United States District Court, E.D. Missouri, Eastern Division
MEMORANDUM AND ORDER
M. BODENHAUSEN UNITED STATES MAGISTRATE JUDGE
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).
3, 2014, plaintiff Barbara Ann Svoboda filed an application
for a period of disability and disability insurance benefits
under Title II, 42 U.S.C. §§ 401 et seq.,
with an alleged onset date of October 18, 2013. (Tr. 291-92).
After plaintiff's application for benefits was denied on
initial consideration (Tr. 235-38), she requested a hearing
from an Administrative Law Judge (ALJ). (Tr. 241-42).
and counsel appeared for a hearing on March 17, 2016. (Tr.
195-226). Plaintiff and her husband testified concerning her
disability, daily activities, functional limitations, and
past work. The ALJ also received testimony from vocational
expert Theresa Wolford, M.S. The ALJ issued a decision
denying plaintiff's application on August 30, 2016. (Tr.
120-29). After receiving additional evidence submitted by
plaintiff, the Appeals Council denied her request for review
on August 16, 2017. (Tr. 106-12). Accordingly, the ALJ's
decision stands as the Deputy Commissioner's final
Evidence Before the ALJ
Disability and Function Reports and Hearing
was born on August 8, 1953, and was 60 years old on the
alleged onset date. (Tr. 300). She lived with her husband in
a condominium. (Tr. 313). She completed high school and
cosmetology school. She worked as a hairstylist for 42 years
until October 2013, when she had surgery to remove a benign
tumor from her right foot. (Tr. 200-01); see also
Cert. Earn. Rec. (Tr. 294-95). Plaintiff listed her
impairments as poor circulation and cellulitis in her right
leg, pain in her right knee, surgery to remove a tumor in
right foot, varicose veins with pooling and swelling, blood
clots, high cholesterol, high blood pressure, and chronic
kidney failure. (Tr. 304). She was prescribed medications for
the treatment of high blood pressure, high cholesterol,
depression, and allergies; she also took low-dose aspirin.
(Tr. 307, 358).
stated in her June 2014 function report (Tr. 313-23) that she
was unable to stand on her foot and right leg and that she
elevated her legs during the day. Her daily activities
included making the bed, unloading the dishwasher, using the
computer, making phone calls, resting or napping, and
watching television. She occasionally prepared dinner and
cleaned the kitchen, but took rest breaks. Her ability to do
housework was limited by fatigue and so her husband did most
of the laundry and a friend cleaned her house, leaving
plaintiff to handle occasional picking up. She stated that
she had difficulty sleeping because her legs “jump[ed]
at night.” (Tr. 314). Her conditions did not impair her
ability to attend to her grooming or personal hygiene and she
was able to drive and go out on her own. Plaintiff was able
to walk for one block before she needed to rest for 10
minutes. She did grocery shopping once a week, spending 30 to
45 minutes on the task. She was capable of managing her
finances and had no impairment in her ability to concentrate
and follow instructions. Her hobbies included watching
television, reading magazines, and talking on the phone. She
used to be able to go shopping, walk in parks, go on weekend
outings, and entertain. She got along well with others but
found it harder to handle stress as she got older. Plaintiff
had difficulties with lifting, squatting, standing, walking,
sitting, and kneeling. The Field Office interviewer described
plaintiff as cooperative and without observable limitations.
testified at the March 2016 hearing that she had a painful
lump removed from between the bones at the top of her right
foot in October 2013. Following the surgery, she was unable
to stand on the foot due to pain and decided that she could
not return to hairdressing. She had pain up to mid-calf and
tenderness in the arch of her foot. (Tr. 203-04). In
addition, she had a long history of osteoarthritis in the
right ankle. She had worked with the pain, using support hose
and resting when she could, but the pain worsened over time.
(Tr. 206). Plaintiff also testified that she had chronic
kidney failure. When she learned that she had this condition,
she gave up drinking soda and stopped taking all pain
medication, including Tylenol. (Tr. 205-06). Finally,
plaintiff had pooling blood and varicose veins in her leg.
