The opinion of the court was delivered by: Catherine D. Perry United States District Judge
This is an action under 42 U.S.C. § 405(g) for judicial review of the Commissioner's final decision denying Alexander Prodes' application for disability insurance benefits under Title II of the Social Security Act, 42 U.S.C. § 401, et seq. and supplemental security income under Title XVI of the Act, 42 U.S.C. §§ 1381, et seq. Claimant Prodes brings this action asserting both physical and mental disability because of diabetes, depression, and bipolar disorder. The Administrative Law Judge concluded that Prodes was not disabled. Because I find that the decision denying benefits was supported by substantial evidence, I will affirm the decision.
On August 27, 2007, Alexander Prodes field for Period of Disability and Disability Insurance Benefits. The Social Security Administration denied the claim, and a timely hearing request was filed. On January 25, 2008, Prodes filed for Supplemental Security Income payments which was escalated to the hearing level. Prodes then appeared and testified at a hearing held on January 30, 2009. The Administrative Law Judge issued an opinion on March 4, 2009 upholding the denial of benefits. On August 19, 2009, the Appeals Council for the Social Security Administration denied Prodes request for review. The ALJ's determination thus stands as the final determination of the Commissioner. Prodes filed this appeal on October 4, 2009.
Claimant's Testimony Before the ALJ Prodes testified that he was 46 years of age, 5'8" tall, and 198 pounds at the time of the hearing. He had three degrees, including a bachelors degree in philosophy, a masters degree in education, and a masters degree in divinity. He also spoke both English and Greek. Prodes had been living in a one bedroom apartment by himself for the past three years. He had been supported, up to the time of his hearing, by his parents and unemployment benefits. Prodes indicated that he had been receiving unemployment benefits since August of 2007 and those benefits were scheduled to end in April of 2009. He testified that to obtain unemployment benefits he said that he was able to work and made three job contacts per week. Prodes was also receiving Medicaid at the time of the hearing.
Prodes alleged disability since July 17, 2007. Specifically, he alleged disability as a result of diabetes, depression, and bipolar disorder. The testimony relevant to his alleged physical disability included Prodes stating that he had uncontrolled diabetes requiring him to take four shots of insulin and two pills each day. He claimed that diabetic neuropathy in his feet caused constant pain and numbness that brought him to tears and frustrated him. Prodes initially said he could not "stand at all" within the year leading up to his hearing, but later detailed activities that required him to both stand and walk. He stated that a couple of his toe nails had fallen off and he had to take sleeping pills to get to sleep at night because the pain and numbness in his feet kept him up. He further alleged high blood pressure, high cholesterol, and diverticulitis which were all controlled by medication. Additionally, Prodes testified that his hands started to shake in 2003, and had gotten worse within the year leading up to his hearing. As for his mental condition, Prodes stated that the mental impairments cause him to be depressed all the time, very angry, stressed out, lacking in patience to be around anyone or do anything, and requiring medication. The alleged side affects of his medication included constant fatigue, constant diarrhea, dizziness, and blurred vision, however, a change in medication had helped with the diarrhea.
Prodes testified that, over the 15 years prior to his hearing, he worked as a second priest for almost five years; case worker and program supervisor assisting the mentally handicapped with daily tasks such as bathing, shopping, going to doctor's appointments, and cleaning for less than a year an a half with two separate employers; shift manager-in-training at McDonalds for approximately eight months; and temporary employee with various employers for no more than two weeks at a time. Prodes stated that he decided to resign from the ministry after being suspended for having an inappropriate internet conversation with a minor female and that he voluntarily returned from ordained to layman's status. He was divorced around the same time. He also quit working as a program supervisor because he did not get along with his bosses. He quit McDonalds on July 17, 2007, because he was unable to stand as a result of the numbness in his feet. Prodes claimed that the inability to stand prevented him from working the grill and he could not lift the ice tea, which weighed from 25 to 30 pounds. Prodes estimated that his last employment as a temporary worker was some time in August of 2007 which he quit because he could not do it anymore.
At the time of hearing, Prodes woke up between 9:00 a.m. and 10:00 a.m., took a nap from 2:00 p.m. to 5:00 p.m., and went to bed at 10:00 p.m. with sleeping pills. Otherwise, he characterized himself as a loner who stayed his apartment unless checking mail, doing laundry once each month, going to the grocery store once or twice each week, or attending a doctor's appointment once each month. Prodes testified that his mailbox was located 50 feet away from the apartment on the same level and the laundry room was located 100 yards away, but getting to the laundry room caused him to take stairs. He used to do laundry weekly and walk to the facility, but, at the time of the hearing, he was only going monthly and driving his car because his arms and shoulders shook when carrying the basket and walking fatigued him. He went to the grocery store at night to avoid people. He carried his own groceries, but did not purchase gallons of milk because he was unable to lift the container. Prodes spent most of his time watching television, only cooked with the microwave, and used his dishwasher. The pain in his feet caused him to move around, so out of eight hours he could stand for one hour, sit for two hours, and spent the rest lying down. He did, however, have his minor children over once per week for supervised visitation and traveled on an airplane to Pennsylvania to see his parents in June of 2008. According to Prodes, up until six months prior to the hearing he was walking one mile to the library.
