United States District Court, D. Colorado
OPINION AND ORDER REVERSING THE COMMISSIONER'S
S. Krieger United States District Court.
MATTER comes before the Court on the Plaintiff's
Complaint (# 1), the Plaintiff's Opening
Brief (# 16), the Defendant's Response
(# 19), and the Plaintiff's Reply
(# 22). For the following reasons, the
Commissioner's decision is reversed and the matter is
remanded for further proceedings.
Court has jurisdiction over an appeal from a final decision
of the Commissioner under 42 U.S.C. § 405(g).
Allen seeks judicial review of a final decision by the
Commissioner denying her claim for disability insurance
benefits (DIB) and supplemental security income (SSI) under
the Social Security Act. In March 2013, Ms. Allen filed for
both DIB and SSI, claiming she became disabled on October 1,
2012. Tr. at 145-60. Her application was denied at all
administrative levels and she now appeals to this Court
pursuant to 42 U.S.C. § 405(g).
time of her alleged onset of disability, Ms. Allen was 38
years old and working out of her home, washing laundry for
other residents of her apartment building. Tr. at 145, 230.
She was previously employed as a cashier and a receptionist.
Tr. at 201-08. Generally, Ms. Allen is obese and suffers from
headaches, back pain, diabetes, depression, and asthma.
Because the challenges on appeal focus only on physical
limitations, the Court summarizes only the medical evidence
relevant to its decision.
Allen's headaches first appear in the record in February
2013 when Ms. Allen presented to physician's assistant
Elizabeth Madrid, complaining of headaches in the crown of
her head that were getting more frequent. She told P.A.
Madrid that Ibuprofen helped some. P.A. Madrid gave her a
trial of Sumatriptan. Tr. at 305. Ms. Allen returned in March
2013 for further treatment for her headaches. P.A. Madrid
treated her with Ibuprofen. Tr. at 299. Ms. Allen's
headaches are not mentioned in treatment notes from visits to
P.A. Madrid from July to October 2013. In November 2013, Ms.
Allen reported to P.A. Madrid that the Sumatriptan helps some
but not completely. Tr. at 502. The record does not contain
any evidence of Ms. Allen's headaches for visits to P.A.
Madrid in December 2013 or January 2014. Tr. at 488, 494. In
February 2014, Ms. Allen reported to P.A. Madrid that the
sumatriptan usually helped with headaches not the most recent
one. In March 2014, P.A. Madrid noted an exacerbation in Ms.
Allen's headaches and increased her sumatriptan. Tr. at
478. In April 2014, Ms. Allen's headaches are listed as a
diagnosis for which P.A. Madrid ordered a neurological
referral. Tr. at 468. After that, Ms. Allen made three visits
to P.A. Madrid without any mention of headaches. Tr. at 442,
combat her obesity, Ms. Allen engaged tried exercise and to
lose weight. In late 2013, Ms. Allen reported that she was
walking on a treadmill for 15 minutes a day, watching what
she ate, and started participation in a diabetes weight-loss
group at the hospital. Tr. at 494, 502, 509. P.A. Madrid
offered encouragement. Tr. at 494, 502. In January 2014, P.A.
Madrid found progress and better control of Ms. Allen's
weight loss. Tr. at 488. In July 2014, Ms. Allen reported
that she had not been walking or exercising due to pain. Tr.
at 449. In August 2014, P.A. Madrid noted that Ms. Allen was
walking with a cane. Tr. at 442.
two medical opinions addressed Ms. Allen's physical
functional limitations, one by her treating physician and
physician assistant, Dr. Askenazi and P.A. Madrid, in August
of 2014, Tr. at 432-37, and one by Dr. Claudia Elsner, a
consulting, examining physician. Tr. at 420-24.
Askenazi opined that Ms. Allen was limited to occasionally
lifting and carrying up to 10 pounds, to sitting without
interruption for 20 minutes, and to standing and walking
without interruption for 10 minutes. Tr. at 432-33. In an
eight-hour workday, he observed that she could sit and walk
for a total of two hours, and stand for a total of one hour.
Tr. at 433. Dr. Askenazi stated that Ms. Allen required the
use of a cane to ambulate and could not walk more than a
block without it. Tr. at 433. These conclusions were
supported by an MRI study that showed canal stenosis and
severe degenerative facets between L4 and L5, as well as a
disc bulge. Tr. at 433. Dr. Askenazi opined that Ms. Allen
would be limited to never reaching or pushing/pulling and to
occasionally handling, fingering, and feeling due to
decreased sensation in both hands. Tr. at 434. He stated that
she could never operate foot controls because of her
neuropathy. Tr. at 434. Dr. Askenazi opined that Ms. Allen
cannot engage in any postural activities, such as climbing,
balancing, or crouching. Tr. at 435. He observed that she
cannot tolerate any environmental factors, such as
unprotected heights, humidity and wetness, or extreme
temperatures because her condition is worsened by such
factors. Tr. at 436. Due to her neuropathy, Dr. Askenazi
further opined that Ms. Allen could not go shopping, travel,
ambulate on her own power, use public transportation, or sort
papers, but could prepare simple meals and care for her
personal hygiene, though she needs help doing so. Tr. at 437.
Elsner diagnosed Ms. Allen as suffering from with grade-3
obesity, diabetes mellitus type 2, and chronic lower back
pain with documented degenerative joint disease plus lumbar
spondylolisthesis. Tr. at 423. In her examination, Dr. Elsner
found that Ms. Allen moved fluently in spite of her habitus,
stood and walked normally without a limp. Tr. at 422. She
also observed Ms. Allen could straight-leg-raise to 80
degrees, but reported immediate buttock pain on the right
side over the sciatic spine. Tr. at 422. The range of motion
in her cervical spine had commensurate extension and rotation
with lateral bending without distress. Tr. at 423. Dr. Elsner
also found some decreased internal hip rotation but thought
it was conditional. Tr. at 423. Based on these findings, Dr.
Elsner opined that Ms. Allen should limit standing to a
maximum of about 10 minutes at a time, interrupt sitting
every hour, and frequently change posture. Tr. at 423. Dr.