United States District Court, N.D. Illinois, Eastern Division
BARBARA A. DALE, Plaintiff,
CAROLYN W. COLVIN, Acting Commissioner of Social Security, Defendant.
MEMORANDUM OPINION AND ORDER
MICHAEL T. MASON, Magistrate Judge.
Plaintiff, Barbara A. Dale has brought a motion for summary judgment seeking judicial review of the final decision of the Commissioner of Social Security ("Commissioner") to deny her claim for Disability Insurance Benefits and Supplemental Security Income. The Commissioner has filed a cross-motion for summary judgment asking the Court to uphold her decision, and that of the Administrative Law Judge ("ALJ"). This Court has jurisdiction to hear this matter pursuant to 42 U.S.C. §§ 405(g), and 1383(c). For the reasons set forth below, Dale's motion for summary judgment  is denied, and the Commissioner's motion  is granted.
A. Procedural History
Barbara Dale filed applications for Supplemental Security Income ("SSI") and Disability Insurance Benefits ("DIB") on May 26, 2010, alleging disability beginning April 12, 2009. The Commissioner denied all claims initially on July 27, 2010, and again upon reconsideration on November 1, 2010. Dale requested a hearing before an Administrative Law Judge on December 3, 2010, and the case was assigned to ALJ Denise McDuffie Martin, who held the requested hearing on November 13, 2011. Dale, Vocational Expert Michelle Peters, and Medical Expert Dr. Ellen Rozenfeld testified at the hearing. (R. at 43.) ALJ Martin issued a written decision on December 7, 2011, denying Dale's request for benefits. (R. at 38.) The ALJ found that Dale had not been under disability as defined by the Act from April 12, 2009 through the date of the decision. (R. at 38.) The Appeals Council denied Dale's request for review on October 15, 2012, and the ALJ's decision became the final decision of the Commissioner (R. at 1.); Estok v. Apfel, 152 F.3d 636, 637 (7th Cir.1998). Dale subsequently filed this action in the district court, seeking review of the ALJ's (and the Commissioner's) decision.
B. Medical Evidence
The medical evidence in the record shows that, on August 25, 2005, Dale saw a clinician at Loretto Hospital for a Mental Health Assessment and Psychiatric Assessment. (R. at 395.) The clinician reported that Dale appeared depressed, anxious, angry, irritable and isolated. (R. at 397.) The clinician further indicated that Dale had an organized thought process and fair impulse control. (R. at 398.) Dale perceived her family as supportive and wanted her family involved in her treatment. (R. at 399.) The clinician diagnosed Dale with adjustment disorder with anxiety and depressed mood and assigned her a 60 on the Global Assessment of Functioning scale, the highest score in a range indicating "moderate symptoms (e.g., flat affect and circumstantial speech, occasional panic attacks) OR moderate difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peers or co-workers). (R. at 409; Global Assessment of Functioning (GAF) Scale, DSM-IV, p. 34.)
Dale saw Dr. Rachel Zahn on March 3, 2008 for a Behavioral Health Consultation. (R. at 537.) Dale reported stress from working 12 hour shifts four-days a week, full-time school three days a week, and recent identity theft. (R. at 537.) Dr. Zahn recommended working on small goals and setting weekly tasks. (R. at 537.) Dr. Zahn diagnosed Dale with adjustment disorder. (R. at 538.)
On March 25, 2008, Dale saw Dr. Zahn for a Behavioral Health Consultation follow-up and guided imagery. (R. at 535.) Dale reported recollections of the death of her mother and PTSD. However, Dale stated that she would utilize guided imagery to find a safe place to re-energize her day. (R. at 535.) Dr. Zahn diagnosed Dale with adjustment disorder. (R. at 535.)
Dale received a Behavioral Health Consultation with Dr. Michael Hansen on July 17, 2008. (R. at 533.) Dale reported improved symptoms and that her grieving had progressed. (R. at 533.) Dr. Hansen diagnosed Dale with adjustment disorder. (R. at 533.)
On August 22, 2008, Dale called Registered Nurse Annie Bryan to report headaches and to request a CT scan. (R. at 530.)
Dr. Hansen saw Dale on September 19, 2008 for another Behavioral Health Consultation. (R. at 527.) At that time, Dale reported improved symptoms. (R. at 527.) She also reported reduced school load and less stress. (R. at 527.) Dale reported a decrease in the intensity of her pain and reported that praying had helped her get answers. (R. at 527.) Dr. Hansen diagnosed Dale with hypertension, adjustment disorder and bereavement. (R. at 527.)
Dr. Bolanie Soyannwo saw Dale on December 3, 2008 for an acute visit. (R. at 518.) At that time, Dale reported right side headaches for the past 2-3 months. (R. at 518.) Dale stated that she had difficulty working due to headaches and occasional nausea. (R. at 518.) Dr. Soyannwo diagnosed Dale with common migraines and adjustment disorder. (R. at 519-20.) She prescribed Excedrin Migraine and Verapamil. (R. at 520.) On December 22, 2008, Dr. Soyannwo took Dale's labs. (R. at 513.)
Dr. Karla Torres conducted a Behavioral Health Consultation with Dale on February 3, 2009. (R. at 511.) Dale reported worse headaches because of remembering losses from the past. (R. at 511.) Dale stated that she noticed a connection between worrying and anxiety with her headaches. (R. at 511.) Dr. Torres diagnosed Dale with Hypertension, Common Migraines, and Adjustment Disorder. (R. at 511-12.) She advised Dale to implement "diaphragmatic breathing and progressive muscle relaxation for muscle tension and worrying that exacerbates headaches." (R. at 511.)
