United States District Court, W.D. Pennsylvania
REPORT AND RECOMMENDATION Re: ECF Nos. 17 and 21
MAUREEN P. KELLY, Magistrate Judge.
Kristi Kae Kiefer ("Plaintiff") brings this action pursuant to 42 U.S.C. § 405(g), seeking judicial review of the final decision of the Commissioner of Social Security ("Defendant" or "Commissioner") denying her application for disability insurance benefits ("DIB") and supplemental security income ("SSI") under Titles II and XVI of the Social Security Act ("the Act"). 42 U.S.C. §§ 401-403; 1381-1383f. This matter is before the Court on cross-motions for summary judgment filed by the parties pursuant to Federal Rule of Civil Procedure 56. (ECF Nos. 17, 21). For the reasons that follow, it is respectfully recommended that Plaintiff's motion for summary judgment (ECF No. 17) be denied, that Defendant's motion for summary judgment (ECF No. 21) be granted, and that the Commissioner's decision be affirmed.
II. PROCEDURAL HISTORY
On April 13, 2009, Plaintiff applied for DIB and SSI alleging that she became disabled on October 7, 2006. (R. at 137-140). Her alleged disabling impairments were depression, anxiety, right wrist pain, hip pain, and hepatitis C. (R. at 60). Both claims were denied on June 25, 2009. (R. at 73, 85). An administrative hearing was held on October 15, 2010 before Administrative Law Judge ("ALJ") John Porter. (R. at 33). Plaintiff's claims were denied by the ALJ in a decision dated January 27, 2011. (R. at 16-26). On June 27, 2012, the Appeals Council denied Plaintiff's request for review of the ALJ's decision, at which time the ALJ's decision became the final decision of the Commissioner. (R. at 1). Plaintiff filed a complaint in this Court on September 14, 2012. (ECF No. 3). Plaintiff and Defendant filed motions for summary judgment on September 23, 201 and November 22, 2013, respectively. (ECF Nos. 17, 21). The cross-motions for summary judgment are now ripe for consideration.
III. STATEMENT OF THE CASE
A. Employment History
Plaintiff worked as a waitress from April of 1994 to November of 2005 (medium work, unskilled). (R. at 51-52, 161). She worked as a merchandise processor from February of 2006 to October 17, 2006 (light to medium work, unskilled). ( Id. ). On her disability report form she indicated that she quit working because she "couldn't do it anymore." (R. at 160).
B. Medical Treatment History
1. Hepatitis C
Plaintiff was seen by Donald A. Walters, D.O., on September 30, 2008. (R. at 220). Dr. Walters ordered tests to rule out hepatitis C. ( Id. ). She returned on October 23, 2008 and Dr. Walters concluded that she was not infected with the hepatitis C virus at that time. (R. at 217). Dr. Walters cautioned that Plaintiff could become infected again if she was re-exposed. ( Id. ).
2. Mental Health
Plaintiff was treated in the Emergency Department at Butler Memorial Hospital ("Butler Memorial") on October 13, 2006 after she abruptly stopped taking four prescribed medications: Valium, Klonopin, Effexor and Seroquel. (R. at 278-279). She was diagnosed with anxiety and medication noncompliance. (R. at 282). Plaintiff was discharged with instructions to call her psychiatrist. (R. at 284).
Two months later, on December 18, 2006, Plaintiff was transported by ambulance and involuntarily admitted to Butler Memorial. (R. at 264-268, 274). She was diagnosed with polysubstance dependence. (R. at 269).
Plaintiff was admitted to a drug and alcohol treatment program at Glade Run Lutheran Services ("Glade Run") on June 30, 2008. (R. at 199). She continued with the program as an outpatient through 2010. (R. at 313). As part of the Glade Run program, Linda Humphreys, M.D., a board certified psychiatrist, completed a Psychiatric Evaluation of Plaintiff on August 27, 2008. (R. at 199). Dr. Humphreys thoroughly documented Plaintiff's past psychiatric history, including her extensive history of drug use. ( Id. ). Plaintiff started drinking alcohol when she was fourteen years old and later began smoking marijuana. ( Id. ). She developed a habit of snorting OxyContin and five years later she began using heroin intravenously. ( Id. ). Dr. Humphreys noted that from April 10, 2003 to December 16, 2006, Plaintiff was receiving drug and alcohol counseling at Irene Stacy Community Mental Health Center but was thrown out of the program because she was stealing on the premises. ( Id. ). Dr. Humphreys also noted that, from the age of 14 until 31, her age at the time of the evaluation, Plaintiff had participated in numerous other inpatient and outpatient drug and alcohol rehabilitation programs. ( Id. ).
