United States District Court, C.D. Illinois
SCHANZLE-HASKINS, U.S. MAGISTRATE JUDGE.
Megan Marie Delaney appeals from the denial of her
application for Social Security Disability Insurance Benefits
(DIB) under Title II and Supplemental Security Income (SSI)
under Title XVI of the Social Security Act (collectively
Disability Benefits). 42 U.S.C. §§ 416(i), 423,
1381a and 1382c. This appeal is brought pursuant to 42 U.S.C.
§§ 405(g) and 1383(c). Delaney filed a Motion for
Summary Judgment (d/e 13). The Defendant Commissioner filed a
Motion for Summary Affirmance (d/e 16). The parties consented
to proceed before this Court. Consent to the Exercise of
Jurisdiction by a United States Magistrate and Reference
Order entered May 18, 2017 (d/e 9). For the reasons set
forth below, the decision of the Defendant Commissioner is
was born November 3, 1986. She completed about two years of
college. She previously worked as a school bus monitor,
general farm worker, and food service manager. She last
worked in June 2012 at a Dollar General store as a cashier.
Delaney suffers from type 1 insulin dependent diabetes,
diabetic neuropathy, diabetic retinopathy, affective
disorder, and anxiety. Certified Transcript of
Proceedings before the Social Security Administration (d/e
11) (R.), 17, 28, 44, 705.
April 28, 2012, Delaney went to the emergency room at
Memorial Hospital in Taylorville, Illinois (Taylorville
Hospital). Delaney had multiple skin infections. The
emergency room physician noted, "She states that her
sugars have been 200 recently and she is not really
following a diet or doing what she is supposed to do although
she does seem to know the risks." The physician
"spent a significant amount of time discussing the risks
of diabetes and encouraging her to follow the appropriate
diet." R. 551. The emergency room physician prescribed
antibiotics for her infections, encouraged her to follow an
appropriate diabetic regimen, and discharged her. R. 552.
16, 2012 Delaney was admitted to St. John's Hospital in
Springfield, Illinois (St. John's). Delaney did not know
the insulin dose prescribed to her. Over the next two days,
the doctors adjusted her insulin dose until she had a
consistent blood sugar reading under 200 with not low blood
sugar events. She was discharged on May 19, 2012. R. 614-15.
29, 2012, Delaney went to St. John's, but left against
medical advice. R. 640. On May 30, 2012, Delaney went to the
emergency room at Taylorville Hospital with low blood sugar.
She was given Glucagon and transferred to St. John's
Hospital for observation and continued monitoring of her
blood sugar. R. 544. She was admitted to St. John's and
discharged on June 2, 2012 with a diabetic diet and a
prescription for insulin. R. 640.
22, 2012, Delaney went to the emergency room at Taylorville
Hospital with low blood sugar. Her diabetes was poorly
controlled. She had not eaten that day and collapsed. She was
given dextrose and became awake and alert. R. 543.
January 25, 2013, Delaney saw Dr. Zulfiqar Hashim, M.D., for
diabetic neuropathy. R. 833-35. Delaney reported "pins
and needle" sensations in her lower extremities. On
examination, Delaney was negative for dizziness, extremity
weakness, headache, numbness in extremities, and tremors.
Delaney also showed no loss of light touch and vibration
sensation in her lower extremities. R. 835. Dr. Hashim
prescribed Neurontin (gabapentin). R. 833.
17, 2013, Delaney saw Dr. Madhumita Banga, M.D., for a follow
up on her diabetes. R. 830-32. Her diabetes was uncontrolled
at the time. The Neurontin was not fully controlling her
neuropathy. Dr. Banga advised her that strict glycemic
control was necessary for neuropathy pain control. R. 830.
20, 2013, Delaney went to America's Best Contacts &
Eyeglasses for an eye examination. R. 605-06. Her corrected
visual acuity was 20/40 in the right eye and 20/70 in the
left. The optometrist referred Delaney to a retina
specialist. R. 606.
September 27, 2013, Delaney saw Dr. Banga for her diabetes.
R. 826-29. Her diabetes was uncontrolled. Dr. Banga increased
her insulin dosages. R. 826.
