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Keiber v. Astrue

September 30, 2009


The opinion of the court was delivered by: Michael T. Mason United States Magistrate Judge

Hon. Michael T. Mason


Michael T. Mason, United States Magistrate Judge.

Plaintiff, Lloyd Keiber ("Keiber" or "claimant"), has brought a motion for summary judgment seeking judicial review of the final decision of the Commissioner of Social Security ("Commissioner"). The Commissioner denied Keiber's claim for Disability Insurance Benefits ("DIB") under the Social Security Act, 42 U.S.C. §§ 216(i) and 223(d). The Commissioner filed a cross-motion for summary judgment requesting that we uphold the decision of the Administrative Law Judge ("ALJ"). We have jurisdiction to hear this matter pursuant to 42 U.S.C. § 405(g). For the reasons set forth below, Keiber's motion for summary judgment is denied and the Commissioner's cross-motion for summary judgment is granted.


A. Procedural History

Keiber filed an application for DIB on May 13, 2005, alleging a disability onset date of August 11, 2004. (R. 71-73). His claim was denied initially on September 2, 2005 and again on December 2, 2005 after a timely request for reconsideration. (R. 62-64, 66-68). Thereafter, Keiber requested a hearing, which was held on September 19, 2006 before Administrative Law Judge Daniel Dadabo ("ALJ Dadabo" or "ALJ"). (R. 39, 460-516). On December 24, 2007, ALJ Dadabo issued a written decision denying Keiber's request for benefits. (R. 26-36). Keiber filed a timely request for review, which the Appeals Council denied on October 26, 2007. (R. 21-24). The ALJ's decision then became the final decision of the Commissioner. Estok v. Apfel, 152 F.3d 636, 637 (7th Cir. 1998); 20 C.F.R. § 416.1481. Keiber subsequently filed this action in the District Court.

B. Medical Evidence

Claimant's seeks DIB for anxiety and affective disorders. He alleges that these disabling conditions stem principally from a traumatic event that occurred on October 30, 1991 while he was the pastor of a Lutheran church. (R. 220, 318, 354). When visiting a parishioner in the hospital, he witnessed the charred, dead bodies of two young boys from his parish who had recently died in a house fire. (Id.). Although Keiber claimed to have been treated by various mental health professionals from 1991 to 2004, these medical records are not included in the record.*fn1

Keiber saw several physicians at Centegra Health System between January 20, 2004 and July 6, 2006. (R. 263-306). Though the records of his approximately forty visits to Centegra over that period are mostly illegible, they do indicate that Keiber was treated chiefly for anxiety and depression, and prescribed a variety of antidepressant medications, including Cymbalta, Prozac, Wellbutrin and Lexapro. (Id.). Because many of the Centegra records are impossible to read, this list of medications is not necessarily comprehensive.

On September 16, 2004, Lessi Smebakken ("social worker Smebakken"), a social worker, performed a Psychiatric Diagnostic Interview Examination of Keiber for approximately one hour. (R. 318-22). Keiber reported suffering from severe depression and anxiety that began after viewing the two dead boys. (R. 318). He stated he was taking Effexor (an antidepressant) and Provigil (a medication promoting wakefulness) at the time. (R. 319). Smebakken observed that Keiber exhibited a depressed mood and anxious affect, although she also noted that he demonstrated good short-term and long-term memory as well as fair attention span and concentration. (R. 320). She diagnosed him with post-traumatic stress disorder ("PTSD") and assigned a Global Assessment of Functioning ("GAF") score of 60. (R. 321). This score indicates "moderate symptoms or any moderate difficulty in social, occupational, or school functioning." Diagnostic and Statistical Manual of Mental Disorders, 34 (4th ed. Am. Psychiatric Ass'n 1994) ("DSM-IV").

Keiber first saw Dr. Afshan Hameeduddin ("Dr. Hameeduddin"), a family practice physician, on October 19, 2004. (R. 202). He reported "not feeling well for the last 3 to 4 weeks," experiencing fatigue, not sleeping well and feeling "extremely depressed." (Id.). Dr. Hameeduddin observed that Keiber was "awake" and "alert," although "sick looking." (Id.). He diagnosed him with "symptoms suggestive of mostly a viral syndrome" as well as "major depression." (Id.).

On December 3, 2004, Keiber saw Dr. Hameeduddin again and reported extreme fatigue, confusion, recurrent mental status changes, a racing heart and chest pains. (R. 197-98). Dr. Hameeduddin diagnosed him with fatigue, confusion and an intermittent twitching sensation. (R. 198).

