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Purifoy v. Colvin

United States District Court, N.D. Illinois, Eastern Division

May 21, 2015

CAROLYN W. COLVIN, Acting Commissioner of Social Security, Defendant.



Plaintiff Janette Purifoy brings this action pursuant to 42 U.S.C. § 405(g) for judicial review of the decision of the Commissioner of Social Security denying her application for Disability Insurance Benefits ("DIB") and Supplemental Security Income ("SSI") under the Social Security Act, 42 U.S.C. §§ 421, 423. (Compl.) [Dkt 1.][1] Plaintiff has moved for summary judgment [dkt 14] and filed a supporting memorandum (Pl.'s Mem.) [dkt 15]. The Commissioner has filed a cross-motion for summary judgment [dkt 19] along with a memorandum in support (Def.'s Mem.) [dkt 20]. Plaintiff has replied. (Pl.'s Reply.) [Dkt 21.] The parties have consented to the jurisdiction of the Magistrate Judge pursuant to 28 U.S.C. § 636(c). [Dkt 10.] For the reasons set forth below, Plaintiff's motion is denied and the Commissioner's motion is granted.


Plaintiff first applied for benefits on May 5, 2009. (R. 293.) After the agency denied her claims initially and on reconsideration (R. 177-94), Plaintiff requested a hearing before an Administrative Law Judge ("ALJ") (R. 197-98). The hearing was held in November 2010. (R. 44-98.) On December 15, 2010, the ALJ issued a decision denying Plaintiff's request for benefits. (R. 139-52.) On February 12, 2012, finding shortcomings with the ALJ's decision, the Appeals Council remanded the case back to the ALJ. (R. 159-61.) After a second hearing in May 2012 (R. 101-34), the ALJ again denied Plaintiff's request for benefits on June 1, 2012 (R. 8-27). The Appeals Council declined Plaintiff's request for review (R. 1-3), so the ALJ's decision is the final decision of the Commissioner. See Villano v. Astrue, 556 F.3d 558, 561-62 (7th Cir. 2009).


Plaintiff applied for benefits at age 48. (R. 293.) In her application, she stated that she stopped work in April 2009 because of alleged disabilities that included diabetes, neuropathy, a uterine fibroid, and depression. (R. 349.) Notably, that statement is at odds with Plaintiff's testimony that she was let go because of attendance problems resulting from her wanting to spend more time with her grandchildren. (R. 52-53.) She had worked as a cashier, a packer at a food factory, and a dietary aide at a hospital. (R. 350, 404.) She attended school until tenth grade. (R. 353.)

Medical Evidence

According to Plaintiff, she was first diagnosed with diabetes in 1994, and her condition has worsened since that time. (R. 51, 55.) Her primary treating physician was Dr. Chukwudozie Ezeokoli, a specialist in internal medicine, who treated her diabetes with insulin. (R. 108, 592, 642, 692.) Plaintiff says that Dr. Ezeokoli was her primary treating physician for diabetes from 2007 until at least May 2012, the time of her second hearing before the ALJ. (R. 108.) All of Dr. Ezeokoli's notes in the record, however, are from 2010 and 2011. (R. 592, 642, 692.)

According to Dr. Ezeokoli's notes, Plaintiff's diabetes was often not well controlled. (R. 592, 594.) This was partly because of Plaintiff's noncompliance with her prescribed treatments, which included taking insulin and metformin. (R. 592.)[2] The doctor observed on a number of occasions throughout 2010 that Plaintiff had not taken her medications, tested her blood sugar, attended appointments, or quit smoking six to ten cigarettes per day as recommended. (R. 592, 596, 598, 692.) In August 2010, Dr. Ezeokoli referred Plaintiff to a diabetes clinic for the fifth time but warned, "If she is not ready to comply with her medications then I cannot really help her and she will most likely end up dying prematurely from a [diabetes] complication." (R. 692.)

In March 2010, Dr. Ezeokoli completed a questionnaire describing Plaintiff's limitations from diabetes. (R. 639-42.) He concluded that Plaintiff could lift 20 pounds occasionally and ten pounds frequently, could stand or walk about four hours during an eight-hour workday, would need to take half-hour breaks every three to four hours, and was likely to miss about three days per month. (R. 640-42.) He observed that she had "[g]eneralized persistent anxiety" but did not say whether Plaintiff had any limitations because of that condition. (R. 643.) He indicated that she had "hyper/hypoglycemic attacks" and elevated blood pressure and tachycardia. (R. 639.)[3] Asked to identify any medication side effects that "may have implications for working, " Dr. Ezeokoli wrote that some side effects of using insulin are "hypoglycemic episodes with agitation, sweating, and altered mental state." (R. 639.)

