7, p. 5). Ms. Neal noted that K.N. had problems speaking clearly and a
limited ability to communicate. (Doc. 4-7, p. 5). Ms. Neal reported that people who
knew K.N. well and people who did not know K.N. well understood her speech
“some of the time.” (Doc. 4-7, p. 5). Ms. Neal indicated that K.N. could tell jokes
or riddles accurately; explain why she did something; use sentences with “because,”
“what if,” or “should have been;” and talk with family. (Doc. 4-7, p. 6). Ms. Neal
indicated that K.N. did not repeat stories she had heard or talk with friends. (Doc.
4-7, p. 6).
On October 22, 2025, Ms. Neal reported that K.N. was not “totally unable to
talk.” (Doc. 4-7, p. 76). Ms. Neal indicated that K.N. had problems talking clearly
and a limited ability to communicate. (Doc. 4-7, pp. 76–77). Ms. Neal indicated
that people who knew K.N. well understood her speech “some of the time” or
“hardly ever” and that people who did not know K.N. well understood her speech
“most of the time.” (Doc. 4-7, p. 76).24 Ms. Neal reported that K.N. could repeat
stories she had heard and talk with family and friends but could not deliver telephone
messages, tell jokes or riddles accurately, explain why she did something, or use
sentences with “because,” “what if,” or “should have been.” (Doc. 4-7, p. 77).
In January and October 2022, Ms. Neal indicated that K.N. had a limited
ability to progress in learning. (Doc. 4-7, p. 7; Doc. 4-7, p. 78). In January, she
reported that K.N. could read upper-case and lower-case letters, print some letters,
and print her name. (Doc. 4-7, p. 7). Ms. Neal reported that K.N. knew the days of
the week and months of the year. (Doc. 4-7, p. 7). Ms. Neal reported that K.N.
could not read simple words, read and understand simple sentences, read or
understand stories in books or magazines, write in longhand, spell most 3-4 letter
words, write a simple story with 6-7 sentences, add and subtract numbers over time,
understand money and make correct change, or tell time. (Doc. 4-7, p. 7). In
24 Ms. Neal likely intended to indicate that people who did not know K.N. well understood her
speech some of the time or hardly ever and that people who knew K.N. well understood her speech
most of the time.
October, Ms. Neal reported that K.N. could read upper-case and lower-case letters,
sometimes read simple words, read and understand stories in books or magazines,
print some letters, print her name, and spell most 3-4 letter words. (Doc. 4-7, p. 78).
Ms. Neal reported that K.N. knew the days of the week and months of the year.
(Doc. 4-7, p. 78). Ms. Neal reported that K.N. could not read and understand simple
sentences, write in longhand, write a simple story with 6-7 sentences, add and
subtract numbers over 10, understand money and make correct change, or tell time.
(Doc. 4-7, p. 78).
In January and October 2022, Ms. Neal indicated that K.N.’s physical abilities
were limited. (Doc. 4-7, p. 8; Doc. 4-7, p. 79). In January, Ms. Neal reported that
K.N. could walk, run, throw a ball, use scissors, work video game controls, and
dress/undress dolls or action figures but could not ride a bike, jump rope, use roller
skates or blades, or swim. (Doc. 4-7, p. 8). In October, Ms. Neal reported that K.N.
could walk, run, throw a ball, ride a bike with training wheels, jump rope, use
scissors, and dress/undress dolls or action figures but could not ride a bike without
training wheels, use roller skates or blades, or swim. (Doc. 4-7, p. 79).
Ms. Neal indicated that K.N.’s impairments affected her behavior with other
people. (Doc. 4-7, p. 9; Doc. 4-7, p. 80). In January, Ms. Neal reported that K.N.
had friends her own age, generally got along with adults, and generally got along
with school teachers. (Doc. 4-7, p. 9). She reported that K.N. could not make new
friends and did not play team sports. (Doc. 4-7, p. 9). In October, Ms. Neal reported
the same except that K.N. could make new friends. (Doc. 4-7, p. 80).
