United States District Court, D. Connecticut
MEMORANDUM OF DECISION DENYING DEFENDANT'S MOTION
FOR ORDER REVERSING THE COMMISSIONER'S DECISION [DKT. NO.
Vanessa L. Bryant United States District Judge.
an administrative appeal following the denial of the
Plaintiff, Karen Rodriguez's, application for Title II
Social Security Disability benefits, and a Title XVI
application for Supplemental Security Income. It is brought
pursuant to 42 U.S.C. §§ 405(g). Karen Rodriguez
(“Plaintiff” or “Rodriguez”) 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. 16]. The Commissioner opposes this
motion. [Dkt. No. 20]. On July 13, 2017, the case was fully
briefed. For the following reasons, Rodriguez's Motion
for an Order Reversing or Remanding the Commissioner's
Decision [Dkt. No. 16] is DENIED.
applied for disability insurance benefits and supplemental
security income in June 2013. [AR 222-32]. She alleged that
she became disabled on January 1, 2011, at age 33, due to
panic attacks, insomnia, anxiety, depression, agoraphobia, a
personality disorder, and asthma. [AR 279]. Her applications
were denied initially and on reconsideration. [AR 126-29,
131-33]. She then requested a hearing before an ALJ. [AR
144-45]. After a hearing, at which Plaintiff was represented
by counsel, Administrative Law Judge (“ALJ”) John
Noel issued a decision on August 20, 2015, finding that
Plaintiff was not disabled under the Social Security Act (the
“Act”). [AR 19-29]. The Appeals Council denied
Plaintiff's request for review, and this action followed.
appeal before this Court, Plaintiff highlights the following
medical conditions: (1) anxiety and depression; (2) right
knee impairment; (3) cognitive deficiencies; and (4) obesity.
Anxiety and Depression
received mental health treatment from therapists and a
psychiatrist at Franciscan Life Center from October 2011
through December 2014. Specifically, Plaintiff received
mental health care from psychiatrist Dr. Joanna Jakubowska,
MD, and from mental health counselors Sister Sophia Peters,
MF-T, and Sister John Mary Sullivan, LMFT. [AR 389-411,
436-447, 480-82]. In notes from an October 24, 2011 visit,
Peters noted that Plaintiff had moved from the Bronx, NY to
Connecticut, and that she had previously been diagnosed with
anxiety and depression. Peters stated that Plaintiff was
taking 60mg of Cymbalta every day. Peters' notes also
stated “ER often for anxiety.” Peters found that
Plaintiff had a Global Assessment of Function of 55 and
recommended weekly therapy sessions with medication
management. [AR 389-92]. Peters also observed that Plaintiff
was well-groomed and calm, that she had an appropriate affect
and a normal mood, that her thought process was intact and
she had no hallucinations, and that she was fully oriented
and her memory, cognitive functioning, capacity for abstract
thought, judgment, and insight were intact. [AR at 390].
Peters recommended weekly therapy and medication management.
November 7, 2011, approximately two weeks after Peters'
notations, Plaintiff presented to Dr. Jacubowska for a
psychiatric evaluation. Dr. Jacubowska noted symptoms
associated with plaintiff's diagnoses, including anxiety,
panic attacks, poor concentration, poor sleep, and fear of
social situations. Dr. Jacubowska diagnosed Plaintiff with
panic disorder with agoraphobia and entertained possible
diagnoses or “ruling out” of major depressive
disorder and bipolar disorder. [AR 393-94]. Plaintiff noted
that her energy and motivation were good, and Dr. Jacubowska
observed that Plaintiff was well-groomed and alert and
oriented to person, time and place. [AR 394]. Plaintiff's
speech was normal in rate, volume, and tone, and her affect
was constructed with no lability and her mood was euthymic.
[AR 394]. Plaintiff's memory was intact, but her
concentration was poor, and Plaintiff denied hallucinations.
Plaintiff's thought process was logical and goal
directed, and Plaintiff had fair insight and good judgment.
[AR 394]. Dr. Jacubowska advised Plaintiff to continue her
current medication regimen, which included Trazodone and
Cymbalta. [AR 393-94]. In a follow-up appointment on November
28, 2011, Dr. Jacubowska noted that despite treatment,
Plaintiff experienced no changes in her symptoms. [AR 395].
saw Peters weekly from November 28, 2011 to January 6, 2012.
[AR 396-97]. On January 6, 2012, Plaintiff reported that she
felt “stronger.” [AR 396]. The session focused on
Plaintiff's goals and the possibility of getting a
general education diploma (“GED”). Peters also
explained that she was leaving the Franciscan Center and that
Plaintiff would be transferred to a different therapist. [AR
on January 20, 2013, Plaintiff began seeing Sullivan, and she
continued see Dr. Jacubowska for medication management. [AR
397]. On March 28, 2012, Sullivan noted that Plaintiff
reported she “continue[d] to struggle” with
anxiety and depression and had been unable to implement any
relaxation techniques. Sullivan reviewed relaxation
techniques with Plaintiff and instructed her to utilize these
techniques when experiencing symptoms. [AR 395]. On a
follow-up appointment on April 24, 2012, Sullivan stated that
Plaintiff reported that she was struggling with sleep
problems and was “unable to sleep through the night due
to anxiety.” [AR 397]. In a treatment note dated April
25, 2012, Jacubowska noted that she was going to discontinue
prescribing Buspar to Plaintiff due to lack of benefits but
would continue to prescribe Cymbalta. She also noted that
Plaintiff had complaints of mood changes, racing thoughts,
irritability and fear/paranoia. [AR 398].
