United States District Court, W.D. Missouri, Western Division
For Steven Brown, Plaintiff: Kathleen Overton, LEAD ATTORNEY, Parmele Law Firm, Springfield, MO.
For Carolyn W. Colvin, Acting Commissioner of SSA, Defendant: OGCSSAR7, LEAD ATTORNEY, Office of General Counsel-SSA Region 7, Kansas City, MO; Jerry L. Short, LEAD ATTORNEY, United States Attorney's Office-KCMO, Kansas City, MO.
NANETTE K. LAUGHREY, United States District Judge.
Plaintiff Steven Brown seeks review of the Administrative Law Judge's (ALJ) decision denying his application for disability insurance and supplemental security income benefits under Titles II and XVI of the Social Security Act. [Doc. 7]. For the reasons set forth below, the ALJ's decision is reversed, and the case is remanded for further consideration.
Brown alleged an onset date of February 1, 2010, from the combined effects of irritable bowel syndrome (IBS) with chronic diarrhea, degenerative joint disease, bilateral knee pain, a baker cyst on his right knee, gastroesophageal reflux disease (GERD), hepatitis, dyskinesia, a reoccurring umbilical hernia, lumbar disk bulge, depression, uncontrolled high blood pressure, hypertensive heart disease, a fractured pubic ramus, astigmatism, obesity, and diabetes. [Tr. 27]. Although his list of impairments is extensive, Brown's primary impairments are IBS, GERD, and a reoccurring umbilical hernia, which will be the focus of the summary of his medical history, below.
Brown has a long history of abdominal pain and digestive-related complications. Brown testified that he has severe, sudden, and frequent loose bowel movements which require him to use the restroom eight to nine times per day for ten to fifteen minutes at a time. [Tr. 34]. Brown frequently loses control of his bowels and if he cannot reach a restroom in time, he has accidents up to three times a day, even while at home. [Tr. 32]. Medical records from March 2009 through January 2013 consistently document complaints of frequent diarrhea and diagnose Brown with confirmed IBS. See e.g., [Tr. 323, 330, 337, 405, 408-9, 429, 457, 464-65, 494, 510, 518, 524, 533, 554 568, 671, 679]. Brown testified that he has had bowel accidents for more than sixteen years, including while he was working. [Tr. 33]. When questioned about how he was able to maintain employment while having frequent accidents, Brown testified that he was frequently fired because he spent considerable time in the restroom or because he had to leave work to change his clothes and shower after an accident. [Tr. 32-34]. Brown's partner also stated in a Third Party Adult Function Report that Brown had frequent bowel movements that had increased in severity over the years. [Tr. 221]. While at his hearing before the ALJ in March 2013, Brown asked to use the restroom, and when he returned, he reported that he had an accident because the restroom was in use. [Tr. 28].
Brown also has a history of abdominal pain associated with GERD and a reoccurring umbilical hernia. See e.g., [Tr. 405, 408, 429, 481, 494, 508, 510, 708]. His hernia was surgically repaired in 2009, [Tr. 35], and again in September 2011, [Tr. 392-94]. A CT scan in December 2012 revealed another hernia. [Tr. 506-7]. In February 2013, Brown's doctor remarked that his hernia was repaired and healing during their last visit, " but now appears to be back. ? Mesh is failing." [Tr. 685]. Brown was scheduled to meet with his surgeon in March 2013. Brown testified that lifting exacerbated the pain caused by his hernia. [Tr. 506-7].
In April 2012, after reviewing some of Brown's medical records, a non-examining state agency consultant, Dr. Denise Trowbridge, M.D., filled out a " Disability Determination Explanation." [TR. 56-66]. Dr. Trowbridge opined that Brown could lift twenty pounds occasionally and ten pounds frequently. He could stand or sit for six hours in an eight-hour day. [Tr. 63]. Dr. Trowbridge observed that Brown's medical history confirms treatment for IBS and GERD, but that there were " no recent notes regarding" IBS. [Tr. 60]. Dr. Trowbridge also acknowledged a history of hernias, but stated that Brown appeared to be fully recovered with no other complications. Id.
After a hearing, the ALJ issued an unfavorable decision, finding at Step 5 of his determination that Brown could perform work that existed in significant numbers in the national economy, including as a cashier, mail clerk, and photocopy machine operator. [Tr. 19]. Brown had the following severe impairments: GERD, diabetes, IBS, hernia, and obesity. [TR-13]. Brown had the Residual Functional Capacity (RFC) to perform light work, including lifting and carrying ten pounds frequently and twenty pounds occasionally, and standing, walking, and sitting six hours in an eight-hour day. [Tr. 15]. He could not climb ladders, ropes or scaffolds. He could only occasionally climb ramps or stairs, stoop, kneel, crouch, crawl, balance, or bend. He could work in a low stress job with only occasional decision-making, changes, and job-related judgment. Id.
In coming to the conclusion that Brown was not disabled, the ALJ gave Dr. Trowbridge's opinion " significant weight" because her " findings and opinions are consistent with the underlying medical evidence." [Tr. 18]. Brown's partner submitted two third-party statements which describe Brown's stomach pain and IBS symptoms. [Tr. 220, 258]. The ALJ gave these reports " little weight" because " the medical evidence . . . does not support this level of headaches nor the fact that claimant can only be in one position for 15-20 minutes." [Tr. 18].
The ALJ also found Brown's testimony as to the intensity and persistence of his symptoms not entirely credible. [Tr. 16]. The ALJ stated that there were certain medical records where Brown did not report diarrhea and that there was an inconsistency between the medical records and Brown's testimony regarding the effectiveness of pain medication. There was also evidence that Brown exercised three to seven times per week to control his diabetes, which was inconsistent with disability. [Tr. 16-17]. The ALJ also remarked ...