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Quarles v. Berryhill

United States District Court, E.D. Missouri, Eastern Division

January 9, 2018

ROCHELLE LASHAY QUARLES, Plaintiff,
v.
NANCY A. BERRYHILL, [1] Acting Commissioner of Social Security, Defendant.

          MEMORANDUM AND ORDER

          JOHN M. BODENHAUSEN UNITED STATES MAGISTRATE JUDGE

         This matter is before the Court for review of an adverse ruling by the Social Security Administration. The parties have consented to the jurisdiction of the undersigned United States Magistrate Judge pursuant to 28 U.S.C. § 636(c).

         I. Procedural History

         In January 2014, plaintiff Rochelle Lashay Quarles filed an application for supplemental security income, Title XVI, 42 U.S.C. §§ 1381 et seq., with an alleged onset date of August 28, 2013.[2] (Tr. 138-46). After plaintiff's application for benefits was denied on initial consideration (Tr. 84-88), she requested a hearing from an Administrative Law Judge (ALJ). (Tr. 91-93).

         Plaintiff and counsel appeared for a hearing on September 15, 2014. (Tr. 26-69). Plaintiff testified concerning her disability, daily activities, functional limitations, and past work. The ALJ also received testimony from vocational expert Delores Gonzalez, M. Ed. The ALJ issued a decision denying plaintiff's applications on November 4, 2015. (Tr. 9-25). The Appeals Council denied plaintiff's request for review on October 20, 2016. (Tr. 1-3). Accordingly, the ALJ's decision stands as the Commissioner's final decision.

         II. Evidence Before the ALJ

         A. Application Documents, Education Records, and Hearing Testimony

         Plaintiff was born on November 30, 1990, and was 22 years old when she filed her application. She received special education services as a student and graduated from high school in May 2010. (Tr. 176). According to IEP documents prepared in December 2009, (Tr. 168-93), plaintiff was diagnosed with emotional disturbance (somatization and poor interpersonal relationships); specific learning disabilities (written expression, math calculation, and math reasoning); and language impairment (semantics and pragmatics). Her medical diagnoses were Cluster B personality traits, panic disorder, depression, and agoraphobia. (Tr. 169). She was placed in regular education classes at least 80 percent of the time. (Tr. 173). According to a “re-evaluation” completed on December 1, 2008, plaintiff's cognitive abilities were in the borderline range, with a Verbal IQ of 69, a Performance IQ of 80, and a Full Scale IQ of 72. (Tr. 170). In addition to academic problems related to her learning diagnoses, plaintiff had poor self-confidence and self-image, had difficulties developing and maintaining peer relationships, manifested anxiety as physical symptoms, and struggled to maintain self-control when angry or upset. (Tr. 169). Although plaintiff's goal was to attend a two-year college, the IEP team identified a number of barriers, including difficulty completing required coursework at a passing level, maintaining self-control when frustrated, and difficulty working with peers. Id. It was the opinion of the team that she was best suited for a career in the service industry. (Tr. 170).

         Plaintiff attended St. Louis Community College between fall 2010 and spring 2014, with a one-year break after the 2012 spring semester. (Tr. 263). She received accommodations in spelling and math, and was given preferential seating, a volunteer note-taker, audio recordings of lectures, and extended time to take her exams in a reduced distraction environment. During her first semester, plaintiff earned B grades in four courses and withdrew from a pre-algebra course. (Tr. 264). Thereafter, her academic performance was quite variable. She withdrew from all her classes in the 2012 spring semester. In the next two semesters, she failed or withdrew from four courses, but she also received an A (Art Appreciation), one B (Stress Management), and two Cs (College Composition II and General Psychology). She failed or withdrew from all her classes in spring 2014. Id. She testified at the hearing that she was not allowed to re-enroll based on her academic performance and failure to complete a financial aid application. (Tr. 48).

         According to a Work History Report plaintiff completed, she was a day care assistant from 2008 through 2009 and a campus worker from 2010 through 2011. (Tr. 216). Plaintiff had a part-time job at Wal-Mart as a stocker from October 2014 through March 2015 until she was terminated for excessive tardiness and absences. She testified that she was frequently late to her shift because relied on public transportation to get to work. (Tr. 51, 266). She also testified that the work was difficult because she had to lift heavy items and meet quotas. She had a part-time job at a Dairy Queen for two months in 2015, but was unable to make change or manage credit cards. She found the job very stressful. (Tr. 49-50). Her employer submitted a letter stating that plaintiff had a hard time focusing and made numerous errors in filling customers' orders. She also had “an attack of nerves” that left her unable to function for 30 minutes. (Tr. 267).

         According to Function Reports completed by plaintiff and her mother (Tr. 208-15, 228-38), plaintiff spent her days attending to personal hygiene, watching television, and talking to family members. She attended church with her mother. She was able to microwave prepared foods. She was responsible for making her bed, taking out the trash, and washing dishes. She went shopping with her mother and was able to go out alone on occasion. She was unable to count change, pay bills, or manage bank accounts. She sometimes had problems getting along with others because, she stated, she “tend[ed] to get angry when told what to do” and “was diagnosed with emotional disturbance based on inappropriate peer interactions and [her] symptoms back in elementary, middle and high school.” (Tr. 233).

