The opinion of the court was delivered by: Sidney I. Schenkier, United States Magistrate Judge
MEMORANDUM OPINION AND ORDER*fn1
The plaintiff, Willie Mae Hawkins, seeks judicial review of a final decision by the Commissioner ("Commissioner") of the Social Security Administration ("Agency") denying her claim for Social Security Income ("SSI"). On August 22, 1997, Ms. Hawkins filed an application for SSI, alleging a disability beginning on October 28, 1996 caused by seizures, back and leg pain, depression and asthma (R. 20). The Agency found that Ms. Hawkins was not disabled, both initially and again upon reconsideration (R. 37-44). On February 8, 1999, Ms. Hawkins, represented by counsel, appeared at a hearing before an Administrative Law Judge ("ALJ") (R. 17). The ALJ subsequently issued a written decision, dated October 29, 1999, denying Ms. Hawkins SSI benefits (R. 17-30). Ms. Hawkins filed a Request for Review and, on February 1, 2002, the Appeals Council denied the request (R. 6-7). Therefore, the decision of the ALJ is the final decision of the Commissioner and is subject to judicial review by the district court. See Luna v. Shalala, 22 F.3d 687, 689 (7th Cir. 1994). Ms. Hawkins subsequently filed a timely complaint in federal court seeking judicial review of the ALJ's decision pursuant to 42 U.S.C. § 405 (g) and 1383(c).
Ms. Hawkins now seeks summary judgment reversing the Commissioner's decision denying her SSI or, in the alternative, remanding the case for further proceedings (doc. #17). The Commissioner has filed a cross-motion for summary judgment to affirm her decision below (doc. #22). For the reasons stated below, the Court grants the Commissioner's motion for summary judgment and denies Ms. Hawkins' motion for summary judgment.
The following facts are taken from the administrative record, the administrative hearing transcript, and the ALJ's written decision. We will set forth the plaintiff's personal and medical history first, followed by a summary of the administrative hearing testimony and the ALJ's written decision.
Ms. Hawkins was born on June 21, 1950, and was 49 years old at the time of the ALJ's decision (R. 19). She has a tenth grade education, and has obtained four months of certified nursing assistant ("CNA") training (Id.). Ms. Hawkins previously has been employed as a sitter and as a CNA, but has not worked since April 1996 when she injured her back while lifting a patient at work (R. 315, 320).
Ms. Hawkins and her grandson live in the house of the plaintiff's boyfriend with the boyfriend and the boyfriend's daughter (R. 313). Ms. Hawkins is the primary caregiver for her fourteen year-old grandson and she occasionally goes shopping with him (R. 352). Ms. Hawkins testified that, otherwise, her daily activities are determined by whether it is a "good day" or a "bad day" (R. 342, 343). On a bad day, all she can manage is to wash up, watch television, work on a puzzle book, and maybe wipe down the minor (Id.). On a good day, the plaintiff feels well enough to do some laundry in the basement (R. 342). Ms. Hawkins estimates that she has about four or five bad days, and two or three good days in any given week (R. 343). Nevertheless, Ms. Hawkins cooks for herself every day (R. 341), though she has stopped doing any grocery shopping (R. 343). Ms. Hawkins used to enjoy playing bingo, but no longer plays due to financial — not physical or mental — constraints (R. 135).
The plaintiff claims that her various physical impairments make it difficult for her to engage in many physical activities for any extended period of time. She has had a history of seizures since she fell at the age of 23, a time when she was drinking "a whole lot" and "everyday" (R. 133). Moreover, Ms. Hawkins has experienced back pain since her injury at work, even after her surgery (R. 80, 127). She is unable to sit for more than twenty to twenty-five minutes before she experiences severe pain for which she must take Motrin (R. 323). Additionally, she can stand for only ten to fifteen minutes before her legs start to feel numb (R. 80, 321). Ms. Hawkins is limited to short walks before both her legs begin to shake and she loses her balance (R. 323-324), and she quickly becomes short of breath when she runs (R. 325). Ms. Hawkins has experienced significant weight fluctuation since her back surgery (R. 134, 333). All this limits her to simple tasks around the home (R. 80), and she often feels depressed and has crying spells (R. 330-331).