Ms. Neal reported that K.N.’s impairments affected her ability to help herself
and cooperate with others in taking care of personal needs. (Doc. 4-7, p. 10, 81). In
January, Ms. Neal reported that K.N. could use zippers, brush teeth, eat using
utensils, pick up and put away toys, hang up clothes, do what she was told most of
the time, and get to school on time. (Doc. 4-7, p. 10). She reported that K.N. could
not button clothes, tie shoelaces, take a bath or shower without help, comb or brush
her hair, wash her hair by herself, choose her clothes, help around the house, obey
safety rules, or accept criticism or correction. (Doc. 4-7, p. 10). In October, Ms.
Neal reported the same, except that K.N. could obey safety rules. (Doc. 4-7, p. 81).
Ms. Neal indicated that K.N.’s ability to pay attention and stick with a task
was limited. (Doc. 4-7, pp. 11, 81). In January, Ms. Neal reported that K.N. could
keep busy on her own and complete chores most of the time but could not finish
things she started, work on arts and crafts projects, or complete homework. (Doc.
4-7, p. 11). In October, Ms. Neal reported the same, except that K.N. could complete
homework. (Doc. 4-7, p. 81).
In January, Ms. Neal indicated that K.N. had “some sleep apnea.” (Doc. 4-7,
p. 12). Ms. Neal did not indicate whether K.N. still had sleep apnea in October 2022.
Ms. Neal requested a continuation of K.N.’s benefits in March 2022 based on
K.N.’s emotional and learning problems. (Doc. 4-4, p. 13; Doc. 4-7, pp. 13–21).
Ms. Neal reported that K.N. had completed first grade, was in a special education
program, and received accommodations at school. (Doc. 4-7, pp. 14–15).25 Ms.
Neal indicated that K.N. received daily reading tutoring. (Doc. 4-7, p. 15). Ms. Neal
reported that K.N. had been tested by a public/community health department,
developmental evaluation center, mental health/intellectual disability, speech and
hearing center, and the Women, Infants, and Children Program. (Doc. 4-7, p. 16).
Ms. Neal did not identify the agencies that performed the evaluations. (Doc. 4-7, p.
16). Ms. Neal reported that K.N. did not receive special therapy, exercises, or other
services for her impairments. (Doc. 4-7, p. 17). Ms. Neal indicated that K.N.
received vocational rehabilitation services at Faucett Vestavia. (Doc. 4-7, p. 18).
Ms. Neal identified K.N.’s grandmother, Wanda Gary, as an individual who could
give information about the child. (Doc. 4-7, p. 20).
On March 30, 2022, Ms. Neal participated in a continuing disability interview.
(Doc. 4-7, pp. 22–27). Ms. Neal did not identify physical or mental conditions that
limited K.N.’s ability to do the same things as other children of the same age. (Doc.
4-7, p. 23). Ms. Neal indicated that K.N. received evaluation or treatment at Pickens
25 K.N.’s school records contradict Ms. Neal’s representations that K.N. was in a special education
program and received accommodations at school. (See Doc. 4-7, p. 58). K.N. received services
from an interventionist for 30 minutes in math and reading each day. (Doc. 4-7, p. 63).
County Medical Center. (Doc. 4-7, p. 23). She did not explain what conditions were
treated or evaluated. (Doc. 4-7, p. 24).
Ms. Neal reported that K.N. experienced new physical or mental conditions
beginning in 2020. (Doc. 4-7, p. 106). Ms. Neal explained that K.N. would “stare
into space” and “c[ould not] comprehend at times.” (Doc. 4-7, p. 106). Ms. Neal
did not identify medical treatment or medication K.N. had received. (Doc. 4-7, pp.
