United States District Court, N.D. Ohio, Western Division
TARA R. BLANTON, Plaintiff,
ANDREW M. SAUL, COMMISSIONER OF SOCIAL SECURITY ADMINISTRATION, Defendant.
REPORT AND RECOMMENDATION OF MAGISTRATE
J. LIMBERT UNITED STATES MAGISTRATE JUDGE
Tara Blanton (“Plaintiff”) requests judicial
review of the final decision of the Commissioner of Social
Security Administration (“Defendant”) denying her
application for disability insurance benefits
(“DIB”) and supplemental security income
(“SSI”). ECF Dkt. #1. In her brief on the merits,
filed on November 19, 2018, Plaintiff asserts that the
administrative law judge (“ALJ”) failed to give
good reasons for not adopting the opinions of both of her
treating physicians, Dr. Singh and Dr. Desai. ECF Dkt. #12.
On February 15, 2019, Defendant filed a brief on the merits.
ECF Dkt. #16. Plaintiff subsequently filed a reply to
Defendant's brief on March 1, 2019. ECF Dkt. #17.
following reasons, the undersigned recommends that the Court
VACATE the ALJ's decision and REMAND this case for
further proceedings consistent with this Report and
FACTUAL AND PROCEDURAL HISTORY
Initial ALJ Decision
5, 2012, Plaintiff protectively filed an application for SSI
alleging disability beginning June 4, 2012 due to depression,
fibromyalgia, mental break down, migraines, pain all over,
asthma, right knee issues, nerves, lower pain issues, and
acid reflux. ECF Dkt. #11 (“Tr.”) at 58, 69, 134,
153, 156. Plaintiff's application was denied initially on
September 4, 2012 and upon reconsideration on November 28,
2012. Id. at 58-68, 70-82, 84, 90. On January 7,
2013, Plaintiff requested an administrative hearing.
Id. at 92-94. Additionally, on August 28, 2013,
Plaintiff protectively filed an application for DIB with the
same alleged onset date of June 4, 2012. Id. at 151,
January 29, 2014, a hearing was held before an ALJ in which
Plaintiff, with counsel, and a vocational expert
(“VE”) testified. Id. at 32-57. The ALJ
issued his decision on April 23, 2014, finding Plaintiff not
disabled and denying her applications for DIB and SSI.
Id. at 6-23. Plaintiff requested a review of the
hearing decision, and on July 19, 2015, the Appeals Council
denied review. Id. at 1-5, 30-31.
September 11, 2015, Plaintiff filed suit, requesting judicial
review of the final decision denying her applications for DIB
and SSI. Blanton v. Comm'r of Soc. Sec., No.
3:15CV1864 (“Blanton I”), at
689-94. After the case was fully briefed, a
magistrate judge issued a Report and Recommendation on June
16, 2016 recommending “that the final decision of the
Commissioner be vacated and that the case be remanded.”
Blanton I, at 712-36. In his report, the magistrate
judge found that the ALJ failed to include certain medical
records as exhibits to the record and the ALJ violated the
treating physician rule by failing to articulate “good
reasons” for failing to assign controlling weight to
the opinions of Plaintiff's treating physicians, Drs.
Singh and Desai. Id. The Court accepted the
magistrate judge's decision and vacated and remanded this
matter to Defendant for further proceedings. Id. at
Subsequent ALJ Decision
the August 15, 2016 remand of this matter to the ALJ, a
second hearing was held on April 26, 2017. Tr. at 617-35. On
May 17, 2017, the ALJ issued a decision, again finding
Plaintiff not disabled and denying Plaintiff's
applications for DIB and SSI for the period of June 4, 2012
through the date of the second decision. Id. at
590-606. In the section of his decision regarding
jurisdiction and procedural history, the ALJ acknowledged
that the District Court remanded the case “to review
the opinions of Dr. Singh and Dr. Desai and provide [sic]
good, articulated reasons for accepting or rejecting the
opinions.” Tr. at 593.
30, 2018, Plaintiff filed the instant suit seeking review of
the ALJ's second decision. ECF Dkt. #1. On October 18,
2018, Defendant filed an answer. ECF Dkt. #10. Plaintiff
filed a brief on the merits on November 19, 2018. ECF Dkt.
#12. On February 15, 2019, Defendant filed a merits brief.
ECF Dkt. #16. Plaintiff filed a reply brief on March 1, 2019.
ECF Dkt. #17.
MEDICAL AND TESTIMONIAL EVIDENCE
Plaintiff's arguments are limited to the treating
physician rule as it pertains to Drs. Desai and Singh, the
undersigned will limit review of the medical evidence to
those two treating physicians and related visits.
Plaintiff's alleged disability onset date is June 4,
2012. Tr. at 134, 151.
medical records suggest she has been a patient of Dr.
