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, Melissa Haman's, application for disability
insurance benefits (“DIB”). It is brought
pursuant to 42 U.S.C. §§ 405(g). Melissa
Haman (“Plaintiff” or
“Haman”) 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. 17.] The Commissioner, in turn,
has moved for an order affirming the decision. [Dkt. No. 24.]
On April 8, 2016 the case was fully briefed. For the
following reasons, Messina's Motion for an Order
Reversing or Remanding the Commissioner's Decision [Dkt.
No. 17] is DENIED, and the Commissioner's Motion to
Affirm that Decision [Dkt. No. 24] is GRANTED.
following facts are taken from the parties' Joint
Stipulation of Facts (“Joint Stipulation”) [Dkt.
No. 37] unless otherwise indicated.
was born in 1970. [Dkt. No. 11-3 at 33.] She graduated from
high school and has no further education. Id. at 33,
36. She worked as a receptionist and show room salesperson at
Southington Glass Company for eight and a half years and
stopped when she broke her ankle on April 6, 2010.
[Id. at 36-38.] She was last insured on December 31,
2015. [Dkt. No. 11-3 at 12.] On August 9, 2011,
Haman applied for a Period of Disability and Disability
Insurance Benefits. [Dkt. No. 11-6 at 189.] On October 19,
2011, a disability adjudicator in the Social Security
Administration denied her initial request for disability
benefits and thereafter denied her request for
reconsideration. [Dkt. No. 11-4 at 71, 85.]
January 22, 2013, Haman appeared (with counsel) for a hearing
before an Administrative Law Judge (“ALJ”). [Dkt.
No. 11-3 at 29.] On February 19, 2013, the ALJ issued a
decision denying benefits. Id. at 12. On July 12,
2014, the appeals council denied Messina'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
February 11, 2010, Haman visited Dr. Phil Watsky, her primary
care physician, complaining of anxiety and fibromyalgia.
[Dkt. No. 11-8 at 316.] Dr. Watsky noted Haman experienced
leg aches, exhaustion, and dizziness, and indicated an
impression that she suffered from fibromyalgia. [Dkt. No.
11-8 at 316.]
March 5, 2010, Haman visited Ellen Babcock, a therapist with
the Bristol Hospital Counseling Center. Id. at 324.
Ms. Babcock recommended Haman practice coping skills to
manage her anxiety and depression. Id. On March 10,
2010, Ms. Babcock conducted an individual therapy session to
discuss Haman's feelings of depression, frustration, and
anger. Id. at 322.
April 5, 2010, Haman fell and fractured her right ankle.
[Dkt. No. 11-8 at 273.] That day, Dr. Frank Gerratana
surgically added stabilizing hardware to her ankle to address
the fracture. Id. at 286, 310. On May 2, 2010, Haman
tripped again, causing “a snapping sensation in her
ankle” and “increased pain.” Id.
at 310. Dr. Gerratana examined her the following day and
noted some swelling, moderately restricted motion, and some
diffuse tenderness of the ankle, but x-rays indicated the
stabilizing hardware was still in place. Id. at 310.
Dr. Gerratana instructed Haman to continue using a CAM walker
(a medical walking boot) and report back for reassessment in
one month. Id. at 310. At her follow-up appointment
on June 3, 2010, Dr. Gerratana noted continued ankle
discomfort and stiffness, but x-rays indicated further
healing. Id. at 309. Dr. Gerratana instructed her to
continue using her CAM walker as well as an ankle brace.
Id. On month later, on July 15, 2010, Dr. Gerratana
noted Haman limped, had some right ankle weakness, and still
took Tylenol and ibuprofen for pain. Id. at 308.
X-rays revealed the right ankle fracture had healed and
showed her right knee was normal. Id. Dr. Gerratana
instructed Haman to begin physical therapy. Id. On
August 19, 2010, Dr. Gerratana noted physical therapy had
“improved motion and strength of her ankle, ” but
had not completely restored its range of motion. Id.
at 307. He ordered Haman to continue the exercise program.
