United States District Court, N.D. Ohio, Eastern Division
JENNIFER L. SKAGGS, Plaintiff,
COMMISSIONER OF SOCIAL SECURITY, Defendant.
MEMORANDUM OPINION & ORDER
Kathleen B. Burke United States Magistrate Judge.
Jennifer L. Skaggs (“Plaintiff” or
“Skaggs”) seeks judicial review of the final
decision of Defendant Commissioner of Social Security
(“Defendant” or “Commissioner”)
denying her applications for social security disability
benefits. Doc. 1. This Court has jurisdiction pursuant to 42
U.S.C. § 405(g). This case is before the undersigned
Magistrate Judge pursuant to the consent of the parties. Doc.
13. As explained more fully below, the Administrative Law
Judge's reasons for discounting Skaggs' credibility
are not supported by the record and/or are not sufficiently
explained to allow this Court the ability to determine
whether the credibility assessment is supported by
substantial evidence. Accordingly, the Court REVERSES and
REMANDS the Commissioner's decision for further
proceedings consistent with this opinion.
filed applications for Disability Insurance Benefits
(“DIB”) and Supplemental Security Income
(“SSI”) on February 13, 2013. Tr. 136, 247, 251.
She alleged a disability onset date of September 1, 2005,
(Tr. 136, 247, 251), but later amended her alleged onset date
to July 20, 2011 (Tr. 36, 136). Skaggs alleged disability due
to fibromyalgia, rheumatoid arthritis, neuropathy, lumbar
radiculopathy, carpal tunnel syndrome, hand numbness,
polyneuropathy, DDD, diabetes mellitus - type 2, sciatica,
vertigo, obesity, and depression. Tr. 71, 157, 174, 271.
Skaggs' applications were denied initially (Tr. 157-172)
and upon reconsideration by the state agency (Tr. 174-185).
Thereafter, she requested an administrative hearing. Tr. 186.
On November 13, 2014, Administrative Law Judge Yvette N.
Diamond (“ALJ”) conducted an administrative
hearing. Tr. 33-70.
December 19, 2014, decision (Tr. 133-154), the ALJ determined
that Skaggs was not under a disability within the meaning of
the Social Security Act from July 20, 2011, through the date
of the decision (Tr. 149). Skaggs requested review of the
ALJ's decision by the Appeals Council. Tr. 21. On March
21, 2016, the Appeals Council denied Skaggs' request for
review, making the ALJ's decision the final decision of
the Commissioner. Tr. 1-7.
Personal, vocational and educational evidence
was born in 1974. Tr. 38, 147, 247. At the time of the
hearing, Skaggs was 40 years old. Tr. 38. She was divorced
with two adult children, ages 21 and 22. Tr. 38. She lived in
a house with her two children. Tr. 38. She weighed 285 pounds
and was 5 feet tall. Tr. 38. Skaggs graduated from high
school and attended college but she did not complete one full
year of college. Tr. 39, 272.
past work included self-employment as an in-home daycare
provider. Tr. 40. She performed that work from 2004 to 2010.
Tr. 40. Skaggs performed the in-home daycare work herself,
having a maximum of six children in her care at a time. Tr.
40. From 2005 until 2007, the age ranges of the children in
her care were 3 months up to 11 years old. Tr. 40-41. In 2009
and 2010, Skaggs only cared for older children. Tr. 41. She
was unable to care for babies and toddlers because she was
unable to pick them up. Tr. 41. She stopped her in-home
daycare work in 2010. Tr. 40. After Skaggs stopped working as
an in-home daycare provider, she applied for one cashier job.
to her in-home daycare work, in 2002, Skaggs worked as an
assistant supervisor in a pre-school for 3-year olds. Tr. 41.
