The opinion of the court was delivered by: P. MICHAEL MAHONEY, Magistrate Judge
MEMORANDUM OPINION AND ORDER
Lisa Stitzer ("Plaintiff") seeks judicial review of the final
decision of the Commissioner of the Social Security
Administration ("Commissioner"). See 42 U.S.C. § 405(g),
1383(c)(3). The Commissioner's final decision denied Plaintiff's
application for Disability Insurance Benefits ("DIB") pursuant to
Title XVI of the Social Security Act (the "Act").
42 U.S.C. § 1381(a). This matter is before the Magistrate Judge pursuant to
consents filed by both parties on December 30, 2003. See
28 U.S.C. § 636(c); Fed.R.Civ.P. 73.
Plaintiff filed for DIB on April 21, 2000, alleging disability
on September 30, 1999. (Tr. 149). Plaintiff's application for
benefits was denied on September 21, 2000. (Tr. 111). On October
24, 2000, Plaintiff filed a request for reconsideration. (Tr.
119). Plaintiff's request for reconsideration was denied on
February 9, 2001. (Tr. 118). Plaintiff then filed a request for a
hearing before an Administrative Law Judge ("ALJ") on February
27, 2001. (Tr. 121). Plaintiff appeared, with counsel, before an
ALJ on May 1, 2002. (Tr. 31). In a decision dated November 29,
2002, the ALJ found that Plaintiff was not entitled to DIB. (Tr.
28). On January 23, 2003, Plaintiff requested a review of the ALJ's decision by the Appeals Council.
(Tr. 11). On May 22, 2003, the Appeals Council denied Plaintiff's
request for review. (Tr. 10).
Plaintiff was born June 9, 1962 and was thirty-nine years old
at the time of her May 2002 hearing. (Tr. 46). Plaintiff
graduated from high school but did not pursue any further
education. Plaintiff testified she has trouble with reading and
arithmetic but is able to write short messages and perform basic
addition and subtraction. (Tr. 47). Additionally, Plaintiff
stated that since March 2002 she could not drive due to a seizure
she suffered in March 2002. Plaintiff's husband drove her to her
May 2002 hearing. At the time of her hearing, Plaintiff was
living with her husband and her teenage daughter. (Id.).
Plaintiff suffers from asthma, seizure disorder, depression and
anxiety. (Tr. 18). It is for these reasons, and some others, that
Plaintiff claims to be disabled.
Plaintiff suffers from seizures. The severity of Plaintiff's
seizures varies. In March 2002 Plaintiff suffered what she called
a "grand mal seizure." (Tr. 49). In addition to the grand mal
seizure, which appears to only happen once or twice a year,
Plaintiff testified that she suffers from "petit mal seizures" a
few times a week. (Id.). With a petit mal seizure, Plaintiff
stated she just sits and stares while other times she physically
jerks uncontrollably. (Id.). The petit mal seizures first
started after Plaintiff's surgery in September 30, 1999. With
regards to the grand mal seizures, Plaintiff stated she had one
in 2002 (as of May 2002), two in 2001, two in 2000 and two in
1999. (Tr. 49-50).
Plaintiff's most recent job was performing home care for a Ms.
Miller. From late 1997 to September 1999, Plaintiff testified
that she would feed, bathe and generally take care of Ms. Miller.
(Tr. 51). General care included such household duties as
vacuuming and washing the dishes. Plaintiff testified that her job at Ms. Miller's sometimes
required lifting of fifty pounds or more. Plaintiff worked on the
weekends for forty eight hours (Ms. Miller had another person
during the week). A normal work day at Ms. Miller's would require
Plaintiff to spend about twenty five percent of her time on her
feet and the rest of the day sitting down. (Tr. 52).
Prior to working for Ms. Miller, Plaintiff performed general
office work through a temporary service. Plaintiff's temporary
jobs usually included filing, general reception work and data
entry. (Id.). Plaintiff was usually not required to lift more
than ten pounds at these jobs. (Id.). Plaintiff's temporary
work required Plaintiff to sit for seven hours. (Tr. 53).
Plaintiff testified that she would normally work about an hour
before standing up to take a break. (Id.). When asked by the
ALJ, Plaintiff stated that she cannot perform the above mentioned
duties now because of her seizures, which Plaintiff stated
prevent her from being able to concentrate and have created
memory problems for Plaintiff. (Id.). Plaintiff was unable to
clearly describe what she meant by memory problems when asked by
Prior to her temporary work, Plaintiff worked for a couple of
months at Swiss Colony in 1997. (Tr. 54). At Swiss Colony,
Plaintiff answered the telephone and did data-entry. (Id.).