Dr. Humphreys conducted a mental status examination of Plaintiff. Dr. Humphreys observed that Plaintiff was alert and fully oriented with a euthymic mood and affect. (R. at 200). Plaintiff denied any symptoms from severe depression but stated "[s]ome days I get down." ( Id. ). She reported symptoms of Obsessive-Compulsive Disorder ("OCD") including: excessive hand washing; worrying she would infect somebody with an unknown disease contracted while sharing needles; checking to make sure doors were closed; and making certain that her dog was ok. ( Id. ). Her cognitive function was within normal limits and she was proud of her sobriety. ( Id. ).
Dr. Humphreys found no evidence of Bipolar Affective Disorder. (R. at 201). Plaintiff's history of impulsivity and high-risk behaviors was potentially attributed to Attention Deficit Hyperactivity Disorder ("ADHD") coupled with OCD traits. ( Id. ). Dr. Humphreys diagnosed Plaintiff with the following: ADHD, combined type; Opioid Dependence, early recovery; rule-out OCD; OCD personality traits; and hypothyroidism. (R. at 201). Her current and highest Global Assessment Functioning score for the past year was 48. ( Id. ). Continued outpatient therapy, aerobic exercise and a trial of Strattera were recommended. ( Id. ).
After the initial evaluation, Plaintiff was seen on an ongoing basis by Patricia Thomas, M.A., her assigned therapist at Glade Run. (R. at 335). Plaintiff was seen periodically by Dr. Humphreys.
On November 3, 2008, Plaintiff was again seen by Dr. Humphreys at Glade Run. (R. at 198). Plaintiff stated that she was feeling better and had tested negative for hepatitis. (R. at 198). On June 17, 2009, Therapist Thomas noted that Plaintiff's OCD traits had diminished. (R. at 335). Plaintiff was not able to get a full night of sleep. ( Id. ). Plaintiff reported increased frustration, difficulty concentrating, and depression. ( Id. ).
On August 13, 2009, Plaintiff told Dr. Humphreys "my life's good now." (R. at 334). She experienced periods of agitation, racing thoughts, and anger. ( Id. ). Plaintiff also reported that she was resuming classes in the fall. ( Id. ). Dr. Humphreys noted that Plaintiff had maintained her sobriety for eighteen months. ( Id. ). Therapist Thomas noted on August 13, 2009 that Plaintiff suffered from racing thoughts, depression, and difficulty concentrating but was maintaining sobriety. (R. at 333). Dr. Humphreys signed a psychiatric evaluation on August 13, 2009. (R. at 330-332). This evaluation is identical to the evaluation she signed on August 27, 2008. (R. at 199, 330-332). It appears to be have been reprinted and assigned a new date. (R. at 199, 330).
A note completed by Dr. Humphreys on August 27, 2009 indicated that Plaintiff's moods were "up and down" - "a bit more" down than up. (R. at 329). Plaintiff was prescribed Wellbutrin. ( Id. ). On September 23, 2009, she complained to Dr. Humphreys and Therapist Thomas that Wellbutrin made her nauseous and she had stopped taking it. (R. at 326-327). Her OCD was "much better" but she suffered from erratic sleep. ( Id. ). Dr. Humphreys prescribed Seroquel. (R. at 327). Seroquel was effective in controlling Plaintiff's racing thoughts and helped her sleep. (R. at 323). In October, 2009, she reported difficulty focusing in school and Dr. Humphreys prescribed Tenex to treat ADHD. (R. at 323-324). On October 30, 2009 she told Therapist Thomas that "school is not for her." (R. at 322). Therapist Thomas noted that Plaintiff did not report any attention problems. ( Id. ). On November 23, 2009, Plaintiff told Dr. Humphreys that school was "better" and she was not as moody. (R. at 321). On January 28, 2010, Plaintiff reported that she stopped taking Tenex due to "excessive fatigue". (R. at 319). She saw improvement after her dosage of Synthroid was increased. ( Id. ). From January through April 2010, Therapist Thomas noted that Plaintiff was doing well in school (R. at 316). Financial difficulties in April 2010 forced her to cut back on Suboxone and she was feeling tired. ( Id. ).
