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Krista Dyanne Longerman v. Michael J. Astrue

October 28, 2011


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


Plaintiff Krista Longerman ("Longerman") seeks review of the final decision of the Commissioner of Social Security ("Commissioner") denying her application for Disability Insurance Benefits ("DIB") under Title II of the Social Security Act ("Act"), 42 U.S.C. § 423(d)(2), and Supplemental Security Income ("SSI") under Title XVI of the Act, 42 U.S.C. § 1382c(a)(3)(A). Before the court are the parties' cross-motions for summary judgment. Longerman asks the court to reverse the Commissioner's decision and award benefits, or in the alternative, to remand the case for further proceedings. The Commissioner seeks an order affirming the decision. For the following reasons, Longerman's motion for summary judgment is granted insofar as it requests a remand, and the Commissioner's motion is denied:

I. Procedural History

Longerman applied for DIB and SSI on September 17, 2007, alleging that she became disabled on January 1, 2007, due to chronic headaches, depression, and anemia.

(Administrative Record ("A.R.") 62, 102-04, 105-06.) Her applications were denied initially on December 21, 2007, (id. at 52, 53, 58-62), and again on reconsideration on March 21, 2008, (id. at 54, 55, 64-67, 68-71). Thereafter, Longerman requested and received a hearing before an administrative law judge ("ALJ"). (Id. at 34-49, 73.) On January 27, 2010, the ALJ issued a decision finding Longerman not disabled. (Id. at 15-23.) The Appeals Council denied Longerman's request for review on November 23, 2010, making the ALJ's decision the final decision of the Commissioner. (Id. at 1-3.) See Getch v. Astrue, 539 F.3d 473, 480 (7th Cir. 2008). Pursuant to 42 U.S.C. § 405(g), Longerman initiated this civil action for judicial review of the Commissioner's final decision. The parties have consented to the jurisdiction of this court pursuant to 28 U.S.C. § 636(c).

II. Background

A. Summary of Medical Evidence

1. Migraine Headaches

Longerman, who is 33 years old, has been suffering from chronic migraine headaches since she was 16 years old. In March 1994, she first sought treatment for her headaches from Dr. Donald Kuhlman, a neurologist. (A.R. 46, 488-89.) About 12 years later, in June 2006, Dr. Kuhlman diagnosed Longerman with longstanding migraine headaches, which were "somewhat suboptimally controlled."*fn1 (Id. at 419.) In September 2006, Dr. Kuhlman noted that Longerman's chronic headaches were reasonably well-controlled with medication, but because of the severity of her headaches, he added another medication to Longerman's treatment regimen. (Id. at 418.) Two months later, in November 2006, Dr. Kuhlman opined that Longerman suffers from severe chronic headaches and increased the dosage of one of her medications. (Id. at 417.) In December 2006, Dr. Kuhlman observed in his treatment notes that Longerman's headaches were "largely unchanged" and he continued her then-current medications. (Id. at 416.)

Dr. Kuhlman's April 2007 treatment notes show that Longerman's headaches had improved since she began taking Avinza (morphine).*fn2 (Id. at 415.) She reported a significant decrease in both the frequency and severity of her headaches. (Id.) Dr. Kuhlman diagnosed chronic headaches, which were relatively stable at that time, and continued her treatment regimen consisting of four different headache medications (including morphine) and two anti-depressants. (Id.)

About three months later, in July 2007, a physician at a pain clinic prescribed Ketoconazole,*fn3 because the pain specialist believed that Longerman's chronic headaches were related to an undiagnosed systemic candida infection. (Id. at 413.) Dr. Kuhlman's notes indicate that in September 2007 Longerman discontinued using Ketoconazole because it was not beneficial to her. (Id. at 411.) Treatment notes show that Longerman continued to experience headaches several times a week and that recent adjustments were made to the dosage of her anti-depressants. (Id.) Dr. Kuhlman opined that Longerman has longstanding severe chronic headaches, which were refractory to a wide spectrum of prophylactic and abortive medications. (Id.) In October 2007, Longerman again complained that she continued to have headaches several times a week. (Id. at 575.) She was taking MS Contin*fn4 and Norco*fn5 , which had been prescribed by her pain specialist. (Id.)

In February 2008, Longerman reported to Dr. Kuhlman that, despite taking numerous medications, she continued to have headaches on a daily basis and had significant discomfort for at least 12 hours out of each 24-hour period. (Id. at 823.) Dr. Kuhlman's treatment notes indicate that Longerman was taking five different pain medications each day to treat her severe headache pain. (Id.) He indicated that Longerman continued to have chronic headaches that were refractory to multiple preventative medications and explained that she is on an "unusual medical regimen . . . which seems to be about as effective (or ineffective) as anything else which has been tried recently." (Id.)

