Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Marciano v. Berryhill

United States District Court, D. New Jersey

January 30, 2019

MAUREEN LYNN MARCIANO, Plaintiff,
v.
NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.

          OPINION

          Freda L. Wolfson United States District Judge

         Maureen Marciano (“Plaintiff”) appeals from the final decision of the Acting Commissioner of Social Security, Nancy A. Berryhill (“Defendant”), denying Plaintiff disability benefits under Title II and XVI of the Social Security Act (the “Act”). After reviewing the Administrative Record (“A.R.”), the Court finds that the Administrative Law Judge (“ALJ”) properly weighed and assigned little weight to the opinions of licensed clinical social worker, Rita Lawler, in addition to Lourdes Montezon, M.D. Accordingly, the ALJ's decision is affirmed.

         I. FACTUAL BACKGROUND AND PROCEDURAL HISTORY

         Plaintiff was born on October 9, 1972, and she was 40 years old on the alleged disability onset date of April 18, 2013. A.R. 36, 80, 146. Plaintiff attended two years of high school, earned her GED through online courses, and completed specialized training as a medical assistant. A.R. 81, 263. Prior to her alleged disability, Plaintiff worked as an office manager and receptionist. A.R. 49, 264, 270.

         On April 17, 2014, Plaintiff applied for social security disability benefits and supplemental security income, alleging disability beginning on April 18, 2013. A.R. 36, 145. Plaintiff's claims were denied on June 10, 2014, A.R. 156-161, and again upon reconsideration on September 13, 2014. A.R. 164-165. Thereafter, Plaintiff requested a hearing, which was held on June 23, 2016, before ALJ Ryan Hoback. A.R. 69. The ALJ determined that Plaintiff was not disabled and denied her claims for social security disability and supplemental security income. A.R. 36-51. Plaintiff requested review by the Appeals Council, which was denied on November 28, 2017. A.R. 1-4. On January 23, 2018, Plaintiff filed the instant appeal.

         A. Review of the Medical Evidence

         Plaintiff has a history of bipolar disorder that pre-dates her alleged disability onset date, for which she occasionally sought mental health treatment at Newton Memorial Hospital Behavioral Health, from 2009 through 2011. A.R. 511-30.

         On July 16, 2013, Vivian Jean Deetjen, BA, of Hackettstown Regional Psychiatric, performed an intake assessment on Plaintiff, during which Plaintiff reported various complaints, including difficulty sleeping, racing thoughts, and feeling anxious and overwhelmed; in addition, Plaintiff stated that she became depressed following the birth of her daughter in April of 2013. A.R. 531-32. A mental status exam revealed that Plaintiff's appearance and hygiene were appropriate; she was cooperative; her eye contact, appetite, judgment, and insight were good; she was oriented in all three spheres; her speech was clear and coherent; her thoughts were relevant; and she denied delusions, alcohol use, drug use, and suicidal or homicidal ideations. A.R. 535-40. Plaintiff's mood, however, was anxious and depressed. A.R. 538. Ms. Deetjen diagnosed Plaintiff with “major depressive disorder, single episode, severe without psychotic features, ” noting a postpartum onset. A.R. 539.

         On July 24, 2013, Rayment Mero, M.D., of Hackettstown Regional Psychiatric, examined Plaintiff's psychiatric condition, during which Dr. Mero noted that Plaintiff had a history of mood lability and instability, and difficulties with anger, irritability, and impulsivity. A.R. 475. Plaintiff's reported stressors included interpersonal problems with her boyfriend and loss of gainful employment. A.R. 475. Plaintiff's mental status exam indicated that Plaintiff was neatly dressed and groomed; she was oriented in all three spheres; her speech was normal; her thoughts were goal directed at times, but circumstantial at other times with a “hint of flight of ideas when [discussing] emotionally charged issues”; her judgment and insight were good; her cognition was intact; her sleep and appetite were normal; she did not display any psychotic symptoms; she denied any suicidal thoughts or ideation; and, although she was tearful and restless, she calmed down considerably as the session progressed. A.R. 476. However, Plaintiff's motor movements were “somewhat” labile, and her content of thought was focused on anger, irritability, and depression. A.R. 476. Dr. Mero diagnosed Plaintiff with bipolar I disorder, prescribed Trileptal and Abilify, and recommended that she seek individual therapy on a consistent basis. A.R. 476-77.

