The opinion of the court was delivered by: SAMUEL DER-YEGHIAYAN, District Judge
This matter is before the court on Plaintiff Tonia Denham's
("Denham") motion for summary judgment and on Defendant Jo Anne
B. Barnhart's ("SSA") motion for summary judgment. For the
reasons stated below, we deny both motions and remand this case
to the Social Security Administration ("SSA") for further
proceedings consistent with this opinion.
On September 22, 1998, Tonia Denham injured her back in an
automobile accident. Before her accident, Denham earned an
associate's degree and held several jobs, including positions as
an assistant funeral director from 1991 to 1993, a frozen food packer in 1994 and 1995, and a jewelry salesperson
and office manager from 1995 to 1998. Since her accident, Denham
has held several part-time jobs, such as a position as a phone
interviewer from January to August of 2000. However, Denham has
not worked at all since August of 2000.
In the months and years following her accident, Denham has
undergone numerous medical examinations and received treatment
from numerous physicians. Immediately following her accident,
Denham received roughly one month of physical therapy for her
back injury. In March and April of 1999, Denham experienced
swelling and strain in her right wrist and had a mass surgically
removed from her left thumb. In late April and early May of 1999,
doctors twice diagnosed Denham with situational depression. Then
in October of 1999, her doctors diagnosed her with asthma and
fibromyalgia, a chronic condition that causes tenderness and pain
in muscle and soft tissue.
In January of 2000, Denham saw Dr. Ellens, her family
physician, for a knot in her right hand Dr. Ellens diagnosed
right hand arthralgia and back pain and ordered more physical
therapy for Denham's right arm, hand, and back. However, Denham
made little progress in therapy and her therapist recommended
referral to a pain clinic in March of 2000. That same month, Dr.
Ellens diagnosed carpal tunnel syndrome in Denham's right wrist
and back pain and instructed Denham to wear a brace on her right
wrist. However, another test conducted the previous month had
found no such evidence of carpal tunnel syndrome.
In late March 2000, an x-ray of Denham's lower back produced
substantially normal findings, although it also revealed that Denham's L5
vertebrae had anomalously fused with her sacrum, the five fused
vertebrae at the base of her spine. In early April, Denham saw
Dr. Labanauskas, an orthopedic surgeon, who diagnosed exaggerated
lumbar lordosis, or abnormal inward curvature of the lower spine,
as well as limited flexion and extension due to pain. He
recommended a new lumbosacral corset, epidural steroid
injections, Vioxx, and Flexeril.
Denham again saw Dr. Ellens in May 2000, who again diagnosed
back pain and asthma, prescribing a back brace, asthma
medication, and continued treatment with Vioxx and Flexeril. Upon
return visits in July, Dr. Ellens also diagnosed edema and knee
strain and instructed Denham to stop taking Flexeril. In early
August, Denham again visited Dr. Labanauskas, who prescribed a
cane for her swollen knees, writing "arthritis" on the
Also in early August, Denham underwent an MRI of her lumbar
spine, which produced normal results. Later that month, Denham
saw Dr. Burnet, who diagnosed back pain, mild depression,
obesity, controlled asthma, stable irritable bowel syndrome, and
insomnia. However, Dr. Burnet's exam found no tenderness in
Denham's spine or joint swelling, unlike Denham's prior exams
with Dr. Ellens. Dr. Burnet suggested that weight reduction and
other non-pharmaceutical methods might aid with Denham's pain.
Dr. Burnet also offered to refer Denham for treatment of her
depression, but Denham declined.
From August to September 2000, Denham received another round of
physical therapy for her back pain. During this period, she
received a transcutaneous electrical nerve stimulation ("TENS") unit to reduce her back
pain, which increased Denham's mobility and tolerance of daily
In late September, another x-ray of Denham's cervical spine
found bilateral cervical ribs. When Denham consulted with Dr.
Jayasanker, a hand surgeon, in late October, he found no
conclusive evidence of carpal tunnel syndrome, but suggested that
her bilateral cervical ribs might be causing pressure on a nerve
and producing her pain.
Denham returned to Dr. Ellens in late September, reporting
improved mobility. Dr. Ellens diagnosed lumbar strain,
hypertension, and asthma, prescribing Flexeril again and
instructing Denham to continue using her TENS unit. She returned
to Dr. Burnet in mid December 2000 and again in March 2001. At
the latter examination, Burnet again noted edema in Denham's
extremities and recommended elastic stockings for the problem.
Dr. Burnet also advised Denham to continue using her TENS unit
and Amitriptyline for her back pain.
Denham applied for Disability Insurance and Supplemental
Security Income disability benefits on May 11, 2000, but the SSA
denied her claims. She requested a hearing and appeared before an
Administrative Law Judge ("ALJ") on August 21, 2001. At the
hearing, the ALJ heard testimony from Denham as well as a
vocational expert ("VE"). Denham testified that she suffers from
chronic neck and back pain with spasms, arthritis in both knees,
asthma, and significant depression, resulting in frequent crying
spells and a significantly decreased ability to concentrate.
As evidence of her pain, Denham testified she is severely
limited in her ability to do ordinary housework and daily tasks, describing a daily
routine of driving her children to school, preparing food in the
microwave, watching television, and talking with her aunt. She
testified that she could not clean vegetables or wash more than a
single dish. When sitting or laying down, Denham claims that she
must prop herself up because of her persistent pain. In addition,
Denham testified that she can barely sweep her floor and that she
cannot mop at all. Finally, she ...