September 1, 2010, Haman returned to Ms. Babcock for the
first time since her ankle surgery, and reported continued
anxiety and depressed mood. Id. at 323. Ms. Babcock
rated Haman's Global Assessment of Functioning
(“GAF”) score as 52 out of 100 and recommended
continued psychiatric treatment to stabilize her mentally and
help her gain the skills needed to maximize her functional
December 2, 2010, Dr. Gerratana noted increased range of
motion in Haman's right ankle, determined she would
“be allowed increased activities, ” and
“expected that she will continue to improve with
time.” Id. at 305.
December 3, 2010, Haman ceased psychiatric treatment at
Bristol Hospital Counseling Center. Id. at 321.
Haman reported she would no longer attend treatment because
she lost her job after she fractured her ankle and had no
source of transportation to counseling appointments.
Id. at 321. Discharge notes indicate Haman's
symptoms of anxiety and depression “waxed and
waned” throughout her treatment. Id. Ms.
Babcock included in Haman's final diagnosis that she
experienced post-traumatic stress disorder and mood disorder
in addition to anxiety and depression. Id. She rated
Haman's treatment goals as “generally met to not
met” and characterized her treatment as
“successful or partially successful.”
March 4, 2011, Haman reported residual right ankle discomfort
as well as knee discomfort which worsened with activity or
changes in the weather. Id. at 304. Dr. Gerratana
noted she walked with a limp and had some diffuse tenderness
in her knees; x-rays revealed some right knee diffuse
osteoporosis. Id. Three months later, on June 13,
2011, Dr. Gerratana noted Haman continued to walk with a
limp, had mild right ankle swelling and some tenderness, and
had slightly decreased range of motion in her ankle.
Id. at 303. X-rays showed the right ankle was
“solidly united.” Id. Dr. Gerratana also
noted mildly restricted motion and some tenderness in
Haman's knees, gave her heel lifts, and instructed her to
continue taking Tylenol and Motrin. Id.
August 12, 2011, Dr. Watsky examined Haman and found her legs
were puffy and she had multiple tender points. Id. He
prescribed Cymbalta for her fibromyalgia. Id.
September 21, 2011, Dr. Sabeen Anwar, a rheumatologist,
examined Haman on referral from Dr. Gerratana. Id.
at 325. She reviewed Haman's medical history including
her ankle fracture and residual pain, fibromyalgia diagnosis
in 1993, and related musculoskeletal pain and stiffness in
her fingers, knees, ankles, hips, and upper back.
Id. Dr. Anwar found no evidence of synovitis,
restricted range of motion only in her right ankle,
tenderness in her hands, and several tender points.
Id. at 325-26. Dr. Anwar assessed Haman has
“5/5 upper and lower extremity strength with the
exception of the right quadricepts which is limited slightly
due to pain.” Id. at 326. X-rays revealed
diffuse osteoarthritis of the right knee. Id. Dr.
Anwar recommended a gradual exercise regimen, yoga, and tai
March 12, 2012, Haman visited the Grove Hill Medical Center
Orthopedic Surgery and Sports Medicine Center (Dr.
Anwar's place of work) regarding her continued ankle
discomfort and fibromyalgia pain. Id. at 345. The
examiner found Haman continued to experience
decreased range of motion in her ankle which caused her to
limp. Id. Haman also reported she was not satisfied
with Dr. Anwar's treatment and would be seeking a different
March 22, 2012, Dr. Nicholas Formica, a rheumatologist,
examined Haman and found she had a “slight
antalgic gait, although [she] walked without the
use of a cane, ” and had “slight soft tissue
swelling about the right ankle region.” Id. at
349. Dr. Formica found Haman had “18/18 tender points .
. . which were quite significant, ” as well as
“diffuse mild to moderate muscle tenderness” and
decreased range of motion of the right ankle. Id. at
350. Dr. Formica found no obvious hand swelling but some mild
tenderness. Id. Haman's motor strength was
intact. Id. Dr. Formica reviewed results of lab
tests Dr. Anwar had conducted and found no inflammation,
further confirming his fibromyalgia diagnosis. Id.
