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Holly v. U.S. Commissioner of Social Security

United States District Court, W.D. Louisiana, Alexandria Division

January 31, 2019

DOUGLAS BRUCE HOLLY
v.
U.S. COMMISSIONER OF SOCIAL SECURITY

          JAMES JUDGE.

          REPORT AND RECOMMENDATION

          Joseph H.L. Perez-Montes United States Magistrate Judge.

         Before the Court is Douglas Bruce Holly's (“Holly's”)[1] appeal of the denial of disability insurance benefits (“DIB”) by the Commissioner of Social Security (“the Commissioner”). Because substantial evidence does not support the ALJ's findings that Holly and his physicians are not credible, the Commissioner's decision should be reversed and Holly should be awarded benefits.

         I. Background.

         Holly filed an application for DIB, alleging a disability onset date of December 28, 2014 (Doc. 10-1, p. 139/421), due to “hole in heart, asthma, sleep apnea, bone spur in left heel, heart murmur, acid reflux, and shortness of breath.” (Doc. 10-1, p. 57/421). That application was denied by the Social Security Administration (“SSA”). (Doc. 10-1, p. 66/421).

         A de novo hearing was held before an Administrative Law Judge (“ALJ”) on March 23, 2016, at which Holly appeared with his attorney and a vocational expert (“VE”). (Doc. 10-1, p. 37/421).[2] The ALJ found Holly has not engaged in substantial gainful activity since December 28, 2014, the alleged onset date. (Doc. 10-1, p. 25/421). The ALJ further found that, although Holly has severe impairments-chronic obstructive pulmonary disease (“COPD”) and obesity-he has at least a high school education and has the residual functional capacity to perform the full range of light work. (Doc. 10-1, pp. 25, 27, 31/421). The ALJ found Holly is unable to do his past relevant medium and heavy work as a laborer, deckhand, corrections officer, and green chain off-bearer (at a plywood plant). (Doc. 10-1, pp. 30-31/421). Because a finding of “not disabled” was directed by § 202.20 of the Medical-Vocational Guidelines, 20 C.F.R. Part 404, Subpart P, Appendix 2, the ALJ found Holly was not disabled at any time through the date of his decision on December 28, 2014. (Doc. 10-1, p. 31/421).

         Holly requested a review of the ALJ's decision, but the Appeals Council declined to review it (Doc. 10-1, p. 4/421), and the ALJ's decision became the final decision of the Commissioner.

         Holly then filed an appeal for judicial review, with the following grounds for relief (Docs. 15, 16):

1. The ALJ's reasons for not crediting the opinion of Dr. Davis, Holly's treating cardiologist, are not supported by substantial evidence.
2. The ALJ's findings as to Holly's credibility are not supported by substantial evidence.
3. The ALJ's finding that Holly retains the residual functional capacity to perform the full range of light work is not supported by substantial evidence.

         II. Evidence.

         A. Holly's medical records.

         Dr. Gregory Ardoin, a pulmonologist, first saw Holly in May 2014 on referral from Dr. Karson. (Doc. 10-1, p. 371/421). Holly complained he had been progressively shorter of breath for years but was markedly worse in the last “many months”; his shortness of breath was aggravated by exertion, relieved by rest, and accompanied by coughing and wheezing, and he had been very tried for the last year. (Doc. 10-1, p. 371/421). Dr. Ardoin noted Holly's history of a bilateral heart catheter, pulmonary hypertension, and severe dyspnea on exertion, with progressively worsening shortness of breath for years, markedly worse in the last several months. (Doc. 10-1, p. 371/421). Dr. Ardoin noted that Holly has significant left ventricle hypertension and hypertrophic cardiomyopathy with normal left ventricle function, asthma with wheezing, hypersomnolence, and snoring. (Doc. 10-1, p. 371/421). Holly could not make it up and down stairs at work without severe distress. (Doc. 10-1, p. 271/421). Dr. Ardoin diagnosed pulmonary artery hypertension, atrial septal defect (“ASD”), hypertrophic cardiomyopathy, dyspnea on exertion, morbid obesity, asthma, and hypertension. (Doc. 10-1, p. 372/421).

