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Debra Kaye Schumacher v. Michael J. Astrue Commissioner of Social Security

April 19, 2012

DEBRA KAYE SCHUMACHER, PLAINTIFF,
v.
MICHAEL J. ASTRUE COMMISSIONER OF SOCIAL SECURITY, DEFENDANT.



The opinion of the court was delivered by: Judge Joan B. Gottschall

MEMORANDUM OPINION & ORDER

Debra Kaye (sometimes spelled "Kay") Schumacher seeks judicial review of a decision by the Commissioner of Social Security ("Commissioner") in which the Commissioner denied Schumacher relief on her claim for disability insurance benefits ("DIB").*fn1 Schumacher completed her application for these benefits on November 5, 2007, claiming that she had been disabled since November 8, 2006 due to the aftereffects of stroke and seizures. Her claim was denied on February 25, 2008, based on a finding that she was capable of light, unskilled work. Schumacher requested reconsideration, which was denied. She then sought a hearing before an Administrative Law Judge ("ALJ"). The ALJ held a hearing and issued an unfavorable decision on June 12, 2009. Schumacher appealed, but the Appeals Council denied her request for review. Schumacher has now filed a complaint in this court and moved for summary judgment. For the reasons below, the motion is denied.

I.BACKGROUND

At the time of the hearing, Schumacher was forty-five years old. She had completed high school and taken a few college courses, but she does not have a college degree. Her past employment included work as a traffic controller for a paper company. In that position, she checked inventory and ensured that the delivery trucks were properly loaded with items for various stores. This was her last substantial gainful activity ("SGA") prior to her alleged disability onset date of November 8, 2006. Schumacher claims to suffer from the after-effects of stroke and seizures. She had a stroke on April 4, 2005, followed by two seizures, the first on November 8, 2006, followed by one in December of that year. The court was not provided with medical records relating to the stroke or to an earlier gastric bypass surgery.

A.Medical History

Schumacher was hospitalized in November 2006. Dr. R. Warren Schubert, the attending physician, noted that she was admitted for new onset seizure, and had a history of cerebrovascular accident (the stroke) and a gastrointestinal bleed. She was loaded with anti-seizure medication, and remained stable throughout the hospitalization. (R. 221.) While hospitalized, she had a consultation with both neurology and hematology. Dr. Arvind Kumar saw Schumacher for her thrombocytopenia, and noted her history of anemia. (R. 222.) At the time, Schumacher denied any headaches, numbness, tingling, or weakness in the extremities. (Id.) Dr. Surendra Gulati, her consulting physician, noted that she had had a stroke on April 2005, but she had no history of seizures prior to the present incident. (R. 227.) He found that Schumacher had "[n]o definite weakness of arms and legs." (R. 228.) He stated that although Schumacher seemed to have a post infarct seizure disorder, he had been informed by Schumacher's husband that she was drinking ten ounces of vodka each day. (R. 225.) This meant that the seizure could have been an alcohol withdrawal seizure, although Dr. Gulati could not be certain. (Id.) Schumacher had electroencephalograms ("EEG") taken, and they were found to be "mildly abnormal" but without any spike or spike wave discharge. (R. 229, 231.) Various doctors ran imaging tests, but other than the evidence of her previous infarction, nothing unusual was observed. (R. 233-36.) A number of the doctors who saw her specifically mentioned her alcoholic beverage intake. Schumacher was discharged in fair condition. (R. 221.) On February 24, 2007, Dr. Gulati administered another EEG. That EEG indicated that Schumacher's basic background activity was "fairly well organized," and as before, although there were some spots of excessive activity, no spikes were observed. (R. 219.)

Schumacher next visited the hospital in August 2007 after being found passed out by her young children. (R. 248.) She was intoxicated, and she admitted to being an alcoholic and to occasional binge drinking. (R. 248, 254.) The emergency department clinician, Dr. Matthew Nitsche, noted that Schumacher had no definite seizure activity at the time, and diagnosed her as having alcohol intoxication. (R. 249.) Schumacher denied having any suicidal thoughts.

In November 2007, Dr. Gulati evaluated Schumacher based on complaints of memory disturbance. (R. 262.) As before, he found that her EEG was abnormal, but there were no observed spike discharges.

