United States District Court, E.D. Missouri, Eastern Division
MEMORANDUM AND ORDER
THOMAS C. MUMMERT, III, Magistrate Judge.
This action under 42 U.S.C. § 405(g) for judicial review of the final decision of Carolyn W. Colvin, the Acting Commissioner of Social Security (Commissioner), denying the application of Pamela Price (Plaintiff) for disability insurance benefits (DIB) under Title II of the Social Security Act (the Act), 42 U.S.C. § 401-433, is before the undersigned by written consent of the parties. See 28 U.S.C § 636(c).
Plaintiff applied for DIB in October 2011, alleging she was disabled as of October 22, 2010, because of arthritis, blood clots, and knee problems. (R. at 95-98, 125.) Her application was denied initially and after a March 2013 hearing before Administrative Law Judge (ALJ) James K. Steitz. (Id. at 6-18, 22-36, 45-50) The Appeals Council denied Plaintiff's request for review, effectively adopting the ALJ's decision as the final decision of the Commissioner. (Id. at 1-3.)
Testimony Before the ALJ
Plaintiff, represented by counsel, was the only witness to testify at the administrative hearing.
Plaintiff was forty-eight years old at the time of the hearing. (Id. at 24.) She is 5 feet 6 inches tall and weighs approximately 240 pounds. (Id. at 26.) She graduated from high school, and was in special education classes for math, spelling, and reading. (Id. at 24-25.) She still has problems pronouncing certain words. (Id. at 25.) She does not have any difficulties reading or doing arithmetic, with the exception of division problems. (Id.)
Asked why she is no longer able to work full-time, Plaintiff explained that she is in constant pain. (Id. at 26.) The pain is worse in her knees, the left more than the right. (Id.) She has had problems with her knees since 2004. (Id.) She has had three surgeries each on both knees, and has to have another left knee replacement. (Id. at 27.) Her knee pain limits her ability to do housework. (Id.) She cannot stand in one place for longer than fifteen minutes before having to sit down. (Id. at 27-28.) She cannot walk for longer than twenty minutes. (Id. at 28.) She cannot squat. (Id.) If she drops something, she has to leave it where it fell. (Id.) Sometimes, her knees give out on her when she is walking around and she falls. (Id.) This happened a couple of weeks earlier. (Id.)
Plaintiff lives in a one-story house with a basement. (Id. at 29.) She cannot go up and down the stairs to the basement. (Id.)
To relieve her knee pain, Plaintiff takes medication and lies down two to three times a day for two to three hours. (Id.)
In addition to knee pain, Plaintiff has pain in her lower back. (Id.) This pain has existed "[f]or quite some years, " but has become "[r]eally bad" in the last two or three years. (Id. at 29-30.) The pain limits her bending, standing, and sitting. (Id. at 30.) The longest she can sit is twenty minutes before having to stand up and stretch. (Id.)
Plaintiff takes medication for deep vein thrombosis (DVT) in her legs. (Id.) She has done so since 2007. (Id. at 31.) And, she has asthma that causes her to be short of breath if she walks too far or tries to do something around the house, e.g., washing dishes or making up the bed. (Id.) Her husband does most of the cleaning around the house. (Id.) If he uses chemicals, she has to go into another room. (Id.) When they go grocery shopping, her husband puts things in the basket and she rides in the cart. (Id. at 32.) She has only driven twice since her knee surgery. (Id.)
Her medications cause side effects of drowsiness and dizziness. (Id.) She has complained of these to her doctor, but he has not changed anything. (Id.)
Asked about hobbies that she used to enjoy but no longer does, Plaintiff testified that she can no longer enjoy dancing or playing baseball and kick-ball. (Id. at 33.) She cannot pick up her three-year old step-granddaughter. (Id.)
Plaintiff also testified that she worked for the Army for twenty-seven years, but the job moved to Kentucky in 2010. (Id. at 34.) She was given a chance to move with the job. (Id.) Asked if she thought about applying for federal disability, Plaintiff replied that she had but the job had then moved out of town. (Id. at 34-35.)
Medical and Other Records Before the ALJ
The documentary record before the ALJ included forms completed as part of the application process, documents generated pursuant to Plaintiff's application, school records, records from health care providers, and assessments of her physical restrictions.
When applying for DIB, Plaintiff completed a Disability Report, disclosing that she stopped working on October 22, 2010, because of her condition. (Id. at 125.) She was 5 feet 9 inches tall and weighed 260 pounds. (Id.) She had completed the twelfth grade, and had not been in special education classes. (Id. at 125-26.) From October 1983 to October 2010, she worked as a personnel technician for the government. (Id. at 126.) She did not otherwise describe the job. (Id. at 127.) On a Work History Report, she described the job as working on computers, answering telephones, making copies, typing, and other miscellaneous duties. (Id. at 159.) During the day, she walked for three hours, stood for two, sat for three, and stooped for one. (Id.) The heaviest weight she lifted was ten pounds; the weight she frequently lifted was less than ten pounds. (Id.)