Prodes testified that he noticed deterioration in his concentration and focus over the year leading up to his hearing requiring him to write things down and found himself simply staring at the television or out his balcony window at times. He also stated that his pace was very slow and his lack of motivation caused him to put things off. He was able to make his doctor's appointments, but doing so required him to refrain from taking his sleeping pills and to set two alarms.
Medical Evidence Before the ALJ On May 28, 2004, Prodes was admitted to St. Anthony's Medical Center for major depression and pathological gambling. Before being admitted he had not been on any medication for almost a year. He complained of general malaise,*fn1 but walked normally with normal gait and did not complain of pain or numbness. Prodes was diagnosed with major depression that was both recurrent and severe. He was given several medications. On June 3, 2004, he was discharged as mildly depressed and prescribed more medications, including insulin.
On March 3, 2006, Prodes saw Aaron Bjorn, MD. Dr. Bjorn diagnosed Prodes as diabetic and instructed him to make and bring in a blood sugar log for their next appointment. He also diagnosed bipolar disorder and noted what appears to be Prodes' statement that he was psychologically stable when on medication. On March 7, 2006, Prodes reported some foot numbness, but no pain and did not bring his blood sugar log. On May 8, 2006, Dr. Bjorn noted that Prodes blood sugar levels were much better. On July 10, 2006, he noted that Prodes blood sugar levels were better in the morning, but were not being monitored at any other time, and his bipolar disorder was stable. Dr. Bjorn again instructed Prodes to make and bring in a blood sugar log for their next appointment.
On October 25, 2007, Prodes saw Lois Mades, Ph.D. for a consultative
exam. Prodes was not on diabetes medication at the time and reported
that he consumed 68 ounces of soda per day and an occasional tea or
coffee. He stated that he had not seen a psychiatrist in about a year
and complained of severe depression, restlessness, occasional suicidal
thoughts without intent or plan, and compulsive hand washing. Dr.
Mades, however, did not notice red or chapped hands as would likely
have been the case if Prodes had been compulsively washing his hands.
Prodes also noted that he enjoyed napping, watching television,
walking, and visiting with his children. He stated that he got along
adequately with others, but noted decreased socialization and
irritability. Dr. Mades opined that Prodes was cooperative, pleasant,
alert, coherent, logical, sequential, had a normal gait with good eye
contact, and was able to maintain adequate attention and concentration
with appropriate persistence and pace. His mood was found to be mildly
depressed with a slightly restricted and generally appropriate affect.
Dr. Mades diagnosed major depressive disorder with a mild single
episode and assigned a Global Assessment Function of 65.*fn2
She stated that his symptoms were more consistent with major depressive disorder than
bipolar disorder and stated that he would be fair to good with
On October 25, 2007, Prodes also saw Loreta Mendoza, MD for a consultative exam. Prodes reported symptoms and habits similar to those he shared with Dr. Mades. He also shared that he was walking approximately two miles two to three times each week to see his children. Dr. Mendoza's observed a normal gait and an ability to heel walk, but difficulty tiptoeing and an inability to completely squat because of discomfort in his lower extremities. She noted that Prodes was only able to squat about two-thirds of the way. Dr. Mendoza diagnosed uncontrolled diabetes with a blood sugar level above 400 and peripheral neuropathy manifested with numbness and tingling in the bottom of both feet and leg cramping. She further observed numbness on pin pricking in both feet and hypertrophy of the toe nails on the left foot.
On December 12, 2007, Prodes went to South County Health Center where he saw Christine Jones, MD. He reported severe pain and swelling in his feet for the past six years aggravated by any movement and causing difficulty wearing shoes, but stated that he had not been on medication for one year. Dr. Jones found he was alert, cooperative, had a normal gait, and was prescribed diabetes medications.
On January 14, 2008, Prodes reported to Dr. Jones that he had not taken medication for his alleged bipolar disorder, Depakote, for two years and that he did not notice any benefit from the mediation. He stated that he was currently feeling depressed and lacked motivation. Prodes was started on Effexor and Lamictal and given a Global Assessment Function of 50/55.*fn3
On January 23, 2008, at South County Health Center, Prodes saw Heather Barker, M.Ed. and shared that he had been sexually propositioned by a pastor who molested his brother and cousin when Prodes was16 years old. He stated that when he was a teacher, at age 28, he had relationships with girls who were 16 and 17. He also stated that he knew his internet relationship with a 14 year old girl, when he was a pastor, was wrong, but he was unable to control himself. Prodes reported that he was always crying during the day, had a terrible outlook, and only felt happy or had fun when seeing his children.