She had worn compression stockings when she was working, but
still experienced pain. (Tr. 207, 212). She went to a
vascular doctor in the 1990s but was told that her veins were
too bad for treatment. (Tr. 208-09). She also was susceptible
to cellulitis. (Tr. 209). These conditions had improved once
she stopped working and was able to keep her foot above her
heart, but after 45 minutes of standing, the blood pooled in
her leg again. (Tr. 210-11). At the request of
plaintiff's counsel, the ALJ agreed to order a
consultative examination to address plaintiff's vascular
problems. (Tr. 223).
husband Daniel G. Svoboda testified that he and the plaintiff
had been married for 19 years. (Tr. 218). He testified that,
when she was working, her leg was “beet red and hurting
her like crazy” when she got home. She would spend the
evening with her foot elevated. (Tr. 219). Presently, she
spent about half the day in that position. The ALJ clarified
that Mr. Svoboda worked during the day and so was only able
to observe his wife once he got home. (Tr. 220).
expert Theresa Wolford was asked to testify about the
employment opportunities for a hypothetical person of
plaintiff's age, education, and work experience who was
able to perform light work, who could lift, carry, push, or
pull 20 pounds occasionally and 10 pounds frequently, who
could sit for six hours in an eight-hour day, stand or walk
for six hours in an eight-hour day, who could occasionally
climb ramps and stairs, and could frequently balance, stoop,
kneel, crouch and crawl. (Tr. 222). According to Ms. Wolford,
such an individual would be able to perform plaintiff's
past work as a hairdresser. If the same individual were
limited to sedentary work with all other limitations
remaining the same, that individual would not have any
transferable skills from her past work. (Tr. 222-23).
annual physical in February 2013, primary care physician
Amita Bhalla, M.D., listed plaintiff's chronic conditions
as hyperlipidemia, anxiety, benign hypertension, varicose
veins,  scoliosis, impaired fasting glucose, and a
history of colon polyps. (Tr. 407-12). Her medical history
included surgical repair of a hernia, paroxysmal
supraventricular tachycardia, and kidney disease. (Tr. 409,
387). Dr. Bhalla described plaintiff as having a sedentary
lifestyle. On examination, she had moderately severe
variscosities in both legs without indication of deep vein
thrombosis. Her Body Mass. Index (BMI) was 32.14, placing her
in the obese category. Dr. Bhalla prescribed medication for
treatment of high blood pressure, high cholesterol,
allergies, and anxiety. An EKG showed no abnormal findings.
September 2013, plaintiff consulted Andrew M. Rouse, M.D.,
regarding a lump on the top of her right foot, which was
gradually getting bigger and was painful with shoe pressure
and activity. (Tr. 440-41). She rated the pain at level 8 on
a 10-point scale. An MRI established that plaintiff had a
lipoma, measuring 2.6 cm by 2.7 cm by 9 cm, that abutted
tendons and muscles in the foot. (Tr. 443-44). The MRI also
disclosed subchondral cysts and marrow edema, likely related
to mild osteoarthritis. On October 22, 2013, Dr. Rouse
excised the lipoma. (Tr. 442). Two weeks later, Dr. Rouse
described the incision as healing well and set November 21,
2013, as a tentative return-to-work date. (Tr. 427, 438).
Plaintiff later asked to postpone her return to work, noting
that she had pain in her feet after being up for a short
period of time. (Tr. 429-30). On November 15, 2013, plaintiff
reported that she felt a “pop” in the foot and
had burning over the incision. (Tr. 431). On December 2,
2013, plaintiff reported that her foot kept swelling and was
tender to the touch, and she found it too painful to wear
shoes or compression socks. Dr. Rouse authorized her to
remain off work indefinitely. (Tr. 432).
Bhalla's findings at plaintiff's next annual physical
in March 2014 did not differ significantly from the 2013
findings. (Tr. 384-96). As relevant here, Dr. Bhalla
described plaintiff's varicose veins as asymptomatic and
noted that she had spider veins in both legs, more so on the
right side. On examination, plaintiff had a normal gait,
strength and tone, and her extremities appeared normal
without edema. Her Body Mass. Index (BMI) was 33.13.
Plaintiff continued to take medications for the treatment of
high blood pressure, high cholesterol, allergies, and
anxiety. Dr. Bhalla instructed plaintiff to follow a low
cholesterol diet, avoid simple carbohydrates, and exercise
regularly. (Tr. 385-86).
2014, plaintiff returned to see Dr. Rouse with complaints of
pain in her right foot and ankle, which worsened when she was
on her feet. (Tr. 436-37). She had a lot of trouble going
down steps and was worried she would lose her balance.
Examination revealed tenderness in the dorsal midfoot. After
reviewing x-rays, Dr. Rouse concluded that plaintiff's
symptoms were consistent with early arthritis in the midfoot.
He prescribed a support for her midfoot and instructed her on
modifying her activities and using ice and
2014, Dr. Bhalla noted that plaintiff was compliant with
medications and diet, but was not exercising as prescribed.
She denied experiencing myalgias or leg pain at that time.
(Tr. 451-52). In September 2014, plaintiff continued to be
noncompliant with exercise recommendations. On examination,
she had intact pedal pulses and exhibited no edema. (Tr.
452-53). The same was noted in January 2015. (Tr. 454-55). At
her annual physical in May 2015, however, plaintiff reported