The opinion
IN THE UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF OHIO
EASTERN DIVISION
AUTUMN KHASAWNEH, on behalf of ) CASE NO. 1:25-CV-02131-CEH
G.A.L. )
) JUDGE CARMEN E. HENDERSON
Plaintiff, ) UNITED STATES MAGISTRATE JUDGE
)
v. )
)
COMMISSIONER OF SOCIAL SECURITY ) MEMORANDUM OPINION AND
ADMINISTRATION, ) ORDER
)
Defendant, )
I. Introduction
Plaintiff, Autumn Khasawneh, on behalf of her minor child G.A.L. (“Khasawneh” or
“Plaintiff”), seeks judicial review of the final decision of the Commissioner of Social Security
denying her applications for Supplemental Security Income (“SSI”). This matter is before me by
consent of the parties under 28 U.S.C. § 636(c) and Fed. R. Civ. P. 73. (ECF No. 21). For the
reasons set forth below, the Commissioner's final decision is AFFIRMED.
II. Procedural History
On May 23, 2023, Claimant filed applications for SSI on behalf of her minor child G.A.L.,
alleging a disability onset date of July 1, 2020 and claiming she was disabled. (ECF No. 9, PageID
#: 244-47). The applications were denied initially and upon reconsideration, and Claimant
requested a hearing before an administrative law judge (“ALJ”). (ECF No. 9, PageID #: 185). On
October 23, 2024, an ALJ held a hearing, during which Claimant, represented by counsel, and an
impartial vocational expert testified. (ECF No. 9, PageID #: 74-92). On October 31, 2024, the
ALJ issued a written decision finding Claimant was not disabled. (ECF No. 9, PageID #: 47-68).
The ALJ’s decision became final on August 13, 2025, when the Appeals Council declined further
review. (ECF No. 9, PageID #: 29-31).
On October 7, 2025, Claimant filed her Complaint to challenge the Commissioner’s final
decision. (ECF No. 1). The parties have completed briefing in this case. (ECF Nos. 11, 12).
Claimant asserts the following assignments of error:
(1) The ALJ failed to properly evaluate functional equivalence in finding “no limitation”
in attending and completing tasks and “less than marked” limitation in caring for
oneself.
(2) The ALJ’s rejection of the opinions of Dr. Bouchard and Dr. Konieczny is not
supported by or consistent with the evidence of record.
(ECF No. 11).
III. Background
A. Relevant Hearing Testimony
The ALJ summarized the relevant testimony from Claimant’s hearing:
Limitations have been alleged on the claimant’s behalf due to difficulty with
regulating her emotions, getting along with others, and understanding,
remembering, and applying information. The claimant’s mother reported that the
claimant cannot read or understand simple sentences or stories in books and
magazines; she cannot write in longhand or spell most three to four-letter words;
and she cannot tell time. Her mother reported that the claimant struggles
academically, and she is concerned that the claimant has dyslexia. The claimant
does not finish what she starts or complete homework. Her mother reported that the
claimant has difficulty hearing, and she struggles to speak in a regular tone of voice
and tactfully. She states that the claimant’s affect is “over the top”; and she has
social emotional issues with peers, family, and teachers. She reported that the
claimant does not have friends her own age, she has difficulty making new friends,
she does not generally get along with adults, and she does not play team sports. She
can be argumentative with other adults, including her mother. Her mother testified
that the claimant was assaulted three times last year because of the claimant’s
difficulty interacting with others. She does not help around the house, do what she
is told most of the time, obey safety rules, or accept criticism or correction. She
also reported the claimant has issues with truancy/absences from school due to
anxiety and PTSD; the claimant claims she has a headache or stomachache to avoid
school. Her mother also testified that the claimant has threatened self-harm or has
engaged in self-injuring behavior (e.g., running a brush over her skin to leave
marks; striking her own head). The claimant’s mother also reported that the
claimant gets triggered and has flashbacks; they are working on cognitive
behavioral therapy before trying prescription medication. She testified that she uses
respite care every six months, and she has done so since the claimant was born; she
testified that she does this because of a combination of her own health issues, a
previous need to care for other older children (though those children are no longer
in her custody), and overwhelm with the claimant.
However, the claimant’s mother also reported that the claimant has no problems
seeing or communicating. She has no limitations in her physical abilities. She can
read capital and small letters and simple words; she can print her name and some
letters; she can write a simple story with six to seven sentences; she can add and
subtract numbers over 10; she knows the days of the week and months of the year;
and she understands money. Her mother testified that the claimant can perform self-
care (e.g., bathing, brushing her teeth) and does not have any problems doing so.
The claimant can keep busy on her own, work on arts and crafts projects, and
complete chores most of the time. She generally gets along with her teachers. She
can use zippers and button her clothes by herself; she can choose her own clothing;
she can eat by herself with utensils; and she can pick up and put away toys.
(ECF No. 9, PageID #: 51-52) (internal citations omitted).
B. Relevant Medical Evidence
The ALJ also summarized Claimant’s health records and symptoms:
In November of 2020, when the claimant was using virtual learning from school,
her mother reported that the claimant was having academic difficulty and mood
swings. At a consultation the following month, the claimant’s mother reported
homeschooling the claimant with no particular curriculum, and the claimant had
difficulty staying on task to get online work done. Her mother also reported that the
claimant had limited interactions with peers that year due to COVID. The claimant
was assessed with learning difficulties and behavior concerns; her provider
encouraged counseling and provided academic resources. The claimant had some
improvement in academics in February of 2021, but she still needed support to stay
on task and complete tasks. Her mother reported that the claimant was enrolled in
school and doing well in August of 2021. In October of 2021, the claimant reported
feeling anxious and stressed regarding bullying. At a pediatric psychological
consult, the claimant presented with a euthymic mood; she was open and engaged;
and her speech was unremarkable. Toward the end of the visit, the claimant
appeared silly and somewhat inattentive and asked if it was time to go. She was
recommended for ongoing therapy.
In March of 2022, the claimant underwent a neuropsychological assessment.
During testing, she was engaged and cooperative; her speech was unremarkable;
her responses demonstrated clear thought content and process; she had some
difficulty sustaining attention and sometimes asked how many items were left on a
particular task, but she benefitted from encouragement and redirection; and her
affect fluctuated (anxious during unfamiliar tasks; decreased mood during
emotional and behavioral functioning measures). Her intelligence testing showed
deficits in working memory and reasoning abilities, but intact cognitive abilities.
