United States District Court, M.D. Pennsylvania
LINDA SAVAGE, 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 Supplemental Security Income benefits under Title XVI of the Social Security Act. Plaintiff contends that the administrative decision, concluding that she has not been disabled since March 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 March 25, 2010, Plaintiff, Linda Savage, protectively filed for Supplemental Security Income ("SSI") benefits under Title XVI of the Social Security Act. (Doc. 8-3, p. 12 of 13; Doc 8-2, p. 17 of 46.) In her application for SSI, Plaintiff claimed that she had been disabled since March 1, 2010. (Doc. 8-5, p. 2 of 14.) On June 9, 2010, the Social Security Administration initially denied Plaintiff's claim. (Doc. 8-4, p. 6 of 63.)
Upon Plaintiff's request, a hearing was held before ALJ Patrick Cutter on July 20, 2011, during which both Plaintiff and Patrick Anderson, a vocational expert, provided testimony. (Doc 8-2, pp. 22-23 of 46.) On September 22, 2011, the ALJ denied Plaintiff's claim, finding that Plaintiff was not entitled to SSI benefits. ( Id. at p. 9 of 46.) Plaintiff filed an appeal with the Appeals Council ( id. at p. 7 of 46) which denied review on January 18, 2013, leaving the ALJ's decision as the final decision of the Social Security Commissioner ( Id. at pp. 2-5 of 46). Consequently, Plaintiff commenced the instant action in this court on March 25, 2013. (Doc. 1.)
B. Plaintiff's General Background
At the time of the hearing, Plaintiff was 31 years old (Doc. 8-2, p. 30 of 46) and was considered a "younger person" whose age would not seriously affect her ability to adjust to other work. See 20 C.F.R. § 404.1563(c). Plaintiff resided with her boyfriend and four of her five children, who ranged in age from 18 months to 11 years old. ( Id. at pp. 30-31, 35 of 46.) She had a limited education,  having completed school through the 9th grade (Doc. 8-2, p. 30 of 46), and she did not have a driver's license, nor had she ever attempted to obtain one. ( Id. at p. 30 of 46.) Her past work history, which did not include working at the level of substantial gainful activity, included working as a kitchen helper, waitress, and fast food cook. ( Id. at p. 43 of 46.)
C. Medical Records
Plaintiff has received medical treatment for hereditary angioedema and scoliosis. ( See Doc. 8-8, pp. 59-60, 70-71 of 90; Doc 8-10, p. 33-35 of 90.) On November 2, 2010, Plaintiff went to the emergency room ("ER") at the Carlisle Regional Medical Center, complaining of lower back pain. (Doc. 8-10, p. 35 of 90.) On a scale of 0 through 10, with 0 representing no pain and 10 representing severe pain, Plaintiff rated her back pain at a 10. ( See id. ) A registered nurse, Tim Schuler, noted that Plaintiff, despite being in pain, was able to ambulate without difficulty and could "perform all activities of daily living without assistance." ( Id. at pp. 33-34 of 90.) Plaintiff was prescribed cyclobenzaprine and Naprosyn for her back pain. ( Id. at p. 37 of 90.) Additionally, Plaintiff started physical therapy at the Drayer Physical Therapy Institute ("Drayer") to address her lower back pain. ( Id. at p. 20 of 90.) Drayer's records show that while Plaintiff has decreased joint mobility, range of motion, and strength, these limitations did not prevent her from being able to work. ( See id. ) Furthermore, an individualized plan was developed to address these limitations. ( See id. at pp. 21-24 of 90.)
Plaintiff also suffers from exacerbations ("flare-ups") of her angioedema. ( See Doc. 8-7, p. 33 of 55; Doc. 8-8, pp. 59-60, 70-71 of 90.) In 2006, Plaintiff experienced an acute flare-up of her angioedema. (Doc. 8-7, p. 33 of 55.) Her neck became swollen, requiring an emergency tracheostomy and intubation at Hershey Medical Center ("Hershey") to ensure that her airway remained open. ( See id. at p. 33 of 55.) On August 22, 2008, Plaintiff suffered another flare-up of her angioedema that also required intubation. ( See Doc. 8-8, pp. 70-71 of 90.) After she was discharged from Hershey, Plaintiff was ordered to start C1-inhibitor therapy for prophylactic treatment of her angioedema. (Doc. 8-7, p. 33 of 55.) Flare-ups, however, continued to send Plaintiff to the ER several more times in the following months, although only one visit resulted in an intubation. ( See Doc. 8-8, pp. 59-60 of 90.) For the other ER visits, Plaintiff's flare-ups could be controlled through medication. ( See Doc. 8-7, pp. 33-35 of 55.)