After being injured while lifting a patient at work in April 1996, Ms. Hawkins underwent back surgery on October 28, 1996 (R. 127). There are no medical records from this period in the official record for this case. The first relevant medical evidence available in the record dates back to March 1997. We will review the medical evidence in chronological order.
Ms. Hawkins was hospitalized at Roseland Community Hospital from March 7-8, 1997 after complaining of chest pains (R. 108-119, 192-213). Cardiac testing revealed that there was no impairment (R. 117-119). However, having been made aware of Ms. Hawkins' history of seizures, hospital testing of the plaintiff's medication levels revealed the level of her seizure medication (Dilantin) was well below the normal range (R. 110).
On September 19, 1997, the plaintiff's treating physician, Dr. Ram Thawani, provided the Agency with a telephone report on the plaintiff's condition (R. 120). Dr. Thawani disclosed that the plaintiff's back surgery had consisted of a lumbar laminectomy at L5-S1 (Id.). Dr. Thawani also noted that Ms. Hawkins' range of motion was decreased, although there had been no recent measurements taken and she was able to walk without a cane (Id.). The plaintiff complained of pain, episodic breathing difficulties, and also of tingling and numbness on both sides (Id.). However, Dr. Thawani was unsure whether this tingling and numbness had a physical etiology (Id.). Additionally, the plaintiff's lungs were clear, there was no end-organ damage, and the doctor had never witnessed an asthma attack (Id.). Dr. Thawani expressed doubts as to the plaintiff's compliance with her asthma and seizure medications (Id.). Finally, while Dr. Thawani commented that the plaintiff was depressed and tearful, he attributed this to a lawsuit the plaintiff was involved in with her former employer (Id.).
On October 9, 1997, Ms. Hawkins underwent a radiological evaluation of her lumbosacral spine (R. 123). In his radiological report, Dr. Eugene Kovalsky noted that the examination showed mildly "advanced degenerative changes involving the lower lumbar facets with degenerative disc pathology at L4-L5" (Id.). Also noted was sclerosis at the articulating surfaces with moderate proliferative changes (Id.).
On that same day in October 1997, Dr. Facundo Dovale performed an Internal Medicine Evaluation at the Agency's request (R. 127-131). The plaintiff's chief complaints at that time were noted to be a history of low back pain, asthma and seizure disorder, in addition to depression (R. 127). Upon physical examination, Dr. Dovale noted that the plaintiff was 5 feet, 6 1/2 inches tall, weighed 226 pounds, and had a blood pressure reading of 150/100 in the right arm and 160/100 in the left arm (R. 129). It was further noted that the plaintiff had a slight limp favoring her right lower extremity, but was able to get on and off the examination table without the use of a cane (Id.).
The plaintiff was tearful while relating her medical and personal history (Id.). That history included a denial of any history of drug or alcohol abuse, but an admission by the plaintiff that she did drink heavily on some occasions (R. 128). Additionally, the plaintiff smoked a half a pack of cigarettes a day at the time, which was less than in the past (Id.). The plaintiff claimed that she did no lifting, but was able to bathe, dress, dust and fix light meals for herself at home (R. 127-128).
As to the plaintiff's back pain, Dr. Dovale's examination revealed some tenderness, but no appreciable paravertebral muscle spasm (R. 130). Additionally, the lumbosacral spine range of motion was normal on upon flexion, extension and side-to-side bending testing (Id.). Ms. Hawkins further demonstrated a full range of motion (at the hips, knees and ankles), an absence of muscular atrophy and an ability to heel/toe walk (Id.). Finally, Ms. Hawkins was able to complete straight leg raising of the right lower extremity pain free to 90 degrees, and experienced slight low back pain and pain in her left buttock upon raising the right side to 60 degrees (Id.).
As to the plaintiff's breathing difficulties, Dr. Dovale noted slightly decreased breath sounds in both lung fields bilaterally (Id.). However, the air exchange was good and there was no wheezing, peripheral clubbing, cyanosis or edema (Id.). Additionally, spirornetry tests performed on the same day revealed some mild restriction prior to the use of a bronchodilator and a normal spirometry after medication (R. 21, 130).
