Randle v. Commissioner

          REPORT AND RECOMMENDATION

          CAROL B. WHITEHURST UNITED STATES MAGISTRATE JUDGE.

         Before the Court is an appeal of the Commissioner's finding of non-disability. Considering the administrative record, the briefs of the parties, and the applicable law, it is recommended that the Commissioner's decision be AFFIRMED.

         Administrative Proceedings

         The claimant, Janita Randle, fully exhausted her administrative remedies prior to filing this action in federal court. The claimant filed an application for disability insurance benefits (''DIB'') and an application for supplemental security income benefits (''SSI''), alleging disability beginning on July 5, 2012.^[1] Her applications were denied.^[2] The claimant requested a hearing, ^[3] which was held on December 9, 2015, before Administrative Law Judge Mary Gattuso.^[4] The ALJ issued a decision on January 26, 2016, ^[5] concluding that the claimant was not disabled within the meaning of the Social Security Act (''the Act'') from July 5, 2012 through the date of the decision. The claimant asked for review of the decision, but the Appeals Council concluded on April 28, 2017 that no basis existed for review of the ALJ's decision.^[6] Therefore, the ALJ's decision became the final decision of the Commissioner for the purpose of the Court's review pursuant to 42 U.S.C. § 405(g). The claimant then filed this action seeking review of the Commissioner's decision.

         Summary of Pertinent Facts

         The claimant was born on July 18, 1966.^[7] At the time of the ALJ's decision, she was 49 years old. She has a high school education.^[8] She has past relevant work experience as a cashier and recreational aide.^[9] She alleges she has been disabled since July 5, 2012 due to Addison's Disease and depression and anxiety.

         Claimant's medical care with her internist, Dr. Melancon, began in January 2012, at which time her records indicate she had suffered with fatigue and depression for 5 months. She was on daily doses of Synthroid and Cortisone Acetate, and also received Prozac and Atenolol. T. 254, 255, 262, 264, 268, 281. Blood tests had multiple abnormal findings, including a very low cortisol level. T. 258, 260. Claimant presented to Dr. Melancon several times with swollen grands, sore throat abdominal pain and upper respiratory infection. T. 267-282.

         Claimant was seen by an endocrinologist, Dr. Alan Burshell, M.D., at Ochsner Foundation in New Orleans from March 2013 through March 2014. The records reflect a history of an Addison's Disease diagnosis in 1989, that she was taking Prednisone in 1991, and since that time had been on daily Hydrocortisone for over 20 years. T. 336. In March 2013, her Cortisol and TSH were both low. T. 345, 349. In July 2013 it was noted in conjunction with her Addison's diagnosis that both ACTH and Cortisol were low. T. 359. Her Cortisone dosage was changed from 20 milligrams once per day to 15 mg and 5 mg in two separate doses. T. 362.

         Ochsner records of November 2013 indicate that since lowering her Cortisol and increasing thyroid medication, claimant had lost weight and her blood pressure was low. Her physician described an "unusual case with evidence for secondary adrenal insufficiency and hypothyroidism.” T. 369. It was noted that her last crisis was in July 2012 secondary to a flu infection. T. 369. Her Cortisone was increased from 15/5 to 20 mg. She was also given a Dexamethasone emergency kit. T.371.

         Claimant presented for follow-up in March 2014. She was still feeling fatigued, but better since the last visit. She had not taken her medications for one week in February 2014, but received a steroid injection at the Urgent Care Clinic and doubled her medication dose for one week, with good results. She exhibited a normal mood and affect. T. 377.

         The record indicates that claimant first received mental health treatment from Sharon Steward, M.D., with whom she was treated for depression in 10 Sessions between February 2013 and January 2014. T. 315-325. During that time, Dr. Steward discussed with claimant the correlation between her mood swings and her Addison's and Thyroid conditions. T. 319, 327. Dr. Steward documented the claimant's positive response to counseling with a “much improved mood” in December 2013, T. 322, T. 329, and indicated that her Global Assessment of Functioning (GAF) score went up to an 80 by January 8, 2014.^[10] T. 325.

         A consulting psychologist, Dr. Fontenelle, evaluated claimant on March 25, 2014, at the request of the State Agency.^[11] While he noted that her IQ test results placed her in a "Low Average" category, he thought that "Anxiety and Nervousness may limit her true intellectual capability.” T.412-413. He described that claimant is: (1) capable to understand job instruction; (2) says she enjoys performing helping type tasks delivery food to the elderly; and (3) is able to concentrate to a limited extent although she is anxious and depressed. T. 414. At that time Dr. Fontenelle noted that claimant “is not receiving medication;” “does receive counseling but discontinued medication through outpatient mental health.” T. 413-414. He diagnosed Generalized Anxiety Disorder and Depression Disorder. T.414.

         Records and a "Medical Source Statement" prepared on September 17, 2014, were supplied by a psychiatrist, Dr. Ravindra Reddy. T 429. The record documents 10 clinical visits with Dr. Reddy from March 12, 2014 to August 20, 2015, with a diagnosis of Major Depressive Disorder and Generalized Anxiety Disorder. T 424- 496. Claimant's medication regimen included Lexapro, Seroquel, and Xanax. T.426. Dr. Reddy felt that claimant had "marked" impairments in interacting appropriately with supervisors and the public, as well as responding appropriately to "usual work situations and to changes in a routine work setting" and “Moderate” impairments in interacting appropriately with co-workers.” T.435. During her appointments from March 2015 to June 2015, claimant indicated that she was “doing OK” with “some” depression at times. During those appointments she also indicated she was in compliance with taking her medications. T. 493-496. On her last visit in August 2015, however, she reported that she was “doing worse” and that she “stopped her medication on her own and has done much worse.” T. 492.

