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Nancy Lott v. Michael J. Astrue

November 30, 2012


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


Nancy Lott claims that she is disabled by a combination of diabetes-related symptoms, kidney dysfunction, carpal tunnel syndrome, hearing and vision problems, depression, and headaches. In 2009 she applied for disability insurance benefits ("DIB"), 42 U.S.C. §§ 416(i), 423, but the Commissioner of Social Security Administration ("Commissioner") denied her application. Currently before the court is Lott's motion for summary judgment challenging the denial of benefits. For the following reasons, her motion is denied:

Procedural History

Lott filed her application for DIB in February 2009, claiming that her physical and mental impairments have prevented her from working since December 17, 2008. (Administrative Record ("A.R.") 115.) The Commissioner denied her claims initially and on reconsideration. (Id. at 57-58.) Lott then requested, and was granted, a hearing before an administrative law judge ("ALJ"). After considering Lott's testimony and medical evidence, the ALJ concluded that she is not disabled as defined in the Social Security Act. (Id. at 19.) When the Appeals Council denied Lott's request for review, (id. at 1-3), the ALJ's decision became the final decision of the Commissioner, see Shauger v. Astrue, 675 F.3d 690, 695 (7th Cir. 2012). On August 17, 2011, Lott filed the current suit seeking judicial review of the ALJ's decision. See 42 U.S.C. § 405(g). The parties have consented to the jurisdiction of this court. See 28 U.S.C. § 636(c).


Lott claims that she has been disabled since December 2008, when she was laid off from her long-standing job as a secretary. According to Lott, her vision and hearing problems led her to make "critical mistakes" at work even before she was laid off, (A.R. 41), and she is unable to work now because of the combination of those problems and carpal tunnel syndrome, depression, headaches, kidney dysfunction, and symptoms related to diabetes. Lott presented both documentary and testimonial evidence in support of her claim at her hearing.

A. Medical Evidence

Lott, who is 57 years old, was diagnosed with diabetes in 1976, (A.R. 155), and received a successful kidney and pancreas transplant in September 2001, (id. at 342). Since then, she travels 240 miles from her home in a Chicago suburb to the University of Iowa Hospital for annual follow-up visits. (Id. at 339, 342.) At her October 2007 follow-up her physician wrote that Lott "has no specific symptoms related to her renal transplant," but noted that she had broken some of her toes and an ankle and had experienced recurring urinary tract infections ("UTIs"). (Id. at 339.) At her October 2008 follow-up her doctor noted that she had not had any bone fractures or UTIs since her last visit and reported that they would continue to monitor her renal and pancreatic endocrine function at regular intervals. (Id. at 342, 344.) But in August 2009 Lott reported having UTIs with increasing frequency in the previous two years, with symptoms including increased urinary frequency and urgency. (Id. at 529.) Lott underwent an ultrasound which revealed moderate hydronephrosis, but her physician, Dr. Mohammed Ahmed, noted that her condition did "not require any further workup or intervention." (Id. at 567.) In September 2009 Lott underwent a cystoscopy which "was completely unremarkable," and an ultrasound "that did not show anything of concern, including masses or significant hydronephrosis." (Id. at 637, 640.) At her April 2010 follow-up, Lott was "happy to report that she has had zero infections" in the previous seven months. (Id. at 640.)

With respect to Lott's complaints of headaches, the record shows that Lott was examined by a neurologist, Rodrigo Ubilluz, in January 2007 who noted that her headaches were at a level of about 5 out of 10. (Id. at 354.) In June 2008 Dr. Ubilluz noted that he had not seen Lott in a year, and that despite her reports of weekly headaches, she wished to continue with the same medications. (Id. at 352.) Six months later Dr. Ubilluz reported that Lott had been doing "quite well" with respect to her headaches, which she reported having about twice a week. (Id. at 351.) Dr. Ubilluz wrote that Lott's headaches "are not very intense" and that her migraine medications were working "remarkably well." (Id.) Lott also brought her headache complaints to a chiropractor, Robert Sheng, who treated her with acupuncture and exercises. (Id. at 359-60.) In December 2008 Dr. Sheng described her headaches as "much improved." (Id. at 360.) Lott reported an uptick in the frequency of her headaches in December 2010, but Dr. Ubilluz wrote that she had stopped taking her headache medicine. (Id. at 617.)

