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Gasparyan v. Astrue

January 13, 2009

KARAPET GASPARYAN, PLAINTIFF,
v.
MICHAEL J. ASTRUE, COMMISSIONER OF THE SOCIAL SECURITY ADMINISTRATION, DEFENDANT.



The opinion of the court was delivered by: Patrick J. Walsh United States Magistrate Judge

MEMORANDUM OPINION AND ORDER

Before the Court is Plaintiff's appeal of a decision by Defendant Social Security Administration ("the Agency"), denying his application for supplemental security income ("SSI"). He asks the Court to reverse the Agency's decision and award benefits or, in the alternative, to remand the case to the Agency for further proceedings. Because the Agency's decision that Plaintiff was not disabled is supported by substantial evidence, the decision is affirmed.

I. BACKGROUND FACTS

A. Plaintiff's Personal History and Work History

Plaintiff was born on October 23, 1956, and was 50 years old at the time of the administrative hearing. (Administrative Record ("AR") 321.) He was born in Armenia and completed eight years of school there. (AR 113, 321.) Plaintiff worked as a part-time laborer in Armenia. (AR 113, 331.) In 1989, he emigrated to the United States. (AR 113, 321.) Since then, he has worked as a driver and janitor. (AR 58, 113.) Plaintiff claimed in his benefits application that he has been unable to work since July 5, 2001, because of head and body injuries, depression, anxiety, mental disorder, headache, pain, dizziness, and loss of balance. (AR 57.)

B. Plaintiff's Medical Condition and Treatment

In a June 24, 2005 report, Dr. Wayne Taubenfeld, Plaintiff's former treating psychologist, who met with Plaintiff on 14 occasions between April 2003 and June 2005, indicated that Plaintiff had been diagnosed with post traumatic stress disorder; major depression, recurrent, severe; headaches, severe; anxiety neurosis; nightmares; and panic disorder. (AR 182.) Dr. Taubenfeld indicated that these diagnoses were based on "neuro-psychological testing," mental status examination, background medical records, family testimony, and Plaintiff's "current emotional state." (AR 182.)

Dr. Taubenfeld reported that, in 1988, Plaintiff was buried alive under rubble in an earthquake in Armenia and spent eight days in a coma. (AR 183.) In 1990, Plaintiff dislocated his shoulder and was hospitalized. (AR 183.) In 1992, Plaintiff "sustained severe physical and emotional injury" in an automobile accident. (AR 183.) In part due to these traumas, according to Dr. Taubenfeld, Plaintiff is seriously impaired in intellectual functioning: his cognitive performance is "in the low range of borderline"; his insight, judgment, and concentration are impaired; and he has organic brain damage as reflected in his poor performance on the Bender-Gestalt test. (AR 183.)

Dr. Taubenfeld noted that Plaintiff had been taking "Prosac [sic], Xanax, Maxalt, Buspar, [and] Tylenol extra-strength [with] Codeine" for over four years, without any apparent improvement in his condition. (AR 182, 183.) Dr. Taubenfeld reported that, in fact, "there has been an increase in depression, insomnia, feelings of hopelessness as well as cognitive deterioration which includes loss of memory and concentration." (AR 183.)

On June 24, 2005, Dr. Noubar Janoian, another of Plaintiff's treating physicians, reported that Plaintiff had been treated since July 2001 for, among other complaints, "[d]epressed mood, panic attacks, choking sensation, low energy level, tension, predominance of negative mood, difficulty to concentrate, and nightmares," as well as "[m]oderate memory impairment, decreased ability to concentrate, read, write or watch television." (AR 186, 187.) Dr. Janoian noted that Plaintiff was taking Prozac and Xanax. (AR 188.) Dr. Janoian diagnosed Plaintiff with depression, insomnia, and anxiety/panic disorder. (AR 189.) In Dr. Janoian's view, Plaintiff's "main disability is anxiety, frequent panic attacks, depression, which started as a result of [the] earthquake in 1988." (AR 190.) Dr. Janoian opined that Plaintiff "has lost hope for recovery and feels hopeless and helpless," and found that his prognosis was "guarded to poor." (AR 190, 191.)

Treatment records from between March 31, 2004 and October 16, 2006 furnished by Dr. Janoian show that Plaintiff was seen on various occasions for depression, insomnia, and anxiety, and was prescribed Prozac and Xanax. (AR 205-06, 210-11, 212-13, 220-21, 224-25, 228-29, 235-36, 245-46.) In a chart note dated June 1, 2006, it was noted that Plaintiff was being prescribed Seroquel, Buspar, and Prozac. (AR 264.) The report also noted that Plaintiff was "anxious, fearful, negative for paranoia, depressed mood, irritable, obsessive-compulsive behaviors, denies suicidal thoughts, experiencing sleep disturbance, no picking behavior, has no mood swings, no prior psych. hospitalization." (AR 265.)

