Miller v. Berryhill
| Decision Date | 07 February 2019 |
| Docket Number | No. 17 C 235,17 C 235 |
| Parties | DOUGLAS A. MILLER, Plaintiff, v. NANCY A. BERRYHILL, Deputy Commissioner of Operations, Social Security Administration, Defendant. |
| Court | U.S. District Court — Northern District of Illinois |
OPINION AND ORDER
Plaintiff Douglas A. Miller seeks to overturn the final decision of the Commissioner of Social Security (the "Commissioner") denying his application for disability insurance benefits ("DIB") under Title II of the Social Security Act, 42 U.S.C. §§ 416(i), 423. Before the Court is Miller's appeal of the Administrative Law Judge's ("ALJ") decision denying his application for DIB and the Commissioner's motion for summary judgment. Because the ALJ's analysis satisfied the requirements of Social Security Ruling 83-20 ("SSR 83-20") and properly evaluated Miller's symptoms, the Court affirms the ALJ's decision to deny his application and grants the Commissioner's motion for summary judgment.
I. Medical History
On December 8, 2004, Miller had surgery performed on his left foot to fix a broken bone in that foot. AR 401. The doctor who performed surgery also noted that Miller was suffering from an acute gout attack, with a diffuse edema on his left foot at the site of the gout. AR 401.The surgery went well, with no complications. AR 401-02. After the surgery, Miller's nurse noted that Miller reported discomfort in his foot between a three and a four on a scale of one to ten. AR 403. She also noted that Miller was using crutches to get to the bathroom. AR 403. The nurse's report further described Miller as obese and noted a history of asthma. AR 403.
After these reports, Miller's medical history is silent until February 28, 2013, when Miller saw a nurse at Greater Elgin Family Care Center ("Greater Elgin"). AR 414. Over the next two years, Miller continued follow up at Greater Elgin, seeking treatment for depression, gout, hypertension, acute gouty arthropathy, diabetes, hypertension, depression, and hyperlipidemia. AR 462, 469, 473, 476, 482, 488, 547, 554, 560, 567, 574, 595, 604. Miller also saw several specialists, including a cardiologist for his hypertension and an orthopedic specialist for his right hip pain. AR 663, 705, 708, 711, 714, 718, 728. He admitted himself to Sherman Hospital in September 2014 for acute renal insufficiency. AR 529. His doctors at Sherman Hospital diagnosed him with acute renal failure, which was likely induced by Miller's medications and new diet. AR 532. They also noted diabetes, hypertension, morbid obesity, a history of gout, and depression. AR 529. After his hospital visit, Miller began seeing a specialist for his kidney problems as well, which included chronic kidney disease. AR 625, 631, 636, 646.
Dr. Mahesh Shah conducted a radiological evaluation for the Bureau of Disability Determination Services on June 10, 2013, and he determined that Miller had a severe degree of degenerative disease of the right hip. AR 449. Also on June 10, 2013, Dr. Jorge Aliaga performed an internal medicine consultative evaluation on Miller. AR 451. Miller reported to Aliaga that he received treatment for diabetes for the past six months, that he had a history of hypertension since January 2013, and that he had suffered from gout attacks since he was 35.AR 451. He reported two to three gout attacks per year, with the last one being in February and lasting six weeks. AR 451. Miller stated that he had hip problems since he fell from a ladder in 2004, when he also broke his foot. AR 451-52. He noted that he had pain in his right hip and could not walk more than five blocks without resting. AR 452. He was taking medication for his pain and rated his pain at a five or six out of ten. AR 452. He also noted a history of asthma. AR 452. Aliaga's physical exam revealed full range of motion in the shoulders, elbows, wrists, left hip, knees, and ankles. AR 453. He had a decreased range of motion in his right hip, however, due to pain. AR 453. His posture and gait were normal, without need of assistive device. AR 453. He did have difficulty squatting and arising due to right hip discomfort, but he could sit and stand without difficulty. AR 454. He appeared depressed. AR 454. Aliaga diagnosed Miller with diabetes, hypertension, gout, "[p]ossible degenerative osteoarthritis of the right hip aggravated by his trauma in 2004," asthma, and depression. AR 454.