He also noted that Haman had difficulty sleeping.
Id. Dr. Formica recommended an alternative
non-steroidal agent to manage Haman's symptoms and an
alternative medication to aid her sleep if medicine
prescribed by Dr. Gerratana proved ineffective. Id.
31, 2012, Dr. Formica examined Haman again and confirmed she
still had “18 out of 18 tender points [and] diffuse
muscle tenderness . . . in all extremities.”
Id. at 360. Dr. Formica prescribed pain medication
to manage her fibromyalgia. Id. at 361. However,
that medication caused Haman's legs to swell, and Dr.
Formica instructed her to stop taking it on June 8, 2012.
Id. at 356.
25, 2012, Dr. Gerratana found Haman's right ankle had
become symptomatic of posttraumatic arthritis, with mildly
restricted range of motion and some diffuse tenderness.
Id. at 379.
September 6, 2012, Dr. Formica noted Haman had “normal
strength, normal gait, . . . [and] no significant joint
swelling.” Id. at 375. He instructed Haman to
take ibuprofen and Tylenol together to manage her
fibromyalgia since she could not afford the cost of Lyrica.
September 24, 2012, Dr. Gerratana noted Haman's continued
limp, moderately restricted range of motion and diffuse
tenderness in her right ankle and knees. Id. at 378.
Otherwise, Haman had “good motion, strength, and
stability” in her left ankle and knees, good hip
motion, and “appropriate mood, affect, orientation, and
coordination.” Id. Dr. Gerratana supplied
Haman with heel lifts and instructed her to continue her
current medications. Id.
October 12, 2012, Dr. Formica noted Haman continued to have
18 out of 18 tender points and diffuse muscle tenderness in
all extremities to a moderate degree. Id. at 371.
Dr. Formica prescribed Flexeril for her fibromyalgia pain.
December 6, 2012, Dr. Formica noted that Haman's
“overall condition ha[d] improved slightly since she is
using the Flexeril” and her sleep pattern had improved.
Id. at 367. However, Haman's overall pain
registered as ten out of ten, she had 18 out of 18 tender
points, and she continued to experience diffuse muscle
tenderness in all extremities. Id. at 367-68. Dr.
Formica also noted Haman was “quite anxious about her
upcoming hearing” regarding disability eligibility.
Id. at 369. He instructed Haman to continue her
current therapy. Id. at 368.
Medical Examinations and Opinions
Plaintiff underwent several independent medical examinations
by non-treating medical experts. Those experts, as well as
Haman's treating physicians, rendered opinions which
was referred by Disability Determination Services for a
mental status examination by consulting psychologist Dr.
Diana Badillo Martinez, Ph.D who reviewed Haman's medical
and psychiatric history, conducted a psychiatric examination
and rendered an opinion. [Dkt. No. 11-8 at 342.] Dr. Badillo
Martinez assessed that Haman is “polite, cooperative,
and engages easily, ” has a normal affect, clear but
slow speech, and average attention span. Id. at
342-43. However, Dr. Badillo Martinez also found Haman had
difficulty sleeping, below average thought processes, weak
reasoning ability, and feelings of inadequacy, with overall
intellectual abilities within the low to average range.
Id. at 343. Dr. Badillo Martinez noted Haman's
low intellectual ability “does not facilitate
recovery” from her physical problems. Id. She
diagnosed Haman with pain disorder associated with
psychological medical factors, panic disorder, and
personality disorder not otherwise specified
(“NOS”). Id. at 344. Dr. Badillo
Martinez recommended individual psychotherapy to gain
awareness of the relationship between her emotions and
physical distress, improve her coping skills, and help her to
overcome her feelings of incapacity. Id. Dr. Badillo
Martinez opined that Haman could engage in sedentary work on
a part-time basis given her condition. Id.
