United States District Court, C.D. California
MEMORANDUM DECISION AND ORDER
SUZANNE H. SEGAL, Magistrate Judge.
Christopher Kirkpatrick ("Plaintiff") seeks review of the final decision of the Commissioner of the Social Security Administration (the "Commissioner" or the "Agency") finding him eligible for Disability Insurance Benefits and Supplemental Security Income from January 22, 2011 through February 16, 2012, but denying him those benefits after February 16, 2012 because of medical improvement. The parties consented, pursuant to 28 U.S.C. § 636(c), to the jurisdiction of the undersigned United States Magistrate Judge. For the reasons stated below, the decision of the Commissioner is AFFIRMED.
Plaintiff applied for Title II Disability Insurance Benefits ("DIB") and Title XVI Supplemental Security Income ("SSI") on January 31, 2011 and February 3, 2011 respectively. (Administrative Record ("AR") 129, 136). In both applications, Plaintiff alleged a disability onset date of January 22, 2011. (Id.). The Agency initially denied Plaintiff's applications on March 8, 2011, (AR 62-66), and upon reconsideration on June 24, 2011. (AR 60-61). On August 5, 2011, Plaintiff requested a hearing before an Administrative Law Judge ("ALJ"). (AR 73). Plaintiff testified before ALJ Marti Kirby on September 7, 2012. (AR 32-57). The ALJ subsequently issued a partially favorable decision on September 25, 2012. (AR 10-26). The ALJ found that Plaintiff was disabled within the meaning of the Social Security Act from January 22, 2011 to February 16, 2012. (AR 26). The ALJ concluded, however, that Plaintiff's disability ended on February 17, 2012 due to medical improvement. (AR 10-11). On October 10, 2012, Plaintiff requested review of the ALJ's decision, which the Appeals Council denied on September 18, 2013. (AR 1-5). Plaintiff filed the instant action on November 15, 2013.
Plaintiff was born on November 6, 1978 and was thirty-two years old on the date that he allegedly became disabled. (AR 35). Plaintiff did not graduate high school or obtain a GED. (AR 36). Plaintiff alleged that he could not engage in substantial gainful activity after January 22, 2011 due to Stage IV Hodgkin's lymphoma. (AR 175, 178). Plaintiff also claimed that he suffered from blood clots in his arms, fatigue due to chemotherapy, deep vein thrombosis ("DVT") in his shoulders, and peripheral neuropathy in his feet and hands. (AR 198, 216). Plaintiff's examining physicians found that these symptoms decreased in severity in the months following Plaintiff's last cycle of chemotherapy on October 14, 2011. (AR 458). On June 5, 2012, Plaintiff underwent surgery on his right knee to repair a torn meniscus suffered in January of 2012, which resulted in a Grade IV cartilage change to the knee. (AR 365).
Plaintiff also claimed he suffered from severe depression. (AR 22). Plaintiff visited a mental health facility in January of 2012. (AR 349). Examining physicians concluded Plaintiff was depressed, but was not a risk to himself or others and recommended that Plaintiff begin counseling. (AR 349, 352). Plaintiff was later prescribed the antidepressant medication Lexapro in May of 2012. (AR 390, 392).
A. Medical History: Treating And Examining Physicians' Findings
1. Physical Condition
On January 22, 2011, Plaintiff presented to the Desert Regional Medical Center ("Desert Regional") in Palm Springs, California with fatigue, malaise, a lack of energy and weight loss. (AR 235). On January 25, 2011, Plaintiff underwent a left inguinal lymph node biopsy which revealed that Plaintiff had Stage IV Hodgkin's lymphoma with bone marrow involvement. (AR 241-44, 275). Plaintiff commenced chemotherapy in early 2011 and started taking Coumadin for "bilateral upper extremity DVT caused by his malignancy[.]" (AR 275). On March 9, 2011, Plaintiff's physician at Desert Regional's Comprehensive Cancer Center ("Cancer Center"), Dr. Murthy Andavolu, reported that Plaintiff was "doing well, " having regained his appetite, and gained a "significant amount" of weight. (Id.). Plaintiff reported no nosebleeds or gum bleeding, no blood in his stool, no fevers or night sweats, no neck pain or swelling, no abdominal pain, and no leg swelling. (Id.).