106, 107). Ms. Neal reported that K.N. had experienced a change in her daily
activities because of physical or mental conditions and stated that K.N. “still
need[ed] reading, math and etc.” and “[didn’t] like being around others.” (Doc. 4-
7, p. 107). Ms. Neal indicated that K.N. continued to receive vocational
rehabilitation services at Faucett Vestavia. (Doc. 4-7, p. 108). Ms. Neal made an
identical report on November 1, 2023. (Doc. 4-7, pp. 142–147).
Medical Records
Ms. Neal submitted records from primary care visits documenting K.N.’s
history of asthma.
K.N. visited University Medical Center on January 30, 2018. (Doc. 4-9, pp.
15–19). Jaquelynn Luker, M.D., noted that K.N. had sleep apnea and a history of
prematurity but had been “developing well.” (Doc. 4-9, p. 15). Dr. Luker diagnosed
K.N. with moderate, persistent asthma. (Doc. 4-9, p. 15). K.N. met the
developmental milestones of using 3–5-word sentences, asking why/what, balancing
on one foot, building a ten-block tower, copying a circle and X, counting to three,
dressing herself, knowing her name/age/gender, playing with other kids, recognizing
three colors, and walking upstairs with alternating feet. (Doc. 4-9, pp. 16–17). K.N.
did not meet the developmental milestones of pedaling a tricycle and being toilet
trained. (Doc. 4-9, p. 17). Dr. Luker recorded normal findings from K.N.’s physical
exam. (Doc. 4-9, p. 17).
K.N. visited University Medical Center on February 13, 2019. (Doc. 4-9, pp.
6–10). Charles Geno, M.D., noted that K.N. had asthma and used a nebulizer
approximately three times per week. (Doc. 4-9, p. 6). Dr. Geno performed a
physical exam and reported normal findings. (Doc. 4-9, p. 8).
K.N. visited University Medical Center for a rash on May 5, 2022. (Doc. 4-
9, pp. 25–30). Dr. Luker performed a physical exam and reported normal findings
for all categories but K.N.’s skin. (Doc. 4-9, p. 8). Dr. Luker noted that K.N. had
“mild persistent asthma without complication” that was “controlled.” (Doc. 4-9, p.
29).
ALJ Hearing
On April 29, 2024, the ALJ held a hearing. (Doc. 4-3, pp. 51–61). Ms. Neal
attended the hearing without K.N. (Doc. 4-3, p. 53). The ALJ asked Ms. Neal
whether she would like to waive her right to representation and proceed with the
hearing or postpone the hearing to obtain representation. (Doc. 4-3, pp. 53–54). Ms.
Neal responded that she wanted to proceed and waived her right to representation.
(Doc. 4-3, p. 54).
The ALJ discussed the evidence in K.N.’s file and explained the standards
that govern a child’s cessation of benefits case before questioning Ms. Neal. (Doc.
4-3, pp. 54–56).
Ms. Neal testified that K.N. was in fourth grade, received speech services
through school, and was seeing a therapist for non-educational purposes. (Doc. 4-3,
p. 56). Ms. Neal indicated that she did not know whether the ALJ had information
about K.N.’s therapy. (Doc. 4-3, p. 56).
The ALJ told Ms. Neal that he had records from Vestavia Elementary, a
consultative psychological report, a consultative speech and language report, and
medical records from Dickens County Medical Center. (Doc. 4-3, pp. 56–57). The
ALJ explained that K.N.’s continuing disability review indicated that K.N. did not
have limitations in the six functional domains. (Doc. 4-3, pp. 57–58). Ms. Neal
asked if the ALJ had records from Jenkins and Richardson Associates and explained
that K.N. began seeing a therapist at Jenkins and Richardson Associates in January
of 2024. (Doc. 4-3, p. 59). Ms. Neal testified that she had faxed the records. (Doc.
4-3, p. 59). The ALJ responded that the Social Security Commission did not receive
evidence dated after July 2023. (Doc. 4-3, p. 59).
