The opinion of the court was delivered by: SIDNEY SCHENKIER, Magistrate Judge
MEMORANDUM OPINION AND ORDER
Plaintiff, Nicole Gentle, seeks judicial review of a final
decision denying her application for disability insurance
benefits, under Sections 405(g) and 416(i) of the Social Security
Act. 42 U.S.C. §§ 405(g), 416(i) (2004). Ms. Gentle filed an
application for Disability Insurance Benefits and Supplemental
Security Income payments on September 18, 2001, alleging she
became disabled on September 4, 2001 due to asthma, back pain and
leg pain (R. 96-98). Ms. Gentle's application was denied and, on
February 19, 2003, an administrative hearing was held before the
Administrative Law Judge (the "ALJ"). During the hearing, Ms.
Gentle, who was represented by counsel, testified to suffering
from depression in addition to the above-listed conditions, and
further claimed that her conditions are exacerbated by her
obesity (R. 26-51). Linda Gels, a vocational expert, also
testified at the hearing (R. 51-58).
Ms. Gentle's benefits claim was denied by the ALJ in a written
decision dated October 31, 2003 (R. 16-21). The ALJ determined
that Ms. Gentle was not disabled because she retained the ability
to perform her past work as either a lunchroom attendant or deli
worker. Ms. Gentle, through her attorney, sought review of the
ALJ's decision on December 5, 2003 (R. 269-274). The Appeals Council denied Ms. Gentle's request for review on February 3,
2004 (R. 9-11), making the ALJ's decision the final decision of
the Commissioner. This lawsuit followed.
Ms. Gentle now seeks summary judgment reversing the
Commissioner's decision or, in the alternative, remanding the
case for further proceedings (doc. # 18). The Commissioner has
filed a cross-motion for summary judgment to affirm the decision
below (doc. # 19). For the reasons stated below, the Court grants
the Commissioner's motion for summary judgment and denies Ms.
Gentle's motion for summary judgment.
The following facts are taken from the administrative record,
the administrative hearing transcript, and the ALJ's written
decision. The Court will discuss Ms. Gentle's personal and
medical history, followed by a summary of the hearing testimony
and the ALJ's written decision.
Ms. Gentle was born on October 1, 1976, making her 26 years old
at the time of the hearing (R. 28). Ms. Gentle is single and
lives with her two children (R. 28). She is 5'11" tall and weighs
approximately 275 pounds (R. 39). Ms. Gentle graduated from high
school, during which time she was enrolled in special education
classes (R. 32-33). Her previous work experience includes
positions held as a deli worker, childcare worker, and school
lunchroom attendant (R. 28-30, 102). Ms. Gentle has not been
employed since she left her job as a lunchroom attendant on
September 4, 2001, but continues to care for her children and
perform general housekeeping duties such as cooking, cleaning,
and grocery shopping (R. 31-32).
The medical records relevant to Ms. Gentle's back and leg pain
date from July 31, 2001, when she complained to her obstetrician,
Dr. Collingham, about shooting pains in her right leg that had
been getting worse over the previous three weeks (R. 180). At the
time, Ms. Gentle was pregnant with her second child. Dr. Collingham referred Ms.
Gentle to a physical therapist and to a neurologist, noting that
she may have either a compressed nerve or lumbar disk syndrome
(R. 180). On September 6, 2001, Ms. Gentle saw Dr. Lee Ann Myers,
a neurologist at Evanston Hospital (R. 170-71). Dr. Myers'
treatment notes indicate that Ms. Gentle reported feeling
shooting pain in her right hip and leg, which she had been
experiencing off and on since November 1998, when she delivered
her first child (R. 170). Ms. Gentle had previously taken
Celebrex for the pain, but it was not effective (R. 170). Dr.
Myers recommended Ms. Gentle find a different job for the
duration of her pregnancy that did not involve standing (R. 169).
Ms. Gentle was working as a lunchroom attendant at the time (R.
On September 24, 2001, Ms. Gentle saw a physician at Evanston
Northwestern Hospital who noted that Ms. Gentle may have multiple
slipped discs, but concluded that nothing could be done about her
condition until after her pregnancy (R. 179). Ms. Gentle was
scheduled for physical therapy three times in November and
December 2001 (R. 182). Ms. Gentle gave birth to her second child
on February 28, 2002 (R. 29). In April 2002, Ms. Gentle had an
MRI of her lumbar spine, revealing a small disc protrusion at the
L5-SI level (R. 246, 252). A letter from Dr. Pamela McShane,
dated April 11, 2002 states that this condition prevents Ms.
Gentle from lifting heavy objects (R. 246). Ms. Gentle's
outpatient psychiatric notes from May 2002 indicate that Dr.
McShane stated that Ms. Gentle's MRI showed "no significant
physical abnormality requiring additional treatment or
disability" (R. 241). The outpatient psychiatric notes also state
that Ms. Gentle's pain symptoms may be related to stress (R.
Ms. Gentle's problems with depression and anxiety were first
documented at age six, when a teacher requested that she be
evaluated by a psychiatrist due to behavioral concerns (R. 163).
Ms. Gentle continued to have emotional problems and received
periodic mental health evaluations while in school (R. 163-164). After graduating from high school, Ms.
