United States District Court, D. Massachusetts
42 U.S.C. Â§ 1383 Review of HHS Decision
of Suit: 863 Social Security: DIWC/DIWW
Michelle Elaine Martin, Plaintiff, represented by Tricia M.
Jacobs, Law Offices of Thomas Libbos.
Carolyn W. Colvin, Defendant, represented by Michael P. Sady,
United States Attorney's Office.
Security Administration, Interested Party, represented by
Thomas D. Ramsey, Office of the General Counsel.
REPORT AND RECOMMENDATION
H. HENNESSY, Magistrate Judge.
Plaintiff, Michelle Elaine Martin, seeks reversal of the
decision by the Defendant, the Commissioner of the Social
Security Administration ("the Commissioner"),
denying her Disability Insurance Benefits ("DIB"),
or, in the alternative, remand to the Administrative Law
Judge ("ALJ"). (Docket #12). The Commissioner seeks
an order affirming her decision. (Docket #14).
Order of Reference dated May 13, 2016, pursuant to 28 U.S.C.
Â§ 636(b)(1)(B) (Docket #19), this matter was referred to me
for a Report and Recommendation on these two motions which
are now ripe for adjudication.
reasons that follow, I RECOMMEND that Martin's Motion to
Reverse (Docket #12) be DENIED and Defendant's Motion for
Order Affirming the Decision of the Commissioner (Docket #14)
filed an application for DIB on June 22, 2012, alleging that
she had been disabled since August 21, 2010. (Tr. 172-78).
The application was denied initially and on reconsideration.
(Tr. 98, 114). Following a March 25, 2014 hearing, the ALJ
rendered a decision unfavorable to Martin on March 26, 2014,
finding that Martin had not been disabled from August 21,
2010, through the date of the decision. (Tr. 17-26).
21, 2015, the Appeals Council denied Martin's request for
administrative review, making the ALJ's decision final
and ripe for judicial review. (Tr. 1-6). Having timely
pursued and exhausted her administrative remedies before the
Commissioner, Martin filed a complaint in this Court on
September 9, 2015, pursuant to 42 U.S.C. Â§ 405(g). (Docket
#1). Martin filed the motion for reversal or remand on
January 13, 2016, (Docket #12), and the Commissioner filed a
cross-motion on February 23, 2016, (Docket #14).
time she claims she became disabled, Martin was forty-one
years old. (Tr. 34). Martin has an associate's degree
from Newbury College. (Tr. 41-42). She last worked in 2010 as
a respiratory therapist at Harrington Regional Hospital,
where she had been employed for approximately ten years. (Tr.
40-41). Martin is married and lives with her husband, Chris
Martin. (Tr. 38). They do not have children. (Id.).
December 21, 2009, Martin was seen at UMass Memorial Hospital
for complaints of vertigo, pain, and numbness (Tr. 547-51).
She told hospital staff she had been previously diagnosed
with MeniÃ¨re's disease and that she had experienced eight
episodes of vertigo in eight days. (Tr. 547). She appeared
normal upon examination. (Tr. 547-48).
January 19, 2010, Martin reported to her primary care
physician, Dr. Kenneth Guarnieri, M.D., experiencing daily
light-headedness, but claimed to have experienced no vertigo
in the prior three weeks. (Tr. 392). In February 2010,
neurologist Dr. Johnny Salameh, M.D. observed that
Martin's neurologic functioning, muscle strength and
tone, reflexes, cerebellar functioning, sensation, and gait
were all normal. (Tr. 478-81). An EEG performed in May 2010
revealed "left temporal polymorphic theta range slowing,
" which the reviewing physician noted was
"consistent with a partial seizure disorder but not
diagnostic of it." (Tr. 559-60). After a follow-up
appointment in June 2010, Dr. Salameh largely echoed his
February observations. (Tr. 475-77). He added that Martin
"denied any loss of consciousness" during her
episodes of vertigo and experienced "no double vision,
no headaches, no nausea, no vomiting, no hearing problems as
well as no pain, numbness or tingling sensation." (Tr.
