United States District Court, W.D. Pennsylvania
MEMORANDUM OPINION AND ORDER OF COURT
TERRENCE F. McVERRY, District Judge.
Plaintiff, Mikel Uncapher, brought this action pursuant to 42 U.S.C. §§ 405(g) and 1383(c), for judicial review of the final determination of the Commissioner of Social Security ("Commissioner"), which denied his application for disability insurance benefits ("DIB") and supplemental security income ("SSI") under Titles II and XVI of the Social Security Act ("Act"), 42 U.S.C. §§ 401-403, 1381-1383(f). This matter comes before the Court on the parties' cross-motions for summary judgment. (ECF Nos. 8, 12). The Record has been developed at the administrative level. (ECF No. 6). The motions have been fully briefed and are ripe for disposition. (ECF Nos. 9, 13). For the following reasons, the Commissioner's Motion will be DENIED, and Plaintiff's Motion will be GRANTED in part and DENIED in part.
A. Procedural History
Plaintiff filed applications for DIB and SSI on May 26, 2010, alleging disability as of May 1, 2010, due to hepatitis C. (R. 134-45, 157). The claims were initially denied on August 3, 2010. (R. 58-66).
Thereafter, Plaintiff requested a hearing, which was held on July 7, 2011, before Administrative Law Judge Barbara Artuso ("ALJ"). (R. 11). Plaintiff was represented by counsel and testified at the hearing. (R. 11). An impartial vocational expert ("VE"), Irene Montgomery, and Plaintiff's mother, Donna Uncapher, also testified. (R. 46, 50). A second VE, Michael Schmidt, was questioned through interrogatories submitted by the ALJ on October 24, 2011, and by Plaintiff's counsel on January 27, 2012. (R. 183-92)
On April 26, 2012, the ALJ issued a decision, which denied Plaintiff benefits. (R. 22). The ALJ's decision became the final decision of the Commissioner on May 8, 2013, when the Appeals Council denied Plaintiff's request for review. (R. 1-5).
Plaintiff filed suit in this Court on June 25, 2013, seeking judicial review of the ALJ's decision. (ECF No. 3). The Commissioner filed an Answer on August 30, 2013. (ECF No. 5). Cross-motions for summary judgment followed. (ECF Nos. 8, 11).
Plaintiff was born January 1, 1984. (R. 153). He is a high school graduate with an Associate's Degree in culinary arts and food service and past relevant work experience as a fast-food worker and packer. (R. 157, 158, 317). However, he has not engaged in substantial gainful activity since his alleged disability onset date of May 1, 2010. (R. 13).
1. Medical Evidence
Plaintiff presented to Western Family Medicine Associates on April 30, 2010, with complaints of abdominal pain and was examined by a physician's assistant, Erin M. Aganad, PA-C. (R. 216). Plaintiff reported that his pain had been occurring persistently for two weeks and got worse with standing. (R. 216). He also reported having experienced fever, nausea, vomiting, and weight loss. (R. 216). During the course of the examination, Plaintiff admitted to using drugs for 10 years; he first used pain medications but then transitioned to heroin, which he claimed to have stopped using about two weeks prior to his appointment. (R. 216). Plaintiff also indicated that he had injected heroin after someone whom he knew had hepatitis. (R. 216). At the end of the examination, the physician's assistant told Plaintiff that he would benefit from suboxone or methadone treatment for his drug abuse and suggested that he go to the emergency room for a workup, as he was at high risk for contracting hepatitis and HIV. (R. 217). Blood work ordered by Plaintiff's physician, Kevin M. Wong, M.D., after the examination revealed elevated ALT/AST levels (10 times the normal limits). (R. 221). Moreover, testing for hepatitis C came back positive. (R. 22). On May 3, 2010, Viharika Bakshi, M.D., from Western Family Medicine, signed a Pennsylvania Department of Welfare Employability Assessment Form on Plaintiff's behalf, stating that he would be temporarily disabled from May 2010 until November 2010 due to abdominal pain. (R. 202).
Plaintiff began receiving methadone maintenance therapy at Medtech Rehabilitation LLC on May 12, 2010. (R. 297). The facility provided Plaintiff with daily doses of methadone and also provided 2.5 hours of monthly counseling. (R. 297).
Plaintiff was referred to Jaideep Behari, M.D., a specialist at the UPMC Center for Liver Diseases in Pittsburgh, Pennsylvania, for treatment of his hepatitis. (R. 221). Dr. Behari first examined Plaintiff on June 3, 2010. (R. 221). Plaintiff's major complaint was "profound fatigue." (R. 221). According to his notes, Dr. Behari suspected that Plaintiff had acute hepatitis C and ordered additional blood work to confirm his impression. (R. 222-23). Dr. Behari also advised Plaintiff that he would need to completely abstain from drugs and alcohol before he could begin receiving hepatitis treatment. (R. 223).
Plaintiff returned to Dr. Behari's office for a follow-up on July 29, 2010. (R. 254). Dr. Behari noted that the results of the blood work confirmed his initial diagnosis. (R. 254). A CT scan from May 2010 did not show cirrhotic liver or any other evidence of portal hypertension, however, and Plaintiff's chronic disease workup was otherwise unremarkable. (R. 254). Dr. Behari also noted that Plaintiff had abstained from using heroin since May 2010 and was still undergoing methadone maintenance therapy (40 mg. daily). (R. 254). Because Plaintiff had only been off drugs for a very short period of time, however, Dr. Behari recommended that he continue to ...