United States District Court, M.D. Pennsylvania
AMANDA A. UNGER, Plaintiff,
CAROLYN W. COLVIN Acting Comm'r of Soc. Sec., Defendant.
SYLVIA H. RAMBO, District Judge.
Presently before the court is Plaintiff's appeal of a final decision by the Social Security Commissioner denying Plaintiff's claim for Disability Insurance Benefits under Title II of the Social Security Act. Plaintiff contends that the administrative decision, concluding that she has not been disabled since August 1, 2010, is not supported by substantial evidence and contains errors of law. For the following reasons, the court will affirm the decision of the Commissioner.
A. Procedural History
On September 2, 2010, Plaintiff, Amanda A. Unger, protectively filed for Disability Insurance Benefits ("DIB") under Title II of the Social Security Act. (Doc. 11-6, p. 2 of 53.) In her application for DIB, Plaintiff claimed that she had been disabled since April 1, 2009. ( Id. ) The Social Security Administration initially denied Plaintiff's claim (Doc. 11-3, p. 2 of 3), and on March 23, 2011, Plaintiff requested a hearing before an Administrative Law Judge ("ALJ") (Doc. 11-4, pp. 17-18 of 75).
A hearing was held before ALJ Randy Riley on April 26, 2012, during which both Plaintiff and Michael Kibler, a vocational expert, provided testimony. (Doc 11-2, pp. 27-29 of 47.) ALJ Riley denied Plaintiff's claim, finding that Plaintiff was not entitled to DIB ( Id. at p. 10 of 47), and on May 31, 2012, Plaintiff filed an appeal with the Appeals Council ( Id. at p. 9 of 47). The Appeals Council denied review on July 1, 2013, leaving the ALJ's decision as the final decision of the Social Security Commissioner. ( Id. at p. 2 of 47.) Consequently, Plaintiff commenced the instant action in this court on July 29, 2013. (Doc. 1.)
B. Plaintiff's General Background
At the time of the hearing, Plaintiff was 50 years old and resided with her husband, Terry Unger ("Mr. Unger"), a disabled veteran. (Doc. 11-2, p. 31 of 47.) Plaintiff could read and write in English, graduated high school, and had one year of post-secondary education. ( Id. ) Her work history includes substitute teaching, working as a stock clerk, and breeding dogs. ( Id. at p. 43 of 47.) More recently, Plaintiff had worked as a job development specialist assisting mentally and physically challenged adults. ( Id. )
C. Medical Records
The gravamen of Plaintiff's instant action is the ALJ's assessment of her psychological impairments. ( See Doc. 12, pp. 12-21 of 22.) Nevertheless, because the record contains evidence that Plaintiff suffered from both physical and psychological impairments, the court will briefly address Plaintiff's physical conditions before focusing on the psychological conditions.
1. Physical Impairments
Plaintiff's physical impairments are related to her back and knees. ( See Doc. 11-8, p. 51 of 100; Doc 13, pp. 11-12 of 28.) On July 15, 2013, Plaintiff claimed that she experienced back pain when she reached for objects. (Doc. 11-8, p. 51 of 100.) X-rays of Plaintiff's back revealed mild degenerative changes to her spine. ( Id. at p. 39 of 100.)
Plaintiff has also complained of intermittent bilateral knee pain, beginning in 2008. ( See id. at p. 26 of 100; Doc. 11-9, p. 5 of 37.) X-rays revealed meniscus damage, arthritis, and a chronic anterior cruciate ligament (ACL) injury of Plaintiff's left knee and similar damage to Plaintiff's right knee. (Doc. 11-8, pp. 19, 23 of 100.) On December 17, 2008, Plaintiff underwent chondroplasty surgery on her left knee. ( Id. at p. 26 of 100.) The surgery appeared to resolve Plaintiff's left knee pain, and on January 31, 2012, Plaintiff reported that her medication provided good relief from her joint pain and that her right knee no longer periodically bothered her. ( See Doc. 11-9, p. 5 of 37.) On April 26, 2012, however, Plaintiff complained that her knees would start to swell when she stood for more than 20 minutes. (Doc. 11-2, p. 40 of 47.)