Gentle does not appear to have sought treatment for depression
until May 2002, when she was diagnosed with major depression and
received a prescription for Celexa (R. 227). At that time, Ms.
Gentle reported to her doctors that she had been sexually abused
by her mother's boyfriends from ages five through fourteen (R.
227-229). She also reported feeling overwhelmed by the task of
caring for her children and that she experienced episodes of
anxiety or panic (R. 227-229). The treatment notes indicate that
Ms. Gentle's obesity is a factor related to her depression (R.
From May 2002 through January 2003, Ms. Gentle continued to
seek regular psychiatric treatment and her doctors made some
adjustments to her medication prescriptions (R. 227-240). As of
January 2003, Ms. Gentle's treatment notes indicate that her
symptoms had improved, although she was still experiencing some
depression, feelings of being overwhelmed, and reluctance to
leave her house (R. 240). Her attending psychiatrist noted that
Ms. Gentle experienced mild constipation and a decreased ability
to concentrate as side-effects of taking Prozac (R. 240, 245). On
April 8, 2003, Dr. Robert Burton wrote a letter stating that Ms.
Gentle had been diagnosed with recurrent major depression, that
her symptoms (decreased energy, depressed mood, panic/anxiety,
and feeling easily overwhelmed) were disabling, and prevented her
from caring full-time for her children, and that Ms. Gentle
should be permitted to have childcare assistance (R. 254).
At the administrative hearing, Ms. Gentle testified that she
has not performed any paid work since she left her position as a
school lunchroom attendant on September 4, 2001, the alleged
onset date of her disabilities (R. 28). The ALJ asked Ms. Gentle
several questions about her employment history. Ms. Gentle stated
that she left her job as a school lunchroom attendant which was
during her second pregnancy because the position required too
much standing, moving around, and lifting, which caused her to experience pain in her back (R.
28-29). She also testified to having experienced difficulty
filling out all the paperwork for the lunchroom attendant
position, which she attributed to her difficulty reading and
writing and maintaining the requisite level of attention (R. 35).
However, there was no evidence that these difficulties rendered
Ms. Gentle's job performance unacceptable to her employer.
At the hearing, Ms. Gentle's attorney claimed that Ms. Gentle
is disabled and that, due to a combination of her impairments,
she is unable to sustain substantial gainful activity (R. 26,
27). Her attorney stated that Ms. Gentle's has low back syndrome,
as indicated by obstetrician's notes (R. 26, 179-181); that she
experiences shooting pain in her right leg, especially when
standing or walking for prolonged periods (R. 26); that she
experiences pain in her back and stiffness in her right leg when
sitting for extended periods of time (R. 26); that she suffers
from asthma, which is triggered by dust, smoke, mold, and hot
weather (R. 26); that she would probably be considered obese,
which exacerbates her pain symptoms (R. 27); that she takes
Prozac for depression, experiences crying spells and is reluctant
to leave her home (R. 27); that she has difficulty keeping up
with her children and household cleaning (R. 27); that, as a
result of taking Prozac and Benadryl, she feels drowsy and must
lie down during the day and also has problems with mental focus
and functioning (R. 27).
Ms. Gentle brought a brace with her to the hearing that she
received from her physical therapist (R. 39). Her physical
therapist instructed Ms. Gentle to wear the brace at all times,
but since Ms. Gentle finds the brace uncomfortable, she only
wears it when she is bending over frequently or when she needs to
lift something (R. 39). She finds it difficult to lift her
daughter, who weighed 25 pounds at the time of the hearing (R.
47). Ms. Gentle stated that she experiences shooting pains on a
daily basis, starting in her lower back, going through both hips,
and down the back of her right leg to her knee (R. 40). Ms. Gentle stated that
she started experiencing this pain several years prior to the
hearing, when she was working at the grocery store (R. 36). She
testified to experiencing this pain when she walks and that the
pain lasts for hours (R. 40-42). Ms. Gentle stated that if she
sits to rest, her leg stiffens, making the pain worse (R. 41).
She takes Vicodin or Extra Strength Tylenol about three times a
week for that pain, but tries to avoid taking Vicodin more often
than three times per week due to the fact that she is nursing her
daughter and also because it causes blurry vision and drowsiness
(R. 41). Ms. Gentle can stand in one place approximately ten or
fifteen minutes before she starts to experience leg or back pain,
after which time she usually lays down (R. 42). She can usually
sit about twenty minutes before she starts to experience pain or
discomfort in her back, at which point she usually stands up (R.
Ms. Gentle testified that she was not certain when she started
seeing a psychiatrist for her depression (R. 34). Although she
was taking Prozac as of the date of the hearing, she was still
experiencing some symptoms of depression (R. 43). She stated that
she regularly experiences crying spells (R. 44) and has
difficulty focusing and keeping appointments (R. 45). Ms. Gentle
testified that she has anxiety attacks about twice a week, during
which her stomach twists, her chest tightens, her head spins, and
she has difficulty breathing (R. 46). When she takes Prozac, Ms.
Gentle experiences dry mouth, upset stomach, and sleepiness (R.
48). She feels especially sleepy when she takes other medication
along with Prozac, such as allergy and sinus medications (R. 48).
She usually takes her ...