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Purcella v. Saul

United States District Court, E.D. California

January 6, 2020

ANDREW SAUL, Commissioner of Social Security, [1]Defendant.




         On July 26, 2018, Plaintiff Serina Teresa Purcella (“Plaintiff”) filed a complaint under 42 U.S.C. § 405(g) seeking judicial review of a final decision of the Commissioner of Social Security (the “Commissioner” or “Defendant”) denying her application for supplemental security income (“SSI”). The matter is currently before the Court on the parties' briefs, which were submitted, without oral argument, to the Honorable Sheila K. Oberto, United States Magistrate Judge.[2]


         On July 28, 2014, Plaintiff protectively filed an application for SSI payments, alleging she became disabled on December 8, 2003 due to post-traumatic stress disorder (“PTSD”), celiac disease, and heart problems. (Administrative Record (“AR”) 151, 153-54, 174-75, 196, 210, 365.) Plaintiff was born on December 20, 1964 and was 49 years old on the date the application was filed. (AR 160, 195.) She has a high school education, past work experience in home patient care, and last worked full-time in 2004. (AR 16, 174-75, 196.

         A. Summary of Relevant Medical Evidence

         1.Community Psychiatry Associates

         On August 29, 2014, Plaintiff presented to Community Psychiatry Associates for treatment of her anxiety and depression. (AR 523.) Plaintiff reported she suffered from depression since 2008 and her “depression ha[d] been severe lately due to [a] medical condition.” (AR 523.) Plaintiff reported experiencing the following symptoms: “poor concentration”; “poor appetite due to celiac disease”; “hopelessness and worthlessness”; “persistent anxiety”; and “panic attacks any time she leaves home.” (AR 523.) The examining physician recommended treatment including Zoloft and Trazodone, in addition to the other psychotropic medications Plaintiff was already prescribed. (See AR 523, 527.)

         At a September 15, 2014 follow up appointment, Plaintiff reported panic attacks that involved chest pain, trouble swallowing, coughing, lightheadedness, nausea, and feeling like she was going to pass out. (AR 522.) Plaintiff stated these panic attacks happened “every time she leaves home.” (AR 522.) On October 6, 2014, Plaintiff reported “irritability” and that she was “dwelling on her panic.” (AR 521.) Plaintiff admitted she “hits her husband” and has done so “for many years.” (AR 521.) This behavior was attributed to her family being physically abusive to her. (AR 521.) Plaintiff reported episodes of palpitations and dizziness, that her energy and concentration were poor, and that she was “angry.” (AR 521.) Plaintiff returned on October 24, 2014, and reported that she had low energy, high anxiety, and an “okay” mood. (AR 520.)

         2. Jordan De-Paz, M.D.

         On June 6, 2014, Plaintiff presented to family practice physician Jordan De-Paz, M.D., for treatment of dermatitis, celiac disease, and hypertension. (AR 616.) Dr. De-Paz recommended Plaintiff take Metropolol for her hypertension, Hydroxyzine for her dermatitis, and other medications for her anxiety. (See AR 619.) On July 3, 2014, Plaintiff returned for a follow up appointment after an emergency room visit. (AR 612.) Dr. De-Paz noted that Plaintiff was seen at the hospital for chest pain. (AR 612.) Dr. De-Paz directed Plaintiff to take Nitrostat for her hypertension and then return for a blood pressure check. (AR 615.)

         Plaintiff returned on July 4, 2014, for her blood pressure check. (AR 610.) Dr. De-Paz found that Plaintiff's blood pressure was within normal limits and directed her to continue her medications and follow-up as needed. (AR 611.) On July 29, 2014, Plaintiff returned for treatment of “pain and itching in face” and other problems including anxiety disorder, hypertension, and celiac sprue. (See AR 606.) Dr. De-Paz noted that Plaintiff was prescribed to take Clonazeapm, Doxycycline Hyclate, Hyroxyzine, Isosorbide Mononitrate, Metroprolol, and Nitrostat daily. (AR 606.)

         3. Michael Cohn, Ph.D.

         On January 5, 2015, Plaintiff reported to psychologist Michael Cohn, Ph.D., for a consultative psychiatric examination. (AR 528-32.) Dr. Cohn noted that Plaintiff complained of anxiety with panic attacks and depression and that she suffered from these issues since she was “young.” (AR 528.) Dr. Cohn noted that Plaintiff saw a psychiatrist every three weeks and may be seeing a counselor as well, although that was unclear and “[Plaintiff] herself does not seem to know.” (AR 528.) Plaintiff reported that “everyone” in her family has mental illness. (AR 529.) Plaintiff reported she was able to take care of personal hygiene without difficulty, was able to pay bills and handle cash appropriately, and was able to make decisions on a daily basis. (AR 529.) Dr. Cohn noted that Plaintiff's concentration, persistence and pace were “adequate.” (AR 529.)