         When plaintiff submitted her application in January 2014, she lived with her mother and two siblings in an apartment. (Tr. 140, 208, 228). In September 2015, plaintiff told the ALJ that her mother's landlord required her to move because there were too many people living in the apartment. (Tr. 40-41).[3] She was temporarily living in a house owned by her boyfriend's mother, but that house was for sale.[4] (Tr. 36-39). She spent her days journaling and watching television. (Tr. 38). She earned money walking dogs, mowing lawns, and babysitting. (Tr. 39-40). Plaintiff did not have a driver's license. She testified that she passed the written portion and obtained her permit but failed the driving portion because she could not parallel park. (Tr. 41).

         Plaintiff listed her impairments as depression, learning disability, anxiety and panic attacks, and chronic irritable bowel syndrome. (Tr. 199). She had difficulties remembering, understanding, concentrating, following instructions, completing tasks, and getting along with others. Her mother stated that plaintiff had a short attention span and needed help staying focused. The Field Office interviewer observed no limitations during a brief telephone interview and described plaintiff as cooperative. (Tr. 196). At the hearing, plaintiff testified that she was unable to work fulltime because she was “too nervous, ” “a complete failure, ” and every other day experienced panic attacks that lasted 30 minutes to an hour.[5] (Tr. 43, 53).

         Plaintiff received medical management from psychiatrist Daniel Mamah, M.D., and case management from Krista Cooperman. Plaintiff testified that Ms. Cooperman took her to medical appointments and encouraged her to take her medications as prescribed. Plaintiff took Prozac once a day before bed, and Aleve and Miralax as needed. (Tr. 54-55).

         Vocational expert Delores E. Gonzalez, M. Ed., was asked to testify about the employment opportunities for a hypothetical person of plaintiff's age, who received special education services, graduated from high school, was able to get some good grades in college, and had no physical limitations, but who was limited to routine, repetitive, noncomplex tasks, not to exceed specific vocational preparation (SVP) level two. Ms. Gonzalez was also asked to assume that the individual was limited to no more than occasional decision-making, occasional changes in the work setting, occasional to no direct contact with the public, and occasional interaction with co-workers and supervisors. (Tr. 63). Ms. Gonzalez testified that such an individual would be able to perform work as a cleaner II (described as medium unskilled work, with an SVP of 1), a silver wrapper (light, unskilled, with an SVP of 1), or a housekeeping cleaner (light, unskilled, with an SVP of 2). (Tr. 63-64). These jobs would be available if the individual were also limited to casual and infrequent interactions with co-workers and no tandem tasks, with end-of-workday production quotas only. An individual who was absent from work two or more days a month or who was off task ten percent of the time would be unable to perform any work in the national economy. (Tr. 67-68). Similarly, a person who required redirection after 30 days on the job would be subject to termination.

         B. Medical Evidence[6]

         Plaintiff began treatment with the BJC BH Community Mental Health Center in 2007. (Tr. 301). According to documents completed in 2012, plaintiff had severe anxiety problems, symptoms of panic disorder, and somatoform disorder. (Tr. 299). She had begun managing her anxiety and panic attacks on her own with fewer requests for outside intervention from her mother, counselor, or doctors, and her symptoms continued to improve. Id. She was hoping to find a place to live with her boyfriend when he was released from incarceration. In the meantime, she was concerned with the custody arrangements for his son. She had two criminal charges in 2011 for interfering with a police officer and having alcohol in the presence of minors. In 2012, she was expelled from Meramec Community College for her participation in a fight. She was allowed to enroll at Forest Park Community College for the winter semester, with the condition that she meet with a counselor on campus.

         Plaintiff began treatment at Midwest Psychiatry on September 14, 2012, for chronic management of mood and anxiety symptoms. (Tr. 326-27). On examination, psychiatrist Daniel Mamah found that plaintiff was oriented, well-dressed and groomed, and had logical, sequential speech. She did not report symptoms of psychosis. She had no disruption in sleep and her appetite was fair. Her intellect was normal and her sensorium was clear. She had restricted affect and fair insight and judgment. Dr. Mamah diagnosed plaintiff with panic disorder with agoraphobia and mood disorder, not otherwise specified, and assigned a Global Assessment of Functioning (GAF) score of 60.[7] He noted that plaintiff's anxiety symptoms involved both attacks and generalized components and that her history of episodes appeared consistent with major depressive episodes but her irritability and behaviors were atypical. She did not present any apparent risk to herself or others and was “fairly well functioning.” Plaintiff was previously prescribed the antidepressants Remeron, Zoloft, Prozac, and Risperdal, and the stimulants Concerta and Ritalin, and was presently taking Celexa. (Tr. 326, 297). Dr. Mamah ordered blood tests to rule out hypothyroidism and increased plaintiff's dose of Celexa. On October 12, 2012, plaintiff reported that she had headaches and chest pains on the increased dose of Celexa and Dr. Mameh prescribed Zoloft instead. Despite the persistence of panic and anxiety symptoms, plaintiff's mood was largely stable and her mental status examination was unremarkable. (Tr. 325). Two weeks later, plaintiff reported that she felt good and had not had any panic attacks, even though she had stopped taking the Zoloft because the pills got wet. Dr. Mamah advised her to resume taking Zoloft. (Tr. 324).

