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Ledesma v. Astrue

November 23, 2009

AMY LEDESMA, PLAINTIFF,
v.
MICHAEL J. ASTRUE, COMMISSIONER OF SOCIAL SECURITY, DEFENDANT.



The opinion of the court was delivered by: Rosalyn M. Chapman United States Magistrate Judge

OPINION AND ORDER

Plaintiff Amy Ledesma filed a complaint on September 3, 2008, seeking review of the Commissioner's decision denying her application for disability benefits. On February 17, 2009, the Commissioner answered the complaint, and the parties filed a joint stipulation on April 15, 2009.

BACKGROUND

I.

On August 25, 2006 (protective filing date), plaintiff applied for disability benefits under Title II of the Social Security Act ("Act"), 42 U.S.C. § 423, and the Supplemental Security Income program of Title XVI of the Act, 42 U.S.C. § 1382(a), claiming an inability to work since March 3, 2006, due to bipolar disorder. Certified Administrative Record ("A.R.") 8, 90. The plaintiff's application was initially denied on February 20, 2007, and, following reconsideration, was denied again on August 20, 2007. A.R. 8. The plaintiff then requested an administrative hearing, which was held on March 6, 2008, before Administrative Law Judge Mason D. Harrell, Jr. ("the ALJ").

A.R. 16-44. On April 4, 2008, the ALJ issued a decision finding plaintiff is not disabled. A.R. 6-15. The plaintiff appealed this decision to the Appeals Council, which denied review on July 3, 2008. A.R. 1-3.

II.

The plaintiff, who was born on July 22, 1968, is currently 41 years old. A.R. 14, 99, 122. She has a 12th-grade education with one year of business college, and previously worked as a receptionist and as a waitress. A.R. 26, 91, 93, 120.

Plaintiff was treated at the Riverside County Department of Mental Health ("RCDMH") from February 1, 2006, to February 13, 2008. A.R. 150-208, 233-38. Her primary treating physician was Bruce Bogost, M.D.,*fn1 A.R. 150-51, 154, 178, 182, 185, 188, 196, 203, 206-07, who diagnosed plaintiff as having bipolar II disorder and polysubstance dependence. See A.R. 150-51, 182, 196. Dr. Bogost and others prescribed several medications to plaintiff, including Zoloft,*fn2 Depakote,*fn3 and Seroquel.*fn4 A.R. 150-51, 153, 178, 203, 206, 236. On September 28, 2006, Dr. Bogost opined plaintiff: was paranoid and suffered from delusions; had a "mild" impairment of her memory and judgment; showed evidence of insomnia, depression and anxiety; was unable to maintain a sustained level of concentration, perform repetitive tasks for an extended period, or adapt to new or stressful situations; could not interact appropriately with strangers, co-workers or supervisors; was fearful and anxious; and needed assistance in keeping appointments. A.R. 151. Dr. Bogost further opined plaintiff could not complete a 40-hour work week without decompensating, and her prognosis was guarded. Id.

On September 4, 2006, Eugene Hu, M.D., an attending physician at Riverside County Regional Medical Center, noted plaintiff appeared to be using cocaine, amphetamine and heroin, and cleared plaintiff for entry into a "detox" program. A.R. 122-23. J. Robinson, L.V.N., noted plaintiff was on Methadone, was "shaky," and admitted using heroin the day before and showed "numerous scarred tract & prior abscess looking sites on [her] body." A.R. 124, 126.

