## Facts

- Several child SSI applicants and representatives brought a putative class action against the Commissioner of Social Security challenging how the SSA evaluates “functional equivalence” for childhood disability.
- Childhood SSI disability is assessed across six functional domains; eligibility generally requires either (i) “marked” limitations in at least two domains or (ii) an “extreme” limitation in one domain.
- Federal law requires consideration of the “combined effect” of all impairments throughout the disability determination process.
- Plaintiffs challenged an SSA internal policy that allows adjudicators to consider the combined effect of multiple impairments when determining the severity rating within a single domain.
- The same policy prohibits “cross-domain” aggregation—i.e., adjudicators may not increase a less-than-marked rating in one domain based on limitations occurring in other domains.
- Plaintiffs alleged the cross-domain prohibition violates the Social Security Act and the SSA’s own regulations requiring combined-effects consideration.
- The district court granted summary judgment for the Commissioner, holding the Act and regulations do not require cross-domain aggregation.
- Plaintiffs appealed.

## Issues

1. Whether the Social Security Act’s combined-effects requirement obligates the SSA to aggregate less-than-marked limitations across different functional domains when evaluating childhood disability.
2. Whether the SSA’s cross-domain prohibition conflicts with the agency’s regulations requiring consideration of impairments in combination.
3. What level of deference is owed to the SSA’s interpretation of the Act and its regulations in structuring the domain-based framework and implementing the challenged policy.

## Decision

- The Second Circuit affirmed summary judgment for the Commissioner.
- The court held the SSA policy does not violate the Social Security Act’s combined-effects requirement.
- The court held the policy is not inconsistent with the SSA’s regulations governing childhood disability evaluation.
- The court accepted the agency’s approach as a permissible method of accounting for combined effects within the domain framework, without requiring cross-domain aggregation of less-than-marked limitations.

## Legal Principles

- The Act requires the SSA to consider the combined effect of all impairments, but it does not mandate a particular method for translating that consideration into domain ratings.
- A domain-based framework may permissibly “channel” the interaction of multiple impairments into severity determinations within the affected domains, without mathematically cumulating limitations from different domains to create a “marked” limitation.
- When Congress entrusts rulemaking authority to an agency, courts defer to reasonable agency interpretations of statutory silence or ambiguity (Chevron-type deference).
- An agency’s interpretation of its own regulations is controlling unless plainly erroneous or inconsistent with the regulation (Auer-type deference), and may also warrant respect based on persuasiveness (Skidmore-type considerations).

## Conclusion

The Second Circuit upheld the SSA’s childhood SSI evaluation policy that considers combined impairments within each functional domain while barring cross-domain aggregation of less-than-marked limitations, concluding the policy reasonably complies with the Act and the agency’s regulations and merits judicial deference.


Encarnacion ex rel. George v. Astrue, 568 F.3d 72 (2d Cir. 2009)