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Warren v. Astrue

July 27, 2010


The opinion of the court was delivered by: Magistrate Judge Young B. Kim


Before the court is Anzetta Warren's motion for summary judgment challenging the denial of her application for supplemental security income ("SSI") under the Social Security Act. See 42 U.S.C. §§ 405(g),1382c, 1383(c)(3). Warren claims that she is disabled by asthma, decreased vision, back pain, and several psychological impairments, including depression and post-traumatic stress disorder. For the following reasons, Warren's motion is granted and this case is remanded for further proceedings consistent with this opinion:

Procedural History

Warren applied for SSI in October 2005, claiming that her disability began on May 1, 2003. (A.R. 32, 73.) The Social Security Administration denied her claim initially and on reconsideration.*fn1 (Id. at 32.) Warren then requested, and was granted, a hearing before an administrative law judge ("ALJ"). (Id. at 33.) The ALJ determined that Warren is not "disabled" as defined in the Social Security Act and concluded that she could return to her past work. (Id. at 30-31.) The Appeals Council granted Warren's request for review. On August 17, 2009, it issued a decision adopting the ALJ's findings in all respects except that it found her past relevant work "did not reach the level considered to be substantial gainful activity." (A.R. 6-7.) The Appeals Council nonetheless found that Warren is not disabled after applying Medical-Vocational Rule 202.10, (id. at 7), which counsels a finding of "not disabled" for a person of Warren's age who is capable of performing light work, see 20 C.F.R. § 404, Subpt. P, App. 2 ("grid rule 202.10"). Warren filed the current suit seeking judicial review of the Appeals Council's decision-which represents the final decision of the Commissioner. See 42 U.S.C. §§ 405(g), 1383(c)(3); 20 C.F.R. § 416.1481. The parties have consented to the jurisdiction of this court. See 28 U.S.C. § 636(c).


The administrative record in this case demonstrates that there are substantial barriers standing between Warren and gainful employment. The challenge the ALJ and Appeals Council confronted, as Warren's attorney acknowledged during the administrative hearing (see A.R. 194-96, 245), was determining whether those barriers are caused by a disability, rather than by Warren's particularly difficult personal circumstances. The record shows that Warren has been the victim of sexual assault more than once, beginning when she was only 10 or 11 years old. (Id. at 114.) She dropped out of school after eighth grade, began committing crimes in her teens, and has spent time in jail for home invasion and check forgery. (Id. at 197-98, 207-11.) In the past 15 years she has not held a job for more than 20 months at a time, and she has struggled with drug abuse and homelessness. (Id. at 78, 198, 206, 211.) At the time of her hearing, she had escaped homelessness by agreeing to clean rooms at a motel on Chicago's southwest side in exchange for a room in the motel. (Id. at 198-99.) Despite that arrangement, Warren maintains that she cannot perform substantial gainful activity because she is disabled by asthma, vision problems, back pain, depression, post-traumatic stress disorder, and anti-social tendencies. At her March 31, 2008 hearing before an ALJ, Warren offered both documentary and testimonial evidence to support her claims.

A. Warren's Evidence

Warren testified that she cannot work because she has disabling pain in her right leg, back, and arms. (A.R. 202.) She said that her back is the source of her worst pain. (Id. at 216.) On a scale of one to ten Warren rated her back pain as sometimes at a five or six, and other times as high as a nine. (Id. at 217.) Warren described arm pain that feels "like little needles pinching in" and pain in her right leg from her toe to her hip, all of which she rated at a nine. (Id. at 218-19.) She also said that she suffers from "bad headaches," which she attributes to having her head "busted" in numerous fights when she was younger. (Id. at 219.) Warren explained that she treats her pain with "pain pills," including ibuprofen, and Tylenol 3 with codeine, which she gets from unidentified people she knows. (Id. at 214.) Warren said that the pills help relieve her pain only sometimes. (Id. at 217.)

