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Vance v. Saul

United States District Court, W.D. Kentucky, Bowling Green Division

August 14, 2019

JAMES E. VANCE, on behalf of MELANIE S. VANCE, deceased PLAINTIFF
v.
ANDREW SAUL, Commissioner of Social Security DEFENDANT

          MEMORANDUM OPINION AND ORDER

          LANNY KING, MAGISTRATE JUDGE

         This matter is before the Court on Plaintiff's complaint seeking judicial review, pursuant to 42 U.S.C. § 405(g), of the final decision of the Commissioner denying her claim for Social Security disability benefits. The fact and law summaries of Plaintiff and Defendant are at Dockets # 13 and 18. The parties have consented to the jurisdiction of the undersigned Magistrate Judge to determine this case, with any appeal lying before the Sixth Circuit Court of Appeals. (Docket # 9.)

         Effective June 1, 2013, the Social Security Administration determined that Plaintiff’s disability ended due to medical improvement and ceased payment of Disability Insurance Benefits pursuant to Title II of the Social Security Act. The Administrative Law Judge (ALJ) affirmed the Administration’s cessation determination but found that, effective February 24, 2016, Plaintiff’s impairments worsened such that she again became disabled and was, therefore, eligible for a new period of Title II benefits. (Administrative Record (AR) at 48.) In other words, the ALJ found that Plaintiff was not disabled during the closed period between June 1, 2013 and February 24, 2016.

         The ALJ’s finding of a re-onset of disability date of February 24, 2016 (but not earlier) did not comport with applicable legal standards. The ALJ’s selection of February 24, 2016 was unsupported by any (and, in fact, contradicted every) medical opinion, which indicated that there was no period of non- disability following Plaintiff’s liver transplant in June 2010. The ALJ based his selection on his own independent (lay) assessment of the medical evidence, which he was unqualified to give. Therefore, the Court will REMAND this matter to the Commissioner for calculation and payment of past-due Title II benefits for the closed period between June 1, 2013 and February 24, 2016.

         Background facts and procedural history

         In March 2010, the Social Security Administration found that Plaintiff was disabled as of April 2009, due to chronic liver disease satisfying Listing 5.05B. (AR at 128.)

         In June 2010, Plaintiff underwent liver transplant surgery. (AR at 36.) Physical therapy notes state that she was bedridden for two years after the transplant. (AR at 67, 1440.)

         Disabled individuals are subject to periodic reviews to determine if they continue to be disabled and entitled to benefits. 20 C.F.R. § 404.1594(a). As part of the continuing-disability review process, in May 2013, the Administration’s non-examining program physician, P. Saranga, assessed Plaintiff as capable of performing a limited range of light work. (AR at 631-37.) In June 2013, the Administration found that Plaintiff was no longer disabled as of June 2013, due to medical improvement. The Administration reaffirmed its decision upon reconsideration, and Plaintiff sought review by an ALJ.

         As described in greater detail below, the medical opinions in the administrative record were unanimous that that the medication Plaintiff was required to take to prevent rejection of her transplanted liver caused serious side effects such as nausea, vomiting, weakness, severe fatigue, loss of stamina (with history of falls), and loss of concentration. Those medical opinions were from Plaintiff’s treating physician, Jason Campbell, M.D. (AR at 1483-86, 3270-73); Dr. Christopher Jones, Director of Liver Transplant Program (AR at 2920); and the medical advisor the ALJ called to testify at the administrative hearing, Samuel Berman, M.D. (AR at 71-72). In addition, after her transplant, Plaintiff experienced episodes of hyponatremia (low level of sodium in the blood), which were severe enough to require hospitalization on two occasions. (AR at 951, 2920, 3271.) According to Dr. Jones, “[a]long with this [hyponatremia] issue come confusion, weakness and dizziness.” (Id.)

         In December 2014, Plaintiff was experiencing symptoms of hyponatremia, and a biopsy revealed liver steatosis (abnormal retention of lipids). (AR at 3271.) Plaintiff was hospitalized for several days to rule out the possibility of organ rejection. (Id.)

         In February 2016, Plaintiff was again hospitalized for several days due to recurrence of hyponatremia symptoms. (AR at 951.)

         In December 2016, Plaintiff was diagnosed with colon/anal cancer. (AR at 70.)

         In September 2016, at Plaintiff’s request, Dr. Campbell completed the physical assessment form. (AR at 1484.)

         In May 2017, Dr. Christopher wrote a letter in support of Plaintiff’s disability claim. (AR at 2920.) Dr. Christopher stated that Plaintiff has had a “very rocky course since her transplant” and that the “side effects of these medications to prevent rejection are weakness, nausea, loss of stamina, loss of concentration and severe fatigue.” (Id.) Dr. Christopher opined that Plaintiff is “not able to work at this time and from her past history she probably will never be able to hold down a job without multiples absences.” (Id.)

         In June 2017, the ALJ held an administrative hearing at which Dr. Berman testified as a medical advisor. (AR at 65-72.)

         In July 2017, Dr. Campbell gave a statement to the effect that the limitations he assessed in September 2016 apply at least as far back as June 2013, when the Administration terminated benefits. (AR at 3271.)

         In January 2018, the ALJ issued a decision, affirming the Administration’s cessation determination as of June 2013 due to medical improvement. (AR at 36, 46.) Additionally, the ALJ found that Plaintiff’s chronic liver disease (post-transplant) worsened after June 2013 to the point that she again became unable to work and disabled as of February 2016. (AR at 48.)

         In November 2018, the Appeals Council declined to disturb the ALJ’s decision, making the ALJ’s decision the Commissioner’s final ...


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