         On August 7, 2013, during a psychiatric follow-up appointment, Dr. Mero indicated that Plaintiff's medication “seems to have begun to work”; however, Plaintiff's “living situation has clearly exacerbated her mood. It appears that her fiancé has been angry and critical of her, and also [Plaintiff] has spread herself too thin trying to help out a girlfriend . . . .” A.R. 479. Plaintiff's mental status exam revealed that Plaintiff's insight and judgment were fair; her cognition was intact; and her sleep and appetite were normal. A.R. 479. On the other hand, although Plaintiff's affect was initially calm and appropriate, she became somewhat labile and tearful when she discussed “recent” life events; also, her mood was irritable and dysphoric. A.R. 479. Dr. Mero ultimately determined that Plaintiff was “not using good judgment in taking care of herself, ” increased her medication dosage, and reemphasized the importance of individual therapy. A.R. 479.

         On August 16, 2013, Plaintiff reported a “steady improvement” in her overall mood, feeling “very pleased” with her ability to find a part time-job with “a lot of responsibility, ” which she looked forward to beginning. A.R. 481. Upon examination, Dr. Mero observed that Plaintiff's affect was “calmer” and “more appropriate”; her mood approached euthymia; she displayed much less anger, irritability, and dysphoria; she denied suicidal or homicidal ideations; her insight, judgment, and sleep improved; her cognition was intact; and her appetite was normal. A.R. 481. Dr. Mero diagnosed Plaintiff with bipolar disorder with mixed features, indicated that Plaintiff's overall mood and functioning improved, and increased Plaintiff's medication dosage to help with sleep. A.R. 481.

         On September 5, 2013, Plaintiff telephoned crises services and spoke with Rita Lawler, licensed clinical social worker (“LCSW”), of Hackettstown Regional Psychiatric. A.R. 637. Ms. Lawler noted that Plaintiff was experiencing post-partum symptoms, most recently being in a six-week state of mania, during which time she was physically aggressive with her partner. A.R. 637. Plaintiff also reported severe bouts of crying, raging, and overall mood changes causing her to feel “out of control.” A.R. 637.

         On September 10, 2013, during another psychiatric follow up appointment, Dr. Mero indicated: “[Plaintiff] reports a relatively stable mood . . . . For the most part, she is better in touch with herself and is aware of what she feels and also how she reacts to various situations, which is very positive and indicates good insight into her problem.” A.R. 483. Dr. Mero's evaluation of Plaintiff as to the following were all normal: affect, mood, insight, judgment, cognition, sleep, and judgment. A.R. 483.

         On September 20, 2013, Rochelle Steinkohl, a nurse practitioner in Dr. Mero's office, examined Plaintiff. A.R. 555. Although Plaintiff indicated that she “continues to be anxious, ” “is not sleeping very well, ” “is easily overwhelmed, ” and “feels pressured, ” she reported doing “a lot better than she was.” A.R. 555. With the exception of some pressured speech and tense and anxious appearance, Plaintiff's mental status exam revealed fair to normal results with respect to the following: appearance, cooperation, eye contact, motor activity, thoughts, sensorium, orientation, attention, and concentration. A.R. 555. Also, Plaintiff did not display any psychotic symptoms, and she denied obsessions, compulsions, as well as suicidal or homicidal ideations. A.R. 555. Ms. Steinkohl increased Plaintiff's medication dosage. A.R. 555.

         On October 10, 2013, Plaintiff reported feeling anxious, difficulty sleeping due to her infant son, and that, although she was looking for employment, she was “not sure if [she could] sustain [work].” A.R. 558. Plaintiff's mental status exam was normal, with the exception of pressured speech, at times, and “some” obsessive thinking and orderliness; Ms. Steinkohl increased Plaintiff's medication dosage. A.R. 558.

         On November 1, 2013, Plaintiff complained of feeling tired and “annoyed all the time, ” stating that she was “worrying about everything.” A.R. 485. She also noted that her household responsibilities made her “anxious and irritable, ” but that she exercises for twenty minutes, twice a day, because it helps “her feel a little bit better temporarily.” A.R. 485. Upon examination, Ms. Steinkohl observed that Plaintiff appeared casually dressed, neat, and clean; she was cooperative with good eye contact; her speech and motor activity were normal; her thoughts were organized and directed; her attention and concentration were fair to good; her insight and judgment were good; her sensorium was clear; she was oriented in all three spheres; and she denied psychotic symptoms, as well as suicidal or homicidal ideations. A.R. 485. However, Plaintiff's mood was “a little down and anxious most of the time”; and she reported obsessions, compulsions, intrusive thoughts based on fears, and increased hand washing.” A.R. 485. Ms. Steinkohl adjusted Plaintiff's medication dosage. A.R. 485.