On March 23, 2011, Plaintiff saw Dr. Andavolu for a follow-up visit. (AR 277). Plaintiff reported continued weight gain, and his exam was otherwise unremarkable. (Id.). Plaintiff remained on Coumadin for his DVT and continued to undergo chemotherapy. (Id.). Plaintiff returned to Dr. Andavolu on April 13, 2011 after completing his third cycle of chemotherapy. (AR 279). Plaintiff reported no complaints and continued to receive treatment for his DVT. (Id.). On May 4, 2011, nurse practitioner Cathy Warne conducted a follow-up examination of Plaintiff. (AR 282). Plaintiff complained of itchy eyes, nasal congestion, and tenderness in his mouth. (Id.). He reported purposeful weight loss, but no headaches, fevers, night sweats, abdominal pain, chest pain, swelling, or shortness of breath. (Id.). Nurse Warne reported that Plaintiff "tolerated [his] chemotherapy well and had a good clinical response." (Id.). Plaintiff's PET-CT scan showed a "complete response." (Id.) Dr. Andavolu confirmed the nurse's findings in an additional report and noted he increased Plaintiff's Coumadin to 7.5 mg daily two days earlier. (AR 284).
On May 11, 2011, Plaintiff underwent a bone marrow biopsy. (AR 286). Plaintiff tolerated the procedure well, (id.), and a microscopic examination of his biopsied bone marrow revealed no evidence of Hodgkin's lymphoma. (AR 290). On June 1, 2011, Plaintiff reported muscle and bone aches, but no other remarkable symptoms. (AR 467). Dr. Andavolu noted on June 30, 2011 that Plaintiff continued to gain weight, his groin lymphadenopathy had disappeared, and he reported no chest or abdominal pain. (AR 466). Plaintiff continued to do well throughout July 2011 and showed signs of near-complete resolution of his Hodgkin's lymphoma. (AR 464). Plaintiff also improved throughout August 2011, showing no signs of fever, swelling, weight loss, chest pain, abdominal pain, or distress. (AR 462). Plaintiff continued to tolerate his chemotherapy well throughout September 2011. (AR 460). After briefly increasing Plaintiff's Coumadin to 10 mg daily in late August 2011, Dr. Andavolu lowered Plaintiff's dose back to 7.5 mg daily on September 22, 2011. (AR 462, 460).
On October 3, 2011, Plaintiff visited Dr. Apollo Gulle in Yucca Valley, California to discuss his lab results. (AR 342). Plaintiff reported no fatigue, fever, night sweats, coughing, chest pain, irregular heartbeat, abdominal pain, constipation, diarrhea, or vomiting. (Id.). Plaintiff was not under any apparent distress, appeared well-nourished, and well-developed. (Id.). Plaintiff's lungs were clear, his heart rhythm was regular, his abdomen was soft and non-tender, and his extremities showed no signs of edema or cyanosis. (Id.). Dr. Gulle noted that Plaintiff's cancer was in remission and his DVT in the upper extremities remained chronic. (Id.). Dr. Gulle prescribed Plaintiff Fenofibrate (160 mg) and Nexium (40 mg), and modified his Coumadin dosage to 5 mg. (AR 343). At the time of his visit, Plaintiff weighed 234 pounds. (AR 342).
On October 19, 2011, Plaintiff visited Dr. Andavolu for a follow-up appointment. (AR 458). Dr. Andavolu reported that Plaintiff was doing well after completing his last cycle of chemotherapy on October 14, 2011. (Id.).
On November 22, 2011, Plaintiff returned to Dr. Gulle for a follow-up examination. (AR 340). Plaintiff reported itchy and dry feet, but no other remarkable symptoms. (Id.). Dr. Gulle prescribed Lidex solution (.05%) for Plaintiff's skin condition and Plaintiff continued to take Fenofibrate, Coumadin and Nexium. (Id.). At the time of his visit, Plaintiff weighed 237 pounds.
