United States District Court, S.D. Ohio, Western Division, Dayton
M. Rose District Judge
REPORT AND RECOMMENDATIONS 
L. Ovington United States Magistrate Judge
Casey Call asserts that his many health problems prevent him
from working. In August 2016, he turned to the Social
Security Administration for assistance by applying for
Disability Insurance Benefits and Supplemental Security
Income. After initial administrative proceedings,
Administrative Law Judge Elizabeth A. Motta denied
Plaintiff's applications based on her conclusion that he
was not under a “disability, ” as the Social
Security Act defines it. (Doc. #6, PageID #s 71-86).
present case, Plaintiff challenges ALJ Motta's
non-disability decision on two main grounds-namely, ALJ Motta
committed reversible error in evaluating the medical-source
opinions and in evaluating his pain and other symptoms. He
seeks an Order remanding this matter for benefits or, at a
minimum, for further administrative proceedings. The
Commissioner finds no reversible error in the ALJ's
decision and asks the Court to affirm her decision.
asserts that he was under a benefits-qualifying disability
starting on August 17, 2015. He was 35 years old on that date
and considered a “younger person” under social
security law. See 20 C.F.R. §§
404.1563(c), 416.963(c). He has a high-school education and
worked as a landscape foreman.
testified at the administrative hearing that he lived in his
wife and two school-aged children, and his wife's
parents. They lived in his wife's parents' house
because, since July 2017, he could no longer care for their
previous home and property. (Doc. # 6, PageID #s
explained that his ability work as a landscape foreman ended
due to Gardner syndrome and his resulting inability to
continue with the work. Id. at 99-100.
syndrome is a form of familial adenomatous … that is
characterized by multiple colorectal polypus and various
types of tumors, both benign (noncancerous) and malignant
(cancerous). People affected by Gardner syndrome have a high
risk of developing colorectal cancer at an early
The dangerous nature of this rare disease is readily seen:
The signs and symptoms of Gardner syndrome vary from person
to person. It is … characterized primarily by hundreds
to thousands of noncancerous … polyps in the colon
that begin to appear at an average age of 16. Unless the
colon is removed, these polyps will become malignant…,
leading to early-onset colorectal cancer at an average age of
Id. As ALJ Motta noted, “There is no doubt
that [Plaintiff] has a serious disease….” (Doc.
#6, PageID #80).
ALJ Motta asked Plaintiff to describe what bothers him the
most, he explained, “I thought I would be a lot better
off than I am right now that-since I've lost my colon,
large intestines-for me, I go to the bathroom 15 to 20 times
a day right now. Every bit of it is painful. Every bit of
it's painful. Just digesting food is a job in itself for
me, along with the … medications, staying hydrated,
and staying nourished.” Id. at 101-02.
Plaintiff reported that he had a colostomy, leaving him with
a colostomy bag. A few months later (in December 2016) he
underwent a reversal surgery, thus eliminating his need for a
colostomy bag. Id. at 102.
asked about his “big issue” with constipation, he
responded, “[t]hat was pre-surgery. That was one of my
main complaints when I actually had my colon still. But since
then, that's no longer an issue for me. It's quite
the opposite.” Id. at 102. In this context,
“quite the opposite” refers diarrhea for which he
takes Imodium 3 times per day and Bentyl but these do not
help him. See id. at 102-04. He must be careful to
drink enough water with these medications to prevent blockage
in his small bowel (he had already experienced 3).
Id. at 104. He also took additional medications
Promathezine, Zofran, and Reglan for nausea; Sulindac for
tumor and polyp suppression; Valium as a muscle relaxer;
Tramadol for pain; and Protoniz for ulcers. He does not feel
the medications work. Id. at 104. Plaintiff's
abdominal pain is “never lower than a 5 or 6, and it
goes up to a 9 or 10.” Id. at 110. He starts
every day with nausea and vomiting. Id. Plaintiff
noted that his disease causes him to be constantly on the
lookout for cancer. Id. at 109.
testified that after he stopped working as a landscape
foreman, he worked part time at a gas station as a cashier
and stock person. Id. at 100. He was fired from this
part-time job because he had too many doctors'
appointments. Id. at 106.
early 2017, when Plaintiff cared for his children by himself,
he microwaved frozen meals, and his children helped with
housework. Id. at 106, 108. He relied on family
members to help with yardwork because “it is too
much.” Id. at 106-07. His other daily
activities were very limited. He could do some shopping.
Id. He described himself as “a
homebody.” Id. at 107. He did Sudoku puzzles
but little else. And he sometimes took his children to the
park but otherwise could rarely play with them. Id.
Sarah Khavari, M.D. - Primary care physician
2016, Dr. Khavari completed a basic-medical form, noting that
she first saw Plaintiff in 2009. (Doc. #6, PageID
#526). She reported diagnoses of Gardner syndrome with no
change (“s/p”) after his total ...