United States District Court, N.D. California
ORDER REGARDING MOTIONS FOR SUMMARY JUDGMENT RE: DKT.
NOS. 23, 29
C. SPERO CHIEF MAGISTRATE JUDGE.
Angelina Gurzenda brought this action seeking judicial review
of the final decision of Defendant Andrew Saul, Commissioner
of Social Security (the “Commissioner”) denying
Gurzenda’s application for supplemental security income
under Title XVI of the Social Security Act. Gurzenda argues
that an administrative law judge (the “ALJ”)
committed reversible error when she failed to address
Gurzenda’s psychosis within the listings, failed to
fully develop the record, and failed to address
non-exertional limitations. The parties have filed cross
motions for summary judgment pursuant to Civil Local Rule
16-5. For the reasons stated below, Gurzenda’s motion
is GRANTED, the Commissioner’s motion is DENIED, and
the case is REMANDED for further administrative proceedings
in accordance with this order.
6, 2016, Gurzenda applied for supplemental security income
for her alleged disability beginning on May 26,
2016. Administrative Record (“AR, ”
dkt. 14) at 285. This is Gurzenda’s third time applying
for Supplemental Security Income. She applied previously on
July 31, 2005 and on October 30, 2014; both of those
applications were denied. The prior unfavorable decision for
Gurzenda’s 2014 application was on May 25, 2016, a day
before the onset date for this current application.
present application was initially denied on November 22,
2016, and denied upon reconsideration on January 23, 2017.
Id. at 129, 146. Gurzenda filed a written request
for a hearing before an ALJ on January 31, 2017. Id.
at 183. A hearing was held on June 27, 2017, in San Jose,
California. Id. at 30–64. Gurzenda was
represented at the administrative hearing by Timothy Reed, an
attorney, but Reed no longer represents her before this Court
on appeal. See Id . at 30; see generally
Gurzenda’s Mot. (dkt. 23). Impartial vocational expert
Robert Raschke, M.Ed., (“VE Raschke”) also
appeared by telephone and testified at the hearing. AR
30. On September 20, 2017, the ALJ issued an
unfavorable decision, finding that Gurzenda was not disabled
under § 1614(a)(3)(A) of the Social Security Act.
See Id . at 15–24. Gurzenda requested review
of the ALJ’s decision, which the Social Security
Administration Appeals Council denied on December 20, 2017,
as it “found no reason under [its] rules to review the
[ALJ’s] decision.” Id. at 1–3.
Gurzenda filed a complaint on January 22, 2018, seeking
judicial review by this Court. Compl. (dkt. 1) at 2. Pursuant
to Civil Local Rule 16-5, Gurzenda filed a motion for summary
judgment, and the Commissioner filed a cross-motion for
summary judgment. See Gurzenda’s Mot.;
Comm’r’s Mot. (dkt. 29).
is fifty-four years old. AR at 557. She was born and raised
in Palo Alto, California, but now resides in San Jose,
California. Id. at 479. Gurzenda is currently
homeless. Id. at 371. She attended school until the
twelfth grade and has a high school diploma. Id. at
325. Gurzenda spent three years in federal prison for
“various offenses.” Id. at 479. She is
currently unemployed, and her main source of income is food
stamps in the amount of $150 per month. Id. at 479.
Gurzenda reports that she does not take care of anyone else.
Id. at 372. She has never been married, and she has
five children. Id. at 465. Gurzenda’s youngest
child is 17 years old and currently lives in foster care.
claim for disability is based primarily on her Morgellons
Disease, which, according to her statement to a doctor, was
diagnosed in 2011 at Santa Clara Valley Medical Clinic.
See Id . at 436. Morgellons Disease, or
“Delusional Parasitosis, ” is a mental disorder
that “causes [Gurzenda] to believe that there are bugs
or other microscopic pathogens [under her skin] causing her
very distressing physical symptoms.” Id. at
She believes the disease either started about seventeen years
ago when her landlord “was putting black mold into her
water supply, ” or that “she likely contracted
[Morgellons] from a tick about [eighteen] years ago.”