Plaintiff's job at Swiss Colony required no lifting or carrying
but, like her temporary work, did require Plaintiff to sit for
seven hours with hourly breaks. (Tr. 55).
Between 1993 and July 1996, Plaintiff worked for the Keen
Company. (Id.). Plaintiff's job at the Keen Company consisted
of data-entry, general customer service, general office work,
filing and tracking packages. (Id.). Like her subsequent jobs,
Plaintiff's job at Keen Company required no lifting or carrying
but did require Plaintiff to sit for seven hours with occasional
Between 1984 and 1993, Plaintiff worked as a transportation
clerk for Sharp Electronic. (Tr. 56). At Sharp Electronic, Plaintiff performed data-entry and
general customer service which consisted of telephone use and
filing. (Id.). Plaintiff's job at Sharp Electronic required no
lifting or carrying but, like her job at the Keen Company, did
require Plaintiff to sit for seven hours with occasional breaks.
A normal day for Plaintiff usually starts with her waking up
around 6:30 a.m. (Tr. 57). After waking, depending on the day,
Plaintiff testified that she does simple housework such as
sweeping, vacuuming (once a month), laundry (once a week), and
grocery shopping. (Id.). Plaintiff does not visit friends or
family or engage in hobbies. Additionally, on a normal day,
Plaintiff will spend an hour or so on the internet. (Tr. 58).
Plaintiff stated she does not watch television during the day,
but instead, when not on the computer or doing housework,
Plaintiff stated she just "sit[s] on the couch and maybe think
about stuff." (Id.).
On a normal day, Plaintiff usually feels tired, fatigued and
weak. According to Plaintiff, these physical feelings have been
the same since her September 1999 accident. (Id.).
Additionally, Plaintiff stated she suffers from tension and
headaches and her bones ache all over her body. (Tr. 61).
Plaintiff's headaches, like some of her other physical ailments,
started after her 1999 surgery. These headaches, which Plaintiff
described as migraines, occur a few times a month and last most
of the day. (Tr. 62). Lastly, Plaintiff stated she suffers from
anxiety type symptoms or depression on a daily basis. (Tr. 67).
Plaintiff's husband, Arthur Stitzer ("Mr. Stitzer"), appeared
before the ALJ during Plaintiff's May 2002 hearing. (Tr. 87). Mr.
Stitzer first testified about Plaintiff's grand mal seizures. Mr.
Stitzer stated Plaintiff usually has a grand mal seizure "six,
seven, eight times a month on an average, maybe one or two a
week, almost always in the evening at night." (Tr. 88). When
asked how he knew the difference between a grand mal and a petit mal, Mr.
Stitzer stated Plaintiff shakes all over and she loses control of
her arms and legs. (Id.). Mr. Stitzer stated Plaintiff usually
does not know she had a seizure. With regards to Plaintiff's
petit mal seizures, Mr. Stitzer stated those usually occur during
the day when he observes Plaintiff "space out for very briefs
periods of time." (Tr. 89). According to Mr. Stitzer, Plaintiff's
petit mal seizures occur "maybe on a monthly basis, eight, nine
times, something like that." (Id.). With regards to daily
activities, Mr. Stitzer testified that he does all the driving
because Plaintiff is unable to drive due to her seizures. (Tr.
91). Additionally, Mr. Stitzer stated that he helps Plaintiff
with the housework and occasionally with dinner. (Id.).
Vocational Expert, Christopher Yep, appeared before the ALJ
during Plaintiff's May 2002 hearing. (Tr. 94). Mr. Yep first
testified that Plaintiff's prior home care position would be an
unskilled position performed at a medium level of exertion.
(Id.). Plaintiff's general office work would be semi-skilled
and her work as the traffic coordinator and transportation clerk
would be skilled. (Id.). Both the general office work and the
traffic coordinator and transportation clerk jobs would be
performed at the sedentary level of exertion. (Id.). The ALJ
then asked Mr. Yep to assume the following:
I.'m going to ask you to assume a hypothetical female
individual who is 39 years of age. . . . Has a high
school education with the ability to read, write, and
use numbers. Let's say basic numbers. All right.
Simple addition and subtraction. Has some prior work.
The same prior work history as [Plaintiff] in this
case with the capacity to perform work with the
following and no other additional limitations. May
perform a full range of work at all exertional
levels, but must avoid concentrated exposure to
allergens, concentrated exposure in the work place to
allergens which would include pollen. I believe dog
and cat hair and mold. . . . And must also avoid
exposure, or concentrated exposure to fumes, odors,
dust, gases, and other pulmonary irritants. The
individual must also avoid exposure to hazards such
as exposed unprotected heights or excavations and exposed unprotected dangerous machinery. And the
individual may not operate a motor vehicle as part of
assigned work duties.
