United States District Court, D. Nebraska
ANGEL S. JONES, Plaintiff,
CAROLYN W. COLVIN, Acting Commissioner of the Social Security Administration, Defendant.
MEMORANDUM AND ORDER
M. GERRARD UNITED STATES DISTRICT JUDGE.
matter is before the Court on the denial, initially and upon
reconsideration, of plaintiff Angel S. Jones' disability
insurance benefits under Titles II and XVI of the Social
Security Act, 42 U.S.C. § 401 et seq. and
§ 1381 et seq. The Court has considered the
parties' filings and the administrative record and
affirms the Commissioner's decision to deny benefits.
filed applications for disability insurance benefits and
supplemental security income in December 2011. T373-402.
Jones' claims were denied initially (T166-69; T170-173;
T174-78) and on reconsideration (T182-90; T191-199; T200-09).
Following two hearings-the first on November 19, 2013, and
the second on April 29, 2014-the administrative law judge
(ALJ) found, in a decision dated May 19, 2014, that Jones was
not disabled as defined under 42 U.S.C. §§ 416(i),
423(d), or 1382(a)(3)(A), and therefore not entitled to
disability benefits. T24. The ALJ determined that, although
Jones suffered from severe impairments, she had the residual
functional capacity to perform other jobs that exist in
significant numbers in the national economy. T13-24; T36-47;
T59-70. The Appeals Council of the Social Security
Administration denied Jones' request for review of the
ALJ's decision. T1-4. Jones' complaint seeks review
of the ALJ's decisions as the final decision of the
Commissioner under sentence four of 42 U.S.C. § 405(g).
medical records generally reflect a history of bipolar
disorder and depression dating back to at least 2006. At that
time, Jones visited Joe Travis, M.D., in connection with a
state-funded program in which Jones was to provide daycare
services. See T115-119. Specifically, Jones asked
Travis to submit a letter on her behalf to a state social
service agency regarding her ability to provide childcare
with an underlying diagnosis of bipolar disorder. Travis
endorsed this idea, and his notes reflect that Jones'
bipolar disorder was under control, and her affect, generally
speaking, was "very bright." T573. Thus, given the
positive nature of the visit, Travis wrote to the state on
Jones' behalf indicating that, in his opinion, Jones was
capable of working with children.
medical records then jump to 2009, when Jones visited Anne
Hoeman, certified physician assistant, regarding
self-inflicted cuts on her arms and legs. T610. Jones
reported that she would unconsciously cut herself in the
night, causing her to wake up with bloody sheets. Jones
remarked that she had been cutting herself for about 9 years,
but that she had no intent of hurting herself. T610.
Impressions from the visit, as reflected in Hoeman's
notes, were (1) unconscious self-inflicted injury, and (2)
history of disassociation disorder and depression. T577.
Hoeman prescribed Paxil and Ambien, and encouraged Jones to
begin counseling. Jones visited Hoeman's office on at
least two subsequent occasions-once in October 2009, and
again in October 2010-for general symptoms related to fatigue
and depression. See, T607; T606. Hoeman refilled or
increased Jones' prescription for Paxil each time, and
again encouraged her to seek counseling.
connection with Jones' prior application for disability
benefits, a psychological interview was performed in July
2009 by Twila Preston, Ph.D. T580. Jones told Preston that
she had manic depressive disorder and bipolar disorder, and
that she had "massive" mood swings. She further
reported that when she became angry, she would lose
"chunks of time, " and that she occasionally woke
up with cuts on her arms and legs. T582. The cutting, she
reported, corresponded with increased stress, and tended to
occur when she slept at night, as opposed to during the day.
T582. Jones also described a fear of being around other
people, and relatedly, a reluctance to leave her home. T582.
"She avoids people, " Preston wrote, "because
she is afraid 'they are all like my brother, threatening
and potentially hurtful.'" T582. Preston's
diagnoses included posttraumatic stress disorder, mood
disorder not otherwise specified, borderline personality
features, and attention deficit hyperactivity disorder
inattentive type by history only. T583.
