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January 16, 2002


The opinion of the court was delivered by: Keys, United States Magistrate Judge.


Plaintiff, Patrick Floress, moves this Court for summary judgment pursuant to Rule 56(a) of the Federal Rules of Civil Procedure. Plaintiff moves the Court to affirm the Commissioner's decision finding him disabled, but to reverse the Commissioner's decision that Plaintiff was not disabled prior to March 8, 1999. For the reasons set forth below, Plaintiff's Motion for Summary Judgment is Granted.


Plaintiff applied for disability insurance benefits ("DIB") and supplement security income ("SSI") on May 18, 1998, alleging a disability onset date of March 25, 1998. (R. at 47-49, 388-391.) However, Plaintiff amended the onset date to September 9, 1998, which was the last date he was employed. (R. at 96, 99.) Plaintiff's claims for DBI and SSI were denied initially and on reconsideration. (R. at 28-31, 34-36.)

Plaintiff requested and received a hearing before Administrative Law Judge Leo L. McCormick ("the ALJ") on March 5, 1999. (R. at 32.) Following the hearing, the ALJ issued a partially favorable decision, finding Plaintiff disabled as of March 8, 1999 and thereafter, but not prior to that date. (R. at 24). On November 18, 1999, Plaintiff filed a Request for Review of Hearing, seeking a review of the ALJ's determination that he was not disabled between September 9, 1998, the onset date Plaintiff alleged in his application, and March 8, 1999, the onset date established by the ALJ. (R. at 11.) On August 23, 2000, the Appeals Council denied Plaintiff's Request for Review, and the ALJ's decision stands as the final decision of the Commissioner. (R. at 7.)



1. Plaintiff's Testimony

At the hearing, Plaintiff testified that he was born on February 11, 1954, and had completed three years of college. (R. at 410.) Plaintiff resides in an apartment in McHenry, Illinois, with his wife of 20 years, his three daughters, and one grandson. (R. at 411.) Plaintiff worked as a restaurant manager for 13 years, until pain and related physical impairments forced him to quit in March of 1998. (R. at 57.) Plaintiff filed his initial application for DIB and SSI on May 18, 1998, alleging an onset date of March 25, 1998.

Plaintiff subsequently took a job as a chef at Host-A-Roast Pig Roast & Catering Company. (R. at 96, 97, 99.) Plaintiff claims that he accepted this position, despite his ailments, because he needed the income to support his family and it was less demanding than his previous job. (Id.) Nevertheless, Plaintiff's impairments forced him to resign from Host-A-Roast on September 8, 1998.(Id.) Plaintiff amended his application to reflect a new onset date of September 8, 1998. (R. 409.) Plaintiff testified that he has not worked since September 8, 1998. (R. at 411.) Plaintiff's only source of income is a Navy disability check for $388.00 per month. (Id.)

Plaintiff described his various impairments to the ALJ. Plaintiff has Belles Palsy and wears a hearing aid in his left ear. Although the hearing aid helps, Plaintiff still has difficulty hearing. (Id.) Plaintiff was prescribed the use of a cane to steady him while standing and walking. (R. at 419.) Plaintiff has pain in "all the joints," including his hips, knees, ankles, lower back, and hands. (Id.) Plaintiff describes the pain in his hips and knees as "aching." (R. at 419, 420.) He drives only short distances, and only once or twice a week. (Id.) Aching pain in his legs, knees, and back prevents Plaintiff from walking more than a block without stopping. (R. at 421.) Plaintiff reported that he could stand for about 15 to 20 minutes, before his back, hips, knees, and ankles begin to ache. (Id.) If he sits for more than one hour, he experiences aching pain in his lower back, hips, and knees. (R. at 422.) Plaintiff uses his cane and chair arms to assist him in standing from a seated position.(Id.)

He takes arthritis medication to relieve pain caused by sitting for long periods of time. (Id.) He takes Sorbrex for pain, as well as water pills and Elavil, a nerve pill that allows him to sleep at night. (R. at 423, 426.) Prior to March of 1999, Plaintiff was taking Arthertex 50 for pain, and before that, he was taking 800 milligrams of Motrin, which did not relieve his pain. (R. at 424.) Plaintiff also takes Atenonol and Lasix for his heart condition, Prilosec for gastro-esophageal reflux disorder, Allopurinol for kidney stones, and Celebrex for arthritis pain. (R. at 370.) He has been on Naprosyn, Darvocet, Tylenol with codeine, and Arthrotec, but says none has helped relieve his pain. (Id.)

Plaintiff also complained of severe aching pain in his knuckles and fingers on both hands, similar to that in his hips and knees. (R. 429.) He testified that the pain in his hands limits his daily activities, preventing him from tying his shoes and making models. (Id.)

In early 1998, Plaintiff began complaining to his physicians that he was suffering from syncopal episodes, which were triggered by hard coughing and laughing. During an episode, Plaintiff would lose muscle control and fall to the ground. In February 1999, one of Plaintiff's doctors decided to track Plaintiff's episodes by attaching a heart monitor to Plaintiff for a thirty-day period. (R. at 414.) Plaintiff called the hospital every time he suffered an attack; in one month, he called the hospital approximately 30 times. (R. at 416.)

Plaintiff stated that the episodes were occurring with increasing frequency and that he had experienced numerous episodes of dizziness and falling. (R. at 433.) The episodes typically lasted a few minutes, although he testified that one lasted for a half an hour. (Id.) Plaintiff testified that he was awake during the episodes, which left him feeling weak, tired, and listless for about a half an hour. (R. at 434.)

