United States District Court, D. Connecticut
RULING ON THE PLAINTIFF'S MOTION TO REVERSE AND
THE DEFENDANT'S MOTION TO AFFIRM THE DECISION OF THE
Vanessa L. Bryant, U.S.D.J.
an administrative appeal following the denial of the
Plaintiff, Nicole Gaathje's, application for disability
insurance benefits (“DIB”) and supplemental
security income benefits (SSI) It is brought pursuant to 42
U.S.C. §§ 405(g).
Gaathje (“Plaintiff” or “Gaathje”)
has moved for an order reversing the decision of the
Commissioner of the Social Security Administration
(“Commissioner”), or remanding the case for
rehearing. [Dkt. No. 13.] The Commissioner, in turn, has
moved for an order affirming the decision. [Dkt. No. 17.]
Magistrate Judge Sarah A. L. Merriam rendered a Recommended
Ruling on the Cross Motions, recommending Plaintiff's
Motion to Reverse the Decision of The Commissioner be denied,
and recommending Defendant's Motion to Affirm be granted.
[Dkt. No. 19.] Plaintiff filed an Objection to the
Recommended Ruling [Dkt. No. 20], and Commissioner filed a
Response in favor of the Recommended Ruling. [Dkt. No. 21.]
The Court accordingly reviews de novo the Magistrate
Judge's Recommended Ruling. 28 U.S.C. §
636(b)(1)(B); Fed.R.Civ.P. 72(b)(3). The Court may adopt,
reject, or modify, in whole or in part, the Magistrate
Judge's Recommended Ruling. 28 U.S.C. § 636(b)(1);
following reasons, the Recommended Ruling is adopted,
Gaathje's Motion for an Order Reversing or Remanding the
Commissioner's Decision [Dkt. No. 13] is DENIED, and the
Commissioner's Motion to Affirm that Decision [Dkt. No.
13] is GRANTED.
following facts are taken from the parties' Joint
Stipulation of Facts (“Joint Stipulation”) [Dkt.
No. 16] unless otherwise indicated, and are undisputed unless
was born on October 21, 1975. [Dkt. No. 16 at 1.] She did not
graduate from high school and has not obtained a GED.
Id. She was last insured on June 30,
1996. [Id. at 211.] Gaathje's
alleged disability began on or about April 2, 2011.
Id. at 1. On December 21, 2011 Gaathje filed an
application for disability benefits, and on December 23,
2011, she applied for supplemental security income. [Dkt. No.
11-6 at 183, 191.] On February 24, 2012, a disability
adjudicator in the Social Security Administration denied her
initial request for disability benefits and thereafter denied
her request for reconsideration. [Dkt. Nos. 11-4 at 60, 72.]
August 29, 2013, Gaathje appeared (with counsel) for a
hearing before an ALJ. [Dkt. No. 11-3 at 31.] On October 23,
2013, the ALJ issued a decision denying benefits.
Id. at 17. On May 18, 2015, the appeals council
denied Gaathje's request for review of that decision
thereby making the ALJ's decision the final decision of
the Commissioner. Id. at 1. This appeal followed.
Plaintiff's Medical History
was first examined for blurred vision, shortness of breath,
and chronic dizziness on August 7, 2009. Id. at 1.
On October 20, 2009, Dr. N.J. Holzer noted Gaathje showed
symptoms of vertigo with hearing loss, and that her August 9
MRI showed no other conditions except indications of sinus
disease. Id. at 1.
years following her October 2009 diagnosis of vertigo and
hearing loss, Gaathje has reported various symptoms to
physicians, including anxiety, trouble sleeping, tinnitus,
pain in her back, hands, wrists, elbows, knees, legs, ankles
and feet, heartburn, and difficulty breathing when exposed to
irritants in the air. [Id. at 2-4; Dkt. No. 11-8
(Medical Records) at 353 (anxiety, back pain, abdominal pain
as of August 2011), 381 (tinnitus and continued dizziness,
hearing loss, vertigo, and joint pain as of March 2012),
369-70 (continued anxiety, dizziness, back and joint pain,
and gastroesophageal reflux as of April 2012), 411 (continued
back pain, abdominal pain, anxiety in May 2012), 494 (hand
pain, difficulty breathing as of October 2012), 447 (joint
pain as of April 2013), 443 (anxiety and trouble sleeping as
of April 2013).]
physical exam in March of 2012 by Jessica Plasse, APRN and
accompanying consultation by Dr. Gregory Lesnik found that
Gaathje had symptoms consistent with vertigo and
“possible Meniere's disease given her history of
hearing loss in the left ear.” [Dkt. No. 11-8 at 382.]
