Byerley v. Colvin
| Decision Date | 14 May 2013 |
| Docket Number | CAUSE NO.: 1:12-CV-91-JEM |
| Parties | JASMINE E. BYERLEY, Plaintiff, v. CAROLYN W. COLVIN, Acting Commissioner of the Social Security Administration, Defendant. |
| Court | U.S. District Court — Northern District of Indiana |
This matter is before the Court on a Complaint for Judicial Review [DE 1], filed by Plaintiff Jasmine E. Byerley on March 22, 2012, and her Plaintiff's Memorandum in Support of Summary Judgment or Remand [DE 18], filed October 1, 2012. Plaintiff requests that the Administrative Law Judge's decision to deny her disability benefits be reversed or, alternatively, remanded for further proceedings. The Commissioner filed a response on January 13, 2013, and Plaintiff filed a reply on January 28, 2013. For the following reasons, the Court GRANTS Plaintiff's request for REMAND consistent with this opinion.
Plaintiff Jasmine E. Byerley filed an application for Disability Insurance Benefits ("DIB") on November 8, 2007, and for Supplemental Security Income ("SSI") on October 31, 2007, alleging disability beginning on July 1, 2005. After her application was denied initially and on reconsideration, Plaintiff requested an administrative hearing. A hearing was held May 10, 2010, and the administrative law judge ("ALJ") found the Plaintiff not disabled from the alleged onset date through the date of her decision. The ALJ's decision became the Commissioner's final decision when the Appeals Council denied Plaintiff's request for review on January 18, 2012. See 20 C.F.R. § 404.981. Under 42 U.S.C. § 405(g), Plaintiff initiated this civil action for judicial review of theCommissioner's final decision.
The parties filed forms of consent to have this case assigned to a United States Magistrate Judge to conduct all further proceedings and to order the entry of a final judgement in this case. Therefore, this Court has jurisdiction to decide this case pursuant to 28 U.S.C. § 636(c) and 42 U.S.C. § 405(g).
Plaintiff was born on June 7, 1980, and was 30 years old on the date of the ALJ's decision. She is approximately 5'1" and 230 pounds and has completed the twelfth grade. Her past relevant work includes work as a gas station cashier, and she was insured through September 30, 2006, for DIB purposes.
Records dating from Plaintiff's first emergency room visit in May 2006 through July 2009 document Plaintiff's history of complaints of rapid heart rate and heart palpitations. Several 24-hour and 30-day Holter monitor tests were administered throughout that time period. Doctors interpreting the results noted one "rare occurrence" of a superventricular tachycardia and two incidents of premature ventricular complexes. Otherwise, the only abnormal results were for intermittent sinus tachycardia with no underlying physical abnormalities found to explain its source. An electrocardiogram ("EKG") from September of 2006 showed a structurally normal heart. A July 2009 EKG found borderline to mild concentric left ventricular hypertrophy but was otherwise normal. Cardiologist Dr. Horace Chastain wrote that Plaintiff's palpitations were not related to her heart and that the "vast majority" of her symptoms were "non-cardiac in nature."
Various medications were prescribed throughout her testing and treatment, with varying levels of success. After the initial emergency room visit in May 2006, Toprol was prescribed but caused weakness and other side effects. In September 2006, Plaintiff was switched to Cardizem. In June 2007, Coreg was added to her treatment when she complained that the Cardizem alone was not effective. In September 2007, Plaintiff had a follow-up exam, and the dosage of Coreg was increased because it seemed to be helping. At an examination in April 2008, Plaintiff reported that she had taken herself off all medications after becoming pregnant. Her doctor prescribed Propranolol, which he said was able to partially control her rapid heart rate once she began taking it as ordered.
Plaintiff's records also contain numerous complaints of headaches. In May 2004, she complained of daily migraines and wrote that her headaches had begun in 1991 or 1992. Dr. Thomas Curfman prescribed naproxen but changed the prescription to Zanaflex in June 2004 when Plaintiff reported the naproxen was not working. In August 2004, Plaintiff reported to Dr. Curfman that the Zanaflex helped some but that the she was still having headaches. In November of that year, she reported continued daily mild headaches and migraines with exposure to sunlight, and in December she said the Zanaflex was helpful but made her sleepy. She again complained of weekly incapacitating headaches to Dr. Curfman in October 2005, and he increased her dosage of Zanaflex. His next record of contact with Plaintiff is from May 2007 when she reported weekly headaches. He had her resume Zanaflex and did not see her again until March of 2008 when she reported fair success with Zanaflex but sleepiness as a side effect. Dr. Curfman prescribed Inderal instead. A record from October 2008 states that Plaintiff reported the Inderal was helping with both her heart and her headaches.