In 2010, Hershey's medical records showed that Plaintiff's last intubation was in 2008 and that her most recent flare-ups were not severe enough to require intubation. (See Doc. 8-10, pp.84-85 of 90.) The records also showed that Plaintiff experienced mild flare-ups "every two weeks per self report." ( Id. ) On February 21, 2010, Plaintiff's medical records showed that she was taking Amicar for prophylactic treatment of her angioedema. (Doc. 8-9, p. 73 of 121.) On November 23, 2010, Dr. Jhaveri noted that Plaintiff was no longer receiving C1-inhibitor therapy. (Doc. 8-10, p. 17 of 90.) Dr. Jhaveri also noted that Amicar had failed to adequately treat Plaintiff's flare-ups of angioedema and considered starting Plaintiff on Cinryze. Plaintiff started Cinryze in place of Amicar in early December of 2010. ( Id. at p. 18 of 90.) On December 29, 2010, Dr. Jhaveri noted that "[s]ince starting Cinryze, [Plaintiff] has had no angioedema attacks." ( Id. at 17 of 90.)
D. Hearing Testimony
Prior to testimony being given, Plaintiff requested that the ALJ reopen her prior SSI claim that she had filed on May 15, 2009. (Doc. 8-2, pp. 26-27 of 46.) Once Plaintiff began testifying, Plaintiff described how her hereditary angioedema affects her. ( See id. at p. 31 of 46.) According to Plaintiff, her flare-ups cause various parts of her body to swell approximately once a week, for a period of three days. ( Id. at pp. 32-34 of 46.) Plaintiff testified that these flare-ups have worsened with age and that when she is swollen she "just stay[s] home and deal[s] with it." ( Id. at pp. 34, 37 of 46.) During the hearing, Plaintiff's counsel noted that Plaintiff was currently experiencing a flare-up: "[I]f you... observe her feet and her hands, there is some slight swelling." ( Id. at p. 29 of 46.) To control her angioedema, Plaintiff takes Cinryze, although she does not take any additional medication during her flare-ups. ( Id. at p. 32 of 46.)
Plaintiff also testified that pain is associated with her flare-ups. ( Id. at p. 39 of 46.) Plaintiff stated that "my whole foot [hurts] right now. It's swollen, you know, because it's a big swelling." ( Id. at p. 40 of 46.) Plaintiff rated her pain level at a 7 or 8 out of 10 while sitting and a 10 while walking. ( Id. at p. 39 of 46.) Plaintiff denied being able to work during a flare-up and stated that she quit her previous job at All American Plazas in 2002 because "they wouldn't let me take the days off I needed when I was swollen." ( Id. at pp. 31, 36 of 46.)
Plaintiff further described the symptoms she experiences during her flare-ups. ( Id. at p. 32, 37.) She testified that, since beginning Cinryze, she has not had any "throat attacks, " but continues to have outbreaks of swelling in other parts of her body, primarily in her hands and feet. ( Id. at p. 32 of 46.) Plaintiff added that the swelling could affect "my one foot or my one hand. I can never tell what it's ever gonna be." ( Id. ) Plaintiff testified that she has been experiencing flare-ups once a week for the past few years, going back at least until May of 2009. ( Id. at p. 37 of 46.)
Plaintiff described a typical day for herself as waking at 8 a.m. ( Id. at p. 34 of 46.) After arising, Plaintiff prepares breakfast for her children and helps them gets dressed. ( Id. at pp. 34-35 of 46.) She then performs household activities such as washing dishes. ( Id. at p. 34 of 46.) Plaintiff shares the responsibility of grocery shopping with her boyfriend. ( Id. ) On days when she has flare-ups, Plaintiff still rises at 8 a.m. ( Id. ) However, Plaintiff testified that she will "stay on the couch more... I'm probably not even on my feet an hour." ( Id. at p. 34, 39 of 46.) Plaintiff admitted that she is able to walk while her feet are swollen but stated that she will not perform household activities or cook meals for her children. ( Id. at pp. 35-36 of 46.) Instead, Plaintiff will heat already prepared meals in the microwave and have the children ...