Ms. Neal disputed the ALJ’s statement and testified that she had confirmation
of faxing the records in December 2024. (Doc. 4-3, p. 60). The ALJ responded that
he did not “have it in the file” and that he could not rely on verbal statements. (Doc.
4-3, p. 60). The ALJ repeated that the most recent evidence in K.N.’s file was from
2023 and that no evidence had been received in 2024. (Doc. 4-3, p. 60). The ALJ
asked whether Ms. Neal had anything else she wanted to present. (Doc. 4-3, p. 60).
Ms. Neal responded that she did not, and the ALJ concluded the hearing. (Doc. 4-
3, pp. 60–61).
THE ALJ’S DECISION
The ALJ found that the CPD, i.e. the most recent favorable medical decision
finding that K.N. was disabled, is the determination dated November 24, 2020.
(Doc. 4-3, p. 34). The ALJ found that, at the time of the CPD, K.N. had a medically
determinable speech and language impairment that functionally equaled the listings.
(Doc. 4-3, p. 34). The ALJ found that medical improvement occurred as of February
14, 2023. (Doc. 4-3, pp. 34–35). The ALJ found that K.N. was a school-aged child
as of February 14, 2023. (Doc. 4-3, p. 35).
The ALJ concluded that K.N.’s speech language impairment had not
functionally equaled the listings since February 14, 2023. (Doc. 4-3, pp. 35–40).
The ALJ found that K.N.’s speech language impairment caused less than marked
limitations in the domains of acquiring and using information and health and
physical well-being. (Doc. 4-3, pp. 36, 39–40). The ALJ found that K.N.’s speech
language impairment caused no limitation in the domains of attending and
completing tasks, interacting and relating with others, moving about and
manipulating objects, and caring for herself. (Doc. 4-3, pp. 36–39).
The ALJ determined that K.N. had a severe impairment of low average
intellectual functioning. (Doc. 4-3, pp. 40–41). The ALJ determined that K.N. had
the non-severe impairments of below average speech language skills and mild
persistent asthma. (Doc. 4-3, p. 40). The ALJ found that, as of February 14, 2023,
K.N. had not had an impairment or combination of impairments that functionally
equaled the listings. (Doc. 4-3, pp. 41–45). The ALJ found that K.N. had less than
marked limitations in the domains of acquiring and using information and health and
physical well-being, and K.N. had no limitation in the domains of attending and
completing tasks, interacting and relating with others, moving about and
manipulating objects, and caring for herself. (Doc. 4-3, pp. 43–45).
Based on a review of the evidence, the ALJ concluded that K.N.’s disability
ended as of February 14, 2023 and that K.N. had not become disabled again. (Doc.
4-3, p. 45).
THE APPEALS COUNCIL’S DECISION
Ms. Neal asked the Commissioner to reconsider the ALJ’s decision. (Doc. 4-
3, pp. 23–26). Ms. Neal indicated that she was appealing the issue of overpayment
because “all funds that were given accommodated [K.N.].” (Doc. 4-3, pp. 23, 25).
To support her appeal, Ms. Neal submitted a letter from Dr. Luker dated
September 5, 2024 in which Dr. Luker explained that he had referred K.N. to
Children’s of Alabama Nephrology, and K.N. was being evaluated for pediatric
hypertension, (Doc. 4-3, p. 17); a fax from Dr. Luker dated August 30, 2024, stating
that K.N. was being seen for health issues at Children’s of Alabama, with the words
“prematurity/kidney” written below, (Doc. 4-3, p. 18); and a referral communication
form reflecting that K.N. was referred to nephrology at Children’s Hospital on
August 29, 2024, (Doc. 4-3, p. 19–20). The Appeals Counsel denied Ms. Neal’s
request for review. (Doc. 4-3, pp. 10–13).
EVIDENCE NOT IN THE ADMINISTRATIVE RECORD
In October 2025 and March 2026, Ms. Neal filed medical records
demonstrating K.N.’s history of high blood pressure. (Docs. 9, 10).26
According to those records, on July 10, 2024, K.N. visited University Medical
Center for a well-child examination. (Doc. 9, p. 14). Dr. Luker noted that K.N.
