Kennedy v. Colvin

          RULING ON MOTION TO REVERSE THE DECISION OF THE COMMISSIONER

          VICTOR A. BOLDEN UNITED STATES DISTRICT JUDGE.

         Jacqueline Kennedy (“Plaintiff”) filed this administrative appeal under 42 U.S.C. § 405(g) against Carolyn Colvin, the Commissioner of Social Security (“Defendant” or “the Commissioner”), seeking to reverse the decision of the Social Security Administration (“SSA”) denying her claim for Title II disability insurance benefits under the Social Security Act. Compl. at 1, ECF No. 1.

         Ms. Kennedy moves for an order reversing the decision of the Commissioner or, in the alternative, an order remanding her case for rehearing. Mot. to Reverse, ECF No. 14. The Commissioner has moved for an order affirming the decision of the Commissioner. ECF No. 15.

         For the reasons that follow, Ms. Kennedy's motion is DENIED, and the Commissioner's motion is GRANTED.

         I. FACTUAL AND PROCEDURAL BACKGROUND

         A. Facts

         Born on October 16, 1959, Tr. at 26, Ms. Kennedy graduated from high school and received no other vocational training. Tr. 35. When she started treatment, she lived in Hartford, Connecticut. Tr. 410.

         1. Medical Evidence

         Ms. Kennedy's medical history includes diabetes mellitus, breast cancer, bi-polar disorder, major depressive disorder, post-traumatic stress disorder, anxiety disorder, arthritis, lumbar pain, and hypertension. Tr. 305, 307, 320, 334, 338, 349-50, 353, 355, 359, 361, 366, 383, 385, 401, 406-07, 413, 417-18, 420, 423-24, 427-34, 437, 442, 447, 458, 464, 476, 478, 492. Her diabetes is “poorly controlled, ” Tr. 305, 407, 458, and her hypertension is uncontrolled, Tr. 308-10, and she is, as a result, at risk of stroke or myocardial infarction, Tr. 310. She also has blurred vision while reading. Tr. 325.

         During the spring and summer of 2010, Ms. Kennedy was diagnosed with stage III breast cancer. Tr. 342-44 (documenting discovery of 2.5 cm mass in her left breast and diagnosing suspected metastatic disease in lymph nodes), 392-95 (confirming presence of stage III carcinoma with metastases in lymph nodes), 398-99, 497-504 (confirming through MRI primary tumor in left breast and enlarged lymph nodes in left axilla). On June 4, 2010, she had surgery to remove a cancerous tumor and metastases in the axillary lymph nodes. Tr. 334-35. She was discharged the following day. Tr. 347-48. On June 17, 2010, a radiation oncologist examined her and recommended radiation therapy to prevent a local recurrence. Tr. 488-89. She underwent chemotherapy for five months and radiation for two months, and she has experienced hot flashes since that treatment. Tr. 320, 350.

         On August 16, 2010, Ms. Kennedy visited Community Health Services. Tr. 475. She explained that she had stopped taking her blood pressure medication because it made her feel depressed, and that she would like to switch her medication. Id. Her blood pressure was elevated and uncontrolled; the advanced practice registered nurse (APRN), Rita Rivera, changed her medication, and noted that Ms. Kennedy was undergoing chemotherapy and experiencing side effects from the treatment. Tr. 476. She also noted that Ms. Kennedy had “benign essential hypertension, ” “poorly controlled” diabetes mellitus, and breast cancer. Tr. 476.

         On August 21, 2010, Ms. Kennedy returned to Community Health Services for a diabetic foot screening with podiatrist Sherwin Tucker, DPM. Tr. 328, 474. He noted that she had newly been diagnosed with diabetes mellitus, and had been referred for a foot screen; he also marked that she did not report podiatric complaints, including that she was not experiencing tingling in her ankles, legs, or feet. Tr. 328. Dr. Tucker counseled Ms. Kennedy about diabetes mellitus and foot care. Tr. 329.

