United States District Court, N.D. Illinois, Eastern Division
MEMORANDUM OPINION AND ORDER
SIDNEY I. SCHENKIER, Magistrate Judge.
Plaintiff Helene Purcell has filed a motion (doc. # 13) to reverse or remand the final determination by the Commissioner of Social Security ("Commissioner"), denying her application for Disability Insurance Benefits ("DIB"). The Commissioner has responded, seeking affirmance of the decision denying benefits (doc. # 37). For the following reasons, the Court grants the Commissioner's motion and denies Ms. Purcell's motion.
On March 15, 2010, Ms. Purcell applied for DIB, alleging a disability onset date of March 15, 2009 (R. 183-89, 226). Her last-insured date was March 31, 2014 (R. 226). Ms. Purcell's claims were denied initially and upon reconsideration, and a hearing was held before an ALJ on March 13, 2012 (R. 77, 146-49, 153-55). In a written opinion issued on March 30, 2012, the ALJ concluded that Ms. Purcell was not disabled from her alleged onset date through the date of the opinion (R. 18-30). The Appeals Council denied Ms. Purcell's request for review of the ALJ's decision (R. 1-6), making the ALJ's decision the final decision of the Commissioner. See 20 C.F.R. § 404.981; Shauger v. Astrue, 675 F.3d 690, 695 (7th Cir. 2012).
We begin with a summary of the administrative record. We review Ms. Purcell's general background and medical record in Part A; the hearing testimony in Part B; and the ALJ's written opinion in Part C.
Ms. Purcell was born December 14, 1961, making her 47 years old on March 15, 2009 - her alleged disability onset date (R. 183). From at least April 2001 until her alleged disability onset date, Ms. Purcell was treated sporadically for depression and bi-polar disorder (R. 339-509). The record reflects a three-day hospital admission at Glenbrook Hospital from April 6 to April 9, 2001 (R. 339-440), and outpatient appointments at the Great Lakes Naval Hospital's psychiatric clinic in November 2006 and April 2007 for medication refills and blood work (R. 502-03, 494-95).
In January 2008, Ms. Purcell's son committed suicide while enlisted in the Navy (R. 114, 116). Ms. Purcell next sought psychiatric treatment in March 2008, when she met with psychiatrist Jeffrey Jones regarding stress over her son's suicide and her mother, who was ill and who later passed away in January 2009 (R. 445, 474-75). Ms. Purcell saw psychiatrists Dr. Jones (three times) and Dr. Charles Ludmer (once) and therapist Barbara Cooper, Ph.D (two times) between April and August 2008 (R. 458-90). While Ms. Purcell demonstrated a dysphoric, or depressed, mood, sadness over the loss of her son, and sad affect at these appointments, her thought processes were not impaired and she did not demonstrate any psychoses (R. 459, 462, 465, 470, 473).
The record does not reflect Ms. Purcell seeking any additional mental health treatment until her alleged onset date. On March 15, 2009, Ms. Purcell was admitted to the emergency room at the North Chicago VA hospital for anxiety and symptoms related to withdrawal from Ativan (R. 852-65, 1139-52). Progress notes from the visit state that Ms. Purcell was observed to have no suicidal or homicidal ideations, and was not a danger to herself or others (R. 855). She was discharged as medically stable that same day, and followed up with psychiatrist Robert C. Powell (R. 454-57).
Ms. Purcell began seeing psychologist Faan Yeen Sidor, Ph.D., on April 10, 2009 and psychiatrist Tracy L. Price on April 24, 2009 (R. 441-53, 547-55). Ms. Purcell would be seen fifteen times by Dr. Sidor and thirteen times by Dr. Price over the next eight months ( Id. ). Throughout this period, Ms. Purcell complained of unresolved depression as a result of her mother and her son passing away as well as auditory hallucinations, paranoia surrounding going out and what she wore, and fear of her husband leaving her (R. 510-33, 537-48). She showed improvement over the summer, but her symptoms worsened starting in September 2009 (R. 906-7, 953-63).
