United States District Court, D. Nebraska
MEMORANDUM AND ORDER ON REVIEW OF THE FINAL DECISION OF THE COMMISSIONER OF SOCIAL SECURITY
WARREN K. URBOM, Senior District Judge.
Barbara Kay Beckett filed a complaint on March 12, 2013, against Carolyn W. Colvin, Acting Commissioner of the Social Security Administration. (ECF No. 1.) Beckett seeks a review of the Commissioner's decision to deny her application for disability insurance benefits and supplemental security income benefits under Title II and Title XVI of the Social Security Act (the Act), 42 U.S.C. §§ 401 et seq., 1381 et seq. The defendant has responded to the plaintiff's complaint by filing an answer and a transcript of the administrative record. (See ECF Nos. 10, 11). In addition, pursuant to the order of Judge Joseph F. Bataillon, dated June 19, 2013, (ECF No. 15), each of the parties has submitted briefs in support of her position. (See generally Pl.'s Br., ECF No. 16; Def.'s Br., ECF No. 26). After carefully reviewing these materials, I find that the Commissioner's decision must be affirmed.
Beckett initially applied for disability benefits on July 1, 2010, alleging an onset date of January 1, 2007. (See ECF No. 11, Transcript of Social Security Proceedings (hereinafter "Tr.") at 134). She later amended the onset date to July 1, 2010, because she lacked insured status for Title II and the only claim to be adjudicated was the Title XVI claim. (Id. at 144, 257). After her application was denied initially and on reconsideration, (id. at 66-69, 70-73) Beckett requested a hearing before an administrative law judge (hereinafter "ALJ"). (Id. at 83-86). This hearing was conducted on October 20, 2011. (Id. at 36-58.) In a decision dated December 22, 2011, the ALJ concluded that Beckett was not entitled to disability insurance benefits. (Id. at 12-33). The Appeals Council of the Social Security Administration denied Beckett's request for review. (Id. at 1-6.) Thus, the ALJ's decision stands as the final decision of the Commissioner, and it is from this decision that Beckett seeks judicial review.
II. SUMMARY OF THE RECORD
Beckett, whose date of birth is June 17, 1968, (Id. at 134) alleged that she stopped working on May 1, 2007, because of her conditions. (Id. at 182). Beckett completed two years of college and had certifications in home health care, peer educator, and CNA. (Id. at 183). She had past work experience as a grill cook, home health care assistant, motel housekeeper, respite caregiver, and vocational workshop supervisor. (Id. at 184).
A. Medical Evidence
Beckett alleged that her disability arose from chronic conditions, including Type 1 diabetes, low blood pressure, neuropathy, gastrointestinal issues, rheumatoid arthritis, and chronic obstructive pulmonary disease (COPD). (Id. at 182). The medical evidence supports some of these issues.
Beckett's primary care physician was Douglas J. States, M.D. She received medical care from him, physician assistants, and nurse practitioners between 2009 and 2011. (Id. at 284-317, 440, 443-45, 741-95). During that time, Beckett was treated for and prescribed medications for diabetes, anxiety, allergies, hypotension, gastroparesis, headaches, hypothyroidism, and renal insufficiency. (Id. at 284-317, 443-445, 741-95).
Beckett's hemoglobin was regularly tested to evaluate her diabetes. (Id. at 279). The target for the A1C test was 6.5. (Id. at 279). On May 5, 2009, Beckett's result was 6.3, which fell in the excellent diabetic control range. (Id. at 324). On August 10, 2009, the hemoglobin was 7.5, which fell in the good diabetic control range. (Id. at 328). On February 3, 2010, the hemoglobin was 8.6, which was in the fair diabetic control range. (Id. at 332). On March 29, 2010, her hemoglobin was 7.9, which was in the good diabetic control category. (Id. at 279). By June 2010, the A1C result was 6.2, which again fell in the excellent control range. (Id. at 353).
Beckett also received medical treatment at a hospital emergency room on a number of occasions. On January 26, 2009, it was determined that she had diffuse gastritis and a small duodenal ulceration, status post upper GI bleeding. (Id. at 416). She spent two days in the hospital. (Id.). She returned to the emergency room on July 25, 2009, complaining of abdominal pain, nausea, loss of appetite, vomiting, and diarrhea. (Id. at 392). She was discharged in improved condition with a clinical impression of gastroesophageal reflux disease. (Id. at 397-98).
On January 7, 2010, Beckett went to the emergency room complaining of a cough, sore throat, and difficulty breathing. (Id. at 388). She was diagnosed with bronchitis. (Id. at 389). She returned on January 26, 2010, complaining that she had been suffering from dyspnea for three weeks. (Id. at 380). The clinical impression was acute bronchitis, anxiety reaction with hyperventilation, and psychogenic hyperventilation syndrome. (Id. at 382). She returned again on February 11, 2010, complaining of palpitations, dyspnea, cough, nausea, and weakness. (Id. at 366). She was discharged in good condition. (Id. at 372).
Beckett went back to the emergency room on February 15, 2010, again complaining of dyspnea, along with chest tightness, wheezing, palpitations, and severe anxiety. (Id. at 354). She was diagnosed as having hyperventilation syndrome and hypertension and was discharged in improved condition. (Id. at 359).