On April 23, 2010, Plaintiff told Dr. Humphries that her boyfriend attempted to strangle her and her mother kicked her out of the house. (R. at 314). Her ex-boyfriend was arrested on drug charges and Plaintiff was charged with assault stemming from their domestic altercation. (R. at 314-316). She found a new place to live and was looking for work. ( Id. ).
On June 3, 2010 Plaintiff did not show for her appointment with Dr. Humphreys. (R. at 312). Dr. Humphreys noted that given Plaintiff's recent problems and interpersonal conflicts the possibility of a substance abuse relapse must be considered. (R. at 312). Therapist Thomas spoke with Plaintiff who reported that she had gone off her medications and flunked out of school for the semester. (R. at 311). After failing to return to Glade Run for treatment, Plaintiff was discharged from treatment at Glade Run on September 15, 2010. (R. at 309). Her whereabouts were listed as "unknown." ( Id. ).
While Plaintiff was receiving treatment at Glade Run, she was also seen by psychologists Martin Meyer, Ph.D., and Julie Uran, Ph.D., of Vocational Psychological Services, on May 13, 2009. (R. at 377). Plaintiff's Intelligence Quotient ("IQ") was assessed as follows: a verbal IQ of 76 (fifth percentile); a performance IQ of 85 (sixteenth percentile); and a full scale IQ of 78 (seventh percentile). (R. at 377). A letter by Dr. Meyer and Dr. Uran to Plaintiff's attorney stated that a "pragmatic interpretation of these results suggests an individual with below average intelligence and expectations would be that she would be slow in assimilating new information." ( Id. ).
3. Heroin Addiction
On December 3, 2008, soon after commencing participation in the Glade Run treatment program in June 2008, Plaintiff began medical treatment for heroin addiction with Richard Schollaert, M.D., of Sewickley Valley Medical Group Internal Medicine Associates. (R. at 206). She was prescribed Suboxone. (R. at 205). On January 2, 2009, Plaintiff reported to Dr. Schollaert that she was "felling well." ( Id. ). At her next visit on February 26, 2009 Plaintiff's condition remained "well." (R. at 204). She returned on April 24, 2009 reporting that she was "generally feeling well" and had not used narcotics. (R. at 204).
On June 23, 2009, Plaintiff stated that she was pregnant. (R. at 345). Dr. Schollaert discussed treatment with Subutex and the possibility of tapering off Suboxone but she did not think she was ready. ( Id. ). On August 18, 2009, Plaintiff told Dr. Schollaert that she had suffered a miscarriage. ( Id. ). Her medications were not changed. ( Id. ). On October 15, 2009, Plaintiff had started school again and was "feel[ing] well." (R. at 344). She returned on December 11, 2009 complaining of stress from school. (R. at 343). Dr. Schollaert opined that she appeared to be "doing well and feeling a lot better about herself." ( Id. ). On February 5, 2010, Plaintiff reported that she was feeling depressed and was thinking of dropping out of school. ( Id. ). She was prescribed Zoloft and instructed to call the doctor in three weeks to report her progress. ( Id. ). Dr. Schollaert's notes from April 2, 2010 indicate that Plaintiff was feeling better, her depression was improved, and she was attending school. (R. at 342). She continued taking Suboxone. ( Id. ).
Plaintiff returned on May 27, 2010 and reported physical abuse by her boyfriend. (R. at 341). After throwing a chair at him she spent the day in jail. ( Id. ). She was still attending a drug and alcohol support group but had dropped out of school. ( Id. ). Her dosage of Suboxone was low and she was thinking of using narcotics again. ( Id. ).
Dr. Schollaert saw Plaintiff again on July 22, 2010. (R. at 339). Plaintiff told him that things were "going very well". (R. at 339). He continued the Suboxone therapy. ( Id. ).
Plaintiff began treatment for hyperthyroidism with Fozia Chatta, M.D., in 2008. (R. at 350). She was prescribed Synthroid to treat the condition. (R. at 350-351). Dr. Chatta advised that she would check her thyroid stimulating hormones ("TSH") level again in six to eight weeks. (R. at 352). On June 30, 2009, Plaintiff's THS level was elevated and Dr. Chatta increased her dosage of Synthroid. (R. at 353). Although Plaintiff was emotional due to her miscarriage, she was doing well otherwise. ( Id. ). Plaintiff explained that she was unable to work due to her treatments for addiction and hepatitis C. ( Id. ). Her TSH level remained elevated on September 2, 2009 and her dosage of Synthroid was increased. (R. at 354). She returned on March 9, 2010 complaining of fatigue and depression. (R. at 355). Dr. ...