In December 2009 Ms. Purcell required hospitalization, and was admitted to the North Chicago VA Hospital from December 14 to December 24 (R. 573-87). On admission, she complained of depression and anxiety (R. 574). The hospital noted she had been drinking on and off over the past nine months and had developed irritability, insomnia, psychotic symptoms (including auditory hallucinations instructing her to kill herself and somatic delusions of ghosts touching her and passing through her), and suicidal thoughts (R. 574, 576). Given her increase in symptoms, even while taking several medications,  Ms. Purcell's doctors suggested she undergo electroconvulsive therapy ("ECT"),  which she began while still hospitalized, on December 14, 2009 (R. 574-76, 583-85). Ms. Purcell underwent ECT four times between December 14 and December 24 ( Id. ). Upon discharge, Ms. Purcell was noted to be doing well and was "excited about going home, feeling safe, with minimal [auditory hallucinations], no other psychotic [symptoms], decreased irritability and improved sleep, decreased depression, more hopeful and with no [suicidal or homicidal intent]" ( Id. ). On December 31, Dr. Sidor noted that Ms. Purcell "continues to recover from severe depression" and was "feeling less depressed and [was] not experiencing any auditory hallucinations, [suicidal intent] or paranoid feelings as she was  prior to her hospitalization" (R. 873-74).
Ms. Purcell underwent ECT seven times in January 2010 and eight more times between February 2010 and July 2010 (R. 588-688). Dr. Sidor noted after a February 1 appointment that Ms. Purcell was not feeling paranoid or experiencing auditory hallucinations and had no suicidal intent; she also reported that she was exercising more often (R. 868). Progress notes from a February 26, 2010 visit to her primary care physician show Ms. Purcell complained of impaired memory as a result of "ECT and medication" (R. 634). During a March 12, 2010 appointment with her primary care physician, she reported feeling better since beginning ECT and said that she had plans to travel in the summer (R. 630). In a March 19, 2010 mental health evaluation completed by a VA doctor, Ms. Purcell reported improvement in her symptoms with ECT but said she was still haunted by her son's death (R. 619). She denied any suicidal or homicidal intent, paranoid thinking, or perceptual disturbances during the evaluation and reported feeling "okay right now" ( Id. ).
On May 4, 2010, Ms. Purcell was evaluated by state agency consulting psychologist Patricia M. Morrin, Psy.D. (R. 984-990). Ms. Purcell reported being able to attend to her personal care, and was able to clean and do laundry (R. 985). Additionally, Ms. Purcell reported she had close friends and "lots of social contacts on Facebook... [and] sees and talks to her friends regularly" (R. 986). She also had good relationships with her husband and daughters (R. 988). Dr. Morrin assessed Ms. Purcell with a slightly flat mood and affect ( Id. ). She also noted that Ms. Purcell's thought processes, immediate and past memory, and ability to recall information and perform calculations were all intact (R. 987). Additionally, she was able to think abstractly, note similarities and differences between objects, and use sound judgment ( Id. ).
On June 3, 2010, state agency medical consultant A. Johnson, Ph.D prepared a mental residual functional capacity questionnaire after reviewing Ms. Purcell's medical record (R. 1347-50). Dr. Johnson opined Ms. Purcell was moderately limited in her ability to: maintain attention and concentration for extended periods of time, complete a normal workday/workweek without interruptions from psychologically based symptoms, perform at a consistent pace without an unreasonable number and length of rest periods, and accept instructions and respond appropriately to criticism from supervisors (R. 1347-48). Dr. Johnson designated Ms. Purcell as "not significantly limited" in the questionnaire's remaining categories of analysis ( Id. ).
In August 2010, Ms. Purcell and her family moved from Illinois to Northern Wisconsin because the cost of living was lower there (R. 1373). On August 31, 2010 she met with local psychiatrist Ashraf N. Ahmed, M.D (R. 1345-46, 1353-54). Dr. Ahmed noted Ms. Purcell had a dysphoric mood with flat affect, but no suicidal or homicidal intent and seemed calm and pleasant (R. 1346). He noted that she was fully alert and oriented, had no abnormal movements, and "was able to count from 20 backwards and remember three objects in five minutes" ( Id. ). Ms. Purcell saw Dr. Ahmed again briefly on November 1, 2010 for medication management; during the appointment she was "calm, pleasant, interactive, " and although she demonstrated "some hostility, " she was able to stop herself from expressing annoyance at the doctor in a sarcastic manner (R. 1338).
Ms. Purcell also saw therapist Maureen Sinkler, LCSW, on October 8, October 18, and November 1, 2010 (R. 1369-75). At the October 8 appointment, Ms. Sinkler noted that Ms. Purcell appeared depressed with a flat affect, but her thought content was logical and organized and her judgment was good (R. 1374). She also reported drinking up to a bottle of wine four times per week (R. 1373-74). By the October 18th appointment, Ms. Purcell had reduced her drinking, and seemed to be somewhat at peace with her son's death even though she was still depressed (R. 1370-71). At her November 1, 2010 appointment, Ms. Purcell reported she was "doing fairly well" and had completely stopped drinking alcohol; Ms. Sinkler opined that the claimant's mood was generally euthymic (non-depressed) and less angry (R. 1369).
