United States District Court, W.D. Pennsylvania
MANDY M. FINK, Plaintiff,
CAROLYN W. COLVIN, Commissioner of Social Security, Defendant.
MEMORANDUM OPINION AND ORDER OF COURT
TERRENCE F. McVERRY, District Judge.
Mandy M. Fink ("Plaintiff") brought this action pursuant to 42 U.S.C. § 1383(c)(3) for judicial review of the final determination of the Commissioner of Social Security ("Commissioner"), which denied her application for supplemental security income benefits ("SSI") under Title XVI of the Social Security Act ("Act"), 42 U.S.C. §§1381-1383(f).
Plaintiff was born on December 18, 1979. (R. 32). She has a GED and has no relevant work history in the past 15 years. (R. 33). The record reflects that Plaintiff has not engaged in substantial gainful work activity since her alleged disability onset date. (R. 33).
Plaintiff alleged disability as of September 1, 2002, due to a combination of physical and mental impairments including hepatitis C, a personality disorder, depression, chronic fatigue syndrome, sleep apnea, anxiety, paranoia, and restless leg syndrome. (R. 155, 172).
Plaintiff has a history of heroin addiction. She is driven by a family friend to a Methadone Clinic every weekday to get her medications. (R. 34). She also attends counseling twice a month. (R. 34-35). On two occasions in 2003 and 2004, Plaintiff was an inpatient at White Deer Run for drug and alcohol rehabilitation. (R. 37). She has not used heroin since 2005. (R. 38). Plaintiff was hospitalized from October 12-18, 2010 after overdosing on drugs and alcohol in a suicide attempt. (R. 259). After treatment, Plaintiff was discharged in significantly improved condition, with her GAF score rising from 30 to 55.
Plaintiff has been diagnosed with hepatitis C since 2003 but does not take any medication for the condition because she needs someone to care for her and she does not currently have that option. (R. 42). She lives in an apartment with her mother and receives food stamps and medical assistance benefits. (R. 32).
The primary issue in this appeal involves the diagnosis of Bharat Jain, M.D., a board-certified specialist in sleep disorders and pulmonary disease. On August 2, 2010, Dr. Jain diagnosed Plaintiff with: (1) pathologic hypersomnolence, likely related to untreated sleep apnea; (2) dyspnea, but ruled out COPD; (3) restless legs, may be related to an iron deficiency; (4) chronic fatigue with depression; and (5) heroin addiction. R. 245-246. Dr. Jain prescribed formal overnight sleep testing to treat her obstructive sleep apnea syndrome.
On January 21, 2011, Muna Jabbour, M.D., performed a consultation for the state Bureau of Disability Determination. Dr. Jabbour noted that Plaintiff had a history of chronic fatigue syndrome. (R. 316.) Dr. Jabbour reported that a neurologic examination was completely normal and that Plaintiff was able to get on and off the examination table, squat and arise, sit, bend, stand, walk, lift, and grasp. (R. 315-16). She also completed a Medical Source Statement in which she indicated that Plaintiff could stand/walk for between two and six hours in an eight hour workday, as well as sit for six hours a day. (R. 319). She listed no physical diagnoses other than the chronic fatigue syndrome and degenerative joint disease. (R. 316).
On February 11, 2011, the state medical consultants provided a Disability Determination Explanation form. Of relevance to this case, the form reflected that Plaintiff had the following "Medically Determinable Impairments and Severity": (1) chronic fatigue syndrome (CFS) - Primary - Severe; (2) Sleep-Related Breathing Disorders - Other - Severe; (3) Affective Disorders - Secondary - Severe; and (4) Anxiety Disorders - Other - Severe." (R. 56). Despite these severe impairments, however, the Court notes that ultimately the state medical consultants determined that Plaintiff was "Not Disabled." (R. 63).
On December 14, 2009, Plaintiff underwent a mental status exam at Southwestern Pennsylvania Human Services Behavioral Health which indicated her cognition to be below average and her insight and judgment to be poor. (R. 222). Adjustment disorder with depression, alcohol abuse, and hepatitis C were indicated on the ...