         At the December 9, 2015 hearing, claimant testified that while she had days free of symptoms from her Addison's Disease, she had 3 or 4 days per week when she felt poorly because of an infection and/or depression. She stated that this caused her to stay in bed for four days about once a month. She felt she could not do an 8hour job, both from the effects of physical problems and depression. T. 45, 49-50, 52-53.

         As to claimant's work activities, the records indicate she was able to work full-time at a Navy Exchange department store from May 1998 to January 2001 and in part-time jobs from March 2005 to January 1, 2014, the date she applied for disability benefits. T. 192. Specifically, claimant worked part-time starting in the fourth quarter of 2013 and extending into 2014, delivering meals for the Council on Aging five days a week, three hours per day. T. 41.

         With regard to her activities of daily living, claimant testified that she lives with her husband and during the day, she plays with her puppies, watches television and reads the newspaper, but is unable to watch a two hour movie without falling asleep. She is able to cook and clean at her own pace. She shops once a month with her husband. They visit their son who attends college in Lafayette, and eat out. She visits with her sister. She drives occasionally after being cleared by her cardiologist in January 2015, but she is afraid that she will pass out when driving.^[12]

         The ALJ posited 3 hypothetical scenarios to the testifying vocational expert. Hypothetical (1) being off task 20% of the work day, and (2) being absent for 2 days per month, yielded testimony that there was no work in the economy. The third hypothetical, with limitation to light work with occasional performance of postural activities and additional restrictions as to routine and repetitive tasks and contact with the public, coworkers, and supervisors, yielded testimony that jobs existed. T. 63-65.

         In response to a hypothetical from claimant's counsel that tracked the marked restrictions in personal associations assigned by the treating psychiatrist (the ability to interact with supervisors and to respond appropriately to usual work situations and changes in routine work setting), the vocational expert testified that such a person could not sustain employment in the types of jobs identified in response to the Judge's third hypothetical. T. 66.

         In her January 26, 2016 ruling, the ALJ found that claimant had severe impairments of: “disorders of the thyroid gland, disorders of the adrenal gland, affective disorder, and anxiety disorder." T. 22. The ALJ later stated, with respect to Addison's Disease and hypothyroidism: "There is no indication that either impairment has caused significant functional limitations." T. 28.

         Analysis

         A. Standard of Review

         Judicial review of the Commissioner's denial of disability benefits is limited to determining whether substantial evidence supports the decision and whether the proper legal standards were used in evaluating the evidence.^[13] ''Substantial evidence is more than a scintilla, less than a preponderance, and is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.''^[14]Substantial evidence ''must do more than create a suspicion of the existence of the fact to be established, but 'no substantial evidence' will only be found when there is a 'conspicuous absence of credible choices' or 'no contrary medical evidence.'''^[15]

         If the Commissioner's findings are supported by substantial evidence, then they are conclusive and must be affirmed.^[16] In reviewing the Commissioner's findings, a court must carefully examine the entire record, but refrain from re-weighing the evidence or substituting its judgment for that of the Commissioner.^[17]Conflicts in the evidence and credibility assessments are for the Commissioner to resolve, not the courts.^[18] Four elements of proof are weighed by the courts in determining if substantial evidence supports the Commissioner's determination: (1) objective medical facts, (2) diagnoses and opinions of treating and examining physicians, (3) the claimant's subjective evidence of pain and disability, and (4) the claimant's age, education and work experience.^[19]

         B. Entitlement to Benefits

         The Disability Insurance Benefit (''DIB'') program provides income to individuals who are forced into involuntary, premature retirement, provided they are both insured and disabled, regardless of indigence.^[20] Every individual who meets certain income and resource requirements, has filed an application for benefits, and is determined to be disabled is eligible to receive Supplemental Security Income (''SSI'') benefits.^[21]

         The term ''disabled'' or ''disability'' means the 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 twelve months.''^[22] A claimant shall be determined to be disabled only if his physical or mental impairment or impairments are so severe that he is unable to not only do his previous work, but cannot, considering his age, education, and work experience, participate in any other kind of substantial gainful work which exists in significant numbers in the national economy, regardless of whether such work exists in the area in which the claimant lives, whether a specific job vacancy exists, or whether the claimant would be hired if he applied for work.^[23]

         C. Evaluation Process and Burden of Proof

         The Commissioner uses a sequential five-step inquiry to determine whether a claimant is disabled. This process required the ALJ to determine whether the claimant (1) is currently working; (2) has a severe impairment; (3) has an impairment listed in or medically equivalent to those in 20 C.F.R. Part 404, Subpart P, Appendix 1; (4) is able to do the kind of work he did in the past; and (5) can perform any other work.^[24] If it is determined at any step of that process that a claimant is or is not disabled, the sequential process ends. ''A finding that a claimant is disabled or is not disabled at any point in the five-step review is conclusive and terminates the analysis.''^[25]

         Before going from step three to step four, the Commissioner assesses the claimant's residual functional capacity^[26] by determining the most the claimant can still do despite his physical and mental limitations based on all relevant evidence in the record.^[27] The claimant's residual functional capacity is used at the fourth step to determine if he can still do his past relevant work and at the fifth step to determine whether he can adjust to any other type of work.^[28]

         The claimant bears the burden of proof on the first four steps.^[29] At the fifth step, however, the Commissioner bears the burden of showing that the claimant can perform other substantial work in the national economy.^[30] This burden may be satisfied by reference to the Medical-Vocational Guidelines of the regulations, by expert vocational testimony, or by other similar evidence.^[31] If the Commissioner makes the necessary showing at step five, the burden shifts back to the claimant to ...