Her achievement testing showed below average performance in reading; she
became easily discouraged on math problems she did not know, but her math and
writing skills were otherwise age-appropriate; and although her verbal
comprehension was intact, she had lower phonemic awareness than expected for
her age. Intelligence testing from the assessment showed a full scale IQ of 80 (low
average), some deficits in adaptive functioning (specifically functional academics,
health and safety, and self-care); but no significant deficits in attention inhibition,
or executive functioning She was assessed with a specific learning disorder
(dyslexia) and PTSD.
The claimant also underwent a behavioral health assessment at the end of April of
2022. The claimant’s mother reported that the claimant was struggling at home and
in school after they moved homes and school districts. The history given to the
provider included that the claimant had been in online school during COVID, and
the claimant’s custody and living arrangement had fluctuated between 2016 and
2020, during which time the claimant’s mother believed the claimant had traumatic
experiences. The assessment was based entirely on the reports from the claimant’s
mother; no mental status examination was performed. The claimant was assessed
with PTSD.
Her counseling records show some remarkable findings as to mood, affect, and
judgment, but in large part, the examinations were otherwise unremarkable. The
claimant experienced a flashback during school in May of 2022; the record
indicates that the claimant asked a teacher for help, and her guidance counselor got
the claimant in touch with her counselor, who held a session. The claimant was able
to identify what she could do to deescalate when she experiences a flashback.
During the examination, the claimant’s mood was nervous and anxious, but she was
otherwise relaxed and engaged, and her insight and judgment were appropriate. A
few weeks later, she reported not having flashbacks or uncomfortable emotions;
her mood was happy, and her examination was otherwise unremarkable. Her
examination in June was similar. She reported some feelings of upset from peers
and negative thinking in July, but her examination was unremarkable. Her
examinations in August were unremarkable, as well; she reported some stressors,
but she also reported having good days at school and having a friend at school. She
was nervous and anxious about moving stress at the end of the month, and she was
irritable regarding class peers, both in August and in September of 2022. She also
reported learning difficulties and academic challenges in October of 2022; on
examination, her mood was sad, nervous, and/or anxious, but the rest of her
examinations were unremarkable. She reported thoughts of self-harm and self-harm
behaviors in November of 2022; on examination, she had depressive thoughts, an
anxious/depressed mood, and impaired judgment. The following month, her
thought content was unremarkable, but her mood was nervous, anxious, and
irritable; she was pleasant and expressive with her counselor, though. She had
depressive cognitions and some irritability related to peer teasing a few days later.
The claimant also received care at Providence House periodically (her mother
testified to using their services for respite care; see Testimony). In the summer of
2022, the claimant was happy and playful; she played outside, watched movies, and
made art projects; she slept well; and there were no “critical incidences” noted
during her stay; the staff also did not have any concerns during her stay. In the fall
of 2022, she was happy, content, and active. There was one altercation between the
claimant and another child started when the other child was aggressive toward the
claimant, but otherwise, the stay was substantially like summer; she was absent
from school during this stay.
At counseling in January of 2023, the claimant was pleasant, but she presented with
some anxiousness, and she was assessed with impaired judgment due to difficulty
managing impulses. Her counseling sessions in February of 2023 were substantially
like January. In March, she reported anxiety surrounded bullying at school, and the
claimant’s mother had kept the claimant out of school that week. On examination,
the claimant was nervous, irritable, and anxious; she had depressive cognitions; and
her judgment was impaired. Her examination in April was similar. She attended
Providence House in the spring of 2023, the claimant was happy, content, and
sociable; she ate and slept well; and there were no critical incident reports. The
claimant did not attend school while at Providence House at this time. In September
of 2023, the claimant reported to her counselor that she was adjusting to a new
school setting and attempting to develop new friendships at school, but she also
reported some difficulties with certain peers. At her examinations, she was anxious
and/or nervous and sometimes impulsive, but the rest of her examinations were
unremarkable.
At a consultative psychological examination in September of 2023, the claimant’s
mother reported that the claimant had difficulty interacting with peers; she
experienced greater than average mood swings and was resistant to discipline and
redirection; she had difficulty concentrating; and she experienced nightmares and
flashbacks. Her mother also reported that the claimant helped with age-appropriate
chores, like cleaning her room and helping with dishes, and doing simple
microwave cooking. During the examination, the claimant showed no distress and
separated easily from her mother; she was well-groomed; she was somewhat
subdued, but pleasant and responsive; she showed no symptoms of hyperactivity,
restlessness, or inattentiveness; she showed no indication of any diminished
tolerance for frustration; and her speech was unremarkable. Intelligence testing
showed a full-scale IQ of 74, but her verbal comprehension index was 89. She was
assessed with BIF, PTSD, and depressive disorder.
She reported to her counselor in October of 2023 that she requested to have her seat
moved in school to better concentrate. She also reported some life stressors and
some adjustments in school; generally, she was anxious and/or nervous; her affect
was either appropriate for the circumstance or labile; and her judgment was
impaired. Her examination in November was similar. The claimant stayed at
Providence House in early November of 2023, where staff described her as happy
and content, and there were no critical incidents reported; she was absent from
school during this visit. In December, she reported to her counselor that she missed
a week of school that month relating to a peer conflict.
At counseling sessions in the spring of 2024, the claimant’s mood was nervous
and/or anxious; her affect generally was appropriate; and her judgment was
impaired. However, she also had sessions where she had some worry, but her mood
was neutral or happy, her behavior was cooperative, and the exam was otherwise
unremarkable. At Providence House in the spring of 2024, she was described as
happy and enjoying the activities. However, she had several instances in which she
was verbally or physically aggressive toward peers. She also was absent from
school while at Providence House.
More recently, her mental status examinations at counseling were within normal
limits. She visited providence House again in August of 2024 without incident.
The undersigned notes that at physical examinations with her primary providers,
the claimant’s psychiatric/mental status examinations were unremarkable.
(ECF No. 9, PageID #: 52-56) (internal citations omitted).
C. Opinion Evidence at Issue
The ALJ explained her assessment of the medical opinions at issue as follows:
The undersigned finds partially persuasive the opinion of consultative
psychological examiner J. Joseph Konieczny, Ph.D., dated September 28, 2023,
opining that the claimant has some limitations in acquiring and utilizing
information, interacting and relating with others, and self-care; and no more than
mild difficulty in attending and completing tasks (10F/4). The undersigned finds
this opinion partially persuasive because it generally is supported by the
consultant’s examination: the claimant showed no distress and separated easily
from her mother; she was well-groomed; she was somewhat subdued, but pleasant
and responsive; she showed no symptoms of hyperactivity, restlessness, or
inattentiveness; she showed no indication of any diminished tolerance for
frustration; her speech was unremarkable; and her intelligence testing showed a
full-scale IQ of 74, but her verbal comprehension index was 89. The more complete
record supports that the claimant does not have any limitations in attending and
completing tasks. At the examination with the consultant, she showed no symptoms
of hyperactivity, restlessness, or inattentiveness (10F/2-6). In October of 2023, the
claimant reported to her counselor that she requested a seat change in school to
better concentrate (11F/10), and none of the records from her examinations or her
counseling sessions in 2023 and 2024 indicate any issues with attentiveness, either.
