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Wheatley v. Colvin

United States District Court, S.D. Florida

May 26, 2017

SUSAN MARIE WHEATLEY, Plaintiff,
v.
CAROLYN W. COLVIN[1], Acting Commissioner of Social Security Administration, Defendant.

          ORDER ON MOTIONS FOR SUMMARY JUDGMENT [DES 17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17, 18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">181]

          WILLIAM MATTHEWMAN, Judge

         THIS CAUSE is before the Court upon Plaintiff, Susan Marie Wheatley's ("Plaintiff) Motion for Summary Judgment and Memorandum of Law in Support Thereof [DE 17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17], and Defendant, Carolyn W. Colvin, Acting Commissioner of Social Security Administration's ("Defendant") Motion for Summary Judgment with Supporting Memorandum of Law and Response to Plaintiffs Motion for Summary Judgment [DE 18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">18]. The parties have consented to magistrate judge jurisdiction. [DE 13]. The issues before the Court are whether the record contains substantial evidence to support the denial of benefits to Plaintiff and whether the correct legal standards have been applied. Lamb v. Bowen, 847 F.2d 698, 701 (11th Cir. 1988).

         I. FACTS

         On February 6, 20');">20');">20');">2013, Plaintiff filed a Title II application for a period of disability and disability insurance benefits, asserting a disability on-set date of June 15, 20');">20');">20');">2012. [R. 17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17].[2] The application was denied initially and upon reconsideration. Id. Following a video hearing on December 3, 20');">20');">20');">2014, the Administrative Law Judge Charles Woode (the "ALJ") issued a decision on May 15, 20');">20');">20');">2015, denying Plaintiffs request for benefits. [R. 14-29]. A request for review was filed with the Appeals Council and denied on May 4, 20');">20');">20');">2016. [R. 1-7].

         A. Hearing Testimony

         The ALJ held a video hearing on December 3, 20');">20');">20');">2014. [R. 30]. Plaintiffs counsel began by stating her theory of the case, which was that Plaintiff has suffered from long-term alcohol abuse and a stroke that occurred in 20');">20');">20');">2009. [R. 34]. According to Plaintiffs counsel, since 20');">20');">20');">2009, Plaintiffs condition has worsened but she has not undergone any therapy for her depression, stroke, or alcohol abuse. Id.

         Plaintiff stated that she was born on February 27, 1957, making her fifty-seven years old at the time of the hearing. [R. 35]. According to Plaintiff, she has a driver's license and drives about three times a week to places that are close to her house, but she stated that she gets anxious driving and does not drive on the interstate. [R. 36]. She attended a "three-year diploma school" and has a degree in nursing. Id. Plaintiff stated that she stopped working sometime in 20');">20');">20');">2011 because her consulting work was starting to become unavailable. [R. 37]. Plaintiff testified that she had been working as a registered nurse until 20');">20');">20');">2006. Id.

         She explained that she cannot work a full-time job now because she had a stroke and had to have a hole in her heart patched, which is why she takes multiple medications, including one that controls her heart rate. [R. 38]. Plaintiff stated that when she wakes up in the morning sometimes her heart rate is 140 and she feels fatigued. Id.

         Plaintiff testified that on a regular basis she sees her internist, Dr. Dennis Egitto, and her neurologist, Dr. Charles Schallop. Id. Further, she sees a cardiologist, Dr. Villa. Id. She stated that she takes Metoprolol twice a day, which keeps her heart rate down, Synthroid for her thyroid, Aspirin, Clonazepam for severe cramps in her leg, and Toprol for high cholesterol. [R. 38-39]. Further, Plaintiff takes Trazodone for depression and to help her sleep at night. [R. 39]. According to Plaintiff, the Trazodone helps with her depression but it does not always keep her asleep. Id.

         Plaintiff testified that the last time she was hospitalized was January 15, 20');">20');">20');">2013, because her right side had become weaker and she thought she had another stroke. [R. 40]. However, she was only malnourished. Id.

         Plaintiff stated that she stopped using alcohol in May of 20');">20');">20');">2014. Id. She said that she is currently not in any pain. Id. Plaintiff testified that sitting is not a problem for her, but walking and using her right hand are problematic. Id. Plaintiff stated that she was right-hand dominant and that her stroke affects her right side, including causing her trouble writing and walking. [R. 35, 40]. She stated that she has to wear solid sneakers because she has poor balance. Id. Plaintiff also estimated that she can only stand for ten to fifteen minutes at a time. [R. 41]. She stated that she could probably lift ten pounds but that her right hand is very weak and she cannot lift with it nor do other things that would come easy to someone else. Id.