         Dr. Cohn diagnosed Plaintiff with anxiety disorder and noted that Plaintiff's mood and affect were anxious. (AR 530-31.) As to Plaintiff's functional abilities, Dr. Cohn opined that Plaintiff was unimpaired in understanding, remembering, and carrying out simple or complex instructions; moderately impaired in relating and interacting with coworkers and the public; unimpaired in maintaining concentration, persistence, and unimpaired in completing day-to-day work activity; unimpaired in accepting instructions; unimpaired in maintaining regular attendance; and unimpaired in performing work activities. (AR 531-32.)

         4. Ritu Malik, M.D.

         On March 26, 2015, endocrinologist Ritu Malik, M.D. performed a consultative examination of Plaintiff. (AR 567-69.) Dr. Malik opined that Plaintiff could sit for at least six hours in an eight-hour workday; stand and/or walk for at least six hours in an eight-hour workday; lift and carry 50 pounds occasionally and 20 pounds frequently; and had no postural, manipulative, visual, communicative, or environmental limitations. (AR 569.)

         5. Doris Karam, M.D.

         On August 17, 2015, Plaintiff established care with internist Doris Karam, M.D. (AR 684.) Dr. Karam treated Plaintiff for abdominal pain and other complications following her cholecystectomy. (AR 684.) Dr. Karam noted that Plaintiff's abdomen was “very distended and very tender.” (AR 688.) On November 23, 2015, Dr. Karam diagnosed abdominal pain and diarrhea and back pain. (AR 682.) On January 29, 2016, Plaintiff was seen in the emergency room for severe abdominal pain. (AR 758.) Plaintiff returned to Dr. Karam on February 24, 2016 for a follow-up visit after her hospitalization. (AR 672.) Dr. Karam indicated Plaintiff may suffer from ulcerative colitis and referred Plaintiff to a gastroenterologist. (AR 676.) On June 10, 2016, Dr. Karam assessed hematuria and referred Plaintiff to a urologist. (AR 670.)

         On November 1, 2016, Dr. Karam treated Plaintiff for back pain. (AR 653.) Dr. Karam noted that Plaintiff had coccyx tenderness and diagnosed sacrococcygeal disorder. (AR 657.) Dr. Karam ordered a lumbar MRI for Plaintiff's back issues. (AR 657.) On November 29, 2016, Dr. Karam assessed coccydynia and lumbar radiculopathy. (AR 651.) On February 14, 2017, Dr. Karam ordered an MRI for Plaintiff's headaches and referred Plaintiff for a neuropsychiatry evaluation due to memory loss issues. (AR 643.)

         On February 28, 2017, Dr. Karam completed a psychiatric medical source statement. (AR 577.) Dr. Karam opined that Plaintiff had marked limitation in her ability to maintain concentration and attention; withstand stress and pressures associated with work; understand, remember or carry out instructions; deal with the public; and moderate limitation in her ability to understand, remember and carry out instructions and relate and interact with coworkers. (AR 577.) Dr. Karam opined that Plaintiff's impairment and associated limitations were “permanent” and that Plaintiff was likely to miss more than half of the work days every month due to her mental issues. (AR 577.)

         6. Leonard Rubin, M.D.

         On April 14, 2017, internist Leonard Rubin, M.D. completed a medical source statement regarding Plaintiff's physical impairments. (AR 844.) Dr. Rubin opined that Plaintiff could lift and/or carry up to 20 pounds frequently and 50 pounds occasionally; could sit, stand, or walk for six hours in an eight-hour workday; and had some manipulative limitations in her left hand. (AR 844-50.) Dr. Rubin opined that Plaintiff had no other limitations. (See AR 847-50.)

         7. Michael Lace, Psy.D.

         On April 17, 2017, psychologist Michael Lace, Psy.D. completed a medical source statement regarding Plaintiff's mental impairments. (AR 834-35.) Dr. Lace opined that Plaintiff was moderately impaired in her ability to interact appropriately with the public, supervisors, and coworkers, and mildly impaired in all other functional abilities. (AR 834-35.)

         8. State ...

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