         Holly, then 42 years old, underwent an echocardiogram in June 2014. (Doc. 10-1, pp. 333-334/421). Holly's left ventricle ejection fraction was about 59% and the wall thickness was at the upper limits of normal; there was mild regurgitation in the pulmonic valve; there was mild to moderate regurgitation in the tricuspid valve; and everything else was normal. (Doc. 10-1, p. 334/421). Cardiopulmonary tests and pulmonary function studies revealed pulmonary hypertension. (Doc. 10-1, pp. 335-345/421). Dr. Ardoin stated Holly's case was very unusual due to a right heart catheter, documented in August 2013. (Doc. 10-1, p. 368/421). Holly's cardiothoracic surgeon recommended trying medications for a while before trying to close the atrial septal defect, so Dr. Ardoin prescribed PDE5 inhibitors to help his hypertrophic diastolic dysfunction. (Doc. 10-1, p. 370/421). Dr. Ardoin diagnosed pulmonary artery hypertension, atrial septal defect, hypertrophic cardiomyopathy, dyspnea on exertion, morbid obesity asthma and hypertension. (Doc. 10-1, p. 368/421).

         In July 2014, Holly had an abnormal pulmonary function study. (Doc. 10-1, pp. 346-/421). Dr. Ardoin noted that Holly said he felt markedly better since treating his asthma with Advair and Spiriva, but was not at normal exercise capacity at work, and his cardiopulmonary exercise test was “remarkably abnormal for both ventilatory limitation…and from his hypoxemia”. (Doc. 10-1, p. 265/421). Dr. Ardoin diagnosed shortness of breath, exercise hypoxemia, pulmonary artery hypertension, COPD, atrial septal defect, asthma, dyspnea on exertion, morbid obesity, and hypertension. (Doc. 10-1, p. 266/421).

         A sleep study in July 2014 showed Holly has severe obstructive sleep apnea syndrome. (Doc. 10-1, p. 347/421). Holly was prescribed a positive airway pressure therapy titration trail study. (Doc. 10-1, p. 347/421). A second sleep study in September 2014 showed his obstructive sleep apnea was controlled by CPAP and he was prescribed home CPAP therapy. (Doc. 10-1, p. 348/421).

         An echocardiogram in September 2014 showed Holly's left ventricle had mildly increased wall thickness, his left and right atriums were mildly dilated, and his pulmonic and tricuspid valves had mild to moderate regurgitation. (Doc. 10-1, pp. 349-50/421). Holly's left ventricle ejection fraction was 62 %. (Doc. 10-1, p. 350/421).

         Holly had another abnormal spirometry report in October 2014. (Doc. 10-1, p. 352/421). Holly was called to undergo a repair of his atrial septal defect, but he refused it. (Doc. 10-1, p. 362/421). Holly stated he was able to do his work with mild to moderate compromise, which was a marked improvement. (Doc. 10-1, p. 362/421). Dr. Ardoin noted Holly still had trace edema and had started CPAP therapy. (Doc. 10-1, p. 362/421). Dr. Ardoin diagnosed Holly with atrial septal defect, exercise hypoxemia, pulmonary artery hypertension, shortness of breath, pulmonary artery hypertension (“PAH”), chronic obstructive pulmonary disease (“COPD”), asthma, hypertrophic cardiomyopathy, dyspnea on exertion, morbid obesity, hypertension, and obstructive sleep apnea on CPAP. (Doc. 10-1, pp. 262-63/421).

         In December 2014, Holly had a blood vessel pop (Doc. 10-1, p. 244/421). Holly's history of benign hypertension was noted (Doc. 10-1, p. 244/421), and he was diagnosed with varicose veins and morbid obesity. (Doc. 10-1, p. 245/421).

