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Michael Daniel O'connor v. Michael J. Astrue

March 30, 2011


The opinion of the court was delivered by: Hon. Dennis M. Cavanaugh




This matter comes before the Court upon the appeal of Michael D. O'Connor ("Plaintiff") from the final decision of the Commissioner of Social Security ("Commissioner"), denying Plaintiff's claims for a period of disability and disability insurance benefits under Title II of the Social Security Act ("Act"). This Court has jurisdiction over this matter pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3). No oral argument was heard pursuant to Rule 78 of the Federal Rules of Civil Procedure.

After considering the submissions of the parties, and based on the following, the motion of the Commissioner is granted and the final decision entered by the Administrative Law Judge ("ALJ") is affirmed.



On June 5, 2008, Plaintiff filed an application for a period of disability and disability insurance benefits, alleging that he became disabled on June 18, 2007. (Administrative Transcript ( "Tr.") at 102--09). The Plaintiff's claim was initially denied on August 7, 2008, and it was denied again upon reconsideration on December 11, 2008. (Tr. at 55--56). Thereafter, on January 14, 2009, Plaintiff requested a hearing before an ALJ. (Tr. at 72--73). The hearing was held on April 15, 2009 before the Honorable James Andres, ALJ ("ALJ Andres"). (Tr. at 19--54). On June 1, 2009, ALJ Andres issued a decision denying Plaintiff's claim for disability insurance benefits. (Tr. at 6--16). Plaintiff sought review of the decision, but the Appeals Council denied his request on December 14, 2009. (Tr. at 1--3). Plaintiff filed a timely complaint with this Court seeking judicial review.


1. The Findings of the Administrative Law Judge

ALJ Andres made the following seven (7) findings regarding the Plaintiff's application for a period of disability and disability insurance benefits: (1) the claimant meets the insured status requirements of the Social Security Act through December 31, 2012; (2) the claimant has not engaged in substantial gainful activity since June 18, 2007, the alleged onset date; (3) the claimant has the following severe impairments: a heart disorder including congestive heart failure, ventricular tachycardia and status post heart surgery with implantation of a defibrillator; (4) the claimant does not have an impairment or combination of impairments that meets or medically equals one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1; (5) the claimant has the residual functional capacity to perform the full range of sedentary work as defined in 20 C.F.R. 404.1567(a); (6) the claimant is capable of performing past relevant work as an assistant public defender, as this work does not require the performance of work-related activities precluded by the claimant's residual functional capacity; (7) and the claimant has not been under a disability, as defined in the Social Security Act, from June 18, 2007 through the date of this decision. (Tr. at 11--16).

2. Plaintiff's Medical History and Evidence

Plaintiff alleges that he has been disabled since June 18, 2007, as a result of suffering from cardiomyopathy, high blood pressure and anxiety. This Court summarizes the Plaintiff's medical history and the evidence pertaining to his impairments below.

i. Medical Evidence Prior to the Alleged Onset Date

Plaintiff was born on August 28, 1959 and worked as an assistant public defender in the State of New Jersey from September 1985 until the alleged onset date of his disability, June 18, 2007. (Tr. at 118, 121--22). On June 29, 1995, Dr. Valentin Fuster recounted in a letter to Dr. Alan Bahler that Plaintiff had experienced shortness of breath, chest discomfort, and fatigability in late December 1994. (Tr. at 320). Based on tests and clinical examinations, Dr. Fuster opined in that same letter that Plaintiff had developed mild cardiomyopathy. (Tr. at 321). On September 13, 1995, Dr. Davendra Mehta reported in a letter to Dr. Fuster that Plaintiff underwent implantation of antitachycardia cardioverter defibrillator PRX3 for ventricular tachycardia. (Tr. at 305). Plaintiff was clinically diagnosed with congestive heart failure in April of 1998 and underwent testing to evaluate his right ventricular function at the Mount Sinai Medical Center. (Tr. at 224). The laboratory testing yielded a number of medical conclusions, including, but not limited to, normal left ventricular size, moderate decreased left ventricular function, severe right ventricular dilatation, and severe decreased right ventricular function. Id.

