United States District Court, W.D. Louisiana, Alexandria Division
REPORT AND RECOMMENDATION
H.L. PEREZ-MONTES, UNITED STATES MAGISTRATE JUDGE.
Jean Chandler (“Chandler”) protectively filed an
application for period of disability and Social Security
Disability Insurance Benefits (“DIB”) under Title
II and Part A of Title XVIII on October 20, 2015. (Doc. 13-1,
pp. 158-164). Chandler alleged a disability onset date of
September 16, 2015, due to Crohn's Disease, fibromyalgia,
chronic pain disorder, “sleep apnea/sleep disorder,
” and depression. Id. at 179-83.
Chandler's claims were initially denied by the Social
Security Administration (“SSA”) on February 12,
2016. Id. at 83-95.
application was heard before an administrative law judge
(“ALJ”) on November 4, 2016. Id. at
39-82. Chandler appeared with Leonard Francois, a vocational
expert (“VE”). Id. Chandler also
appeared with her attorney Yuri Beck. Id. The ALJ
denied Chandler's claim on February 21, 2017.
Id. at 18-34. The ALJ determined that Chandler was
not disabled under the Social Security Act (the
“Act”), finding at step five of the sequential
evaluation process that she is capable of making a successful
adjustment to other work that exists in significant numbers
in the national economy. Id. at 21-34.
December 22, 2017, the Appeals Council denied Chandler's
request for review, and the ALJ's February 21, 2017
decision became the final decision of the Commissioner of
Social Security (the “Commissioner”). (Doc. 13-1,
in forma pauperis, Chandler filed this appeal for
judicial review. (Doc. 1). Chandler asserts the findings of
the Commissioner are not based upon substantial evidence and
that improper legal standards were applied. Id. at
2. Chandler also filed post-decision medical records with
this Court. (Doc. 17, pp. 1-23).
Commissioner responded. (Doc. 18). Chandler's appeal is
now before the Court for disposition.
Summary of Pertinent Facts
November 4, 2016 administrative hearing, Chandler testified
that she is 44 years old. (Doc. 13-1, p. 44). She is 5 feet
tall and weighs approximately 230 pounds. Id. She
resides with her husband and daughter in Dry Prong,
Louisiana. Id. at 45. Chandler has a high school
diploma and no additional vocational training or
certifications. Id. She has never served in the
last worked in September of 2015 at Heart of Louisiana Credit
Union. Id. at 46. Chandler had trouble concentrating
at work and doing her job. Id. She was offered a
demotion but resigned. Id. Chandler worked there for
over 20 years. Id. For about seven years until 2015,
she was an Operations Manager. Id. at 46-48. This
position required her to work with redesigning a new branch,
work with vendors, maintain an ATM at a local business, and
oversee the collections department. Id. at 47. She
supervised one employee. Id. at 47-48. Prior to
being Operations Manager, Chandler worked for over five years
in member services. Id. at 48. She opened accounts
and dealt with customers. Id.
testified she was having diarrhea, stomach pain, and nausea,
which caused problems with concentration at work.
Id. at 49. She was treated for depression, mood
swings, and bipolar disorder. Id. Chandler testified
she lost her son in an accident almost three years ago.
Id. She attributes a combination of everything
affected her ability to focus on things. Id. When
offered a demotion to go back to member services, she felt
she could not deal with people like before and could not
has not worked since September of 2015 and has not applied
for any jobs since that time. Id. Chandler drew
unemployment for about five or six months, from the fourth
quarter of 2015 through the third quarter of 2016.
Id. at 50. She testified she called and asked if
there were any openings but did not actually submit any
applications. Id. Chandler's husband is their
only source of income and they are struggling to maintain.
Id. at 50-51.
has had Crohn's disease for over 20 years which causes
her to have severe bouts of diarrhea multiple times a week,
nausea, and stomach pain. Id. at 51. It has
progressively worsened over time. Id. She has bouts
with a perianal fistula from the Crohn's disease which
causes problems sitting for periods of time when it flares
up. Id. Chandler stated she takes Phenergan when she
gets nauseous. Id. at 52.
has fibromyalgia. Id. at 51. She has muscle spasms
and pain in different parts of her body when doing anything
strenuous. Id. She also has severe right knee pain
when first standing up and walking, and cannot stand for long
periods of time. Id. She takes Librax for pain and
omeprazole for stomach pain. Id. at 52.
typical day, Chandler takes her daughter to school, visits
with her grandmother, and goes back home. Id. She
folds clothes and does laundry. Id. She uses a
rolling cart to bring laundry to the laundry room.
