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Kogan v. Colvin

United States District Court, W.D. Missouri, Central Division

October 11, 2016

AMY KOGAN, Plaintiff,
CAROLYN W. COLVIN, Acting Commissioner of Social Security, Defendant.


          Nanette K. Laughrey United States District Judge

         Plaintiff Amy Kogan appeals the Commissioner of Social Security's final decision denying her application for disability insurance benefits and supplemental security income. The decision is reversed and the case remanded for award of benefits.

         I. Background

         Kogan was born in 1971, is a high school graduate, and took one year of college. She has most recently worked as a part-time floral worker and part-time relief cook, and farther in the past worked as a telephone operator and a hotel security guard. Kogan alleges she became disabled beginning on June 30, 2011 due to medical and psychiatric conditions. In this appeal, she focuses on her psychiatric conditions.

         A. Medical history

         Kogan began seeing Nancy Pope, a licensed professional counselor, at Pathways Community Behavioral Healthcare in May 2011. Kogan described her sleep as very poor, with nightmares and frequent awakenings. She reported poor appetite, anhedonia, lethargy, poor concentration, frequent crying, and suicidal ideation. Pope noted there was no evidence of psychotic features, but that the sleep problems might indicate a mood disorder.

         Kogan saw Pope again on May 25, 2011. Pope noted Kogan's flat affect and monotone speech, and provided grief counseling in connection with Kogan's loss of her grandmother. Kogan followed up with her primary care physician, Dr. Neill, the same day. The doctor diagnosed depression and prescribed Paroxetine and instructed Kogan to continue seeing her therapist at Pathways.

         At the request of Dr. Neill, Kogan saw Steven Adelman, Psy.D., in June 2011 for a psychological assessment. Kogan reported her history of anxiety and grief, cluster headaches, and sleep disturbances. Dr. Adelman noted Kogan appeared moderately depressed and seemed to be suffering from sleep deprivation. His assessment included adjustment disorder and cluster headaches, and he wanted to rule out a sleep disorder. He opined that Kogan might have problems dealing with detailed instructions or withstanding the normal stress of the workplace.

         Kogan followed up with Dr. Neill in July 2011 for her depression symptoms. She reported that her depressed mood had improved a little and that the continued therapy sessions had been helpful. She still had sleep difficulties, anhedonia, low appetite, poor focus, and migraines. The doctor diagnosed depression, migraine, and insomnia, and prescribed Topomax and Trazadone, in addition to continuing her other medications. At a visit in August 2011, Dr. Neill continued the Topomax, to help with headaches and possibly stabilize Kogan's mood.

         She continued to see Nancy Pope for individual therapy sessions throughout 2011. In July, Pope observed flat affect and frequent crying throughout the session. In August, Kogan reported feeling happier, but in September, reported feelings of low self-esteem and worthlessness. In September, they reviewed coping strategies, and in early October, Pope noted Kogan's depression was continuing toward stability. But in later October, Kogan reported a renewal of depression in connection with looking for work. In November, Pope observed increased symptoms of depression. At a December 1 visit, Kogan reported feeling very sad and hopeless, and expressed a death wish but no plan for self-harm At a December 10 visit, Pope characterized Kogan's depression as significant and gave her information about crisis hotlines.

         Kogan continued to see Pope throughout 2012. Kogan reported suicidal ideation in January. She reported improvement in her depression in early February, but that she also had poor sleep and suicidal ideation. On February 20, Pope noted Kogan appeared distressed, was stuttering and losing words, and that her judgment and insight were questionable. Kogan said she had not slept for three nights and disclosed that she had been hurting herself by cutting. They discussed the possibility of hospitalization, but Kogan did not want to pursue that option out of fear of alienating family members. On February 27, Pope noted Kogan was "acutely depressed." Tr. 583.

         On March 2, 2012, Kogan saw Dr. Judith Grimmond at Pathways to discuss medication. Kogan reported continued cutting and that she wished she was dead. The doctor's assessment was major depressive disorder and anxiety disorder, with a GAF of 55. She prescribed medication for anxiety and sleeplessness, and advised that Kogan continue therapy.

         On March 5, 2012, Kogan appeared at Pope's office with fresh cuts on her arms, and reporting continuing depression and feelings of numbness and indifference. On March 12, in addition to insomnia, she reported an apparition or dream of a deceased male friend. A few days later at a visit with Dr. Grimmond, she reported that she thought she saw people when she experienced significant sleep deprivation. On March 30, she told Dr. Grimmond that her thoughts were clearer, but she continued to have nightmares, visions, and "wild dreams." Tr.

         548. Pope described Kogan's mood as dysphoric on April 24, and lethargic on May 7. At a visit with Dr. Neill on May 7, the doctor diagnosed depression and insomnia, among other things. At a May 29 visit, Pope noted Kogan displayed significant depression and fresh cuts, and noted her symptoms were "quite unremitting." Tr. 617. In July, Pope noted Kogan had psychomotor retardation, racing thoughts, restless sleep, numbness, and anhedonia.

         Dr. Grimmond transferred Kogan's psychiatric care to psychiatrist Satnam Mahal, M.D. In July 2012, Dr. Mahal observed that Kogan had continuing depression, low energy, poor motivation, difficulty focusing on tasks, and visual hallucinations. He noted that Kogan was "easily distractible and had to have questions repeated to her several times[.]" Tr. 585.He diagnosed major depressive disorder-recurrent with psychotic features, migraines, and obesity, and assigned a GAF score of 50. He instructed Kogan to continue attending individual therapy and taking Paxil, Abilify, and Trazadone. At an August visit, Dr. Mahal noted Kogan's affect was somewhat blunted; she reported different voices telling her negative things.

         At a July 30, 2012 session with Pope, Kogan reported suffering a great deal of stress. She told Pope that in stressful conditions, she had visual hallucinations that she called "gravelings, " which she characterized as neither kind nor malevolent. Tr. 527. At a session with Pope on August 20, Kogan said the gravelings and dark shadows were still present, but had become quieter. Pope noted that Kogan still exhibited psychomotor retardation and questionable insight. At an August 27 session with Pope, Kogan reported waking, seeing her deceased grandmother on her bed, and discovering that the vision was an "evil substitute." Tr. 614. Pope noted Kogan had been suffering from auditory and visual ...

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