Prior to the pre-school work, Skaggs also worked as a sales
clerk/stock clerk/cashier in a toy store and as a mortgage
loan representative. Tr. 42-43.
is an obese woman (Tr. 410, 419) who seeks disability based
on her multiple medical conditions. Since 2005 through at
least 2014, Skaggs has been diagnosed with and treated for
various conditions, including urinary problems (Tr. 368-405,
541-543, 546, 625), diarrhea (Tr. 429-431, 456-458, 469,
477-480, 482-483, 485-486, 544-545, 546, 573-578), heartburn
(Tr. 544-545), rheumatoid arthritis (Tr. 356, 490-503, 505,
555-556, 594-602), fibromyalgia (Tr. 356, 419, 431, 504, 506,
551-552, 555, 579-593, 594-602), diabetes mellitus, type II
(Tr. 540, 552, 555-556), back and leg pain (Tr. 406-428, 504,
514-516, 536, 553, 571-572, 579-593, 603-611, 626-627),
sensory loss/neuropathy (Tr. 504, 537-539, 540, 603-611,
625-632), foot pain (Tr. 540, 623-624), speech difficulty
(603, 606, 607), and depression (Tr. 485-486, 489, 552,
555-556). In 2013 through the first part of 2014, Skaggs lost
her medical insurance coverage and could not afford medical
treatment, including medications. Tr. 47-48, 102, 282, 289,
297, 517, 527.
Physical impairment medical opinions
examining physician's opinion
6, 2013, Marsha D. Cooper, M.D., saw Skaggs for a
consultative evaluation. Tr. 517-525. Skaggs' daughter
was with her at the visit. Tr. 519. Skaggs complained of
heartburn, swollen legs, her fingers getting stuck sometimes,
aches in her body all the time, urinary and fecal
incontinence, and low back pain. Tr. 517. Skaggs indicated
she had been off of her medication since January because her
child had turned 18 years old and she lost her medical card,
which was really the reason why she was applying for
disability. Tr. 517. On examination, Dr. Cooper observed that
Skaggs was “very obese, short statured female, [and]
somewhat theatrical.” Tr. 519. Dr. Cooper's
examination of Skaggs' spine revealed a negative straight
leg raise, loss of lordotic curve, and no gross deformities.
Tr. 519. There was no cyanosis, clubbing or edema in
Skaggs' extremities and Skaggs' pedal pulses were
good at 3/4. Tr. 519. There were no effusions, redness, heat
or gross deformities observed in Skaggs' bones/joints.
Tr. 519. Dr. Cooper also observed that Skaggs was slightly
pigeon-toed with her right foot; she did not require
assistive devices; she had a normal cadence to her gait; and
she had no issues with weight transfer or balance. Tr. 519.
Skaggs' deep tendon reflexes were equal and symmetric at
2/4; she had normal right and left hand grips; normal finger
to nose with eyes open and closed; normal manual dexterity;
Rhomberg and Babinski were normal; and Skaggs had normal
balance. Tr. 519. With the exception of slight limitations in
range of motion with flexion and extension of the dorsolumbar
spine, range of motion testing was normal. Tr. 522-525.
Manual muscle testing was normal. Tr. 521.
Cooper's clinical impression was that:
The claimant's physical complaints do not correlate with
any of the findings that I find. Additionally, her back pain
can easily be explained by her gross obesity. Her innumerable
somatic complaints however, do not correlate to the clinical
findings. This candidate is capable of sedentary work with no
issues. No abnormal neurologic findings are found. There are
no abnormal findings of the cardiovascular or pulmonary
system. Her intellect is excellent as well.
21, 2013, state agency reviewing physician Leon D. Hughes,
M.D., completed a physical RFC assessment. Tr. 78-80. Dr.
Hughes opined that Skaggs could occasionally lift/carry 20
pounds and frequently lift/carry 10 pounds; stand/walk a
total of 4 hours; sit about 6 hours; and push/pull
unlimitedly other than as shown for lift/carry. Tr. 78. Dr.
Hughes explained that the exertional limitations were based
on Skaggs' massive obesity, noting that her BMI wavered
between 55 and 60. Tr. 78. Dr. Hughes also opined that Skaggs
had the following postural limitations: occasional climbing
ramps/stairs, stooping, kneeling, crouching, and crawling and
never climbing ladders/ropes/scaffolds. Tr. 78-79. Dr. Hughes
explained that the postural limitations were based on
Skaggs' massive obesity and DJD. Tr. 79. Dr. Hughes opined
that Skaggs was limited to frequent handling and fingering
due to CTS. Tr. 79. Dr. Hughes also opined that Skaggs
would be required to avoid hazards, i.e., unprotected
heights, due to her obesity. Tr. 79-80.
reconsideration, on July 2, 2013, state agency reviewing
physician John L. Mormol, M.D., completed a physical RFC
assessment. Tr. 107-109. Dr. Mormol reached the same opinions
as Dr. Hughes regarding Skaggs'
limitations. Tr. 107-109.