Id. at 432, 464. Gurzenda reports in her application
that she “really ha[s] something growing on [her] head
[like] a parasite, ” which feels like “its going
to [her] brain” and causes constant, severe pain in her
head. Id. at 378.
has a history of substance abuse as well as other mental
health issues. See Id . at 70, 80–81. She
admitted to previously using methamphetamine but states that
she has been sober since 2014. Id . at 70. Gurzenda
also spent time in prison for offenses relating to controlled
substances. Id. While incarcerated, she began to
experience psychiatric symptoms, such as depression and
post-traumatic stress. Id. at 80–81, 464.
These symptoms have gotten worse due to her Morgellons and
the current stressors of being homeless and unemployed.
Id. at 464.
Reza Kafi, M.D.
September 29, 2015, Gurzenda went to see Reza Kafi, M.D., for
a dermatology visit for her Morgellons. Id. at 514.
Dr. Kafi reported that Gurzenda requested a biopsy of her
scalp and said “[i]f [she doesn’t] do the biopsy
today, there will be problems.” Id. Dr. Kafi
further stated Gurzenda knows she has Morgellons, but she
wants “a biopsy to see what is wrong in the
area.” Id. Gurzenda told Dr. Kafi “that
[her] hair has [a] firm cord that wraps around [her]
postauricular scalp and around [her] ear, causing [a] crease
in [the] earlobe, and causing pain” and that she
“feel[s] like [she’s] dying from this.”
Id. Dr. Kafi concluded the results from the physical
skin exam showed there were no “fibers” coming
from Gurzenda’s scalp. Id. at 516. Dr. Kafi
stated Gurzenda “has a fixed delusion” and that
“this is NOT A PRIMARY SKIN PATHOLOGY, [she] needs
mental/behavioral health help with this issue.”
Id. at 517. However, before Dr. Kafi could provide
her with a referral and paperwork, Gurzenda “abruptly
left the clinic.” Id. at 516.
Asian Americans for Community Involvement: Social Worker
Americans for Community Involvement, a non-profit
organization that provides healthcare services, appears to be
where Gurzenda’s receives most of her medical care. Her
psychiatrist and social workers are employed here. Their
records also provide the strongest support for her disability
letter sent to social services on August 12, 2016, Jenny Kim,
MSW, wrote that Gurzenda “received rehabilitation
therapy twice per month since May 13, 2016 with a former
therapist, and has been scheduled with bi-weekly sessions
with [a] counselor since August 12, 2016.” Id.
at 454. Jenny Kim sent a second letter to social services on
September 2, 2016 which was co-signed by Kao Saechao, LCSW.
Id. at 461. They again reiterated that Gurzenda
“had received treatment” and that she was
diagnosed with “[p]sychotic disorder with delusions due
to known physical condition, ” “inadequate
housing, ” and “problem related to social
environment, unspecified.” Id.
April 5, 2017, Gurzenda had an appointment with Kyong Ohk
Kim, ASW, and Mio Hidaka, LCSW, to talk about her goals
moving forward to help her cope with her Morgellons.
Id. at 540. They recorded “[f]or the next 6
months, [Gurzenda] will practice mindfulness
meditation” and “attend individual therapy
session[s] bi-weekly to regulate her symptoms” with the
desire for Gurzenda to be “less anxious about [her]
Morgellons disease and [to] enjoy daily activities.”
Id. Kyong Kim and Hidaka stated that Gurzenda
“continues . . . having pains and symptom (e.g.,
depressive mood and anxiety, easily tired, and agitated, and
pain in her ear and body, paranoid about her disease) which
are a result of her diagnosis of Morgellons disease”
and that her homelessness “makes [it] difficult to
manage her symptoms.” Id. They concluded that
Gurzenda “has strong interests [in] taking care of her
pain and [is] very independent and resilient.”