(97-98). Based on the above, Mr. Yep stated that there would be
no impact on past relevant work. (Tr. 98). The ALJ next asked Mr.
Yep to further assume the following modifications:
[l]ifting and carrying is limited to up to 20 pounds
on an occasional basis and ten pounds frequently with
sitting, standing, and walking limited respectively
and with normal breaks up to six hours each in an
eight hour day. The individual may not climb ladders,
ropes or scaffolds. May otherwise climb ramps and
stairs, balance, stoop, kneel, crouch, and crawl on
no more than occasion [sic] basis.
(Tr. 98-99). Based on the further limitations, Mr. Yep stated
such an individual could not do the home care work. However, the
individual could perform all of Plaintiff's other prior work.
(Tr. 99) The ALJ then asked Mr. Yep to assume further the
All right. You are to assume further the individual
does not possess the capacity to, let's say recall
and carry out complex or detailed instructions, or to
maintain such extended attention or concentration as
would be required for the performance of complex or
detailed tasks at a sustained workman like pace. The
individual would however retain the capacity to
understand, recall, and carry out short simple
instructions and to focus upon and attend to and
carry out simple tasks at a sustained workman like
pace. Let's also, we didn't add in there that the
individual should not have to perform more than
minimum use of basic math skills.
(Id.). Based on the above, Mr. Yep stated that such limitations
would eliminate the remainder of the prior work because of
Plaintiff's remaining jobs were semi-skilled to skilled. (Id.).
Focusing on the area of unskilled work within the region of the
State of Illinois, the ALJ asked Mr. Yep whether, based on the
limitations stated above, an individual could perform any work.
In response, Mr. Yep stated that, at both the sedentary and light
level, the individual could perform assembly (32,747 positions), sorting (12,228 positions) and
packaging (22,371 positions). (Tr. 100). While the packaging
position listed by Mr. Yep would only be light work, the assembly
and sorting positions would be forty percent sedentary
(approximately 12,800 positions and 4,800 positions respectively)
and sixty percent light. (Id.).
Again, the ALJ asked Mr. Yep to further assume
that lifting and carrying would be limited to ten
pounds on an occasion [sic] basis and to lighter
items such as small hand tools, individual case
files, could be performed on a frequent basis. And
let's further state that standing and walking would
be limited to a combined total of two hours in an
eight hour day.
(Tr. 101). Based on these last limitations, Mr. Yep stated such
limitations would eliminate the packaging position and the light
work assembly and sorting positions, but would not eliminate the
sedentary assembly and sorting positions. (Tr. 101-102). The ALJ
then asked Mr. Yep to assume further that
standing and walking would be limited to let's say a
maximum of 15 minutes continuously without being able
to sit down for one or two minutes. It could still be
up to two hours in an eight hour day, but 15 minutes
continuously without being able to sit for a minute
(Tr. 102). Mr. Yep stated that such further limitations would not
effect the remaining jobs because they are primarily sedentary.
Finally, the ALJ asked Mr. Yep to assume, separate and apart
from any previous hypothetical, the following:
she cannot stand for any duration continuously. . . .
That sitting is less than two hours in an eight hour
day. Must be able to shift positions at will from
sitting, standing, or walking. Would require
unscheduled breaks at approximately 30 to 45 minute
intervals. Would require rest periods, apparently at
that for as long as one hour. Could lift less than
ten pounds on an occasional basis. . . . Can use the
hands to grasp, turn, and twist objects ten percent of the day. Use
the fingers for fine manipulation ten percent of the
day. Reaching, including overhead with the upper
extremities for only five percent of the day. Can
bend and twist at the waist five percent of the day.
Also limited exposure to cold, extremes of heat and
cold, high humidity, chemicals, solvents, cleaners,
soldering fluxes, cigarette smoke, perfumes, fumes,
odors, dust, and gases, pollen, dog and cat hair, and
mold. And does not have the capacity to tolerate even
low stress jobs.
(Tr. 103-104). Based on the above, Mr. Yep stated such individual
could not perform Plaintiff's prior work or perform any of the
previously mentioned sedentary jobs because of the restrictions
on breaks and the ten percent use of the hands. (Tr. 104).
In September 1999, while driving her car, Plaintiff began to
realize that she could not move her right leg and had no
sensation in her right leg. Plaintiff apparently blacked out and
woke up after her car had gone off the road and rolled over. (Tr.
