United States District Court, D. Connecticut
LISA M. BLACKERT, Plaintiff,
NANCY E. BERRYHILL, ACTING COMMISSIONER OF SOCIAL SECURITY, U.S.A., Defendant.
RULING RE: MOTION FOR JUDGMENT ON THE PLEADINGS (DOC.
NO. 23) & MOTION TO REVERSE THE COMMISSIONER’S
DECISION (DOC. NO. 19).
C. Hall United States District Judge.
Lisa M. Blackert (“Blackert”) brings this action
under title 42 section 405(g) of the United States Code,
appealing from the final determination of the Commissioner of
Social Security (“the Commissioner”), denying her
disability insurance benefits and supplemental security
income. Motion to Reverse the Decision of Commissioner
(“Pl.’s Mot.”) (Doc. No. 19). The
Commissioner cross-moves for an order affirming that
decision. Defendant’s Motion for Judgment on the
Pleadings (“Def.’s Mot.”) (Doc. No. 23).
reasons set forth below, the Motion to Reverse the Decision
of the Commissioner is GRANTED, and the Motion for Judgment
on the Pleadings (Doc. No. 23) is DENIED. The case is
remanded to the ALJ for proceedings consistent with this
Blackert was born in 1958, and was 52 years and 9 months old
at the age of her alleged onset date of March 21, 2011.
Plaintiff’s Statement of Facts (Doc. No. 19-1) at 2.
She is a licensed practical nurse, but has not worked since
March of 2011, with the brief exception of a nursing position
she held in 2013, from which she was terminated two weeks
into a three week orientation program because she
“wasn’t catching on fast enough and [she] was too
slow.” Certified Transcript of Record
(“R.”) at 129.
medical record begins in February of 2011. On February 8,
2011, Blackert was seen by David Bounds, APRN, and Dr. Mark
Thimineur for “chronic migraines, knee, multifocal
pain.” R. at 396. Treatment notes from that visit
reflect that Blackert’s “pain medications are
helping to some extent, but she is still having more
headaches than she would like.” Id. She was
diagnosed with “Chronic headache pain secondary to
migraines, neuralgias.” R. at 397.
was seen by Dr. Thimineur again on April 19, 2011, for
bilateral “knee pain due to ACL repair and chronic
migraine headaches.” R. at 399. Dr. Thimineur noted
that Blackert was taking Relpax and Topamax for her
headaches, both of which “help her,” and was also
taking Percocet for her knee pain. Id.
saw Courtney Howard, Certified Physician’s Assistant,
for July 25, 2011, for hypertension, migraine headaches, and
depression. Howard’s notes reflect that
Blackert’s headaches were “controlled with pm
Relpax” and that she was “doing ok on Effexor
75mg” with respect to her depression.
October 27, 2011, Blackert saw Heather Alfonso, Advanced
Practice Registered Nurse, for pain resulting from migraine
headache and headache. R. at 403– 04. Blackert’s
headaches were described as having an “aching and
crushing” quality, with associated symptoms of
“swelling, photosensitivity, nausea and vomiting during
headache.” R. at 403. Treatment notes reflect that
Blackert’s headaches are alleviated by
“medication, rest and dark room” and exacerbated
by “bright lights, loud noise, chewing and
stress.” Id. The severity of Blackert’s
headaches was characterized as “2” and the
narrative section notes that Blackert was “[d]oing well
with current medication regime.” Id. Results
of physical and neurological exams were all in the normal
January 27, 2012, Alfonso saw Blackert again and noted that
her “[p]ain levels, functionality have remained stable
without any major changes since the last visit.” R. at
April 17, 2012, Alfonso saw Blackert again. R. at 409.
Alfonso’s treatment notes reflect that Blackert’s
younger sister died of a heart attack since her last visit,
and that she was very upset as a result. Id. Alfonso
states that Blackert “has a hard time even getting out
of her house to run errands.” Id.
18, 2012, Alfonso saw Blackert again. Alfonso’s notes
state that “Patient reports >50% relief of pain,
improvement in participation in activities of daily living on
current medication regimen, Patient does not report any side
effects or adverse reactions from prescribed opioid
medications and No aberrant behaviors related to prescribed
opioids identified during this visit.” R. at 414.
January 15, 2013 Alfonso saw Blackert again, and noted that
Blackert “will potentially be starting a new position
in assistive living.” R. at 418. Alfonso further notes
that Blackert’s “pain levels are stable”
and that her pain is “manageable.” R. at 419.
April 10, 2013, Alfonso saw Blackert again. Alfonso states
that Blackert’s “pain levels have been stable
with Percocet,” and that Cymbalta (an antidepressant)
has been “helping significantly.” R. at 421.
10, 2013, Alfonso saw Blackert again, and noted that Blackert
reported both that her “current pain medication regimen
are ‘helping tremendously’” and that
Blackert “noticed an increase in her migraines (15 or
more episodes) with nausea over the past 2 months.” R.
at 425. In this visit, Alfonso and Blackert discussed the
possibility of Botox injections for her migraines, and
Blackert “verbalize[d] interest” in that
treatment. Id. Alfonso’s notes describe
Blackert’s migraines as occurring “on greater
than 15 days per month for at least 3 months” with
“at least five full filling [sic] criteria for migraine
without aura, headaches on average last more than 4
hours.” Id. Alfonso describes the pain as
“moderate or severe in intensity” with
“nausea and/or vomiting, photophobia and
phonophobia.” R. at 426. Alfonso further notes that
Blackert “complains of pain and muscle tenderness of
her neck and shoulders.” Id. During this
visit, Alfonso describes administration of “Spinal
accessory nerve block” and “Occipital nerve
block” for “pain relief” and “Trigger
point injection” for “pain control.” R. at
August 20, 2013, Blackert saw APRN Patricia Blanc at Cornell
Scott Hill Health Center. During that visit, Blackert
reported “sparks out of peripheral of right eye x
weeks” and “Constant migraine headaches x 30
years.” R. at 385. Blanc’s notes reflect that
Blackert was aware of a CT scan “about four years ago
with shows ?? lesion on the brain but nothing was done about
it. Neurologist who saw her is now in prison.”
Id. She also states that Blackert’s pain in
her neck was greater than her shoulder pain, and rated that
pain at 6/10. Id. Testing was ordered, including an
October 8, 2013 Alfonso saw Blackert again. Blackert reported
that her pain levels were “somewhat exacerbated with
the barometric pressure changes and recent sinusitis.”
R. at 429.
saw Blackert again on October 10, 2013. She noted that
Blackert was experiencing pain in her right knee. R. at 374.
Thimineur saw Blackert on November 5, 2013. Spinal accessory
nerve blocks and trigger point injections were administered
in the cervical/shoulder areas. R. at 434.
Hong Lin saw Blackert on January 3, 2014, for medication
management related to her complaints of depression and
anxiety. He adjusted her dose of Cymbalta downward, and also
prescribed Ativan and Ambien. R. at 485.
saw Blackert again on January 7, 2014. Blackert reported that
an MRI had been conducted, and showed new lesions, but was
still awaiting “results.” R. at 437.
Hong Lin saw Blackert again on February 7, 2014. He notes at
that time that Blackert “is coming to terms with her