Plaintiff also completed a Function Report. (Id. at 145-50.) Asked to describe what she does during the day from when she wakes up until she goes to bed, Plaintiff reported that she eats breakfast, watches television, prepares dinner around four o'clock, eats, watches television until bedtime, takes a shower, and goes to bed. (Id. at 145.) Her husband feeds their dog. (Id. at 146.) Her impairments prevent her from sleeping well. (Id.) She is slower when dressing and bathing. (Id.) She needs reminders to take medication. (Id. at 147.) She prepares simple meals, e.g., sandwiches and frozen dinners. (Id.) The only household chore she does is dusting. (Id.) This takes about an hour once a week. (Id.) Her hobbies include watching television and going to church. (Id. at 149.) Her impairments adversely affect her abilities to lift, squat, bend, stand, reach, walk, sit, kneel, climb stairs, and complete tasks. (Id. at 150.) She cannot not walk farther than one-quarter mile before having to stop and rest for several minutes. (Id.) As long as she is not in pain, she can pay attention indefinitely. (Id.) She can follow written and spoken instructions well. (Id.) She gets along well with authority figures. (Id. at 151.) She can handle changes in routine, but not stress. (Id.) She uses a cane and wears glasses. (Id.)
When interviewed when applying for DIB, it was noted that Plaintiff was polite and helpful during the 90-minute interview, had appropriate appearance and grooming, and had problems standing up from the chair. (Id. at 122.) The interviewer also remarked that "no degree of limitation noted." (Id.)
Plaintiff's records from the Special School District of St. Louis County list a May 1981 verbal intelligence quotient (IQ) score of 64 on the Wechsler Intelligence Scale for Children - Revised (WISC-R), a performance IQ of 87, and a full scale IQ of 73, placing her within the borderline range of intelligence. (Id. at 182, 183.) It was noted that she could "attend to a specific task for a 30 minute period." (Id. at 183.) At sixteen, she was functioning at a 2.7 grade level in written expression and spelling, a 4.3 level in mathematics, and a 3.4 level in reading. (Id. at 185.) She was diagnosed as mentally retarded. (Id.)
The relevant medical records before the ALJ are summarized below in chronological order.
On January 6, 2009, Plaintiff complained to Timothy Jennings, D.O., of right calf pain for the past two days. (Id. at 282.) Tests revealed DVT. (Id.) Plaintiff elected to be treated as an outpatient and was started on a blood thinner, Coumadin. (Id.) She was also prescribed Vicodin for pain. (Id.) Six days later, her right leg was still a little tender to palpation, but the right calf was of the same diameter as the left. (Id. at 281.) She was continued on the Coumadin. (Id.)
Plaintiff saw Dr. Jennings on January 28 about a persistent cough and was diagnosed with an upper respiratory infection. (Id. at 280.)
In March, Plaintiff consulted an orthopedist, Lyndon B. Gross, M.D., Ph.D., about the pain caused by her right knee chondromalacia (damage to the cartilage under the kneecap). (Id. at 357-58.) She was described as "failing nonoperative management." (Id. at 357.) Surgical intervention was discussed with the goal of lessening her pain. (Id. at 358.) It was anticipated that surgery would not halt the degeneration of her knee. (Id.)
After Dr. Gross again examined Plaintiff on April 30, the recommendation of surgery was renewed. (Id. at 354-56.) Surgery - a right knee arthroscopy; chondroplasty medial femoral condyle, lateral tibial plateau, patella, trochlear groove; limited synovectomy - was performed on May 13. (Id. at 351-53.) Plaintiff's post-operative diagnoses were right knee grade III chondromalacia medial femoral condyle, grade III chondromalacia lateral tibial plateau, grade II chondromalacia patella, and grade III chondromalacia trochlear groove. (Id. at 351.)
When seen by Dr. Gross on May 26, Plaintiff had some swelling of her right knee, but had a range of motion from 0 to 90 degrees. (Id. at 350.) She had normal sensation and normal motor function in the femoral, tibial, and peroneal nerve distribution. (Id.) She was started on a nonsteroidal anti-inflammatory drug (NSAID) and was to aggressively work on regaining a full range of motion and strength in her knee. (Id.)
Plaintiff reported to Dr. Gross on June 23 that she thought her right knee was improving, but she was still having some pain in both knees. (Id. at 349.) The range of motion in her right knee had increased to being from 0 to 120 degrees. (Id.) On examination, she had some tenderness to palpation over the medial aspect of the knee. (Id.) Dr. Gross advised her to continue taking an NSAID and to do a strengthening program. (Id.)
Plaintiff saw Dr. Jennings in July about her elevated blood pressure. (Id. at 278.) Her dosage of Bystolic, a beta blocker used to treat hypertension, was increased. (Id.)
On August 3, she consulted Dr. Jennings about pressure in her right ear and muffled hearing. (Id. at 277.) Dr. Jennings noted that Plaintiff had not consulted the orthopedist, Dr. Farley, she had been referred to at the last visit. (Id.)
The next day, Plaintiff returned to Dr. Gross, reporting that her right knee was doing well but her left knee felt somewhat painful and as if it was going to give way. (Id. at 347-48.) She had a range of motion in each knee from 0 to 120 degrees. (Id. at 347.) She also had some tenderness to palpation over the left knee but not the right knee. (Id.) Dr. Gross discussed with her the degeneration in her left knee and that it would not be unreasonable to try physical therapy to try to strengthen the muscles. (Id.) Other measures, including a corticosteroid injection or knee arthroplasty, were discussed. (Id. at 347-49.)
Also on August 4, Plaintiff was seen by Mitchell B. Rotman, M.D., another orthopedist in Dr. Gross' practice, for evaluation of a ganglion in her right wrist. (Id. at 346.) The ganglion was aspirated and imploded. (Id.)
In September, Plaintiff had a neoplasm, or tumor, consistent with a ganglion cyst excised from her right wrist. (Id. at 287-92.)
In December, she saw Dr. Jennings for an upper respiratory infection and was prescribed an ...