Id. She sometimes puts the dishes in the dishwasher.
Id. Chandler sometimes shops and uses a wheelchair
cart when she does. Id. She testified her husband
does most of the shopping. Id. at 52-53. She goes to
church. Id. at 53. Her husband does the yard work
because she is not able. Id. Because she can stand
or sit, she can do some household chores. Id. She
does not vacuum. Id. Chandler testified vacuuming
“throws my fibromyalgia” and starts pain in her
arms and legs. Id.
hobbies and interests consist of reading novels and watching
television. Id. at 54. Sometimes she uses a
computer. Id. She can use a computer, an iPad, and a
smart phone. Id. Chandler tries to read and cannot
just sit and do nothing. Id.
testified she can shower or bathe and dry her hair.
Id. She has a chair in her bathroom so she does not
have to stand the whole time. Id. She must sit down
and dry her hair. Id. Chandler testified she can
take care of herself and dress herself. Id. at 55.
testified she has sleep apnea and falls asleep easily.
Id. She uses a CPAP machine but still gets sleepy
during the day. Id. She has used a CPAP machine for
about five years. Id. She has severe mood swings and
cries a lot. Id. She has trouble focusing and
forgets what she is doing. Id. Due to her dramatic
mood swings, she is easily aggravated with other people.
Id. at 56. Chandler testified she does not associate
with a lot of people. Id. She has been this way for
a couple of years, beginning after her son was killed.
sees Dr. Kirkikis for Crohn's disease, Dr. Quillin for
psychological issues, Dr. Brunet for her knee, Dr. English
for psoriasis, Dr. Shoshay for her fasciitis, Dr. Gallaher as
her general practitioner, Dr. Hajmurad for nerve pain and
neuropathy, Dr. Shaleb for fibromyalgia, Dr. Foray for sleep
issues, and Dr. England for her eyes. Id. at 56-57.
hospitalized in 2016 for an acute flare-up of Crohn's
disease. Id. at 57. Chandler testified she was no
longer taking Humira and began having problems with her
Crohn's beginning in early 2016. Id. She could
not afford Humira because she no longer had insurance.
Id. at 57-58. After her hospitalization, she was
able to restart Humira through an assistance program.
Id. at 58. Chandler testified she was doing better
with her Crohn's disease and not having diarrhea and
nausea every day. Id.
testified she received counseling from Dr. Stokes, another
psychologist with Dr. Quillin. Id. Chandler no
longer sees Dr. Stokes because she cannot afford it.
Id. She sees Dr. Quillin for medication management.
Id. at 59. She believes some of the medication
causes blurry vision. Id. She has trouble reading
and uses different pairs of glasses. Id. She did not
know of other side effects of her different medications.
her June 2016 hospitalization, Chandler went to Urgent Care
for excruciating knee pain. Id. She then went to Dr.
Brunet, an orthopedic doctor. Id. Chandler testified
Dr. Brunet felt the knee swelling was arthritis and that
there was not much she could do. Id. Chandler stated
Dr. Brunet has not recommended any knee surgery. Id.
She tries to exercise some, but not a lot because it is too
painful. Id. at 60. She uses an elliptical machine
at home, but usually only walks five to ten minutes.
Id. She can stand in place for a couple of minutes.
Id. She testified she is limited by pain in her knee
and feet. Id. Sitting is okay unless her fistula
flares up. Id. She cannot lift a box of copy paper
but can lift a six-pack of Cokes or a gallon of milk.
Id. at 61. She stated it hurts her stomach or legs
to lift. Id.
testified she tries to get along with people but does not see
a lot of people. Id. She gets aggravated easily.
Id. Chandler stated that she had trouble dealing
with people at her job and got aggravated just talking with
people. Id. at 62. She testified she can concentrate
on instructions if it is written down in front of her.
Id. If something requires longer concentration, she
drifts off or must get up and go to the bathroom.
Id. She loses her focus and has a hard time getting
back to what she was doing. Id. at 63.
testified Crohn's disease is the main problem that keeps
her from working. Id. at 64. Her second problem is
focusing on the task at hand. Id. at 64.
hearing, the ALJ and Chandler's attorney discussed Dr.
Kirkikis opinion statement in which he discusses and circles
some findings that track the irritable bowel disease, listing
5.06. Id. at 43. The ALJ notes that Dr. Kirkikis
circles a couple of lab findings that would be consistent
with that listing level severity - hemoglobin less than 10
grams per deciliter 60 days apart and albumin levels at less
than 3.0 grams. Id. The ALJ could not find any
hemoglobin low levels that were 60 days apart, and could not
find any albumin levels that met that threshold. Id.
