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Blundell v. Commissioner of Social Security

United States District Court, Third Circuit

October 24, 2013



FREDA L. WOLFSON, District Judge.

Gregory Steven Blundell ("Plaintiff") appeals from the final decision of the Commissioner of Social Security (the "Commissioner"), [1] denying Plaintiff disability benefits under the Social Security Act ("Act"). Plaintiff contends that the record substantiates his claims that his is disabled, and requires a conclusion that he is entitled to disability insurance benefits. Specifically, Plaintiff maintains that the Administrative Law Judge (the "ALJ") erred in determining that Plaintiff was not totally disabled and could perform certain jobs. After reviewing the administrative record, this Court finds that the ALJ's decision is supported by substantial evidence in the record, and accordingly, affirms the ALJ's decision to deny Plaintiff disability benefits.


A. Procedural History

Plaintiff first filed an application for Social Security Disability Benefits and Supplemental Security Income Benefits on June 24, 2009, alleging a disability onset date of January 31, 2009. AR 147-51, 152-58[2]. Both the initial applications and requests for reconsideration were denied. Id. at 94, 96-97. Following a timely request for a hearing, on March 22, 2011, Plaintiff appeared before ALJ Therese A. Hardiman in Wilkes Barre, Pennsylvania. See id. at 47-93 (Transcript of Hearing). On April 21, 2011, the ALJ issued an unfavorable decision denying Plaintiff benefits on the basis that Plaintiff was not disabled. Id. at 16-31. Plaintiff petitioned the Social Security Appeals Council (the "Appeals Council") for review of the ALJ's decision, which was denied on September 12, 2012. Id. at 1-5. Plaintiff subsequently filed the instant action before this Court on October 4, 2012.

B. Background

Plaintiff was born on May 6, 1956, and was 52 years old on the alleged disability onset date. AR 30. Before his disability, Plaintiff had a job, as he had had for substantially his entire career doing marketing work, including research, copywriting, and arranging meetings, conferences, and other activities. Id. at 24, 30. Plaintiff contends that he stopped working full time in January 2009, and that his attempts to continue part time work at home were unsuccessful, as a result of lightheadedness, spatial issues, numbness in his hands, difficultly finding words in speech, difficulty working in a timely manner, and general fatigue, lack of energy, and dizziness. Id. at 24-25. In sum, Plaintiff claims that he had no energy to do work. Id. at 25. In connection with his application for benefits, Plaintiff visited several medical professionals for evaluation of his physical and mental health. I detail the relevant findings of these professionals below.

C. Review of Medical Evidence

1. Physical Health

On August 4, 2008, Plaintiff, at the referral of his treating physician, Dr. Daryl Kim, [3] visited Dr. Steven Golombek, a rheumatologist. AR 304-307; see also id. at 259-60. In his report, Dr. Golombek indicated that Plaintiff had been previously diagnosed with Lyme disease but the disease appeared to have been treated with little lingering effect. Id. at 259; see also id. at 27, 419. Although Plaintiff complained to Dr. Golombek about numerous symptoms he had had over the previous years - including fatigue, dizziness, and spatial issues - Dr. Golombek's report noted that all previous laboratory tests of Plaintiff were normal, other than a Vitamin D deficiency. Id. at 419. Dr. Golombek's own examination revealed that Plaintiff was in overall good health. Id. at 259-60. However, Dr. Golombek further identified Plaintiff as having reported ongoing chronic fatigue syndrome ("CFS"). Id. at 419-20. Dr. Golombek continued to meet with Plaintiff though at least December 2010, and although many of his handwritten notes for these follow up visits are difficult to decipher, it appears that there was no substantial change in Dr. Golombek's observations or diagnoses of Plaintiff with respect to his Lyme disease, Vitamin D deficiency, or CFS, except for the prescription of the drug Cymbalta. Id. at 304-307. Based on his care of Plaintiff, Dr. Golombek completed a "Doctor's Social Security Medical Report Form" in December 2010, in connection with Plaintiff's disability claims. AR 393. On the form, Dr. Golombek diagnosed Plaintiff with CFS, and he further indicated that, as a result of this diagnosis, Plaintiff was significantly limited in his ability to do basic work activities, to the extent that Plaintiff would be unable to perform substantial gainful employment. Id. In support of his diagnosis, Dr. Golombek indicated that he found Plaintiff's complaints to be credible. Id.

In January 2010, Plaintiff visited Dr. Henry Rubenstein for a consultative physical examination at the request of the state agency. Id. at 358-59; see also id. at 27. Dr. Rubenstein's report noted that Plaintiff had a history of CFS and Lyme disease, although the Lyme disease had been treated satisfactorily. Id. at 358. Dr. Rubenstein's observations of Plaintiff's physical exam revealed virtually nothing unusual; he observed that Plaintiff was "alert and oriented, answer[ing] questions in a reasonable manner, " had "no difficulty getting on and off the examination table, " and that his "[r]ange of motion and muscle strength in the upper and lower extremities [was] normal." Id. at 358-59. Overall, Dr. Rubenstein indicated no physical issues with Plaintiff other than his CFS. Id. at 359.