         On December 17, 2013, Plaintiff reported “enormous difficulty sleeping, describing at times racing thoughts as well as intrusive thoughts, ” and that she was contining to look for work. A.R. 564. Plaintiff's mental status exam returned normal results with respect to her appearance, cooperation, speech, motor activity, affect, thoughts, sensorium, and orientation; however, Plaintiff's mood was tearful and anxious; she reported ruminations, intrusive thoughts, and frequent worrying; and her concentration and attention were decreased. A.R. 564. Ms. Steinkohl prescribed Seroquel to assist with Plaintiff's sleep. A.R. 564.

         On January 14, 2014, Plaintiff reported feelings of exhaustion, increased anxiety, as well as fears of driving and using elevators. A.R. 568. Plaintiff also described a feeling of “impending doom, ” stating that she was no longer “enjoying anything.” A.R. 568. Ms. Steinkohl's mental status exam indicated fair to normal results with respect to Plaintiff's appearance, cooperation, eye contact, motor activity, thought process, concentration, attention, sensorium, orientation, insight, and judgment. A.R. 568. Conversely, Plaintiff's speech was pressured at times; her mood was dysphoric and anxious; and while she continued to report some obsessions and compulsions, they were occurring “a little” less frequently. A.R. 568. Ms. Steinkohl added Clonazepam to Plaintiff's medications. A.R. 568.

         On February 4, 2014, Plaintiff stated that she “felt better” with the Clonazepam; she was having less intrusive thoughts, she was less jerky and nervous, she was feeling less stress, and she was able to sleep for 10 to 12 hours a night. A.R. 571. Upon examination, Ms. Steinkohl observed that Plaintiff was casually dressed; she was well groomed; she was cooperative with good eye contact; her speech and motor activity were normal; her thoughts were organized; she denied psychotic and manic symptoms, as well as suicidal or homicidal ideations; her obsessions and compulsions decreased; her concentration and attention were fair to good; her sensorium was clear; and she was oriented in all three spheres. A.R. 571. Moreover, Plaintiff described her depression and anxiety as “mild.” A.R. 571. Ms. Steinkohl prescribed Plaintiff Lamictal for mood stabilization. A.R. 571.

         On March 4, 2014, Ms. Steinkohl noted as follows:

[Plaintiff] has been very stressed lately. . . . She continues to look for a job, but is unable to find anything within an hour from home. She states that her mornings are difficult. She struggles getting the day started, but once she gets going, she is generally okay . . . . She reports that Clonazepam is managing her anxiety. . . . She says that she has been able to manage at home with chores and the children . . . . She reports that she [has] generally been eating better and tries to use the treadmill, two to three times a week, for approximately 15 to 20 minutes.

A.R. 488. Aside from “mild” anxiety and “some” obsessions and compulsions around cleaning, Plaintiff's mental status exam returned fair to normal results with respect to her appearance, cooperation, eye contact, speech, motor activity, affect, thoughts, concentration, attention, insight, judgment, sensorium, and orientation; she also denied feelings of mania and depression, as well as suicidal or homicidal ideations. A.R. 488. Ms. Steinkohl concluded that, although Plaintiff continued to complain of tiredness because her sleep is interrupted by her10-month-old son, Plaintiff's mood was “more stable.” A.R. 488. Ms. Steinkohl discontinued Plaintiff's use of Seroquel at night. A.R. 488.

         On April 1, 2014, Ms. Steinkohl indicated that “Plaintiff has been feeling a little bit more agitated lately, more stressed, the source is primarily about her five-year-old daughter who has been bullied at school . . . as well as concern about finances.” A.R. 491. Moreover, Plaintiff reported increased anxiety, impending doom, negative thoughts, intrusive thoughts before bed, and fearfulness of driving. A.R. 491. Upon examination, Plaintiff's appearance, cooperation, eye contact, speech, motor activity, affect, thoughts, concentration, attention, insight, judgment, sensorium, and orientation were fair to normal; she also denied delusions and hallucinations, and suicidal or homicidal ideations. A.R. 491. However, Plaintiff was anxious and described some obsessions and compulsions. A.R. 491. Mr. Steinkohl concluded that, although Plaintiff was anxious, her mood is “fairly stable, ” and that Plaintiff “has been able to manage things at home as well as her own personal needs . . . .” A.R. 491.

