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Detar v. Colvin

United States District Court, M.D. Pennsylvania

March 31, 2015


MEMORANDUM Docs. 1, 5, 6, 7, 9

GERALD B. COHN, Magistrate Judge.


I. Procedural Background

On December 13, 2010, Plaintiff filed an application for disability insurance benefits ("DIB") and supplemental security income ("SSI") under the Social Security Act, 42 U.S.C. §§401-433, 1382-1383 (the "Act"). (Tr. 161-73). On March 7, 2011, the Bureau of Disability Determination denied these applications (Tr. 72-91), and Plaintiff filed a request for a hearing on May 2, 2011. (Tr. 114). On April 4, 2012, an ALJ held a hearing at which Plaintiff-who was represented by an attorney-and a vocational expert ("VE") appeared and testified. (Tr. 31-63). On June 11, 2012, the ALJ found that Plaintiff was not disabled and not entitled to benefits. (Tr. 8-30). On July 23, 2012, Plaintiff filed a request for review with the Appeals Council (Tr. 7), which the Appeals denied on October 18, 2013, thereby affirming the decision of the ALJ as the "final decision" of the Commissioner. (Tr. 1-6).

On December 11, 2013, Plaintiff filed the above-captioned action pursuant to 42 U.S.C. § 405(g) to appeal the decision of the Commissioner. (Doc. 1). On February 18, 2014, the Commissioner filed an answer and administrative transcript of proceedings. (Docs. 5, 6). On April 1, 2014, Plaintiff filed a brief in support of his appeal ("Pl. Brief"). (Doc. 7). On May 1, 2014, Defendant filed a brief in response ("Def. Brief"). (Doc. 9). On July 16, 2014, the parties consented to transfer of this case to the undersigned for adjudication. (Doc. 12, 13, 14). The matter is now ripe for review.

II. Standard of Review

When reviewing the denial of disability benefits, the Court must determine whether substantial evidence supports the denial. Johnson v. Comm'r of Soc. Sec., 529 F.3d 198, 200 (3d Cir. 2008); Brown v. Bowen, 845 F.2d 1211, 1213 (3d Cir. 1988). Substantial evidence is a deferential standard of review. See Jones v. Barnhart, 364 F.3d 501, 503 (3d Cir. 2004). Substantial evidence "does not mean a large or considerable amount of evidence, but rather such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'" Pierce v. Underwood, 487 U.S. 552, 565 (1988) (quoting Consol. Edison Co. of New York v. N.L.R.B., 305 U.S. 197, 229 (1938)). In other words, substantial evidence requires "more than a mere scintilla" but is "less than a preponderance." Jesurum v. Sec'y of U.S. Dep't of Health & Human Servs., 48 F.3d 114, 117 (3d Cir. 1995) (citing Richardson v. Perales, 402 U.S. 389, 401 (1971)).

III. Sequential Evaluation Process

To receive disability or supplemental security benefits, a claimant must demonstrate an "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 423(d)(1)(A); 42 U.S.C. § 1382c(a)(3)(A). The Act requires that a claimant for disability benefits show that he has a physical or mental impairment of such a severity that:

He is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work.

42 U.S.C. § 423(d)(2)(A); 42 U.S.C. § 1382c(a)(3)(B).

The Commissioner uses a five-step evaluation process to determine if a person is eligible for disability benefits. See 20 C.F.R. § 404.1520; see also Plummer v. Apfel, 186 F.3d 422, 428 (3d Cir. 1999). If the Commissioner finds that a Plaintiff is disabled or not disabled at any point in the sequence, review does not proceed. See 20 C.F.R. § 404.1520. The Commissioner must sequentially determine: (1) whether the claimant is engaged in substantial gainful activity; (2) whether the claimant has a severe impairment; (3) whether the claimant's impairment meets or equals a listed impairment from 20 C.F.R. Part 404, Subpart P, Appendix 1 ("Listing"); (4) whether the claimant's impairment prevents the claimant from doing past relevant work; and (5) whether the claimant's impairment prevents the claimant from doing any other work. See 20 C.F.R. §§ 404.1520, 416.920. Before moving on to step four in this process, the ALJ must also determine Plaintiff's residual functional capacity ("RFC"). 20 C.F.R. §§ 404.1520(e), 416.920(e).

The disability determination involves shifting burdens of proof. The claimant bears the burden of proof at steps one through four. If the claimant satisfies this burden, then the Commissioner must show at step five that jobs exist in the national economy that a person with the claimant's abilities, age, education, and work experience can perform. Mason v. Shalala, 994 F.2d 1058, 1064 (3d Cir. 1993). The ultimate burden of proving disability within the meaning of the Act lies with the claimant. See 42 U.S.C. § 423(d)(5)(A); 20 C.F.R. § 416.912(a).