On November 30, 2005, clinical psychologist Dr. Rosa Colonna conducted an evaluation of Plaintiff for the state department of social services. (AR 154-59.) Dr. Colonna noted that Plaintiff reported that he suffered from chronic depression and anxiety, that he felt paranoid because people were talking about him and following him, and that his memory was poor. (AR 154.) Plaintiff told her that his problems first began after the 1988 earthquake and got worse after the car accident in 1992. (AR 155.) Although Plaintiff stated that he was receiving outpatient mental health treatment once every two months and taking various medications, including Prozac, he told Dr. Colonna that the treatment was only minimally helpful. (AR 155.) Dr. Colonna noted that Plaintiff stated he drank approximately four shots of alcohol per day and had attended AA meetings in the past. (AR 156.)

Dr. Colonna reported that Plaintiff was "minimally cooperative" and exhibited poor effort in testing. (AR 154, 156.) She reported that his thoughts were organized in a linear fashion and that there was no evident psychomotor slowing. (AR 156.) She assessed his current intellectual functioning as low average and found his memory, attention, and concentration mildly diminished. (AR 156.) She reported that the results of Plaintiff's testing on memory malingering were indicative of poor effort, and that his test results overall "do not appear to be a totally valid estimation of the claimant's ability at this time." (AR 157.) Her diagnosis was: rule out alcohol abuse v. alcohol dependence, dysthymia; personality disorder, dependent traits. She assessed a Global Assessment of Functioning ("GAF") score of 60.

Dr. Colonna concluded that Plaintiff would be able to understand, remember, and carry out "short, simplistic instructions without difficulty," but would have a "mild inability" to understand, remember, and carry out detailed instructions. (AR 158.) She found that Plaintiff would be able to interact appropriately with supervisors, co-workers, and peers, but recommended that he continue to obtain outpatient mental health treatment services owing to his long history of emotional disturbance accompanied by alcohol abuse. (AR 158.)

On May 2, 2006, Plaintiff went to the Los Angeles County Department of Mental Health. There, he filled out an initial contact form in which he stated that he suffered from anxiety, depression, headaches, and paranoid delusions. (AR 277.) Plaintiff reported that he was not a recovering alcoholic and that he was not currently abusing any substances. (AR 277.) Cecilia Garcia, a social worker who met with him, noted on an initial assessment form that Plaintiff had no history of psychiatric hospitalization or suicide attempts, and that he had been attending outpatient therapy with his psychologist, which ended when the therapist moved away. (AR 281, 310.) Ms. Garcia diagnosed major depressive disorder, assigned a GAF of 40, and referred Plaintiff to Dr. Larisa Levin for medical evaluation. (AR 286.)

Plaintiff was thereafter seen by Dr. Levin. On May 22, 2006, she noted that Plaintiff reported a history of being depressed, fearful, and having poor sleep, and was currently on Prozac. (AR 288.) In a medication note dated June 22, 2006, Dr. Levin noted that Plaintiff was paranoid and fearful but denied suicidal ideation, and that he did not experience anhedonia or panic attacks. (AR 290.) On July 27 and September 27, 2006, Dr. Levin noted that Plaintiff should continue on his current prescription medications, which were Prozac, Buspar, and Seroquel. (AR 291, 292.)

On January 10, 2007, after the ALJ issued his decision denying Plaintiff's application, Dr. Levin completed a Mental Impairment Questionnaire provided by Plaintiff's counsel. (AR 315-18.) In it, Dr. Levin diagnosed Plaintiff with major depressive disorder, assigned a GAF of 48, and noted that Plaintiff was continuing to experience disturbing thoughts and feelings, despite his compliance with medication. (AR 315.) In response to a question asking for a description of the clinical findings that "demonstrate the severity of [Plaintiff]'s mental impairment and symptoms," Dr. Levin wrote: "[D]epressed mood, [illegible] isolation, paranoid ideations, [illegible] to concentration, forgetful." (AR 315.) Dr. Levin noted that Plaintiff did not have reduced intellectual functioning, but opined that Plaintiff would have marked restrictions in activities of daily living; marked difficulties in maintaining social functioning; marked deficiencies of concentration, persistence, or pace; and noted that Plaintiff had experienced three episodes of decompensation, each of at least a two-week duration, within a 12-month period. (AR 317.) Dr. Levin opined that Plaintiff's impairments would cause him to be absent from work more than four days per month, that his impairment had lasted or would be expected to last at least twelve months, and that Plaintiff was not a malingerer. (AR 318.)*fn1

C. The Administrative Proceedings

On July 15, 2005, Plaintiff filed an application for SSI benefits that was denied initially and upon reconsideration. (AR 32, 37, 43, 45.) An Administrative Law Judge ("ALJ") then held a hearing on November 2, 2006, at which Plaintiff testified. (AR 319-42.) Plaintiff testified that he could lift only five to seven pounds, walk no more than one or two blocks, and sit no more than two to three hours at a time. (AR 338-39.) Plaintiff testified that he could not sleep more than two to three hours at night without waking up because of fearful thoughts and ...


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