26 Ms. Neal submitted the records after the Commissioner filed an initial brief in this matter, (Doc.
6). Therefore, the Commissioner’s initial brief does not address this evidence. On March 26,
2026, the Commissioner responded to the evidence Ms. Neal filed in March 2026. (Doc. 11).
reported no new concerns or concerns with home and environmental safety. (Doc.
9, p. 14). K.N. was not using her Flovent inhaler for asthma but was using albuterol
at school as needed. (Doc. 9, p. 14). K.N. was meeting “all behavioral and
developmental milestones.” (Doc. 9, p. 14). K.N.’s grandmother reported that K.N.
stayed awake “later than she should” but otherwise reported no concerns with K.N.’s
sleep. (Doc. 9, p. 14). K.N. had adequate nutrition, no concerns with voiding or
stooling, and did not have a fever, infection, weight loss, fatigue, chest pain, or
shortness of breath. (Doc. 9, p. 14).27 Dr. Luker indicated that K.N. had boils,
chronic asthma, and a history of prematurity. (Doc. 9, p. 14). Dr. Luker’s physical
exam yielded normal results. (Doc. 9, pp. 16–17). Dr. Luker determined that K.N.
had elevated blood pressure, ordered labs, and recommended that K.N.’s caregivers
start keeping a log of K.N.’s blood pressure twice per day. (Doc. 9, p. 18). Dr.
Luker opined that K.N. was “overall” a “healthy 10-year-old girl.” (Doc. 9, p. 18).
On December 23, 2024, K.N. visited University Medical Center to follow up
on her blood pressure issues. (Doc. 9, p. 9). Paul Lavender Jr., M.D., noted that
K.N. had a history of high blood pressure readings at the clinic, was not on
medication, did not present complaints, and had “lots of stress at home.” (Doc. 9, p.
27 Dr. Luker abbreviates “shortness of breath” as “SOB.” See MEDLINE PLUS, Understanding
Medical Words: A Tutorial – Appendix B: Some Common Abbreviations, NATIONAL LIBRARY OF
MEDICINE (last updated March 6, 2020) https://medlineplus.gov/appendixb.html
[https://perma.cc/RK7V-FC54].
9). Dr. Lavender indicated that K.N. had boils, chronic asthma, and a history of
prematurity. (Doc. 9, p. 9). Dr. Lavender performed a physical exam that yielded
normal results. (Doc. 9, p. 11). Dr. Lavender determined that K.N. had slightly
elevated blood pressure on the first reading and normal blood pressure on a repeat
reading. (Doc. 9, p. 12). Dr. Lavender recommended that K.N.’s caregivers
continue to check her blood pressure at home and follow up with her primary care
provider in 3 to 4 months. (Doc. 9, p. 12).
Ms. Neal obtained a “good faith estimate” from Children’s of Alabama dated
April 22, 2025 that explained how much an anticipated nephrology visit for K.N.
would cost. (Doc. 9, pp. 1–2). The estimate listed K.N.’s diagnosis as high blood
pressure. (Doc. 9, p. 2). K.N. visited Children’s of Alabama’s nephrology clinic on
June 11, 2025. (Doc. 9, pp. 3, 5). Kyle Deville, M.D. ordered labs for “elevated BP
without diagnosis of hypertension.” (Doc. 9, pp. 3, 5). Dr. Deville indicated that
the clinic would call K.N.’s caregivers with results from a home blood pressure
monitor and follow up based on those results. (Doc. 9, p. 5). The lab and blood
pressure monitor results are not in the record.
On February 2, 2026, K.N. visited University Medical Center for a well-child
examination. (Doc. 10, p. 3). Dr. Luker noted that K.N. presented with pediatric
hypertension and was “rarely” using an inhaler for asthma. (Doc. 10, p. 3). K.N.
was “perform[ing] above grade level” and “earning all A’s in school.” (Doc. 10, p.
