The opinion of the court was delivered by: Michael M. Mihm United States District Judge
This matter is now before the Court on Plaintiff's Motion for Summary Reversal and the Commissioner's Motion to Affirm. For the reasons set forth below, Plaintiff's Motion for Summary Reversal is DENIED, and the Commissioner's Motion to Affirm is GRANTED.
The Plaintiff, Allan W. Young, applied for Supplemental Security Income and Disability Insurance Benefits on December 20, 2005, (R165-73), alleging that he was completely disabled due to his diabetes and a seizure disorder (R165-73). At the time, he was 50 years old, 5'7" tall, and 176 pounds (R190). He does not smoke, drink, or use illegal drugs (R93-94). He lives alone*fn1 in a mobile home in the country (R89). However, his elderly father lives next door, and he receives some financial assistance and help around his house from a woman who visits him several times a week (R92, 106-07). Mr. Young has a high school education (R196), and has previously worked as a laborer, parts packager, operating engineer, floor maintainer, and creative advertiser (R198). He stated in his disability report that he been unemployed since March, 2003 (R191), but he testified that he performed occasional work with his brother at the horse stables of his treating physician, Dr. Reed, up until October 2005 (R89, 98, 198).
Mr. Young's initial claim was denied on March 2, 2006 on the grounds that he was not fully disabled (R122). His subsequent request for reconsideration of the claim was denied on May 17, 2006 (R129-33). He then requested a hearing by an Administrative Law Judge ("ALJ") on May 31, 2006 (R139).
The hearing before ALJ John Dodson took place on August 21, 2008 in Peoria, IL (R74). Vocational Expert ("VE") Dr. James Lanier as well as Mr. Young and his attorney, Mr. Thomas Henry, were present. Id. Mr. Young testified that on the alleged onset date, October 15, 2005, he suffered a black out seizure while performing a song at church and was hospitalized (R84-85). See also R257 (Mr. Young describes the blackout seizure as including "head turning and body stiffening" and a generalized headache afterwards); R205-07 (documentation of eyewitness accounts of his seizures, including the incident described above).
In addition to the black-out seizures, Mr. Young also testified to having mild seizures where "a glaze comes over" and he gets a "funny feeling," but does not "black out" (R84). The seizure typically lasts two to three minutes, and he knows that he is having a seizure as it happens. Id. See also R432 (neurologist notes that according to the claimant, a "mild seizure" lasts about ten seconds and is a "strange sensation in the form of a pressure sensation and his forehead sweats. He feels a little bit spacy but he does not completely lose [sic] consciousness"). During a "mild seizure" he continues what he is doing or "might sit down.and wait until it passes.just relax" (R84). After a seizure has occurred, he discusses what happened with someone, and often lays down to rest (R96).
Since the alleged onset date, Mr. Young has been treated for his epilepsy and diabetes by two physicians. Dr. James Reed, who treated him following his hospitalization through at least May 2006, noted that Mr. Young had suffered from Jacksonian tremors since he was a child (R294) and that he had an elevated blood sugar level (R293), which he diagnosed as diabetes on November 21, 2005 (R292). He also described Mr. Young as a "social outcast" with a "real odd personality" (R294). See also (R331) (opining that "most of his problems come from having a long standing personality problem, anxiety state"). Dr. Reed hoped that controlling Mr. Young's blood sugar could help with the seizures (R291), but he also placed him on Depakote to treat the seizures and Phenobarb to help with his seizures and anxiousness (R331). While Mr. Young was on his medication, Dr. Reed noted that Mr. Young was having fewer seizures and that he was looking and feeling better (R329).
Dr. Reed referred Mr. Young to neurologist Dr. Jianming Dong for an electroencephalogram ("EEG") test on November 28, 2005. It was a "normal awake and drowsy EEG without definite evidence of epileptiform abnormalities or electrographic seizure activities," although that diagnosis did not foreclose the possibility that Mr. Young had a seizure disorder or epilepsy (R257). Dr. Dong's assessment found "[t]he infrequent sporadic pattern of clinical events is not very typical for epileptic seizure disorder. . . . The patient may have undetectable diabetes and hyperlipidemia which are potential risk factors for cerebrovascular and cardiovascular events. . . . I recommend the patient to decrease caffeine intake. Excessive use of caffeine may cause agitation, anxiety attacks and shaking episodes" (R267).
From at least January, 2007, Mr. Young began seeing Dr. Kenneth Krock as his physician (R336). Mr. Young was again suffering from seizures and had not been taking any Depakote, Phenobarb or Metformin (his diabetes medication) for several months. Id. Dr. Krock classified the seizure disorder as "questionable" or "undiagnosed" in nearly every medical report filed, but also noted that neurological exams would be necessary for a conclusive diagnosis. See, e.g., R370 ("Doesn't sound typical of any kind of seizure to me, but again I believe more history is needed and more follow up."); R392 (suggesting neurological testing since "[t]he underlying nature of the seizures has never directly been elucidated and I am not particularly clear whether or not he truly has a seizure disorder").