Preston described Jones as open, cooperative, and alert.
T582. She wrote that Jones' speech was "logical,
coherent, and goal-directed, " and noted her appearance
as "neat and clean." T582. But she also remarked
that Jones had poor judgment, was anxious, and demonstrated
poor frustration tolerance. T582. Accordingly, Preston opined
that Jones could sustain concentration and attention for
simple tasks, but would likely have more trouble with
complicated tasks. Relatedly, while she could understand and
remember short and simple instructions, "[s]he would
have a difficult time carrying these out under ordinary
supervision due to her avoidance of others." T583.
Preston assigned Jones a global assessment of functioning
(GAF) score of 40. T583.
in connection with the present claim, was evaluated again in
March 2012-this time by Michael Baker, Ph.D. T614. At that
interview, Jones reported a history of bipolar disorder and
attention deficit disorder, and stated that she last used
Paxil in May 2011. With respect to her mental health status,
Baker remarked that Jones was "alert and well oriented,
" and that she had "no difficulty following the
train of conversation." T616. But, consistent with the
prior evaluation, he also wrote that Jones' judgment and
insight are "low, " and that the cuts on her arm,
while not deep enough to necessitate stiches, were
nonetheless "obvious." T615. Baker's diagnoses
included bipolar disorder, not otherwise specified, reported
by history, and rule out borderline personality disorder.
T616. He concluded:
In regards to mental limitations related to work activities,
[Jones] seems able to remember and understand instructions,
procedures, and locations. Her maintenance of attention,
concentration, and pace seems adequate for routine,
noncomplex, tasks. She reports some social anxiety, but she
interacted adequately during the session. If social or
interpersonal demands were too stressful then that would be
problematic. Her use of good judgment and responding
appropriately to changes in the workplace would also be based
on not overly stressful or complex work.
Baker assigned Jones a GAF score of 50. T616.
November 19, 2013 hearing on this claim, the ALJ ordered an
additional psychological examination, which occurred in
January 2014 with Margaret Donovan, Ph.D. T675. Donovan, too,
noted Jones' remarks regarding social anxiety and
frequent blackouts. As reflected in the report, the blackouts
occurred during times of stress, and would often cause Jones
to lose "two or three hours at a time." T677.
Further, Jones told Donovan that the blackouts were the only
time in which she engaged in cutting/self-mutilation, and
that the blackouts occurred anywhere from once or twice a
month, to once or twice a week, depending on whether she was
taking medication. T677. Donovan's diagnoses included
depressive disorder, not otherwise specified, reading
disability (dyslexia), and borderline personality disorder
with dissociation. T680. Donovan concluded:
Because of her personality disorder [Jones] will have
difficulty getting along with coworkers and bosses. She would
definitely do better in a job where she had little contact
with coworkers. She also would do better in a job where she
is not around a lot of people as she has anxiety that
strangers will harm her.
The prognosis for the personality disorder is poor,
especially since she is not in therapy and does not see that
she can change anything. . . . Her prognosis for mood
disorder is good if she takes the medication.
T680-81. Donavan assigned Jones a GAF score of 65.
record also contains reviews from state agency psychological
consultants Rebecca Braymen, Ph.D., and Linda Schmechel,
Ph.D. Braymen, who conducted a review of Jones' records
in connection with a separate application for benefits,
indicated that Jones had moderate limitations in the ability
to understand, remember, and carry out detailed instructions;
to perform activities within a schedule; to work in proximity
to others; to interact with the general public; and to
respond appropriately in the work setting, to name a few.