On December 8, 2011, Plaintiff again presented with no signs of fatigue, fever, night sweats, distress, respiratory problems, or any other remarkable complications. (AR 338). Plaintiff reported chest congestion, an itchy throat, a runny nose and body aches. (Id.). Dr. Gulle prescribed Plaintiff amoxicillin (500 mg) in addition to his regular medications. (AR 339). Plaintiff weighed 236 pounds at the time of his examination. (AR 338).
Plaintiff returned to Dr. Gulle on January 16, 2012 complaining of a swollen right knee due to an attempt to return to work as a construction worker. (AR 336). Dr. Gulle noted that although Plaintiff experienced swelling and pain in his right knee, x-rays of the knee were unremarkable and Plaintiff reported no history of trauma, weakness or numbness. (Id.). Dr. Gulle diagnosed Plaintiff with a sprained right knee and recommended treatment with NSAIDs, ice and a wearable immobilizer. (Id.).
On January 18, 2012, Plaintiff returned to Dr. Andavolu. (AR 457). Dr. Andavolu noted that Plaintiff's cancer was in complete remission, although his DVT persisted. (Id.). Plaintiff complained of an injury to his right knee, which required the use of crutches. (Id.). Plaintiff reported no additional complaints. (Id.).
On February 1, 2012, Plaintiff visited Dr. Jeffrey Seip in Yucca Valley for a knee examination. (AR 422). Plaintiff reported mild joint pain and denied any locking, popping, or other mechanical symptoms of the right knee. (Id.). Plaintiff also described a stable and nonprogressive pattern of symptoms. (Id.). Dr. Seip concluded Plaintiff was not at risk of falling, diagnosed Plaintiff with a sprain of the right lateral collateral knee ligament, and referred Plaintiff to physical therapy. (AR 423).
At a February 8, 2012 physical therapy session, Plaintiff reported mild to moderate knee pain, which the physical therapist noted was "significantly decrease[d]" by his knee brace. (AR 359). The physical therapist began Plaintiff on a treatment plan that included therapeutic and strengthening exercises, electric stimulation, and hot/cold packs, with a frequency of one treatment per day, twice a week for six weeks. (AR 360).
Plaintiff returned to Dr. Andavolu on February 16, 2012 for a follow-up visit regarding Plaintiff's lymphoma. (AR 451). Dr. Andavolu reiterated that Plaintiff was doing well and noted that Plaintiff had stopped taking Coumadin for his DVT two weeks earlier. (AR 451). Plaintiff's right knee showed signs of swelling and tenderness. (AR 452).
On February 20, 2012, Plaintiff visited Dr. Chahat Thakur in Yucca Valley for a variety of lab tests related to his lymphoma. (AR 419). There, Plaintiff reported that he was still taking Coumadin at that time, in contrast to what Dr. Andavolu noted about Plaintiff's Coumadin dosage four days earlier. (AR 420).
Plaintiff also listed Coumadin as a current medication the following day, during a follow-up appointment for his knee. (AR 416). Nurse practitioner Hector Alvarez reported Plaintiff had no pain during several knee examinations, but did note lateral joint line tenderness during an exam of Plaintiff's right meniscus. (AR 418). Plaintiff underwent a procedure to drain the right knee joint of fluid and reported no complications afterwards. (Id.). Nurse Alvarez ordered Plaintiff to continue with physical therapy. (Id.).
On March 5, 2012, Plaintiff returned to Dr. Thakur for further lab tests, this time to evaluate Plaintiff for hypertriglyceridemia. (AR 413). Dr. Thakur noted Plaintiff was taking Lopid for the condition, and had been complying with the treatment and taking his medicine as directed. (Id.). Plaintiff denied experiencing any symptoms related to hypertriglyceridemia. (Id.). Dr. Thakur prescribed Tricor (145 mg), to be taken once daily for 30 days, with two refills following. (AR 414). Plaintiff did not list Coumadin as one of his current medications at this visit. (Id.). Plaintiff weighed 246 pounds at the time of his examination. (Id.).