         Plaintiff testified that she does not cook, vacuum, mop the floor, do any yard work, or clean her house. [R. 42-43]. However, Plaintiff explained that she does rinse off dishes and put them in the dishwasher, pay her bills over the phone, do laundry, take out the trash, and go grocery shopping. Id. She also testified that she takes care of her fifteen-year-old cat and does not have any hobbies. [R. 43].

         Then, Plaintiffs counsel asked questions of Plaintiff. Id. Plaintiff admitted that she was an alcoholic, but stated that she had been sober since May of 20');">20');">20');">2014 after she completed "rehab." [R. 44]. According to Plaintiff, she goes to Alcoholics Anonymous meetings twice a week. [R. 45]. Plaintiff stated that she recently had some CAT scans that showed that she had "diffuse injury, which could be age related or from alcohol." [R. 45-46]. Plaintiffs counsel told the ALJ that she made an appointment with a neurologist named Dr. Siddiqui for Plaintiff to meet with, and counsel asked for twenty-one days after the hearing to admit the results of that examination to the ALJ.[3] [R. 46]. The ALJ agreed to allow counsel twenty-one days to admit these Dr. Siddiqui records into the record. Id.

         Plaintiff then testified about the last job she worked at before she became disabled. According to Plaintiff, she worked as an independent contractor nurse consultant for a law firm on medical malpractice and product liability cases. [R. 47]. As a consultant, Plaintiff testified that she did not type but she had a transcriptionist who would type for her. [R. 48]. Further, Plaintiff stated she had to carry and lift boxes of medical records. Id. Plaintiff stated that she started to have trouble concentrating and focusing on what she was doing at her job. [R. 48].

         According to Plaintiff, she has a stool that she uses to get into her bed and she has a shower chair that she uses in her shower because of her fatigue. [R. 53]. Plaintiff stated that when she goes to the grocery store she tries not to use both her hands to lift a gallon of milk because she is trying to build strength in her right hand. [R. 57-58]. She also testified that her hands sometimes shake. [R. 58].

         Next, Mark Anderson, a vocational expert, testified. [R. 59]. He classified Plaintiffs past work as a registered nurse at the medium level of exertion and as a skilled occupation and her work as a nurse consultant at the sedentary level of exertion and also as a skilled occupation. [R. 60]. The ALJ posed the vocational expert a hypothetical in which an individual was limited to working at the light exertional level, only frequently handling with the right hand, never climbing ladders, ropes or scaffolds, and should avoid all exposure to hazards such as unprotected heights and dangerous machinery. Id. Given those facts, the expert found that the individual could perform past relevant work as a nurse consultant. Id. The expert further stated that, if the individual was unable to perform past work, the individual could work as a phlebotomist (light exertion level and semi-skilled), a first aide attendant (light exertion level and semi-skilled), or a cardiac monitor technician (sedentary exertion level and skilled). [R. 61].

         Next, the ALJ posed a hypothetical in which an individual could do everything listed in the first hypothetical, except that the individual could only perform sedentary work. Id. The expert responded that such an individual could perform past work as a nurse consultant or could work as a cardiac monitor technician. Id.

         The ALJ posed a third hypothetical in which an individual could do everything listed in the first hypothetical, except that the individual was limited to sedentary work and, due to the combination of their impairments, could not work for eight hours a day for five days a week. [R. 62]. The expert responded that there would be no work for an individual who was so limited. Id.

         Plaintiffs counsel then asked a few questions of the vocational expert. Id. Counsel asked if the nurse consultant job required a good deal of concentration, to which the expert testified that he could only say that a nurse consultant would be required to adhere to temperament "D, " "which means they have to direct, control and plan activities...beyond giving and receiving simple instructions." Id. Further, the expert stated that the cardiac monitor technician was classified as a stressful occupation in which an individual must use judgment and work under specific instructions. [R. 64]. The first aide attendant was also classified as a stressful occupation where an individual must deal with people beyond giving and receiving simple instructions and must use their judgment. [R. 65].

         B. Medical Record Evidence

         In reaching his decision to deny Plaintiffs benefits, the ALJ reviewed the medical evidence of record, the relevant portion of which is summarized chronologically below.