The ALJ asked Warren why she had not sought medical treatment for her pain. Warren explained that she had seen a doctor at the Englewood Health Center, but said that the clinic staff told her she would have to pay for the treatments, which she cannot afford to do. (A.R. 202-03.) She testified that she tried to obtain a state medical card, but she could not get one because she did not have a social security card or state identification. (Id.) When the ALJ told Warren that there are clinics where she could obtain treatment without a medical card, she responded that the clinic she had visited told her that without a medical card she would have to pay for treatment. (Id. at 214.)

Warren also discussed her psychological struggles. She described feeling threatened, as though people are "coming up on" her, and said that she sometimes hears footsteps outside her door when no one is there. (A.R. 222.) She has suicidal thoughts but said she tries "not to think about things like that." (Id. at 223.) Warren described getting into verbal altercations with people at the motel as often as three times a week. (Id. at 224-25.) She described feeling sad and only looking forward to being by herself in her room. (Id. at 231.) Warren explained that she had received counseling at the Chicago Department of Public Health, but said that she stopped attending because she had to walk to get there, and her leg and back pain made that impossible. (Id. at 220.) She submitted records from the Chicago Department of Public Health describing her as having poor judgment and concentration, memory impairment, impulsivity, and suicidal ideation. (Id. at 153.)

As for her struggles with substance abuse, Warren testified that she had been clean and sober for "about two and a half years," but before getting clean she abused alcohol and used "a whole lot" of crack. (A.R. 211-12.) She described using crack "every day, all night long." (Id. at 212.) Warren told the ALJ that she had been able to get clean on her own. (Id.)

The ALJ questioned Warren at length about her work cleaning the motel where she was staying and her other daily activities. (A.R. 204.) Warren said that she needs to clean for about four to five hours a day, four or five days a week. (Id.) She said that when her pain makes it too difficult for her to clean, her daughter-who was also living in the motel-would do the work for her. (Id. at 205.) Warren described her responsibilities as changing the linens, wiping down surfaces, and sweeping. (Id.) She explained that she cannot use the vacuum or clean under the beds and said that residents complain about her work. (Id. at 205, 226.) She said that she forces herself to work through the pain because otherwise she would have no place to live. (Id. at 219.) Warren said that when she is not cleaning she spends her day in her room watching television. (Id. at 212.) She said she only has one friend and that they usually talk on the phone rather than visit in person. (Id. at 213.)

In support of her testimony Warren submitted medical records spanning the period from January 2005 to May 2006. In January 2005 Dr. Kenneth Gong examined Warren at the behest of the SSA. (A.R. 105.) Dr. Gong described Warren's main complaints as back pain and asthma. (Id.) He noted that exposure to bleach, dust, and other smells trigger her asthma, but said that her use of an albuterol inhaler "is helpful." (Id.) Dr. Gong reported that Warren had "mild to moderate difficulty" getting on and off the examination table and noted that she had "diffuse tenderness to even the slightest palpation throughout her spine." (Id. at 106-07.) An MRI of her spine showed mild degenerative changes with some narrowing in the areas of disc space and "what appear to be prominent atherosclerotic calcifications." (Id. at 118.) Dr. Gong noted that Warren walked with a slight limp and had "decreased ability to finger and manipulate." (Id. at 107.) He conducted visual testing which revealed visual acuity of 20/50 in the right eye and 20/200 in the left. (Id. at 110.) Dr. Gong diagnosed Warren as having asthma, chronic low back pain, bilateral wrist pain that could be carpal tunnel syndrome, and polysubstance abuse. (Id. at 108.)

In January 2006 the SSA asked Dr. Robert Prescott to evaluate Warren's mental status. (A.R. 111.) Warren told Dr. Prescott that she used cocaine and marijuana and drank a six pack of beer once or twice a month. (Id. at 112.) She described having only one friend and reported getting along with only one of her five living children (her sixth child had died). (Id. at 112-113.) She told Dr. Prescott that she feels depressed, worries a lot, has trouble sleeping, and experiences frequent severe headaches. (Id. at 113.) She reported attempting suicide several times between 1980 and 2000. (Id. at 114.) She described being the victim of more than one sexual assault, and told Dr. Prescott that she does not trust ...

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