Paraminder B. Singh, M.D., since approximately 2002. Tr. at
325. From 2002 to 2012, Plaintiff's medical records from
Dr. Singh (as well as Dr. Muhammad Khan, M.D.) regularly
document her history of migraine headaches. Tr. at 265-66,
272-76, 278, 283-85, 290, 295, 301, 304-05, 309, 311-13,
320-22, 324-25, 504, 507, 512, 525, 529, 537.
February 2010, Plaintiff presented to an emergency department
for an accident in which she slipped on ice at a gas station,
injuring her left hip and left knee. Id. 212-16.
Plaintiff presented with Dr. Singh to get an MRI on her left
knee and for follow up treatment. Id. at 217-19.
January 2012, Plaintiff presented to the emergency department
complaining of migraine headaches. Id. at 225-30.
She was discharged the same day in stable condition.
Id. at 225. In September, October, and December
2012, Plaintiff presented to Dr. Singh with complaints of
back pain, anxiety, myalgias (noted as starting 5 years
prior), incapacitating and frequent headaches (noted as
starting 10 years prior with episodes lasting 3-4 days),
depression (noted as starting 1 year prior), and obesity.
Id. at 504-05, 507-09, 515.
28, 2013, Plaintiff presented to Dr. Singh with issues on
swallowing and a sore throat as well as back pain and
myalgias. Id. at 510. On June 13, 2013, Plaintiff
presented to Dr. Singh for a follow up visit after being in a
car accident. Id. at 512. Plaintiff had pain in her
left shoulder and left knee, neck pain, and headache
symptoms. Id. Dr. Singh prescribed Vicodin and
instructed Plaintiff to get an MRI and X-ray. Id. at
513. Dr. Singh also recommended physical therapy.
Id. at 511. Plaintiff continued presenting with
similar complaints pain, myalgias, depression, and headaches
throughout 2013. Id. at 429-30, 432-34, 515-32.
Also, beginning around December 2013, Dr. Singh treated
Plaintiff for degenerative disc disease by prescribing her
Vicodin. Tr. at 429-30, 1161-81. However, in December 2014,
Plaintiff received an MRI of her lumbar spine, and the
results were normal. Id. at 2028.
2014 and 2015, Plaintiff continued visiting Dr. Singh for the
aforementioned symptoms as well as for various complaints of
hypertension, shortness of breath, anxiety, asthma, joint
pain, dyspnea, back pain, edema, and rashes. Tr. at 977-1080.
February 25, 2014, Plaintiff presented to Dr. Singh for a
follow up visit with complaints of hypertension, anxiety,
asthma, joint pain, and a “leaky bladder.” Tr. at
977. Subsequently, Dr. Singh referred Plaintiff for a
Pulmonary Function Test (“PFT”), which Plaintiff
underwent on February 28, 2014. Id. at 982-83,
1223-25. Her PFT results indicated that there was no
noticeable significant obstruction or restriction, but she
had impaired diffusion capacity, which raised suspicions for
a pulmonary vascular disease, including emphysema related
findings or interstitial lung disease. Id. at 1225.
The report also noted that Plaintiff has a history of asthma
and chronic smoking. Id. at 1223, 1225. During a
July 28, 2014 visit, Plaintiff stated that her headaches have
improved more than 50% since her last hospitalization.
Id. at 1025.
March 4, 2015, Plaintiff was hospitalized overnight for
chronic obstructive pulmonary disease (“COPD”)
and breathing problems. Id. at 1090. On June 1,
2015, Plaintiff complained of chronic itching, which she
described felt like bugs crawling all over her body, and Dr.
Singh subsequently refilled her medications. Id. at
1119-25. Plaintiff visited an emergency department with
complaints of a cough and chest pain during October 2015 and
in February, April, May, and July 2016. Tr. at 1548-1675,
2, 2012, Dr. Singh opined about Plaintiff's medical
conditions and listed Plaintiff's medical conditions as
including myalgia, depression, joint pain in ankle and foot,
asthma, malaise, and knee pain. Id. at 870-71. Dr.
Singh further opined that Plaintiff “has all over pain
caused from the myalgia and joint pain, ” and that she
cannot bend, lift, twist, walk for long periods of time,
becomes fatigued very easy, and her asthma causes her
breathing problems. Id. Dr. Singh indicated that
Plaintiff could stand or walk for one to two hours and she
could carry up to 5 pounds frequently. Id. at 871.
Dr. Singh concluded that Plaintiff “is completely
disabled due to her conditions, ” and “the pain
she suffers from affects her daily living.”
20, 2013, Dr. Singh completed a physical capacity evaluation
and opined that Plaintiff can stand or walk a total of one
hour and can sit for a total of two hours in an 8 hour
workday. Tr. at 399-400. Dr. Singh also opined that Plaintiff
can lift up to 10 pounds rarely and she is likely to have
partial or full day unscheduled absences from work occurring
5 or more days per month due to her conditions. Id.