         Holly saw Dr. Ardoin three times in January 2015. Holly was treated for an upper respiratory infection, and a heart murmur was noted (systolic grade III/IV in LUSB), as well as edema and morbid obesity. (Doc. 10-1, pp. 248-49/421). Holly reported a long history of heart murmur since age 4 after having open heart surgery. (Doc. 10-1, p. 249/421). Holly underwent an EKG, lab work, x-rays, a cardiopulmonary, and pulmonary function studies at the request of Dr. Gregory Ardoin, a pulmonologist. (Doc. 10-1, pp. 267-284, 297-302/421). Holly was 5'10” tall and weighed 289 pounds. (Doc. 10-1, p. 258/421). Dr. Ardoin diagnosed shortness of breath; gastroesophageal reflux disease (“GERD”); ASD; hypertrophic cardiomyopathy; obstructive sleep apnea on CPAP; asthma; morbid obesity; dyspnea on exertion; pulmonary artery hypertension; and exercise hypoxemia. (Doc. 10-1, p. 258/421). Dr. Ardoin found Holly's asthma, reactive airways disease, and obstructive lung disease had improved markedly, and his pulmonary hypertension “may have improved somewhat.” (Doc. 10-1, p. 259/421). Dr. Ardoin noted that Holly's primary limiting factor is hypoxemia with exercise, and his second most limiting factor is hypertrophic cardiomyopathy/diastolic dysfunction. (Doc. 10-1, p. 159/421). Dr. Ardoin found Holly was unable to do physical labor (his usual work requirements) without respiratory distress due to hypoxemia. (Doc. 10-1, p. 258/421). Dr. Ardoin recommended that Holly stop working, since he was doing physical labor, but Holly said he could not. (Doc. 10-1, p. 359/421).

         Holly was referred to Dr. Wesley W. Davis, a cardiologist, in April 2015. (Doc. 10-1, p. 402/421). Holly was 42 years old, 69” tall, weighed 310 pounds, and his blood pressure was 118/63. (Doc. 10-1, p. 402-404/421). After Holly underwent tests, Dr. Davis diagnosed primary pulmonary hypertension, obesity, hypertension, and asthma. (Doc. 10-1, p. 404/421).

         In June 2015, Dr. Davis noted Holly's “leaking valve” (since open heart surgery in1976) and asthma. (Doc. 10-1, pp. 406-407/420). Dr. Davis found Holly had pitting edema in both lower extremities (more om the right) and varicose veins. (Doc. 10-1, p. 408/421), and is disabled due to hypertension, chronic stasis changes (right leg more than left), obesity, his ASD repair at age 4, edema, and moderate primary pulmonary high blood pressure. (Doc. 10-1, p. 406/420). Dr. Davis diagnosed venous insufficiency of both lower extremities, primary pulmonary hypertension, hypertension, asthma, and obesity. (Doc. 10-1, p. 406/420). Dr. Davis recommended that Holly elevate his feet one hour in the morning and one hour in the afternoon, and continue taking his medications (Lasix, potassium chloride, omeprazole, Advair, Spiriva, Ventolin, and Inderal). (Doc. 10-1, p. 408/421).

         Dr. Ardoin evaluated Holly in August 2015 and found shortness of breath, dyspnea on exertion, pulmonary artery hypertension, atrial septal defect, asthma, and chronic obstructive pulmonary disease. (Doc. 10-1, p. 353/421). Dr. Ardoin noted that, given Holly's hypertrophic cardiomyopathy and pulmonary hypertension, complicating obesity, and obstructive sleep apnea, Holly's condition could be made worse if the ASD was closed since it could be acting as a “pop off valve.” (Doc. 10-1, p. 354/421). Dr. Ardoin prescribed a PDE5 inhibitor for his pulmonary hypertension. (Doc. 10-1, p. 349/421). Dr. Ardoin also stated that Holly is “completely disabled and unemployable at this time.” (Doc. 10-1, p. 355/421).

         In September 2015, Dr. Ardoin wrote that Holly is unable to perform physical labor due to severe exercise hypoxemia caused by a combination of pulmonary hypertension, atrial septal defect, hypertrophic cardiomyopathy, and severe persistent asthma. (Doc. 10-1, p. 410/421). A cardiopulmonary stress test documented severe hypoxemia with mild to moderate exercise. (Doc. 10-1, p. 410/421). Dr. Ardoin noted that Holly's ...


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