October 12, 2012, Dr. Formica, who had been treating Haman
since March 22, 2012, rendered an opinion on Haman's
physical limitations. [Dkt. No. 11-8 at 365.] He explained
that fibromyalgia patients experience severe fatigue, poor
concentration, anxiety, poor sleep, and difficulty coping
with normal activities of daily life, as well as muscular
pain and tenderness. Id. He found Haman's daily
limitations and chronic pain could be exacerbated
unpredictably and a flare up of her symptoms could last seven
to ten days. Id. Dr. Formica also stated Haman has a
permanent limp, a seven percent disability of her left knee
due to a fall in 2001, and pain in her right ankle.
Id. As a result, Dr. Formica concluded Haman is not
a candidate for employment of any kind. Id.
agency consultant Dr. Khurshid Khan reviewed the
Plaintiff's medical record and determined Haman had
multiple medically determinable impairments including
fractures of a lower limb, fibromyalgia, osteoporosis,
anxiety, personality disorder, and somatoform
disorder. [Dkt. No. 11-4 at 76.] He found Haman
retained the Residual Functional Capacity (“RFC) to
occasionally lift 20 pounds, frequently lift 10 pounds,
stand, walk, or sit for six hours in an eight-hour workday,
and push or pull an unlimited amount. Id. at 77. He
opined that Haman could occasionally climb ramps, stairs,
ladders, ropes, or scaffolds, could frequently balance,
stoop, or kneel, and could occasionally crouch or crawl.
Id. at 78-79. Limitations were attributed to
Haman's fibromyalgia and fractured right ankle.
Id. at 78.
Pamela Fadakar, PsyD, examined Haman's mental health
records in supplementation of Dr. Khan's review to
determine whether Haman had any qualifying mental health
conditions and their impact on her residual functional
capacity. In her opinion, Id. at 76-77. none of
Haman's mental impairments met or equaled the
requirements of a listed impairment, as Haman was only mildly
restricted in activities of daily living and social
functioning and had no recorded episodes of decompensation.
Id. Dr. Fadakar opined that Haman's mental
limitations render her moderately limited in ability to
follow detailed instructions, maintain attention or
concentration for extended periods, perform at a consistent
pace without an unreasonable number of rest periods, or
complete a normal workday without interruptions from
psychologically-based symptoms. Id. at 80. She
opined that Haman could “perform simple/routine tasks
for 2 [hour] periods during a [normal] work day/ [week] in a
setting [without] strict time or production
requirements” and could “adhere to a set schedule
up to her physical limits and work around others, ” but
would “have difficulty performing more complex tasks in
a timely manner.” Id. at 80. Dr. Fadakar also
opined that Haman is “better suited for non-public
work” but can “relate adequately w[ith]
supervisors and coworkers on a superficial basis and request
help when needed.” Id. at 80.
Carol Honeychurch, a State agency consultant, reviewed the
medical record, found Haman has three medically determinable
impairments and assessed her Residual Functional Capacity
(“RFC”). Based on her findings that Haman had a
fracture of a lower limb, fibromyalgia, anxiety, and
personality disorders, all of which were medically
determinable impairments, Dr. Honeychurch opined that Haman
retains the RFC to occasionally lift 20 pounds, frequently
lift 10 pounds, stand, walk, or sit for six hours in an
eight-hour workday, and is unlimited in ability to push or
pull. Id. at 91-92. She opined that Haman could
occasionally climb ramps or stairs, could never climb
ladders, ropes, or scaffolds, and could occasionally balance,
stoop, kneel, crouch or crawl. Id. at 92-93.
Limitations were identified as arising from Haman's
fibromyalgia and fractured right ankle. Id. at 93.
Warren Leib provided a mental health analysis to supplement
Dr. Honeychurch's analysis. He found Haman's anxiety
and personality disorders do not qualify as listed
impairments, and found her impairments render her moderately
limited in ability to follow detailed instructions, maintain
attention or concentration for extended periods, perform at a
consistent pace without an unreasonable number of rest
periods, or complete a normal workday without interruptions
from psychologically-based symptoms. Id. at 94-95.
