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Guillory v. Colvin

United States District Court, W.D. Louisiana, Lake Charles Division

January 30, 2018





         I. Background

         A. Procedural Background

         Terrence Paul Guillory ("Guillory") filed an application for disability insurance benefits ("DIB") on May 28, 2015, alleging a disability onset date of November 1, 2014 (Doc. 6-1, p. 139/495) due to reactive airway disease, tinnitus, post-traumatic stress disorder ("PTSD"), and a skin disorder (Doc. 6-1, p. 167/495). That application was denied by the Social Security Administration ("SSA") (Doc. 6-1, p. 87/495).

         A de novo hearing was held before an administrative law judge ("ALJ"), at which Guillory appeared with his attorney and a vocational expert ("VE") (Doc. 6-1, p. 42/495). The ALJ found that, although Guillory has severe impairments of eczema, asthma, and anxiety/PTSD, he has the residual functional capacity to do sedentary work that is unskilled, does not entail exposure to heat, odors, gases, fumes, or poorly ventilated areas, and does not require him to interact or communicate with the public (Doc. 6-1, pp. 16, 19/495). The ALJ also found there are jobs existing in significant numbers in the economy that Guillory can perform, such as document specialist (DOT 249.587.018, sedentary, SVP 2, 73, 000 jobs in the national economy) (Doc. 6-1, p. 26/495). The ALJ concluded that Guillory was not disabled, as defined in the Social Security Act, from November 1, 2014 through the date of her decision on July 25, 2016 (Doc. 6-1, pp. 25-26/495).

         Guillory requested a review of the ALJ's decision, but the Appeals Council declined to review it (Doc. 6-1, p. 4/495). The ALJ's decision became the final decision of the Commissioner of Social Security ("the Commissioner").

         Guillory next filed this appeal for judicial review of the Commissioner's final decision. On appeal, Guillory contends the Appeals Council erred in declining to review the ALJ's decision because Guillory submitted new and material medical evidence that created doubt as to whether the ALJ's decision was supported by substantial evidence (Doc. 7).

         The Commissioner filed a response to Guillory's appeal (Doc. 12) Guillory's appeal is now before the Court for disposition.

         B. Medical Records

         Guillory served in the United States Navy, the United States Navy Reserve, and the National Guard (Doc. 6-1, p. 185/495). Beginning April 1, 2012, Guillory received VA benefits for service-connected PTSD and unspecified depressive disorder, which were found to be 70% service- connected (Doc. 6-1, pp. 232, 236/495).

         In March 2012, the VA listed Guillory's problems as: dyspnea (shortness of breath); asthma, unspecified; depression, NOS; anxiety disorder; nicotine dependence; PTSD; and unspecified housing or economic circumstance (Doc. 6-1, pp. 258/495).

         In December 2012, Guillory's blood pressure was 133/81, he was 71 inches tall, and he weighed 216 pounds (Doc. 6-1, pp. 274, 451/495). Guillory was treated for PTSD, asthma, and an itchy rash on his arms and face (Doc. 6-1, p. 449/495). Guillory reported smoking half a pack of cigarettes per day (Doc. 6-1, p. 450/495). Guillory was taking Albuterol, Budesonide, Doxepin, Prazosin, and sertraline (Doc. 6-1, p. 450/495). Guillory had cracking on both palms and fingers due to eczema (Doc. 6-1, p. 453/495). Guillory also had a two-week old, diffuse, red rash on his face and arms, with some lichenification[2] (Doc. 6-1, pp. 450, 453/495). Guillory's rash was believed to be an allergic reaction and he was prescribed betamethasone and a Decadron Dose Pak (Doc. 6-1, p. 451/495). Guillory was strongly urged to stop smoking due to his asthma (Doc. 6-1, p. 451/495).

         In January 2013, Guillory reported his rash had resolved with the medication, but returned on his back, wrist, buttocks, and both legs, and he developed boils (Doc. 6-1, p. 448/495). By February the rash was widespread and inflamed (Doc. 6-1, p. 442/495). Guillory was prescribed Cipro (Doc. 6-1, p. 442/495). A week later, the rash was improved but not completely gone (Doc. 6-1, p. 437/495). It was determined the rash was probably a reaction to exposure to some chemical at work (Doc. 6-1, p. 437/495).

         In February 2013, during counseling, Guillory reported his PTSD and anxiety medications were not working; he was under a lot of stress; he was not able to relax or enjoy things: he had quit his job because he was allergic to something in that workplace; he was struggling with school and his grades were not good; and he had filed for bankruptcy (Doc. 6-1, p. 442/495). Guillory had also signed up for another 6 years with the National Guard (Doc. 6-1, p. 442/495). Guillory showed continued improvement in his PTSD symptoms (Doc. 6-1, p. 443/495). His appearance, speech, eye contact, posture, orientation, thoughts, affect, memory, concentration, judgment and insight were good, but his mood was anxious (Doc. 6-1, p. 443/495).

         A mental status exam in March 2013 showed Guillory was so hypervigilant at night that he fought against his sleep meds, so his medications were changed (Doc. 6-1, p. 433/495). Guillory's mood was irritable, and his affect was restricted in range (Doc. 6-1, p. 434/495). Guillory was diagnosed with depression, anxiety, and PTSD at Axis I, and a GAF of 65 at Axis V[3] (Doc. 6-1, p. 434/495). Guillory's Zoloft was increased, his Prazosin and Doxepin were continued, and Klonopin was started (Doc. 6-1, p. 434/495).