Thus, the opinion that the claimant has even mild limitations in attending and
completing tasks is not consistent with the more complete record. Otherwise, this
opinion is consistent with the other evidence of record. Therefore, the opinion is
persuasive.
The undersigned finds partially persuasive the opinion of the claimant’s current
primary pediatrician, Brian Bouchard, M.D., dated January 31, 2024, opining that
the claimant has moderate limitations in acquiring and using information, caring
for oneself, and health and physical well-being; she has marked limitations in
attending and completing tasks and in interacting and relating with others; and she
has no limitations in moving about and manipulating objects (18F/3-6). The
undersigned finds this opinion partially persuasive because his opinions regarding
the claimant’s acquiring and using information, caring for oneself, and moving
about and manipulating objects are both supported by the doctor’s examinations of
the claimant, and they are consistent with the other evidence of record. However,
his opinions as to attending and completing tasks, interacting and relating with
others, and health and physical well-being are neither supported by his own
examinations (e.g., unremarkable mental status exam at 2F/11-13 (02/09/23), nor
are they consistent with the more complete record. As noted above, as to attending
and completing tasks, she showed no symptoms of hyperactivity, restlessness, or
inattentiveness at her consultative examination (10F/2-6), she reported taking
affirmative steps to better concentrate in school (11F/10), and none of the records
from her examinations or her counseling sessions in 2023 and 2024 indicate any
issues with attentiveness. For interacting and relating with others, none of Dr.
Bouchard’s examinations indicate that the claimant had any difficulty interacting
with him; rather, his opinion appears to be based solely on reports from the
claimant’s mother. As set forth in this decision, while the record supports some
limitations in this domain of functioning (e.g., counseling sessions where her mood
was anxious and/or nervous; reports of some peer conflicts at counseling and at
Providence House (e.g., 19F/9-10 and 28F/7-9, respectively); and teacher reports
of some difficulty responding to criticism and socializing with peers (17F)), the
record also supports that the claimant interacted well with peers at school more
recently (e.g., ETR observations at 20F/30-66; no noted difficulty interacting with
counselor or physicians). Finally, as to health and physical well-being, the record
does not support any limitations. Dr. Bouchard’s opinion is based on the claimant’s
mental health and obesity. As discussed above, the claimant’s obesity is non-severe.
While the record contains allegations of somatic complaints related to the
claimant’s anxiety, there are not objective medical findings to support them; and
the record does not contain evidence of other limitations that impact this domain
(e.g., chronic medication side effects; need for intensive medical care as a result of
being medically fragile; periodic exacerbations of impairments). Because these
opinions are not consistent with the record, but the balance of the opinion is both
supported and consistent as discussed above, the opinion is partially persuasive.
(ECF No. 9, PageID #: 60-61).
IV. The ALJ’s Decision
The ALJ made the following findings relevant to this appeal:
1. The claimant was born in May 2013. Therefore, she was a school-age child on May 3,
2023, the date application was filed, and is currently an adolescent.
3. The claimant has the following severe impairments: post-traumatic stress disorder (PTSD);
borderline intellectual functioning (BIF); and depressive disorder.
4. The claimant does not have an impairment or combination of impairments that meets or
medically equals the severity of one of the listed impairments in 20 CFR Part 404, Subpart
P, Appendix 1.
5. The claimant does not have an impairment or combination of impairments that functionally
equals the severity of the listings.
6. The undersigned finds that the claimant has not been disabled, as defined in the Social
Security Act, since May 3, 2023, the date the application was filed.
(ECF No. 9, PageID #: 48-68).
V. Law & Analysis
A. Standard of Review
The Court’s review “is limited to determining whether the Commissioner’s decision is
supported by substantial evidence and was made pursuant to proper legal standards.” Winn v.
Comm’r of Soc. Sec., 615 F. App’x 315, 320 (6th Cir. 2015); see also 42 U.S.C. § 405(g).
“[S]ubstantial evidence is defined as ‘more than a scintilla of evidence but less than a
preponderance; it is such relevant evidence as a reasonable mind might accept as adequate to
support a conclusion.’” Rogers v. Comm’r of Soc. Sec., 486 F.3d 234, 241 (6th Cir. 2007) (quoting
Cutlip v. Sec’y of HHS, 25 F.3d 284, 286 (6th Cir. 1994)).
“After the Appeals Council reviews the ALJ’s decision, the determination of the council
becomes the final decision of the Secretary and is subject to review by this Court.” Olive v. Comm’r
of Soc. Sec., No. 3:06 CV 1597, 2007 WL 5403416, at *2 (N.D. Ohio Sept. 19, 2007) (citing Abbott
v. Sullivan, 905 F.2d 918, 922 (6th Cir. 1990); Mullen v. Bowen, 800 F.2d 535, 538 (6th Cir. 1986)
(en banc)). If the Commissioner’s decision is supported by substantial evidence, it must be
affirmed, “even if a reviewing court would decide the matter differently.” Id. (citing 42 U.S.C. §
405(g); Kinsella v. Schweiker, 708 F.2d 1058, 1059–60 (6th Cir. 1983)).
B. Standard for Disability
An individual under the age of eighteen is considered disabled if she “has a medically
determinable physical or mental impairment, which results in marked and severe functional
limitations, and which can be expected to result in death or which has lasted or can be expected to
last for a continuous period of not less than [twelve] months.” 42 U.S.C. § 1382c(a)(3)(A). The
regulations provide a three-step process for evaluating a child’s disability claim. 20 C.F.R. §
416.924(a). First, the ALJ must determine whether the claimant is engaged in substantial gainful
activity. 20 C.F.R. § 416.924(b). Second, the ALJ must establish whether a claimant has a severe
medically determinable impairment. 20 C.F.R. § 416.924(d). Third, the ALJ must consider
whether the claimant has an impairment or combination of impairments that meets or medically
equals the listings. 20 C.F.R. § 416.924(d). If a severe impairment does not meet or medically
equal any listing, the ALJ must decide whether it results in limitations that functionally equal the
listings. 20 C.F.R. § 416.926a.