On January 30, 2008, Prodes told Barker that his marriage ended because his wife did not put him first, siding with his family on certain issues, and because of infertility since he believed children made a positive difference and gave meaning and purpose to life. Prodes concluded that he was healed from seeking out younger women after the situation that ended his pastoral career scared and repulsed him. He notice positive changes from his three weeks on medication in that he had not cried that week and was a lot calmer. Prodes was also very encouraged about being able to work again. Barker suggested a bipolar support group encouraging Prodes to connect with others.
On February 4, 2008, Prodes again visited Dr. Jones at South County Health Center. He was doing ok with a mood that was a "little stable" and thought the medication was helping a bit. He stated that he was feeling slightly anxious because his unemployment benefits would end the following month, but was working with rehabilitation services to find a job. Prodes was sleeping ok and his physical health was better because of regular medication. Dr. Jones also noted a significant history of non-compliance.
On February 6, 2008, Prodes told Barker that he had received his last unemployment check that day, but another doctor was filling out paperwork for vocational rehabilitation so that he could work with them to find a job. The doctor encouraged him to look for part-time employment on his own. Prodes responded that he had done so, but believed his former employers might be giving negative references because he was not mentally well when employed at those companies.
Barker provided a phone number for other support group options because transportation was problematic for the bipolar support group timing.
On March 3, 2008, Prodes again told Dr. Jones he was doing ok with a mood that was a "little stable" and again stated that he thought the medication was helping a bit. He was, however, feeling slightly depressed and bogged down because of the financial difficulties that resulted from his unemployment running out and not working. He again reported that he was working with rehabilitation services to find a job. Prodes was sleeping ok.
On March 5, 2008, Prodres told Barker he was feeling very depressed mostly because he did not have an income outside his parent's assistance and because he could not be with or provide for his children. On March 12, 2008, Prodes told Barker he was talking to someone about switching clinic doctors and discussed his discomfort with his ex-wife's boyfriend. On March 26, 2008, Prodes told Barker he would begin seeing Kyra Cass, MD and discussed ways to approach the role of his ex-wife's boyfriend.
On March 27, 2008, Prodes saw Dr. Cass at South County Health Center. He stated that he did not like his last doctor, had lost control of his bowels, urinated on himself, and believed he was sleep walking because he would wake and find lights on or would have skinned knees without remembering having gotten up. He reported feeling groggy in the morning because of medicines he had been given the month before. Prodres had also thrown up a small amount of blood on the same night he reported having had a bad dream. Dr. Cass concluded that Prodes had irritable bowel syndrome, bipolar disorder, and a lot of stress. She also noted that he had no pain and a full range of motion before prescribing a number of medications. On March 31, 2008, Prodes reported still feeling some depression, so Dr. Cass increased his medication.
On April 9, 2008, Prodes told Barker he would no longer be speaking to his ex-wife, had shame regarding his children, and had received a letter from vocational rehabilitation stating that he could start their program. He was happy about starting the program and had scheduled meetings with a Greek Orthodox pastor for additional counseling related to his family. Barker commended him starting the program and seeking additional counseling.
On April 23, 2008, he told Dr. Cass that he was feeling fatigue throughout the day which his medication was not helping, that he had regained control of his bowels yet still had frequent diarrhea, maintained a blood sugar level of 180-50, was eating not so great food, and was willing to give up soda. He further stated that he was walking two to three miles daily. Dr. Cass noted that Prodes' neuropathy improved with medication, but the medication could have been attributing to his uncontrolled blood sugar.
On April 23, 2008, Prodes told Barker he was frustrated that his services were switching to Medicaid which did not allow him to use the transportation he had been using. He believe he would be charged for services he was not using, but Barker and Prodes called another transportation provider during their session and learned that he would not be charged and would not have to be picked up early. Barker used this as a lesson in corrective behavior as an alternative to jumping to conclusions.
On May 7, 2008, Prodes told Barker it would be his last session because Medicaid did not allow him to be a psychiatry or counseling patient there. His last session was a review of progress and goals with his new psychiatrist.
On May 21, 2008, Prodes came in complaining of fatigue and isomnia, but had to leave and reschedule before seeing Dr. Cass because his ride service had come. On May 27, 2008, Prodes saw Zachary Newland, DPM at South County Health Center. He complained of pain in his feet at night with numbness and tingling during the day. Newland prescribed medication.
On June 11, 2008, Prodes told Dr. Cass that his blood sugar was between 150-180, one of the medications he was taking bothered his stomach, he was going to court that month regarding the custody of his children, and that he walked two miles daily. Dr. Cass prescribed medications.
On July 10, 2008, Prodes was treated at St. Alexius Hospital's emergency room with complaints of bleeding from the rectum and flank pain. Prodes stated that he had felt the pain for two to three days and described it as crampy and intermitten. Prodes was discharged that same date with a diagnosis of acute diverticulitis, prescriptions for medication, ...