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Karen J. Conner v. Michael J. Astrue

August 10, 2011

KAREN J. CONNER, PLAINTIFF,
v.
MICHAEL J. ASTRUE, ) COMMISSIONER OF SOCIAL SECURITY, DEFENDANT.



The opinion of the court was delivered by: Magistrate Judge Cox

MEMORANDUM OPINION AND ORDER*fn1

Plaintiff, Karen J. Conner ("Conner"), seeks judicial review of a final decision of the Commissioner of the Social Security Administration ("SSA") denying her application for a period of disability and for Social Security Disability Insurance Benefits ("DIB") under Title II of the Social Security Act ("Act").*fn2 Conner has filed a Motion for Summary Judgment [dkt. 24], seeking a judgment reversing or remanding the Commissioner's final decision. For the reasons set forth below, Conner's motion is granted.

I. PROCEDURAL HISTORY On May 10, 2008, Conner filed an application for DIB, alleging a disability onset date of

September 24, 2007.*fn3 The SSA denied her application initially, and again upon reconsideration.*fn4 Thereafter, Conner filed a timely written request for a hearing, which was granted.*fn5 On September 14, 2009, a hearing was conducted before Administrative Law Judge ("ALJ") Lovert F. Bassett in Evanston, Illinois.*fn6 During the hearing, the ALJ heard testimony from Conner, as well as vocational expert ("VE"), William Newman, and medical expert ("ME"), Mark Overlander, Ph. D.*fn7

On September 28, 2009, the ALJ issued an unfavorable decision finding that Conner was not disabled under the Act.*fn8 On September 25, 2009, Conner appealed the ALJ's determination to the Appeals Council of the SSA, who denied Conner's request on June 22, 2010,*fn9 making the ALJ's ruling the final decision of the Commissioner.*fn10 Conner filed this action on August 23, 2010.*fn11

II. STATEMENT OF FACTS

We now summarize the administrative record. We set forth the background evidence of Conner's history and medical complaints, followed by the objective medical evidence considered by the ALJ. We then discuss the hearing testimony, before addressing the ALJ's written opinion.

A. Introduction and Medical Evidence

Conner was born on September 26, 1950, making her fifty-nine years old on the date that the ALJ issued his decision.*fn12 After graduating from high school, she worked at Underwriters Laboratory ("UL") for 37 years, where she attained the position of senior engineering assistant.*fn13

Conner was terminated from UL in August 2008, after taking an extended medical leave of absence due to her emotional breakdowns at work.*fn14 Conner claims she can no longer work due to anxiety, depression, a stress disorder, high blood pressure, and gastroesophageal reflux disease ("GERD").*fn15

Conner has been divorced three times and has three grown children.*fn16 At the time of the hearing, she was living alone in Lakemoor, Illinois.*fn17

We begin our review of Conner's relevant medical history on October 24, 2007, one month after the alleged disability onset date. Conner, who was then on medical leave for depression,*fn18

received an initial evaluation from psychiatrist Steven J. Resis, M.D on that date.*fn19 She related crying frequently and being unable work under her current stress level.*fn20 Conner reported that her regular physician, Mackie Snebold, M.D., had prescribed her increasing dosages of Fluoxetine, and that she had experienced two remote nervous breakdowns and one remote hospitalization.*fn21 Dr. Resis described Conner as "an anxious, tearful, slightly overweight white female" who experienced some difficulties with memory, concentration, and focusing on a topic, but whose speech was "generally clear and coherent."*fn22 Dr. Resis noted that Conner's judgment and insight appeared fair, and that her motor exam was normal.*fn23 He diagnosed Conner with "Major Depression, recurrent of moderate to severe severity" and ruled out "Bipolar Disorder NOS" and "Anxiety Disorder NOS."*fn24

Dr. Resis increased Conner's dosage of Prozac from 60 mg to 80 mg and continued her on Lorazepam for her anxiety.*fn25 Dr. Resis also assigned Conner a Global Assessment of Functioning ("GAF") score of 55*fn26 and referred her to Nancy Peterson Walz LCSW, ACSW, for counseling.*fn27

On November 27, 2007, Dr. Resis noted that, although Conner was crying somewhat less on her increased dosage of Prozac, she was still crying fairly often and having ongoing issues with memory, concentration, and getting things done.*fn28 Conner reported waking and feeling very anxious and worried about the things she needed to do.*fn29 Dr. Resis anticipated that Conner would return to work by mid-December 2007.*fn30 On November 21, 2007, Dr. Resis noted Conner's report of "intense anxiety" since "working on some important issues" in counseling which troubled her.*fn31