Based on his examination, Dr. Dovale's overall clinical impressions were that the plaintiff suffered from: chronic low back pain without evidence of radiculopathy; a history of asthma, which appeared mild by physical examination; a history of seizure disorder, which appears to be uncontrolled despite her taking Phenobarbital and Dilantin; elevated systolic and diastolic blood pressure; and a history of depression (R. 131). Dr. Dovale noted that further attention to the issue of depression would be deferred pending a psychiatric consultative evaluation to occur later that day (R. 128).
That psychiatric examination was completed on October 9, 1997, by Dr. Donna Luchetta (R. 133-137). Dr. Luchetta described Ms. Hawkins as a well groomed and cooperative person, who used a cane to walk, and had difficulty rising up from a chair (R. 133). Ms. Hawkins stated that her problems began when she developed seizures at age 23 — a time when she was drinking alcohol "a whole lot" and "everyday" (Id.). While Ms. Hawkins did claim to have abstained from alcohol for the last six or seven months, she also stated that she had taken a little "shot of brandy" a week before the examination (Id.). Ms. Hawkins complained of back pain, crying spells, a 50-75 pound weight gain since her back injury, and difficulty sleeping (R. 134). There had been no past history of psychiatric hospitalization, however (Id.). Ms. Hawkins identified her daily activities as including cooking, doing the laundry, watching television, reading, doing crossword puzzles and taking care of her finances (Id.).
Dr. Luchetta observed that Ms. Hawkins appeared sad and slightly withdrawn, making only occasional eye contact and remaining "tearful throughout much of the examination" (Id.). Ms. Hawkins also exhibited slight psychomotor retardation and a restriction in her range of emotions (Id.). On the other hand, Dr, Luchetta noted that Ms. Hawkins showed a good stream of conversation, sequential thought processes, and acceptable impulse control (R. 135-136). Furthermore, there was no indication that Ms. Hawkins suffered from any special preoccupation, confusion, hallucination, or delusion (Id.). Nor was there any evidence of suicidal or homicidal ideation (R. 135).
Dr. Luchetta found that Ms. Hawkins performed adequately on tests inquiring into orientation, memory, recent and remote memory, calculation, and abstract thinking, with one exception (R. 136). The one exception consisted of several occasions where the plaintiff reversed pairs of numbers in a digit recall test designed to determine the plaintiff's memory capacity (Id.). Dr. Luchetta indicated that "[t]his seemed to have been done purposely, as the answers were very close approximations" (Id.). In the end, Dr. Luchetta diagnosed Ms. Hawkins with alcohol dependence in partial early remission (Id.).
On October 22, 1997, Ms. Hawkins was treated in the emergency room at Provident Hospital (R. 138-140). Ms. Hawkins had bruised her right leg and was in pain (R. 138). Ms. Hawkins was discharged on the same day with instructions to take Motrin as needed (R. 140).
Shortly thereafter, on November 18, 1997, Agency reviewer Kirk W. Boyenga, Ph.D., completed a Psychiatric Review Technique Form (R. 141-149) and a Mental Residual Functional Capacity Assessment (R. 150-153). In the Psychiatric Review, Dr. Boyenga noted that Ms. Hawkins' medical records indicated evidence of a substance addiction disorder (R. 147). But, it was Dr. Boyenga's opinion that this impairment created only a slight limitation in her ability to take part in the activities of daily living and her ability to maintain social functioning (R. 148). And, while Dr. Boyenga found evidence that Ms. Hawkins might on some occasions experience deficiencies in concentration, persistence or pace, there was no evidence that Ms. Hawkins ever experienced an episode of deterioration or decompensation in a work or work-like setting (Id.). In the Mental Residual Functional Capacity assessment, Dr. Boyenga again noted that Ms. Hawkins suffered from a substance addiction (R. 152), and found that the one significant restriction that resulted therefrom was a moderate restriction in her ability to maintain attention for extended periods (R. 150). The doctor elaborated that Ms. Hawkins' "[c]oncentration is impaired, but allows performance of simple and semi-skilled tasks" (R. 152).*fn2
On November 18, 1997, Agency reviewer Dr. Julius Calvo Villaflor, issued a Physical Residual Functional Capacity Assessment (R. 154-162). The results of this assessment include a finding that Ms. Hawkins is able to lift 50 pounds occasionally and 25 pounds frequently (R. 155). Additionally, Ms. Hawkins was found to be able to sit, walk or stand for six hours in an eight-hour workday (Id.). Finally, it was noted that Ms. Hawkins should kneel or crawl no more than occasionally, and should avoid ladders, climbing ropes, scaffolding and workplace hazards altogether (R. 156, 158).*fn3
On December 18, 1997, Ms. Hawkins was again treated in an emergency room, this time at Cook County Hospital (R. 163-165). Ms. Hawkins went to the hospital after experiencing back pain for one week (R. 163). Ms. Hawkins was again discharged on the same day with instructions to take pain medication as needed (R. 165).