In December 2007, Schumacher was admitted for alcohol intoxication and suicidal ideation. Dr. Schubert reported that Schumacher had a significant history of alcohol binge drinking. (R. 274.) She was referred to Dr. Gawtham Gutta for an evaluation, and he concluded that she needed "immediate abstinence and withdrawal of alcohol." (R. 278.) He also stated that she had equal strength in her upper and lower extremities, and she denied any numbness or asymmetrical weakness. (R. 277.) As part of this hospital trip, Schumacher had a psychiatric evaluation with Dr. Cosme Lozano. She strongly denied any suicidal tendencies, and she appeared alert, oriented, and had coherent and sequential though processes. (R. 280.) Dr. Lozano agreed that she was not suicidal, and recommended that she be discharged.

Schumacher saw a psychologist, Dr. William Hilger, as part of her disability determination in January 2008. Dr. Hilger found her to be a fluent and cooperative patient. (R. 291.) He performed various mental capacity tests, and found that she had fair mental potential so long as she kept taking her medication. (R. 294.) He stated that if Schumacher continued taking her medication, she should be able to perform work-related activities that involved understanding and memory, sustained concentration, and adaptation. He did note, however, that she might have to perform simpler, more repetitive clerical-type tasks. (Id.)

On February 12, 2008, Dr. Joseph Mehr performed a psychiatric review and completed a mental RFC assessment. He found that Schumacher had moderate restrictions on activities of daily living and in maintaining social functioning, but only mild limitations in maintaining concentration, persistence, or pace. (R. 305.) He noted some moderate limitations on her ability to understand, remember, and carry out detailed instructions. (R. 309.) However, he concluded that as long as she did not return to heavy drinking, she would be able to complete a normal workday and week. (R. 311.)

Dr. Ernest Bone completed a physical RFC assessment on February 15, 2008. He placed some limitations on Schumacher's ability to lift or carry more than ten to twenty pounds, and stated that she should only occasionally climb ramps or stairs and never climb ladders, ropes, or scaffolds due to her history of seizures. (R. 314-15.) He found no manipulative limitations, meaning that Schumacher had no limitations in feeling, handling, fingering, or reaching. (R. 316.) Dr. Bone also stated that there were no "residual effects" from the stroke at the time. (R 320.)

In a letter dated March 21, 2008, Dr. Schubert sent a letter stating that he believed Schumacher was disabled due to her stroke, seizures, and depression. (R. 355.) He also mentioned the side effects of her medications, which could cause drowsiness and lethargy, as well as the potential that any stress could increase her risk of gastric bleeding. (Id.) Included with the letter is a stroke RFC questionnaire. Dr. Schubert noted that emotional factors contributed to the severity of Schumacher's symptoms, and that she frequently experienced symptoms severe enough to interfere with attention and concentration. (R. 357.) He stated that she would need to take a break every hour or two with her legs elevated. (R. 358.) In measuring her hand strength and finger manipulation, Dr. Schubert stated that she had significant limitations, and could only use her left hand to grasp, turn, or twist 6% of the time and to perform fine manipulations 34% of the time. (R. 359.) Dr. Schubert found Schumacher incapable of even "low stress" jobs." (R. 360.)

In March 2008, Schumacher reported another "possible" seizure that might have occurred six weeks earlier. (R. 628.) The treating doctor was uncertain as to whether the event was a seizure, and an examination was negative. (Id.)

Dr. Gregory Hawley saw Schumacher at various points in the spring of 2008 for evaluation and treatment of depression. (R. 329-35.) During the sessions, Schumacher reported significant improvement on the medication that she had been prescribed, and said that she had no cravings or "slips" with respect to alcohol. (R. 334.) She did report issues with a gambling craving. (R. 332.) Lauran Jansons, a Psy.D., was also seeing Schumacher at this time for counseling. (R. 345-53.) Schumacher reported difficulty with activities like balancing a check book and cooking, and said that she was depressed.

(R. 352.) After she returned from a camping trip in July 2008, Schumacher reported that she drank alcohol on the trip. (R. 432.) In November 2008, Dr. Hawley noted that Schumacher's mood seemed "much improved," and that she ...


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