December 4, 2013, Delaney saw a retina specialist at the
Washington University School of Medicine Ophthalmology and
Visual Sciences Department. She reported "smudgy vision
with floating lines since September 2013. Her corrected
vision was 20/40 in the right and 20/60 in the left. R. 688.
On December 12, 2013, ophthalmologist Dr. Chin Yee, M.D.,
performed a Panretinal Photocoagulation (PRP) on Delaney to
limit the effects of diabetic retinopathy. The procedure
involved burning parts of the retina with lasers. R. 696. Dr.
Yee repeated the PRP procedure on December 19, 2013 and
January 2, 2014. R. 694-95.
February 20, 2014, Delaney returned to Washington University
for intravitreal injections. At that time, her corrected
visual acuity was 20/50 in the right eye and 20/60 in the
left. R. 693. On March 26, 2014, Delaney went to Washington
University for intravitreal injections. At that time, her
corrected visual acuity was 20/50 in the right eye and 20/60
in the left. R. 692.
April 9, 2014, Delaney saw state agency physician Dr. Vittal
Chapa, M.D., for a consultative examination. R. 698-701. Dr.
Chapa noted that Delaney had documented diabetic retinopathy
in both eyes. Delaney's corrected visual acuity was 20/50
in the right eye with pinhole acuity of 20/70, and 20/70 in
the left eye with pinhole acuity of 20/70. Her visual fields
were normal on gross confrontation. R. 698.
April 10, 2014, Delaney saw state agency psychologist Dr.
Dolores Trello, Psy.D., for a mental status examination. R.
704-08. Delaney reported that she had social anxiety all of
her life. She said she felt anxious around people. Delaney
also reported that she was depressed. She said she went
through depression after her miscarriage in June 2013. She
reported having trouble sleeping. She took Benadryl
over-the-counter to help her sleep, but did not take any
other medication for her mental condition. R. 705.
reported that she had two friends and a boyfriend. She said
that she went to a lake often and liked to sit around a fire.
She said that she liked to draw and make jewelry. She said
she depended on her parents for emotional support. Delaney
said that she could cook, do laundry, and perform household
chores. She could drive. R. 706.
Trello noted that Delaney's concentration was good. Her
immediate, recent, and remote memory was intact. Dr. Trello
assessed major depressive disorder, recurrent of moderate
severity, social anxiety, panic attacks without agoraphobia,
and generalized anxiety disorder. R. 707.
19, 2014, Delaney saw state agency optometrist Dr. Chelsey
Moore, O.D., for a consultative eye examination. R. 711-15.
She reported receiving injections in her eyes to help with
the diabetic macular edema. She reported that she was forced
to quit work due to vision decline. R. 711. On examination,
Delaney had corrected visual acuity of 20/30 in the right eye
and 20/40 in the left, with no pinhole improvement. R. 712.
Delaney's confrontation visual fields were full. She had
no cataracts. The fundoscopic examination showed scars on the
retina from the PRP treatments. Visual field testing showed
mild superior defect in the right eye and moderate superior
defect in the left, attributed to the PRP treatments. Dr.
Moore concluded that Delaney had "a couple of areas of
mild decreased visual field areas, but would not hinder
Claimant in activities of daily living." R. 713.
Moore assessed proliferative diabetic retinopathy post PRP
treatments "to prevent retinal tears/breaks/detachments
in future, " and a history of macular retinal edema
treated with injections to prevent further vision damage. Dr.
Moore opined that Delaney was at great risk of losing her
vision due to her uncontrolled diabetes. Dr. Moore
recommended continuing to follow care instructions from the
Washington University physicians, driving only during the
daytime in familiar locations, continue wearing glasses, but
not contact lenses. Dr. Moore also opined that, "a hand
held magnifying glass may help near vision." R. 713.
29, 2014, state agency physician Dr. Charles Kenney, M.D.,
prepared a Physical Residual Functional Capacity Assessment.
R. 121-23. Dr. Kinney opined that Delaney had no physical
functional limitations. Dr. Kenney opined that Delaney's
visual limitations would not affect her ability to work. R.
continued to have monthly injections in her eyes from May
2014 through January 2016. R. 850-51, 853, 855, 857, 863-869,
February 26, 2015, Delaney saw state agency physician Dr.