         Plaintiff suffered a stroke on January 2, 20');">20');">20');">2009, and experiences right-sided weakness as a result of the stroke. [R. 391]. Apparently, Plaintiff had a hole in her heart since birth, which caused the stroke. [R. 527]. Plaintiff had a CT scan and was diagnosed with "acute nonhemorrhagic left basil ganglia infarct." [R. 399]. Further, after an echocardiogram, the impression was that Plaintiff had "an atrial septal aneurysm with a small open patent foramen ovale with left to right shunt, and positive bubble test." [R. 391].

         On July 15, 20');">20');">20');">2009, Plaintiff saw Dr. Sharon Andrade-Bucknor for an echocardiogram. [R. 319-20');">20');">20');">20]. Dr. Andrade-Bucknor concluded that a diastolic filling pattern indicated impaired relaxation. [R. 320');">20');">20');">20]. Further, she concluded that there was "increased echogenicity of the interatrial septum consistent with an interatrial closure device." Id.

         Plaintiff presented to Dr. Charles Schallop from approximately May 31, 20');">20');">20');">2011 through July 16, 20');">20');">20');">2013. [R. 324, 325-43, 344, 434-43, 454-66, 501]. Dr. Schallop noted that Plaintiff had left-based ganglia infarction with right leg cramping at nighttime and status post-PFO procedure with placement of an Ampiatzer cribriform occlude. [R. 325]. On May 31, 20');">20');">20');">2011, Plaintiff had a stable neurological examination and Dr. Schallop stated that Plaintiff was able to work full-time.[4] Id. However, Dr. Schallop noted that he urged Plaintiff to quit smoking and that Plaintiff would be prescribed Klonopin. Id. After a scan in March of 20');">20');">20');">2012 showed that Plaintiff had elevated LFT of the liver, she reported back to Dr. Schallop. [R. 336]. In July of 20');">20');">20');">2012, Dr. Schallop saw Plaintiff again and he stated Plaintiff was responding well to Klonopin for her right leg cramping at nighttime, she had apparently stopped smoking, and her neurological exam was normal. [R. 338].

         However, on January 15, 20');">20');">20');">2013, Plaintiff had an emergency office visit with Dr. Schallop because a month prior to the visit she was experiencing weakness, lethargy, dizziness, and unsteady gait. [R. 342, 434]. Dr. Schallop admitted Plaintiff to the hospital "for progressive neurological symptoms with tachycardia" and possibly atrial fibrillation/malignant cardiac rhythms. Id.

         From January 15 through January 17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17, 20');">20');">20');">2013, Plaintiff was hospitalized at Palm Beach Gardens Medical Center. [R. 366]. The records note that Plaintiff was admitted with neuromuscular weakness and seemed to be symptomatic of hyponatremia.[5] Id. Plaintiff denied any chest discomfort, tightness, or pressure, reported moderate alcohol consumption, and reported her history as a smoker. [R. 367]. After being examined for neurovascular disease and having a cardiology consultation, Plaintiff was diagnosed with hyponatremia multifactorial, which was corrected, hypokalemia (low potassium), and hypothyroidism, in addition to having a thyroidectomy in the past. [R. 366]. The hospital adjusted Plaintiffs medication because she seemed "to be noncompliant with her oral supplement." [R. 366]. Further, Plaintiffs EKG revealed sinus tachycardia and her MRI showed "mild atrophy with white matter pathology suggestive of mild microvascular ischemic changes." [R. 372, 389].

         Plaintiff then reported to Dr. Augusto Villa on January 24, 20');">20');">20');">2013, for her abnormal EKG and heart murmur. [R. 467-79]. Dr. Villa noted that Plaintiffs echocardiogram confirmed that Plaintiffs PFO closure device was functioning normally. [R. 468]. After Plaintiff was started on beta blocker therapy for tachycardia she reported feeling better and planned to start physical therapy. Id. Plaintiff reported that she was still smoking cigarettes every day and stated that she drank 1-2 glasses of wine per night. [R. 469]. Dr. Villa said that Plaintiff appeared well developed, well nourished, and in no acute distress, but he did state that Plaintiff had an abnormal heart rate. [R. 469-70]. Plaintiff was advised to quit smoking, avoid stimulants like caffeine and alcohol, and monitor her blood pressure and heart rate twice a day. [R. 470].