Dr. Ernst Bone and Dr. R. Oh, both Disability Determination doctors, reviewed Miller's medical files and determined that, because there was "no other evidence from claimant's treating sources" from the time period between Miller's alleged onset date and his date last insured, they had to deny his claim "for insufficient evidence." AR 135, 147. They did, however, check "yes" to affirm that Miller's impairments would reasonably be expected to produce his pain and symptoms and that the medical evidence alone substantiated Miller's statements about the intensity, persistence, and functionally limiting effects of the symptoms. AR 136, 148. Dr. M. Difonso, PsyD, and Dr. Loretta McKenzie, PhD, also Disability Determination doctors, noted no information regarding a psychiatric impairment prior to the date last insured. AR 136, 148.III. Disability Claim and Hearing Testimony
On April 23, 2013, Miller filed for DIB. AR 218. He alleged that he became disabled on November 28, 2003. AR 218. The Commissioner initially denied his claim on July 23, 2013 and again on reconsideration on June 27, 2014. AR 153, 159. Miller requested a hearing, which was held on July 7, 2015 and at which Miller did not have counsel representing him. AR 39. Dr. James M. McKenna, a medical expert, testified at the hearing. AR 21. Although the ALJ's opinion states that Stephanie Archer, a vocational expert, also testified, the transcript of the hearing does not reflect this.
Miller testified that his youngest son and his son's girlfriend live with him. AR 56. He was able to drive, although only about once a month prior to the hearing and once a week prior to that. AR 56. Miller stated that he did little cleaning, although he periodically washed the dishes and did some cooking. AR 57. He dressed and bathed himself when able to leave his bed, although approximately 2-3 days per week the pain and swelling in his legs prevented him from doing so. AR 57.
Miller stated he became disabled on November 28, 2003, when he fell from a ladder while decorating a Christmas tree. AR 57-59. He testified that he injured his hips, knees, and ankles, and he also broke two bones in his foot as a result of the fall. AR 59. Miller did not have insurance at the time, and so rather than immediately seeking medical attention, he confined himself to bedrest for eight days. AR 59-60. After he was still suffering symptoms, he saw a podiatrist for his pain. AR 60. After reviewing an x-ray of Miller's foot, the doctor determined that Miller had two broken bones and would need surgery, although the surgery had to wait until the swelling in Miller's feet went down. AR 60. Miller had outpatient surgery on his left foot onDecember 8, 2004. AR 60-61. Miller stated that he could not walk for three or four months after the surgery because his feet were so swollen. AR 62. After about eight months, he testified that he was able to walk without crutches approximately once a week. AR 63. He further testified that since his surgery, he has been confined to his bed for three days each week. AR 64. Miller stated that he went to rehab for his foot, which helped him walk. AR 66. Other than the treatment discussed above, he did not have any other treatment for his foot prior to 2007. AR 67. He did not have treatment for his heart or hip prior to 2007. AR 67.
Miller did testify that he suffered gout attacks 3-4 times per year prior to 2007, and he sought treatment for those attacks. AR 67. Initially the gout attacks lasted about three days; by 2007, they lasted for two weeks. AR 67. The podiatrist who performed surgery on his foot also prescribed Miller medication for the gout, which made the outbreaks less severe and less frequent. AR 68.
Miller testified that he did not seek treatment for his hip and foot again until 2013, due to lack of resources and the fact that he did not have insurance. AR 69. He did not seek out low cost medical care or clinics because he was unaware of them—his sister "dragged" him to one in 2013 because of his condition. AR 69. He first saw a doctor again in February 2013. AR 70. Miller testified that he mentioned his hip pain at the first appointment, but the doctor wanted to focus on his blood pressure, which he found more concerning. AR 70. Miller stated that he did not go to the doctor until 2013 because he viewed going to a doctor as "a sign of weakness." AR 72. He testified that he wanted to recover through rehab on his own. AR 72.
Miller stated that he attempted to rehab himself in 2006 by going to a nearby recreation center and working with staff members there. AR 72, 75. He testified that he once went to the recreation center 183 days in a row and usually would go 3-4 days per week. AR 73. He walkedin the swimming pool, swam, lifted weights with his upper body, and did sets of exercises with his legs without weights. AR 73-74. After this rehab and prior to 2007, Miller testified that he was able to walk about 1000 steps without assistance. AR 74.
Dr. James McKenna testified next. McKenna testified that the record reflected that on December 8, 2004, Miller was morbidly obese. AR 78. Using Miller's height and weight at the time, McKenna calculated a BMI of 38.5. AR 78. However, McKenna stated that, with regard to Miller's foot, Miller's medical record merely reflected "somebody who may have had a fracture or two." AR 79. McKenna testified that he would have expected "perfect healing" based on the surgery performed and found no evidence in the record of any complication resulting from that...
To continue reading
Request your trial