Giles v. Barnhart, C04-2061.

• Court: U.S. District Court — Northern District of Iowa
• Writing for the Court: Jarvey
• Citation: Giles v. Barnhart, 368 F.Supp.2d 924 (N.D. Iowa 2005)
• Decision Date: 28 April 2005
• Docket Number: No. C04-2061.,C04-2061.
• Parties: Patricia GILES, Plaintiff, v. Jo Anne B. BARNHART, Commissioner of Social Security, Defendant.

368 F.Supp.2d 924

Patricia GILES, Plaintiff, v. Jo Anne B. BARNHART, Commissioner of Social Security, Defendant.

No. C04-2061.

United States District Court, N.D. Iowa, Eastern Division.

April 28, 2005.

COPYRIGHT MATERIAL OMITTED

Cynthia A. Rybolt, Legal Services Corp. of Iowa, Waterloo, IA, for Plaintiff.

Lawrence D. Kudej, US Attorney's Office, Cedar Rapids, IA, for Defendant.

REVISED ORDER¹

JARVEY, United States Magistrate Judge.

This matter comes before the court pursuant to briefs on the merits of this application for disability insurance benefits. On March 11, 2005, the parties consented to the exercise of jurisdiction by a United States Magistrate Judge pursuant to 28 U.S.C. § 636(C). (Docket # 12). The final decision of the Commissioner of Social Security is reversed and this matter is remanded for award of benefits.

PROCEDURAL BACKGROUND

Plaintiff Patricia Giles applied for Title II Social Security benefits and Title XVI supplemental security income benefits on October 23, 2000, alleging an inability to work since October 23, 2000, due to chronic headaches, hyperthyroidism, arthritis, and hypertension. Ms. Giles' application was originally denied and was denied on reconsideration. A hearing before Administrative Law Judge (ALJ) John E. Sandbothe was held on October 9, 2003. In an opinion dated March 4, 2004, the ALJ denied benefits. On July 15, 2004, the Appeals Council denied Ms. Giles' request for review.

FACTUAL BACKGROUND

Ms. Giles' relevant medical history is set forth below:

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                 DATE MEDICAL DIAGNOSIS, PROCEDURE, TREATMENT
                PROVIDER FINDINGS, NOTES, ETC
                ------------------------------------------------------------------------------------------------------------------
                9/20/00   PCHC                S: Also complains of episodes of headache that usually come in
                                              clusters for a few days, headaches are frontal and usually associated
                                              with runny eyes and conjunctiva injection. Sometimes takes
                                              Tylenol with some relief
                                              A: Cluster headaches. (Tr. 198)
                ------------------------------------------------------------------------------------------------------------------
                