Two months later, in April 2008, Longerman reported that she was participating in a headache study at the University of Illinois, which involved the implantation of an occipital nerve stimulator. (Id. at 822.) The following month, she underwent surgery to implant occipital nerve stimulation electrodes. (Id. at 869-71.) About five months later, in October 2008, she reported that the stimulator was helpful in reducing the severity of her headaches, but she still continued to have headaches. (Id. at 820.) Even though Longerman was participating in the clinical trial, she continued with her then-current treatment regimen. (Id. at 855-56.) Dr. Kuhlman's treatment notes indicate that Longerman was taking four different pain medications and two anti-depressants. (Id. at 820.) Dr. Kuhlman recommended that Longerman see "a specialty pain physician to oversee and manage the use of her chronic long and short-term narcotics." (Id. at 821.)

In June 2009, Dr. Kuhlman completed a Headaches Impairment Questionnaire at the request of Longerman's attorney. (Id. at 838-43.) He noted that Longerman has daily chronic refractory migraine headaches of moderate to severe intensity that typically last from one to eight hours. (Id. at 838-39.) Her symptoms include mood changes and photosensitivity. (Id. at 839.) Stress and hunger triggered her headaches. (Id. at 839-40.) Dr. Kuhlman had been unable to relieve Longerman's pain despite substituting medications to relieve her symptoms. (Id. at 841.) He opined that her pain and other symptoms were frequently severe enough to interfere with her attention and concentration and estimated that Longerman would be absent from work for more than three days a month and she was capable of performing only low-stress jobs. (Id. at 841-42.) He marked that when she experienced a headache she could not perform even basic work activities.*fn6 (Id. at 842.)

Dr. Kuhlman also noted that Longerman suffers from psychological limitations that also affect her ability to work on a sustained basis. (Id.)

2. Depression

Longerman also has received treatment for depression for a number of years. In September 2007, she underwent a psychiatric evaluation with Dr. Jerry Gibbons. (A.R. 658-60.) At that time, Longerman complained of feeling depressed and reported that she had been hospitalized in March 2007 following a suicide attempt. (Id. at 658, 719-20.) Because her mental status examination was indicative of a depressed mood, Dr. Gibbons prescribed an anti-depressant and recommended that Longerman continue with her individual therapy sessions. (Id. at 659-60.) Dr. Gibbons assessed Longerman's overall level of functioning and assigned her a Global Assessment of Functioning ("GAF") score of 55.*fn7 (Id. at 659.) Dr. Gibbons diagnosed major depressive disorder (single episode), obesity, status post-gastric bypass surgery, migraine headaches, and anemia. (Id.)

In October 2007, Longerman's mood had improved, but she was having vivid dreams and experiencing hypersomnia (excessive amounts of sleepiness). (Id. at 670.) In December 2007, she complained of feeling depressed, being sick a lot, and having less energy. (Id. at 676.) Dr. Gibbons noted that Longerman's mood was depressed and he increased her anti-depressant dosage. (Id.) A month later, Longerman's depression had not improved. (Id. at 679.)

Next, in March 2008, Margaret Wharton, Psy.D., a state agency psychologist, reviewed Longerman's medical file and completed forms assessing her mental residual functional capacity ("RFC") to perform work-related activities. (Id. at 635-52.) Dr. Wharton opined that Longerman's cognitive and attention skills are intact and adequate for "simple one-two step work tasks as well as detailed tasks." (Id. at 651.) She described Longerman's mental status and adaptive skills as being within normal limits, but her interpersonal skills were moderately limited by depressive symptoms. (Id.) In assessing the degree of Longerman's functional limitations, Dr. Wharton opined that she has mild restrictions in her daily activities, mild difficulties in maintaining concentration, persistence, and pace, and moderate difficulties in maintaining social functioning. (Id. at 645.)

About one year later, in April 2009, Dr. Eva Kurilo, a psychiatrist, evaluated Longerman. (Id. at 886-88.) Longerman reported a long history of depression with symptoms of disrupted sleep, loss of enjoyment of activities, sadness, decreased concentration, fatigue, irritability, and some anxiety. (Id. at 886.) She had not worked since 2007, when she was fired from her job due to frequent absences related to her depression and migraine headaches. (Id. at 887.) Dr. Kurilo assessed Longerman's overall level of functioning and assigned her a GAF score of 50.*fn8 (Id.) She diagnosed major depression (moderately severe and recurrent), migraine ...

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