Leena Khanzode, M.D.
has seen Leena Khanzode, M.D., who appears to be her primary
doctor, several times since she applied for supplemental
security income. First, on August 17, 2016, Gurzenda went to
see Dr. Khanzode for a psychiatry assessment. Id. at
534. Dr. Khanzode reported Gruzenda told her she “feels
a crawling and burning sensation in her head and that a dark
growth matter is coming out of her head.” Id.
Gurzenda also told Dr. Khanzode that she feels
“‘something [is] moving around’ on [the]
back of her head, and [that] something is growing inside
[her] ear, its [sic] long and keeps moving.”
Id. Gurzenda told Dr. Khanzode that she is
“not crazy” and that the “doctors that she
has gone to have not helped her.” Id. Dr.
Khanzode wrote that Gurzenda believes “her case has
‘fallen through the cracks’” and that she
is getting “worse and worse.” Id. Dr.
Khanzode recorded Gurzenda’s symptoms as “feeling
depressed because she has not been well, low energy,
conc[entration] is poor, anhedonia, does not feel well to do
activities, sleep is not so good, DFA, appetite is ok, no
SI/HI.” Id. She also wrote that Gurzenda is
under increased stress as she has “no job” and
“no place to live.” Id. As Gurzenda
reported running out of medication a month earlier, Dr.
Khanzode prescribed Gurzenda Zyprexa and Prozac to take daily
in hopes of relieving her pain and anxiety. Id. at
October 5, 2016, Gurzenda went to see Dr. Khanzode for a
follow-up appointment. Id. at 537. Once again, Dr.
Khanzode reported Gurzenda “has been feeling depressed
because she has not been well, low energy, conc[entration] is
poor, anhedonia- does not feel well to do activities, sleep
is not so good, DFA, appetite is ok, no SI/HI.”
Id. Dr. Khanzode also mentioned Gurzenda
“stated she has bodyache, esp[ecially] her feet,
” that she “has been anxious recently, ”
and that “wanted to leave early from this visit as she
was in pain.” Id. Dr. Khanzode reported
Gurzenda had “stopped Zyprexa as it was too sedating,
” so she increased her Prozac prescription and
restarted her on Zyprexa at a decreased dosage. Id.
April 5, 2017, Gurzenda went to see Dr. Khanzode again for
her “delusional parasitosis.” Id. at
543. Dr. Khanzode reported Gurzenda “is less depressed,
crying less, energy is low, angry, anhedonia, sleep is
restless, appetite is too good, gaining weight, no
SI/HI.” Id. She noted that Gurzenda
“believes she has the M[orgellons] syndrome and now
wants a biopsy.” Id. Dr. Khanzode found
“no significant change” in her mood, thought
process, motor activity, behavior, or medical condition since
her last visit. Id. Dr. Khanzode “encouraged
[Gurzenda] to exercise and eat healthy, ” told her to
continue Prozac, and increased her Zyprexa prescription back
to its original strength. Id. at 544.
15, 2017, Dr. Khanzode reported Gurzenda was
“depressed, irritable, crying easily, energy is low,
angry, anhedonia, sleep is restless, appetite is too good,
gaining weight, no SI/HI.” Id. at 557. Dr.
Khanzode wrote there was a “notable change” in
Gurzenda’s mood from her last visit and she seemed more
depressed. Id. at 558. Dr. Khanzode believed this
change was a result of Gurzenda feeling “overwhelmed
after she lost her client who she was living with.”
Id. However, Dr. Khonzode noticed “no
significant change” in her thought process or behavior.
Id. She increased Gurzenda’s Prozac dosage and
told her to continue with Zyprexa. Id.
March 1, 2017, Dr. Khanzode sent a letter to the Social
Security office. Id. at 554. She wrote that
“Gurzenda suffers from a Psychotic Disorder and is
being treated with medications for the same.”
Id. Dr. Khanzode continued that “[d]ue to her
psychiatric illness she may not [be] able to work fulltime
and her prognosis is guarded.” Id.
Ralph H. Wood, M.D.