In determining whether an impairment or combination of impairments functionally equals
the listings, the ALJ assesses the claimant’s functioning in terms of 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 Self; and 6) Health and Physical Well-
Being. 20 C.F.R. § 416.926a. In making this assessment, the ALJ compares how the claimant
performs with children who do not have an impairment. 20 C.F.R. § 416.924a(b). To functionally
equal the listings, the claimant’s impairment must result in “marked” limitations in two domains
or an “extreme” limitation in one domain. 20 C.F.R. § 416.926a(d). The regulations state that a
“marked” limitation exists when a person’s “impairment(s) interfere with [their] ability to
independently initiate, sustain or complete activities.” 20 C.F.R. § 416.926a(e)(2)(i). “‘Marked’
limitation also means a limitation that is ‘more than moderate’ but ‘less than extreme.’” (Id.).
C. Discussion
Plaintiff raises two issues on appeal. First, she asserts that ALJ failed to properly evaluate
functional equivalence in finding “no limitation” in the domain of attending and completing tasks
and “less than marked” limitation in the domain of caring for oneself. (ECF Doc. 11, pp. 12-16).
Next, she asserts that the ALJ’s rejection of the opinions of Dr. Bouchard and Dr. Konieczny is
not supported by or consistent with the evidence of record. (Id., pp. 16-19).
1. Evaluation of Functional Equivalence
Plaintiff first asserts that the ALJ’s determination that G.A.L. has “no limitation” in the
domain of Attending and Completing Tasks and only “less than marked” limitations in the domains
of Acquiring and Using Information, Interacting and Relating with Others, and Caring for Yourself
is not supported by substantial evidence. (ECF Doc. 11, p. 12). She asserts that the ALJ erred by
considering G.A.L.’s inability to consistently attend and function in school only in the domain of
Acquiring and Using Information, when it was in fact relevant to multiple domains. (Id.) She also
asserts the ALJ erred by selectively relying on normal findings while ignoring materially
inconsistent evidence demonstrating serious interference with functioning in these domains. (Id.)
The Commissioner responds that the ALJ’s determinations are supported by substantial
evidence and the Plaintiff’s assertions to the contrary seek to have this court impermissibly re-
weigh the evidence. (ECF Doc 12, pp. 6-8.) The Commissioner does not address the argument that
the ALJ omitted relevant evidence from her assessment of these domains, but rather asserts that
the evidence she cited was sufficient to provide substantial evidence in support of her
determination.
When making disability determinations, the ALJ must compare the whole child’s
functioning in all activities at home, school, and in their community to children of the same age
without impairments. 20 C.F.R. § 416.91a(b). The ALJ must consider all relevant evidence in the
record when determining whether the claimant is disabled. 20 C.F.R. § 416.924(a). But the ALJ
need not directly address in the written decision every piece of evidence before her. See Kornecky
v. Comm'r of Soc. Sec., 167 F. App’x 496, 508 (6th Cir. 2006) (citation omitted). However, by
regulation, the ALJ must evaluate a child’s impairment-related limitations in any affected
domain. 20 C.F.R. § 416.926a(c) (emphasis added).
a. G.A.L.’s Absences
It is undisputed that G.A.L. was frequently absent from school during the relevant period.
School records show that G.A.L. missed 23 of 96 days in the 2021-2022 school year.1 The ALJ
noted there were various reasons for these absences: sometimes, G.A.L was absent because she
was staying at Providence House, a residential facility, and other times her mother called in the
absences. (Id.) Plaintiff asserts that the ALJ failed to consider whether G.A.L.’s impairments were
contributing factors to these frequent absences. However, the record does not demonstrate that
these absences were caused by G.A.L.’s mental health impairments. As the ALJ noted, Plaintiff
testified that G.A.L.’s visits to Providence House for respite care were to give G.A.L.’s mother the
ability to get care for her own medical needs and to care for her other children and herself. (ECF
Doc. 9, PageID #: 55, citing PageID #: 54-56). These absences total approximately 5 days of each
1 This reflects her attendance in the Wickliffe City School District, where G.A.L. enrolled in December 2021. (ECF
Doc. 9, PageID #: 923).
academic semester. (see, e.g., ECF Doc 9, PageID #: 601 (05/27/22-06/01/22); Page ID #: 605
(10/27/22-11/1/22); Page ID #: 609, 1298 (04/20/23-04/25/23); PageID #: 1301 (11/02/23-
11/07/23) PageID #: 1304 (3/08/24-3/15/24)). During these visits, she reportedly “transitioned
well” and was described as “happy and playful” and “content and sociable” by staff, although there
were a few instances of peer conflict. (Id. at PageID #: 601, 606, 609, 1301, 1304). The other
absences – which account for a significant majority of the time she missed - appear to have been
called in by her mother. During most of these absences, it appears G.A.L. was home and not
receiving any additional medical or mental health intervention.
Plaintiff’s argument is that these absences result from symptoms of G.A.L’s disability, and
were relevant to all the domains assessed by the ALJ, who only referenced the absences in her
explanation of domain of Acquiring and Using Information. (ECF Doc. 11, p. 12). However,
despite Plaintiff’s assertion that the record shows G.A.L.’s absences are the result of trauma
symptoms and anxiety, the records she cites in support of this are not clear-cut. She cites the
following:
• An October 7, 2021 MetroHealth MyChart message from G.A.L.’s mother to her
primary care physician stated that her mother was keeping [G.A.L.] home from
school an average of one day a week “due to personal problems she is facing at
school,” including bullying. (ECF Doc. 9, PageID #: 561). Her mother reported that
G.A.L. “says she wants to die and everyone hates her, has extreme distress and
anxiety” and expressed concern that G.A.L. could not “focus on learning” while
being “traumatized and abused.” (Id.)
• A MetroHealth treatment note from October 8, 2021 states that G.A.L. was
evaluated by pediatric psychology primary care based on her mother’s report that
she since returning to school in person, G.A.L. was experiencing bullying by peers
and conflict with her teacher. (ECF Doc. 9, PageID #: 565). At the examination,
she presented with “a euthymic mood, she was open and engaged and spoke in a
normal rhythm, rate, and tone and had fair insight. Towards the end of the visit she
appeared silly and somewhat inattentive and was asking if it was time to go. No
abnormal thought processes noted.” (Id. at PageID #: 566). The evaluating
psychologist assessed “mood concerns, irritability, sadness, low self-esteem, which
appears to be exacerbated by bullying at school.” She recommended that, “[t]he
family would likely benefit from support in advocating for help at school with
bullying, and [G.A.L.] would likely benefit from ongoing therapy to address mood
and self-esteem concerns.” (Id.)
