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Seechan v. Astrue

May 5, 2010


The opinion of the court was delivered by: Gary S. Austin United States Magistrate Judge



Plaintiff Sia Seechan ("Plaintiff") seeks judicial review of a final decision of the Commissioner of Social Security ("Commissioner" or "Defendant") denying her application for supplemental security income pursuant to Title XVI of the Social Security Act. The matter is currently before the Court on the parties' briefs, which were submitted, without oral argument, to the Honorable Gary S. Austin, United States Magistrate Judge.*fn1


Plaintiff protectively filed her application on or about May 5, 2006, alleging disability beginning January 15, 2006, due to mental illness. AR 71-83. Her application was denied initially and on reconsideration, and Plaintiff requested a hearing before an Administrative Law Judge ("ALJ"). AR 56-67. ALJ Christopher Larsen held a hearing on February 28, 2008, and issued an order denying benefits on May 19, 2008. AR 14-20, 330-347. On January 30, 2009, the Appeals Council denied review. AR 3-5.

Hearing Testimony

ALJ Larsen held a hearing on February 28, 2008, in Fresno, California. Plaintiff appeared and testified with the assistance of an interpreter. Plaintiff was represented by attorney Sengthiene Bosavanh. Vocational Expert ("VE") Thomas Dachelet also testified. AR 330-347.

Plaintiff was born August 6, 1970. She lives with her husband and children, although she could not say how many children live in the home. AR 336.

Plaintiff does not drive and has never driven. She gets a "ride with the children." AR 336. She attended school in Thailand, but did not know the length of that education. She cannot speak or understand English, nor can she read or write English. AR 336-337. She has not had any educational or vocational training in the United States. AR 337.

Plaintiff's last position was as a cleaner with Vapor Technologies. She stopped working because the company closed down. AR 337. She has not tried looking for other work because she does not speak English. Asked how she got the position with Vapor Technologies, she explained that a friend employed by Vapor took her to work there. AR 338.

When asked whether she would be able to perform any of her past jobs, Plaintiff explained she was not longer able to do so because she has trouble sleeping, is depressed, has no energy and hears voices. AR 338. She experiences pains in her stomach as well, but it comes and goes. AR 338. She no longer has headaches. AR 339.

The medications prescribed to treat her conditions help, however, they do not relieve all the symptoms. AR 339. Plaintiff indicated she has trouble concentrating "a little bit." She can focus on one activity for about five minutes before losing her focus. AR 339.

When she goes to sleep and closes her eyes, she sees and hears "things" that keep her awake. AR 339-340. When she dreams, she sees her father and her husband's first wife, both of whom are dead. She hears their voices "all the time." AR 340. She gets a couple hours of sleep at night; once she awakes she cannot go back to sleep. Occasionally she sleeps "a little bit" during the day. AR 340. About once a week she suffers from having no energy. Because she sleeps so little, she is often tired. AR 340.

When asked what depression meant to her, Plaintiff indicated that because she had no family or parents here in the United States, she is alone and that causes her to be depressed. AR 340-341. She does not have suicidal thoughts. AR 341. She eats very little and feels stressed. The nightmares sometimes occur two to three times a night, or can occur two or three times per week. AR 341.

Plaintiff does not suffer from dizziness any longer, and she could not recall the last time she suffered from dizziness. AR 341. She has trouble remembering things. AR 341. Plaintiff indicated she does not remember meeting with her attorney two weeks prior to the hearing, nor does she recall delivering documents to her attorney. AR 341-342. She often forgets the people she meets or the activities she has done. AR 342. Dealing with others does not cause her any problems. She regularly socializes with two friends. AR 342.

A typical day for Plaintiff is staying home and doing nothing. Her children do the cooking and cleaning. Her three children are about sixteen, seventeen and eighteen years of age, but she does not know their exact ages. AR 342-343. Although she used to do the cooking and cleaning, she no longer does so because she does not "feel good to do that anymore." AR 343. She feels "stressed, depressed and not interested at all." AR 343.

Plaintiff does not remember working for Cargill Meat Solution Corporation, SOS Staffing Services or Broomfield Skilled Nursing. AR 344.

VE Dachelet indicated that Plaintiff's previous work with Vapor Technologies was considered a medium physical demand, unskilled. The skills are not transferable. AR 345. When asked to consider a hypothetical worker of Plaintiff's age, education and work experience, who can understand, remember and carry out simple one or two-step job instructions, VE Dachelet indicated that the hypothetical worker could perform Plaintiff's past relevant work. AR 345.

In a second hypothetical, involving a hypothetical worker of Plaintiff's age, education and work experience, who cannot maintain attention and concentration reliably throughout an eight-hour work day or a forty-hour work week, VE Dachelet indicated that such a worker could not perform Plaintiff's past relevant work nor any other work found in the national economy. AR 345-346.

Plaintiff's counsel asked the VE whether forgetfulness in included in simple repetitive tasks; the VE clarified that forgetfulness involves reduction to the simple world of work. AR 346.

Medical Record

The entire medical record was reviewed by the Court. A summary of the reports and treatment notes is provided below.

Ina Shalts, M.D.

Plaintiff was treated by Dr. Shalts from August 28, 2006, through January 28, 2008, for depression.

