United States District Court, D. Colorado
CYNTHIA M. PARAZAK, Plaintiff,
ANDREW M. SAUL,  Commissioner of Social Security, Defendant.
OPINION AND ORDER
REID NEUREITER, UNITED STATES MAGISTRATE JUDGE
government determined that Plaintiff Cynthia M. Parazak was
not disabled for purposes of the Social Security Act.
12-28. Ms. Parazak has asked this Court to review that
decision. The Court has jurisdiction under 42 U.S.C. §
405(g), and both parties have agreed to have this case
decided by a U.S. Magistrate Judge under 28 U.S.C. §
636(c). Dkt. #11.
Ms. Parazak filed her initial application for Social Security
Disability benefit on March 29, 2015, she alleged that she
suffered from the following impairments: fibromyalgia,
cervical radiculitis, cervical spondylosis, lumbar
radiculitis, lumbosacral spondylosis, left knee pain, morbid
obesity, sleep apnea, degenerative disc disease, and lateral
recess stenosis. AR 82-83. At the time of her application,
Ms. Parazak had not been diagnosed with Trigeminal Neuralgia
Parazak has a lengthy history of receiving medical treatment
for pain. She began treating at Colorado Pain in October
2014, and continued to receive treatment off and on through
September 2015. AR 339-401. In December 2015, Ms. Parazak
began treatment at Colorado Comprehensive Spine
(“CCS”) for lower back pain. AR 719-29. Later, on
September 13, 2017, CCS records indicate that that Ms.
Parazak had a history of “diffuse neck pain. Trigeminal
neuralgia.” AR 717, 719.
March 29, 2016, Ms. Parazak went to the emergency room
complaining of left ear and jaw pain, left sinus tenderness,
and headache and pain that had been radiating down her neck
for four days. AR 69. On April 7, 2016, Ms. Parazak reported
this new, different jaw pain in a visit to Family Care
SouthWest. AR 683-87. At that time, physician assistant Lisa
Keller, P.A.-C., suggested that these new symptoms could be
TGN after Ms. Parazak reported that she stopped taking one of
her medications, Topamax, because she thought it was causing
the new pain. Id. The left jaw pain was accompanied
by pain in her ear, mid cheek, lower cheek and into her upper
neck and had lasted more a week and a half. AR 683. Ms.
Keller noted that Ms. Parazak “has never had this kind
of jaw pain-just wanted to die.” Id. On April
14, 2016, Ms. Parazak again saw Ms. Keller and reported that
talking bothered her jaw, but it was “overall much
better, ” and Ms. Keller again suggested that the pain
was TGN. AR 679. Ms. Keller prescribed a steroid to help with
the TGN pain. AR 687. Later, on January 19, 2017, Mr. Parazak
was prescribed medication specifically for TGN. AR 645. In
the interim, Ms. Parazak had been prescribed several
medications for pain other than her jaw pain. AR 648, 650,
654, 657, 667 & 677.
to the medical records from Family Care SouthWest, Ms.
Parazak continued to be treated for TGN through June 2017,
when Ms. Keller discussed the effectiveness of the medication
prescribed for Ms. Parazak's TGN. Ms. Parazak was
prescribed a different medication to treat her TGN because
the medication she was taking (carbamazepine) was not
effective at a lower dose and caused her to be
“nonfunctional” on a higher dose. AR 608-12.
these records, the ALJ stated there was no medical evidence
to substantiate Ms. Parazak's complaints and determined
that her TGN was non-severe. AR 20. Ms. Parazak argues that
there was medical evidence to establish that she was disabled
because of the pain she was experiencing, and she should be
entitled to Social Security benefits. Here, Ms. Parazak
limits her appeal to one issue: whether the ALJ properly
concluded that Ms. Parazak's TGN was non-severe. Dkt.
#15, p.7 at ¶12 & pp.17-19.
Social Security appeals, the Court reviews the decision of
the administrative law judge (“ALJ”) to determine
whether the factual findings are supported by substantial
evidence and whether the correct legal standards were
applied. See Pisciotta v. Astrue, 500 F.3d 1074,
1075 (10th Cir. 2007). “The phrase ‘substantial
evidence' is a ‘term of art' used throughout
administrative law to describe how courts are to review
agency factfinding.” Biestek v. Berryhill, 139
S.Ct. 1148, 1154 (2019) (quoting T-Mobile South,
LLC v. Roswell, 135 S.Ct. 808, 815 (2015)).
“Under the substantial-evidence standard, a court looks
to an existing administrative record and asks whether it
contains sufficient evidence to support the agency's
factual determinations … [T]he threshold for such
evidentiary sufficiency is not high. Substantial evidence
… is more than a mere scintilla … It means-and
means only-such relevant evidence as a reasonable mind might
accept as adequate to support a conclusion.”
Id. (citations and internal quotation marks
Court “should, indeed must, exercise common
sense” and “cannot insist on technical
perfection.” Keyes-Zachary v. Astrue, 695 F.3d
1156, 1166 (10th Cir. 2012). The Court cannot reweigh the
evidence or its credibility. Lax v. Astrue, 489 F.3d
1080, 1084 (10th Cir. 2007). At the same time, determination
of whether substantial evidence supports the
Commissioner's decision is not simply a quantitative
exercise, for evidence is not substantial if it is
overwhelmed by other evidence or if it constitutes mere
conclusion. Fulton v. Heckler, 760 F.2d 1052, 1055
(10th Cir. 1985). Ultimately, the Court must review the
record as a whole, and “[t]he substantiality of
evidence must take into account whatever in the record fairly
detracts from its weight.” Universal Camera Corp.
v. NLRB, 340 U.S. 474, 488 (1951); see also
Casias, 933 F.2d at 800-01.
second step of the Commissioner's five-step sequence for
making determinations,  the ALJ found that Mr. DeHerrera has
the following severe impairments: (1) degenerative disk
disease; (2) fibromyalgia; and (3) obesity. AR 18. The ALJ
also found that Ms. Parazak had the “medically
determinable impairments” of tinnitus, sleep apnea, and
depression, all of which were deemed “non-severe in
nature.” AR 18-19. The ALJ did not address Ms.
Parazak's other complaints from her application, and
separately addressed Ms. Parazak's diagnosis with TGN
without specifically stating whether it was a medically
The claimant has been diagnosed with trigeminal neuralgia
(Ex.10 F). She alleges that she has headaches brought on by
bright light and that these headaches often prevent her from
completing her work. Although her treating source, Lisa
Keller, PA-C, has also listed this condition in a residual
functional capacity assessment, the restrictions cited are
not supported by objective medical signs or exam findings
(Exs. 11F & 13F). Because there is no medical evidence to
substantiate the claimant's alleged symptoms or
restrictions from this condition, the ...