Plaintiff also has been diagnosed with fibromyalgia ("FM"). The earliest mention of FM in the records is a December 2004 letter from Dr. Curfman that included an impression for "possible fibromyalgia." He noted her daily, generalized pain and stated that she had found a website discussing FM which she thought explained her situation. On January 10, 2005, orthopaedist Dr. Dan Wilcox's records show an impression of "probable fibromyalgia," and he recommended an examination by a rheumatologist. On May 27, 2005, Plaintiff visited rheumatologist Dr. Karen Ringwald for testing. Dr. Ringwald's notes from October 2005 include an impression of FM. She encouraged Plaintiff to exercise and seek a support group for FM but otherwise recommended no specific treatment. She noted that the Cymbalta Plaintiff received as part of her psychiatric treatment would also be beneficial for her FM.
Plaintiff also has complained of right shoulder pain stemming from a June 2001 injury. An MRI done in February 2004 showed mild tendinosis without a rotator cuff tear. An orthopaedic surgeon saw no need for surgery and referred Plaintiff to another orthopaedic doctor. That doctor found some tenderness in the right shoulder and ordered an electromygraphy ("EMG") test. His records indicate that the EMG and MRI found no significant abnormalities.
Plaintiff also has a history of gastroesophageal reflux disease ("GERD") and irritable bowel syndrome ("IBS"). She initially complained of both in 2001 and was treated with a high fiber diet after tests discovered no underlying causes. She reported that symptoms of diarrhea and cramping returned in December 2003. She was put on new medications, and an endoscopy and colonoscopy with biopsies were ordered. All returned normal results. Another endoscopy and colonoscopy were performed in February 2009, and both were again normal.
Plaintiff also has diagnoses of asthma and mild sleep apnea. Records show occasional asthma flare-ups and frequent complaints of sinus and chest infections, shortness of breath, and chest tightness. A December 2009 report from Dr. James Pushpom, whom Plaintiff saw for sleep apnea studies, noted that Plaintiff's bronchial asthma was well controlled.
Consultative physical exams were performed by Dr. Milan Za in June 2007 and Dr. H.M. Bacchus in March 2008. Dr. Za wrote that Plaintiff's gate was normal and that she had no problem getting on and off the exam table or out of the chair. He noted a regular, normal heart beat. He found mild lower lumbar paraspinal tenderness but a normal range of motion in all joints and normal strength. Dr. Bacchus wrote that Plaintiff's gait and station were normal and that she was able to walk, hop, and squat normally. He also noted some muscle tenderness but with good range of motion and strength. He concluded that Plaintiff physically retained functional capacity for general, light duties.
The record shows that Plaintiff has been in treatment for mental health issues at Park Center since November 2002, when she was hospitalized for twelve hours due to suicidal thoughts. She was also hospitalized in Park Center's Transitional Care Services for two weeks in January of 2003 and for a week in February of 2003 for suicidal thoughts or actions. Except for a Global Assessment Functioning ("GAF") score of 45-50 assigned during her initial hospitalization, Park City records consistently report GAF scores of 50.
Plaintiff's treating psychiatrist at Park Center, Dr. Vijoy Varma, prepared two "Report of Psychiatric Status" documents for Plaintiff's disability application, dated March 2006 and April 2007. The first contained diagnoses of Bipolar II Disorder, Dissociative Disorder NOS, and Borderline Personality Disorder (Provisional) with a current GAF of 40. Dr. Varma wrote thatPlaintiff is frequently in conflict with others and often preoccupied with her physical illnesses. He wrote that her thought processes were coherent but tangential and easily distracted. He also had to stop the standard serial sevens test because she became anxious after making a mistake. He wrote that her daily activities included writing and crafts but that she claimed to stay in bed often due to migraines and FM pain. In the section on social functioning, Dr Varma stated that Plaintiff works hard to be friendly and likeable but has lots of chaotic relationships and becomes highly defensive and argumentative if criticized. He concluded that these conflicts, along with her mood swings and trouble concentrating "would limit [her] ability to work in a cooperative, productive way." AR 868. In response to a question about her ability to do simple work routines, he responded that her attendance would be inconsistent due to health problems, mood swings, irritability, and...
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