Dr. Lesnik ordered a diagnostic test to determine whether
Gaathje experienced Meniere's disease or vestibular
migraines. Id. at 382. The diagnostic test, a
videonystagmography (VNG) evaluation, found Gaathje had
“borderline normal VNG” with “not
clinically significant” variations. Id. at
416. In conjunction with the VNG, Gaathje completed a
questionnaire regarding her dizziness and hearing loss, and
also reported she experienced impaired vision, lip numbness
and tingling, weakness in her arms or legs, and a
“tendency to get upset easily.” Id. at
411-12. At a follow-up appointment in June 2012, Dr. Lesnik
reviewed the diagnostic results and concluded
“Meniere's disease is a very likely
diagnosis.” Id. at 426. Similarly, in
conjunction with an April 2012 physical exam also by Ms.
Plasse, Dr. Robert Sidman also concluded Gaathje experienced
“dizziness/possible Meniere's disease.” [Dkt.
No. 11-8 at 391.]
addition to Meniere's disease, physical exams by Ms.
Plasse as early as August 2011 consistently assess that
Gaathje experiences anxiety disorder. [Dkt. No. 11-8 at 354.]
Gaathje has taken various anxiety medications since 2011.
[See e.g., id. at 354 (August 2011 anxiety
medication), 391 (April 2012 anxiety medication.] When
Gaathje switched primary care doctors in March 2013, Andrea
Dameron, APRN, referred Gaathje for a mental health
evaluation. Id. at 440. At the evaluation in April
2013, Gaathje reported anxiety that began with trauma during
her adolescence and has increased in recent years due to
medical complications. Id. at 444. Gaathje reported
that her “medical issues . . . keep her from doing
things she wants to do.” Id. at 444. Despite
that, Gaathje listed her personal strengths as artistic
talent, gardening, her sense of humor, and her relationship
with her children. Id. at 443. Beth LaFontaine,
LADC, Gaathje's mental health evaluator, found no
abnormalities in Gaathje's mental status or behavior.
Id. at 444. Ms. LaFontaine concluded Gaathje
experienced anxiety, educational problems, impairment in
social, occupational, or school functioning, and other
psychosis and environmental problems, and created a treatment
plan requiring Gaathje to attend weekly therapy sessions.
Id. at 444-46.
2013, Lisa Harrison, APRN also evaluated Gaathje's mental
health. Id. at 456. Ms. Harrison found Gaathje had
normal thought processes, mood and affect, associations,
judgment and insight. Id. at 458. Ms. Harrison found
no hallucinations, delusions, or psychotic thoughts.
Id. Ms. Harrison prescribed two anxiety medications
with a plan to assess side effects and efficacy at a
follow-up appointment. Id. at 456-58. At a
subsequent appointment two weeks later, Gaathje reported
continued anxiety and trouble sleeping. Id. at 466.
Ms. Harrison adjusted Gaathje's medication. Id.
has also been treated for abdominal pain and irritable
bowels. In January of 2011, Gaathje reported to Ms. Plasse
abdominal pain and irritable bowels, but stated symptoms were
controlled with prescribed medication along with
over-the-counter heartburn medication. Id. at 341.
In April 2012, Ms. Plasse examined Gaathje and Dr. Sidman
prescribed Gaathje medication to treat gastroesophageal
reflux and abdominal bloating, as well as continued
medication for Gaathje's anxiety and dizziness.
Id. at 391. In addition, Gaathje's medical
records indicate a history of gestational diabetes.
Id. at 447.
Plasse has also treated Gaathje for Reactive Airways
Dysfunction Syndrome. [Dkt. No. 11-9 (Continued Medical
Records) at 494.] Gaathje reported “deep
breathing” and a cough, for which Ms. Plasse prescribed
use of two inhalers. Id. at 494.
also reported hand pain in October 2012. Id. at 494.
An x-ray of the hand in October 2012 was normal. Id.
at 527. In June 2013, Gaathje reported to the emergency room
with wrist, hand, elbow, and foot pain. Id. at 538.
X-rays and evaluation showed possible rheumatoid arthritis,
but the treating emergency physician could not exclude other
possible diagnoses. Id. The emergency physician
treated Gaathje with pain medication. Id. In August
2013, Gaathje saw Dr. Sandeep Varma regarding her joint and
extremity pain. Id. at 519. Dr. Varma found no
evidence of inflammatory disease, but likely polyarthralgia.
Id. Dr. Varma prescribed Celebrex for Gaathje's
Expert Examinations and Opinions
August 29, 2013, APRN Dameron, who treated Gaathje for the
ten (10) week period beginning May 29, 2013 and ending August
8, 2013, completed a medical source statement regarding
Gaathje. [Dkt. No. 11-9 at 558.] Ms. Dameron's statement
indicated that that Gaathje has the following limitations: 1)
she may occasionally and frequently lift 10 pounds; 2) she
may stand, walk, and sit for six hours in an eight hour day;
3) she is limited in pushing and pulling; 4) she cannot kneel
or crawl; 5) she can occasionally climb, balance, crouch, and
stoop; 6) she is limited in the ability to finger and can
reach only occasionally; 7) she is limited in hearing; and 8)
she is limited in her exposure to noise. Id. at
558-61. Ms. Dameron lists as the reasons for Gaathje's
limitations polyarthralgia involving multiple joints,
vertigo, hearing loss, Meniere's Disease, and chronic
tympanic disturbances. Id. at 558-61.
to Dr. Damerons assessment, on February 23, 2012, Dr. Barbara
Coughlin, a State agency medical consultant, reviewed
Gaathje's medical records, communicated with Gaathje, and
provided an analysis for Gaathje's disability benefits
claim. [Dkt. No. 11-4 at 54.] Dr. Coughlin found
Gaathje's vestibular system disorder (vertigo and
dizziness) constituted a severe medically determinable
impairment. Id. at 56-7. Dr. Coughlin found
Gaathje's statements regarding her symptoms
“partially credible, ” in light of medical
assessments showing “mild” or
“intermittent” causes for her reported symptoms.