On August 28, 2006, Plaintiff was seen at the Tulare Adult Clinic for a psychiatric evaluation. Plaintiff reported sleep disturbances and "hearing voices." Through an interpreter, Plaintiff indicated she has been depressed for six months. She has crying spells, and low energy. Her appetite is affected and she is always tired. She indicated she heard voices call her name when she was alone, but she could not describe the voices. She often replied that she did not remember things in response to a question. The doctor noted Plaintiff was asked how old she was and she said she did not know, but apparently was able to tell a case manager her age during an earlier interview. Plaintiff indicated she would fall asleep and then wake up, and these symptoms started when she found out her husband had a previous wife, who is now deceased. She also believes she hears her father calling her name. Plaintiff denied any suicidal or homicidal ideation. She reported she feels hopeless, and that she suffers from a lot of headaches, dizziness and unsteadiness. It was noted that Plaintiff's primary care physician prescribed Seroquel 200 mg two times a day, Geodon 20 mg two times a day, and Aprazolam 0.5 mg two times a day. Plaintiff reported feeling better, without side effects, but she remains depressed. It was also noted that Plaintiff may be noncompliant with her medication because the bottle of Seroquel was nearly full, and when asked Plaintiff indicated she did not know how to take the medication. Plaintiff indicated a history of back pain, dizziness and headaches. AR 302.

Dr. Shalts' mental status exam results of August 28, 2006, indicate Plaintiff was of an average build, with good hygiene and clean clothing. Plaintiff became more talkative throughout the interview, and the doctor noted that a lack of eye contact could be cultural. Plaintiff's speech was goal directed, she denied any suicidal or homicidal ideation. The doctor noted Plaintiff's memory was intact and her insight and judgment were limited. AR 303. Dr. Shalts diagnosed major depressive disorder, recurrent, moderate, rule out psychotic disorder. A GAF*fn3 score of 50 to 55 was noted. Dr. Schalts' plan included discontinuing the use of Geodon, adding Seroquel at 400 mg and 15 mg of Remeron. Plaintiff was to continue using Aprazolam 0.5 mg for anxiety. AR 304.

A treatment note dated November 2, 2006, indicates Plaintiff reported "doing much better on medications," the depression had decreased and that she was no longer hearing the voices. The medications were not causing any side effects. Plaintiff was guarded and her affect was flat. She was to continue medications and follow up treatment. AR 291.

On December 28, 2006, Plaintiff reported the medication was helping, but that a few weeks ago she began to experience more anxiety and depression. She was not sleeping well after running out of Seroquel and was hearing voices again. Plaintiff was alert and oriented, her memory was intact. The treatment plan was to continue use of Seroquel, Remeron, and Aprazolam. Xanax was added. AR 284.

On March 8, 2007, Plaintiff reported that she continued to hear voices of people speaking to her, "sometimes in the morning and sometimes at night." She awakens a few times during the night and when she takes the Seroquel it makes her drowsy. She indicated her children did the chores at home and she spends a lot of time in her room. AR 197. Dr. Shalts noted Plaintiff was alert and oriented, answered questions through the interpreter, and appeared depressed. Plaintiff denied suicidal or homicidal ideation, her affect was flat and her insight and judgment were limited. She was to continue taking medications prescribed, and Abilify was additionally prescribed. AR 197.

On March 22, 2007, Plaintiff said the voices had decreased but that she still heard them sometimes "mumbling and rambling" and that it continued to scare her. However, she said her depression was decreased. Dr. Shalts noted Plaintiff had good eye contact and answered questions through the interpreter. Plaintiff denied suicidal ideation and her affect was flat. Dr. Shalts opined Plaintiff's insight and judgment were limited. She was to continue taking the medications prescribed. AR 195.

The following month, Plaintiff reported that she continued to hear voices and was paranoid. She denied suicidal or homicidal ideation and noted her depression was decreased.

Dr. Shalts increased the dosage of Abilify and discussed a treatment plan with Plaintiff. AR 186.

On August 7, 2007, Plaintiff advised Dr. Shalts that she felt good on her medication, she did not hear voices anymore, did not feel depressed and was sleeping well. She indicated she had recently suffered from stomach upset, nausea and dizziness. AR 140. Plaintiff was cooperative, denied suicidal ideation, and denied auditory and visual hallucinations. Plaintiff was stable on her regular medications, and had not reported any side effects from those medications. AR 140. Dr. Shalts did refer Plaintiff to the emergency room with regard to her vomiting and nausea. AR 140-141.

On September 13, 2007, Plaintiff denied hearing voices on that date, but indicated she "hears voices off and on." She was alert and oriented, and mildly depressed. She denied suicidal or homicidal ideation. Insight and judgment were fair. She was to continue taking prescribed medications. AR 132.

On January 28, 2008, Plaintiff was "stable on medication" and she was to continue taking Abilify, Seroquel, Aprazolam and Remeron. She denied hearing voices and indicated she was "sleeping and eating well." AR 127.

Ravi I. Kumar, M.D.

On May 3, 2006, Plaintiff saw Ravi I. Kumar at the Tulare Community Health Clinic. She reported dizziness and an inability to sleep at night. Plaintiff's interpreter indicated she would not sleep at night due to nightmares that her husband's first wife is trying to kill her. The nightmares have been a problem for two to three months and she is depressed. Dr. Kumar's examination noted Plaintiff was somewhat pale and did not make eye contact. Plaintiff did not have suicidal ideation or plans. Dr. Kumar assessed dizziness, nightmares, insomnia and ...

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