Dr. Ezeokoli's questionnaire is the only assessment of Plaintiff's limitations in the record by a treating physician. Although the questionnaire mentions Plaintiff's anxiety, the record does not contain evidence that she received professional psychiatric treatment for any mental disabilities.[4] In regard to her application for disability benefits, however, additional physicians completed assessments of Plaintiff's limitations caused by both her diabetes and depression.

The earliest of the additional assessments is from September 2009, when Dr. Donna Hudspeth and Dr. Charles Kenney reviewed Plaintiff's medical records. (R. 549-70.) Dr. Hudspeth, a psychologist, concluded that Plaintiff's depression did not constitute a severe impairment because Plaintiff had only mild limitations in concentration, persistence, or pace and no extended episodes of decompensation. (R. 549, 559.) Dr. Hudspeth appears to have based her assessment on notes from "Dr. Rana, " but those notes are not in the record. (R. 561.) Dr. Kenney focused on Plaintiff's physical ailments from her diabetes and uterine fibroid. (R. 563.) He concluded that she could lift 50 pounds occasionally and 25 pounds frequently, and could stand, walk, or sit for six hours in an eight-hour workday, with no limitations in movement. (R. 564.) He also opined that Plaintiff's statement about her activities of daily living were inconsistent with the physical findings. (R. 570.) Dr. Kenney's opinion was affirmed later in 2009 by state-agency physician Dr. David Mack. (R. 575-77.)

In March 2011, Plaintiff went to the emergency room complaining of pain in her left arm. (R. 741.) She said that the pain had lasted five months and rated its intensity as ten out of ten. ( Id. ) A physical exam, however, revealed a normal range of motion in her upper extremities. (R. 743.)

Four months later, Dr. Peter Biale examined Plaintiff on behalf of the state agency. (R. 754-57.) He observed that she had some limitation in moving her left shoulder but had a "full range of motion noted in all other joints." (R. 756.) He also noted that she had "no difficulty" getting on and off the examination table or getting up from a chair, that she had a wide-based gait without the use of an assistive device, and that she had a normal range of motion in her back. (R. 755-56.) She did, however, lose balance when trying to squat and do a heel-and-toe walk and complained of dizziness when moving from sitting to lying down and getting back up. ( Id. ) Around the same time, x-rays of Plaintiff's left shoulder showed no abnormalities. (R. 759.) Relying on Dr. Biale's examination, another state-agency physician, Dr. Calixto Aquino, found that Plaintiff could lift 20 pounds occasionally and ten pounds frequently, and could sit, stand, or walk for six hours in an eight-hour workday. (R. 722.)

Agency doctors also reviewed Plaintiff's mental condition in 2011. First, Dr. Henry Fine performed a psychiatric evaluation of Plaintiff in July 2011. (R. 749-52.) He observed that her "[a]ttitude and degree of cooperation were good, " but that, based on Plaintiff's description of her symptoms, she has "major depression with suicidality, auditory hallucinations and paranoid ideas of reference." (R. 749, 751.) He added that Plaintiff's "depression apparently started somewhat after she stopped working" and is "currently not treated, but she's scheduled to be evaluated and begin treatment." (R. 751.) Reviewing Dr. Fine's evaluation, Dr. Joseph Cools then determined that Plaintiff had "moderate" limits in concentration, persistence, or pace, and had one or two extended episodes of decompensation. (R. 717.) He also concluded that Plaintiff was suffering from major depression "though the severity is questionable" because of her lack of treatment or medication and because she "allege[d] more limitations in functioning than are supported by the medical data." (R. 719.)

The assessments from Dr. Aquino and Dr. Cools were affirmed in November 2011 by two agency physicians, Dr. Bharati Jhaveri and Dr. Donald Cochran. (R. 703-05.) The reviewing doctors again noted Plaintiff was "poorly compliant with diabetes medication" and had "not sought or received any mental health treatment." (R. 705.) They concluded that ...

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