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Tanaskovic v. Commissioner of Social Security Administration

United States District Court, D. Arizona

March 31, 2017

Olivera Tanaskovic, Plaintiff,
Commissioner of Social Security Administration, Defendant.


          David K. Duncan United States Magistrate Judge.

         Olivera Tanaskovic appeals from the denial of her application for benefits by the Social Security Administration. This Court has jurisdiction pursuant to 42 U.S.C. § 405(g) and, with the parties' consent to Magistrate Judge jurisdiction, pursuant to 28 U.S.C. § 636(c). Tanaskovic argues that she is entitled to benefits because, among other reasons, the ALJ failed to properly weigh the medical source opinions. (Doc. 25) The Court agrees.


         Tanaskovic did not complete high school[1] and was 34 years old in January 2011, the amended onset date of her alleged disability. (Tr. 13, 35, 39) Her past relevant work was as a cashier, cashier/checker, and receptionist. (Tr. 65)

         Medical Evidence: Treating Providers[2]

         In early December 2010, Tanaskovic established care with a psychiatric nurse practitioner, James Milacek. (Tr. 434-39) NP Milacek described her mood as anxious, angry, and depressed and he prescribed her various medications based on his diagnosis of mood disorder NOS, adjustment reaction with mixed emotional features, and depressive disorder. (Tr. 436, 437, 439)

         Subsequently, Tanaskovic received treatment from NP Milacek in late December 2010, March 2011, April 2011, July 2011, September 2011, October 2011, November 2011, and April 2012. At these medication management appointments, NP Milacek noted anxiety (March 2011 at Tr. 562, April 2011 at Tr. 543, September 2011 at Tr. 508, October 2011 at 492); depression and anxiety (December 2010 at Tr. 600, July 2011 at Tr. 529, November 2011 at 484, April 2012 at Tr. 467); and constricted affect (July 2011 at Tr. 528, September 2011 at Tr. 508, October 2011 at Tr. 492, April 2012 at Tr. 466).

         In May 2012, Tanaskovic presented to the emergency department for suicidal ideation and self-inflicted lacerations. (Tr. 339-43) She was evaluated for inpatient psychiatric care but was released home with directions to follow-up with a psychiatric care clinic the following day. (Tr. 339) The record does not indicate whether she did, in fact, follow-up the following day. However, less than three weeks later, she had an appointment with NP Milacek where he concluded her status was “worsened” because of her increasing mood instability and self-harming behaviors. (Tr. 450)

         Ten days after this appointment with NP Milacek, Tanaskovic again presented to the emergency department reporting suicidal thoughts and panic attacks.[3] (Tr. 364) The psychiatric evaluation described her as feeling overwhelmed, “currently not showering on a regular basis and has generally decompensated.” (Tr. 358) She was discharged with instructions to seek follow-up treatment. (Tr. 359, 379)

         Tanaskovic continued to have regular medication management appointments with NP Milacek in July 2012, August 2012, September 2012, November 2012, January 2013, February 2013, and March 2013. In September 2012, Tanaskovic reported that her mood was “a little bit better.” (Tr. 687) In January 2013, Tanaskovic first reported auditory hallucinations. (Tr. 676) In February 2013, she reported that she was in “less distress.” Otherwise, her symptoms were either “unchanged” or “worsened.” (Tr. 629, 645, 676, 682)

         At these appointments, NP Milacek noted that her mood was anxious (November 2012 at Tr. 682, February 2013 at Tr. 664); depressed and anxious (September 2012 at Tr. 688, March 2013 at Tr. 644, April 2013 at Tr. 628) or depressed, anxious, and agitated (January 2013 at Tr. 676). He described her thought content as fearful (February 2013 at Tr. 664); depressive and fearful (September 2012 at Tr. 688, March 2013 at Tr. 645, April 2013 at Tr. 628); or depressive, fearful, help/hopelessness, and anhedonic (January 2013 at Tr. 676). He also noted her affect as blunted (January 2013 at Tr. 676) or constricted (February 2013 at Tr. 664, March 2013 at Tr. 644, April 2013 at Tr. 628).

         In April 2013, Tanaskovic transferred care to psychiatrist Hany Ashamalla, M.D. At her initial evaluation, Dr. Ashamalla noted that Tanaskovic had fair insight and judgment, auditory and visual hallucinations, flat affect, dysphoric mood, occasionally loose associations, and thought content that was “paranoid” and “fearful.” He diagnosed her with schizoaffective disorder and prescribed various medications. (Tr. 713-16)

         Tanaskovic had medication management appointments with Dr. Ashamalla in May 2013, June 2013, July 2013, August 2013, and September 2013. The medical records consistently document that Tanaskovic reported auditory and visual hallucinations. (May 2013 at Tr. 709, June 2013 at Tr. 749, July 2013 at Tr. 773, August 2013 at Tr. 769, September 2013 at Tr. 765)

         In conjunction with her August 2013 appointment, Dr. Ashamalla completed a form entitled “Medical Assessment of Claimant's Ability to Perform Work Related Activities” (the “RFC Form”). (Tr. 769) He designated Tanaskovic as having a “moderate” ability to perform simple tasks and to respond appropriately to supervisors but rated her limitations as “moderately severe” or “severe” in all other areas. (Tr. 760-61) He also indicated that her psychiatric symptoms had a moderately severe impact on the sustainability of her work pace. (Tr. 761)

         In September 2013, Dr. Ashamalla noted that Tanaskovic stated that her symptoms - hearing voices, overwhelming anxiety, and nightmares - were the same despite further changes in medication. (Tr. 765) In response, he again modified her medication regime. (Tr. 767) There are no further medical records from Dr. Ashamalla in the record before the Court.[4]

         Medical Evidence: Non-Treating Physicians[5]

         In October 2012, Elliot Salk, Ph.D., reviewed Tanaskovic's file and found that she had mild restrictions in her activities of daily living and moderate difficulties in maintaining social functioning and in maintaining concentration, persistence, or pace. (Tr. 82, 95) Dr. Salk found that she had some moderate RFC limitations and concluded that she was capable of performing “simple tasks on a sustained basis.” (Tr. 83-86; 97-99) He concluded that she was not disabled.

         On reconsideration in July 2013, Stephen Bailey, Ed.D., found that Tanaskovic had some moderate limitations and described her RFC as follows:

[Tanaskovic] maintains the ability to understand, remember and carry out simple 1-2 step work related instructions. She can make commensurate work related decisions and adjust to changes in the routine work setting. She can work with and ...

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