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Kravat-Jahner v. Colvin

United States District Court, D. Arizona

March 6, 2014

Cari Kravat-Jahner, Plaintiff,
v.
Carolyn W. Colvin, Acting Commissioner of Social Security, Defendant.

ORDER

BRIDGET S. BADE, Magistrate Judge.

Cari Kravat-Jahner (Plaintiff) seeks judicial review of the final decision of the Commissioner of Social Security (the Commissioner), denying her application for disability insurance benefits under the Social Security Act (the Act). The parties have consented to proceed before a United States Magistrate Judge pursuant to 28 U.S.C. § 636(b) and have filed briefs in accordance with Local Rule of Civil Procedure 16.1. For the following reasons, the Court reverses and remands to the Commissioner for further proceedings.

I. Procedural Background

In May 2010, Plaintiff applied for disability insurance benefits under Title II of the Act. 42 U.S.C. § 401-434. (Tr. 24.)[1] Plaintiff alleged that she had been disabled since May 2008. (Tr. 24.) After the Social Security Administration (SSA) denied Plaintiff's initial application and her request for reconsideration, she requested a hearing before an administrative law judge (ALJ). After conducting a hearing, the ALJ issued a decision finding Plaintiff not disabled under the Act. (Tr. 25-34.) This decision became the final decision of the Commissioner when the Social Security Administration Appeals Council denied Plaintiff's request for review. (Tr. 1-6); see 20 C.F.R. § 404.981 (explaining the effect of a disposition by the Appeals Council.) Plaintiff now seeks judicial review of this decision pursuant to 42 U.S.C. § 405(g).

II. Medical Records and Assessments of Plaintiff's Mental Health

The record before the Court establishes the following history of diagnosis and treatment related to Plaintiff's mental health. The record also includes opinions from a lay witness and state agency physicians who reviewed the records related to Plaintiff's mental health.

A. Jasbir Bisla, M.D., Treating Psychiatrist

Psychiatrist Jasbir Bisla, M.D., treated Plaintiff first at the Terros Clinic and then in private practice. (Tr. 251-62, 266-69, 288-90, 293-94, 296-97.) He first saw Plaintiff in May 2008. (Tr. 285.) Dr. Bisla noted that Plaintiff was not taking her medication and that she had become angry and lost a job. (Tr. 285-86.) On examination, Dr. Bisla reported that Plaintiff had a dysphoric mood, and that she was alert and oriented, had a good appearance, good eye contact, normal motor activity, an appropriate affect, normal speech, logical thought process, good concentration, intact memory, good intelligence, good insight, and good judgment. (Tr. 285-286.) Dr. Bisla diagnosed mood and anxiety disorders (Tr. 286-287), assessed a Global Assessment of Functioning (GAF) score of 65 (Tr. 285), and prescribed psychiatric medication.[2] (Tr. 286-287.)

Dr. Bisla examined Plaintiff in October 2008. (Tr. 250-254.) Plaintiff reported that she had been taking prescribed psychiatric medication, that her psychiatric medications were working well, and that her mood was stable, her anger was under good control, and her panic attacks had subsided - which she attributed to reuniting with her spouse. (Tr. 251.) She denied mood, panic, and obsessive compulsive symptoms. (Tr. 251-252.) Dr. Bisla noted that Plaintiff typically talked rapidly, got angry quickly, and had a labile mood. (Tr. 253.)

Dr. Bisla next examined Plaintiff in May 2009, noting he had not seen Plaintiff in six months. (Tr. 255-256.) Plaintiff that reported she had lost a job due to anger issues. She also reported that she had been taking psychiatric medication obtained elsewhere, and that she had better control of her emotions and better energy with medication. (Tr. 255.) On examination, Dr. Bilsa reported that Plaintiff had an anxious, dysphoric mood and rapid speech, but also good grooming, good eye contact, calm psychomotor activity, an appropriate affect, a logical and goal-directed thought processes, and normal attention span. ( Id. ) Dr. Bisla continued Plaintiff's current treatment. (Tr. 256.)

