Stackhouse v. Barnhart

• Decision Date: 22 May 2006
• Docket Number: No. CIV.A. 05-1069(JR).,CIV.A. 05-1069(JR).
• Citation: 435 F.Supp.2d 28
• Parties: Murleana STACKHOUSE, Plaintiff, v. Jo Anne B. BARNHART, Commissioner, Social Security Administration, Defendant.
• Court: U.S. District Court — District of Columbia

435 F.Supp.2d 28

Murleana STACKHOUSE, Plaintiff, v. Jo Anne B. BARNHART, Commissioner, Social Security Administration, Defendant.

No. CIV.A. 05-1069(JR).

United States District Court, District of Columbia.

May 22, 2006.

Jeffrey S. Gutman, The George Washington University Law School, Washington, DC, for Plaintiff.

Fred Elmore Haynes, U.S. Attorney's Office, Washington, DC, for Defendant.

MEMORANDUM

ROBERTSON, District Judge.

Plaintiff Murleana Stackhouse seeks judicial review and reversal of a final decision of the Commissioner of the Social Security Administration denying her Supplemental Security Income disability benefits. Before the court are plaintiff's motion for summary judgment [7], and defendant's motion for a judgment of affirmance [10]. For the reasons discussed below, the defendant's motion will be denied; the plaintiffs motion will be granted.

1. Background

A. Fibromyalgia

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases at the National Institutes of Health, fibromyalgia syndrome is a "common and chronic disorder characterized by widespread muscle pain, fatigue, and multiple tender points." [7-2] at 4.¹ Fibromyalgia may also be characterized by sleep disturbance, morning stiffness, headaches, irritable bowel syndrome, numbness or tingling of the extremities, and cognitive and memory problems. Id. at 5.

Fibromyalgia is not a disease, but rather a syndrome that is marked by signs and symptoms. It cannot be diagnosed using objective methods, but a physician may diagnose fibromyalgia if a patient experiences pain with the application of four kilograms of pressure upon at least 11 of 18 paired tender points (i.e. 11 of 36) on the body that have been identified by the American College of Rheumatology. [7-2] at 5 (citing "Questions and Answers about Fibromyalgia").

There are no medications available to treat fibromyalgia, but doctors prescribe pain-killers, anti-inflammatory medication, and anti-depressants to treat its symptoms. One drug used to treat the pain aspect of fibromyalgia is Oxycontin, a potent opioid-based Schedule II drug for moderate to severe pain. [7-2] at 6.² Used alone, it can cause tiredness; when combined with other pain relievers or antihistamines, it can cause severe or "dangerous" drowsiness. [7-2] at 6.³

B. Plaintiff's relevant medical history

Ms. Stackhouse was born in 1959; at the time of her November 2003 hearing, she was 44 years old. [10] at 5. She suffers from fibromyalgia, lumbar and cervical disc disease, lumbar and cervical disc disease radiculopathy, right shoulder disorder, bilateral carpal tunnel syndrome and bronchial asthma. [7-2] at 4.

Ms. Stackhouse first reported significant pain in 1997, when she was admitted to the hospital with chest pains. [10] at 6. She was diagnosed with an upper respiratory infection and "atypical chest pain." Id. at 6. After a serious fall in February 1998, she began experiencing constant pain. Dkt. # 5 at 452. In September 1998, she sought treatment for neck pain that radiated into the right arm. [10] at 6. An MRI taken at the time was normal, as were the plaintiff's x-rays, though the doctor noted there were some mild spinal abnormalities. Id.

In February 1999, Ms. Stackhouse again reported to the local hospital that she was experiencing neck pain that radiated into her right arm. She indicated that she had been in pain for eight months. [10] at 6. EMG testing again indicated some mild abnormalities. Over the next few months, plaintiff underwent therapy, but she had essentially the same symptoms and pain. Id. at 7.

In April 1999, plaintiff began seeing Dr. Hampton J. Jackson. He ordered lab testing in April 1999 that ruled out rheumatoid arthritis and some other possible causes for Ms. Stackhouse's pain. A myelogram with CT scan was also normal. [10] at 8. However, Dr. Jackson did find that Ms. Stackhouse had significant trigger points for her pain in her upper trapezius muscle, and administered a paraspinal block injection to help alleviate pain. Id.

By January 2000, plaintiff was taking Oxycontin regularly for pain. [10] at 8. In February 2000, Dr. Jackson found that she had increased symptoms, and he increased her medication as well as administering a facet block injection to alleviate pain. Ms. Stackhouse experienced some relief. [10] at 9.