• A Pediatric Neurology new patient visit on March 24, 2023 note states that G.A.L
had tension headaches once ever 1 to 3 weeks. (ECF Doc. 9, PageID #: 655). Notes
indicated that G.A.L. reported that her moods were “good” and counseling was
helpful. (Id. at PageID #: 654). On examination, her mental status was normal. (Id.
at PageID #: 655). The examining neurologist opined that “I suspect anxiety/PTSD
as well as lifestyle factors are contributing to [G.A.L.’s] headaches at this time,”
and recommended the headaches be treated with ibuprofen and acetaminophen, as
well as placing a referral for anxiety/mood, PTSD, and bullying concerns. (Id. at
PageID #: 655).
• At the October 23, 2024 hearing, her mother testified that G.A.L. missed substantial
school days due “varied reasons,” including headaches and stomach aches,
flashbacks to prior abuse, and the school’s failure to provide her needed
accommodations, such as a non-verbal cue for when she was triggered and the
opportunity to check-in with a trusted adult. (ECF Doc. 9, PageID #: 84-85). Her
mother testified “she knows how to get herself back, and thankfully, she’s self-
aware.” (Id.) She testified that G.A.L. had “developed a phobia of going to school”
and sometimes refused to go due to assaults at school and the way kids would gang
up to pick on her. (Id. at PageID #: 85-86.)
• An Initial Evaluation Team Report completed in January 8, 2024 by Wickliffe City
School District noted that G.A.L.’s “attendance has impacted the team’s ability to
provide consistent, proactive skill building” with regard to coping skills and social
problem solving skills. (ECF Doc. 9, PageID #: 914-15). The ETR notes that, after
experiencing “social conflicts and bullying from peers,” G.A.L. refused to attend
school beginning in March 2023, ultimately missing 65 days of school. She finished
her fourth grade year completing work at home. (Id. at PageID #: 923.) She returned
in person for fifth grade, but was absent 22 days from August through November
13, “including 2 days Out of School Suspension in September 2023, as she was
involved in physical altercation with peer in the bathroom,” and absent 10 days
from November 14 to January 5, while attending on an adjusted half day schedule.
(Id.)
In explaining her determination that G.A.L. had “less than Marked limitations” in the
domain of Acquiring and Using Information, the ALJ noted “[d]uring the 2022-2023 school year,
the claimant had over 55 absences. The claimant’s 2023-2024 school records indicate that she had
at least 45 full-day absences.” (ECF Doc. 9, PageID #: 63). The ALJ identifies these absences as
a contributing factor to G.A.L.’s challenges in the domain of Acquiring and Using Information,
and Plaintiff does not challenge her assessment of this domain. (Id.)
b. Limitations in Attending and Completing Tasks
First, Plaintiff asserts that the ALJ erred in assessing that G.A.L. had no limitation in the
domain of Attending and Completing Tasks. (ECF Doc. 11, p. 12). She argues that “[t]he record
shows that G.L.’s impairments manifest most dramatically in her inability to consistently attend
and function in school; yet, the ALJ evaluated G.L.’s chronic absenteeism in the wrong domain.”
(Id.) She asserts that G.A.L.’s absences show “shows she cannot consistently attend school,
tolerate the environment, regulate her emotions, and persist through ordinary demands.” (ECF
Doc. 11, at p. 12). She also links G.A.L.’s absences directly to her impairment of PTSD, stating
“[a] child who repeatedly cannot remain in the school environment due to PTSD symptoms is
demonstrating interference” in the domain of Attending and Completing Tasks. (Id. at pp. 12-13).
Social Security regulations explain that the domain of attending and completing tasks
considers a school-age child’s ability to focus their attention, follow directions, complete
schoolwork, organize school materials, avoid careless mistakes, and complete family chores. 20
C.F.R. § 416.926a(h)(2)(iv); see also Williams-Dorsey v. Comm'r of Soc. Sec., 2024 WL 345035
at *6 (N.D. Ohio, July 18, 2024).
Plaintiff’s assertion that the ALJ failed to consider G.A.L.’s absences in assessing her
functioning in this domain is inaccurate. The ALJ’s decision notes that G.A.L.’s mother “reported
the claimant has issues with truancy/absences from school due to anxiety and PTSD; the claimant
claims she has a headache or stomachache to avoid school. The claimant’s mother also reported
that the claimant gets triggered and has flashbacks.” (ECF Doc. 9, PageID #: 63-64). This is
precisely the evidence that Plaintiff asserts she overlooked. Further, Plaintiff fails to identify any
record evidence connecting G.A.L.’s absences with the functional abilities in this domain. In fact,
during some of her absences, G.A.L. continued to complete schoolwork when homework packets
were provided by her teachers. (See, e.g., Id. at PageID #: 606-07). Notes from her residential care
at Providence House in November 2023 state that she “especially liked reading books, completing
puzzles, playing board games, [and] completing arts and crafts projects with beads and foam,”
among other activities. (Id. at PageID #: 1301). In March 2024, staff at Providence House again
noted that she “enjoyed … working on puzzles,” among other activities. (Id. at PageID #: 1304).
Thus, it is hard to see how Plaintiff expects the ALJ to have made a causal connection between
G.A.L.’s frequent absences from school and her ability to focus her attention, follow directions,
and even complete schoolwork when the opportunity was offered to her.
In contrast, the ALJ cited specific evidence from across the relevant period in supporting
her finding that G.A.L. had no limitation in the domain of Attending and Completing Tasks. After
noting Plaintiff’s concerns about G.A.L.’s absences and her inability to “finish what she starts or
complete homework,” the ALJ noted that Plaintiff also testified that G.A.L. could “keep busy on
her own, work on arts and crafts projects, and complete chores most of the time.” (ECF Doc. 9,
PageID #: 63-64). This was consistent with classroom observation records stating G.A.L. could
“follow along with the classroom activity, she initiated and completed her assignment, and she
cleaned up after herself; she did not exhibit difficulty in this domain.” (Id. at PageID #: 64). It was
also consistent with medical records from G.A.L.’s therapy providers, showing that G.A.L. was
“attentive” during counseling sessions, and actively advocated to move her seat away from other
students to allow her “to better concentrate on her schoolwork.” (Id. at PageID #: 723, 725).
c. Limitations in Interacting and Relating with Others
Towards the end of her argument regarding the domain of Attending and Completing
Tasks, Plaintiff asserts that the ALJ also erred in assessing that G.A.L. had a less than marked
limitation in the domain of Interacting and Relating to Others. (ECF Doc. 11, p. 14). She notes that
records show that G.A.L was suspended after a verbal exchange escalated into a physical
altercation with “pushing, shoving, hair pulling, punching” and which required medical treatment,
as well as her mother’s testimony and other school records regarding ongoing challenges with
peers and teachers. (Id., citing ECF Doc. 9, PageID #: 846, 694).