On February 10, 2007, psychiatrist Romualdo R. Rodriguez, M.D., examined plaintiff, A.R. 127-35, and noted she was not under the influence of drugs at the time. A.R. 130. Dr. Rodriguez found plaintiff: had "coherent and organized" though processes and was not delusional; had "no current suicidal, homicidal or paranoid ideation"; described "her mood as euthymic"; was "polite, serious and relaxed" and not "tearful"; although feeling "helplessness and hopelessness at times, [plaintiff does] not [feel] worthless and guilty"; was "alert and oriented . . . [and] appears to be of at least average intelligence"; "could recall three items immediately and two items after five minutes"; "could perform serial threes [and] . . . can correctly and quickly complete simple mathematic problems"; and "was able to follow . . . conversation well." A.R. 130-31. Nevertheless, Dr. Rodriguez found plaintiff's "[i]nsight into her problems is very problematic," and determined plaintiff was "still actively using drugs illegally and not getting proper care for her mental health issues." A.R. 132. Dr. Rodriguez diagnosed plaintiff with: post-traumatic stress disorder, attention deficit hyperactivity disorder (ADHD) and polysubstance dependence, and he determined her Global Assessment of Functioning (GAF) was 60.*fn5 Id. Dr. Rodriguez opined that, "if [plaintiff] stopped all illegal drugs and [was] properly treated for ADHD and/or any other mood disorders she may have, she could easily recover from her problems within twelve months." A.R. 133. Dr. Rodriguez found plaintiff was: (1) "[a]ble to understand, remember and carry out simple one or two step job instructions"; (2) "[a]ble to do detailed and complex instructions"; (3) "[s]lightly limited in her ability to relate and interact with supervisors, co-workers and the public"; (4) "[m]oderately limited in her ability to maintain concentration and attention, persistence and pace"; (5) "[s]lightly limited in her ability to associate with day-to-day work activity, including attendance and safety"; (6) "[s]lightly limited in her ability to adapt to the stresses common to a normal work environment"; (7) "[s]lightly limited in her ability to maintain regular attendance in the work place and perform work activities on a consistent basis"; and (8) "[s]lightly limited in her ability to perform work activities without special or additional supervision." A.R. 133-34.

On February 15, 2007, nonexamining psychiatrist Barbara A. Smith, M.D., opined plaintiff suffers from an affective disorder and a polysubstance dependence, and determined plaintiff's impairments were not severe. A.R. 136-46. Dr. Smith opined plaintiff has: (1) "mild" restriction of activities of daily living; (2) "marked" difficulties in maintaining social functioning; (3) "marked" difficulties in maintaining concentration, persistence or pace; and (4) three episodes of decompensation, each of extended duration. A.R. 144. Dr. Smith found plaintiff's drug abuse and alcoholism were material and without those conditions, plaintiff's "impairment [would] not [be] severe[,]" and plaintiff would have no restriction in activities of daily living, no difficulties in maintaining social functioning, "mild" difficulties in maintaining concentration, persistence or pace, and no episodes of decompensation. A.R. 144, 146.

On May 3, 2007, Dr. Bogost, who had not seen plaintiff since December 7, 2006, opined plaintiff: showed no signs of psychosis and her memory was intact; had mildly impaired judgment; showed evidence of confusion, depression and anxiety and showed negative symptoms for apathy; could maintain a sustained level of concentration, but could not adapt to new or stressful situations; could not interact appropriately with family, strangers, co-workers or supervisors; was hostile, fearful and anxious; and needed assistance in keeping appointments. A.R. 150. Dr. Bogost again opined plaintiff could not complete a 40-hour work week without decompensating, and that her prognosis was guarded. Id.

On February 13, 2008, an unidentified physician at RCDMH diagnosed plaintiff as having an unspecified mood disorder and heroin and methamphetamine dependence. A.R. 238. He/she opined that plaintiff: showed evidence of insomnia, depression, anxiety and compulsive behaviors, as well as impaired judgment and concrete thought patterns; showed no ability to maintain a sustained level of concentration, sustain repetitive tasks for an extended period, or adapt to new or stressful situations; showed no ability to interact appropriately with family, strangers, co-workers or supervisors; needed assistance with hygiene, and was unable to manage funds in her best interest; "missed her appointments and has refused to go for lab work," and her prognosis was "chronic." Id.

Medical expert Joseph M. Malancharuvil, Ph.D., testified at the administrative hearing that plaintiff has a mixed substance abuse disorder, an organic affective disorder with bipolar features secondary to substance abuse, and a personality disorder, not otherwise specified. A.R. 26-36. Dr. Malancharuvil opined that her mental limitations would be "marked" if she's intoxicated, but, if not abusing drugs, she would have only a "mild" limitation in her activities of daily living, "mild" difficulty maintaining social functioning, "mild-to-moderate" difficulties maintaining concentration, persistence or pace, and no episodes of decompensation. A.R. 28-29. Dr. Malancharuvil further opined plaintiff is restricted to ...


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