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Paris v. Saul

United States District Court, D. Kansas

September 6, 2019

DEBORAH L. PARIS, Plaintiff,
v.
ANDREW M. SAUL,[1] Commissioner of Social Security, Defendant.

          MEMORANDUM AND ORDER

          KATHRYN H. VRATIL, UNITED STATES DISTRICT JUDGE

         Plaintiff appeals the final decision of the Commissioner of Social Security to deny disability and disability insurance benefits under Title II of the Social Security Act ("SSA"), 42 U.S.C. §§401-34. For reasons stated below, the Court reverses the decision of the Commissioner and remands for further proceedings.

         Procedural Background

         On April 7, 2015, plaintiff filed her disability and disability insurance applications with the Social Security Administration. She alleged a disability onset date of December 19, 2014. Plaintiff s benefit application was denied initially and on reconsideration. On September 13, 2017, an administrative law judge ("ALJ") concluded that plaintiff was not under a disability as defined in the SSA and that she was not entitled to benefits. See Transcript Of Administrative Record (Doc. #14) filed December 7, 2018 ("Tr.") at 39-54. On July 12, 2018, the Appeals Council denied plaintiff s request for review. Tr. at 1-4. Plaintiff appealed the final decision of the Commissioner to this Court. The decision of the ALJ stands as the final decision of the Commissioner. See 42 U.S.C. § 405(g).

         Factual Background

         The following is a brief summary of the factual record.

         Plaintiff is 56 years old. She worked as a school teacher and choir director until December 19, 2014. Since that time, plaintiff has worked occasionally as a substitute teacher and a choir director at her church, but has not engaged in substantial gainful activity.

         I. Medical Evidence

         In October of 2013, plaintiff was diagnosed with stage 2 breast cancer. She underwent a lumpectomy, chemotherapy and radiation therapy. Plaintiff has been cancer free since 2015.

         Due in part to her cancer treatments, plaintiff developed ongoing problems with fatigue, peripheral neuropathy, cardiomyopathy, thoracic ascending aortic aneurysm, migraines, sleep apnea and Hashimoto's thyroiditis. The peripheral neuropathy in plaintiffs legs and feet has worsened over time and continues to cause pain. Plaintiff treats her migraine headaches with medication, but it does not always control the headaches in a timely manner.

         Beginning in June of 2015, Jeffrey Snyder, M.D., plaintiff s primary care physician, treated her for fatigue, peripheral neuropathy, migraine headaches and joint pain. On September 7, 2016, Dr. Snyder noted that plaintiff s fatigue was so profound that she could "hardly function." Tr. 841. By November 30, 2016, Dr. Snyder noted that plaintiff was still battling fatigue throughout the day and had not been able to substitute teach. Tr. 849.

         In March of 2017, Dr. Snyder submitted a medical source statement in support of plaintiff s claim for disability. Dr. Snyder noted that plaintiff suffered from cardiomyopathy, thoracic ascending aortic aneurysm, migraines, moderate obstructive sleep apnea and hypothyroidism. Tr. 795. Dr. Snyder opined that plaintiff could work for only two hours each day and that she is unable to perform the material duties of any occupation because of profound fatigue. Tr. 796-97. Dr. Snyder's opined that plaintiffs profound fatigue could not be fully explained by one condition and was likely caused by multiple factors. Tr. 797. Dr. Snyder noted that his "personal observation during recent office visits is that of a profoundly fatigued individual, with little tolerance for activities requiring significant energy expenditure." Tr. 797.

         Beginning March 1, 2016, Clinton Malone, M.D., a cardiologist, treated plaintiff for cardiomyopathy and thoracic ascending aortic aneurysm. Dr. Malone opined that plaintiff had marked limitation of physical activity, as demonstrated by fatigue, palpitation, dyspnea or anginal discomfort with ordinary physical activity. Tr. 790. Dr. Malone opined that stress contributed to plaintiffs symptoms and that she was incapable of working even a low stress job. Tr. 790. Dr. Malone explained that with work, she experienced elevated blood pressure, shortness of breath and profound fatigue which worsened with exposure to high stress jobs. Tr. 790. Dr. Malone also noted that plaintiff s physical symptoms and limitations caused emotional distress including crying and anxiety. Tr. 790.

         Carol Phelps, M.D., a medical consultant for Disability Determination Services, opined that plaintiff could perform light work. Dr. Phelps opined that plaintiff could stand or walk with normal breaks for about six hours in an eight-hour day. Tr. 121. Likewise, Dr. Phelps found that plaintiff could sit with normal breaks for about six hours in an eight-hour day. Tr. 121.

         II. Plaintiffs Testimony

         Plaintiff testified that she continued to work as a teacher throughout her cancer treatment. Tr. 87. She testified that beginning in August of 2014, she experienced "severe fatigue" while performing her job responsibilities. Tr. 87. By December of 2014, she was "falling apart" and could "hardly make it through the day." Tr. 88. Plaintiff asked for accommodations at work, but ...


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