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Kerns v. Commissioner of Social Security

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

June 25, 2019

CHERYL A. KERNS, Plaintiff,
v.
COMMISSIONER OF SOCIAL SECURITY, Defendant.

          Patricia A. Gaughan Judge.

          REPORT AND RECOMMENDATION

          JAMES R. KNEPP II UNITED STATES MAGISTRATE JUDGE.

         Introduction

         Plaintiff Cheryl A. Kerns (“Plaintiff”) filed a Complaint against the Commissioner of Social Security (“Commissioner”) seeking judicial review of the Commissioner's decision to deny disability insurance benefits (“DIB”). (Doc. 1). The district court has jurisdiction under 42 U.S.C. §§ 1383(c) and 405(g). This matter has been referred to the undersigned for preparation of a report and recommendation pursuant to Local Rule 72.2. (Non-document entry dated May 23, 2018). Following review, and for the reasons stated below, the undersigned recommends the decision of the Commissioner be affirmed.

         Procedural Background

         Plaintiff filed for DIB in March 2012, alleging a disability onset date of June 1, 2009. (Tr. 196-98). Her claims were denied initially and upon reconsideration. (Tr. 110-13, 128-30). Plaintiff then requested a hearing before an administrative law judge (“ALJ”). (Tr. 135-36). Plaintiff (represented by counsel), and a vocational expert (“VE”) testified at a hearing before the ALJ on August 12, 2014. (Tr. 32-65). On December 9, 2014, the ALJ found Plaintiff not disabled in a written decision. (Tr. 11-26). The Appeals Council denied Plaintiff's request for review, making the hearing decision the final decision of the Commissioner. (Tr. 1-4); see 20 C.F.R. §§ 404.955, 404.981. Plaintiff filed a timely complaint against the Commissioner on May 25, 2016 in the Northern District of Ohio. See Kerns v. Comm'r of Soc. Sec., No. 1:16-cv-1264 (N.D. Ohio) (Doc. 1). On November 4, 2016, the parties filed a joint motion to remand the case, see id. at Doc. 16, which the Court granted, id. at Doc. 18; Tr. 1073.

         Plaintiff (again represented by counsel) and a VE testified at a remand hearing before the ALJ on July 19, 2017. (Tr. 971-1019). On September 6, 2017, the ALJ again found Plaintiff not disabled in a written decision. (Tr. 941-53). The Appeals Council denied Plaintiff's request for review, making the hearing decision the final decision of the Commissioner. (Tr. 924-29); see 20 C.F.R. §§ 404.955, 404.981. Plaintiff timely filed the instant action on May 23, 2018. (Doc. 1).

         Factual Background [1]

         Personal Background and Testimony

         Plaintiff was born in July 1967, making her 41 years on her alleged onset date. (Tr. 68). She alleged disability due to depressive disorder, opiate induced mood disorder, asthma, obesity, scoliosis, and chronic obstructive pulmonary disease (“COPD”). See id.

         Plaintiff had a high school education and a certificate in welding. (Tr. 37-38). She had past work as a cab driver (Tr. 38), and a machinist (Tr. 39). Plaintiff attended approximately two or three years of college, but dropped out due to poor grades as a result of memory issues. (Tr. 978-79).

         2014 Hearing

         At the 2014 hearing, Plaintiff believed that her most limiting impairment was posterior tibial tendon dysfunction in her feet and her cervical stenosis which affected her balance. (Tr. 43-44). Plaintiff also suffered from, inter alia, anxiety and depression. (Tr. 51). Plaintiff started mental health treatment in 2012 but believed she “should have been getting treatment for a long [time] before [she] started”. (Tr 52). Plaintiff's symptoms included a lack of motivation, decreased energy, appetite fluctuations, and a loss of interest in social interaction. (Tr. 52-53). Plaintiff testified her depression also caused difficulties with concentration and focus, noting she would “disappear” in the middle of conversations. (Tr. 54). By way of example, she described pulling out of a funeral procession because she “forgot what [she] was doing”. Id.; see also Tr. 1005.

         Plaintiff also had anxiety. (Tr. 55). She could handle “a little” shopping, but perspired and hyperventilated if the store became crowded or there were children crying nearby. Id. She had anxiety attacks approximately two to five times per month. Id. At home, Plaintiff's anxiety was triggered by arguments with her son. Id.