         On August 26, 2010, Ms. Kennedy met with a registered dietician, Leila Bruno, MS, RD, CDE. Tr. 325. Ms. Bruno noted that Ms. Kennedy had been newly diagnosed with diabetes mellitus and that she also had breast cancer. Id. Ms. Kennedy reported that she had lost ten pounds over the past three months, was experiencing increased blurry vision, decreased appetite, and nausea, especially after the chemotherapy treatments. Id. Ms. Bruno's report also stated that Ms. Kennedy did not lack adequate sleep, and that she exercised regularly by walking, though less since she began receiving chemotherapy treatment. Tr. 326. Ms. Kennedy also reported that she was not feeling pain or numbness in her lower body, and Ms. Bruno noted that Ms. Kennedy's diabetes mellitus was under “fairly good control.” Tr. 326. On September 2, 2010, Ms. Kennedy and Ms. Bruno attended a diabetes education class. Tr. 324-25.

         On December 22, 2010, Ms. Kennedy visited Community Health Services to request a refill of her blood pressure medication and met with registered nurse Everol Ennis. Tr. 322-23; 467-69. She had stopped taking her diabetes mellitus medication because “she read about [a] side effect of nausea and stated that chemo was already making her nauseous.” Tr. 322. Her final round of chemotherapy was scheduled for that week. Id. She also stated that she stopped taking her blood pressure medication because it made her depressed, but that she was ready to begin taking the medication again. Id. Nurse Ennis assessed that Ms. Kennedy had “[b]enign essential hypertension poorly controlled” because Ms. Kennedy had not been taking medication for months. Tr. 323. She also assessed that Ms. Kennedy's diabetes mellitus was “poorly controlled secondary to no medication for months.” Id.

         On January 24, 2011, Ms. Kennedy visited Community Health Services for a follow-up appointment and met with Dr. Daman Ali. Tr. 320-21; 465-66. At that point, Ms. Kennedy had completed chemotherapy and was scheduled for radiation therapy to begin after a few weeks. Tr. 320. Dr. Ali noted that Ms. Kennedy's blood pressure was elevated, and that she reported that she had been experiencing hot flashes since finishing chemotherapy. Tr. 321.

         Ms. Kennedy underwent radiation therapy until late April 2011. Tr. 494-95. She reported having a localized skin reaction and feeling fatigued after completing the radiation, but she otherwise tolerated the treatment and recovered well. Tr. 492. She had a mammogram on May 11, 2011, that revealed no evidence of malignancy. Tr. 341, 491.

         On May 18, 2011, Ms. Kennedy returned to Community Health Services and met with Dr. Darren Martin, who checked her blood pressure and blood sugar. Tr. 461. Dr. Martin noted that Ms. Kennedy's blood sugar was within normal limits, and her blood pressure was slightly elevated. Id. Dr. Martin also noted that Ms. Kennedy reported that she was complying with medications, but also reported that she does not like to take medications; Dr. Martin advised her of the importance of complying with her prescription. Id.

         On June 3, 2011, Ms. Kennedy returned to Ms. Bruno for nutrition counseling. Tr. 318- 19; 459-60. Ms. Bruno noted that Ms. Kennedy had elevated blood pressure and was overweight, and that Ms. Kennedy reported that she was walking, doing exercise, had new glasses, and that her energy was improving. Tr. 318-19. Ms. Bruno also noted that she suspected that Ms. Kennedy's diabetes mellitus had not improved, and that she had hyperlipidemia. Tr. 319. Ms. Bruno counseled Ms. Kennedy about her “medication administration and compliance” and about her diet. Tr. 319.

         On June 7, 2011, Ms. Kennedy visited Community Health Services for a physical. Tr. 455. She reported anxiety and depression, as well as feeling tired. Tr. 456. She also visited Community Health Services on June 21, 2011, and reported that she had been feeling “weird” on her medication, and that she had been experiencing headaches for about two weeks. Tr. 305.