4). K.N. reported that she slept through the night, but did not sleep a minimum of
8.5 hours nightly. (Doc. 10, p. 4). K.N. failed a vision screening and had elevated
blood pressure. (Doc 10, pp. 6, 8). Dr. Luker’s physical exam yielded otherwise
normal results. (Doc. 10, pp. 6–7). To address K.N.’s high blood pressure, Dr.
Luker ordered labs and prescribed K.N. 12.5 mg of HCTZ daily. (Doc. 10, p. 8).28
Dr. Luker recommended that K.N. visit an optometrist to address her visual deficits.
(Doc. 10, p. 8). Dr. Luker opined that K.N. was “doing well and meeting all of her
developmental milestones.” (Doc. 10, p. 8). In a letter dated February 18, 2026, Dr.
Luker wrote that he was treating K.N. for “medical conditions involving her vision
and blood pressure” and indicated that K.N. required “breaks to use the restroom as
needed” because of medication side effects. (Doc. 10, p. 1).
STANDARD OF REVIEW
The scope of review in this matter is limited. “When, as in this case, the ALJ
denies benefits and the Appeals Council denies review,” the Court “review[s] the
ALJ’s ‘factual findings with deference’ and [his] ‘legal conclusions with close
scrutiny.’” Riggs v. Comm’r of Soc. Sec., 522 Fed. Appx. 509, 510–11 (11th Cir.
2013) (quoting Doughty v. Apfel, 245 F.3d 1274, 1278 (11th Cir. 2001)).
28 HCTZ, or Hydroochlorothiazide, is a “thiazide diuretic,” i.e. a “water pill.” MAYO CLINIC,
Hydrochlorothiazide (last updated Feb. 1, 2026) https://www.mayoclinic.org/drugs-
supplements/hydrochlorothiazide-oral-route/description/drg-20071841 [perma cc]. HCTZ is used
to treat high blood pressure and fluid retention. Id.
The Court must determine whether there is substantial evidence in the record
to support the ALJ's factual findings. “Substantial evidence is more than a scintilla
and is such relevant evidence as a reasonable person would accept as adequate to
support a conclusion.” Crawford v. Comm’r of Soc. Sec., 363 F.3d 1155, 1158 (11th
Cir. 2004). In making this evaluation, a district court may not “decide the facts
anew, reweigh the evidence,” or substitute its judgment for that of the ALJ. Winschel
v. Comm’r of Soc. Sec. Admin., 631 F.3d 1176, 1178 (11th Cir. 2011) (internal
quotations and citation omitted). If the ALJ’s factual findings are supported by
substantial evidence, then a district court “must affirm even if the evidence
preponderates against the Commissioner’s findings.” Costigan v. Comm’r, Soc. Sec.
Admin., 603 Fed. Appx. 783, 786 (11th Cir. 2015) (citing Crawford, 363 F.3d at
1158).
With respect to the ALJ’s legal conclusions, a district court must determine
whether the ALJ applied the correct legal standards. If the district court finds an
error in the ALJ’s application of the law, or if the court finds that the ALJ failed to
provide sufficient reasoning to demonstrate that the ALJ conducted a proper legal
analysis, then the court must reverse the ALJ’s decision. See Cornelius v. Sullivan,
936 F.2d 1143, 1145–46 (11th Cir. 1991).
DISCUSSION
Ms. Neal argues that the Secretary erred by failing to consider new medical
evidence. (Doc. 1, p. 5). Construing Ms. Neal’s complaint liberally, the Court
identifies three issues Ms. Neal raises. The Court must determine whether the
Appeals Council erred by denying review of Ms. Neal’s claim based on evidence
submitted after the ALJ’s decision; whether this Court should remand Ms. Neal’s
case for reconsideration based on new, material evidence; and whether the ALJ erred
by failing to obtain and review the therapist records Ms. Neal referenced during the
ALJ hearing.29
The Appeals Council did not err by declining to review the ALJ’s decision
based on the evidence Ms. Neal submitted after the ALJ rendered his decision.