October 5, 2016, Ralph H. Wood, M.D., performed an internal
medicine evaluation. Id. at 473. This was a
consultative examination arranged by the Department of Social
Services. Id. at 472. Dr. Wood reported that
Gurzenda’s chief complaints at this exam were her
depression and Morgellons. Id. at 473. She told to
Dr. Wood that she had “been depressed for many
years.” Id. Dr. Wood also reported that
Gurzenda said she has been seeing “a psychiatrist for
at least five years” and that “[c]urrently she
sees her psychiatrist once a month and a therapist every two
weeks.” Id. In terms of physical pain, Dr.
Wood wrote “she complains of numbness and tingling and
itching in her head particularly in the posterior
aspect”; however, “[w]hen [Dr. Wood] looked at
the scalp it appeared normal to [him].” Id.
Dr. Wood concluded that Gurzenda’s head pain is
“probably related to her mental problems and
depression” and not a physical impairment. Id.
Wood also completed a physical examination of Gurzenda and
discovered no major issues. Id. at 474. In Dr.
Wood’s functional capacity assessment, he determined
Gurzenda “can stand and/or walk for six hours out of an
eight-hour shift” and that he found “no
limitations on sitting.” Id. at 475. Dr. Wood
also found that Gurzenda “can regularly lift, push, or
pull up to 20 pounds and occasionally 30 pounds” and
that she had “no hand movement or fine finger
limitations.” Id. If she had any limitations,
Dr. Wood believed they would be on a “psychiatric
basis.” Id. Dr. Wood’s impression of
Gurzenda from the visit was that she may have
“[c]hronic psychosis with itching in scalp” and
“[p]ossible Morgellons syndrome.” Id.
Jeremy Blank, Psy.D.
October 11, 2016, Gurzenda visited Jeremy Blank, Psy.D., for
a psychological evaluation. Id. at 478. This was
another consultative exam arranged by the Department of
Social Services. Id. at 477. Dr. Blank reported that
Gurzenda stated she “had Morgellan’s [sic]
disease for 17 years” and that she was “diagnosed
with bipolar disorder about 10 years ago, and . . . developed
PTSD from experiences while in prison several years
back.” Id. at 478. He reported that Gurzenda
is “currently being treated by a psychiatrist and a
mental health therapist” and that she is currently
taking medications and responding “positive[ly]”
to them. Id. at 479. As Dr. Blank had “no
medical records available for review, ” he had to rely
on Gurzenda’s testimony of her medical history.
Id. at 478. Dr. Blank said her current symptoms
included “poor sleep, frequent worry and anxiety, and
depression” and that her current homelessness
“adds to her level of stress and worry.”
of the appointment, Dr. Blank conducted a mental status
examination. Id. at 479. He reported that Gurzenda
appeared “well groomed with good hygiene, ” was
“cooperative, ” her motor activity was
“intact, ” she had “good” eye
contact, “coherent” speech, and seemed
“alert.” Id. Dr. Blank also stated that
Gurzenda scored a “25 out of 30” on a “mini
mental status exam, ” which tests things such as
“arithmetic, memory and orientation” and is
normally used “to screen for dementia.”
Id. at 480. This score fell within the
“normal” limits and Dr. Blank reported
“[s]he had no difficulty following simple or complex
directions” and that her concentration and attention
was “unimpaired.” Id. at 479–80.
Dr. Blank also found that Gurzenda’s judgment and
insight received “fair” marks, and her thought
process was “intact” and “linear and
logical.” Id. at 480. However, he noted
Gurzenda was “impaired” with calculations as she
was “unable to complete all serial 7’s, ”
and that her memory was also “mildly impaired” as
she “recalled 3 out of 3 items immediately and 2 of 3
words after a brief delay with inference.” Id.
at 479–80. Dr. Blank also found that her mood was
“hypomanic” and there was “some suggestion
of delusion material.” Id. at 480. He
determined she was emotionally “[m]oderately to
severely impaired due to a variety of mental health
struggles” and was also “[m]oderately to severely
impaired” functionally. Id. at 481. Dr.