Dr. Amarish Dave ("Dr. Dave"), a neurologist, examined the claimant on December 27, 2004. (R. 199-201). Keiber complained of weakness, pain all over his body, forgetfulness and clumsiness, and claimed to have a history of PTSD. (R. 199-200). Dr. Dave stated that claimant's symptoms could be explained solely by PTSD, but he ordered a magnetic resonance imaging ("MRI") scan of Keiber's brain to explore any structural or biological factors that might be causing his symptoms. (R. 200).

According to the reviewing radiologist, the MRI, taken on January 7, 2005, revealed "a significant degree of cortical atrophy of both cerebral hemispheres, particularly near the vertex" with a degree of cortical atrophy significantly greater than that of a normal individual Keiber's age. (R. 157). After reviewing the MRI on January 10, 2005, Dr. Dave stated that Keiber's brain atrophy was "difficult to correlate with symptoms" and that the findings did not necessarily indicate there was a specific problem.(R. 196). He recommended that claimant undergo a spinal tap to rule out the possibility of chronic infectious etiology or another inflammatory process. (Id.).

Keiber saw Dr. Hameeduddin again on February 15, 2005 and appeared alert, awake and in no apparent distress. (R. 195) He reported that he was in an "okay" mood. (Id.). Dr. Hameeduddin noted that the spinal tap recently performed was negative. (R. 195, 203-05). He diagnosed Keiber with chronic fatigue and severe cortical atrophy. (R. 195).

Social worker Smebakken performed a second Psychiatric Diagnostic Interview Examination of Keiber on April 5, 2005. (R. 254-58). The claimant stated he was taking two medications at the time: Cymbalta and Clonazepam (for panic disorders). (R. 255). He reported having no energy and a lack of motivation. (R. 254). Keiber also mentioned that his fifteen-year-old daughter had recently been diagnosed with a hematoma on the brain, which required very expensive medication. (Id.). Smebakken observed that Keiber was well-groomed, had good short-term and long-term memory, had fair attention span and concentration, and appeared to be obsessed with his health.

(R. 256). She diagnosed him with PTSD and, as before, assigned a GAF score of 60.

(R. 257).

More than one month after Keiber applied for DIB on May 13, 2005, Dr. Ann Callison, a psychiatrist, examined Keiber on June 24, 2005. (R. 208-11). She noted that she had seen Keiber on a monthly basis from February 10, 1999 through August 25, 2003. (R. 208). However, documentation of these visits is not contained in the record. On June 24, 2005, Dr. Callison observed that Keiber was well-mannered, neatly dressed, well-groomed, fully oriented and exhibited good abstract thinking and judgment, although he also demonstrated poor focus and multiple shifts of attention.

(R. 208-10). Keiber reported having symptoms correlated with PTSD, panic disorder, major depression and attention deficit disorder, and stated that in the past, he responded positively to Prozac and Xanax, an anti-anxiety medication. (R. 208, 211). Dr. Callison noted that Keiber had changed jobs several times and had been unable to maintain steady work, although she never opined on whether Keiber would be unable to work in the future. (R. 211).

On July 4, 2005, claimant went to the emergency room after a sudden onset of redness on his forehead and a 102.0 degree fever. (R. 215-16). He was diagnosed with cellulitis, which was "probably secondary to an insect bite." (R. 216).

The Illinois Department of Human Services referred Keiber to Dr. Frank Elmudesi ("Dr. Elmudesi,"), a psychiatrist, for a clinical interview and mental status examination.

(R. 220-22). On August 13, 2005, Dr. Elmudesi spent approximately one hour interviewing claimant. (R. 220). Keiber reported suffering from depression and anxiety episodes ever since he witnessed the charred bodies of the two boys in 1991. (Id.). He also stated that he felt increasingly uncomfortable around people, hypervigilant, experienced memory problems and had difficulty relaxing. (R. 220-21). He claimed to be taking three psychotropic medications at the time of the interview: Cymbalta, Clonazepam and Ritalin. (R. 221).

Dr. Elmudesi observed that Keiber displayed a clean and neat appearance, and was "alert and fairly well oriented in all spheres." (R. 221). He observed no psychotic signs, symptoms or any hallucinations. (Id.). He found that the claimant exhibited fair judgment and insight, a friendly and cooperative demeanor, and had an intact memory.

(R. 221-22). Dr. Elmudesi stated that Keiber showed classic PTSD symptoms, including hypervigilance, nightmares, avoidance of discussing the traumatic event, physical and emotional tension, decreased concentration and proneness to distractibility. (R. 221). He also noted lethargy and mild difficulty with basic tasks of concentration and mental flexibility. (R. 222). Dr. Elmudesi concluded that Keiber ...

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