Hima Atluri, M.D., for consultative examination. R. 845-49.
Delaney reported that she was following her diabetic regimen
and, "[s]ince almost 2011 to now" she has had
"no diabetic ketoacidosis, and no hypoglycemic
reactions." R. 845. On examination, her corrected visual
acuity was 20/50 in the right eye and 20/40 in the left, both
with or without pinhole. R. 847.
March 4, 2015, her corrected visual acuity was 20/50 in the
right eye and 20/60 in the left. R. 851.
March 16, 2015, Delaney saw state agency psychologist, Dr.
Stephen Vincent, Ph.D., for a mental status examination. R.
888-91. Delaney reported, "[S]he has tried to work as a
cashier at Dollar General, but stopped secondary to a history
of interacting with co-workers and supervisors, as well as
episodes of sudden onset of intense fear and panic episodes
related to interacting with the general public." R. 888.
She reported having anxiety when she had to leave her home.
She was prescribed clonazepam for the anxiety. She took the
medication when she knew she was leaving her home. She said
she had "episodes of sudden onset of intense fear,
particularly when she is outside of her 'comfort zone,
' with symptoms that include fear of losing control,
dizziness and lightheadedness, chest pain, discomfort,
shortness of breath, tightness around her throat, trembling
and shaking and episodes of accelerated heart rate." R.
888-89. She reported that she lived with her boyfriend. She
also reported that she liked to paint, read, and care for her
dog, "which she finds therapeutic." R. 889. Dr.
Vincent assessed generalized anxiety disorder; panic
disorder, with agoraphobic features; and social anxiety
disorder. Dr. Vincent stated that cognitively, she was
intact. R. 891.
April 2, 2015, state agency physician Dr. James Hinchen,
M.D., prepared a Physical Residual Functional Capacity
Assessment. R. 139-42. Dr. Hinchen opined that Delaney could
frequently lift ten pounds and occasionally lift 20 pounds;
stand and/or walk about six hours in an eight-hour workday;
sit about six hours in an eight-hour workday; occasionally
climb ramps and stairs; never climb ropes, ladders, and
scaffolds; and occasionally balance. Dr. Hinchen also opined
that Delaney should avoid concentrated exposures to vibration
and hazards. Dr. Hinchen opined that Delaney was not
functionally limited by her impaired vision. R. 140-41.
April 29, 2015, Delaney went to see endocrinologist Dr. Anju
Gurung, M.D., for uncontrolled type 1 diabetes. Delaney
reported that she missed taking her Lantus insulin 1-2 times
per week and missed taking her Humalog insulin 1-2 times per
day. She also did not eat three meals a day. She often
skipped breakfast. She also ate snacks during the day. Her
lunches and dinners usually included 60 grams of
carbohydrates. Her meter showed blood sugar readings of
232-330 in the mornings, 200s-300s at lunchtime and
suppertime, with some readings in 400s-500s when she ate
chocolates and cookies. R. 993. Dr. Gurung adjusted her
insulin dosages, instructed her to eat three meals a day
without snacks, and referred her to a dietician to learn to
count carbohydrates. R. 996.
16, 2015, Delaney underwent a consultative examination by
optometrist Dr. Ronald Weingart, O.D. R. 894-905. Delaney
reported to Dr. Weingart that she regularly bumped into walls
and tripped over unseen objects on the floor. She said that
she easily lost her balance and periodically fell. She
reported that she had to use railings and walls to guide her
movement. She said that she held onto friends or family
members to walk outside, especially at dusk. R. 894. Delaney
reported that she could not read cooking ingredients or
recipes. She said she could not tell if a meal was fully
cooked. Delaney reported that she lost her cashier job
"after a blood vessel burst inside her in 2013
preventing her from being able to read credit card
numbers." R. 894.
Weingart said Delaney had poor depth perception and had lost
much of her peripheral vision. R. 895. Dr. Weingart opined:
Ms. Delaney experiences difficulty while walking, reading,
reading cooking instructions, and preparing a meal. She is
unable to locate and maintain an occupation, as well as,