On February 20, 2009, Dale saw Physician's Assistant William Bush for headaches. (R. at 509.) Dale reported headaches almost daily for a whole week. (R. at 509.) She stated that she had been unable to work more than two days during the past two weeks and had blurred vision. (R. at 509.) Physician's Assistant Bush diagnosed Dale with common migraines. (R. at 510.)
Dale saw Dr. Jewel Scott on February 24, 2009 for a regular check-up. (R. at 506.) Dale reported more frequent headaches due to her 4am-11am shift work at the airport. (R. at 506.) Dale believed her work schedule interrupted her sleep schedule and caused her headaches. (R. at 506.) Dr. Scott diagnosed Dale with common migraines. (R. at 508.)
Dale saw Physician's Assistant Bush again on March 20, 2009. (R. at 504.) Dale reported headaches, which she described as "sharp." (R. at 504.) She reported that she had similar headaches as early as the 1980s, but had not had one recently, until the past year. (R. at 504.) Bush recommended Dale follow-up with an optometrist, and continue taking Excedrin. (R. at 505.)
On March 24, 2009, Dr. Scott saw Dale for follow-up regarding her headaches. (R. at 499.) Dale reported her pain at the time of the appointment as a 0 out of 10. (R. at 499.) Dale requested a letter for work because of her tardiness associated with her headaches. (R. at 499.) Dr. Scott wrote a letter on Dale's behalf stating that she suffered from headaches, possibly due to her lack of sleep stemming from her assigned shift work. (R. at 498.)
Dale received a brain CT scan on March 28, 2009. (R. at 497.) The CT scan was normal and no intracranial abnormalities were identified. (R. at 497.)
On April 14, 2009, Dale saw Dr. Scott for another follow-up. (R. at 299.) At that time, she reported that she continued to have headaches, decreased concentration, and decreased ability to focus. (R. at 299.) Dr. Scott noted Dale appeared to have a depressed affect. (R. at 300.) Dr. Scott diagnosed Dale with common migraines. (R. at 300.)
Dr. Scott saw Dale on April 15, 2009. (R. at 295.) On the same day, Dale had a Behavioral Health Consultation follow-up with Dr. Zahn. (R. at 296.) Dale stated that she continued to have migraines and discussed recollections of past abuse. (R. at 296.) Dale reported having strong feelings toward a man and realized that her husband was never there for her when she was sick. (R. at 296.) Dr. Zahn encouraged Dale to keep journaling and diagnosed Dale with common migraines and adjustment disorder. (R. at 296-97.)
On April 30, 2009, Dale saw Dr. Hansen for a Behavioral Health Consultation follow-up. (R. at 294.) She reported that her symptoms had improved. (R. at 294.)
Dale arrived for a follow-up with Dr. Scott on May 12, 2009. (R. at 289.) Dale's chief complaint was for headaches that became worse when she touched the temporal area. (R. at 289.) Dale reported that relaxation techniques helped a little to alleviate pain. (R. at 289.) She also reported a better mood and better ability to organize thoughts and concentrate. (R. at 289.) Dale stated that her employer fired her for frequent absences but stated she felt better since resuming a normal schedule as opposed to shift work. (R. at 289.) Dr. Scott diagnosed Dale with common migraines. (R. at 290.)
On June 23, 2009, Dale saw Dr. Scott for a follow-up regarding depression and headaches. (R. at 286.) Dale reported significant relief in headaches with Cymbalta. (R. at 286.) However, Dale reported worse depression, sad feelings, and an inability to get out of bed for several days. (R. at 286.) Dale reported that her brother had died 2 weeks earlier and that she was able to get the energy to go to the funeral and felt better being with family. (R. at 286.) Dr. Scott diagnosed Dale with depressive disorder and common migraines. (R. at 287.)
On the same day, Dale saw Dr. Zahn for a Behavioral Health Consultation. (R. at 474.) Dale reported experiencing emotional pain and wanting to remain in bed; she also reported that she had cancelled several doctors' appointments. (R. at 475.) Dr. Zahn encouraged Dale to journal her thoughts and feelings and to follow-up for support. (R. at 475.) Dr. Zahn diagnosed Dale with depressive disorder and common migraines. (R. at 476.)
On July 28, 2009, Dale had a follow-up visit with Dr. Scott for a rash on her upper thighs. (R. at 279.) Dale reported that she was not doing well, had missed several days of classes due to lack of energy and continued to grieve the loss of her brother. (R. at 279.) Dale reported that she was going through a divorce, and that she experienced more "emotional pain" dealing with the memories of her cousin molesting and raping her as a child. (R. at 283.) She reported that her migraines began improving with Cymbalta. (R. at 280.) Dr. Scott diagnosed Dale with depressive disorder and common migraines. (R. at 280.)
That same day, Dale also saw Dr. Torres for a Behavioral Health Consultation follow-up for bereavement and depression. (R. at 468.) Dale reported depression, trouble falling asleep/sleeping too much, and feeling tired/having little energy for several days. (R. at 468.) She also reported having trouble concentrating and having suicidal thoughts. (R. at 468.) However, she also reported that, overall, she felt better. (R. at 468.) Dr. Torres reported that Dale was mildly depressed, but did not have any suicidal plan or intent. (R. at 468-69.)
Dr. Scott saw Dale on December 14, 2009 for a follow-up visit. (R. at 272.) Dale reported headaches, but a better mood. (R. at 272.) Dale reported that she continued to remain at home and that she had gained 28 pounds. (R. at 272.) Dr. Scott noted that her depression and headaches seemed to be improving. Dale told Dr. Scott that she journalled as a way to process the death of her brother. (R. at 276.) Dr. Scott concluded that Dale ...