Plaintiff returned to Nurse Alvarez on March 6, 2012 for a follow-up appointment on his knee and was referred for more physical therapy. (AR 410). During sessions held on March 14 and March 29, 2012, Plaintiff continued to report mild to moderate knee pain, and the physical therapist remarked that Plaintiff was making slow progress at both sessions. (AR 362). Plaintiff was discharged from physical therapy following the March 29, 2012 session. (AR 363).
On March 27, 2012, Plaintiff visited Dr. Navid Zenooz for a chest x-ray and CT scan of his abdomen and pelvis after experiencing abdominal pain. (AR 356, 428). Dr. Zenooz reported that the CT scan revealed Plaintiff was suffering from umbilical and bilateral inguinal hernias. (AR 356). Dr. Zenooz otherwise reported unremarkable and normal findings from both examinations. (AR 356, 428). The next day, Dr. Thakur referred Plaintiff to a general surgeon for the hernias. (AR 406).
On April 10, 2012, Plaintiff visited Dr. Renato Guzman in Yucca Valley following Dr. Thakur's referral. (AR 399). Dr. Guzman noted that both of Plaintiff's hernias "have been present for years, " and that "[t]he umbilical hernia only bothers [Plaintiff] when he lays on his stomach. The inguinal hernias are asymptomatic." (Id.). Dr. Guzman's notes reveal no other assessments or orders for further treatment. (AR 399-400). Plaintiff also did not list Coumadin as one of his current medications. (AR 400). Plaintiff weighed 241 pounds at the time of his examination with Dr. Guzman. (Id.).
Plaintiff returned to Nurse Alvarez on May 9, 2012 for a follow-up appointment on his knee. (AR 393). Nurse Alvarez referred Plaintiff to an orthopedist and also ordered an x-ray of Plaintiff's knee. (AR 395). Plaintiff weighed 236 pounds at the time of his visit with Nurse Alvarez. (AR 394).
On May 17, 2012, Plaintiff returned to Dr. Andavolu for a follow-up appointment regarding his lymphoma. (AR 445). Dr. Andavolu reported Plaintiff had a high red blood cell count, stemming from Plaintiff's history of smoking, but noted that Plaintiff was doing well otherwise and his lymphoma was in "complete remission." (Id.). Dr. Andavolu also commented that Plaintiff admitted to smoking marijuana. (Id.). Plaintiff was ordered to undergo lab tests and a PET-CT scan and follow up with Dr. Andavolu in another three months. (Id.).
On May 29, 2012, Plaintiff saw Nurse Alvarez for a pre-operation appointment on his knee. (AR 386). Plaintiff reported moderate pain in the knee. (Id.). Nurse Alvarez noted Plaintiff had a family history of osteoarthritis. (Id.). Plaintiff described joint stiffness, as well as locking, popping, and giving away of his knee. (Id.). Plaintiff told Nurse Alvarez these symptoms occurred for less than fifteen minutes upon waking up each morning, but later said his symptoms occurred several times daily. (Id.). Plaintiff estimated he could walk five to ten blocks, walk up stairs normally, and walk down stairs with a rail. (Id.). Plaintiff denied the need of an assistive device during any of these estimated activities. (Id.). Plaintiff weighed 233 pounds at the time of his visit with Nurse Alvarez, and did not report Coumadin as one of his current medications. (AR 387-388). Nurse Alvarez prescribed Plaintiff thirty tablets of Norco, a hydrocodone/acetaminophen medication, with no refills. (AR 388).
Plaintiff underwent arthroscopic surgery on his right knee on June 5, 2012 in Yucca Valley. (AR 365). Dr. Seip performed the surgery and made a post-operation diagnosis of Grade IV cartilage change to the majority of Plaintiff's right knee joint. (Id.). Dr. Seip reported no other complications from the procedure. (Id.).
Plaintiff returned to Nurse Alvarez on June 12, 2012 for a post-operation appointment. (AR 383). Nurse Alvarez noted "[Plaintiff's] course has improved, " and that despite Plaintiff's family history of osteoarthritis, Plaintiff's personal medical history was negative for the condition. (Id.). Nurse Alvarez also reported that Plaintiff had been prescribed Vicodin following the surgery. (Id.). Nurse Alvarez reported similar findings one week ...