MEMORANDUM OPINION AND ORDER The plaintiff, Sarah Granados, seeks review of the final decision of the Commissioner ("Commissioner") of the Social Security Administration ("Agency") denying her application for Disability Insurance Benefits ("DIB") under Title II of the Social Security Act ("Act"). 42 U.S.C. §§ 423(d)(2). Ms. Granados asks the court to reverse and remand the Commissioner's decision, while the Commissioner seeks an order affirming the decision.
PROCEDURAL HISTORY Ms. Granados applied for DIB on June 26, 2007, alleging that she had been disabled since September 2, 2005, due to depression, anxiety, and panic disorder. (Administrative Record ("R.") 90, 116). Her application was denied initially and upon reconsideration. (R. 42-48, 51-56). Ms. Granados continued pursuit of her claim by filing a timely request for hearing. (R. 62). An administrative law judge ("ALJ") convened a hearing on June 9, 2009. (R. 25). Ms. Granados, represented by counsel, appeared and testified at the hearing. (R. 25). In addition, Mr. Mallick Mendrick testified as a vocational expert. (R. 25). On July 1, 2009, the ALJ issued a decision finding that Ms. Granados was not disabled because she retained the capacity to perform jobs that exist in significant numbers in the national economy. (R. 17-24). This became the final decision of the Commissioner when the Appeals Council denied Ms. Granados's request for review on October 20, 2009. (R. 3-5). See 20 C.F.R. §§ 404.955; 404.981. Ms. Granados has filed an amended complaint appealing that decision under 42 U.S.C. § 405(g), and the parties have consented to the jurisdiction of a Magistrate Judge pursuant to 28 U.S.C. § 636(c).
Vocational Evidence Ms. Granados was born on September 27, 1977, making her thirty-one years old at the time of the ALJ's decision. (R. 90). She dropped out of school after 8th grade, but later got her GED. (R. 120). She had a child, and she says her parents then gave her the choice of whether she wanted to continue with school; she chose not to. (R. 28). She had several short-term retail store positions from 1994 to 2000. (R. 104). From 2000 until 2005, she worked as a special order representative in automotive parts sales. (R. 104). She lifted no more than ten pounds at a time in this job, and performed it mostly while sitting. (R. 106-07).
Medical Evidence Ms. Granados' life is not the stuff of a Norman Rockwell portrait. As already noted, she was a mother before high school and chose not to continue her education. Things did not improve at all from that unfortunate start. Her father was imprisoned for drug offenses. She is in a battle with her child's father for custody of her son. That man was living with a girlfriend whose children were taken away by DCFS. She was taking care of her sister's two children because her sister, addicted to crack, neglected them. And she's been treated for several years for severe depression.
Ms. Granados was admitted to Ottawa Community Hospital for treatment of depression and anxiety in September of 2005. She related multiple problems: her father going to jail, relationship troubles with her boyfriend, and sexual harassment at work. (R. 183). Her mood was depressed, but she was not suicidal. (R. 183). Her thought process was organized. (R. 183). Dr. Michael Glavin diagnosed her with major depression and anxiety disorder, assigned her a GAF score of 40*fn1 , and started her on a prescription for Xanax, Lexapro, and Lunesta. (R. 184). Also, Ms. Granados was referred to a "partial hospitalization program for group and individual therapy." (R. 186).
During these therapy sessions, Ms. Granados' GAF score ranged from 45-48 in the end of 2005, to 55 in June 2006. (R. 218-244). She generally reported mild to moderate sadness, and that she was very anxious. She continued to discuss her concerns about her father and relationship problems with her boyfriend. She took a road trip to Albuquerque, New Mexico, with a girl friend. (R. 222). She worked on getting her GED, and spent time walking, biking and playing tennis. (R. 223-224). During one session, she told her therapist that Dr. Glavin recommended she apply for disability and that she had already been granted benefits. (R. 243). She also explained that she lost her job due to the stress she was going through, and was taking care of her mother. (R. 243).
