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Gray v. Astrue

September 30, 2010


The opinion of the court was delivered by: Frazier, Magistrate Judge


Plaintiff, Michael J. T. Gray, seeks judicial review of a final decision of the Commissioner of Social Security denying his June, 2007, applications for disability benefits and supplemental security income. Gray's applications were rejected following an administrative determination that he was not disabled. The administrative decision became final when the Appeals Council declined to review the decision reached by an Administrative Law Judge (ALJ). Judicial review of the Commissioner's final decision is authorized by 42 U.S.C. § 405(g) and 42 U.S.C. §1383(c)(3).

To receive disability benefits, a claimant must be "disabled." A disabled person is one whose physical or mental impairments result from anatomical, physiological, or psychological abnormalities which can be demonstrated by medically acceptable clinical and laboratory diagnostic techniques and which prevent the person from performing previous work and any other kind of substantial gainful work which exists in the national economy. 42 U.S.C. §§ 423(d)(1)(A), 423(d)(2)(A), 1382c(a)(3)(B), 1382c(a)(3)(D).

The Social Security regulations provide for a five-step sequential inquiry that must be followed in determining whether a claimant is disabled. 20 C.F.R. § 404.1520; 416.920. The Commissioner must determine in sequence: (1) whether the claimant is currently employed, (2) whether the claimant has a severe impairment, (3) whether the impairment meets or equals one listed by the Commissioner, (4) whether the claimant can perform his or her past work, and (5) whether the claimant is capable of performing any work in the national economy. Clifford v. Apfel, 227 F.3d 863, 868 (7th Cir. 2000). If the claimant does not have a listed impairment but cannot perform his or her past work, the burden shifts to the Commissioner at Step 5 to show that the claimant can perform some other job. Id.

At the time of the ALJ's decision, Gray was 30 years old. He had the equivalency of a high school education and relevant work experience as a drywall hanger. The ALJ evaluated Gray's applications through the last step of the sequential analysis and concluded that he had severe physical and mental ailments: degenerative disc disease of the cervical and lumbar spine, bipolar disorder, and a history of alcohol dependence. These ailments did not meet or equal one of the impairments listed in the Social Security regulations. The ALJ also determined that Gray retained the ability to perform work except for jobs requiring him to lift or carry objects weighing more than 25 pounds frequently or more than 50 pounds occasionally; stand or walk more than 6 hours in an 8-hour workday, or perform more than simple work activity. While these limitations prevented Gray from performing his past job as a drywall hanger, the ALJ found that Gray was not disabled because he could still perform a number of packer and assembly jobs (R. 9-22).

Gray challenges the Commissioner's decision on several grounds, discussed below. Under the Social Security Act, a court must sustain the Commissioner's findings if they are supported by substantial evidence. 42 U.S.C. § 405(g). Substantial evidence is "more than a mere scintilla" of proof. The standard is satisfied by "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401 (1971); Butera v. Apfel, 173 F.3d 1049, 1055 (7th Cir. 1999). Because the Commissioner of Social Security is responsible for weighing the evidence, resolving conflicts in the evidence, and making independent findings of fact, this Court may not decide the facts anew, reweigh the evidence, or substitute its own judgment for that of the Commissioner. Id. However, the Court does not defer to conclusions of law, and if the Commissioner makes a serious error, the decision will be reversed unless the Court is satisfied that no reasonable trier of fact could have come to a different conclusion. Sarchet v. Chater, 78 F.3d 305, 309 (7th Cir. 1996).

In their briefs, the parties have adequately summarized the medical evidence and other portions of the administrative record. To the extent necessary, relevant portions of the record are discussed below.

I. Evidence Supporting ALJ's Assessment of Mental Impairment

Gray offers several arguments in support of his position that the ALJ's decision is not supported by substantial evidence. Initially, he points generally to his testimony and testimony provided by Ms. Milazzo, claiming that this evidence is consistent with hospitalization records for symptoms of depression and anxiety. This argument is evaluated as a challenge to evidence supporting the ALJ's assessment of the functional severity of Gray's mental ailment.

ALJs rate the degree of a person's mental functional limitation based on the extent to which the impairment interferes with the ability to function independently, appropriately, effectively, and on a sustained basis. 20 C.F.R. § 404.1520a(c). The focus is on four areas: activities of daily living; social functioning; concentration, persistence, and pace; and episodes of decompensation. Id. The first three areas are rated on a five point scale ranging from none to extreme. The last area is rated on a four-point scale ranging from none to four or more. Id.