2. Psychological Impairments
Plaintiff has sought medical care for numerous psychological impairments, including post-traumatic stress disorder (PTSD) from watching her first husband commit suicide, psychosis with depression, generalized anxiety disorder, and panic disorder with agoraphobia. ( See Doc. 11-7, p. 31 of 101; Doc. 11-8, p. 75 of 100.) While seeking treatment, Plaintiff has reported that she suffers from hallucinations and sees images of bugs crawling over and under her skin, a woman in her backyard, and her deceased first husband after he shot himself in the head. (Doc. 11-7, p. 31 of 101; Doc. 11-8, p. 95 of 100.) Plaintiff has received medical care for these impairments from the Veterans Administration ("VA"), as the spouse of a disabled veteran. ( See Doc. 11-7, p. 84 of 101.) Holly R. Kricher, Psy.D., a licensed psychologist, and Victoria M. Acker, PA-C, have been Plaintiff's primary care providers. ( See id. at pp. 18-94 of 101.)
The VA first became involved with Plaintiff's care on January 8, 2010. ( See id. at p. 18 of 101.) At this time, Plaintiff received a psychological consult and a PTSD screening. ( Id. ) The screening was negative. ( Id. ) On March 3, 2010, PA-C Acker diagnosed Plaintiff with generalized anxiety disorder and panic disorder, as well as alcohol dependence in early remission. ( Id. at p. 5 of 28.) PA-C Acker assessed Plaintiff's global assessment of functioning (GAF) at 60, indicating some moderate symptoms. ( Id. at p. 5 of 28.)
Prior to September 2010, Plaintiff reported that her treatment regimen was working well. ( See id. at pp. 31-34 of 101.) On September 28, 2012, however, Plaintiff complained that her psychological impairments had worsened and that she had developed hallucinations. ( Id. ) PA-C Acker assessed Plaintiff's GAF at 40 and provided Plaintiff with a referral for therapy to deal with unresolved grief issues regarding her first husband's suicide. ( Id. ) After reporting that she was not improving, Plaintiff's medications were adjusted on November 3, 2010. ( Id. at pp. 27-28 of 101.)
On December 1, 2010, Plaintiff began treatment with Dr. Kricher. (Doc. 11-8, pp. 53-54 of 100.) Plaintiff told Dr. Kricher that she was hallucinating images of her deceased husband's body after he had shot himself in their bedroom. ( Id. ) Dr. Kricher diagnosed Plaintiff with PTSD. ( Id. ) After complaining that her hallucinations had worsened, Plaintiff was diagnosed with psychosis on December 15, 2010. ( Id. at p. 92 of 100.) Plaintiff was informed, however, that her condition may not have improved because of her failure to take her medications as instructed. ( Id. at p. 91 of 100.)
On January 31, 2011, PA-C Acker again adjusted Plaintiff's medications, believing Plaintiff's symptoms were not indicative of a true psychosis. ( Id. at pp. 71-72 of 100.) PA-C Acker noted that Plaintiff complained of contradictory symptoms, such as stating that she felt calmer overall but later claiming that she suffered from three to four panic attacks per day. ( Id. ) Plaintiff also told PA-C Acker that she knew her hallucinations were not real but later stated that she did not understand why her husband could not see what she sees. ( Id. ) On July 21, 2011, PA-C Acker re-assessed Plaintiff's psychological condition and characterized Plaintiff's hallucinations as "unusual" because the hallucinations occurred in all three spheres and lasted throughout the entire day. ( Id. at pp. 46-47 of 100.)
On October 28, 2011, Plaintiff had a therapy session with Dr. Kricher. (Doc. 11-9, pp. 19-20 of 37.) Plaintiff again reported contradictory information. ( Id. ) Plaintiff told Dr. Kricher that she had not left her home since her last appointment in June of 2011, but Plaintiff had attended several appointments with other medical care providers during that time. ( Id. ) During the therapy session, Plaintiff also stated that she was uninterested in pursuing more intensive therapy. ( Id. )
On November 14, 2011, Dr. Kricher completed a medical source statement, reporting that Plaintiff's psychological impairments caused marked and extreme limitations in all mental demands except for understanding and recalling short, simple instructions and making simple work-related decisions. (Doc. 11-8, pp. 99-100 of 100.) However, on November 16, 2011, only two days later, Plaintiff told PA-C Acker that she was feeling better and no longer hallucinated images of bugs crawling on her skin. (Doc. 11-9, pp. 11-12 of 37.) Plaintiff also re-emphasized that she was not interested in therapy. ( Id. ) Plaintiff's ...