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Tucakovic v. Saul

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

September 18, 2019

ANDREW M. SAUL, [1] Commissioner of Social Security, Defendant.



         This action is before the court for judicial review of the final decision of the defendant Commissioner of Social Security denying the applications of plaintiff Olivera Tucakovic for disability insurance benefits (DIB) and supplemental security income (SSI) benefits under Titles II and XVI of the Act, 42 U.S.C. §§ 401-434, 1381-1385. The parties have consented to the exercise of plenary authority by the undersigned United States Magistrate Judge pursuant to 28 U.S.C. § 636(c). For the reasons set forth below, the final decision of the Commissioner is affirmed.

         I. BACKGROUND

         Plaintiff was born on November 30, 1963, and was 52 years old at the time of her alleged onset date. (Tr. 57.) She filed her application for DIB benefits on November 24, 2015 (Tr. 138-48) and for SSI benefits on January 16, 2016. (Tr. 149-59.) She alleged a June 12, 2015 onset date and alleged disability due to rectal/colon cancer and hemorrhoids. (Tr. 57.) Her application was denied, and she requested a hearing before an Administrative Law Judge (ALJ). (Tr. 73-74.)

         On February 23, 2018, following a hearing, an ALJ issued a decision finding that plaintiff was not disabled under the Act. (Tr. 18-30.) The Appeals Council denied her request for review. (Tr. 1-6.) Thus, the decision of the ALJ stands as the final decision of the Commissioner.


         The following is a summary of plaintiff's medical and other history relevant to her appeal.

         On March 23, 2015, plaintiff underwent a colonoscopy and was subsequently diagnosed with adenocarcinoma with a small polyp nearby that was also cancerous. (Tr. 263, 266.) On June 16, 2015, plaintiff underwent laparoscopic low anterior colon resection at SSM Health DePaul Hospital. (Tr. 663.) She was discharged on June 21, 2015.

         On June 29, 2015, plaintiff was treated in the emergency room for rectal pain from hemorrhoids. She complained of intermittent streaks of blood in her stool with mild abdominal cramping. (Tr. 375.)

         On July 1, 2015, plaintiff was seen for post-operative evaluation. She continued to complain of constipation, severe rectal pain with bleeding, stomach pain, and nausea. Examination revealed a large external prolapsing hemorrhoid. Dr. Morin M. Hanson, a colon and rectal surgeon, recommended an urgent hemorrhoidectomy, surgery to remove hemorrhoids, and referral to oncology for treatment of Stage III anorectal cancer and chemotherapy. (Tr. 317.)

         On July 13, 2015, plaintiff was seen in the emergency room at Barnes-Jewish St. Peter's Hospital for rectal pain, weakness, and syncope or fainting. She had had chronic diarrhea and worsening rectal pain since her surgery. She was nauseated and was having difficulty eating and drinking. (Tr. 287.) She was diagnosed with syncope, abdominal pain, diarrhea, and history of colorectal cancer. She was discharged the same day with Percocet, for pain. (Tr. 297, 305.)

         From July 17 to 23, 2015, plaintiff was hospitalized at DePaul Health Center for nutritional support, hydration, pain control, and sitz baths after being diagnosed with "failure to thrive." (Tr. 318, 21.) On exam she was weak and pale with three nonhealing, swollen, hemorrhoid wounds. She underwent a hemorrhoidectomy. (Tr. 332.)

         By July 28, 2015, plaintiff's appetite had improved and she had no nausea. She was having bowel movements, but they were painful. She continued to report occasional pressure in her rectal area, occasional bleeding, and occasional constipation. (Tr. 323-25.)

         On August 7, 2015, plaintiff began chemotherapy treatments. (Tr. 861.) She reported being constipated for the past four days and was having trouble passing urine. (Tr. 987.)

         On August 9, 2015, her side effects from chemotherapy included appetite change, weight loss, bleeding, weakness, fatigue, night sweats, shortness of breath, constipation, dizziness, and sleep issues. (Tr. 1156-57.) On August 27, 2015, she had complaints of constipation. (Tr. 876.) On September 8, 2015, her doctor noted she felt the same. (Tr. 1180-81.)

         On September 12, 2015, plaintiff received additional chemotherapy. She continued to feel poorly with frequency of stools, pain in the perianal area, and cold intolerance. (Tr. 1178-80.)

         On September 24, 2015, plaintiff reported she had felt great the previous day, although she felt terrible that morning. (Tr. 933.) The next day she reported feeling tired after chemotherapy. She said she needed a laxative to have a bowel movement. She felt pain and swelling in her rectal region and excessive gas and some urgency with bowel movements. (Tr. 326.)

         On October 6, 2015, plaintiff received additional chemotherapy. She experienced weakness, fever and chills, bruising, hot flashes, shortness of breath, constipation, rectal pain, myalgia, dizziness, headaches, sleep issues, and hair loss. (Tr. 689, 1199-1200.)

         On October 8, 2015, plaintiff returned to DePaul Hospital for hydration and disconnection of her chemotherapy pump. She looked unwell and stated that she had had diarrhea the previous night and felt constant pressure in her rectum. (Tr. 707.)

         On October 20, 2015, she reported feeling better but with significant side effects from chemotherapy. She continued to have arthralgias, myalgias, intermittent rectal pain, and small frequent stools. (Tr. 1218.)

         On October 22, 2015, plaintiff felt lightheaded. She returned to DePaul for evaluation of abdominal cramping following her last chemotherapy treatment. She was instructed to drink magnesium citrate, a supplement to treat constipation, and use a Fleet enema. (Tr. 741, 750.)

         Plaintiff underwent additional chemotherapy on November 3, 2015. (Tr. 760.) On November 15, 2015 she reported being weak and slightly nauseous, and that she was experiencing decreased sleep and liquid intake. The next day she returned for hydration after being nauseous the previous night. She stated that her arms and legs felt weak and heavy and that she felt lightheaded upon standing. (Tr. 778, 786.)

         During follow up on November 17, 2015, plaintiff complained of shortness of breath, myalgia, dizziness, sleep issues, and hair loss. (Tr. 1234.) The next day she received additional chemotherapy. (Tr. 799.) On November 20, 2015, she reported mild nausea with no bowel movement for three days. (Tr. 817.)

         At a December 1, 2015, appointment plaintiff reported that she had felt very weak up until Thanksgiving when she ...

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