         On July 5, 2011, Ms. Kennedy returned to Community Health Services for a blood pressure check, and met with APRN Susan Neagle. Tr. 316. Nurse Neagle recorded that Ms. Kennedy's blood pressure was elevated. Tr. 316-17. Nurse Neagle renewed Ms. Kennedy's prescription, making some changes to the medication, and told Ms. Kennedy to follow up in two weeks. Tr. 315. Ms. Kennedy missed the next appointment; she returned on September 8, 2011, for refills of her prescription. Id. She also returned on October 25, 2011. Tr. 311-13. Nurse Neagle noted on that visit that Ms. Kennedy had elevated blood pressure, and that her diabetes was better under control. Tr. 313.

         On November 8, 2011, Ms. Kennedy visited Community Health Services for a blood pressure check. Nurse Neagle noticed an improvement since Ms. Kennedy's last visit, and also noted that Ms. Kennedy “stated that she is not compliant with her medications because she has a problem with focusing because she is out of a job, ” and that Ms. Kennedy “states that she takes the medication probably three times out of the week.” Tr. 310. Nurse Neagle advised Ms. Kennedy of the “importance of taking all medications as prescribed.” Tr. 310. On December 1, 2011, Ms. Kennedy returned, and Nurse Neagle noted that her blood pressure was “uncontrolled.” Tr. 309-10.

         On February 23, 2012, Ms. Kennedy had a bilateral mammogram that revealed no malignancy. Tr. 340.

         On July 3, 2012, Ms. Kennedy returned to Community Health Services for a refill of her prescription. Tr. 307-08; 441-42. She also requested, and was prescribed, Effexor for depression. Tr. 307-08. She returned on June 21, 2012, for a blood pressure check; she reported that she had not been taking her medication because she “felt ‘weird on it.'” Tr. 305.

         On September 14, 2012, through the referral of her primary care physician, Ms. Kennedy met with a licensed clinical social worker, Maritza Degonzalez, because Ms. Kennedy had stopped eating and was sleeping ten or eleven hours each day. Tr. 378. Ms. Kennedy reported to Ms. Degonzalez that she had plans to commit suicide by overdosing on medication, and she described a previous suicide attempt, several years earlier: she had set her car on fire while inside it, and then was hospitalized at Mt. Sinai Hospital. Tr. 378.

         Ms. Kennedy also reported a history of alcohol abuse, a previous boyfriend who had physically and verbally abused her, and that she had recently lost her job and faced eviction. Tr. 379. Ms. Degonzalez recorded that Ms. Kennedy appeared depressed, that her thought process appeared impaired, and that her thought content appeared relatively impaired. Tr. 380. Ms. Degonzalez also referred Ms. Kennedy to go to the emergency room “for further evaluation and possible in patient hospitalization for safety and medication evaluation.” Tr. 382. Ms. Kennedy was taken to the hospital in an ambulance. Tr. 382. Once there, hospital staff diagnosed Ms. Kennedy as having had an anxiety attack and being depressed. Tr. 350.

         On September 29, 2012, Ms. Kennedy met with licensed clinical social worker Joanne Gayeski and psychologist Margarita Hernandez. Tr. 349-53. Ms. Kennedy reported her medical history, described above, as well as her typical behavior: she described that she was “independent but is not self-motivated, ” that she “can do her own grooming, cleaning, shopping, and cooking, ” and that she “is able to take public transportation without assistance.” Tr. 351. The report also stated that Ms. Kennedy “is knowledgeable of how to pay bills, use the telephone directory, and utilize postal and banking services.” Id. Ms. Kennedy stated that she was “currently working part time as a personal care assistant, indicating that her start date was July 2012.” Id. She reported that she worked fifteen hours bi-weekly. Id. She also reported that before that job, she worked as a supervisor “for female adolescents in a ...