         On May 9, 20');">20');">20');">2013, Sheila Clark Jackson completed a Disability Determination Explanation. [R. 69-77]. Plaintiff alleged disability due to "a stroke, anemia, right leg tremors, hypothyroidism, and depression." [R. 74]. Ms. Jackson determined that Plaintiff suffered from one severe impairment-CVA, late effects of cerebrovascular disease. Id. Ms. Jackson also determined that Plaintiffs exertional limitations were the following: occasionally lifting or carrying twenty pounds, frequently lifting or carrying ten pounds, standing and/or walking for a total of six hours in an eight-hour workday, sitting for a total of six hours in an eight-hour workday, and unlimited pushing or pulling other than lifting and/or carrying. Id.

         Finally, Ms. Jackson determined that Plaintiff could perform her past relevant work as a nurse consultant as it was actually performed. [R. 76-77]. She found Plaintiff to not be disabled. Id.

         Plaintiff presented to Dr. Schallop again on July 16, 20');">20');">20');">2013, for a follow-up visit. [R. 501]. Dr. Schallop stated that Plaintiff was neurologically stable, smoked about A of a pack of cigarettes per day, worked at Glades Medical Center in the ICU, and was going to start Zoloft "per psychiatry." Id. Plaintiff was advised to continue her use of Klonopin because she was at "high-risk for withdrawal symptoms." Id. Dr. Schallop stated that Plaintiff had improved and told her to continue working in the critical care unit at Glades Medical Center. Id.

         It appears that Plaintiff consulted a psychiatrist, Dr. Philip Scharfer, M.D. in July of 20');">20');">20');">2013 for depression and anxiety.[6] [R. 303]. Plaintiff presented to Dr. Scharfer for "depression secondary to physical problems" and the doctor diagnosed Plaintiff with dysthymic disorder.[7]Id.

         Plaintiffs attorney, Carol Witschel, who is also her sister, completed a Function Report-Adult for Plaintiff on August 19, 20');">20');">20');">2013. [R. 251-58]. Plaintiff stated that her conditions limit her ability to work because she fears driving outside of her "immediate home area, " she cannot concentrate, she lacks coordination and is unstable when walking, her hands shake, she has difficulty sleeping through the night, she has a weak appetite, she has a racing heart, she gets anxiety in social situations, and she has depression. [R. 251]. According to Plaintiff, she wakes up every day in a state of severe anxiety, takes her medication, watches television, feeds her cat, and occasionally shops for necessities, talks on the phone, naps, and sleeps on her sofa rather than in her bed. [R. 252]. Plaintiff stated that she lost interest in her former hobbies of reading, gardening, shopping, socializing, and going to the beach. [R. 255]. She also alleged that she gets angry and argumentative in response to any disagreement and cries frequently. [R. 256]. Plaintiff indicated that her conditions affect her lifting, squatting, bending, standing, reaching, walking, memory, completing tasks, concentration, understanding, following instructions, using hands, and getting along with others. Id. She alleged that she can only pay attention for a few minutes at a time and does not finish what she starts. Id.

         On September 12, 20');">20');">20');">2013, Dr. Trina Christner completed a Disability Determination Explanation-Reconsideration. [R. 80-92]. Plaintiff admitted that she had an alcohol problem. [R. 81]. Dr. Christner concluded that, in addition to CVA, Plaintiff also suffered from anxiety disorders, which were nonsevere. [R. 87]. Dr. Christner concluded that, under the "paragraph B" criteria of the listings, Plaintiffs anxiety disorders mildly restrict her activities of daily living, cause Plaintiff to have mild difficulty with social functioning, cause Plaintiff to have mild difficulty in maintaining concentration, persistence or pace, and do not cause Plaintiff to have any repeated episodes of decompensation of extended duration. [R. 88]. Dr. Christner noted that, although Plaintiff claims that she has depression and had been treated with Klonopin, Plaintiffs symptoms had not prompted a referral to a psychiatrist and she was not diagnosed with depression. Id. Plaintiff was again found to not be disabled. [R. 92].

         On March 11, 20');">20');">20');">2014, Plaintiffs former employer, Calvin Warriner, submitted an email to Plaintiffs counsel. [R. 297]. Mr. Warriner claimed that Plaintiff was his "go-to nurse paralegal for almost 20');">20');">20');">20 years" because she was thorough, meticulous, and had extensive knowledge of critical care nursing. Id. According to Mr. Warriner, Plaintiffs work product began to deteriorate around 20');">20');">20');">2005 when she "became slow and started missing deadlines, " started making excuses for turning in work late, and her work became sloppy. Id. Mr. Warriner alleges that around 20');">20');">20');">2011 he stopped sending her work because he could no longer "in good conscience bill clients for her work." Id.