         Plaintiff lived alone. (Tr. 56). On a typical day, she woke around 10:00 a.m. and cared for her dogs and cat. Id. Plaintiff's son came over “just about every day” and assisted her with lifting objects and putting away groceries. Id. There were days where Plaintiff did not feel like getting out of bed. (Tr. 57).

         2017 Hearing

         At the time of the 2017 hearing, Plaintiff still lived alone, but her son helped with yard work and housework, including cooking and cleaning. (Tr. 980). She drove a car and sometimes made brief grocery store trips. Id.

         Plaintiff testified that psychiatrist Dr. Brojmohun, and later psychiatrist Dr. El-Sayegh treated her for major depressive disorder and generalized anxiety disorder. (Tr. 999). She attempted suicide in 2011 by ingesting pills (Tr. 1001), which led her to start mental health treatment with Ms. Grippi, a nurse practitioner. (Tr. 1000-01). Plaintiffs mental impairments caused her to stay at home most of the time and affected her ability to concentrate on things such as television or reading. (Tr. 1002-03). Plaintiff had anxiety when around groups of people and did not socialize. (Tr. 1003-05). She had difficulty remembering things and wrote herself reminder notes “all the time”. (Tr. 1005). Plaintiff reported trying many different medications and noted she was “kind of stable now”, meaning that her depression was unchanged. (Tr. 1001-02).

         Relevant Medical Evidence

         On December 18, 2011, Plaintiff walked into to the emergency room and reported that she intended to commit suicide by ingesting sleeping pills, but her son had stopped her. (Tr. 334). Plaintiff appeared oriented and cooperative, but had suicidal ideation. Id. Providers transferred Plaintiff to Northcoast Behavioral Healthcare (“Northcoast”) for inpatient psychiatric care (Tr. 336), where she remained hospitalized for ten days, see Tr. 370 (discharge summary).

         While at Northcoast, Plaintiff told Rajeet Shrestha, M.D., that she had a “bad few years”. (Tr. 370). She cited financial pressures and noted her home was in foreclosure. Id. She became increasingly depressed, hopeless and helpless. Id. Plaintiff reported no prior psychiatric treatment or psychotropic medications. Id. She was cooperative and compliant with treatment. (Tr. 371). Her mood was “still somewhat depressed and fragile” at the beginning of her hospital stay. Id. At discharge, Plaintiff was alert and oriented, with regular speech, a “good” mood; euthymic affect, goal-directed thoughts, good insight and judgment, and no suicidal ideation. (Tr. 372). Dr. Shrestha diagnosed depressive disorder (not otherwise specified, rule out major depressive disorder), alcohol dependence, opioid dependence, nicotine dependence, asthma, obesity, and chronic pain; she assigned a Global Assessment of Functioning (“GAF”) score of 65[2]. (Tr. 372). She was prescribed several medications on discharge. Id.

         In January 2012, Plaintiff saw Patricia Grippi, M.S.N., A.P.R.N-B, at Signature Health for a psychiatric evaluation. (Tr. 382). Plaintiff reported depression, chronic pain, reliance on alcohol and street drugs for pain, insomnia, anxiety, fear, loss of interest and motivation, loss of self-esteem, and difficulty concentrating. Id. Ms. Grippi observed Plaintiff to be “sloppily dressed” and disheveled. Id. Plaintiff had good eye contact and a logical thought process, but never smiled, and had spontaneous pressured speech. Id. She denied suicidal ideation, had good concentration and memory, and had fair judgment, knowledge, and insight. Id. Ms. Grippi adjusted Plaintiff's medications and referred her for individual counseling and case management. (Tr. 383). Later that month, Plaintiff reported decreased depression with no suicidal thoughts. (Tr. 386). She was taking classes at Kent State University and recently took in her previously-homeless bipolar 23-year-old son. Id. Plaintiff reported she “motivated herself enough to clean up a bedroom” in her home for him and was working hard to cope with his irritability and temper. Id. On examination, Plaintiff had good eye contact, smiled frequently, and was open with her feelings; she had a logical and organized thought process, good concentration, and fair insight, judgment, and knowledge. Id.

         In February 2012, Plaintiff returned to Ms. Grippi, reporting she continued to feel depressed, but did not have suicidal thoughts. (Tr. 391). Ms. Grippi found Plaintiff had good eye contact, smiled appropriately, and had spontaneous coherent speech; she had a logical and organized thought process, good concentration and memory, and fair insight, judgment, ...


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