The opinion of the court was delivered by: Peter G. Sheridan, U.S.D.J.
This matter is before the Court on the appeal of Plaintiff, Toni Lee Chiaradio from the Commissioner of Social Security's ("Commissioner") denial of her application for disability insurance benefits. Plaintiff filed an application for disability insurance benefits on November 10, 2005 alleging disability beginning September 10, 2005 due to chronic asthma, lower lumbar pain*fn1 , cystitis, bipolar disorder and diverticulitis. (R. 93).
Plaintiff is a high school graduate with no vocational training. Plaintiff worked as a data entry clerk for a copier company and as a secretary/receptionist in 2000-02 for Newbridge Services where she greeted patients, answered the telephone, handled patient files and copied documents. At Newbridge Services, she wrote, typed and moved small objects. This entailed sitting for five hours, standing for an hour and walking for an hour. In 2002, Ms. Chiaradio changed careers. She became a self-employed office and home cleaner. She worked in this field until September 10, 2005.
Plaintiff is a 48 year old woman who weighs approximately 135 pounds. Plaintiff suffers from chronic asthma and uses Singular, Advair, a nebulizer and a Albuteral inhaler to control her symptoms. She is a moderate smoker (5-10 cigarettes per day for many years). She speaks with a raspy voice due to the nebulizer and other inhalers she has used every day since the 1980s. In addition, Plaintiff allegedly suffers from chronic cystitis and diverticulitis. Her medications include Carisoprodol and Skelaxin every four to six hours. Lastly, Plaintiff suffers from bipolar disorder which she describes as chronic depression and anxiety with panic attacks. She takes Lexapro, Trazadone and Xanax daily. Due to her depression, she is tearful twice a week because she does not feel good, wishes to work and to be more active.
Approximately two months after filing for disability insurance benefits, Plaintiff completed an Adult Function Report. Paraphrasing, Plaintiff summarizes her daily activities as follows. In the mornings, she awakes and immediately uses her nebulizer and takes medication to breathe better. Then she awakes her daughter (14 years of age) and helps prepare her for school. She drives her daughter to school. Upon returning home, Plaintiff takes medicine to relieve back pain, performs some chores, and re-uses her nebulizer. In the afternoon, she will pick up her daughter from school, make dinner and do other housework. After dinner she nebulizes again and applies a heating pad to her back. Finally, she takes all her evening medications, showers and goes to bed. Plaintiff acknowledges that she takes care of all her personal care (at a slower pace); but doesn't do any yard work because of her asthma. She seldom leaves the house except to see a doctor or her sister. Since she drives a car, she attends to her own banking and shops for food and clothes. Plaintiff reads books and the bible. Socially, Plaintiff talks to friends on the phone and regularly visits with her sons who come for dinner. She regularly attends church, group therapy and a psychiatrist. (R. 144).
Plaintiff states that as a result of her condition she can not lift, squat, bend, stand, reach, walk, sit, kneel, climb stairs or complete tasks. She can not walk without stopping and using her nebulizer. She uses a cane for her back and wears a mask outside to prevent allergic reactions and asthma. (R. 135).
At the hearing, Plaintiff testified that she takes oral steroids every few months for her asthma. The oral steroids make her irritable and exacerbate her bipolar disorder. (R. 43). She limits her walking to a block, and avoids being outside when the weather is humid, rainy or cold. (R. 47). According to Plaintiff, she cannot work as a receptionist since her breathing is affected when it rains, or by inhaling perfume or dust. In addition, exposure to sick people can compromise her breathing.
Medical Reports with Regard to Cystitis
The reports of Essex Hudson Urology document Plaintiff's history of cystitis and treatment between 2004 to 2006. On October 7, 2004 Plaintiff was treated for chronic cystitis and pain management. At the time, Plaintiff complained of pressure along her bladder and lower back, as well as urinary problems with frequency, straining to urinate, slow urinary stream and difficulty starting urination. On examination she appeared to be in no distress. Her appearance, blood pressure, and heart rate were normal. Her lungs were clear bilaterally and she had a regular heart rate and rhythm.
On October 14, 2004 she was seen for a follow up exam as she was still having symptoms. A cystoscopy was performed and was negative. On October 26, 2004 she was seen again complaining of same symptoms and lower abdominal discomfort. The doctors prescribed Percocet for pain. November 30, 2004 progress notes indicate she was doing better on Elmiron, Ditropan and Atrax.
On January 27, 2005, doctors described her abdominal discomfort as occasional. She reported gross hematuria, although according to the record, her urinalysis had always been negative.
On October 18, 2005, David S. Wu, M.D. examined Plaintiff as a follow up for interstitial cystitis. At the time of Wu's examination, she was relatively stable with medications and her urine cytology was negative. She was treated with Elmiron.
Medical Reports with Regard to Asthma Treatment
On November 4, 2004, Plaintiff was admitted to Chilton Memorial Hospital. At the time, Plaintiff complained of asthma and difficulty breathing for the past two days. Her speech was coherent. (R. 229). She was given Proventil and IV steroids which yielded mild improvement. The results of a radiology study revealed that Plaintiff's lungs were clear and her heart was normal. Medhat Ismail, M.D. diagnosed acute severe asthma most likely secondary to smoking.
On September 26, 2005, Plaintiff was again treated at Clilton Memorial Hospital Emergency Room for an asthma attack. Her airway was compromised, her breathing was labored and she was apprehensive. She had mild difficulties with breathing, wheezing, and a non-productive cough. She reported pain in her head and in between her shoulder blades. Her lungs were clear. She reported smoking 1/4 pack of cigarettes per day. She was discharged with instructions to see her doctor. She was given a prescription for an Albuteral inhaler, Prednisone and Davorcet. (R. 226). The radiology report revealed hyperinflation of the lung fields and flattening of the hemidiagrams consistent with obstructive lung disease. Her heart size was within normal limits.
On February 2, 2006, Plaintiff was again admitted to Chilton Memorial for acute exacerbation of asthma. On admission, she was experiencing mild wheezing. She was placed on IV steroids and a bronchodialotor with good clinical response. She was discharged with a tapering dose of Prednisone. The final diagnosis was acute exacerbation of asthma, toxic effects of tobacco, bipolar disease and anemia.
Reports with regard to Bipolar Disorder
The record documents Plaintiff treated at Newbridge Services, Inc. between September 11, 2001 and July 26, 2006 for counseling and medication for her ...