In May of 1998, Dr. Mehta said that the electrocardiogram showed "evidence of frequent PVCs with right atrial enlargement." (Tr. at 223). He reported that Plaintiff had a raised ventricular pressure with a prominent V wave, but that he remained very stable from an arrhythmia standpoint. Id. On June 24, 1999, Dr. Mehta wrote an Implantable Cardioverter Defibrillator ("ICD") Report to Dr. Fuster, which recounted that Plaintiff underwent a successful generator change of antitachycardia cardioverter defibrillator for ventricular tachycardia. (Tr. at 196--97). While Dr. Mehta noted that Plaintiff had right ventricular dysplasia, he also asserted that Plaintiff had no known congestive heart failure and the procedure to change Plaintiff's generator was uncomplicated. Id.

On February 17, 2007, Dr. Fuster stated that Plaintiff's ICD had "fired 3 times in the last few months." (Tr. at 651). As a result of these ICD discharges, which were related to Plaintiff's ventricular tachycardia, Plaintiff was admitted to Mount Sinai Hospital on February 22, 2007. (Tr. at 649--50). Plaintiff denied experiencing syncope, but complained of abdominal discomfort. (Tr. at 650). After consulting with Dr. Mehta, Plaintiff decided to proceed with a catheter ablation procedure. (Tr. at 648). The Ventricular Tachycardia ablation was performed on Plaintiff by Dr. Mehta on April 4, 2007, and after mapping, an RVOT VT was identified and successfully ablated. (Tr. at 640, 643). Dr. Mehta concluded on April 17, 2007 that Plaintiff was "totally free of spontaneous ventricular arrhythmias" but that there was no clinical doubt that "there is increasing right heart failure with some left ventricular dysfunction." (Tr. at 640).

ii. Medical Evidence from the Alleged Onset Date: June 18, 2007 On June 18, 2007, Plaintiff was admitted to the emergency room at University Hospital ("UMDNJ") in Newark, New Jersey after his ICD had fired multiple times. (Tr. at 410). Plaintiff noted pressure and tightness in his chest, but did not suffer from nausea, vomiting, shortness of breath, or sweating. Id. He was not under any respiratory distress, but Plaintiff did report chest pains and was identified as having tachycardia and cardiomegaly. (Tr. at 411, 415). Discharged from the University Hospital on June 19, 2007, Plaintiff went to the emergency room at St. Barnabas Medical Center later that day because his ICD discharged approximately ten times. (Tr. at 446, 454). Plaintiff underwent an echocardiogram on June 20, 2007 that revealed severe left ventricular systolic function, mild aortic insufficiency, mild mitral insufficiency, moderate tricuspid insufficiency, and severely dilated right atrium and right ventricle. (Tr. at 481). He was discharged from St. Barnabas Medical Center on June 27, 2007 with diagnoses of ventricular tachycardia, cardiomyopathy, hypertension, and thrombophlebitis. (Tr. at 454). Upon his discharge, Plaintiff's condition had stabilized and he was instructed to follow up with Dr. Mehta, his treating cardiologist. Id.

On August 30, 2007, Mount Sinai Hospital admitted Plaintiff to treat his arrhythmia. (Tr. at 493). He elected to undergo an anterior right ventricular foci ablation along with reprogramming of his ICD. (Tr. at 494). The ablation procedure was successful and Plaintiff was discharged from Mount Sinai Hospital in stable condition on September 2, 2007. (Tr. at 494--95). On December 20, 2007, Dr. Sean Pinney, who is also one of Plaintiff's treating physicians, assessed Plaintiff's condition and noted that he experiences dyspnea on exertion while walking up hills or carrying groceries; however, Dr. Pinney also said that Plaintiff denies any dyspnea at rest, any angina, or recent syncope. (Tr. at 700). Further, Dr. Pinney determined that Plaintiff "appeared in no acute distress." (Tr. at 701). Plaintiff's heart had a regular rate, normal S1 and S2 rhythm, and no murmurs, rubs, or gallops. Id. His lungs were clear to auscultation and the jugular veins were distended. Id.