         In May 2013, Guillory again reported anxiety due to life-changing events: his grandfather, which whom he was very close, passed away; his home had burned down the month before! he and his family stayed in several different places for a month until they found a new place! and he was dismissed from school for failure to complete assignments due to lack of a computer for that month (Doc. 6-1, p. 430/495). However, Guillory said he would be able to resume classes (Doc. 6-1, p. 430/495). It was noted that Guillory was coping adequately with these challenges (Doc. 6-1, p. 430/495).

         In July 2013, Guillory reported stress due to moving and problems sleeping, and admitted he had been out of Zoloft and Klonopin for a week and had not been taking his sleep medicine (Doxepin) because there was so much going on and it made him tired (Doc. 6-1, p. 426/495). Klonopin was helping Guillory's irritability (Doc. 6-1, p. 426/495). Guillory's mood was "down" and his affect was constricted (Doc. 6-1, p. 426/495). Dr. Victor B. Bush, a psychiatrist, found Guillory had not been compliant with his medications, he was still dealing with the loss of his home in a fire, and his relationship with his wife was strained (Doc. 6-1, p. 427/495). Guillory was then 30 years old (Doc. 6-1, p. 428/495). Dr. Bush diagnosed depression, PTSD, and anxiety at Axis I; and a GAF of 60 at Axis V (Doc. 6-1, p. 427/495). Dr. Bush decreased Guillory's Doxepin and continued his other medications (Doc. 6-1, p. 427/495).

         In August 2013, Guillory's mood was still a little down and his affect constricted, he was compliant with treatment, he continued to have poor sleep and a depressed mood, and his anxiety was triggered by financial stressors (Doc. 6-1, p. 423/495). Dr. Bush again found Guillory's GAF was 60 (Doc. 6-1, p. 423/495). Guillory's Doxepin was discontinued and Hydroxyzine was prescribed (Doc. 6-1, p. 423/495).

         In September 2013, Guillory's restrictive lung disease and reactive airway dysfunction (diagnosed in April 2012) were evaluated (Doc. 6-1, p. 418/495). It was noted that Guillory had childhood asthma, was a current half-pack per day smoker, and had been exposed to dust, smoke, and other irritants in the Gulf War (Doc. 6-1, p. 418/495). Due to his lung disease, Guillory required intermittent inhalational bronchodilator therapy, intermittent use of inhalational anti-inflammatory medication, intermittent use of an oral bronchodilator, and antibiotics (Doc. 6-1, p. 418/495). Guillory's pulmonary function report was normal (pre-bronchodilator FEV-1/FVC of 80% and post-bronchodilator FEV-1/FVC of 84%) (Doc. 6-1, pp. 418-19/495). Guillory's mid-expiratory flow rates FEF were 25-75%, 62% suggestive of small airway disease (Doc. 6-1, p. 419/495). Guillory's small airway disease was found likely to be related to exposure events in Southwest Asia, since the onset of his respiratory symptoms was during his Gulf War deployment (Doc. 6-1, p. 419/495). Meter-dose inhalers were recommended (Doc. 6-1, p. 419/495).

         In October 2013, Guillory's mood and affect were anxious (Doc. 6-1, p. 416/495). Guillory explained he draws and paints, and plans to get an airbrush (Doc. 6-1, p. 416/495). Guillory lives with his wife and her four children, and his wife recently began working, which helped with the family finances "tremendously" (Doc. 6-1, p. 416/495). Guillory reported medication compliance (Doc. 6-1, p. 416/495).

         In November 2013, Guillory's mood and affect were anxious, but he showed improvement in his ability to manage his anger and his PTSD symptoms (Doc. 6-1, p. 415/495). Guillory reported stress and anger which appeared to emanate from family issues and the holiday season (Doc. 6-1, p. 414/495). Guillory admitted he had not been taking his medications, in part because they had been changed and he was waiting for the new ones to arrive (Doc. 6-1, p. 414/495). Guillory and his wife agreed to take the children in for counseling, also (Doc. 6-1, p. 414/495), which they did in December (Doc. 6-1, pp. 412-13/495).

         In January 2014, Guillory said he was discouraged about his children's behavior and felt misunderstood by his wife (Doc. 6-1, p. 411/495). Guillory admitted he had never receive his medications and had not taken any in about 6 weeks, so the doctor's office re-ordered them (Doc. 6-1, p. 411/495). When he still had not received his medications two weeks later, it was discovered they were being mailed to his old post office box and the Post Office had the packages (Doc. 6-1, p. 410/495).

         In February 2014, Guillory's blood pressure was 124/82 and he weighed 221 pounds (BMI 35) (Doc. 6-1, pp. 267, 399/495). In his PTSD reassessment, Guillory reported having repeated disturbing memories, thoughts, or images "quite a bit;" repeated disturbing dreams-a little bit; suddenly feeling as if the stressful experience was happening again-moderately; feeling very upset when something reminds him of the stressful experience-quite a bit; having physical reactions when something reminds him of the stressful experience-quite a bit; avoiding thinking about or having feeling related to the stressful experience-extremely; avoiding activities of situations that remind him of the stressful experience-extremely; loss of interest in activities he used to enjoy-quite a bit; feeling distant or cut off from others-moderately; feeling emotionally numb-moderately; feeling as hit his future will somehow be cut short-moderately; trouble falling or staying asleep-extremely; feeling irritable or having angry outbursts-extremely; having difficulty concentrating-quite a bit; being "super-alert, " watchful, or on guard-extremely; and feeling jumpy or easily startled-extremely (Doc. 6-1, pp. 401-02/495). These things had made it very difficult for Guillory to work, take ...

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