Dr. Singh remarked that when Plaintiff is under stress, she
“falls apart, ” and explained that Plaintiff
cannot concentrate and forgets basic tasks, gets muscle
spasms that worsen her pain, gets headaches that occur
frequently (at least 2-3 times a day and Plaintiff needs the
lights off and to rest), and gets severe depression.
Id. at 400.
September 21, 2016, Dr. Singh opined in a letter that
Plaintiff is permanently unable to work because she suffers
from vulvar cancer, chronic degenerative disc disease,
anxiety, chronic pain, myalgia, myositis, and hypertension.
Tr. at 1717.
medical records suggest she has been a patient of Dr. Bipin
M. Desai, M.D., since approximately January 2012.
See Tr. at 252. On January 30, 2012, Plaintiff
visited Dr. Desai with the chief complaint of depression. Tr.
at 253. After evaluating her, Dr. Desai diagnosed Plaintiff
with major depressive disorder that is recurrent and
moderate. Id. Dr. Desai prescribed Celexa and
instructed her to continue on Xanax. Id. at 254.
Plaintiff continued seeing Dr. Desai on a monthly basis.
Id. at 254-58, 377-84, 411-14. In February 2012,
Plaintiff reported feeling better although the Celexa made
her lethargic. Id. at 255. Dr. Desai instructed her
to stop Celexa and start Prozac. Id. In April 2012,
Plaintiff complained that she was feeling depressed, anxious,
and irritable following a recent hysterectomy, and Dr. Desai
prescribed her Risperdal. Id. at 256. In June 2012,
Dr. Desai noted that Plaintiff applied for a medical card and
SSD. Id. at 258. Also during this visit, Dr. Desai
diagnosed Plaintiff with another disorder-pain disorder
associated with psychological factors and a medical
condition. Id. In July 2012, Dr. Desai prescribed
Plaintiff Abilify and instructed her to stop taking
Risperdal. Id. at 377. In September 2012, Dr. Desai
prescribed her Pristiq and instructed her to stop taking
Prozac. Id. at 381. In October 2012, Dr. Desai
started Plaintiff on Cymbalta and instructed her to stop
taking Pristiq. Id. at 382-83. In November 2012,
Plaintiff reported feeling a little better and that she was
coping better with her chronic pain. Id. at 384.
However, in December 2012, Plaintiff reported that she could
not stop crying. Id. at 411. Dr. Desai subsequently
prescribed her Lexapro, and Plaintiff reported feeling better
later that month. Id. at 412-13. Shortly thereafter,
from December 27, 2012 until January 25, 2013, Plaintiff was
hospitalized due to increased depression and having a
“mental breakdown.” Id. at 386-87.
March, May, and August 2013, Plaintiff reported that she was
feeling “pretty good” and was coping with
stressors, as well as awaiting her SSD hearing. Tr. at 415,
417, 419. Plaintiff continued seeing Dr. Desai in 2014
through 2016 with visits noting that she reported either
feeling good or that she felt anxious, depressed, or tired.
Id. at 1928-67.
18, 2012, Dr. Desai completed a mental functional capacity
assessment and marked Plaintiff as being moderately limited
or markedly limited in almost every category. Tr. at 868-69.
Additionally, Dr. Desai noted that Plaintiff had major
depression that is moderate and recurrent, had pain that is
chronic and due to physical and psychological factors, and
had low energy. Id. at 869.
August 29, 2013, Dr. Desai filled out a questionnaire as to
mental residual functional capacity and marked Plaintiff as
being either moderate or marked limitations in each area. Tr.
at 402-04, 425-27. Dr. Desai opined that Plaintiff would be
likely to have partial or full day unscheduled absences from
work occurring 5 or more days per month due to her diagnosed
conditions and/or side effects of medication. Id. at
continued seeing Dr. Desai regularly throughout 2014 to 2016,
in which she consistently reported feeling “pretty
good” and denied using substances or having manic
symptoms, hallucinations, delusions, and other symptoms of
psychotic process. Tr. at 1928-1967. In June 2016, Plaintiff
reported feeling depressed and anxious, but subsequently
reported that her depression and anxiety had decreased.
Id. at 1956, 1958, 1960. In October 2016, she
reported feeling very anxious and also reported that she was
diagnosed with cancer of the vulva. Id. at 1966.
the District Court remanded the case back to the ALJ, a
second hearing was held on April 26, 2017, in which
Plaintiff, with counsel present, and a vocational expert
(“VE”) testified. Tr. at 617-35. Plaintiff
testified that she has not worked at all since the prior
hearing on January 29, 2014 and that her fibromyalgia and
depression have worsened. Id. at 621. She also
stated that she was hospitalized ...