May 11, 2012 treatment notes, Dr. Jacubowska stated that
Plaintiff continued to complain of racing thoughts and poor
sleep, and Dr. Jacubowska prescribed Abilify to treat these
symptoms. [AR 398]. In her June 7, 2012 treatment notes, Dr.
Jacubowska stated that Plaintiff's dosage of Abilify
would be increased and that Plaintiff continued to suffer
from anxiety and poor sleep.
mental health treaters' notes from December 12, 2012
through November 21, 2013 state that during this period of
time, Plaintiff continued to suffer from symptoms of anxiety,
depression, agoraphobia, and panic attacks. [AR 401-410]. On
October 29, 2013, Sullivan completed a Mental Impairment
Questionnaire. This questionnaire is co-signed by Dr.
Jacubowska. Sullivan stated that Plaintiff had a diagnosis of
panic disorder with agoraphobia and major depressive
disorder. Sullivan noted that Plaintiff was taking the
following medications: Celexa, Lemictal, Klonopin, and
Abilify, all of which are used to treat anxiety and
depression. Positive clinical findings included poor
concentration, auditory halluciations, paranoia, depressed
mood, and constricted affect. Plaintiff's judgment and
insight were rated “fair, ” Plaintiff was well
groomed, and under “cognitive status, ” Sullivan
noted that Plaintiff was oriented to person, place, and time,
her memory was intact, her attention was fair, and her
concentration was poor. Sullivan noted that Plaintiff had a
slight problem in carrying out single-step instructions and
changing from one simple task to another. [AR 385]. Sullivan
stated that Plaintiff would have an “obvious
problem” with respect to: (1) using appropriate coping
skills to meet ordinary demands of a work environment; (2)
handling frustration appropriately; (3) interacting
appropriately with others in a work environment; (4) asking
question or requesting assistance; (5) getting along with
others without distracting them or exhibiting behavioral
extremes; (6) carrying out multi-step instructions; (7)
focusing long enough to finish assigned simple activities or
tasks; (8) performing basic work activities at a reasonable
pace/finishing on time; and (9) performing work activity on a
sustained basis. [AR 382-86].
November 12, 2013, Plaintiff told Dr. Jacubowska that she was
doing well. [AR 409, 436]. Plaintiff's sleep had improved
with an increase in Klonopin and she denied having a
depressed mood. [AR 409]. Dr. Jacubowska found that Plaintiff
was alert and oriented to person, place, and time, that
Plaintiff's mood was normal and that Plaintiff's
affect was constricted but with no lability. [AR 409, 436].
Plaintiff did not hallucinate, and her judgment and insight
January 22, 2014, Dr. Jacubowska completed a Medical Report
for Incapacity for the State of Connecticut's Department
of Social Services. Dr. Jacubowska states that Plaintiff had
been diagnosed with panic disorder with agoraphobia and
bipolar I disorder. Dr. Jacubowska opined that Plaintiff
experiences panic attacks, poor sleep, inability to focus,
high anxiety, and poor concentration. She added that
Plaintiff “continues to have a fear of social settings.
[AR 411-415]. On the form, Jacubowska marked a box indicating
that Plaintiff could not work while she was being treated.
continued treatment with Sullivan and Dr. Jacubowska
throughout 2014. [AR 438-47, 481]. In January 2014, Plaintiff
reported that she had more anxiety during the holidays and
felt overwhelmed by her responsibilities. [AR 440]. Dr.
Jacubowska found that Plaintiff was oriented to person,
place, and time, Plaintiff's mood was normal and her
affect was constricted, but she exhibited no lability. [AR
440]. Plaintiff did not have hallucinations and her judgment
and insight were good. [AR 440]. Dr. Jacubowska noted that
Plaintiff's mood was stable and her anxiety had increased
in the context of recent stressors. [AR 440]. She recommended
that Plaintiff continue therapy and her current medications,
and she reported the same findings during subsequent
evaluations, except in December 2014.
date, Dr. Jacubowska observed that Plaintiff's affect was
bright instead of constricted, and Plaintiff reported that
she was doing well. [AR 440-41, 444-47]. Dr. Jacubowska also
saw Plaintiff in January, March, and April 2015, at which
point Dr. Jacubowska found that Plaintiff was alert and
oriented to person, place, and time, her mood was dysphoric,
her affect was constricted, she had no lability or
hallucinations, and her judgment and insight were good. [AR