By May of 2000, at least one of Ms. Stackhouse's multiple physicians, Dr. Palmer, had diagnosed her with fibromyalgia. [5] at 552-53; [10] at 13. In June and August 2000, Ms. Stackhouse symptoms worsened again, and Dr. Jackson indicated that her condition made her unfit for any work. [10] at 9. After a brief respite, by October 2000, her condition had worsened yet again. Id. at 10. A November 2002 MRI, however, was normal. A third physician, Dr. T.K. Asadi, treated the plaintiff in November 2000 and January 2001. In November 2000, Dr. Asadi found that plaintiff had full muscle strength, a normal gait and stance, and a limited cervical and lumbar spine range of motion. By January, Ms. Stackhouse had regained a full range of cervical and lumbar spine motion. [10] at 11.

In October 2001, a fourth physician — Dr. Potter, a rheumatologist — separately diagnosed the plaintiff with fibromyalgia. [10] at 11. That month, he indicated that she was unable to work, and that her pain had been unresponsive to treatment. [10] at 11. In December 2001, Dr. Jackson agreed, indicating in a letter that plaintiffs fibromyalgia, among her other conditions, prevented her from working. [10] at 11-12.

When Ms. Stackhouse returned to Dr. Asadi in February 2002, she had multiple tender points, all over. Dr. Asadi continued treatment, with medication, through March, June, and August of 2002. He could find no organic reason for her continuing pain. At each visit, she had full muscle strength, a normal gait, and a full range of cervical and lumbar motion. [10] at 12. His reports, however, — dating from November 2000 to September 2002 — all contain diagrams indicating that Ms. Stackhouse had 19 to 20 tender points, all over her body. A diagram, prepared by Dr. Potter on February 5, 2002, represented only the front of Ms. Stackhouse, but indicated nine tender points. Dr. Palmer's March 7, 2003 letter further states that Ms. Stackhouse's "musculoskeletal examination was significant for tender points." [7-2] at 5.

There is now consensus among the physicians that Ms. Stackhouse has fibromyalgia, among other conditions. Although the records reflect periods of improvement, they have been very brief and plaintiffs conditions continue to cause her substantial, effectively unremitting, pain. At nearly every visit to her treating physicians, she has reported back, neck, arm, or shoulder pain, as well as numbness and sleep difficulties. [7-2] at 5. Her pain level is a nine out of ten both morning and afternoon, and she has difficulty engaging in all activities of daily living. [7-2] at 7. She cannot lift ten pounds frequently or occasionally, has significant limitations in her gross and fine motor skills, can only walk or stand for two or three minutes at a time, requires a sit/stand option (at will), and cannot be employed in a position requiring good vision. [7-2] at 4. She takes Oxycontin for her pain, and several other drugs to help relieve her lumbar and cervical radiculopathy, bronchial asthma, allergies, gastroesophageal reflux disease, and migraines. [7-2] at 6-7. She uses a cane to assist her when walking any distance. [5] at 198. A three block walk takes her at least 20 to 25 minutes, because she must stop frequently to relieve her pain. She needs assistance dressing, cooks infrequently, and requires her children's help with grocery shopping and laundry. [7-2] at 9. She has difficulty writing, and can only write her name before experiencing pain. [7-2] at 10. Her condition also prevents her from leaving her home to visit people or attend religious services, and she has no hobbies. [7-2] at 16.

C. Plaintiff's employment history

Ms. Stackhouse has a tenth grade education. [7-2]. Prior to developing her current health problems, she was employed, at various times, as a clothing store clerk, a teacher's assistant, and child care worker. [10] at 5. At one of the administrative hearings, Ms. Stackhouse testified that her last form of employment was providing some modest baby-sitting services, for about two hours a day. [5] at 193. The children were all school-aged, and she did not prepare meals for them, dress them, or drive them anywhere. Her only responsibility was to watch them do their homework for two hours a day. Id. She fell asleep, however, four out of every five days the children were in her home, and, after a year, discontinued the babysitting because she felt she could not properly monitor the children. [5] at 206-207. She has been unemployed since that time. At both her 2001 and 2003 administrative hearings, vocational experts testified that, if her testimony about her condition was credible, there were no jobs she could perform. [5] at 180; id. at 216.

D. Procedural History

Ms. Stackhouse applied for Supplemental Social Security Income (SSI) on April 27, 2000, and was denied benefits on August 1, 2000. [7-2] at 2. On April 26, 2001, she requested a hearing before an Administrative Law Judge (ALJ); the hearing was held on October 31, 2001. Id. On April 22, 2002, the ALJ denied Ms. Stackhouse's claim. She filed a timely appeal with the Social Security Administration's (SSA) Appeals Council, which remanded the case to the ALJ for consideration of Ms. Stackhouse's fibromyalgia and a more detailed explanation of how Ms. Stackhouse's subjective complaints were inconsistent with her demeanor and physical activity. [7-2] at 2-3. On May 8, 2003, the ALJ held another hearing and, on November 7, 2003, again rejected plaintiff's claim. Ms. Stackhouse requested another review from the Appeals Council; the request was denied on February 26, 2005. The Council stated...