Mental impairment medical opinions
examining psychologist's opinion
August 5, 2013, consultative examining psychologist Wayne
Morse, Ph.D., conducted a consultative evaluation. Tr.
526-534. Skaggs drove herself to the evaluation. Tr. 526.
Skaggs' chief complaints were back pain, which started at
age 7 due to a motor vehicle accident; rheumatoid arthritis,
which was diagnosed at age 18 months; chronic diarrhea; and
diabetes. Tr. 526-527. Skaggs indicated that her diabetes was
well under control with medication but she was not taking
medication due to a lack of medical insurance. Tr. 527. She
reported that her pain level increases with any type of
physical activity. Tr. 527. Dr. Morse noted that, in 2012,
Skaggs reported having 10-12 bowel movements per day and was
referred to a physician for a colonoscopy. Tr. 527. As far as
activities of daily living, Skaggs reported that she has good
days and bad days so her ability to perform household chores
depends on how she is feeling on a particular day. Tr. 528.
She reported that her symptoms had been “seriously
interfering with her functioning for most of her life, but
especially the past 3 years.” Tr. 528. Dr. Morse
observed that Skaggs had a difficult time walking and sitting
due to her back problems and she shifted uncomfortably in her
seat and had to stand up and walk around during the
evaluation briefly to relieve her discomfort. Tr. 529.
Skaggs' overall mood was depressed and anxious with a
broad and appropriate affect. Tr. 529. She was very tearful
when talking about her mental health symptoms. Tr. 529. She
reported suicidal thoughts with a plan but she expressed no
serious intent or sense of immediacy. Tr. 529.
Morse diagnosed major depressive disorder, recurrent, severe
without psychotic features; specific phobia (situational
type); post-traumatic stress disorder; dissociative disorder
(not otherwise specified); learning disorder (not otherwise
specified). Tr. 530. Dr. Morse opined that Skaggs'
prognosis was poor, indicating that Skaggs did not feel the
need for mental health treatment; her medical problems
continued to deteriorate, which exacerbated her mental health
issues; and without psychotherapy and psychotropic
medication, it was very unlikely that her currents symptoms
would improve. Tr. 531. Dr. Morse indicated Skaggs had
“serious medical issues that limit her mobility and
exacerbate her psychopathology.” Tr. 531.
respect to Skaggs' functional abilities, Dr. Morse opined
that Skaggs would have no difficulty remembering work-like
procedures and no difficulty understanding and remembering
very short and simple instructions but she would have
difficulty understanding and remembering detailed
instructions due to her dissociative symptomatology. Tr. 532.
He opined that Skaggs would have no difficulty carrying out
very short and simple instructions, as well as detailed
instructions but she would have considerable difficulty
sustaining an ordinary routine, performing at a consistent
pace, making simple work-related decisions, and completing a
normal workday without frequent interruptions from her
dissociative symptomatology, limited physical mobility, and
anxiety. Tr. 532. Dr. Morse opined that the evidence
suggested that Skaggs had great difficulty interacting with
the general public due to her social anxiety and fear of men
and those symptoms would significantly interfere with her
ability to work in coordination with others, ask simple
questions, request assistance or respond appropriately to
criticism from supervisors but she would be able to maintain
socially appropriate behavior and adhere to basic standards
of neatness and cleanliness. Tr. 532-533. Dr. Morse also
opined that the evidence suggested that Skaggs would be
unable to respond appropriately to changes in the work
setting, set realistic goals, make plans independently of
others, or engage in activities independent of supervision or
direction; she needed a great deal of assistance managing
household chores and her finances but she was able to care
for her personal hygiene; and she would have considerable
difficulty managing normal, everyday work pressures. Tr. 533.
reconsideration, on August 13, 2013, state agency reviewing
psychologist Leslie Rudy, Ph.D., completed a Psychiatric
Review Technique (“PRT”) (Tr. 104-105) and Mental
RFC Assessment (Tr. 109-111).
PRT, Dr. Rudy found that Skaggs would have mild restrictions
in activities of daily living; moderate difficulties in
maintaining social functioning and in maintaining
concentration, persistence, or pace; and no repeated episodes
of decompensation. Tr. 105. In the Mental RFC Assessment, Dr.
Rudy found no understanding and memory limitations but found