10/11/00  PCHC — Dr.          S: Had written a script for Atenolol [on 9/28/00] which patient
                          Deborah             never picked up. (Tr. 195)
                          Johnson
                ------------------------------------------------------------------------------------------------------------------
                10/23/00  Allen               Presented to emergency room after passing out at work. Had an
                          Memorial            additional seizure-like episode in the emergency room and was
                          Hospital —          not particularly post ictal afterwards, just a little confused for a
                          Dr. Steven          few moments. Diagnosis: New onset of seizure activity; syncopal
                          Lamar, ER           episode. The head computerized tomography was negative
                          physician;          Admitted to the hospital. Review of symptoms during history/physical
                          Dr. Deborah         include chronic episodes of dizziness, chronic headache
                          Johnson,            — usually generalized and throbbing — no relief with Tylenol
                          admitting           or Motrin. Assessment: syncopal episode with subsequent seizures
                          physician           as reported; hypertension, controlled, hyperthyroidism
                                              Plan: She has an appointment at Iowa City. She had been
                                              referred there earlier in the month when seen by me for her
                                              hyperthyroidism for further management. (Tr. 157-160)
                ------------------------------------------------------------------------------------------------------------------
                10/23/00  Allen               Procedure: CT Head WO Contrast
                          Memorial            Impression: Negative noncontrast CT imaging of brain. (Tr
                          Hospital —          164-65)
                          Dr. Greg
                          Raecker
                ------------------------------------------------------------------------------------------------------------------
                10/24/00  Allen               Consultation: History of hypertension, hyperthyroidism, chronic
                          Memorial            headaches, daily headaches. She does have chronic headaches
                          Hospital —          for the past almost 15 years, daily headaches, mainly in the front
                          Dr. Thomas          temporal area and at times she does get aggressive headache
                          Mulakkan,           which does cause some nausea and photophobia. Past medical
                          Consulting          history significant for headache, history of hyperthyroidism on
                          Physician           mediation, planning to go to Iowa City for radioactive treatment
                                              hypertension. Clinical Impression: General exam and neurological
                                              exam are unremarkable without any focal deficits. The
                                              patient possibly had an episode of change in mental status most
                                              likely due to cyncope, vasovagal episode. In addition, with her
                                              history of headaches, she may have a vertebrobasilar type of
                                              vascular headache during syncope. She does have chronic headache
                                              most likely due to tension, stress headache. However,
                                              vascular cause cannot be entirely excluded, underlying common
                                              migraine is a possibility. (Tr. 161-62)
                ------------------------------------------------------------------------------------------------------------------
                10/25/00  Allen               Normal MRI of the brain. (Tr. 164)
                          Memorial
                          Hospital —
                          Dr. Lawrence
                          Liebscher
                ------------------------------------------------------------------------------------------------------------------
                10/30/00  PCHC — Dr.          S: Followup visit from her recent hospitalization on 10/23/00 with
                          Deborah             syncopal episodes. Since discharge patient still complains of
                          Johnson             chronic headaches. She did not get any relief from Fioricet
                                              which she was on in the hospital. On discharge I placed her on
                                              Midrin and still no relief with this. She states that headaches
                                              are frontal and constantly aching with feeling of pressure behind
                                              the eyes. CT of head and MRI were negative for any space
                                              occupying lesion.
                                              A: Chronic headache, questionable atypical migraine verses related
                                              to her hypothyroidism. Patient states she does not feel she
                                              is able to go back to work at this time because of chronic
                                              headaches and dizziness, certainly when she returns to work she
                                              will not be able to operate machinery. Work excuse given until
                                              10th this month. (Tr. 195)
                ------------------------------------------------------------------------------------------------------------------
                

1/25/01   Convenient          S: Headache and pain behind her eyes. (Tr. 292)
                          Care — Dr.
                          Garold
                          Moyer
                ------------------------------------------------------------------------------------------------------------------
                02/21/01  PCHC — Dr.          S: Patient [has] history of hypothyroidism and cluster headaches
                          Kelly Cobb          who presents for complaint of pain in right leg and lower back.
                                              She states she just woke up like this morning and she does not
                                              recall any trauma to the area. She describes just a cramping
                                              aching sensation all the way down her leg. She states that her
                                              knee was swollen earlier this morning but this is resolved. She
                                              did not report any other arthritic complaints. No neck stiffness.
                                              No shooting pains. No limitation of use of her joints.
                                              O: Musculoskeletal examination, she has tenderness over the
                                              lower L-spine. There is no other evidence of trauma to the leg,
                                              the knee is without effusion, warmth or tenderness. Patient
                                              complains of pain wherever you touch the right leg. She also
                                              complains of pain in the right leg with straight leg raise and with
                                              flexion and extension of the knee.
                                              A: Thyroid disease. Patient has not followed up with endocrine.
                                              Musculoskeletal pain of unknown origin. (Tr. 191)
                ------------------------------------------------------------------------------------------------------------------
                03/22/01  PCHC — Dr.          S: Patient ... presents complaining of pain in her right knee
                          Kelly Cobb          constantly. She states it feels like it is pulsing inside. She also
                                              states she has had some stiffness in her hands in the morning
                                              and also pains in her shoulders.
                                              O: Extremities, no edema. Musculoskeletal, there is no evidence
                                              of acute synovitis. She has good range of motion of her shoulders,
                                              elbows, wrists and digits in both hands. She has good
                                              range of motion of both knees. There does seem to be bony
                                              deformity of the right

...