T586-87. Schmechel, who reviewed Jones' records in
connection with the underlying claim, reached similar
conclusions. In her March 2012 assessment, she observed that
Jones had "marked limitations" in the ability to
understand and remember detailed instructions, and to
interact appropriately with the general public. T619-20. She
further concluded that Jones was moderately limited in her
ability to, among other things, maintain attention and
concentrate for extended periods, to set goals, and to carry
out detailed instructions. T619-20. Despite these
limitations, however, both consultants concluded that Jones
could maintain some form of unskilled employment.
See, T603; T637.
Hearing Testimony - November 19, 2013
testified at the administrative hearing that she was unable
to work because of "[i]ndiscretion, " noting that
she felt "[n]ervous" and "[i]tchy" in
public, and that she would start "scratching" and
"panicking" around others. T123. She also discussed
her diagnosis for bipolar disorder, which contributes to her
desire to be alone, "away from everything and
everyone." T128. Jones said that she gets distracted
easily, and that she has an attention span of 5 to 20
minutes, depending on whether she is on her medication.
also testified to other factors that, she contends,
contribute to her inability to work. For example, she
discussed her dyslexia, which prevents her from filling out
job applications. T123-24. She also described herself as
forgetful, noting that, in a previous job, she would
sometimes forget to show up for work. T132. And she testified
more generally to her medical history, stating that she was
on Paxil and Meclozine at the time of the hearing, and that
she had not seen a therapist for 13 years. T126-27.
also described frequent blackouts, which, she says, cause her
to lose chunks of time. She elaborated,
A: I've always described them as white-outs. I'll be
arguing with my mom one minute about taking the garbage out.
And the next thing I know I'm sitting in my bedroom and I
feel the overpowering need to apologize because I feel like
I've done something.
Q: Don't know what's happened in the interim period?
. . .
Q: How frequently does that occur?
A: Honestly, it happens quite often. And sometimes it
doesn't happen until I go to sleep It's one of
these-I'll remember laying down to go to sleep and the
next thing I know I'm coming to and there are problems.
My arms and legs will be covered in blood. Physical harm.
Myself. I'm assuming that I wound up cutting myself.
I've woke up from something like this fighting myself and
hitting myself. But I don't remember ever doing anything.
presented the vocational expert (VE) with a hypothetical
based on a person who could lift 20 pounds on occasion and 10
pounds on a frequent basis; could sit or stand for 6 hours;
has limited use of the extremities; has difficultly reading
and writing; could write and change things on a computer; has
the ability to "pace adequate [sic] for routine,
non-complex tasks"; must work in an area with no
interaction with the general public; must conduct routine,
repetitive tasks; whom has a problem with change, and who
must have minimal interactions with coworkers. T143-44. Such
a person, the VE opined, could perform light, unskilled work,
such as a production assembler, laundry worker, or hand
ALJ, following cross-examination of the VE, ordered a
follow-up consultative examination.
Hearing Testimony - April 29, 2014
at the second hearing, listed blackouts and physical pain as
the most severe conditions that interfere with her ability to
work. T85. With respect to physical pain, she cited problems
with her hips, ankle, and spinal cord. When questioned about
this condition, Jones said that she had been to a doctor the
previous July, but that she had not been back-and was not
currently on medication-due to financial constraints. T85-86.
presented the vocational expert (VE) with a hypothetical
similar to the one presented at the prior hearing.
Specifically, the ALJ asked the VE to consider an individual:
with no past relevant work; who could lift up to 20 pounds on
occasion, 10 pounds on a frequent basis; who could stand for
6 hours or sit for 6 hours in an 8-hour day; who has
unlimited use of the extremities; who could have no contact
with the general public, and minimal contact with peers and
supervisors, and coworkers; and who could perform simple, yet
repetitious work. T101. Based on that hypothetical, the VE
opined that such a person could perform light, unskilled
work, such as housekeeping or production-type work. T101-102.
Responding to the VE's assessment, the ALJ then added a
condition to the hypothetical, asking the VE to assume, in
addition to the conditions described above, that the
individual was unable to carry out short and simple
instructions under ordinary supervision. T102. With that