On February 3, 2011, Dr. Ahmed completed an RFC questionnaire about Ms. Purcell (R. 1333-36). Dr. Ahmed noted Ms. Purcell became easily frustrated and irritated in encounters with other people and overwhelmed with stress, which could trigger her symptoms (R. 1333). He opined that her symptoms had not impacted her ability to concentrate, but did lend to mood instability, irritability, poor impulse control, anger, and frustration with supervisors (R. 1333-34). He anticipated Ms. Purcell would be off-task more than 15 percent of a work day and was unable to function in a competitive work setting, but that she had no other medical or psychological conditions which impacted her ability to function (R. 1334). In evaluating Ms. Purcell's bi-polar disorder, Dr. Ahmed checked boxes on the RFC form indicating the symptoms he had noticed in Ms. Purcell during his treatment of her: one depressive symptom (anhedonia, or the reduced ability to experience pleasure in normal activities) and no manic symptoms (R. 1335).
On September 14, 2011, Ms. Purcell saw Dr. Ahmed for the first time since November 1, 2010, again for a very brief medication management appointment (R. 1351). Dr. Ahmed noted that the claimant reported that she was eating and sleeping well and that her medications seemed to be helping. He did not see any anger, violence or aggression ( Id. ). After meeting with Dr. Ahmed, Ms. Purcell saw therapist Maureen Sinkler, also for the first time since November 1, 2010 (R. 1367-68). Ms. Sinkler also noted that Ms. Purcell's mood was euthymic, she had a sense of humor and she had accepted her son's death even though it still absorbed her every day ( Id. ). Ms. Sinkler's treatment plan did not set a follow-up date for Ms. Purcell to return to therapy; instead she was to follow-up "as needed" ( Id. ). There is no indication in the record that Ms. Purcell pursued additional therapy or medical appointments with either Dr. Ahmed or Ms. Sinkler.
Four months later, on January 26, 2012, Dr. Ahmed completed another RFC questionnaire for Ms. Purcell (R. 1355-58). The record does not indicate that Dr. Ahmed saw Ms. Purcell between the September 14, 2011 visit and January 26, 2012. In this RFC, Dr. Ahmed noted that Ms. Purcell was argumentative, challenging, and hostile to supervisors, and had frequent mood swings (R. 1356). She would need to be off-task more than 15 percent of the time because she was "tired" and "forgetful" ( Id. ). In evaluating Ms. Purcell's bi-polar disorder, Dr. Ahmed checked boxes on the RFC form indicating the symptoms he had noticed in Ms. Purcell during his treatment of her: two depressive symptoms (anhedonia and psychomotor agitation, or purposeless and unintentional movements) and six manic symptoms (inflated self-esteem, involvement in activities with high probability of painful consequences that are not recognized, pressure of speech, decreased need for sleep, flight of ideas, and easy distractibility) (R. 1357). Dr. Ahmed again checked a box indicating that Ms. Purcell would be unable to function in a competitive work setting for an eight-hour day ( Id. ). The record reflects no progress notes from Dr. Ahmed or Ms. Sinkler discussing or otherwise recognizing these symptoms.
At the hearing before the ALJ on March 13, 2012, Ms. Purcell, who was represented by counsel, and a vocational expert ("VE") testified (R. 77).
Ms. Purcell was fifty years old at the time of the hearing, and lived with her husband and twenty year old daughter (R. 82). Ms. Purcell testified that she did not have any difficulty getting in, out, or around her home (R. 84). Ms. Purcell has a driver's license and was able to drive forty minutes to the hearing location (R. 83).
During the hearing, Ms. Purcell testified that she is a high school graduate (R. 84, 85) and served in the United States Navy as a "radioman" from 1980 through 1986, receiving an honorable discharge (R. 85). She has been supported financially by her husband's income since her alleged onset date (R. 86). Although Ms. Purcell has not worked for wages since her alleged onset date, she volunteered several times at a thrift store in October 2011 and helped clean a lake over the summer that same year (R. 87). She did not complain of any mental or physical difficulty in performing her volunteer duties (R. 88, 89).
Ms. Purcell's past work included working as a filing clerk for six months in 2008 and 2009, receptionist in 2006, customer service representative in 2006 and 2007, and sales associate from 2002 through 2004 (R. 89-91). Ms. Purcell testified that she would not be able to return to any of her past jobs if she was asked, as she has a "hard time ...