IV. Relevant Facts in the Record

Plaintiff was born on September 17, 1984 and was classified by the Regulations as a younger individual through the date of the ALJ decision. (Tr. 25). 20 C.F.R. § 404.1563. Plaintiff has a limited education and past relevant work as a shift manager, cashier, and dishwasher. (Tr. 25). Plaintiff's appeal addresses only the ALJ's assessment of his seizures and mental impairments, and the Court will limit its discussion accordingly.

A. Function Report and Testimony

On January 11, 2011, Plaintiff submitted a Function Report. (Tr. 241-51). He reported that pain interferes with his sleep but not his personal care. (Tr. 242). He indicated that he can use public transportation and go out alone, but cannot drive because of epilepsy and a brain tumor. (Tr. 244). He reported that he does not spend time with others and does not go anywhere on a regular basis. (Tr. 245). He indicated problems walking, standing, and lifting due to epilepsy and memory and concentration due to his brain tumor. (Tr. 246). He indicated that he did not have problems getting along with others, but does not follow written instructions very well and cannot pay attention for "long." (Tr. 246). He reported that he gets along with authority figures "pretty good, " had never been fired from a job due to problems getting along with others, and handles changes in routine "very well." (Tr. 247). However, he indicated that he does not handle stress well. (Tr. 247). He also reported constant pain from seizures and headaches from his brain tumor. (Tr. 249). He reported that he had seizures once or twice a week, three to four times per month, despite taking medications. (Tr. 251).

On April 4, 2012, Plaintiff appeared and testified before the ALJ. (Tr. 38). He testified that he did not have a drivers license due to epilepsy and legal problems. (Tr. 38). He testified that he "average[d]... two to three seizures a week" since starting Keppra in 2009. (Tr. 45). He testified that he had only been "seizure free for a little short of a month" after starting Keppra. (Tr. 45). He testified that his depression caused him to be overwhelmed and lose interest in activities. (Tr. 47). Plaintiff's fiance testified that, "over the last couple of years, " he had "roughly two [seizures] a month, " and "sometimes six a month." (Tr. 52-53).

B. Medical Records

Plaintiff began reporting seizures in 2008. (Tr. 264). On November 4, 2008, an MRI of Plaintiff's brain was negative except for a "small right pituitary microadenoma." (Tr. 264).

On April 26, 2010, Plaintiff presented to Dr. Brian Burke, M.D., at Bellefonte Family Practice, after being released from jail. (Tr. 269). Dr. Burke noted that Plaintiff's "brain abnormality on MRI" was "not felt to be causing symptoms." (Tr. 269). Plaintiff had been "tolerating medications well." (Tr. 269). Plaintiff was "aware that he does not meet criteria for disability but he has hired a lawyer to get disability from SSI." (Tr. 269). Plaintiff did not mention any problems with seizures. (Tr. 269-70).

On May 20, 2010, Plaintiff presented to Dr. Muhammad Qamar, M.D., at Universal Community Behavioral Health Outpatient Clinic ("Universal"). (Tr. 294). Plaintiff had been seeing Dr. Qamar, but had stopped coming for a few months, so he was being evaluated at a "new patient." (Tr. 294). Plaintiff reported symptoms of depression and post-traumatic stress disorder ("PTSD"). (Tr. 294-95). On mental status examination, his mood was "depressed and anxious" but his general appearance, motor activity, and speech were normal, his thought process was logical, his IQ, insight, and judgment were fair, and his "capacity for activities of daily living" was "good." (Tr. 296). Plaintiff was diagnosed with major depressive disorder secondary to brain tumor and PTSD and assessed a GAF of 50, with the highest GAF in the past year of 70. (Tr. 297). Plaintiff was prescribed Zoloft for depression, Prazosin for nightmares, and Vistaril for anxiety. (Tr. 297). On June 3, 2010, Plaintiff reported that the medications were "helping him" and Dr. Qamar observed that he was "stable on his medications." (Tr. 299). His mood was "fine" and his mental status examination was otherwise normal. (Tr. 299). His medications were continued except for Prazosin, which was increased due to some continued nightmares. (Tr. 299).

On June 7, 2010, an MRI of Plaintiff's brain was negative except for "one or two tiny new focal areas of increased FLAIR signal in the deep white matter, probably small vessel ischemic disease." (Tr. 281).

On July 8, 2010, Plaintiff followed-up with Dr. Qamar. (Tr. 300). He had missed an appointment on July 1, 2010 and ran out of medication, so he reported increased symptoms. (Tr. 300). He stated that "when he was taking his medications he did very good and would like to continue the same medications." (Tr. 300). His mood was "fine" and his mental status examination was otherwise normal. (Tr. 300). Plaintiff's medications were continued. (Tr. 300). On September 13, 2010, Plaintiff reported that his "last seizure was in June." (Tr. 382).

On February 4, 2011, Plaintiff had a consultative examination with Dr. Dana Irwin, PhD. (Tr. 303). Plaintiff reported that his fiance had multiple sclerosis, was ambulatory with a cane, and received SSI, so he had assumed most domestic tasks in their residence. (Tr. 304). He reported social isolation since his ...

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