On September 24, 2010, Beckett went to the emergency room complaining of a headache and abdominal pain. (Id. at 450, 455). She refused to submit to a CT scan or a GI cocktail (Id. at 455). She was admitted for acute renal failure, but it was resolved by the time she was discharged on September 27, 2010. (Id. at 456-457). At that time, her blood pressure and blood sugars were well-controlled. (Id. at 457). She returned to the emergency room on October 20, 2010, complaining of abdominal pain. (Id. at 498). Beckett went back to the emergency room on January 22, 2011, again complaining of dyspnea. (Id. at 756). She was discharged in good condition after being treated with Ativan. The clinical impression was acute exacerbation of COPD and anxiety reaction. (Id.). On July 19, 2011, Beckett went to the emergency room with a cough, sinus pain, fever, chills, and muscle aches. (Id. at 752). It was determined that she had acute bronchitis. She was discharged in improved condition. (Id. at 753).
The medical evidence also shows that Beckett had cataract surgery on both eyes in December 2008. (Id. at 268, 573, 585-86, 597, 610-11). On June 4, 2010, Beckett had a colonoscopy, which indicated two probable polyps. (Id. at 351). She sought treatment for migraines from September 24, 2010, to August 17, 2011. (Id. at 669-687).
In January 2009, Beckett was placed in a boot after it was determined that she had a fracture in her foot. (Id. at 277). She continued to complain of pain in January 2010. (Id. at 276). The boot was discontinued in March 2010 because she was not healing well and she had a foot ulcer. The physician discussed with her the relationship between elevated blood sugar readings and healing. (Id.). On January 13, 2011, Richard Raska, D.P.M., noted that Beckett had an ulcer on her foot which had not responded to conservative care for the previous six months. (Id. at 526, 539). He operated on it on January 13, 2011. (Id. at 527-28, 546-47). On February 3, 2011, Beckett reported she had been walking excessively on the foot, and Raska noted that patient noncompliance was a factor in the treatment. (Id. at 529).
In addition, Beckett reported that she was diagnosed with juvenile rheumatoid arthritis, but blood tests showed a normal rheumatoid factor of 6.3. (Id. at 416).
The record includes a physical residual functioning capacity (RFC) questionnaire which apparently was completed by States. (Id. at 338-344). It indicated that Beckett began treatment in January 2009 and had last been seen on May 5, 2010. (Id. at 339). Her diagnoses included diabetes, gastroparesis, high blood pressure with orthostatic hypotension, neuropathy, COPD, and rheumatoid arthritis. The prognosis was chronic illness with medical management. The form indicates that Beckett's impairments were seldom severe enough to interfere with her attention and concentration. (Id. at 340). Beckett had the ability to ambulate effectively unassisted by a cane or other assistive device to perform daily activities such as traveling to and from a workplace, using standard public transportation, shopping, banking, and climbing several steps at a reasonable pace with the use of a single hand rail. (Id.).
The form stated that Beckett's symptoms would interfere to the extent that Beckett was unable to maintain persistence and pace to engage in competitive employment. (Id. at 340). However, it stated that Beckett could work two to four hours per day and work four to six days per week. (Id. at 341). Her symptoms slightly impaired her ability to perform activities of daily living. States noted that Beckett's symptoms could be exacerbated by physical activity, movement or overuse, temperature extremes, work stress, and static positioning. It was medically reasonable to expect that she may need to lie down or recline periodically throughout the day to relieve or reduce her symptoms. She would be likely to miss work four or more times per month. (Id.). Beckett was likely to experience fatigue which would moderately impair her ability to work and would need four breaks in an eight-hour work day in addition to two standard breaks and a lunch break. (Id. at 342). Beckett could occasionally lift up to 20 pounds, sit for 60 minutes, and stand for 30 minutes. She had good use of both hands and fingers for bilateral manual dexterity. (Id. at 343). According to States, Beckett could sit for about six hours in an eight-hour day and stand or walk for about two hours. (Id.).
B. Medical Opinion Evidence
Jerry Reed, M.D., completed a physical RFC assessment on September 9, 2010. (Id. at 429-436). He determined that Beckett could occasionally lift and/or carry 20 pounds and frequently lift and/or carry 10 pounds. (Id. at 430). Reed stated that she could stand and/or walk at least two hours in an eight-hour workday and sit about six hours in an eight-hour workday, with periodic sitting and standing to relieve pain. She was unlimited in pushing and pulling. Reed noted that Beckett had chronic conditions including insulin-dependent diabetes mellitus and hypertension. The notes indicated a history of juvenile rheumatoid arthritis, but she was not under the care of a rheumatologist. Reed stated that Beckett had a medically determinable impairment that imposed periodic flares of symptoms, including neuropathy in the feet, a history of degenerative knees, and a history of asthma that would pose environmental limitations. Beckett would be precluded from heavier exertion related to low energy. (Id. at 431).
Reed stated that Beckett could occasionally climb, balance, stoop, kneel, crouch, and crawl. The limitations were based on Beckett's low energy and abdominal discomfort. (Id. at 431). She had no manipulative limitations, could write legibly on forms, and had no dexterity deficits despite the history of rheumatoid arthritis. (Id. at 432). She had previously had cataract surgery, and she had no visual limitations and was able to watch television and read the Bible. (Id.). She had no communicative limitations. (Id. at 433). Reed recommended that Beckett avoid concentrated exposure to extreme heat ...