United States District Court, D. Colorado
OPINION AND ORDER REVERSING THE COMMISSIONER'S
S. KRIEGER UNITED STATES DISTRICT COURT JUDGE.
MATTER comes before the Court on the Plaintiff's
Complaint (# 1), the Plaintiff's Opening
Brief (# 15), the Defendant's Response
(# 16), and the Plaintiff's Reply
(# 17). 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).
Poulos seeks judicial review of a final decision by the
Commissioner denying her claim for disability insurance
benefits (DIB) under the Social Security Act. In January 2012,
Ms. Poulos filed for DIB, claiming she became disabled in
October 2010. Tr. at 785-94. Following remand by the Appeals
Council, her application was denied at all administrative
levels and she now appeals to this Court.
Court summarizes only the medical evidence relevant to its
decision. Here, the dispositive issue concerns the weight
given to the medical opinions as to limitations in Ms.
Poulos' mental capacity. At the time of her alleged onset
of disability, Ms. Poulos was 40 years old. Tr. at 787. She
was previously employed as a cashier and in customer service.
Tr. at 841.
2012, Dr. Brent Geary, a consulting examiner, saw Ms. Poulos
for a mental evaluation. Tr. at 984-89. Dr. Geary observed
that Ms. Poulos' motor level was elevated but observed no
other mannerisms or physiological symptoms. Tr. at 985.
Though her speed of speech was hastened, her associations
were logical. Tr. at 985. She appeared nervous to Dr. Geary
but was able to focus on the topics at hand. Tr. at 985. He
estimated her intellectual functioning to be at the bottom of
the average range. Tr. at 985. Ms. Poulos scored 29 out of 30
on the modified Mini Mental Status Examination, incorrectly
identifying a clock to read 1:55 instead of 11:10. Tr. at
985. Based on his examination, Dr. Geary diagnosed Ms. Poulos
as suffering from bipolar disorder (currently moderate),
history of alcohol abuse, and victim of physical abuse as an
adult. Tr. at 987. He then opined that she had no limitations
understanding and memory, but was unreliable, disorganized,
and prone to leave tasks and duties undone. Tr. at 988. With
regard to social interaction, she was able to get along, but
she was withdrawn at the exam. Tr. at 988. Finally, he opined
that she would have difficulty with change in the workplace
because she is not organized and a disruption of structure
would cause her trouble. Tr. at 988.
2012, Dr. S.K. Castro, a state-agency non-examining
physician, completed a psychiatric review technique (PRT).
Tr. at 990-1003. She found Ms. Poulos to be mildly limited in
her activities of daily living, and moderately limited in
both social functioning and maintaining concentration,
persistence, and pace. Tr. at 1000. She found no episodes of
decompensation. Tr. at 1000. In explaining her opinion, Dr.
Castro noted that Ms. Poulos' statements are generally
consistent and credible, but she only gave partial weight to
Dr. Geary's opinion that Ms. Poulos would have difficulty
with workplace changes because it was not consistent with the
overall evidence. Tr. at 1002. She concluded that the overall
evidence supports no more than moderate limitations in all
work-related mental abilities. Tr. at 1002.
Castro later completed a mental residual functional capacity
(RFC) assessment based on her review of the record in July
2013. Tr. at 1051-53 . She found Ms. Poulos was not
significantly limited in many areas of ability: remembering
locations and work procedures, understanding and remembering
both simple and detailed instructions, carrying out simple
instructions, performing activities on a schedule with
regular and punctual attendance, sustaining an ordinary
routine without supervision, working in proximity with others
without distraction, making simple work-related decisions,
asking simple questions, getting along with coworkers without
distraction, maintaining socially appropriate behavior, being
aware of normal hazards and taking precautions, traveling in
unfamiliar places, and setting realistic goals and plans
independent of others. Tr. at 1051-52. Dr. Castro found Ms.
Poulos moderately limited in carrying out detailed
instructions, maintaining attention and concentration for
extended periods, completing a normal workweek without
interruptions from symptoms, interacting appropriately with
the public, accepting instructions and responding
appropriately to criticism, and responding appropriately to
changes at work. Tr. at 1051-52.
October 2013, Dr. Constantina Abarikwu, Ms. Poulos'
treating physician, completed a mental capacity evaluation.
Tr. at 1102-03. She treated Ms. Poulos from 2010 when she was
diagnosed with bipolar depression and migraine headaches
since 2010. Tr. at 1102. Despite treatment with medication
and psychological counseling, Dr. Abarikwu found that Ms.
Poulos to be moderately limited in her ability to respond
appropriately to coworkers and perform repetitive tasks. Tr.
at 1102. Ms. Poulos' limitations were moderately severe
with regard to understanding, carrying out, and remembering
instructions; responding appropriately to supervision;
performing simple tasks; and demonstrating reliability. Tr.
at 1102-03. Ms. Poulos was also severely limited in
responding to customary work pressures, performing complex
tasks, maintaining attention and concentration, and
demonstrating emotional stability. Tr. at 1102-03. Dr.
Abarikwu stated that these findings were based on regular
office visits and in consultation with Ms. Poulos'
psychologist. Tr. at 1103. She concluded that Ms. Poulos does
not have the mental stamina to sustain full-time employment
due to intermittent memory lapses and alterations in mental
state, as well as anxiety, social phobias, and decreased
concentration. Tr. at 1103.