Chandler's attorney noted that the lowest level of
albumen he found was 3.1 grams, just above the threshold.
Id. at 64. He found hemoglobin at level 8.2 on June
12 and 8.6 on June 9. Id. The ALJ noted that for the
purpose of the listing analysis, the abnormal readings have
to be separated by 60 days. Id. at 64-65.
Chandler's attorney noted another low hemoglobin on May
11, 2016 at 9.7 grams. Id. at 65.
attorney questioned her about her Crohn's disease.
Id. Chandler testified her average day consists of
stomach pain and diarrhea. Id. at 65-66. She goes to
the bathroom with diarrhea three to five times on an average
day. Id. at 66. Chandler stated she has nausea
several times a week but not daily. Id. On a bad
day, she has to go to the bathroom with diarrhea probably 12
to 15 times. Id. Chandler testified no matter what
she is doing, she must leave, drop that task, and go to the
bathroom. Id. Chandler wears adult diapers if she is
having a bad day and must go somewhere. Id. She must
stay close to a bathroom. Id. at 67. She often
cannot make it to the bathroom in time. Id. Chandler
testified she is often thinking about when she will have to
go to the bathroom next. Id. She stated her fistula
is reoccurring. Id. Chandler has on average about
two bad days in a week. Id. at 68.
testified Dr. Shaleb diagnosed her fibromyalgia. Id.
at 68. Dr. Shaleb sent Chandler to a neurologist for nerve
conduction testing with Dr. Hajmurad. Id. Chandler
testified that the nerve conduction study confirmed she had
fibromyalgia. Id. She stated it is worse with
exertion. Id. She has all over pain and tenderness
all the time. Id. at 69. She has tenderness in her
arms. Id. She has joint pain which she associates
with arthritis and fibromyalgia. Id.
testified Dr. Quillin diagnosed her with bipolar disorder and
major depression. Id. During a bout of depression,
Chandler does not want to do anything and wants to be by
herself at home. Id. She does not want to be around
family. Id. She feels down a lot of the time.
Id. at 71. She cries all the time. Id. She
has anxiety and takes Abilify, Ativan, and Wellbutrin.
Id. Sometimes she has panic attacks, which occur
monthly and are triggered by environmental stressors.
Id. During bouts of depression, she has trouble
maintaining focus and completing tasks. Id. at 72.
This occurs three or four times a week. Id. She also
has issues sleeping during the day. Id. If she must
travel, her husband always drives so she is not driving any
distances by herself. Id.
her ability to work, Chandler testified that Dr. Kirkikis
said her bouts of diarrhea, stomach pain, and nausea would
probably prohibit her from maintaining a job. Id. at
73. Dr. Kirkikis estimated she would be absent from work more
than once a week due to her issues. Id. Chandler
testified Dr. Quillin stated that not focusing prohibited her
from working. Id. Chandler used to enjoy work but
became overwhelmed, would cry, and feel bad about coming to
work every day. Id. Without her issues, she felt she
would be working. Id.
did not need any clarification regarding Chandler's past
work. Id. at 74. The ALJ asked the VE to
characterize Chandler's past work history. Id.
The VE testified that during her 20 years at the credit
union, Chandler performed the job of financial institution
manager, DOT number 186.167-086, skilled work, SVP
level 8, physical demand level sedentary. Id. The VE
testified Chandler also performed the job of collection and
credit manager, DOT number 169.167-086, skilled work, SVP
level 8, physical demand level sedentary. Id. at
74-75. She also performed the job of head teller, DOT number
211.132-010, skilled work, SVP level 8, physical demand level
light. Id. at 75. The characterizations given were
both as generally performed and as she actually performed
that work. Id.
asked the VE to assume a hypothetical individual with the
same age, education, and past work experience as Chandler
with the following limitations: light work; lifting and
carrying 20 pounds occasionally, ten pounds frequently;
standing and walking for up to six hours in an eight-hour
day; sitting for up to six hours in an eight-hour day;
occasional climbing of ramps and stairs, but no climbing of
ladders, ropes, or scaffolds; occasional balancing, stooping,
kneeling, crouching, and crawling; no exposure to hazards
such as unprotected heights and dangerous moving machinery;
no exposures to extremes of heat or cold; limited to simple,
routine, repetitive work; limited to simple work-related
decisions; and only frequent interaction with supervisors and
coworkers and only occasional interaction with the public.
