United States District Court, W.D. Missouri, Western Division
NANETTE K. LAUGHREY, United States District Judge
Jennifer Koenig appeals the Commissioner of Social
Security's final decision denying her application for
disability and disability insurance benefits, and
supplemental security income. The decision is affirmed.
was born in 1985. She alleges she became disabled on April 1,
2010. Her date last insured was June 30, 2013. The
Administrative Law Judge held a hearing on January 1, 2015
and denied her application on January 29, 2015. The Appeals
Council denied her request for review on April 13, 2016.
Koenig's appeal to this Court concerns mental
December 23, 2010, Koenig went to the emergency room, stating
that her boyfriend told her she had had a seizure. Koenig
said she was not taking any medication for seizures but had
in the past. After being examined, Koenig told the nurse she
wanted to leave, so she was discharged.
January 26, 2011, Koenig saw Henry Wisdom, D.O., at North
Central Missouri Mental Health Center. She reported that she
had been diagnosed with bipolar disorder and had issues with
seizures. The doctor prescribed Lamictal and hydroxyzine.
saw Dr. Wisdom again on February 23, 2011 for a supportive
psychotherapy session. Dr. Wisdom noted that he was not
“certain what [Koenig] want[ed]. On the one hand she
said she wants to get her kids back, and on the other hand
she wants to have the medication she was taking prior to
going into a drug and alcohol facility[.]” Tr. 292. The
doctor increased Koenig's medication dosages. He
instructed her to continue therapy, as it seemed to help.
visit on March 23, 2011, Dr. Wisdom noted that Koenig was
“able to concentrate.” Tr. 293. She was well
oriented and taking her medication. Dr. Wisdom also noted
that Koenig was participating in therapy, “with good
April 20, 2011, Koenig saw Dr. Wisdom for another follow-up
appointment. Dr. Wisdom suggested involvement in local and
church activities and vocational rehabilitation.
next saw Dr. Wisdom on May 18, 2011. The doctor did not
change Koenig's medications.
went to the emergency room on June 19, 2012 with an injury to
her left foot. X-rays showed multiple fractures. The next
day, Koenig had surgery.
went to the emergency room on August 15, 2012, reporting a
seizure that had lasted for two minutes. She refused a drug
test, but other tests indicated no cardiac event.
December 7, 2012, Koenig saw Linda Lock at Truman Medical
Center Behavioral Health for a psychological examination and
to begin receiving outpatient services. She reported that she
was required by Grundy County Family court to participate in
mental health services. Koenig said she had stopped taking
her psychotropic medication two years earlier and wanted to
start them again. She said that since stopping them, she had
headaches, anxiety, social anxiety, mood swings, and
depression. Her mental status examination was largely normal,
although Lock noted that Koenig's “attention and
concentration [were] impaired as evidenced by [her] stating
that she cannot even watch TV and do something else at the
same time.” Tr. 357. Her memory was intact. The
therapist recommended Koenig receive individual therapy and
work with employment services.
December 12, 2012, Koenig saw Trena Willich, a community
support specialist, at Truman Medical Center. Koenig said
that she did not have any income and wanted to work. Willich
noted that Koenig was talkative and polite with a bright
had a psychiatric evaluation by Douglas Burgess, M.D., a
staff psychiatrist at Truman Medical Center, on December 18,
2012. Koenig reported that her mood was “up and
down” and that she was irritable and snapped at people
for minor things. Tr. 348. She also stated that her mood was
“alright, ” but then said she had been depressed
for the past 2 to 3 weeks. Id. Koenig stated that
medication had not been effective in the past because she did
not take it consistently, but she was interested in resuming.
Koenig stated that she had used alcohol and drugs in the
past, but had not used alcohol for four months, or drugs
since entering treatment in 2009. Koenig's behavior was
cooperative, she was well oriented, and she displayed intact
memory. Dr. Burgess opined that Koenig's mood lability
was largely due to situational stressors and assessed a GAF
score of 38. He diagnosed bipolar disorder, major depressive
disorder, alcohol dependence under partial remission, and
methamphetamine dependence in remission by report. He
prescribed sertraline and recommended psychotherapy.
January 11, 2013, Koenig was discharged from the outpatient
program, having “completed all of her outpatient
treatment goals.” Tr. 366. The discharge summary noted
that she had a stable transition plan and a stable relapse
April 8, 2013, Koenig saw Jean Tadokoro, M.S.W., L.C.S.W.,
about substance abuse issues and in an effort to regain
custody of her son. On April 10, 2013, Koenig began attending
group therapy related to addiction recovery skills. Therapy
continued several times a week through early June of 2013,
when Koenig had a positive drug test. Koenig said she would
not comply with her revised treatment plan, so was discharged
from the program.
April 12, 2013, an x-ray of Koenig's left foot showed an
old healed fracture of the left fourth and fifth metatarsal
bones and post-operative changes, but was otherwise
1, 2013, Koenig saw David Whitmer, M.D., at the Truman
Medical Center Emergency Department. She described
experiencing an episode in which she felt nauseated, sweaty,
and like she was going to pass out. A ...