         Plaintiff was admitted to Clarita Way for alcohol abuse rehabilitation on April 6, 20');">20');">20');">2014, and was discharged on May 20');">20');">20');">20, 20');">20');">20');">2014. [R. 502-14]. Plaintiff stated that she had a long history of alcohol abuse, which had gotten progressively worse, as she was drinking about one to two liters of chardonnay per day. [R. 502]. The records indicate that the doctors wanted to taper Plaintiff off Klonopin after seven days in rehab. [R. 503]. During her stay, Plaintiff complained of lower extremity edema because she was on her feet and ambulating a lot, but that improved after a few days when Plaintiff elevated her legs and increased her fluid intake. [R. 504-05]. Further, Plaintiff complained of neck pain on her right side that was radiating down to her scapula. [R. 506]. The doctor recommended that Plaintiff take ibuprofen and that she continue therapy and exercise, as Plaintiff stated that exercise relieved the pain. Id.

         Plaintiffs daughter, Erica Wheatley Disner, submitted a letter dated November 5, 20');">20');">20');">2014. [R. 283-85]. Ms. Disner asserted that Plaintiff had been incapable of "responsible, meaningful work in her trained field of nursing or nurse consulting, for at least two years" because of Plaintiffs depression and substance abuse. [R. 283]. According to Ms. Disner, Plaintiffs alcoholism and depression worsened when Ms. Disner went off to college in or around 20');">20');">20');">2000 and throughout her undergraduate years. [R. 283-84]. Ms. Disner noted that, in 20');">20');">20');">2009, Plaintiff had a stroke and traveled to Miami for medical treatment following the stroke. [R. 284]. She also noted that Plaintiff had packed multiple water bottles filled with vodka in her suitcase. Id.

         According to Ms. Disner, Plaintiff recovered physically after her stroke but never seemed to mentally recover, as she continued to be depressed and was hospitalized for malnutrition. Id. Ms. Disner stated that after Plaintiff left rehab, she relapsed for a few days and became hostile towards Ms. Disner, and ultimately did not attend Ms. Disner's wedding. [R. 285].

         On November 13, 20');">20');">20');">2014, Matt Witschel, Plaintiffs brother, wrote an email to Carol Witschel. [R. 286-87]. Mr. Witschel stated that after he recently visited Plaintiff she appeared weak and fragile and opined that a hiring manager would not hire her for any type of work. [R. 286]. He explained that when he entered her home it was in shocking disarray with newspapers piled up, dirty dishes around the home, the kitchen was dirty, and there were expired foods in the refrigerator. Id. Mr. Witschel noted that Plaintiff, who is only fifty-seven years old, is frail and moves around slowly as if she were in her 80's or 9O's. Id. He observed that Plaintiff was "repeating herself often and generally not making sense most of the time, " and he said that he believed some of her physical limitations are the result of her stroke. Id.

         Plaintiffs sister and representative in this case, Carol Witschel, submitted a letter on November 17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17, 20');">20');">20');">2014. [R. 288-296]. Attached to this letter were exhibits, which were letters from family and friends of Plaintiff describing her condition. [R. 297-309]. In her letter, Ms. Witschel stated that Plaintiff was "in denial concerning the main source of many of her debilitating health (physical and mental) problems: long term alcohol abuse." [R. 288]. According to Ms. Witschel, Plaintiff was a functioning alcoholic for many years, as she drank too much but still managed to work "fairly consistently." [R. 289]. Ms. Witschel stated that Plaintiff had a stroke on January 2, 20');">20');">20');">2009, and was subsequently diagnosed with a congenital hole in her heart, which caused the stroke. Id. After the stroke, Ms. Witschel said that Plaintiff made a full recovery besides her fine motor skills on her right side, which is illustrated by her handwriting. Id. Ms. Witschel noted that Plaintiff had the hole in her heart patched. Id. Further, Ms. Witschel stated that Plaintiff was diagnosed in January of 20');">20');">20');">2013 with malnutrition, which was causing Plaintiff to have a racing heart, weakness in her limbs, and irrational behavior. [R. 291]. According to Ms. Witschel, Plaintiff has been drinking since she left rehab in May of 20');">20');">20');">2014 and has become very hostile and angry towards her family again. [R. 293-94]. Ms. Witschel claimed that Plaintiff is now living off withdrawals from her 40IK savings and is paying a 10% penalty for withdrawing those funds early. Id.