The record also documents Lott's recurrent ear infections and associated hearing difficulties. In June 2003 Lott saw Dr. Oscar Alonso regarding her complaints of hearing loss and tinnitus. (Id. at 254.) His examination revealed right otitis media with effusion-in other words, fluid behind the eardrum-but no sign of nasopharyngeal pathology. (Id.) Dr. Alonso prescribed medicine to combat her seasonal allergies and suggested that she might benefit from having an ear tube placed in her right ear. (Id.) A year later Lott presented with ear pain and Dr. Alonso reiterated his opinion that she might benefit from ear tubes. (Id. at 257.) In September 2004 Lott underwent the ear-tube surgery and at a follow-up in October, Dr. Alonso described her examination as "essentially normal." (Id. at 261.) A year and a half went by before Lott next saw Dr. Alonso-he described her as being "lost to follow-up"-at which point he described her eardrums as normal. (Id. at 262.) Another year later, in February 2007, Lott returned to Dr. Alonso complaining of decreased hearing. (Id.) He diagnosed an ear infection which he treated with antibiotics. (Id.) The next month Lott underwent an audiogram which showed "a mild to severe mixed hearing loss in the right ear and a severe to profound mixed hearing loss in the left ear." (Id. at 263.) Lott had yet another ear-tube procedure in early 2007, after which her hearing was much improved and Dr. Alonso again described her examination as normal. (Id. at 264.) When Lott presented in the fall of 2007 with yet another ear infection, Dr. Alonso performed a third ear-tube insertion. (Id. at 265.) She continued to see Dr. Alonso into the summer of 2009, who noted that future ear-tube surgeries may be necessary. (Id. at 477.)

With respect to her vision issues, in the spring of 2007 Dr. Aaron Weinberg examined Lott and noted that her visual acuity was 20/40 in one eye and 20/70 in the other. (Id. at 411.) He noted that Lott underwent eye surgery in 1998 and wrote that she described her vision as "stable to somewhat improved" since undergoing surgery. (Id.) In November 2007 Dr. Weinberg re-examined Lott and reported her visual acuity as being 20/25 on one side and 20/70 on the other. (Id. at 412.) He described her condition as stable and suggested that they continue to observe her conservatively. (Id.) A year later, in the fall of 2008, Dr. Weinberg rated Lott's visual acuity as 20/30 on one side and 20/100 on the other and again described her condition as "stable." (Id. at 413.) In April 2009 Dr. Weinberg submitted an eye report to the state disability agency opining that Lott has the unlimited ability to read fine print, drive safely, and avoid common hazards in the workplace. (Id. at 409.) He reported that Lott would only have the occasional ability to perform activities that require good hand/eye coordination, but the continual ability to perform activities that require good distant, detailed vision. (Id.) Lott next saw Dr. Weinberg in August 2010, who once again described Lott's condition as "stable" and suggested that they "continue to observe her retinal findings conservatively." (Id. at 630.)

Lott also presented evidence documenting her complaints of carpal tunnel syndrome and leg pain. She suffered a stress fracture in her ankle in August 2007 after which she underwent physical therapy. (Id. at 421, 428.) She has ongoing problems with her feet and underwent debriding of her toenails. (Id. at 425.) In October 2007 her physical therapist reported to her doctor that Lott reported "feeling much better" and no longer experiencing "any type of discomfort in the lower leg." (Id. at 434.) With respect to her carpal tunnel syndrome, in June 2008 Dr. Ubilluz noted that Lott had pain in her right wrist and trouble typing and picking things up. (Id. at 352.) In October 2009 examining physician Dr. Ravikiran Tamragouri reported that Lott's "ability to grasp and manipulate with each hand is normal," although she complained of difficulty turning door knobs and picking up small objects from a tabletop because of a "glove type of numbness." (Id. at 574.) Dr. Ubilluz wrote in December 2010 that Lott was experiencing "problems" in her hands, noting that she has left-hand weakness and atrophic muscles in both hands. (Id. at 617.)

Lott underwent a psychological evaluation in October 2009 in connection with her disability claim. The examining psychologist reported that although her thought process was logical and she did not give any signs of psychosis, Lott meets the criteria for generalized anxiety disorder and moderate depression. (Id. at 578.) A reviewing psychiatrist noted that Lott has poor memory and is easily distracted, and opined that she has moderate limitations in activities of daily living, social functioning, and concentration, persistence, or pace. (Id. at 581, 591, 593.) The psychiatrist commented that Lott "is limited to simple routine tasks." (Id. at 597.)

In June 2009 reviewing physician Dr. Frank Jimenez completed a physical residual functional capacity ("RFC") assessment form. (Id. at 448-55.) He opined that Lott can sit, stand, or walk with normal breaks for about six hours in an eight-hour day. (Id. at 449.) He found that she has no manipulative, visual, or hearing limitations. (Id. at 451-52.) A second reviewing physician, Dr. David Bitzer, reviewed Lott's file in November 2009 and confirmed Dr. Jimenez's assessment of her ability to sit, walk, and stand and her capacity to hear and see. (Id. at 600, ...

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