On December 12, 2007, Dr. Resis noted that, while Conner was doing "somewhat better," she was "quite terrified" of returning to work "due to sleep disturbance and anxiety and fears."*fn32

On January 9, 2008, Dr. Resis noted Conner's report that she could return to work, "but was not particularly optimistic that she can do well in the current environment," was tolerating her current medication, and had found counseling helpful.*fn33 On January 30, 2008, Dr. Resis noted that Conner was struggling intensely with interpersonal issues at work, feared being "pushed out of [UL] due to their being very negative towards her," was doing fairly well on 80mg of Prozac and in counseling.*fn34

Dr. Resis also noted that Conner's energy was okay outside of work and she was generally sleeping alright, other than when worrying excessively about work.*fn35

On February 11, 2008, Dr. Resis noted his report to a Cigna doctor that Conner was doing fairly well with her activities of daily living, but would not do well if she returned to work under her current supervisor.*fn36 Dr. Resis futher noted his report that, "if there are no changes in the situation," Conner may be able to return to work in the next two months.*fn37 On February 15, 2008, Dr. Resis noted that Ms. Walz had informed him that Conner did not have a suicidal plan, but was "very distressed about the possibility of having to return to work."*fn38 On February 19, 2008, Conner was seen by Dr. Resis on an emergency basis due her struggling with suicidal ideation.*fn39 After she reported a remote suicide attempt, Dr. Resis reviewed coping strategies with Conner and continued her on 80 mg of Paxil, with a trial pack of Lamictal augmentation.*fn40 On February 27, 2008, Dr. Resis noted that Conner was highly anxious, especially when discussing returning to work under her previous supervisor.*fn41 She denied any suicidal ideation and showed some slight improvement with Lamictal.*fn42 Dr. Resis continued Conner on Prozac and Lamictal in the morning.*fn43

On March 12, 2008, Dr. Resis noted that Conner was "intensely dysphoric and tearful throughout the session," had significant difficulties with day to day functioning, and reported feeling more agitated since taking the Lamictal.*fn44 Dr. Resis continued Conner on Prozac and advised her to discontinue Lamictal and take Seroquel at night.*fn45 On March 19, 2008, Dr. Resis noted Conner's report that the Seroquel was helping her sleep without nightmares, and that she was agitated and distraught at times, but doing better.*fn46 Dr. Resis also noted Conner's statements that she would be unable to return to work at UL, and would be seeking an independent psychiatric evaluation for long-term disability.*fn47 On May 7, 2008, Dr. Resis noted that Conner was struggling with significant anxiety, and had reported "some periodic nightmares about working at UL.*fn48 On June 4, 2008, Dr. Resis noted that Conner's mood had stabilized without any active suicidal ideation, and she was sleeping well Prozac.*fn49 During the past four visits, Conner was continued on her medication.*fn50

On August 6, 2008, Dr. Resis noted Conner's report of financial difficulties and concerns about her job at UT, and that she was crying on daily, with clear impairments.*fn51 Due to financial concerns, Dr. Resis lowered Conner's Prozac dosage from 80mg to 40mg, and gave her a one month supply of 30 mg of Cymbalta.*fn52 On October 1, 2008, Dr. Resis noted Conner's report of several incidents of significant difficulties with stress and functioning.*fn53 Dr. Resis also noted that Conner had stopped seeking counseling for financial reasons.*fn54 Conner agreed to continue on 30mg of Cymbalta, and switch it from the evening to the morning, and also lower her Prozac to 20mg.*fn55

In notes from October 2007, Dr. Resis listed Conner's symptoms as frequent crying, anxiety, mood instability, sleep disturbance, insomnia / impaired memory and concentration.*fn56 He further noted that examinations revealed fatigue, sad behavior, blunted affect, sad/angry thought content, and decreased memory and recall problems, and that Conner had decreased her interaction with friends.*fn57 However, he also noted that Conner's language comprehension and expression were good and her activities of daily living were normal.*fn58 Dr. Resis assigned a current GAF score of 55, noting that Conner's highest score in the past year had been 80, and her baseline score -- denoting her usual ability to function -- was 85.*fn59 Dr. Resis opined that Conner "needs to improve significantly before returning to work."*fn60 In notes from November and December 2008, Dr. Resis described Conner similarly, but assigned her a current GAF score of 60, with her highest and baseline score for the past year being 75.*fn61 He noted that her activities of daily living were "ok," and that she was unable to "work in current work environment," but exclaimed that performing Conner's job duties in an alternative work setting was "possible!"*fn62