With a few exceptions, the claimant is allowed to present new evidence
at each stage of this administrative process. See 20 C.F.R. § 404.900(b).
The Appeals Council must consider new, material, and chronologically
relevant evidence and must review the case if “the administrative law
judge’s action, findings, or conclusion is contrary to the weight of the
evidence currently of record.” [20 C.F.R.] § 404.970(b).
Ingram v. Comm’r of Soc. Sec. Admin., 496 F.3d 1253, 1261 (11th Cir. 2007).
“[W]hen a claimant properly presents new evidence to the Appeals Council, a
reviewing Court must consider whether that new evidence renders the denial of
29 The Commissioner argues that the ALJ’s decision is supported by substantial evidence. (Doc.
6). The Commissioner has addressed the new medical evidence Ms. Neal submitted to this Court
in March 2026, (see Doc. 11), but the Commissioner has not addressed the therapist records Ms.
Neal discussed during the administrative hearing. (See Docs. 6, 11).
benefits erroneous.” Ingram v. Comm’r of Soc. Sec. Admin., 496 F.3d 1253, 1262
(11th Cir. 2007).
As discussed above, Ms. Neal submitted new medical records to the Appeals
Council which indicate that K.N. was being evaluated and/or treated for kidney
disease. (Doc. 4-3, pp. 17–20). These records do not suggest that K.N.’s kidney
issues, alone or in combination with K.N.’s other impairments, caused K.N. marked
or severe impairments in any of the six functional domains. Therefore, the evidence
does not render the ALJ’s findings or conclusions contrary to the weight of the
evidence in the record, and the Appeals Counsel did not err by failing to review the
case and consider the new evidence.
Likewise, the new medical records Ms. Neal submitted to this Court do not
require this Court to remand Ms. Neal’s case for reconsideration. Pursuant to
sentence six of 42 U.S.C. § 405(g), a district Court must remand a benefits
application to the Commissioner for further development of the record if the
claimant demonstrates “that there is new evidence which is material and that there
is good cause for the failure to incorporate such evidence into the record in a prior
proceeding.” 42 U.S.C. § 405(g). Evidence is material if it is “relevant and
probative so that there is a reasonable possibility that it would change the
administrative result.” Caulder v. Bowen, 791 F.2d 872, 877 (11th Cir. 1986). Like
the records submitted to the Appeals Council, the records submitted to this Court do
not suggest that K.N. has an impairment or combination of impairments that cause
marked or severe impairment in any of the six functional domains. Ingram, 496 F.3d
at 1261. Thus, the evidence is not material and does not provide grounds for a
sentence six remand.
Turning to the third question, the ALJ erred when he failed to obtain and
review the therapy records Ms. Neal identified during the hearing.
A social security claimant “bears the burden of proving that [she] is disabled”
and “is responsible for producing evidence to support her claim.” Larry v. Comm’r
of Soc. Sec., 506 Fed. Appx. 967, 968–69 (11th Cir. 2013) (citing Ellison v.
Barnhart, 355 F.3d 1272, 1276 (11th Cir. 2003)). Yet, “[b]ecause a hearing before
an ALJ is not an adversary proceeding, the ALJ has a basic obligation to develop a
full and fair record.” Larry, 506 Fed. Appx. at 968–69 (quoting Cowart v.
Schweiker, 662 F.2d 731, 735 (11th Cir. 1981)). Developing the record “is an
onerous task, as the ALJ must ‘scrupulously and conscientiously probe into, inquire
of, and explore for all relevant facts.’” Henry v. Comm’r of Soc. Sec., 802 F.3d 1264,
1267 (11th Cir. 2015) (quoting Cowart, 662 F.2d at 735). When a claimant proceeds
pro se, the ALJ’s duty to develop the record is heightened. Wisner v. Astrue, 496 F.