Dr. Bisla examined Plaintiff again in September 2009. (Tr. 257-258.) Plaintiff reported that she was "doing well, " that her depression had not been bothering her, and that she had no problems other than irritability, which she attributed to her menstrual period. (Tr. 257.) Dr. Bisla reported that Plaintiff had an euthymic mood, good grooming, good eye contact, calm psychomotor activity, an appropriate affect, normal speech, logical and goal-directed thought processes, and normal attention span. (Tr. 257.) Dr. Bisla noted that Plaintiff's mood was better although she experienced menstrual-related anger "a few days" monthly. (Tr. 258.) Dr. Bisla continued Plaintiff's current treatment and added medication (Klonopin) for menstrual-related irritability. ( Id. )

Dr. Bisla next examined Plaintiff in April 2010. (Tr. 259-260.) Plaintiff reported that medication was effective, but that she had difficulty affording Effexor. (Tr. 259.) Dr. Bilsa reported that on examination Plaintiff had an anxious mood, hyperactive psychomotor activity, rapid speech, good grooming, good eye contact, an appropriate affect, a logical and goal-directed thought processes, and normal attention span. (Tr. 259). Dr. Bisla prescribed psychiatric medication, noting that Plaintiff's compliance to treatment was poor due to her inability to afford Effexor. (Tr. 259-260.)

Dr. Bisla examined Plaintiff in May 2010. (Tr. 261-262.) Plaintiff reported increased anxiety and depression and an inability to maintain a job since discontinuing psychiatric medication due to her inability to afford it. Dr. Bisla recommended that Plaintiff seek treatment through an indigent care mental health agency, but Plaintiff resisted based on a reported past "bad experience at one agency." (Tr. 262.) On examination, Plaintiff had a sad mood, easy distraction and poor concentration, a labile affect, and rapid speech. Plaintiff was also alert and oriented, demonstrated good eye contact, had a normal gait, had logical thought processes, could perform normal calculations, had an average fund of knowledge, and her insight, impulse control, and judgment were intact. (Tr. 261.) Dr. Bisla assessed a GAF score of 55, noting a previous GAF of 75. He concluded that Plaintiff was not doing well because she was not taking prescribed medications. (Doc. 261-62.)

Dr. Bisla examined again Plaintiff in September 2010. (Tr. 268-269.) Plaintiff reported experiencing anger and anxiety despite taking prescribed psychiatric medication regularly. (Tr. 268.) On examination she had an irritable mood, a labile affect, rapid speech, limited attention and concentration; she was also alert and oriented, demonstrated good eye contact, had a normal gait, had a logical thought processes, and her insight and judgment were intact. (Tr. 268.) Dr. Bisla assessed a GAF score of 55, noting a previous score of 75, and concluded that Plaintiff was experiencing "partial benefit" from medication. Dr. Bisla continued Plaintiff's treatment. (Tr. 268.)

Dr. Bisla next saw Plaintiff in October 2010 to complete "forms for her attorney." (Tr. 266-67.) Plaintiff reported experiencing anger and anxiety despite taking her prescribed medication regularly. (Tr. 266.) Dr. Bilsa examined Plaintiff and reported that she had an anxious, irritable mood, a labile affect, rapid speech, fidgetiness, easy distraction, and limited concentration. ( Id. ) Plaintiff was also alert and oriented, demonstrated good eye contact, had a normal gait, logical thought processes, and her insight and judgment were intact. (Tr. 266.). Dr. Bisla assessed a GAF score of 55, noting a previous score of 75. ( Id. ) He concluded that Plaintiff was experiencing "partial benefit" from medication and continued treatment. ( Id. )