In the domain of Interacting and Relating to Others, the regulations provide that children
should be able to effectively communicate with others through expressions, gestures, and actions
in different contexts throughout the day. SSR 09-5p, 2009 WL 396026 (S.S.A. Feb 17, 2009). The
child should also “be able to form relationships with family members, friends, and others, and to
sustain those relationships over time in an age-appropriate manner.” Id. The issue is not whether
there is any limitation in this domain, but whether the degree of limitation is “marked” (meaning
more than moderate).
In explaining her determination that G.A.L. had “less than marked” impairment in this
domain, the ALJ addressed her mother’s testimony and school records indicating that G.A.L. “has
social emotional issues with peers, family, and teachers …. does not have friends her own age, she
has difficulty making new friends, …. [and] can be argumentative with other adults, including her
mother.” (ECF Doc. 9, PageID #: 65). The ALJ also noted the testimony that G.A.L. was assaulted
3 times in the past year due to her difficulty interacting with others. (Id.) The ALJ did not overlook
or omit this evidence of physical conflict. However, the ALJ explained that her determination of
the severity of G.A.L.’s limitation in this area was influenced by other evidence, including her
mother’s testimony that G.A.L. “generally got along with her teachers,” and education records
indicating that while G.A.L. sometimes snapped at other students who criticized her, at other times
she was greeted by peers, interacted with them in helpful ways, and was able to “keep up” in
“sports, games, and other extracurricular activities.” (Id.) She noted that the record supported the
conclusion that some of G.A.L.’s “ difficulty interacting with others” was impacted by virtual
learning, homeschooling, or other settings where the claimant was without access to peers,
including “her absences,” which are again enumerated in the analysis of this domain. (Id.) Further,
educational and counseling records, as well as the consultative psychological examiner’s report,
supported the finding that G.A.L. was able to form friendships and relationships with peers and
felt more comfortable in the school environment with time. (Id. at PageID #: 402, 712, 734). Thus,
the ALJ explicitly considered most of the evidence that the Plaintiff asserts she overlooked,
omitted, or failed to apply to this domain.
d. Limitations in Caring for Self
Finally, Plaintiff asserts that the ALJ erred in determining that G.A.L. had a “less than
marked” limitation in the domain of Caring for Self. (ECF Doc. 11, p. 15). She asserts that the
ALJ “reduces the domain to basic hygiene while minimizing evidence of significantly impaired
emotional regulation.” (Id.) She asserts that the ALJ overlooked evidence of self-harm, depressive
thoughts, and impaired judgment with impulsivity, and failed to examine evidence that G.A.L.
“required multiple respite placements,” and a 504 evaluation noted substantial impairment in mood
regulation. (Id.)
The domain of Caring for Self considers how well a child maintains a healthy emotional
and physical state. 20 C.F.R. § 416.926a(k); Social Security Ruling 09–7p. School age children in
this domain should be independent in my daily activities such as dressing and bathing, although
they may still sometimes need to be reminded to do these activates routinely. Id. They should begin
to recognize that they are competent in doing some activities and that they have difficulty with
others. Id. They should be able to identify circumstances where they feel good about themselves
and when they feel bad, and begin to develop understanding of what is right and wrong and what
is acceptable and unacceptable behavior. Id. Furthermore, they should begin to demonstrate
consistent control over their behavior, and should be able to avoid behaviors that are unsafe or
otherwise not good for them as well as beginning to imitate more of the behavior of adults they
know. Id.
In assessing G.A.L’s ability to care for herself, the ALJ notes the record is “not entirely
consistent with allegations of disabling mental functional limitations.” (ECF Doc. 9, PageID# 58).
She noted that both school records and her mother’s testimony support the finding that G.A.L. had
good hygiene and did not have any problems performing self-care activities like brushing her teeth,
bathing, choosing her clothing, dressing herself, eating, and cleaning up her toys. (Id. at PageID#
66). However, the ALJ’s analysis does not stop here – she also cites some of the same records
highlighted by Plaintiff and notes that educational records show minimal disciplinary incidents
and support the finding that G.A.L. had challenges with managing her emotions, and responding
to changes in routine and criticism, but also was able to manage her anxiety and moods once she
entered the classroom, and was observed interacting “well” with others, cleaning up after herself,
and helping peers. (Id. at 66-67). She cited G.A.L.’s neuropsychological assessment and
counseling records, explaining how they support a finding of “some limitation in this domain,” but
also show significant strengths, such as the ability to ask for help from a teacher during a PTSD
flashback, and identify what she could do to deescalate that situation, as well as requesting that
her seat be moved so that she could concentrate better in class. (Id. at PageID #: 67, citing Page
ID #: 401-01, 725). Further, as the ALJ explains, her determination is consistent with the opinions
of G.A.L.’s pediatrician, the consultative psychological examiner,2 and the state agency
psychological consultants. (Id. at PageID #: 67, citing Page ID #: 712, 870-71, 160, 166-67).
It is true that the ALJ does not discuss G.A.L.’s periods of residential care in this domain,
but Plaintiff fails to articulate a clear reason why she should have done so. Records from
Providence House indicate that G.A.L.’s mother sought respite care so that G.A.L.’s mother “could
decompress and take time to think about employment and resources available to her” because she
was “an overwhelmed parent.” (Id. at PageID #: 601, 609, 1301). G.A.L. consistently transitioned
well to this change in environment, and staff regularly noted no behavior concerns. (Id. at PageID
#: 601, 606, 609, 1301).
The ALJ discusses some of G.A.L.’s absences in reviewing the evidence relevant to self-
care, explaining “[t]he claimant’s ETR indicates that the claimant had difficulty managing her
emotions and to address the claimant’s anxiety, she was permitted to attend school for half-days
for a time; however, the claimant wanted to return to a full-day schedule (20F/30-66 (01/08/24)).”
(Id. at PageID #: 58-59). She also notes that G.A.L.’s IEP accommodations included services on
coping strategies and “breaks as requested,” but does not refence any documentation regarding
how frequently G.A.L. needed to use these accommodations. (Id. at PageID #: 59).