Supp. 2d 1299, 1302 (N.D. Ala. 2007) (citing Cowart, 662 F.2d 731, 735 (11th Cir.
1981)); see Santos v. Soc. Sec. Admin., Comm’r, 731 Fed. Appx. 848, 854 (11th Cir.
2018) (“This duty is greater for an unrepresented claimant[.]”) (citing Graham v.
Apfel, 129 F.3d 1420, 1422–23 (11th Cir. 1997); Hudson v. Heckler, 755 F.2d 781,
784–85 (11th Cir. 1985)).
“In determining whether a claimant is disabled, the ALJ must consider the
evidence as a whole.” Henry, 802 F.3d at 1267 (citing Spencer v. Heckler, 765 F.2d
1090, 1093 (11th Cir. 1985) (per curiam)). Accordingly, “remand for further factual
development of the record before the ALJ is appropriate where ‘the record reveals
evidentiary gaps which result in unfairness or clear prejudice.’” Henry, 802 F.3d at
126 (quoting Brown v. Shalala, 44 F.3d 931, 935 (11th Cir. 1995) (per curiam)).
Here, the ALJ did not fulfill his duty to develop a full and fair record. As
discussed, Ms. Neal stated that K.N. saw a therapist before the ALJ hearing and that
she faxed therapy records to the Administration. (Doc. 4-3, p. 59). The ALJ stated
that he did not have those records, and there is no indication that the ALJ allowed
Ms. Neal to submit the records or that he otherwise attempted to obtain those records.
In light of Ms. Neal’s pro se status and comments about missing records during the
hearing, the ALJ’s duty to “scrupulously and conscientiously probe into . . . all
relevant facts” required him to provide Ms. Neal an opportunity to submit the records
or to otherwise make reasonable attempts independently to obtain and review the
records before he decided Ms. Neal’s claim. Henry, 802 F.3d at 1267.
Because the record before this Court does not include the therapy records
identified during the ALJ hearing, this Court “ha[s] no way of knowing” whether the
records would support Ms. Neal’s allegations of K.N.’s functional deficits. Brown,
44 F.3d at 931, 936.30 “In the absence of proof to the contrary, however, we must
assume that [the records] [would] lend credence to her allegations.” Brown, 44 F.3d
931, 936. Ms. Neal would be “undoubtedly prejudiced” by a “lack of medical . . .
documentation supporting [her] allegations of disability.” Brown, 44 F.3d at 935–
36. Accordingly, the Court finds that the ALJ failed to develop the record, and Ms.
Neal was prejudiced as a result.
CONCLUSION
“The ALJ did not satisfy his duty to develop a full and fair record [citation
omitted] and correlatively, did not consider the evidence as a whole.” Henry, 802
F.3d at 1270. The ALJ’s failure to determine whether the therapy records identified
by Ms. Neal contained evidence of K.N.’s functional deficits resulted in an unfair
and prejudicial judgment regarding the child’s disability status. See Henry, 802 F.3d
at 1270 (citing Brown, 44 F.3d at 935–36). Accordingly, pursuant to sentence four
of 42 U.S.C. § 405(g), the Court will reverse the Commissioner’s decision and
remand this matter for determination of whether the therapy records from Jenkins
30 Likewise, the Court is unable to determine whether the therapy records are “chronologically
relevant” because although the records post-date the cessation of disability determination, the
Court cannot ascertain whether they contain medical opinions that “relate back to” the date of that
decision. See Washington v. Soc. Sec. Admin., Comm’r, 806 F.3d 1317, 1322 (11th Cir. 2015).
and Richardson Associates contain information that would affect the ALJ’s findings
and conclusions.
DONE and ORDERED this March 27, 2026.
ft DELINE HUGHES HAIKALA
UNITED STATES DISTRICT JUDGE
48