On April 9, 2008, Dr. Mehta summarized his meeting with Plaintiff in a letter to Dr. Fuster. He said Plaintiff's only symptom since the catheter ablation "has been episodes of decreased vision in the right eye associated with nausea and dizziness." (Tr. at 743). Dr. Mehta stated that Plaintiff's jugular venous pressure was moderately elevated and that cardiac auscultation revealed a systolic murmur. Id. His chest was clear with good bilateral air entry. Id. Generally, Dr. Mehta was "quite happy with the results of catheter ablation." Id. Nonetheless, in an undated, unsigned form filed in support of an Application for Disability Retirement with the State of New Jersey - Department of the Treasury, Division of Pensions and Benefits, Dr. Mehta opined that Plaintiff was totally and permanently disabled and unable to perform his job duties because of his recurrent ventricular tachycardia. (Tr. at 606--07).

In June 2008, Plaintiff was transported to St. Barnabas Medical Center after an apparent appropriate discharge of his ICD. (Tr. at 543). Plaintiff was alert, fully oriented, and subsequently discharged. (Tr. at 543, 547). Thereafter, Plaintiff saw Dr. Mehta in November 2008 and did not complain of arrhythmia or his defibrillator. (Tr. at 736). On December 2, 2008, Dr. Pinney saw Plaintiff for a follow-up evaluation. (Tr. at 731). Dr. Pinney noted that Plaintiff's blood pressure was 104/80 mmHg and that his heart had a regular rate and rhythm with normal S1 and S2. Id. In addition, Plaintiff saw Dr. Howard Goldbas, a State Agency Medical Consultant, on December 10, 2008. (Tr. at 707--14). Dr. Goldbas noted that Plaintiff was able to walk four METS on a stress test and determined that Plaintiff could do light household chores, and walk up to 2 blocks and half a flight of stairs. Id. Dr. Goldbas also asserted that Plaintiff should avoid all exposure to hazards and avoid concentrated exposure to extremes of temperature, wetness, and humidity. (Tr. at 711). In March 2009, Plaintiff underwent an echocardiogram that revealed his ejection fraction to be 44 percent. (Tr. at 733). Finally, on April 6, 2009, Dr. Pinney noted that Plaintiff's blood pressure was 108/70 mmHg and that his heart again had a regular rate and rhythm with normal S1 and S2. (Tr. at 775). However, Dr. Pinney was concerned about Plaintiff's slow mentation (that is, mental activity), which he speculated may be a result of low cardiac output or attributable to Plaintiff's use of the benzodiazepine Xanax, which can have a sedative effect on the body and mind. Id. He instructed Plaintiff to take a cardiopulmonary stress test and to be evaluated for cardiac transplantation. (Tr. at 775--76).

iii. Psychiatric Evaluations of Plaintiff

On July 11, 2008, Dr. Ronald Silikovitz conducted an independent psychological evaluation of Plaintiff. (Tr. at 559). During this mental examination, Plaintiff was able to repeat a six-digit sequence forwards and a four-digit sequence backwards. (Tr. at 561). He spelled "world" correctly forwards and backwards, and followed one and two-step directions correctly. Id. He was properly oriented to time, place, and person and denied any history of hallucinations, paranoia, or suicide ideation. Id. Plaintiff's mood was appropriate and he manifested a range of affect. Id. He maintained good eye contact and was not overtly anxious or depressed during the examination. (Tr. at 561--62). Plaintiff came across as credible to Dr. Silikovitz, who found no evidence of exaggeration of symptoms of anxiety, such as nervousness, tension, and worry. (Tr. at 561--62).

Plaintiff described his daily routine to Dr. Silikovitz, indicating that he would wake up around 10:30 a.m. Id. He would take his dog out, eat a "breakfast-lunch type meal," fill out paper work for disability, and make phone calls. Id. Plaintiff would play on the computer, do laundry, empty the dishwasher, and clean pots and pans. Id. He also took on home projects, such as putting in a fence in the backyard. Id. Plaintiff would do Sudoku puzzles, watch baseball, read, and visit regularly with friends. Id. Dr. Silikovitz determined that Plaintiff is capable of and competent to handle his funds; moreover, he rated Plaintiff's global assessment of functioning (GAF) score as 60 and listed his prognosis as "fair." (Tr. at 562--63). On July 21, 2008, State Agency psychologist Frances E. Hecker, Ph.D. also completed an initial psychiatric review technique to assess Plaintiff's impairments. (Tr. at 564). Dr. Hecker determined that Plaintiff's anxiety-related disorder was not severe. Id. Dr. Hecker ...

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