         On December 18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">18');">18 and 19, 20');">20');">20');">2014, Plaintiff presented to Dr. Stephanie Renfrow, a clinical psychologist, to discuss Plaintiffs current level of psychological and cognitive functioning. [R. 517');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17, 526-34]. Dr. Renfrow submitted a letter after consulting with Plaintiff. Plaintiff complained of "memory loss and severe emotional distress, " but stated that she had been sober since May of 20');">20');">20');">2014. [R. 533]. Dr. Renfrow indicated that there were "significant impairments" in the following areas: processing speed, visuospatial reasoning and detection, attention, impulsivity, fine motor agility, immediate and delayed memory, as well as severe depression and anxiety. [R. 517');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17]. In the Emotional, Behavioral, and Personality Functioning section, Dr. Renfrow noted that, although Plaintiff appeared fearful, nervous, and exhibited physical symptoms of trembling, shaking, numbness, becoming flushed, and feeling wobbly in the legs, this was "interpreted with some caution due to a slight inconsistency in responding and an over-reporting of problems." [R. 532]. According to Dr. Renfrow, Plaintiff would have "significant difficulty learning and applying new skills, processing new information in a timely and accurate manner, recalling important details and working with hands-on or otherwise visual material (including reading, monetary tasks, writing)." Id. Further, the doctor stated that Plaintiffs cognitive functioning is likely worsened by her current state of depression and anxiety, "as well as possible additive neuropsychological effects of long-term alcohol abuse." Id. Dr. Renfrow noted that Plaintiffs level of motivation, energy, concentration, interest, and perseverance were also probably impaired by her current emotional state. Id. She diagnosed Plaintiff with major neurocognitive disorder due to multiple etiologies; major depressive disorder, recurrent episode, severe; unspecified anxiety disorder; and alcohol use disorder, in early remission. [R. 533]. Dr. Renfrow recommended that Plaintiff obtain psychological and psychiatric services and pursue brain imaging to determine to what extent neurological damage to her brain may have occurred as a result of long-term alcohol use. Id. The doctor concluded that Plaintiff would likely have great difficulty establishing and maintaining employment. Id.

         Carol Witschel submitted a Declaration in support of Plaintiff s disability benefits on July 14, 20');">20');">20');">2015, in which she reiterated Plaintiffs long-term alcohol abuse. [R. 310-312]. According to Ms. Witschel, Plaintiff has been an alcoholic since the 1990's and has gotten progressively worse. [R. 310]. Ms. Witschel stated that Plaintiffs testimony at the December 3, 20');">20');">20');">2014, hearing in front of the ALJ was false when Plaintiff claimed that she had been sober for six months. Id. Ms. Witschel claims that Plaintiff has not been sober since she left rehab in May of 20');">20');">20');">2014, and that Plaintiffs drinking has resumed and is occurring more frequently. Id. Ms. Witschel also claims that Plaintiff is "embarrassed to truthfully reveal to her regular doctors the extent of her mental and physical distress." [R. 311].

         C. ALJ Decision

         The ALJ issued his decision on Plaintiffs claim for benefits on May 15, 20');">20');">20');">2015. [R. 14-29]. The ALJ explained the five-step sequential evaluation process for determining whether an individual is disabled. [R. 17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17');">17-19]. He found that Plaintiff met the insured status requirements of the Social Security Act through December 31, 20');">20');">20');">2016, and had not engaged in substantial gainful activity since June 15, 20');">20');">20');">2012, the alleged on-set date. [R. 19]. The ALJ then found that Plaintiff suffers from the following severe impairments: status post cerebrovascular accident, tachycardia, and alcohol abuse. Id. The ALJ explicitly stated that these physical impairments "more than minimally limit [Plaintiffs] ability to perform basic work activities and therefore are severe." Id.

         Further, the ALJ stated that Plaintiffs medically determinable mental impairments of major depressive disorder and unspecified anxiety disorder, "considered singly and in combination, do not cause more than minimal limitation in [Plaintiffs] ability to perform basic mental work activities and are therefore nonsevere." Id. The ALJ then evaluated the four functional areas of the "paragraph B" criteria. Id. The ALJ concluded that "[b]ecause [Plaintiffs] medically determinable mental impairments cause no more than 'mild' limitation in any of the first three functional areas and 'no' episodes of decompensation which have been of extended duration in the fourth area, they are nonsevere." [R. 20');">20');">20');">20].