         When plaintiff returned to Midwest Psychiatry in January 2013, she was feeling stressed because her boyfriend had been arrested and she was trying to raise money for his legal fees. (Tr. 323). She had again stopped taking Zoloft, this time because she was taking cold medicine. Nonetheless, there were no reports of panic attacks and her mental status examination was again unremarkable. During a medical visit in March 2013, plaintiff reported improvement in her mental health with Zoloft. (Tr. 288). In April 2013, Laura Romer, APRN, of Midwest Psychiatry, noted that plaintiff was experiencing a lot of drama and continued to be inconsistent in taking her medication. (Tr. 322). Plaintiff reported that she had poor focus and low motivation, leading to a poor grade in one of her classes. She also had some issues with motivation and anger. On examination, her mood was up and down and her insight and judgment were poor. She was assigned a GAF of 50. In May 2013, plaintiff was “generally doing well.” (Tr. 316-21). She had no significant depressive symptoms. Although she had some irritability and mild anxieties, “the latter symptoms appear[ed] to be in remission.” (Tr. 319). Dr. Mamah recommended counseling for anger and behavior management, but plaintiff refused. Id. She was taking her medication as prescribed. Plaintiff presented with essentially normal mental status, with appropriate and well-modulated affect. Her GAF was 65.[8] (Tr. 320). In August 2013, plaintiff reported that she was doing well and had no major mood or anxiety symptoms or significant stressors. She was planning to go to school in the fall. (Tr. 334-39). Her condition was stable and her GAF was 70. Her clinical presentation was similar in November 2013. (Tr. 340-45). She reported that she had done well on her midterms. Dr. Mamah again recommended individual counseling to help her cope with general stressors. (Tr. 343). Her GAF remained at 70. (Tr. 344).

         Dr. Manah saw plaintiff five times in 2014. In February, he noted that plaintiff was more irritable and was snapping at people. She was also more depressed with occasional sleep interruption. (Tr. 471-73). She did not identify any increased stressors and school was still going well. She was taking her medications. Although her mental status examination was unremarkable, Dr. Mamah assessed that her condition had worsened and started her on Lamictal.[9] Her GAF was 55. (Tr. 472). In May, plaintiff reported that she was doing fairly well and had not had any significant mood swings since starting the Lamictal. (Tr. 474-77). She had left school after failing some classes and was working fulltime at McDonald's. On examination, she had normal speech and coherent thought processes, her insight and judgment were good, and she was oriented. Her memory was intact, her attention and concentration were normal, and she displayed an average vocabulary. Her mood was “ok” and her affect was euthymic. (Tr. 479). Her GAF was 70 and Dr. Mamah assessed that she was “doing relatively well.” (Tr. 476). In August 2014 (Tr. 478-81), plaintiff was still “doing relatively well.” (Tr. 478). Work at McDonald's was stressful, she said, and she had had one panic attack since her last visit. On examination, her mental status remained unremarkable. Her GAF was 70 and Dr. Mamah found that she had “no major symptoms.” (Tr. 480). Plaintiff reported in October 2014 that she was working overnight shifts and looking for other work. (Tr. 482-85). She could not recall having any panic attacks, although she had one episode of feeling faint. She reported having some mood swings, which she described as not severe. Her mental status examination was unremarkable. Dr. Mamah increased the dosage of plaintiff's Lamictal. (Tr. 484). In December 2014, plaintiff reported that she had quit McDonald's and was working at Wal-Mart. (Tr. 487-89). She had some mood swings, but they did not last long. It was noted that plaintiff was “social but complained of up and down moods” and had not been taking her medication as instructed. (Tr. 489). She was encouraged to begin walking to improve her moods. Her Lamictal dosage was increased. Her mental status examination was unremarkable.

         Dr. Manah saw plaintiff on four occasions in 2015. In February, she reported that she thought she would be fired from Wal-Mart for missing work, which she attributed to stress or being too cold. (Tr. 492-94). She stated she felt some generalized stress and depression and was not sleeping well. She had stopped taking the Lamictal, which she thought made her moody. (Tr. 492). Her mental status evaluation was unremarkable and Dr. Manah assessed her condition as stable. (Tr. 494). He prescribed trazadone to help with sleep and again recommended counseling to her. Id. In March, plaintiff reported that she was no longer working and she was worried about finding another job. (Tr. 497-99). She had daily periods of depression. She wanted a medication “that makes [her] happy” and asked for Xanax, which a friend had given her. (Tr. 497). Her sleep had improved after taking trazadone a single time and she had started counseling. Other than an anxious mood, her mental status examination was unremarkable. (Tr. 498). Dr. Manah noted that her ability to manage daily stressors was poor and decided to switch her antidepressant from Zoloft to Prozac. (Tr. 499). In April, she reported that she was “doing much better with current medication regimen.” She had no significant mood symptoms. (Tr. 502). She would begin a job at Schnucks in the ...


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