Bowie v. Barnhart

United States Court of Appeals
Fifth Circuit
F I L E D
August 22, 2006
Charles R. Fulbruge III
Clerk
In the
United States Court of Appeals
for the Fifth Circuit
_______________
m 05-31056
Summary Calendar
_______________
BRENDA BOWIE,
ON BEHALF OF DE’ERICA BOWIE,
Plaintiff-Appellant,
VERSUS
JO ANNE B. BARNHART,
COMMISSIONER OF SOCIAL SECURITY,
Defendant-Appellee.
____________________________________
Appeal from the United States District Court
for the Western District of Louisiana
m 1:04-CV-1602
____________________________________
Before SMITH, GARZA, and PRADO,
Circuit Judges.
PER CURIAM:*
Brenda Bowie, an applicant for Supplemen-
tal Security Income (“SSI”) disability benefits
on behalf of her minor daughter, De’Erica,
appeals the district court’s affirmance of the
Social Security Commissioner’s decision to
deny the requested benefits on the ground that
* Pursuant to 5TH CIR. R. 47.5, the court has de-
termined that this opinion should not be published
and is not precedent except under the limited
(continued...)
*(...continued)
circumstances set forth in 5TH CIR. R. 47.5.4.

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2
De’Erica is not disabled within the meaning of
the Social Security Act. We affirm.
I.
In 1995, at the age of two, De’Erica suf-
fered kidney failure and required an organ
transplant. At that time she was found to be
disabled and began receiving SSI benefits.
Pursuant to a continuing disability review, the
Social Security Administration terminated her
benefits in November 2001.
Bowie, on behalf of her daughter, filed a
new application for SSI benefits in July 2002
on the basis of the child’s continuing kidney
problems. In March 2004, after holding a
hearing, an administrative law judge (“ALJ”)
ruled that although De’Erica is severely im-
paired, she is not disabled within the meaning
of the Act. Bowie appealed to the agency’s
Appeals Council, which declined to review the
case. The ALJ’s ruling accordingly became
the final administrative decision of the Com-
missioner.
Bowie sought judicial review of that deci-
sion in federal district court, arguing that in
failing to find De’Erica disabled, the ALJ erred
by (1) rejecting a finding by the school board
that her daughter has a learning disorder, (2)
failing to address the negative side-effects of
the immuno-suppressants taken by the child to
prevent her body’s rejection of the trans-
planted kidney, (3) finding that the child has
less than marked limitations in the six domains
covered by agency regulations, (4) failing to
address the effect of Denys-Drash syndrome
on the child, and (5) rejecting Bowie’s request
to supplement the record with additional
medical records substantiating the diagnosis of
Denys-Drash syndrome. After reviewing the
briefs and administrative record, a magistrate
judge determined that the ALJ’s ruling is
supported by substantial evidence in the re-
cord. He accordingly recommended that the
Commissioner’s decision be upheld.
Specifically, the magistrate judge found that
although there are indications that De’Erica
has learning difficulties, the record does not
reflect a disabling learning disorder. The
magistrate judge additionally found that the
ALJ did consider the side effects caused by the
immuno-suppressants and further found that
substantial evidence in the record supports the
ALJ’s determination that these effects are not
disabling. The magistrate judge likewise held
that medical records support the ALJ’s finding
that though De’Erica’s post-transplant status
and learning problems qualify as severe impair-
ments, the child does not suffer from any
marked limitations in the relevant functional
domains. The judge noted that Bowie had not
pointed to any record evidence that indicated
otherwise.
Although the ALJ never mentioned Denys-
Drash syndrome by name, the magistrate judge
found that the ALJ had adequately considered
the effects the disease had on the child by
taking all of its symptoms into account when
determining the extent of her functional limita-
tions.1 Finally, the magistrate judge deter-
1 Denys-Drash syndrome consists of three main
parts: congenital kidney disease, Wilms’ tumor (a
type of kidney cancer), and malformation of the
sexual organs (also known as an intersex disorder)
caused by mutations in the Wilms’ tumor suppres-
sor gene. De’Erica’s renal failure and Wilms’
tumor were considered by the ALJ in reaching his
decision to deny benefits. Bowie argued in the
district court that the ALJ erred by failing to con-
sider and develop the record with respect to a pos-
sible intersex disorder, but the magistrate judge
found that De’Erica’s medical records did not
indicate that the child had such a disorder, and that
(continued...)