Conner saw Ms. Walz on a weekly to bi-monthly rate from November 2007 through April 2008.*fn63 The notations of Ms. Walz show that Conner reported poor sleep, appetite, memory and concentration, depressed mood and anxiety, and a history of suicide attempts.*fn64 Ms. Walz noted greatly diminished capacity and assessed a severe major depressive disorder.*fn65

Mental examinations revealed blunted, flat and anxious affect, and little improvement in her depression and instability.*fn66

On April 16, 2008, Ms. Walz completed a mental residual functional capacity assessment ("RFC"), listing Conner's diagnosis as "Major Depressive Affective Disorder, Moderate to Severe, with a GAF of 45-50."*fn67 Ms. Walz described Conner's symptoms as depression, feeling hopeless and overwhelmed, experiencing anxiety, suicidal thoughts, crying, poor sleep, difficulty structuring and organizing daily activities, inconsistent stability, decreased energy, mood disturbance, difficulty concentrating, bipolar syndrome, irrational fears, intense and unstable relationships, and manic syndrome.*fn68 She also noted that Conner had "issues with her current supervisor" and assessed Conner as unable to meet competitive standards in maintaining regular attendance, complete a normal workday or workweek without interruptions due to her symptoms, deal with normal work stress, deal with stress of semiskilled and skilled work, travel in unfamiliar places and use public transportation.*fn69 Ms. Walz also reported that Conner was seriously limited -- but not precluded -- in several other areas, including understanding and remembering simple instructions, performing at a consistent pace and responding appropriately to work changes.*fn70 She opined that Conner would miss two to four work days per month because of her symptoms.*fn71

On June 18, 2008, Dr. Snebold, who had seen Conner two to three times yearly since 1989, completed a psychiatric report.*fn72 Dr. Snebold noted a September 25, 2007 phone call from Connor complaining of extreme anxiety and being unable to work, tearful, and emotional.*fn73 Dr. Snebold further noted Conner's daily activities as driving once per week to go shopping, watching one movie per day, reading with a short attention span, and becoming very tense when going out to the mailbox.*fn74 Dr. Snebold also noted Conner's personal problems with co-workers who continued to send her letters from work.*fn75 Dr. Snebold opined that Conner's work led to increased symptoms and diagnosed her with depression and anxiety, noting that she has few coping mechanisms.*fn76

Dr. Snebold also completed an Arthritic Report, which also noted depression and anxiety with an onset date of 2001 and exacerbation during September 2007.*fn77 Dr. Snebold noted tenderness in Conner's right medial knee after extensive walking, and pain in her great right toe secondary to trauma.*fn78 Dr. Snebold opined that Conner is able to stand, walk, or sit for one hour at a time.*fn79 He also noted that she must be able to walk around during an eight-hour day, and a job which permits shifting positions at will from sitting, standing, and walking would be "preferred."*fn80

On June 23, 2008, State agency non-examining reviewer, Dr. Campa, completed a form indicating the presence of a "Major Depressive Disorder."*fn81 Dr. Campa also indicated that Conner had no restrictions in activities of daily living, mild difficulties in maintaining social functioning, moderate difficulties in maintaining concentration, persistence or pace, and no episodes of decompensation of extended duration.*fn82 In his RFC assessment, Dr. Campa indicated that Conner is moderately limited in her ability to understand, remember, and carry out detailed instructions, maintain attention and concentration for extended periods, perform activities within a schedule, maintain regular attendance, and be punctual within customary tolerances.*fn83 Dr. Campa also noted moderate limitations in Conner's ability to: complete a normal workday and workweek without interruptions from psychologically based symptoms; perform at a consistent pace without an unreasonable number and length of rest periods; interact appropriately with the general public; get along with co-workers or peers without distracting them or exhibiting behavioral extremes; and respond appropriately to changes in the work setting.*fn84

On July 17, 2008, Conner underwent a consultative examination with Gurbax Saini, M.D., regarding her anxiety and depression.*fn85 Dr. Saini reported that Conner was crying throughout the entire interview and had related being picked on by her co-workers.*fn86 Conner denied any history of nausea, vomiting, ...

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