Thereafter, on October 7, 1998, Ms. Hawkins underwent a psychological assessment by a psychologist, Dr. Mark Langgut (R. 166-172). Dr. Langgut described Ms. Hawkins as an adequately groomed and dressed person, whose speech was clear and direct (R. 166). He commented that her eye contact was "rather poor," her answers were often slow and deliberate, and she walked slowly (albeit without assistance) (Id.). Moreover, Ms. Hawkins weighed 230 pounds, having gained 30 pounds in the preceding four to five months (R. 168). Ms. Hawkins indicated that she was living with her boyfriend and that her daily activities included cooking, limited housekeeping, paying bills and shopping with assistance (Id.).
Dr. Langgut observed that Ms. Hawkins was cooperative throughout the examination, but exhibited a sad, tearful and fretful demeanor (Id.). Dr. Langgut said Ms. Hawkins' sadness was related to her limited level of ability, concern over her future, her physical pain, as well as her recent weight gain (Id.).
Dr. Langgut administered several standard psycho-diagnostic tests, including the Michigan Alcohol Screening Test, the Beck Depression Inventory, and the Minnesota Multiphasic Personality Inventory-Index II ("MMPI") (R. 169). Dr. Langgut noted that during the testing, Ms. Hawkins seemed distracted and was "generally preoccupied with advancing her own agenda (i.e., discussing her [l]imitations and pain . . .") (R. 168). As to the Michigan Alcohol Screening Test, while Ms. Hawkins denied any problems or difficulties in this area, Dr. Langgut nonetheless expressed concern regarding "a history (and possible current use/abuse) of alcohol" (R. 169-170). Dr. Langgut's notes regarding the Beck Depression Inventory indicate that while Ms. Hawkins does not appear to be a suicide threat, she does exhibit a number of depressive qualities (R. 169). Finally, Dr. Langgut deemed the results of the MMPI as inconclusive, because they presented "evidence of an invalid profile" (Id.). Dr. Langgut went on to state:
[Ms. Hawkins] presented with significant elevations in
nearly all scales rendering any meaningful
generalizations of personality virtually impossible.
She appears to have naively endorsed nearly all
indicators of pathology in an attempt to underscore
her difficulties and problems. However, due to this
manner of responding, she has obscured any meaningful
generalizations from this measure.
(Id.). In the final "Recommendations" portion of his report, Dr. Langgut summarized his impressions (R. 170). He concluded, "[Ms. Hawkins] would appear to require some degree of support, structure and a therapeutic outlet in which she can discuss those areas of depression that she feels on a daily basis" (Id.).
Dr. Langgut also completed a "Medical Assessment of Ablility to Do Work-Related Activities (Mental)" Form (R. 171-172). His responses on this form indicate his opinion that Ms. Hawkins is unable to "understand, remember and carry out complex job instructions," and at least "seriously limited, but not precluded" in her ability to relate to co-workers, deal with the public, use judgment, deal with work stresses, function independently, maintain her attention/concentration, and behave in an emotionally stable manner (Id.). Furthermore, it was Dr. Langgut's opinion that Ms. Hawkins was "limited, but satisfactory" to "seriously limited, but not precluded" in her ability to "[u]nderstand, remember and carry out detailed but not complex, job instructions;" was no worse than "limited, but satisfactory" to follow work rules and interact with supervisors; and was somewhere between "more than satisfactory" and "limited, but satisfactory" in her ability to ...