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3
mined that supplementation of the record with
additional evidence of the Denys-Drash diag-
nosis was not necessary, because the com-
plications caused by the disease were already
in the record and considered by the ALJ.
Bowie filed objections to the magistrate
judge’s report and recommendation, arguing,
inter alia, that he had made an inappropriate
medical finding. Over these objections, the
district court adopted the recommendation and
affirmed the Commissioner’s decision to deny
benefits. The court noted that “the Magistrate
Judge’s incidentalreferences to medical defini-
tions, with appropriate citations, are informa-
tional only and do not purport to form any
basis for the ultimate conclusions reached.”
The court further stated that the record re-
flects that the medical experts who testified at
the administrative hearing “have considered
the underlying Denys-Drash syndrome in
formulating their opinions.”
II.
“Our review is limited to determining
whether the Commissioner’s decision is sup-
ported by substantial evidence and whether the
proper legal standards were applied.” Swist ex
rel. Green v. Barnhart, No. 05-50562, 2006
U.S. App. LEXIS 9938, at *3-*4 (5th Cir.
Apr. 20, 2006) (per curiam) (unpublished).
“Substantialevidence is such relevant evidence
as a reasonable mind might accept as adequate
to support a conclusion.” Greenspan v.
Shalala, 38 F.3d 232, 236 (5th Cir. 1994).
“[I]t must be more than a scintilla, but it need
not be a preponderance.” Leggett v. Chater,
67 F.3d 558, 564 (5th Cir. 1995). Findings of
fact made by the Commissioner and supported
by substantial evidence are conclusive. See 42
U.S.C. § 405(g).
III.
In determining whether a child is disabled
within the meaning of the Social Security Act,
the Commissioner must consider
(1) whether the child is engaged in substan-
tial gainful activity; (2) whether the child
has an impairment that is “severe;” and
(3) whether the child’s impairment is medi-
cally or functionally equivalent in severity
to the impairments listed in the disability
regulations. For the third inquiry, the ALJ
must consider whether the applicant’s im-
pairment results in a marked limitation in
two domains or an extreme limitation in
one domain for the following: (1) acquiring
and using information; (2) attending and
completing tasks; (3) interacting and relat-
ing with others; (4) moving about and man-
ipulating objects; (5) caring for oneself; and
(6) health and physical well-being.
Swist, 2006 U.S. App. LEXIS 9938, at *4-*5
(internal citations and quotations omitted). A
“marked limitation” is one that “interferes seri-
ously with your ability to independently ini-
tiate, sustain, or complete activities.” 20
C.F.R. § 416.926a(e)(2). It is a limitation that
is “more than moderate” but “less than ex-
treme.” Id.
The ALJ rested his decision on the third
prong. In contending that De’Erica is, con-
trary to the ALJ’s determination, disabled,
Bowie reasserts on appeal all of her arguments
made to the district court, including that the
magistrate judge erred by making an “inde-
pendent medical finding” in holding that “the
symptoms discussed by physicians in the rec-
ord and the ALJ are caused by or [are] a result
of De’Erica’s Denys-Drash Syndrome.”
1(...continued)
the burden of proving such a condition fell on
Bowie, not the Commissioner.

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4
Because none of the doctors whose opin-
ions are a matter of record found that De’Erica
suffers a marked limitation in any of the rele-
vant domains, and because Bowie has pointed
us to no medical evidence to the contrary, we
agree with the magistrate judge that the ALJ’s
determination regarding the severityof De’Eri-
ca’s functional limitations is supported by
substantial evidence.
We further agree, for the reasons stated in
the magistrate judge’s recommendation, that in
reaching his determination of non-disability,
the ALJ adequately took into account
De’Erica’s learning problems, the side-effects
the child suffered as a result of taking immuno-
suppressants, and all symptoms indicative of
Denys-Drash syndrome. Because the ALJ
considered all symptoms in the record indica-
tive of Denys-Drash, we agree with the mag-
istrate judge that supplementation of the re-
cord to substantiate that diagnosis was not
necessary. Furthermore, we agree with the
district court that the magistrate judge’s elabo-
ration of the symptoms of Denys-Drash did
not amount to an inappropriate medical finding
based on evidence outside of the record, but
rather was merely an informational discussion
designed to explain why the ALJ had not erred
by failing to mention the syndrome by name.
Because the ALJ’s decision to denybenefits
on account of non-disability is supported by
substantial evidence, we AFFIRM.

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