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Cooper v. Colvin

United States District Court, C.D. Illinois, Springfield Division

November 30, 2016

CAROLYN COLVIN, Acting Commissioner of Social Security, Defendant.



         Plaintiff Michael J. Cooper appeals from the denial of his application for Social Security Disability Insurance benefits and Supplemental Security Income Disability benefits under Titles II and XVI of the Social Security Act. 42 U.S.C. §§ 416(i), 4231381a, and 1382c. This appeal is brought pursuant to 42 U.S.C. §§ 405(g) and 1383(c). Plaintiff has filed a Motion for Summary Judgment (d/e 11) and Defendant Commissioner of Social Security has filed a Motion for Summary Affirmance (d/e 15). For the reasons set forth below, the Decision of the Commissioner is REVERSED and REMANDED for further proceedings.

         I. BACKGROUND

         Plaintiff was born January 31, 1962. Plaintiff graduated high school and has worked in the past as a laborer/construction worker, auto glass installation specialist, and auto glass installation manager. See R. 229; R. 82 (correcting listing of iron worker to construction worker II). Plaintiff testified that he last worked as a glass installation specialist in 2010 when he was laid off because he was no longer able to install glass. R. 53.

         Plaintiff's medical history is set forth in Plaintiff's brief and the Administrative Law Judge's (ALJ) opinion. The Court provides a brief summary here to put Plaintiff's claims in context.

         Plaintiff was a patient of Dr. S. David Ross for many years. During that time, Dr. Ross diagnosed Plaintiff with numerous conditions and prescribed multiple medications, including steroids. At the hearing, Plaintiff testified that Dr. Ross misdiagnosed him, had him on the wrong medications, and “almost killed” him. R 65.

         In approximately the fall of 2012, Plaintiff stopped seeing Dr. Ross and, upon further testing by other physicians, several of Dr. Ross's diagnoses were ruled out or resolved when Plaintiff stopped taking the steroids. See R. 65; R. 1116 (December 19, 2013 medical record of Dr. Lynn Speck indicating Plaintiff's “diabetes due to glucocorticoids appears to have resolved” and that he “no longer has adrenal insufficiency”). The record suggests that the steroids prescribed to Plaintiff contributed to the epidural lipomatosis on Plaintiff's thoracic spine. R. 65; R. 867 (May 16, 2013 medical record of Dr. Lewis noting that Plaintiff's spinal epidural lipomatosis “was an unusual complication of prolonged steroid therapy”); see also (last visited November 30, 2016) (providing that “[e]pidural lipomatosis is a rare disorder in which an abnormal amount of fat is deposited on or outside the lining of the spine”; common symptoms include back pain and weakness; also noting that patients who use steroids for many years are more likely to get epidural lipomatosis).

         The medical record shows that, by late 2012 and thereafter, Plaintiff generally complained of the following conditions/symptoms: hypogammaglobulinemia (a/k/a common variable immunodeficiency), back pain, gastrointestinal issues, headaches, hand tremors, fatigue, anxiety, depression, sleep apnea, and shoulder pain. He was also diagnosed with neuropathy. R. 787-89 (electromyography conducted April 2013).

         On November 18, 2012, Plaintiff applied for Disability Insurance benefits. On June 14, 2012, Plaintiff applied for Supplemental Security Income Disability benefits. In both applications, Plaintiff alleged disability beginning January 1, 2011.

         II. THE HEARING

         On January 28, 2014, the ALJ held a hearing. Plaintiff testified that the problems that kept him from working include his back pain, Crohn's disease, migraines, his “immune situation” (the hypogammaglobulinemia), tremors in his hands, fatigue, and depression. R. 58-60. Plaintiff testified he suffered side effects from his medication, including the Imitrex for migraines, which put him to sleep. R. 59.

         Plaintiff testified he has seven or eight migraines a month. R. 68. The migraines make him sick (vomiting) and he takes the Imitrex, which puts him to sleep. R. 59, 68. It takes about 30 minutes for the medication to kick in and then he sleeps for three to four hours. R. 68. In some cases, Plaintiff has to go to the hospital or Prompt Care for an injection of Dilaudid for the migraines. R. 69.

         Plaintiff also testified that he currently undergoes infusion treatments for his hypogammaglobulinemia at the hospital every two weeks, which takes eight hours and cannot be done on the weekends. R. 69. Plaintiff testified the infusions started approximately four years earlier, while he was still working. R. 81. In the past, he underwent the infusions every three weeks but that was not working. R. 69.

         Plaintiff sees a psychiatrist once a month and a therapist every three or four weeks, sometimes more frequently. R. 60, 70. He sees Dr. Ferdinand Salvacion from the pain clinic for his back pain. R. 71. Plaintiff has been told by a surgeon that surgery is not an option for his back pain. Id. Plaintiff takes morphine and Norco for his back pain and uses ice and heat ...

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