         The ALJ noted that there is no evidence in the record of Plaintiff seeking mental health treatment for her depression and Plaintiff admitted that the Trazodone she takes is effective for her depression. Id. Therefore, the ALJ determined that he would give little weight to the evidence submitted post-hearing, which diagnosed Plaintiff with mental impairments and recommended that Plaintiff not seek employment due to severe emotional and neurocognitive impairments, because it was not supported by the record as a whole. Id. The ALJ gave great weight to the portion of the opinion of the State agency psychological consultant concluding that Plaintiff did not have a severe mental impairment. Id.

         The ALJ next found that Plaintiff does not have an impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments in 20');">20');">20');">20 CFR Part 404, Subpart P, Appendix 1. Id. According to the ALJ, Plaintiffs tachycardia does not meet the criteria of listing 4.05 "because she does not have recurrent arrhythmias, not related to reversible causes, such as electrolyte abnormalities or digitalis glycoside or antiarrhythmic drug toxicity, resulting in uncontrolled, recurrent episodes of cardiac syncope or near syncope, despite prescribed treatment, and documented by resting or ambulatory (Holter) electrocardiography, or by other appropriate medically acceptable testing, coincident with the occurrence of syncope or near syncope." [R. 21 ]. The ALJ stated that that the record does not show that Plaintiff has had any sensory or motor aphasia but does show that Plaintiff has a stable gait and is neurologically stable. Id.

         The ALJ then completed a residual functional capacity ("RFC") assessment and found that Plaintiff has the residual functional capacity to perform "sedentary work as defined in 20');">20');">20');">20 CFR 404.1567(a), except she can frequently handle with the right hand and should not climb ladders, ropes, or scaffolds, and should avoid all exposure to hazards such as unprotected heights and dangerous machinery." Id. The ALJ attested that he had considered all of Plaintiffs symptoms and "the extent to which these symptoms can reasonably be accepted as consistent with the objective medical evidence and other evidence, " as well as all of the opinion evidence. Id.

         The ALJ then followed the two-step process-first, determining whether there is an underlying determinable physical or mental impairment that could reasonably be expected to produce Plaintiffs pain or other symptoms, and then evaluating the intensity, persistence, and limiting effects of Plaintiff s symptoms to determine the extent to which they limit her functions. [R. 21-22]. The ALJ went through Plaintiffs testimony at the hearing and the various medical records in detail. [R. 22-23]. The ALJ found that "the claimant's medically determinable impairments could reasonably be expected to cause the alleged symptoms; however, the claimant's statements concerning the intensity, persistence and limiting effects of these symptoms are not entirely credible for the reasons explained in this decision." [R. 22]. He specifically found that in terms of Plaintiffs alleged impairments, "she had a stable gait, full motor function strength, and has been described as neurologically stable, " and had "a normal ejection fraction and confirmation that her PFO closure device was functioning normally." Id. Moreover, the ALJ noted that Plaintiff did not stop working due to any of her alleged impairments but because her job was outsourced to India. Id.

         In terms of the opinion evidence, the ALJ explained that "little weight is given to the opinion of the State agency medical consultant, who opined [Plaintiff] could perform light work, as it is inconsistent with the evidence described above that showed [Plaintiff] to have tachycardia and some problems with her right side."[8] [R. 23]. Further, the ALJ "gave great deference to [Plaintiffs] testimony at the hearing regarding the weight she could lift and her ability to sit for fairly long periods and her other complaints in limiting her to sedentary work." Id. However, the ALJ did not give significant weight to the opinions of "other sources, " including Plaintiffs former employer, Plaintiffs friend, Plaintiffs daughter, and Plaintiffs retirement account manager, because their opinions were not consistent with the preponderance of the opinions and observations by medical doctors in this case. Id. In sum, the ALJ concluded that his residual functional capacity assessment was supported by the objective medical evidence of record and Plaintiffs testimony. Id.

         Next, the ALJ concluded that Plaintiff was capable of performing past relevant work as a nurse consultant. Id. Finally, he found that Plaintiff "has not been under a disability, as defined in the Social Security Act, from June 15, 20') ...


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