Id. at 75-76. The ALJ asked the VE if, based on
those limitations, whether that hypothetical individual could
perform any of Chandler's past work. Id. at 76.
the ALJ's hypothetical, the VE testified there was no
past work available to that individual. Id. The ALJ
inquired about the sedentary work Chandler performed as a
credit manager and financial institution manager and what
limitations in the hypothetical preclude Chandler's past
work. Id. The VE testified that occasional contact
with the public primarily precludes past work as Chandler had
frequent to constant contact with the public. Id.
The VE stated that Chandler's past work was highly
skilled work, all SVP level 8. Id. The VE stated
that the hypothetical required unskilled, simple work-related
decisions and Chandler performed past jobs that were highly
skilled and required her to make complicated decisions.
Id. at 76-77.
testified that there are other jobs in the national economy
that such a person could perform. Id. at 77. The VE
stated that the individual with such limitations could work
as a price marker, DOT number 209.587-034, unskilled work,
SVP level 2, exertional level light (273, 000 jobs in the
national economy). Id. The VE testified the
individual could work as a housekeeper, DOT number
323.687-014, unskilled work, SVP level 2, physical demand
level light (137, 000 jobs in the national economy).
Id. The VE further testified that the individual
could work as a cafeteria attendant, DOT number 311.677-010,
unskilled, SVP level 2, physical demand level light (60, 000
jobs in the national economy). Id.
asked the VE to assume the hypothetical individual is
exertionally limited to sedentary work with essentially the
same non-exertional limitations as before. Id. at
78. The ALJ asked the VE to assume the following limitations:
lifting and carrying 10 pounds occasionally, five pounds
frequently; standing and walking for up to two hours in an
eight-hour day; sitting for up to six hours in an eight-hour
day; occasional climbing of ramps and stairs, but no climbing
of ladders, ropes, or scaffolds; occasional balancing,
stooping, kneeling, crouching, and crawling; no exposure to
hazards such as unprotected heights and dangerous moving
machinery; no exposures to extremes of heat or cold; limited
to simple, routine, repetitive work; limited to simple
work-related decisions; and only frequent interaction with
supervisors and coworkers and only occasional interaction
with the public. Id. at 75-76. The ALJ asked the VE
if, based on those limitations, whether that hypothetical
individual could perform any of Chandler's past work.
the ALJ's second hypothetical, the VE testified there was
no past work available to that individual. Id. The
VE asked some clarifying questions to determine whether jobs
would be available in the national economy to that
individual. Id. at 79. The ALJ clarified that the
limitation of occasional public contact includes telephone
contact with the public. Id. The VE testified that
there are other jobs in the national economy that such a
person could perform. Id. The VE testified that the
individual could perform work as a document specialist, DOT
number 249.587-018, unskilled, SVP level 2, physical demand
level of sedentary (73, 000 jobs in the national economy).
Id. The VE also testified the individual could work
as a surveillance system monitor, DOT number 379.367-010,
unskilled work, SVP level 2, physical demand level sedentary
(17, 000 jobs in the national economy). Id.
asked the VE to assume those same limitations, except that
due to various physical and mental limitations, the
individual would need at least two additional breaks other
than the normal workday breaks, each a 15-minute duration;
would be absent at least two days or more per month; and
would be off task at least 20 percent of the workday.
Id. at 79-80. The VE testified that the third
hypothetical would eliminate all jobs in the national economy
for the individual. Id. at 80. That is true for the
individual limitations, both individually and collectively.
attorney asked the VE to assume in the first hypothetical
that the individual's condition markedly limited her
ability to perform activities within a schedule and maintain
regular attendance within customary tolerances. Id.
The VE testified that no unskilled jobs would be available in
the national economy with that limitation. Id. at
81. Chandler's attorney asked the VE to assume in the
first hypothetical that the individual had to be allowed to
take unscheduled breaks for regular durations up to 10 times
a day. Id. The VE testified no jobs would be
available to that individual in the national economy.
determine disability, the ALJ applied the five-step
sequential process outlined in 20 C.F.R. § 404.1520(a).
The sequential process required the ALJ to determine whether
Chandler: (1) is presently 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 (“Appendix 1”); (4) is unable to do
the kind of work she did in the past; and (5) can perform any
other type of work. 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. See Greenspan v.
Shalala, 38 F.3d 232, 236 (5th Cir. 1994), cert. den.
914 U.S. 1120 (1995) (citing Lovelace v. Bowen, 813
F.2d 55, 58 (5th Cir. 1987)).
entitled to benefits, an applicant bears the initial burden
of showing that she is disabled. Under the regulations, this
means the claimant bears the burden of proof on the first
four steps of the sequential analysis. Once this initial
burden is satisfied, the Commissioner bears the burden of
establishing that the ...