On Dr. Krock's referral, Mr. Young saw a second neurologist, Dr. Erhan Ergene who performed a second EEG to rule out epileptiform abnormalities (R430). The EEG, performed on July 28, 2008, was "normal" (R434). Based on Mr. Young's self-reported history, Dr. Ergene noted there were "possible complex partial seizures." Id. He recommended another EEG -- which Mr. Young refused -- and an MRI to test for structural causes of the seizures such as mesial temporal sclerosis. Id. The MRI, performed on August 29, 2008 did detect mesial temporal sclerosis (R435). Dr. Ergene also recommended that Mr. Young take Trileptal to control his seizures, but Mr. Young refused. Id.
Mr. Young identified in his testimony several factors that he believed caused seizures to occur. The first factor is his adult onset diabetes (R86). In testimony, he noted that he had not experienced a black out seizure while on Metformin, the drug used to treat his diabetes. Id. Failure to get enough sleep and fatigue was a second factor which allegedly triggered a seizure (R96). A third factor was heat and humidity (R87, 432). Mr. Young also testified that he had tooth problems that "seem to enhance it" and that he had "heard . from someone or read it someplace" that the psoriasis in his ears could also "promote" the seizures (R97).
When asked about his daily activities, Mr. Young testified that he typically wakes up around 11 a.m., makes breakfast and takes his prescribed medication (R87-88). He performs occasional yard work and drives to nearby Canton, IL for groceries or to run errands several times each week (R90). Sometimes he goes to the library to pick up movies to watch at home (R93). He plays guitar and composes original music for performance at several churches in the area (R90-91). At home, he receives visits from a female friend several times a week (R92). He takes a walk about three times each week to exercise (R93). He also cleans his home and music equipment from time to time (R105).
Mr. Young testified that he had stopped working for several reasons because of his alleged disability. First, he cited safety reasons as a primary concern (R97-98). He also spoke about pain that interfered with his ability to perform prior jobs, like baling hay and moving packages (101). His knees "hurt so bad that [he] tried to stay off them," but that being "conscious" of the problem helped alleviate the pain (R104). He stated that his shoulders and knees were "out of whack" and that he occasionally had numbness in his knees and toes, but that he had been doing isometric exercises which helped (R99, 101). He also noted that lifting too much weight, such as fifty pounds, would cause long-term pain (R99-100). Finally, he could sit for at least an hour, but had to get up and move around to get the circulation going after that (R94).
Another factor which impeded his ability to work was that it took him longer to perform tasks. In addition to being easily worn out due to his age (R105), he testified to being very "cautious" in going about his daily activities (R103), and that he keeps a diary of his diet (R88). See also R86-87 (testifying that watching what he eats and what medication he takes is "kind of a full-time job"). When asked whether he would accept a janitorial job, Mr. Young said that he was concerned about the "rat race, the getting up and trying to fit their schedule and not keeping pace with.my own personal life.and the lifting and. you don't know the people you're around" (R103-04). He further explained that the work went "against [his] health" and "didn't seem to be worth it.for what small pay there was" (R105).
An assessment of Mr. Young's Physical Residual Functional Capacity ("PRFC") conducted by medical consultant Sandra Bilinsky on February 2, 2006 found that he was "alert and oriented" with normal gait and coordination and with an extremely elevated blood sugar level (R311). Due to the alleged syncope or seizures, which was possibly related to his uncontrolled diabetes, she recommended that he "avoid unprotected hazards including climbing of ladders, rope and scaffolds and the operation of dangerous machinery (R308).
Based on Mr. Young's testimony, medical records, and the RFC assessment, the ALJ found that Mr. Young had certain limitations; namely, "he cannot climb ladders, ropes or scaffolds, he cannot kneel or crawl, he must avoid concentrated exposure to unprotected hazards such as heights and machinery, he must avoid concentrated exposure to extreme heat and cold, and he needs a stand/sit option" (R55). Because of these limitations, Mr. Young was unable to perform a full range of light work; therefore, the ALJ posed the following hypothetical to the VE to determine what jobs, if any, Mr. Young could perform:
Doctor, I want you to assume a person with the same age, education, and work experience as the claimant, and assume further that this person is capable of performing the full range of light work, except he's not to have any ropes, ladders, or scaffolds; he would avoid concentrated exposure to unprotected hazards such as heights and machinery; he would also have to avoid exposures to extreme heat and cold . . . and also have a sit/stand option; and there would be no kneeling or crouching, ...