Brown v. Astrue
Decision Date | 27 October 2011 |
Docket Number | CAUSE NO. 1:10-CV-00450 |
Parties | ASHLEY E. BROWN, Plaintiff, v. MICHAEL J. ASTRUE, Commissioner of Social Security, Defendant. |
Court | U.S. District Court — Northern District of Indiana |
Plaintiff Ashley E. Brown appeals to the district court from a final decision of the Commissioner of Social Security ("Commissioner") denying her application under the Social Security Act (the "Act") for a period of disability and Disability Insurance Benefits ("DIB") and Supplemental Security Income ("SSI").1 (See Docket # 1.) Brown filed an opening brief on June 2, 2011, and the Commissioner responded on September 12, 2011. (Docket # 17, 23.) Brown, however, failed to file a reply brief, and the time to do so has since passed. For the following reasons, the Commissioner's decision will be AFFIRMED.
On October 26, 2006, Brown filed an application for SSI, alleging disability from April 1, 2000. (Tr. 17.) Her claim was denied initially and upon reconsideration, and Brown requested an administrative hearing. (Tr. 17.) On March 4, 2009, Brown filed an application for DIB, alleging disability since January 1, 2007, her date first insured. (Tr. 17, 89-97.)Administrative Law Judge ("ALJ") Bryan J. Bernstein conducted a hearing on August, 6, 2009, at which Brown, who was represented by counsel, Brown's grandmother, and a vocational expert ("VE") testified. (Tr. 17, 625-55.)
On April 23, 2010, the ALJ rendered an unfavorable decision to Brown, concluding that she was not disabled because she failed to establish that she did not engage in substantial gainful activity (SGA) since the date her SSI application was filed and because she could perform a significant number of jobs in the national economy despite the limitations caused by her impairments. (Tr. 17-28.) The Appeals Council denied Brown's request for review, making the ALJ's decision the final decision of the Commissioner. (Tr. 2-5, 597-622.)
Brown filed a complaint with this Court on December 17, 2010, seeking relief from the Commissioner's final decision. (Docket # 1.) She raises the following three arguments in her appeal: that the ALJ improperly evaluated (1) the opinion of her treating physician, Dr. Peter Jakacki; (2) Brown's symptom testimony; and (3) the SGA issue. (Opening Br. of Pl. in Social Security Appeal Pursuant to L.R. 7.3 ("Opening Br.") 11-16.)
At the time of the ALJ's decision, Brown was twenty-two years old (Tr. 14, 26-28, 91), had a high school education (Tr. 627), and had previously worked as a cashier and waitress (Tr. 100, 635-36). Brown alleges that she became disabled as of April 1, 2000, for SSI purposes, and as of January 1, 2007, for DIB purposes, due to Gitelman's Syndrome, major depression, and borderline personality disorder. (Opening Br. 1-2.)
At the hearing, Brown testified that she suffered from Gitelman's Syndrome, a genetic kidney disease that causes low potassium and magnesium levels. (Tr. 629-32.) Brown reported that Dr. Peter Jakacki, her treating physician, would send her to the hospital periodically to get her potassium and magnesium levels checked and, if they were low, to get an infusion, which could last anywhere from three to eight hours. (Tr. 632.) Because of her Gitelman's Syndrome, Brown stated that she had to take fifty pills of potassium and twenty pills of magnesium each day, along with injecting magnesium in her leg daily and receiving vitamin B injections three times a week to increase her energy level. (Tr. 632-34, 643-44.) Brown further indicated that she took Ambien to help her sleep, a water pill to hold potassium in, and Phenergan to help with her nausea. (Tr. 634.) Brown also stated that she had depression, for which she took Celexa. (Tr. 634.) In total, Brown estimated that she took eighty-six pills per day. (Tr. 644.) As for side effects, Brown testified that her medications often made her nauseous and caused vomiting (Tr. 646) and that she took Immodium every morning to prevent the magnesium from acting as a laxative (Tr. 633, 643). Brown also reported urinary frequency, requiring her to use the restroom every twenty to thirty minutes and an average of six times during the night, headaches three to four times a week, and constant neck pain and knots. (Tr. 633, 643-44.) Brown also indicated that she took a one to two hour nap each day due to lack of energy. (Tr. 643.)
