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Parazak v. Saul

United States District Court, D. Colorado

October 30, 2019

ANDREW M. SAUL, [1] Commissioner of Social Security, Defendant.



         The government determined that Plaintiff Cynthia M. Parazak was not disabled for purposes of the Social Security Act. AR[2] 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.

         Factual Background

         When 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 (“TGN”).

         Mr. 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.

         On 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.

         According 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.

         Despite 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.

         Standard of Review

         In 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 omitted).

         The 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.


         At the second step of the Commissioner's five-step sequence for making determinations, [3] 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 determinable impairment:

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 ...

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