United States District Court, W.D. Louisiana, Lake Charles Division
REPORT AND RECOMMENDATION
H.L. Perez-Montes United States Magistrate Judge
Thibodeaux Brasseaux (“Brasseaux”) filed an
application for disability insurance benefits
(“DIB”) on December 26, 2013, alleging a
disability onset date of October 1, 2012 (Doc. 5-1, p.
168/259) due to fibromyalgia, depression, and anxiety (Doc.
5-1, p. 190/259). That application was denied by the Social
Security Administration (“SSA”) (Doc. 11-1, p.
de novo hearing was set for March 2015 before an
administrative law judge (“ALJ”). Brasseaux
appeared with her attorney and a vocational expert
(“VE”) (Doc. 11-1, p. 59/259). At the start of
the hearing, Brasseaux amended her disability onset date from
October 1, 2012 to January 1, 2007, and asked for a
continuance in order to gather and submit additional medical
records (Doc. 11-1, p. 64/259). The hearing was postponed
(Doc. 5-1, p. 64/259).
rescheduled de novo hearing was held before an ALJ
in May 2015. Brasseaux appeared with her attorney (Doc 5-1,
p. 36/259). The ALJ found that Brasseaux met the insured
status requirements through December 31, 2012, and through
that date she had severe impairments of disorder of the
cervical spine, disorder of the lumbar spine, fibromyalgia,
and obesity (Doc 5-1, p. 21/259). The ALJ further found
Brasseaux had the residual functional capacity to do the full
range of light work and could perform her past relevant work
as a sales counselor through the date last insured (Doc. 5-1,
pp. 24, 27/259). The ALJ concluded that a finding of
“not disabled” was directed by Medical-Vocational
Rule 202.21 of 20 C.F.R. Pt. 404, Subpt. P, Appendix 2
("the grids") (Doc. 5-1, p. 28/259). Therefore,
Brasseaux was not under a "disability" as defined
in the Social Security Act at any time from January 1, 2007
through December 31, 2012, the date last insured (Doc. 5-1,
requested review of the ALJ's decision, but the Appeals
Council declined to review it (Doc. 5-1, p. 8/259). The
ALJ's decision became the final decision of the
Commissioner of Social Security (“the
next filed this appeal for judicial review of the
Commissioner's final decision. The sole issue raised by
Brasseaux on appeal is whether the Commissioner properly
evaluated the post-hearing treating source medical opinions
from Dr. Phillip Landry and Dr. Jason Morris, regarding
Brasseaux's functional abilities prior to her date last
insured (December 31, 2012) (Doc. 8).
Commissioner responded to Brasseaux's appeal (Doc. 9),
and Brasseaux filed a reply (Doc. 10). Brasseaux's appeal
is now before the Court for disposition.
2004 through 2010, Brasseaux was treated for depression and
anxiety by Dr. Phillip A. Landry, a psychiatrist, and was
prescribed Wellbutrin, Lexapro, Xanax, and Lunesta (Doc. 5-2,
pp. 455-474, 789-796/998). In September 2005, Dr. Landry
noted Brasseaux was “stressed out” from Hurricane
Rita, her job (at a funeral home), overwhelmed, unable to
handle stress, depressed, unable to sleep, and planning to
resign from her job (Doc. 5-2, p. 472/998). Dr. Landry
increased her Lexapro and Xanax (Doc. 5-2, p. 472/998).
January 2006, Brasseaux had successfully returned to her job,
but was very depressed, anxious, and grieving from the recent
death of her brother, having difficulty going to work, and
having difficulty sleeping (Doc. 5-2, pp. 471, 789/998).
Brasseaux planned to apply for short-term disability (Doc.
5-2, p. 471/998). In July 2006, Brasseaux was recovered from
her depression, had resigned from her job at the funeral
home, and planned to go to school to become a contractor
(Doc. 5-2, p. 468/998). Dr. Landry found she was “doing
very well” (Doc. 5-2, p. 468/998).
January 2007, Brasseaux was dysphoric due to menopause and
having stress because her husband did not like that she was
no longer working, but she was doing “extremely
well” by July 2007 (Doc. 5-2, pp. 466-467/998). In
2008, Brasseaux began having problems with Lexapro, which she
had been taking for five years, so she began trials of other
medications, finally resuming taking Lexapro at a higher
dosage (Doc. 5-2, pp. 459-64/998). The higher dosage of
Lexapro finally returned her mood to normal (Doc. 5-2, pp.
458/998). In 2010, Brasseaux again became depressed (Doc.
5-2, p. 457/998). Wellbutrin was added to her medication
regimen, and she became stable again (Doc. 5-2, pp.
received ongoing treatment for chronic sinusitis, vertigo,
irritable bowel syndrome, gastroesophageal reflux disease,
and hypothyroidism from Dr. Morris from 2004 through 2010
(Doc. 5-2, pp. 534-551, 705-731/998).
was treated for recurrent urinary tract infections and
urinary frequency from May 2006 to June 2011 (Doc. 5-2, pp.
cervical spine MRI in June 2009 showed Brasseaux had bulging
discs and osteophytic ridging at ¶ 2-3, C4-5, and C5-6,
but there was no significant stenosis (Doc. 5-2, p. 420/998).