Brown previously worked at Texas Roadhouse for three to four months and Buffalo Wild Wings for a year. (Tr. 635-46.) She testified that she worked four nights a week, from about five o'clock to eleven or twelve o'clock at night and that she last worked in January 2008. (Tr. 636.) Brown has not applied for any other work since she left Buffalo Wild Wings. (Tr. 636.)As for her employment limitations, Brown stated that she could not sit or stand a lot, would need frequent bathroom breaks every twenty to thirty minutes, had to be able to leave work if her levels were low, and needed to work a night shift because her symptoms were worse in the morning. (Tr. 636-37; 646.)
Brown testified that she lived on her own with her almost one-year-old daughter and was currently pregnant. (Tr. 638.) She reported that she got help from her daughter's father, but was able to clean the home and take care of her daughter. (Tr. 639.) Brown also stated that she was currently taking three online college courses. (Tr. 628.)
Brown's grandmother also testified at the hearing, stating that Brown understated her pain and symptoms (Tr. 648) and that Dr. Jakacki had taken a special interest in her (Tr. 647). According to Brown's grandmother, Brown was able to work previously because she was good with people and her employers would give her bathroom breaks, allow her to leave early if she did not feel well, and gave her a stool to sit on. (Tr. 648-50.) The grandmother also testified that Brown could not walk very far—a block or two—without needing to rest, could hardly stand, and could not sit for very long. (Tr. 649-50.) She further indicated that she helped Brown take care of her daughter, as did Brown's aunt, the baby's father, and the father's family. (Tr. 650.)
An impartial VE also testified at the hearing. The ALJ posited to the VE a hypothetical of a person who "would not be able to perform work that imposes close regimentation of production," required hourly restroom breaks, lasting three to five minutes each, had to be able to sit or stand while working, could not stand or walk longer than seventy-five percent of aneight hour workday or for prolonged periods lasting more than a half hour, and could lift and carry as much as twenty pounds occasionally and ten pounds frequently. (Tr. 651-52.) While the VE stated someone with this profile could not perform Brown's past work, he further testified such an individual could perform other light exertion jobs such as a laundry folder, mail clerk, and collator operator. (Tr. 652.) The VE indicated that, if Brown missed more than four working days a month, none of these jobs would be available. (Tr. 654.)
Dr. Peter A. Jakacki, Brown's primary care physician since early 2005,3 wrote two relevant letters concerning Brown's condition. (Tr. 231-33, 227-30.) In the January 30, 2008, letter, Dr. Jakacki indicated that he had seen Brown regularly since February 2005 and reported that she suffered from Gitelman's Syndrome, a genetic renal tubular defect in which the kidney wastes an excessive amount of potassium and magnesium resulting in chronic severe and recurrent episodes of hypokalemia (low potassium) and hypomagnesemia (low magnesium). (Tr. 231.) He opined that Brown "would need to intermittently be hospitalized for prolonged IV potassium and magnesium if intermittent emergency room visits to get IV potassium and magnesium did not suffice." (Tr. 231.) He also reported that Brown had, among other ailments, severe migraine headaches, knots in her neck and shoulders, and urinary urgency, all of which he linked to her Gitelman's Syndrome. (Tr. 231-32.) Dr. Jakacki stated that Brown had become depressed due to her physical health, which aggravated her condition. (Tr. 233.) He then noted that her impairments were lifelong as Gitelman's Syndrome is a genetic disease. (Tr. 233.)
In regards to work, Dr. Jakacki reported that Brown's workplace had accommodated her in the past by allowing her to sit behind the counter when she could not stand, leave frequently for bathroom breaks, work evenings due to severe morning headaches, and sometimes miss work due to emergency room visits or hospital stays. (Tr. 233.)
According to Dr. Jakacki's June 9, 2009, letter, Brown suffers from an array of chronic medical problems with life-threatening implications, the most severe of which is Gitelman's Syndrome. (Tr. 227.) Dr. Jakacki further reported that Brown has to take tremendously high doses of potassium and magnesium at least four to five times a day, totaling approximately fifty capsules of potassium and twenty or more pills of magnesium throughout the course of the day. (Tr. 227.) Dr. Jakacki stated that "the magnesium causes severe watery diarrhea and fecal urgency," requiring Brown to rush to the bathroom and making it difficult for her to maintain her magnesium levels even when she takes it appropriately dispensed throughout the day. (Tr. 227, 229.) Because of the diarrhea, Brown will lose further potassium and magnesium, causing unexplained drops in her levels and oftentimes resulting in emergency room visits as these drops frequently occur when the doctor's office is closed. (Tr. 229.) While the mere taking of excessive high doses of potassium and magnesium will put her in a steady state, Dr. Jakacki opined that, even when she takes these very high doses, ...
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