Blank’s diagnostic impressions were that Gurzenda had
“[b]ipolar I disorder, most recent episode manic,
moderate” and he assessed “rule out”
diagnoses of “[p]ost traumatic stress
disorder” and “unspecified schizophrenia spectrum
and other psychotic disorder.” Id.
this examination was requested by the Department of Social
Security, Dr. Blank also completed a “work related
abilities and impairments chart” where he listed what
he believed Gurzenda’s level of impairment would be
with respect to various work-related skills. Id. Dr.
Blank’s responses were as follows: (1) Gurzenda’s
ability to follow simple instructions was
“unimpaired”; (2) her ability to follow complex
or detailed instructions was “mildly impaired”;
(3) her ability to maintain adequate pace or persistence to
perform one or two step simple repetitive tasks was
“unimpaired” and for complex tasks was
“mildly impaired”; (4) her ability to maintain
adequate attention and concentration was “moderately
impaired”; (5) her ability to adapt to changes in job
routine was “moderately impaired”; (6) her
ability to withstand the stress of a routine workday was
“mod[erately]-sev[erely] impaired”; (7) her
ability to interact appropriately with co-workers,
supervisors, and the public on a regular basis was
“mod[erately]-sev[erely] impaired”; and (8) her
ability to adapt to changes, hazards, or stressor in a
workplace setting was “mod[erately]-sev[erely]
Veena Gowra, M.D.
December 15, 2016, Gurzenda went to see Veena Gowra, M.D.,
for “ear pain and [for] Morgellons disease.”
Id. at 517. Dr. Gowra reported that Gurzenda was
“alert and oriented, no apparent distress” and
had a “slightly scaly rash of the lobule, other wise .
. . normal.” Id. at 518. She ran a few tests,
and nothing came back physically abnormal regarding her
Morgellons. See Id . at 519–26. Dr. Gowra
mentioned that Gurzenda again “request[ed] a referral
to Dermatology for a biopsy of her scalp” due to the
pain in her head from Morgellons. Id. at 517. Dr.
Gowra granted that request and gave her ointment for her ear.
See Id . at 518–19.
20, 2017, Gurzenda saw Dr. Gowra for “pain” from
hypertension and stress. Id. at 562–63. The
medical record from the visit is rather short, but it appears
Dr. Gowra may have prescribed her additional medication to
help with the increased pain. Id. That same day Dr.
Gowra also wrote a letter to the Social Security office.
Id. at 561. It contained two sentences and stated
that Dr. Gowra was “certify[ing] that Gurzenda,
Angelina is eligible for permanent disability” and to
contact her if there are “any other questions.”
Id. Dr. Gowra also filled out a “general
assistance program” form for Gurzenda as well,
identifying Morgellons as the reason for Gurzenda’s
disability. Id. at 560. Dr. Gowra checked boxes
saying there would be a “significant restriction of
activities of daily living” and “significant
deficiencies of concentration, persistence or pace”
because of Gurzenda’s Morgellons. Id. She also
checked that Gurzenda is “incapable of low stress jobs,
” that she feels Gurzenda is “permanently
disabled/ unable to work, ” and that she supports
Gurzenda pursuing a disability claim. Id. Dr. Gowra
wrote that the “objective evidence” of
Gurzenda’s limitations was from a “physical
evaluation” she had done of Gurzenda. Id.
S. Khan, M.D.
Khan, M.D., a state agency consultant, reviewed
Gurzenda’s medical records in November 2016 and found
that she suffered from the following medically determinable
impairments: affective disorders (primary, non-severe);
schizophrenic, paranoid and other functional psychotic
disorders (secondary, non-severe); fibromyalgia (other,
non-severe); and dermatitis (other, non-severe). Id.
at 139. Dr. Khan considered Listing 12.03 (schizophrenic,
paranoid and other functional psychotic disorders) and 12.04
(affective disorders) and found none of Gurzenda’s
medically determinable impairments satisfied the
“paragraph A” criteria for either Listing.
Id. at 140. Dr. Khan also evaluated whether any of
Gurzenda’s impairments satisfied the “paragraph
B” criteria for the same Listings and determined that
they did not. Id. Dr. Khan found that Gurzenda had a
“mild” restriction of activities of daily living,
“moderate” difficulties in maintaining social
functioning, “moderate” difficulties in
maintaining concentration, persistence, or pace, and no
episodes of decompensation of extended duration. Id.
