United States District Court, E.D. Missouri, Eastern Division
P. NOCE UNITED STATES MAGISTRATE JUDGE.
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.
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.)
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.
following is a summary of plaintiff's medical and other
history relevant to her appeal.
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.
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.
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.)
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,
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.)
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.)
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.)
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.)
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.
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.
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.)
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.
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.)
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.)
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.)
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.)
December 1, 2015, appointment plaintiff reported that she had
felt very weak up until Thanksgiving when she ...