2. Medical Evidence

Plaintiff contends that he suffers from several medical conditions, including arthritis in the hips, knees, hands, and lumbar spine (R. at 261-262, 320, 322.), severe obstructive sleep apnea syndrome (R. at 263.), cataplexy with narcolepsy (R. at 373.), cardiac impairment (R. at 245, 309.), fibromyalgia, bursitis of the wrists, edema of the ankles, obesity (R. at 379.), gastrointestinal reflux disease (R. at 305.), and partial hearing loss in the left ear. (R. at 320.) Since January of 1998, Plaintiff has been under the continuous care of a team of doctors, including his primary physicians, two orthopedists, a neurologist, a cardiologist, and a rheumatologist.

· Dr. Arun Narang, M.D. and Dr. Sunita Narang, M.D. — Primary Treating Physicians

On January 9, 1998, Plaintiff began regularly seeing his primary physicians for complaints of blackouts, fatigue, and dizziness. (R. 160.) Following a syncopal episode in January of 1998, Plaintiff underwent an MR of the brain. (R. 190.) The MR revealed that the ventricular system and other CSF spaces were normal for Plaintiff's age. (Id.) The test indicated that the cerebrum, cerebellum, and brain-stem exhibited normal imaging characteristics without focal lesions. (Id.) Alteration of signal in the left mastoid air cells was revealed and determined to be likely the result of chronic or possibly acute inflammatory changes in this structure. (Id.)

Dr. Narang's office notes revealed that Plaintiff had another syncopal episode on March 2, 1998, which occurred as a result of Plaintiff laughing loudly. (R. 163.) Dr. Narang prescribed a heart monitor for Plaintiff after he experienced more fainting spells, and Plaintiff participated in an arrhythmia surveillance and transtelephonic monitoring program. (R. at 134.) Plaintiff's condition was monitored from March 13, 1998 through April 14, 1998, and again in February 1999. (R. at 384-385.) While being monitored, Plaintiff experienced episodes of passing out, dizziness, chest discomfort, weakness, shortness of breath, head pressure, palpitations, and lightheadedness. (Id.)

On June 16, 1998, Dr. Narang diagnosed ventricular arrhythmia, noting that Plaintiff's syncopal episodes were non-cardiac in nature. (R. at 238.) The doctor indicated that, in addition to experiencing dizziness, shakiness, and nervousness, Plaintiff has reactive hypoglycemia, as well as arthritic knees and hips. (R. at 241-242.) Dr. Narang opined that Plaintiff's ability to do work-related activities was limited with respect to standing, moving about, lifting, carrying and handling objects, and traveling. (R. at 242.) The medical records indicated that Plaintiff's "[d]isability is due to arthritis of hips and knees." (Id.) Office notes from May 4, 1998 and July 2, 1998 document Plaintiff's continuing syncopal episodes, his symptoms of shakiness and dizziness, and a diagnosis of obstructive sleep apnea syndrome. (R. at 165-167.)

· Dr. Warren S. Jablonsky — Treating Orthopedist

Dr. Jablonsky saw Plaintiff on January 21, 1998, for a follow-up evaluation of his left hip pain. (R. at 185.) Plaintiff reported that the Daypro samples provided by Dr. Narang did not relieve the pain from his arthritis. (Id.) Plaintiff explained that he had decreased his hours of work to 12-13 hours a day, but that he was still on his feet during the workday. (Id.) Plaintiff complained of a significant amount of pain in his hip, as previously described. (Id.) Dr. Jablonsky reported that Plaintiff's exam was essentially unchanged. (Id.) The doctor recommended seated work for Plaintiff, with occasional standing and walking, and no climbing for four weeks after the visit. (Id.) Dr. Jablonsky provided Plaintiff with Naprelan for pain relief and detailed the risks and benefits of proceeding with a total hip arthroplasty at such a young age. (Id.)

On February 11, 1998, Plaintiff met with Dr. Jablonsky again and advised him that the Naprelan had given him some relief from his pain. (R. at 187.) However, Plaintiff continued to complain of pain with lengthy standing or ambulation. (Id.) His examination revealed no significant palpable tenderness in the lateral aspect of the hip. However, Plaintiff did suffer pain with range of motion, primarily internal and external rotation. (Id.) Dr. Jablonsky again discussed the possibility of proceeding with total hip arthroplasty and a rehabilitation program. (Id.) Plaintiff decided to hold off, and Dr. Jablonsky recommended the use of a cane and prescribed Naprelan or Naprosyn for a month. (Id.)

On March 20, 1998, Plaintiff visited Dr. Jablonsky for a follow-up and complained of recent pain in his left hip. (R. at 225.) Plaintiff also told Dr. Jablonsky that he had some right lower extremity pain, secondary to a previous L5-S1 herniation that had been treated by Dr. Parikh. (Id.) Plaintiff stated that his hip pain remained unchanged, and that his back pain had been aggravating his hip pain, and vice versa. (Id.) Dr. Jablonsky again explained the benefits and risks of a total hip arthroplasty, and Plaintiff agreed to consider it further. (Id.)

On June 4, 1998, Dr. Jablonsky diagnosed Plaintiff with degenerative joint disease of the left hip. (R. at 261.) He indicated structure changes, including anatomical deformity, bone destruction, and bone hypertrophy, with decreased joint space and osteophytes. (Id.) Dr. Jablonsky noted loss of joint motion in the hip with flexion of 100 degrees. (R. at 262.) He noted that Plaintiff uses a cane for assistance in weight bearing, and again indicated total hip arthroplasty as the ...

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