         On April 29, 2014, Plaintiff indicated that she worries “about everything” and reported monetary and familial stressors; however, her dad was providing her with financial assistance. A.R. 501. Plaintiff further indicated that she was capable of completing chores at home[, ] caring for her children, ” and “has continued to exercise” regularly. A.R. 501. Although Plaintiff's mood was anxious, she reported ruminations, and expressed fears of driving, her mental status exam with respect to the following were fair to normal: appearance, cooperation, eye contact, speech, thoughts, concentration, attention, insight, judgment, orientation, and motor activity. A.R. 501. Plaintiff also denied feeling depressed, manic, psychotic, and suicidal or homicidal ideations. A.R. 501. Plaintiff's mood was “more stable, ” and Ms. Steinkohl increased her medication dosage to further assist with mood stabilization. A.R. 501.

         On May 1, 2014, Ms. Lawler, LCSW, completed a Social Security Psychiatric Report on Plaintiff's behalf. Therein, she indicated that Plaintiff experiences between two and five manic episodes per year which varied greatly in duration, and that she suffered from daily anxiety and manic symptoms, the latter of which were manageable with medication. A.R. 471. According to Ms. Lawler, Plaintiff would also become enraged and that would impact “all areas” of functioning, including social, occupational, and familial, and Plaintiff's “episodes” ended with severe depression or visits to the emergency room. A.R. 471. Ms. Lawler noted that Plaintiff's ability to perform work related activities was “greatly limited or based on [Plaintiff's] emotional stability. She is very sensitive to medication and medication needs to be closely monitored for efficacy.” A.R. 472. Finally, Ms. Lawler determined that Plaintiff had acceptable activities of daily living, a supportive partner, her impairments were mental only, and Plaintiff was capable of managing or directing her own interests. A.R. 473.

         On June 6, 2014, Ms. Steinkohl reported that Plaintiff felt anxious “all the time” and that “her biggest stress was financial stress, ” although she was considering “going to school to get some new skills.” A.R. 504. Plaintiff indicated that she “worries about something bad happening to her children, ” “is fearful when driving, ” and “there are times when she gets knots in her stomach from her anxiety.” A.R. 504. With the exception of anxious mood and some obsessive ruminations, Plaintiff's appearance, cooperation, eye contact, speech, motor activity, thoughts, concentration, attention, sensorium, orientation, and judgment were all normal; Plaintiff additionally denied any depression, mania, delusions, hallucinations, and suicidal or homicidal ideations. A.R. 504. Ms. Steinkohl increased Plaintiff's medication and concluded that, although Plaintiff was continuously anxious, her mood was stable, she was capable of sleeping at night, and she could manage the household and children. A.R. 504.

         On June 10, 2014, Clara Castillo-Velez, Ph.D, a state agency medical consultant, independently reviewed Plaintiff's medical records. A.R. 188-21. Dr. Castillo-Velez determined that Plaintiff's psychological symptoms either caused insignificant or moderate limitations in her ability to perform various work-related tasks over the course of a normal workday and workweek, ultimately concluding that Plaintiff “can maintain concentration, persistence and pace for simple tasks.” A.R. 121. Likewise, on September 12, 2014, Joan F. Joynson, Ph.D., also a state agency medical consultant, independently reviewed Plaintiff's medical records and assessed a moderate mental residual functional capacity. A.R. 143.

         On September 23, 2014, Ms. Steinkohl reported that Plaintiff was “working at Kessler in the Neuro Psych Unit, where she is dealing with people with traumatic brain disorders, ” although she considered it to be “very difficult, frustrating, ” and requiring “a lot of patience.” A.R. 593. Plaintiff indicated that she initially started as a temp; however, she was offered and accepted a full-time position. A.R. 593. A mental status exam revealed that Plaintiff was dressed in work clothes; she was well groomed; she was cooperative with good eye contact; her speech and motor activity were normal; she denied any psychotic symptoms, and suicidal or homicidal ideations; her concentration and attention were good; her thoughts were organized; her sensorium was clear; and she was oriented in all three spheres. A.R. 593. On the other hand, Plaintiff was anxious; reported obsessive ruminations and impending doom; and she was fearful of “what bad thing will happen.” A.R. 593. Ms. Steinkohl prescribed Plaintiff Lexapro. A.R. 593.