At the hearing, plaintiff described his treatment efforts with different health care providers. He explained that he had recently been taking two bipolar medicines (Lamictal and Klonopin), and a sleep aid (trazodone). He had tried other medications as well, including a series of injections which helped him stay sober. He described sleeplessness, poor appetite with weight loss, paranoia, memory deficits, and poor concentration. He also described mood swings and frequent crying spells. He indicated he had few social contacts and engaged in few activities outside of self-care and child-care responsibilities. He described anxiety attacks and panic attacks occurring about twice a week. He estimated that he could perform some household chores for short periods of time and said he could prepare simple meals using a microwave. Ms. Milazzo did not testify (R. 23-62).*fn1

Medical records show that plaintiff was hospitalized in January and May, 2003; March 17, 2006; June 20-23, 2007; and May 20-21, 2008 (R. 433-465, 512-534, 637-647, 674-703). He received treatment for various ailments, including facial fractures from a motor vehicle collision, recurrent major depressive disorder, bipolar disorder, drug overdose, alcohol intoxication, suicidal gesture, and anxiety disorder.

The ALJ evaluated plaintiff's testimony and decided that while his ailments produced the symptoms he described, the intensity, persistence and limiting effects described were not entirely credible (R. 18). The ALJ considered plaintiff's testimony along with the hospitalization records and other evidence and rated the degree of functional loss resulting from plaintiff's mental impairment as follows: moderate restrictions on plaintiff's activities of daily living; mild difficulties maintaining social functioning, concentration, persistence, or pace; moderate restrictions on plaintiff's ability to understand, remember, and carry out detailed instructions; and no repeated episodes of decompensation of extended duration, absent substance abuse (R. 20).

A review of the record reveals substantial evidence supporting the ALJ's assessment of the functional severity of plaintiff's mental health impairment. Plaintiff's hospitalizations in January, 2003; March, 2006; and June, 2007; reveal little information about his functional limitations during the relevant period of time. The most recent hospitalization was an overnight stay. On that occasion, plaintiff's mood was depressed and he had a cut on his neck which was assessed as a suicidal gesture. His thought process was logical, his affect was appropriate, his insight was good, his memory was intact and his judgment was within normal limits (R. 686, 696). The diagnoses included alcohol intoxication, supported by laboratory reports showing a level of alcohol well over the standard for legal intoxication (R. 688, 737, 739). Progress notes showed that plaintiff was calm, cooperative and responsive. The medication given was a single dose of Ativan, an anti-anxiety agent. Plaintiff's symptoms subsided overnight and he was discharged with a recommendation to avoid alcohol and drugs, continue outpatient treatment, and take his current medications (R. 697). A rational ALJ was not required to infer from this evidence that plaintiff's mental ailment produced a marked or extreme degree of limitation in any of the relevant functional categories on a sustained basis.

Other evidence substantially supports the ALJ's assessment of plaintiff's mental functional limitations, including hospital records, laboratory reports, records of outpatient care, and findings and opinions of examining and non-examining physicians (R. 552-568, 668-670, 676-696, 730-34, 739-40, 749-50, 752-757). This evidence is adequate to persuade a rational person that the functional limitations caused by plaintiff's mental impairment were in the mild to moderate range.

Plaintiff also argues that the ALJ ignored global functioning assessments other than the 53 rating from Joy Webster. This statement is incorrect. In addition to Joy Webster's assessment, the ALJ considered a lower rating (45) selected by Dr. Loynd in July, 2008 (R. 16). Because Dr. Loynd assessed plaintiff's condition at a time when he was not taking psychiatric medications, the ALJ was not required to view this evidence as a description of plaintiff's overall functional performance (R. 749-750).

Plaintiff also challenges the ALJ's assessment of his subjective pain complaints. Because this argument coincides with a challenge to the ALJ's credibility assessment, it is discussed separately.

Plaintiff also argues that the evidence does not support the ALJ's finding that his bipolar disorder was generally well-controlled with prescribed psychotropic medication since May, 2008. He points to Dr. Loynd's July, 2008, report, which includes a GAF score of 45.

The evidence describing the severity of plaintiff's mental ailments after May, 2008, is somewhat conflicting. While Dr. Loynd gave a rather severe GAF assessment, that assessment does not take into account plaintiff's response to psychiatric medications. During his interview with Dr. Loynd, plaintiff was alert and oriented to person, place and time. He maintained good eye contact, showed no psychomotor agitation, used regular speech, had logical and goal-directed thoughts, and described no hallucinations or delusions. Plaintiff had sweaty palms, appeared "mildly anxious and slightly depressed," and his insight and judgment were deemed "fair." (R. 750). During the same period of time, Dr. Taca assessed plaintiff's mental status numerous times and adjusted his medications. She noted fewer mood swings, lower anxiety levels, and fewer racing thoughts. She reported that plaintiff was "doing well" with the medicine prescribed by Dr. Loynd and extended follow-up visits from 2-week intervals to 4-8 week intervals ...

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