Id. at 57. Dr. Coughlin found Gaathje had no
exertional limitations, could climb ramps or stairs
occasionally, could never climb ladders, could occasionally
balance, and could stoop, kneel, crouch, or crawl without
limitation. Id. at 57. Dr. Coughlin also found
Gaathje should avoid all exposure to “hazards
(machinery, heights, etc.).” Id. at 58. All
limitations were ascribed to Gaathje's vertigo and
dizziness. Id. at 57-58.
on July 11, 2012, Dr. Nabil Habib, a State agency medical
consultant, reviewed Gaathje's medical records and
information supplied by Gaathje, and provided a second
analysis for Gaathje's disability benefits claim. [Dkt.
No. 11-4 at 68.] Dr. Habib also found Gaathje's
vestibular system disorder constituted a severe medically
determinable impairment. Id. at 68. Like Dr.
Coughlin, Dr. Habib found Gaathje's account of her
symptoms partially credible based on mild or intermittent
evidence of causal conditions. Id. at 69. Dr. Habib
determined Gaathje had the same limitations Dr. Coughlin
identified, caused by Gaathje's vertigo and dizziness.
Id. at 69-71.
The Hearing Before the ALJ
August 29, 2013, Gaathje appeared for a hearing before ALJ
Ryan Alger. [Dkt. No. 11-3 at 31.] Gaathje was represented by
counsel. Id. at 33. Gaathje testified she last
worked in 2011, as a plant merchandiser in customer service
for Lowe's Home Store. Id. at 36. Gaathje stated
she ceased working after “only a couple months”
because the work was too physically taxing. Id. at
36. Gaathje explained “it was a lot of lifting and
bending, and walking, standing.” Id. at 36-37.
testified to her abilities and disabilities at the hearing.
She testified that she currently lives with her husband and
three children, aged eighteen, sixteen, and eight (as of the
time of the hearing). Id. at 37. Gaathje indicated
bright lights trigger her vertigo and dizziness, and that she
has to wear sunglasses in the grocery store. Id. at
38. In 2011, she had a vertigo episode triggered by viewing
headlights and street lamps while driving at night.
Id. at 37. As a result, she no longer drives.
Id. In fact, Gaathje indicated the fluorescent
lights at the hearing made her dizzy, and it appears from the
transcript the ALJ turned off the overhead lighting for her.
Id. at 37-38.
testified she usually feels comfortable lifting and carrying
up to five pounds at a time, but that sometimes lifting a
gallon of milk “aggravate[s]” her symptoms.
Id. at 42. Her joint pain prevents her from cooking
2-3 times per week, and certain cooking tasks, like
“lift[ing] the pan [of pasta] up to strain the water,
” are particularly painful. Id. at 39, 41. She
also has difficulty doing laundry. Id. at 39.
However, Gaathje can regularly load her dishwasher and dust,
and her children and husband help her with other chores as
necessary. Id. at 39.
addition, Gaathje indicated she sometimes has trouble getting
into and out of bed because it requires her to bend her
knees. Id. at 40. Gaathje testified she has trouble
with activities requiring her to lift her arms above her
head, including putting on a shirt and washing her hair, but
she can otherwise dress and bathe herself. Id.
Gaathje agreed with the ALJ's characterization that
“some days are better than others.” Id.
has vertigo episodes about twice a week, they occur at
random, and they last roughly half an hour. Id. at
42-43. When she has a vertigo episode, the room spins and she
is left with “no energy.” Id. at 43.
Medication helps to manage her episodes, however, she
testified it's “usually a good two days before I
start to feel normal again.” Id. Gaathje also
indicated she gets migraines two or three times per week,
sometimes concurrent with vertigo episodes. Id. She
manages migraines by lying down with a cold compress and
taking medicine. Id. at 44. A migraine typically
lasts three to four hours. Id. Migraines and vertigo
episodes are also sometimes accompanied by blurry vision.
Id. In addition, Gaathje indicated her ears ring two
to three times per month, for about half an hour per episode.
Id. at 45.
indicated she sometimes experiences panic attacks when away
from home, caused by fear that she might have a vertigo
episode. Id. at 46. Panic attacks cause her
shortness of breath and racing thoughts. Id. Gaathje
participates in counseling sessions twice per week for
anxiety treatment, and also sees a psychiatrist monthly.
Id. at 45. The psychiatrist has prescribed her with