         On October 21, 2014, Ms. Steinkohl noted that Plaintiff had quit her job after approximately ten weeks due to the following: “it was just too stressful. She was spending approximately 5 hours a day commuting . . . . She states that when she was at work, she was always worrying about if something happened with one of her children, she was so far away . . . how would she be able to help them.” A.R. 596. Upon examination, Plaintiff was casually dressed; she was cooperative with good eye contact; although pressured at times; her speech was normal; her motor activity was normal; her thoughts were organized; she denied delusions or hallucinations and suicidal or homicidal ideations; her attention and concentration were fair to good; her sensorium was clear; and she was oriented. A.R. 596. However, Plaintiff was anxious, and she reported obsessive ruminations, constant worrying, and feelings of guilt. A.R. 596. Ms. Steinkohl concluded her assessment by indicating that Plaintiff was maintaining her usual routine while “looking for other employment.” A.R. 596. Ms. Steinkohl discontinued Plaintiff's Lexapro but increased her Lamictal dosage. A.R. 597.

         On February 6, 2015, Ms. Steinkohl indicated that Plaintiff “had been doing fine”; however, she was “extremely stressed” because she had to move, which was disrupting and made her feel “completely anxious.” A.R. 599. Aside from Plaintiff's anxious mood and, at times, pressured speech, her mental status exam with respect to her appearance, cooperation, eye contact, motor activity, affect, thoughts, sensorium, attention, concentration, and orientation were otherwise fair to normal. A.R. 599. Plaintiff additionally denied delusions, hallucinations, paranoia, and suicidal or homicidal ideations. A.R. 599.

         On March 10, 2015, Ms. Steinkohl noted that Plaintiff moved to a new apartment with her family and was in the process of unpacking and getting resettled. A.R. 602. Plaintiff reported increased anxiety in social situations. A.R. 602. Plaintiff's mental status exam was relatively normal, with the exception of anxious mood and obsessive and compulsive tendencies. A.R. 602. Ms. Steinkohl increased Plaintiff's medication dosage. A.R. 602.

         On April 28, 2015, Plaintiff “continue[d] to complain of anxiety” and described impending doom; she also indicated that she was starting school in May, which contributed to her anxiety, but she was able to sleep at night and planned on walking on a regular basis. A.R. 611. Notwithstanding her anxious mood, Ms. Steinkohl indicated that Plaintiff's mental status exam with respect to her appearance, cooperation, eye contact, speech, motor activity, affect, thoughts, sensorium, orientation, concentration, attention, and concentration were fair to good. A.R. 611. Plaintiff also denied all of the following symptoms: depression, mania, delusions, hallucinations, paranoia, obsessive and compulsive tendencies, as well as suicidal or homicidal ideations. A.R. 611.

         On June 18, 2015, Ms. Steinkohl reported that Plaintiff withdrew from school because her tuition and grant applications contained errors; however, Plaintiff had hoped to continue in the fall. A.R. 614. Ms. Steinkohl also indicated that Plaintiff recently completed the “last day” of her temporary, six-week job at Weichert, and, although she had hoped it continued, Plaintiff “had lots of anxiety while she was there, ” relating to her “daughter . . . at school, her children, ” and finances. A.R. 614. An examination revealed that Plaintiff was casually dressed; she was cooperative with good eye contact; her speech and motor activity were normal; her thoughts were organized; although she was anxious and reported obsessive ruminations, she denied delusions, hallucinations, paranoia, compulsive tendencies, and suicidal or homicidal ideations; her attention and concentration were fair; her sensorium was clear; and she was oriented in all three spheres. A.R. 614.

         On August 13, 2015, Plaintiff indicated that was working a part-time job which required her to write reports for a medical doctor, although she continued to experience financial stress. A.R. 618. Plaintiff further indicated difficulties with the following: remaining asleep, leaving her house, and driving her car. A.R. 618. And, while Plaintiff reported chronic anxiety, she experienced fewer racing thoughts and denied panic attacks. A.R. 618. Ms. Steinkohl performed a mental status exam which demonstrated that Plaintiff was casually dressed; she was cooperative with good eye contact; her speech and motor activity were normal; her thoughts were organized; she denied delusions, hallucinations, and suicidal or homicidal ideations; her attention and judgment were good; her concertation was fair; her sensorium was ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.