With regard to the ALJ’s analysis of all the functional domains challenged by Plaintiff,
there is a difference of interpretation regarding whether G.A.L.’s impairments directly caused her
absences, or whether a complex mix of internal and external factors led to G.A.L.’s frequent
2 Plaintiff asserts that the ALJ’s determination conflicts with the consultative examiner’s opinion that G.A.L. would
have “inconsistent task completion during PTSD episodes.” (ECF Doc. 11 at p. 16). However, the consultative
examiner raised this issue in the domain of attending and completing tasks, where he also opined that, except during
flashbacks, she would have only “mild” difficulty. (ECF Doc. 9, Page ID #: 712). With regard to self care, he opined
that “As a result of her intellectual limitations and mood symptoms, G.A.L. would have diminished tolerance for
frustration and diminished coping skills which would impact her capabilities in some of these areas,” while also
noting that “[d]uring the course of the evaluation, she showed no indication of any diminished tolerance for
frustration.” (Id. at Page ID #: 711-12).
absences from school. On this issue, reasonable minds could reach different conclusions, but this
Court cannot substitute its own judgment for that of the ALJ. As stated above, this court’s review
is limited to determining whether substantial evidence supports the ALJ’s finding that these
domains were not markedly limited. See Blakley, 581 F.3d at 406 (“The substantial-evidence
standard ... presupposes that there is a zone of choice within which the decision makers can go
either way.”). Even where Plaintiff has identified evidence that supports an alternative finding, the
Court will not disturb the Commissioner’s decision so long as substantial evidence also supports
the conclusion the ALJ reached. O'Brien v. Commissioner of Soc. Sec., 819 F. App’x 409, 416 (6th
Cir. 2020). Under this standard, the Court cannot reweigh the evidence or substitute its judgment
for that of the ALJ. Joni W. v. Comm'r of Soc. Sec., No. 2:23-CV-2505, 2024 WL 488044, at *7
(S.D. Ohio Feb. 8, 2024). Here, the ALJ’s findings are supported by substantial evidence within
her “zone of choice.” Felisky v. Bowen, 35 F.3d 1027, 1035 (6th Cir. 1994). Plaintiff has not
identified any significant evidence overlooked or omitted by the ALJ. Accordingly, the ALJ’s
determination of functional equivalence must be upheld.
2. Evaluation of Medical Opinions
Plaintiff’s second assignment of error asserts that the ALJ erred in rejecting the marked
limitations assessed by treating pediatrician Dr. Bouchard and in characterizing the opinion of
consultative examiner Dr. Konieczny. (ECF Doc. 11 at p. 16, 19). She argues that the ALJ
improperly dismissed the opinions by mischaracterizing the basis of the opinion or selectively
citing normal findings while ignoring consistent, contradictory evidence. (Id.)
Social Security Regulations provide that the Social Security Administration “will not defer
or give any specific evidentiary weight, including controlling weight, to any medical opinion(s) or
prior administrative medical finding(s).” C.F.R. § 404.1520c(a). Nevertheless, an ALJ must
“articulate how [he] considered the medical opinions and prior administrative medical findings”
in adjudicating a claim. 20 C.F.R. § 404.1520c(a). In doing so, the ALJ is required to explain how
he considered the supportability and consistency of a source’s medical opinion(s) but generally
is not required to discuss other factors. 20 C.F.R. § 404.1520c(b)(2). Medical source opinions are
evaluated using the factors listed in 20 C.F.R. § 404.1520c(c). The factors include: supportability;
consistency; the source’s relationship with the claimant; the source’s specialized area of practice,
if any; and “other factors that tend to support or contradict a medical opinion.” 20 C.F.R. §§
404.1520c(c), 404. 1520c(b)(2) (“The factors of supportability [ ] and consistency [ ] are the most
important factors we consider when we determine how persuasive we find a medical source's
medical opinions . . . . ”).
a. Opinion of Dr. Bouchard
Dr. Bouchard, G.A.L.’s pediatrician, opined in January 2024, that G.A.L. had moderate
limitations in acquiring and using information, caring for oneself, and health and physical well-
being; marked limitations in attending and completing tasks and in interacting and relating with
others; and no limitations in moving about and manipulating objects. (ECF Doc. 9 at Page ID #:
868-71). The ALJ found Dr. Bouchard’s opinion partially persuasive, noting that “his opinions
regarding the claimant’s acquiring and using information, caring for oneself, and moving about
and manipulating objects are both supported by the doctor’s examinations of the claimant, and
they are consistent with the other evidence of record.” (Id. at PageID #: 60). She found his opinions
regarding attending and completing tasks, interacting and relating with others, and health and
physical well-being were neither supported by his own examinations nor consistent with the “more
complete record.” (Id. at PageID #: 60-61). This analysis will focus on the first two disputed areas
of the opinion, because even if the ALJ had adopted Dr. Bouchard’s opinion that G.A.L. had
moderate (less than marked) limitations in the area of health and physical well-being, this would
not have affected the outcome of the disability determination.
Plaintiff asserts that the ALJ’s explanation fails for two reasons: first, because she
“improperly equated ‘supportability’ with the presence of abnormal mental status findings during
brief office visits,” and second, because her determination that a portion of his opinion was
inconsistent with the record is, itself, inconsistent with that record. (ECF Doc. 11 at 17-18). Neither
of these assertions withstands scrutiny.
As noted by the Commissioner, the regulations state that “The more relevant the objective
evidence and supporting explanations presented by a medical source to support his or her medical
opinions … the more persuasive the medical opinions … will be.” 20 C.F.R. § 416.920c(c)(1).
Here, Dr. Bouchard’s opinion does not identify any objective evidence he used to support it, and
his explanations are brief and somewhat vague. (ECF Doc. 9 at PageID #: 868-71). Both the
Commissioner and the ALJ noted that none of Dr. Bouchard’s treatment notes indicate that G.A.L.
had any difficulty interacting with him, and Plaintiff does not identify any specific notes that they
either overlooked or omitted. (ECF Doc. 12 at p. 9, citing ECF Doc. 9 at PageID #: 60-61). It is
undisputed that Dr. Bouchard did not note abnormal mental status findings during his examinations
or treatment of G.A.L. He offers no explanation at all for the opinion that G.A.L. had “marked
limitation” in attending and completing tasks. (Id. at PageID #: 869). His explanation for the
opinion that G.A.L. had marked limitation in interacting and relating with others is a note that she
had “[f]requent behavior concerns at school related to interactions with peers,” and was “extremely
sensitive to any comments or criticisms.” (Id.) There is no indication that Dr. Bouchard had access
to school records, however. As discussed supra, disciplinary issues at school were infrequent.