He explained that Haman could perform simple or routine tasks
for two hours at a time during a normal workday in a setting
without strict time or production requirements, and could
adhere to a set schedule up to her physical limits and work
around others, but would have difficulty performing more
complex tasks in a timely manner. Id. at 95. In
addition, Dr. Leib noted Haman's moderately limited
ability to interact with the general public appropriately
made her better suited for work in a non-public setting,
although she could relate adequately with supervisors and
coworkers on a superficial basis. Id. at 95. Dr.
Leib also noted Haman is moderately limited in her ability to
respond appropriately to changes in the work setting, but
could adapt to minor or routine work adjustments, travel,
avoid safety hazards, and set simple work goals. Id.
The Hearing Before the ALJ
January 22, 2012, ALJ James E. Thomas (“ALJ
Thomas”) held a hearing to consider Haman's
disability claim. [Dkt. No. 11-3 at 31.] Haman was
represented by counsel. Id. at 34. Haman testified
she last worked on April 6, 2010, as a receptionist and show
room salesperson at Southington Glass Company. Id.
at 36-37. She worked at Southington Glass for eight and a
half years answering phones, scheduling appointments, and
handling sales. Id. at 37-38. She sometimes lifted
and carried glass, but asked for assistance lifting items
weighing over eight to ten pounds due to her fibromyalgia.
Id. at 43-44. She stopped working in April 2010 when
she tripped and fractured her ankle. Id. at 38.
Haman explained she completed five months of physical therapy
after her ankle surgery and continued to practice at-home
physical therapy as of the hearing date. Id. at 39.
She still had residual pain in her ankle, as well as
fibromyalgia pain “throughout [her] whole body every
minute of every day.” Id. at 39-40. Her
fibromyalgia pain worsened after her 2010 accident.
Id. at 44.
also described her daily living conditions. She walks with a
cane when she needs to leave her house and the weather is
inclement or her legs are swollen. Id. at 40-41. She
explained she walks with a limp and walking is more difficult
when her legs swell. Id. With a cane, she can walk
“maybe a quarter mile” at a time. Id. at
51. Haman also noted her left knee is arthritic and prevents
her from kneeling, squatting, bending, or running.
Id. at 41-42.
added that she gets “really, really bad headaches to
the point that [she] can't think straight.”
Id. at 47. She also testified she is more forgetful
than she used to be, and has to write things down to remember
them. Id. Her headaches last three to four days at a
time and occur four to five times per month. Id. at
47-48. She takes ibuprofen or Tylenol to manage her headaches
but is allergic to migraine medication. Id. at 48.
average daily pain level is a six or seven out of ten, but on
“really bad days” her pain level rises to nine.
Id. at 49. Weather affects her pain level; in the
winter, Haman has a “really bad” day about
eighteen to twenty out of every thirty days. Id. Her
fibromyalgia pain, combined with anxiety, “keeps [her]
from doing daily life” and has led her not to leave her
house alone anymore. Id. at 48-49. When her
fibromyalgia pain is particularly bad, Haman lays down for
twenty to thirty minutes to “try to calm down.”
Id. at 53. She stated she lays down due to
fibromyalgia pain one to four times per day. Id.
also testified she has arthritis in her hands and her
fingers swell roughly twice a week, which makes it difficult
for her to pick things up, hold onto things, or wash her
hair. Id. at 56, 63. When her fingers are swollen,
Haman can use a computer for half an hour at a time.
Id. at 57.
testified she has had anxiety since she was fifteen years old
but stopped seeing a therapist after her fall in April 2010.
Id. at 53-54. Haman stopped attending therapy
because she was using crutches which made it “hard to
get around” and could not drive. Id. Once she
was sufficiently healed to go to therapy again it had been
over a year since her last appointment. Id. at 54.
Because of the delay, she would have had to pay for a renewed
intake meeting, which she could not afford. Id. at