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Peterson v. Astrue

August 2, 2009


The opinion of the court was delivered by: Dennis L. Beck United States Magistrate Judge



Plaintiff Jennifer C. Peterson ("Plaintiff") seeks judicial review of a final decision of the Commissioner of Social Security ("Commissioner") denying her application for disability insurance benefits pursuant to Title II the Social Security Act. The matter is currently before the Court on the parties' briefs, which were submitted, without oral argument, to the Honorable Dennis L. Beck, United States Magistrate Judge.*fn1


Plaintiff filed her initial application on May 24, 2004, alleging disability since June 1, 2002, due to bipolar disorder and depression. AR 53-56, 59-68. After her application was denied initially and on reconsideration, Plaintiff requested a hearing before an Administrative Law Judge ("ALJ"). AR 30-34, 36-40, 41. ALJ Peter Belli held a hearing on April 5, 2006, and issued an order denying benefits on August 17, 2006. AR 60-69, 506-529. On October 18, 2007, the Appeals Council denied review. AR 5-8.

Hearing Testimony

ALJ Belli held a hearing on April 5, 2006, in Sacramento, California. Plaintiff appeared with her attorney, Dennis Cameron. Vocational expert ("VE") Jim Van Eck also appeared and testified. AR 285.

Plaintiff testified that she was 35 years old at the time of the hearing. She lived in a house with her husband and four children, ages 13, 11, 8 and 6. AR 290-291. Plaintiff graduated high school and last worked briefly in 2002, at a florist. AR 292, 309. Plaintiff could not continue working because it became "too much" and she started missing too much work. AR 306.

Plaintiff explained that she could no longer work because she gets confused and has a hard time reading and writing because of her medications. AR 294. Plaintiff takes 300 mg of Lamictal, 300 mg of Wellbutrin and .75 mg of Synthroid during the day, and 100 mg of Seroquel and 25 mg of Xanax at night. AR 294-295. She also feels that "life is too big," but isn't sure if that is from the medication or the bipolar disorder. AR 296.

Plaintiff further testified that she stopped drinking alcohol two years and four months ago and is currently in AA. She is a sponsor and goes to meetings once or twice as week. She has also conducted meetings in the past. AR 297. Plaintiff has a valid driver's license and drives almost everyday. AR 298.

When asked about her medical problems, Plaintiff explained that she was bipolar and cycles three to four times a week. AR 299. She described her cycles as "rapid," meaning that she experiences depression and mania "sometimes in one day, or a couple days." AR 306. She was hospitalized most recently in October 2005 because she was suicidal. In 2004, she was hospitalized because she was suicidal and was suffering from depression and mania at the same time. In 2002, she was hospitalized in both April and July. AR 300. Plaintiff currently sees a therapist once every three weeks to "get her life in order." AR 301.

Plaintiff testified that she was not hospitalized in 2003. During that year, her mother, sister and mother-in-law helped her take care of her children, though they did not spend all day with her. She was the sole caretaker of her three year old from 6 a.m. to 2 p.m., when her husband worked. Plaintiff could not work in 2003 because she was "just confused." AR 303-304.

When questioned by her attorney, Plaintiff explained that she has mania 80 percent of the time and depression 20 percent of the time. The mania makes her "keep going up and up until [she] can't sleep." AR 306. It also sometimes makes her think she is indestructible and she does things she shouldn't. AR 306-307. Plaintiff once left her house for six months. AR 307.

When she is depressed, she can't move and stays in bed. She can't think straight and has been suicidal. AR 308. Of her four hospitalizations, the first one was for two weeks, the second one was for five weeks and the third and fourth were for one week each. AR 308.

Plaintiff also has an eating disorder and still has problems with bulimia and overeating. AR 308.

At the conclusion of the hearing, the VE testified that Plaintiff's prior work falls into the light level of exertion. AR 310.

Medical Record

On April 9, 2001, Plaintiff voluntarily admitted herself to Pacific Shores Hospital because she was acutely depressed, was suicidal and her bulimia was out of control. Plaintiff was discharged on April 22, 2001, which was before her treatment team felt that she was ready. During her treatment, she responded well to medication and intensive inpatient food rehabilitation. On discharge, her affect was constricted and her mood was mildly to moderately depressed. She had no suicidal ideations and no hallucinations or delusions. Her insight and judgment were fair. Plaintiff was diagnosed with major depression and bulimia nervosa. Her prognosis was guarded. AR 107-117.

Plaintiff returned to Pacific Shores voluntarily on June 18, 2001, for acute depression and out of control bulimia. Plaintiff was started on a different medication, which she tolerated well. On July 12, 2001, Plaintiff was discharged with diagnoses of major depression and bulimia nervosa and her prognosis was guarded. AR 118-124.

On March 5, 2002, Plaintiff underwent a psychiatric assessment performed by Thomas E. Bittker, M.D. Plaintiff complained that she was "up and down" every three days and continued to binge and purge daily. She had been sober for 12 days. On mental status examination, Plaintiff was alert and cried at times. Her affect was congruent and she acknowledged a depressed mood with occasional feelings of hopelessness, helplessness and worthlessness. Plaintiff's thoughts were focused and she was able to respond to questions in a goal directed fashion. She had sufficient insight to appreciate that her upbringing was traumatic (abuse by stepfather) and understood that she was somehow chemically unstable. AR 125-127.

Dr. Bittker diagnosed bipolar disorder, mixed, post-traumatic stress disorder, alcohol abuse and bulimia nervosa. He noted that Plaintiff represented "something of a dilemma" because the medications she needed to control her bulimia would exacerbate her mood disorder. He recommended that Plaintiff discontinue Prozac and start two new medications. AR 127.

On August 27, 2002, Plaintiff began treatment with Shep Greene, M.D., at the Lassen County Mental Health Department. Plaintiff reported only a partial benefit from her medications and explained that she continued to experience manic episodes, though they were less intense and less frequent. On mental status examination, Plaintiff's speech was of normal rate and rhythm and no psychomotor agitation/retardation was noted. Her mood was labile, yet she displayed a full range of affect. Plaintiff was alert to person, place and date and her cognitive exam was intact. Plaintiff's estimated intelligence was above average. Insight with regard to her condition was good and her judgment was marginal. He diagnosed Plaintiff with bipolar disorder, not otherwise specified, and bulimia. Plaintiff was started on a new medication. AR 173-175.

Dr. Greene's notes from October 1, 2002, indicate that Plaintiff's husband called to report that Plaintiff had taken 8 1/2 tablets of Klonopin in six hours in an effort to sleep. Despite the medication, Plaintiff was not able to sleep and Dr. Greene recommended that she voluntarily admit herself to break the cycle of mania. AR 169.

On October 17, 2002, Plaintiff was admitted to West Hills Hospital because she was acutely manic. She was given medication that effectively sedated her and controlled her mood. On discharge, her mood was mildly euphoric to euthymic and her affect was somewhat labile. Her speech was mildly pressured, but corrected from the time of admission. Thought content and perception were normal and her cognitive capacity was at Plaintiff's baseline. Insight and judgment were "perhaps mildly impaired," though judgment was deemed to be intact. Plaintiff was allowed to return to her pre-hospitalization level of activity, but she was told not to operate a motor vehicle. Her discharge diagnosis was bipolar disorder, manic phase, with psychotic features. AR 129-130.

On October 21, 2002, Plaintiff saw Dr. Greene and appeared less manic, though she reported sleeping 17 hours a day while she was hospitalized. Dr. ...

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