2. Mental Health

On July 28, 2009, Dr. Joel E. Morgan, a neuropsychologist, performed a psychiatric evaluation on Plaintiff as the request of his insurance carrier. AR 308-317. In his evaluation report, Dr. Morgan noted that during the examination, Plaintiff "presented as a neatly and casually dressed male, looking somewhat younger than his stated age of 53." Id. at 311. Dr. Morgan further observed that Plaintiff "presented in a forthright and clear manner and was a relatively good historian... [and] his speech was relevant and coherent; however he was quite tangential and at times had difficultly expressing his thoughts in a forthright manner." Id. Nevertheless, Dr. Morgan perceived "no suggestion of an underlying thought disorder or any departures from normal reality testing." Id. Apart from general nervousness associated with the testing procedure, "psychotic symptoms were not appreciated or reported, " and Plaintiff "did not exhibit any overt evidence of clear neurological symptoms, such as gait disturbance, difficulties with coordination, balance, hemiparesis aphasia or other frank neurological symptoms." Id. In connection with the validity of his symptoms, Plaintiff scored within the normal range, representing a "valid profile" with "no evidence of exaggerating, feigning or malingering." Id. at 312. With respect to the results of intelligence testing, Dr. Morgan explained that Plaintiff had "average intellectual functioning with intact visual and verbal memory abilities, " and that his "executive functions, language and visual-perceptual abilities are normal, " but that Plaintiff's "processing speed and fine-motor dexterity are lower than expected." Id. at 314.

Turning to Plaintiff's emotional and personality aspects, Dr. Morgan noted that Plaintiff consistently self-reported several issues, including malaise, gastrointestinal complaints, and mild social avoidance. Id. Dr. Morgan identified these symptoms as consistent with mild depression, but noted that Plaintiff repeatedly denied any depression and instead attributed his complaints to CFS. Id.

In responding to specific questions set forth by the insurance carrier, Dr. Morgan explained, inter alia, that Plaintiff "report[ed] a desire to return to work." Id. at 315. Dr. Morgan noted that his "neurocognitive profile indicates average to above average functioning, " but nevertheless Plaintiff's "weakness in processing speed... may make it difficult for him to perform his required duties as quickly as necessary." Id. Moreover, Dr. Morgan concluded that the test results "indicate the presence of preoccupation with somatic complaints, which is consistent with the diagnosis of CFS, " and that based on Plaintiff's "diagnosis of CFS, he may also require a flexible schedule that includes tel-commuting or a truncated work day." Finally, Dr. Morgan explained that "individuals diagnosed with CFS commonly find improvement with a combination of pharmacological and psychotherapeutic approaches, " and recommended that Plaintiff seek such treatment. Id. [4]

Plaintiff submitted to another neurological evaluation on January 19, 2010, by Dr. Wilfred van Gorp, Ph.D, a neuropsychologist. See AR 348-57. Following extensive examination and testing, Dr. Gorp determined that Plaintiff had "consistently slow speed of information processing, lower than expected memory performance, and difficulty on a test of judgment." Id. at 352. Dr. Gorp further explained that despite Plaintiff's "high score on an untimed test resistant to decline following an illness or injury, other test scores reflect [l]ow [a]verage or below performance on measures of speed processing." Id. In noting other variations among Plaintiff's neurological test scores, Dr. Gorp stated that "these discrepancies most likely reflect sequelae to his CFS diagnosis and represent barriers to returning to work." Dr. Gorb concluded that Plaintiff "is a man whose work imposed demands for rapid and efficient performance" and that his current test results indicate that Plaintiff "will be unable to fulfill these demands as he had in the past." Id.

On February 24, 2010, Plaintiff, at his counsel's request, underwent a third neurological evaluation by Dr. Benjamin H. Natelson, M.D., a neurologist. In a two-page letter, Dr. Natelson summarized his findings based on Plaintiff's reported symptoms and medical history; Dr. Natelson did not perform independent psychological testing on Plaintiff. See AR 360-61. In his letter, Dr. Natelson indicated that Plaintiff was diagnosed with Lyme disease in 2005, from which he recovered following treatment, and that in 2008, Plaintiff was diagnosed with CFS. Id. at 360. Dr. Natelson noted that Plaintiff reported low activity levels and several other symptoms consistent with a diagnosis of "more severe" CFS. Id. With respect to Plaintiff's past medical history, Dr. Natelson determined both his psychiatric and physical diagnoses were largely normal, but did note that Plaintiff was a thoracic breather, which could contribute to his CFS symptoms. Id. Dr. Natelson then observed that, in his opinion, the previous analysis of Plaintiff's illness was "limited" and that Plaintiff's "symptom severity is certainly great enough to explain his inability to work." Id. at 316. Dr. Natelson further concluded that he believed Plaintiff to be "100% disabled, " could "not fulfill his former duties as an executive, " and could not "work 8 hour [ sic ] in simple, sedentary job-without the ability to remove himself from the workplace to rest." Id.

D. Testimonial Record

1. Plaintiff's ...

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