Dr. Khan also concluded that Gurzenda’s impairments did
not meet the “paragraph C” criteria for Listings
12.03 and 12.04. Id. Dr. Khan attributed
“great weight” to the results from Dr.
Blank’s mental evaluation. Id. at 142.
Khan then completed a residual functional capacity assessment
and found that Gurzenda had moderate limitations concerning
her ability to “understand and remember detailed
instructions, ” her ability to “carry out
detailed instructions, ” her ability to “maintain
attention and concentration for extended periods, ” her
ability to “perform activities within a schedule,
maintain regular attendance, and be punctual within customary
tolerances, ” her ability to “work in
coordination with or in proximity to others without being
distracted by them, ” and her ability to
“complete a normal workday and workweek without
interruptions from psychologically based symptoms and to
perform at a consistent pace without an unreasonable number
and length of rest periods.” Id. at
142–43. Furthermore, in terms of social interactions
and adaptations, Dr. Khan found moderate limitations in her
ability to “interact appropriately with the general
public, ” her ability to “accept instructions and
respond appropriately to criticism from supervisors, ”
her ability to “get along with coworkers or peers
without districting them or exhibiting behavioral extremes,
” her ability to “maintain socially appropriate
behavior and to adhere to basic standards of neatness and
cleanliness, ” her ability to “respond
appropriately to changes in the work setting, ” her
ability to “be aware of normal hazards and take
appropriate precautions, ” and her ability to
“set realistic goals or make plans independently of
others.” Id. at 143–44. Dr. Khan
concluded that Gurzenda has the “ability to do simple
unskilled work with limited public contact” and that
she was not disabled. Id. at 139.
Alan Berkowitz, M.D.
Berkowitz, M.D., a state agency consultant, completed a
reconsideration analysis in January 2017. Id. at
121. He reviewed Gurzenda’s medical history and found
that she suffered from: affective disorders (primary,
non-severe); schizophrenic, paranoid and other functional
psychotic disorders (secondary, non-severe); fibromyalgia
(other, non-severe); dermatitis (other, non-severe);
essential hypertension (other, non-severe); and trauma and
stressor related disorders (other, severe). Id. at
122. Dr. Berkowitz considered the same listings that Dr. Khan
considered, Listings 12.03 and 12.04, along with Listing
12.15 (trauma and stressor related disorders). Id.
at 123. Dr. Berkowitz reached the same conclusion that
Gurzenda’s impairments do not satisfy the
“paragraph A, ” “paragraph B, ” or
“paragraph C” criteria for any of those listings.
Id. Like Dr. Khan, he attributed “great
weight” to the results from Dr. Blank’s mental
evaluation and found that Gurzenda suffered from the same
moderate limitations as discussed above. Id. at
124–27. Dr. Berkowitz found that Gurzenda’s
impairments “do not prevent [her] from performing work
[she has] done in the past as a/an caregiver” and that
her “condition is not severe enough to keep [her] from
working.” Id. at 129.
Administrative Hearing on June 27, 2017
began her examination of Gurzenda with questions concerning
Gurzenda’s employment history. Id. at
37–44. Gurzenda stated she had worked for K-Mart for
“a couple months” in 2005 “unloading the
truck and stocking shelves.” Id. at
37–38. She then worked at Lucky Stores in 2005 and 2006
as a courtesy bagger for “seven months” and as a
checker for “two months.” Id. at
38–39. During her time as a checker, Gurzenda
“ha[d] difficulty with the computers” and
“couldn’t do the codes for produce and stuff,
” so her employment was cut short. Id. at 39.
Next, Gurzenda worked for Dollar Tree in 2006
“unloading the truck” for a period of
“maybe two months.” Id. at 39–40.
These jobs were all part-time and required her to do some
light lifting, between twenty and fifty pounds, by herself.