On October 7, 2010, Dr. Bisla completed a "Medical Assessment of the Patient's Ability to Perform Work Related Activity." (Tr. 291-92.) Dr. Bisla found that Plaintiff had moderate limitations ("an impairment which affects but does not preclude ability to function") in deterioration of personal habits and in her ability to perform simple tasks. (Tr. 291.) He also found that Plaintiff had moderately severe limitations ("an impairment which seriously affects ability to function") in her abilities to: understand, carry out, and remember instructions; perform complex tasks; perform repetitive tasks; and perform varied tasks. ( Id. ) In addition, Dr. Bisla found that Plaintiff had severe limitations ("extreme impairment of ability to function" in her abilities to: relate to other people; attend to daily activities, such as going to meetings, working around the house, and socializing; respond appropriately to supervision; respond appropriately to coworkers; respond to customary work pressures; complete a normal workday/workweek without interruptions from psychologically based symptoms; and perform at a consistent pace without an unreasonable number/length of rest periods. (Tr. 291-92.)

Dr. Bisla next examined Plaintiff in July 2011. (Tr. 293-294.) Plaintiff reported decreased anger with compliance to treatment, but increased stress due to financial difficulty related to her spouse not working. (Tr. 293.) On examination she had an anxious, irritable mood, a labile affect, rapid speech, fidgetiness, easy distraction, limited concentration, but she was alert and oriented, demonstrated good eye contact, had a normal gait, had logical thought processes, and her insight and judgment were intact. ( Id. ) Dr. Bisla assessed a GAF score of 55, noting a previous GAF score of 75. ( Id. ) He concluded that Plaintiff was receiving "partial benefit" from medication and continued treatment, noting her compliance to treatment was "fair." ( Id. )

B. Mary Downs, Ph.D, Agency Reviewing Physician

On August 11, 2010, Mary Downs, Ph.D, a state agency psychologist, completed an assessment based on her review of the records. (Tr. 58-60.) Dr. Downs found that Plaintiff had affective and anxiety disorders that were "not severe." (Tr. 60.)

C. Adrianne Gallucci, Psy.D., Agency Reviewing Physician

On November 29, 2010, Adrianne Gallucci, Psy.D, a state agency psychologist, reviewed the record and completed an assessment. (Tr. 67-68.) Dr. Gallucci noted that medication kept Plaintiff's mood stable and concluded that Plaintiff had affective and anxiety disorders that were not severe mental impairments. (Tr. 68.)

D. Third-Party Statement

In a Third-Party Report, dated May 26, 2010, Plaintiff's friend Matthew Garcia indicated that Plaintiff had difficulty with anxiety and "outbursts with others." (Tr. 185-187.) He also reported that Plaintiff cared for her personal needs without difficulty (Tr. 181), performed household chores without help or encouragement (Tr. 182), prepared simple meals (Tr. 182), attended "[a]ll needs" of her six-year-old son, including transporting him to and from school and playing with him (Tr. 180-181, 183-184), cared for a pet (Tr. 181), drove an automobile (Tr. 183), and went shopping. (Tr. 183-184.) He also indicated that Plaintiff did not need "special reminders" to care for her personal needs, to take medication, or to go places. (Tr. 182, 184.) He further stated that Plaintiff could go places alone (Tr. 183-184), manage her personal finances (Tr. 183), and pay attention for five hours. (Tr. 185.) He further noted that Plaintiff's condition did not affect her abilities to remember, complete tasks, understand, or follow instructions. ( Id. )

E. Plaintiff's Statement

In a Function Report, dated October 2, 2010, Plaintiff reported that she had anxiety, difficulty getting along with others, and a lack of motivation. (Tr. 220, 225-226.) She also reported that she cared for her personal needs without difficulty (Tr. 221-222), performed household chores without help or encouragement (Tr. 223), prepared simple meals (Tr. 222), cared for her son, including "everything a [six-year-]old needs[, ]" such as walking him to and from school, shopping for his school clothing and supplies, assisting him with homework, taking him to the park, and attending his school events. (Tr. 221, 223-224.) Plaintiff also stated that she cared for pets (Tr. 221, 224), crocheted (Tr. 224), drove an automobile "if [she absolutely had] to" (Tr. 223), and went shopping. (Tr. 223.) She also reported that she did not need special reminders to care for her personal needs, to take medication, or to go places (Tr. 222, 224), that that she could go places alone (Tr. 223-224), ...


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