Brasseaux was evaluated by Dr. Craig G. Morton, a physical
medicine and rehabilitation specialist, in November 2009
(Doc. 5-2, p. 439/998). Dr. Morton noted her one-year history
of neck and shoulder pain after falling (Doc. 5-2, p.
439/998). Dr. Morton also noted her history of chiropractic
care, and prescribed physical therapy for cervical
stabilization and occipital nerve release (Doc. 5-2, p.
426/998). Physical therapy improved Brasseaux's range of
motion and decreased her pain levels (Doc. 5-2, pp. 435, 438,
had chiropractic treatment from September 2010 through
December 2011 (Doc. 5-2, pp. 477-86/998). Brasseaux fell
again in June 2011, which caused an acute exacerbation of her
back pain (Doc. 5-2, p. 478/998).
December 2011, an MRI of Brasseaux's lumbar spine showed
degenerative change in the facets at ¶ 4-5 with
prominent osteophytes, but no significant spinal stenosis
(Doc. 5-2, p. 422/998). Brasseaux also had milder
degenerative change at the L3-4 and L5-S1 facets, and
bilateral Tarlov cysts at ¶ 2 (Doc. 5-2, pp. 422, 520/998).
Brasseaux had some degeneration of the joints at ¶ 4-5
(Doc. 5-2, p. 422/998). Brasseaux was referred to Dr. Morton
(Doc. 5-2, p. 422/998).
December 2011, Brasseaux complained of low back and buttock
pain going to the right thigh, worse after having been on her
feet (Doc. 5-2, p. 426/998). Brasseaux was still tender and
restricted in range of motion as before (Doc. 5-2, p.
429/998). Brasseaux stated both her pain medication and the
chiropractor gave her some relief (Doc. 5-2, p. 426/998). A
lumbar MRI showed mild facet arthrosis at ¶ 4-5 with
bulging discs, and degenerative changes at ¶ 5-S1 (Doc.
5-2, p. 429/998). Dr. Morton noted that fibromyalgia
complicated her condition, and diagnosed mild foraminal
stenosis at ¶ 4-5 (Doc. 5-2, p. 164, 425/998). Dr.
Morton prescribed a TENS unit, a Medrol dose pack, and
physical therapy (Doc. 5-2, pp. 164, 425/998).
had chiropractic treatment in 2012 and 2013 for all-over pain
and TMJ (Doc. 5-2, pp. 240-258/998).
January 2012, Dr. Morton sent Brasseaux to physical therapy,
but Brasseaux only completed 9 of the 15 prescribed visits
(Doc. 5-2, p. 160/998). Dr. Morton noted that Brasseaux was
doing well with Neurontin and her leg pain had resolved, but
continued to have dull low back pain with standing that
improved with rest (Doc. 5-2, p. 161/998). Brasseaux's
medication list included Lisinopril, Lexapro, Xanax, Santura,
Armour Thyroid, Lunesta, and Medrol (Doc. 5-2, p. 162/998).
Brasseaux was tender to palpation over the multifidus and
lumbar paraspinals on the right, and the lumbar paraspinals,
multifidus, and sacroiliac joint on the left (Doc. 5-2, p.
162/998). She also had mildly restricted forward flexion and
moderately restricted right and left rotation/extension (Doc.
5-2, p. 162/998). Brasseaux had failed conservative care with
chiropractics, so Dr. Morton prescribed physical therapy for
cervical stabilization and occipital nerve release in
December 2011 (Doc. 5-2, pp. 426, 477-86/998). Brasseaux
noted improvement in her range of motion as well as decreased
pain levels (Doc. 5-2, pp. 435, 450-51/998). Dr. Morton noted
she was doing well with Neurontin, therapy was helping, and
she rated her back pain a 4/10 (worse with standing, improved
with rest) (Doc. 5-2, p. 161/998). Brasseaux's leg pain
was resolved (Doc. 5-2, p. 162/998). Brasseaux's forward
lumbar flexion was mildly restricted and her right and left
lumbar rotations were moderately restricted (Doc. 5-2, pp.
January 2012, Dr. Landry found Brasseaux was doing well on
her medications and prescribed Xanax, Lexapro, and Wellbutrin
(Doc. 5-2, p. 112, 117/998).
January 2012 through January 2015, Brasseaux underwent
chiropractic treatment for neck and back pain at ¶ 5,
C2, C3, C4, C5, C6, T7, and T8 (Doc. 5-2, pp. 232-258/998).
April 2012, Brasseaux was referred by Dr. Snow for
acupuncture to treat her fibromyalgia pain (Doc. 5-2, p.
6/998). Brasseaux also reported pain in her right hip, right
sided sciatica, lower back, and neck that is aggravated by
wind, cold temperatures, and dampness (Doc. 5-2, p. 11/998).
Treatments in April through July 2012 gave Brasseaux
temporary relief (Doc. 5-2, pp. 6-24/998).
2012, Brasseaux's main complaint was fibromyalgia. Dr.
Landry added a trial of Cymbalta (Doc. 5-2, p. 119/998). In
June 2013, Dr. Landry added Halcion ...