319). Plaintiff was brought to the Saint Anthony Medical Center
Emergency Room in Rockford, Illinois. (Id.). A CAT scan of
Plaintiff's brain was taken. The CAT scan revealed a "hyperdense
mass in the left frontal lobe with a surrounding area of edema."
(Tr. 321). Additionally, a localized mass effect with mild
subfalcine herniation and compression of the lateral ventricle
was noted. (Id.). No acute hemorrhage or hematoma was noted.
(Id.). Contrast scans of Plaintiff's brain were then taken
which revealed the mass in Plaintiff's left frontal lobe to be a
large cerebral arteriovenous malformation ("AVM"). (Tr. 319).
After the CAT scan, Plaintiff saw Dr. M.M. Soriano. (Id.).
Dr. Soriano's physical exam of Plaintiff revealed Plaintiff's
Cranial nerves II through XII were intact, her lungs were clear,
normal S1 and S2, and her reflexes, sensory and motor exam was
normal. (Id.). Dr. Soriano's impressions of Plaintiff, based on
his physical exam and Plaintiff's CAT scan, were that Plaintiff
had a "giant AVM." (Id.). Ultimately, Dr. Soriano ordered an ambulance
transport Plaintiff to Dr. Gerald Brune at the University of
Illinois, Chicago for treatment. (Id.).
On October 1, 1999, Plaintiff began testing at the University
of Chicago, Illinois. (Tr. 307). Specifically, Plaintiff first
had a Weinberg catheter positioned in her right common carotid
artery. Selective injection showed filling of the distal common
carotid, internal carotid artery cervical portion and external
carotid artery. (Id.). An aneurysm was noted at the C2 level of
the vertebral body measuring approximately 7 mm in diameter. The
distal common and external carotid arteries appeared normal.
(Id.). Another Weinberg catheter was placed in Plaintiff, this
time in her right internal carotid artery. (Id.). Selective
injection showed filling of the distal internal carotid and
anterior middle cerebral arteries. A gross enlargement of the
left anterior cerebral artery A2 segment and the pericallosal
arteries was noted. The pericallosal artery measured
approximately five times its normal size and had two fusiform
aneurysms along its path. (Id.). Another Weinberg catheter was
positioned in Plaintiff's left common carotid artery. (Tr. 308).
Selective injection showed filling of the left carotid cervical
circulation. (Id.). The distal common and external carotid
arteries appeared normal and the left internal carotid artery
appeared diffusely enlarged and tortuous. (Id.). A final
Weinberg catheter was positioned in Plaintiff's left vertebral
artery. (Id.). Selective injection showed filling of the
posterior circulation intracranially. (Id.). The left vertebral
artery and basilar trunk were enlarged diffusely and some
enlargement of the left posterior cerebral artery was noted.
(Id.). In conclusion, radiologist Dr. Vicotr Aletich reported
the cerebral angiography demonstrated a high flow arteriovenous
fistula supplied predominantly by the left pericallosal artery in
an antegrade manner. (Tr. 309). This finding, according to Dr.
Aletich, was associated with diffuse enlargement of both carotid
arteries as well as the vertebral arteries and basilar trunk.
Multiple aneurysms situated on both internal carotid arteries and the left
pericallosal artery were also noted, presumably related to the
increase flow. (Id.).
On October 5, 1999, Dr. John Hughes, of the University of
Illinois at Chicago Medical Center's Department of Radiology,
issued an electroencephalographic report. (Tr. 310). In his
report, Dr. Hughes wrote the following:
The background rhythm in this record consists of well
organized and moderately well developed waves of 9½
to 10 per second bilaterally synchronous and
symmetrical. Intermixed are 2 to 3 second waves on
the left temporal area, diffuse 3 to 5 per second
waves and slow transients on the right temporal
area. . . . IMPRESSION: The sharp waves on the
temporal areas indicate the presence of discharging
foci within those regions. In addition a moderate
degree of focal slow wave abnormality was seen on the
left temporal area and a mild to moderate degree on
the right temporal area indicating a
neurophysiological disturbance within those regions.
Finally a mild to moderate degree of diffuse disorder
is seen indicated a generalized cerebral involvement.
Also on October 5, 1999, Dr. Michael Thorton, of University of
Illinois at Chicago's Medical Center, performed a cerebral
angiogram and embolization of her left parenchymal arteriovenous
fistula. (Tr. 312). Dr. Thorton reported that "two injections of
pure glue were performed into the arteriovenous fistula fed from
the left pericallosal artery. This resulted in apparent large
decrease flow through the fistula." (Id.). The fistula,
according to Dr. ...