(ECF Doc. 9 at PageID #: 952). He later responded to a question about school attendance by stating
that G.A.L. “had many problems with school attendance due to behavior but also disputes over
IEP application and instances of bullying.” (ECF Doc. 9 at PageID #: 870). It is again unclear what
“behavior” Dr. Bouchard is referencing – and whether he intended to attribute that behavior to
G.A.L., her peers, or adults. The ALJ also specifically noted a February 2023 examination of
G.A.L. where Dr. Bouchard did not identify any mental abnormalities, although he did recommend
that she continue with “routine counseling” for mental health and noted she had an IEP in place at
school. (ECF Doc. 9 at PageID #: 67, citing PageID #: 372-74). Further the ALJ notes that at many
appointments with other primary care providers, “the claimant’s psychiatric/mental status
examinations were unremarkable.” (Id., citing PageID #: 598 (08/31/20); 584 (02/08/21); 577
(08/30/21); 558 (10/25/21); 537 (10/28/22); 533 (04/21/23); 1008 (11/06/23); 1003 (03/11/24)).
In contrast, Plaintiff supports her assertion that Dr. Bouchard based his opinion on
“longitudinal treatment, parental reports, school-based functioning, and the pattern of
exacerbations documented throughout the record” with a citation to the opinion itself, which does
not identify any evidence underlying his findings. (ECF Doc. 11 at p. 17). She makes the broad
observation that “[p]ediatric primary care often involves integrating school records, behavioral
reports, and caregiver observations,” but fails to show that this was relevant to Dr. Bouchard’s
opinion. (Id.) She asserts that educational records support Dr. Bouchard’s opinion, but there is no
evidence that he had access to any of G.A.L.’s academic records, as he does not reference them.
(Id. at p. 18). Further, the educational record she cited is the initial referral for evaluation
completed by school staff in late 2023. (Id., citing ECF Doc. 9 at PageID #: 886-87).
In analyzing Dr. Bouchard’s opinion, the ALJ addressed the elements of supportability and
consistency by identifying records from Dr. Bouchard’s treatment of G.A.L. and the record as a
whole which she found inconsistent with his conclusions. This is not error. Creter v. Saul, No.
1:20-cv-0840, 2021 WL 809323 at *11 (N.D. Ohio 2021) (Finding the ALJ did not err because he
“specifically cited treatment records he felt were inconsistent with [the expert opinion],
and explained why.”) In contrast, Plaintiff cites other records – also addressed by the ALJ – that
could lead to a different conclusion. However, it is not the role of this Court “to reconsider facts,
re-weigh the evidence, resolve conflicts in evidence, decide questions of credibility, or substitute
its judgment for that of the ALJ.” Reynolds v. Comm’r of Soc. Sec., 424 F. App’x 411, 414 (6th
Cir. 2011) (citing Youghiogheny & Ohio Coal Co. v. Webb, 49 F.3d 244, 246 (6th Cir.
1995)). Therefore, the ALJ’s determination must be upheld.
b. Opinion of Dr. Konieczny
Finally, Plaintiff challenges the ALJ’s characterization of the opinion of consultative
psychological examiner Dr. Konieczny. (ECF Doc. 11 at p. 19). The ALJ found this opinion
“partially persuasive” (ECF Doc. 9 at PageID #: 60). The portion of the explanation that Plaintiff
asserts mischaracterized Dr. Konieczny’s opinion states that G.A.L. had “no more than mild
difficulty in attending and completing tasks.” (Id.) This is also the only part of the opinion that the
ALJ did not find persuasive, as she found “the opinion that the claimant has even mild limitations
in attending and completing tasks is not consistent with the more complete record.” (Id.)
The section of Dr. Konieczny’s opinion relating to the domain of attending and completing
tasks states:
As a result of her PTSD, G.A.L.’s abilities in these areas would be somewhat
sporadic and inconsistent. When she is having recurring thoughts or flashbacks, she
would have difficulty maintaining focus on even simple multi-step tasks. She
otherwise would have a mild degree of difficulty in this area due to her intellectual
limitations.
(Id. at PageID #: 712). Thus, Plaintiff is correct that the ALJ’s statement that Dr. Konieczny opined
G.A.L. had “no more than mild difficulty in attending and completing tasks” is inaccurate – his
opinion clearly implies that on those occasions when she was having PTSD flashbacks, her
limitations in this area would be more than mild. Further, the Commissioner fails to address this
issue in his brief, despite the fact it is identified in a subheading and was discussed with specificity
on the final page of Plaintiff’s brief.3 (ECF Doc. 11 at p. 19).
Although the ALJ mis-stated the content of Dr. Konieczny’s opinion relating to the domain
of attending and completing tasks, it is not clear that an accurate recital of his opined limitations
would lead to a finding of marked impairment in this domain, especially given the other evidence
cited by the ALJ in support of her finding. Nevertheless, even if it did, remand of G.A.L.’s case
on the basis of this issue would prove futile. It is well established that “[n]o principle of
administrative law or common sense requires us to remand a case in quest of a perfect opinion
unless there is reason to believe that the remand might lead to a different result.” Shkabari v.
Gonzales, 427 F.3d 324, 328 (6th Cir. 2005) ((quotation marks and citation omitted)).
As explained supra, in order for a claimant under the age of 18 to functionally equal the
listings and qualify for SSI, the claimant’s impairment must result in “marked” limitations in two
domains or an “extreme” limitation in one domain. 20 C.F.R. § 416.926a(d). Here, even if the ALJ
found Dr. Konieczny’s opinion persuasive and determined that his statement that G.A.L. would
have “sporadic and inconsistent…. difficulty maintaining focus on even simple multi-step tasks”
during her PTSD flashbacks meant that she was markedly limited in that area - an outcome which
is far from certain - it would not result in a finding of disability because the ALJ had not found a
marked limitation in any other functional domain. Therefore, regardless of whether the ALJ erred
in the analysis of Dr. Konieczny’s opinion, remand would be futile.
VI. Conclusion
3 The Court notes it was omitted from Plaintiff’s statement of the issues. (ECF Doc. 11 at p. 1).
For the foregoing reasons, the Commissioner's final decision is AFFIRMED.
IT IS SO ORDERED.
Dated: June 29, 2026
s/ Carmen E. Henderson
CARMEN E. HENDERSON
U.S. MAGISTRATE JUDGE
26