See Id . at 37–40. Gurzenda then spent time in
prison. After Gurzenda’s incarceration, she
“helped clean the laundromat” for “a couple
of months.” Id. at 41. This job was
particularly stressful for her as the owner was
“[s]creaming at [her] all the time.” Id.
at 42. Although Gurzenda did receive some monetary payment,
the main reason she cleaned the laundromat was so that she
would have a place to wash up and stay for the night.
Id. at 42. The ALJ asked Gurzenda whether she was
currently employed, and Gurzenda testified that she was
working part-time as a caregiver after filing her
application, but that had ended before this hearing.
Id. at 43. She received no monetary payment, and
instead could “stay there like two nights a week”
in return for her services. Id. Gurzenda’s
17-year-old son, who is currently in foster care, was also
allowed to stay with her on those nights. Id.
the ALJ asked Gurzenda about her daily activities.
Id. at 44. Gurzenda testified that she is currently
staying in “a conversion van . . . a couple nights a
week” with one of her friends. Id. Since her
friend takes his van to work during the day, Gurzenda spends
“most days” at Columbus Park. Id. at 46.
She “go[es] there all the time” and “sit[s]
at the park a lot.” Id. Gurzenda also spends
her time “try[ing] to take care of [her] appointments,
” which she gets to through ride services set up by her
doctors since her hips and feet “bother [her] a
lot.” Id. at 44– 46. She also looks
forward to spending time with her son. Id. at 47.
asked Gurzenda why she has not been able to work, and
Gurzenda testified that she has trouble focusing.
Id. at 47. Gurzenda explained that her
“Morgellons disease has gotten extremely worse”
and her “head bothers [her] real bad all the time and
[her] ear, and [she] feel[s] a lot of confusion.”
Id. She further stated that “[i]t’s just
gotten progressively worse and all the mental health
medications don’t seem to do nothing.”
Id. Gurzenda testified saying she feels like she has
“do[ne] nothing with [her] life, ” as she has not
been able to raise her son, hold a job, or have a home for
“all these years” because her Morgellons has been
so extreme. Id. at 48.
attorney, Timothy Reed, began his examination of Gurzenda by
asking Gurzenda what other mental health conditions she was
currently experiencing. Id. at 49. Gurzenda
testified that she was “diagnosed with anxiety and
depression, and traumatic stress disorder, and
fibromyalgia.” Id. Her anxiety, depression,
and PTSD cause her to “have trouble sleeping at
night” and as a result she gets “maybe
four” hours of sleep a night, making her “feel
tired all-day long.” Id. at 50. The
fibromyalgia causes aching throughout “all [her] joints
all over [her] body” and Gurzenda feels like she has
“a headache that never goes away.” Id.
Reed also asked how much weight Gurzenda believed she could
“lift and carry” using the example of milk
gallons, to which she replied that she could pick up one full
gallon and “maybe” two full gallons. Id.
at 51. Besides lifting, Gurzenda also has problems walking
because her feet “[r]eally hurt all the time.”
Id. Gurzenda testified that it takes her “[a]t
least 10 minutes” to walk one block and that she can
only stand for “less than 10 minutes” as her
“legs go numb a lot.” Id. at
then began her examination of a vocational expert, VE
Raschke, by asking him a series of hypotheticals surrounding
“a hypothetical individual who has the same vocational
profile as [Gurzenda’s] as far as age, education, and
prior work experience.” Id. at 56. The ALJ
first asked if “an individual who was limited to
simple, repetitive task characteristic of unskilled work that
required only routine contact with co-workers and the
public” would be able to “perform any of
[Gurzenda’s] prior work.” Id. VE Raschke
testified that “the only two jobs that would continue
to exist would be the job as a bagger . . . or a laundry
worker.” Id. The ALJ then asked what jobs
would be available if “contact with the co-workers and
the public could be occasional” was added to the
hypothetical. Id. at 57. VE Raschke answered that
none of Gurzenda’s prior jobs would fit this profile as
the employee is “exposed to the public on a frequent
basis, ” but identified other jobs currently available
in the economy that would fit this ...