On February 24, 2006, Mark Langgut, Ph.D., performed a consultative psychological evaluation in connection with Ms. Granados' application for benefits. (R. 192). Ms. Granados reported experiencing sadness, hopelessness, lethargy, sleeplessness, anhedonia, decreased concentration, impaired decision-making, and irritability. (R. 194). Testing revealed her memory skills were intact. (R. 193). She had no ability to perform simple mathematic calculations. (R. 194). She could not explain the meaning of proverbs. (R. 194). Dr. Langgut thought she might have significant difficulty with forming generalizations and understanding concepts. (R. 194). Her judgment was mildly impaired, as was her insight into her own situation. (R. 194). She exhibited some mild persecutory delusions and moderately intense phobias of being out in public. (R. 194).
Psychologist Patricia Beers reviewed the medical record as of May 3, 2006. She thought Ms. Granados had mild restrictions in her activities of daily living, mild restrictions in maintaining concentration, moderate difficulties in social functioning, and one or two episodes of extended decompensation. (R. 206). Dr. Beers also found Ms. Granados was moderately limited in her ability to work with others, interact approprately with the general public, accept instructions and respond to criticism, and travel to unfamiliar places and use public transit. (R. 210-11). Dr. Beers thought she could understand, recall and execute most instructions, and perform work if she were in a socially restrictive vocational setting. (R. 212).
One of Ms. Granados' therapists, Lynn Ballinger -- who saw Ms. Granados from January through November in 2006 -- filled out a questionnaire about her condition in November 2006.
(R. 411). Ms. Ballinger said Ms. Granados had bipolar disorder and major depressive disorder with anxiety, and that her GAF -- and highest GAF over the last year -- was 55. (R. 411). Insight was limited, affect was depressed and anxious, and judgment was "okay." (R. 411). There was some evidence of paranoia. (R. 411). Ms. Ballinger also checked off a laundry list of Ms. Granados' reported complaints: panic attacks, decreased energy, anhedonia, sleep disturbance, emotional lability, social withdrawal, generalized anxiety feelings of guilt, difficulty concentrating, appetite disturbance, and blunt affect. (R. 411). Ms. Ballinger felt Ms. Granados was moderately limited in activities of daily living, and decompensation in work-like settings, and markedly limited in social functioning and concentration. (R 412). She also said Ms. Granados could not even do part-time work at that point "due to high anxiety, depression, and adjustment to medication." (R. 412).
Ms. Granados was back in the hospital for her psychological problems in May 2007. (R. 544). Her mood was labile, and she was anxious, tearful, and irritable. (R. 544). Her thought process showed some disruption, and her concentration and memory were somewhat decreased.
(R. 544). Her judgment and insight were impaired. (R. 544). She was abusing her Xanax -- taking an entire prescription in a short period -- and was not functioning at work. (R. 544). She was also buying Xanax on the street and using marijuana. (R. 544). Her GAF was 30. (R. 545). She was placed on Seroquel, Cymbalta, and Buspar. (R. 550).
Following her hospitalization, Ms. Granados was back in therapy with Ms. Granados. She skipped several appointments, one because her house was burglarized. (R. 526-29). She also was having trouble taking off work to make sessions. (R. 525). She said she really enjoyed her job working at a bar. (R. 525). During the first part of 2008, her GAF ranged from 40 on March 26, to 58 on March 12, and June 4. (R. 520-529).
On October 28, 2008, Ms. Granados told Ms. Ballinger that she had not taken her medication for two months because she didn't want to. (R. 530). She said things were going well with her boyfriend. (R. 530). Thought process was linear, impulse control was fair, insight was fair, and judgment was normal. (R. 530). Although mood was depressed, affect was appropriate and memory was intact. (R. 530). GAF was 50. (R. 530).
On January 26, 2009, Ms. Granados reported that she had to take care of two of her sister's children because her sister was staying out all night smoking crack. (R. 532). Mood was anxious and depressed. (R. 532). Insight was fair, judgment was normal, and memory was intact. (R. 532). GAF was 48. (R. 532).
In February 2009, Ms. Granados again indicated that her relationship with her boyfriend was going well. (R. 536). The bar she worked at had closed for the winter. (R. 536). There was some anxiety, but minimal depression and mood swings. (R. 536). She was "stable overall." (R. 536). Insight and judgment were good, and memory was intact. (R. 536). GAF score was 45. (R. 536).
Things remained essentially the same, but in April 2009, Ms. Granados reported that she was pregnant. (R. 535). She was very anxious and confused ...