476). Dr. Salameh continued Martin on Topomax, which had
reduced the frequency of her dizzy spells. (Tr. 475).
underwent a three-day study in July 2010 to determine the
cause of her frequent episodes of dizziness and vertigo. (Tr.
696-98). During the study, an EEG was performed during
Martin's waking and sleeping hours. (Tr. 697). On the
third day of the examination, Martin reported an episode of
vertigo while playing a videogame. (Tr. 696). The episode
lasted ten to fifteen seconds. (Id.). Martin remained
standing and did not report any disorientation or confusion
during the episode. (Id.). The examining neurologist, Dr.
Jayant Phadke, M.D., reported that the results of an EEG
during the episode were "completely normal" and
that Martin's subjective symptoms were likely the results
of a panic episode and not an "ictal
September 2010, neurologist Dr. Nabil Ahmad, M.D. examined
Martin and noted she had intact strength and muscle tone,
intact sensation, 2-3 reflexes with downgoing toes, intact
coordination, and a normal gait. (Tr. 566-68). Dr. Ahmad
noted that the cause of Martin's vertigo episodes
remained unclear, but her vertigo was unlikely the result of
complex partial seizures. (Tr. 567). Neurologist Dr.
Catherine Phillips, M.D. also examined Martin and noted
"she is doing better now that she is no longer at
work." (Tr. 567-68).
February 2011, Dr. Fred Arrigg, Jr., M.D. attributed
Martin's episodes of vertigo and dizziness to
Martin's prior diagnosis of MeniÃ¨re's disease and
history of migraines. (Tr. 288-89). Dr. Arrigg noted a
"marked improvement" since Martin started taking
Topamax and Zonisamide to treat her migraines. (Id.).
February 4, 2011, ophthalmologist Dr. Hugh Cooper, M.D.
reported that Martin had suffered a "mini stroke"
in 2008 which "resulted in left sided weakness and loss
of vision in her left eye, which reportedly returned to
normal." (Tr. 286). Dr. Cooper noted that a full work-up
at the time was negative, but Martin reported
"persistent intermittent episodes of vertigo, which
occur sporadically lasting one to two minutes and resolve
spontaneously." (Id.). He noted that Martin's
vertigo had "improved on medication" and found no
visual impairments. (Tr. 287).
April 2011, Martin presented at the emergency room of
Harrington Memorial Hospital after a reported episode of
vertigo. (Tr. 301-02). An examination returned normal
results, with intact orientation, mentation, cerebellar
function, motor skills, and sensation. (Tr. 302). The
examining physician noted that Martin was "in no
distress." (Id.). Her gait was steady, at a normal pace,
and without difficulty. (Id.).
August 2011, after complaining of abdominal pain and
bloating, Martin was seen by gastroenterologist Dr. Madan
Zutshi, M.D. (Tr. 359). Dr. Zutshi found her symptoms to
suggest Irritable Bowel Syndrome. (Id.). Dr. Dean Rodman,
M.D. performed a CT scan of Martin's abdomen and pelvis
with unremarkable results. (Tr. 292).
November 2011, Martin complained to Dr. Guarnieri of left hip
pain. (Tr. 351). Upon examination, her hip was mildly tender
to palpation. (Tr. 352). Dr. Marc Camacho, M.D. conducted an
x-ray on November 15, 2011 with unremarkable results. (Tr.
February 2012, Martin told Dr. Guarnieri she was feeling
better after receiving steroid injections to treat her hip
pain. (Tr. 348). Martin reported recurrent episodes of
vertigo, back pain, shortness of breath, and elevated heart
rate when climbing stairs. (Id.). She appeared normal upon
examination. (Tr. 349). Dr. Guarnieri referred Martin to
cardiologist Dr. Sheena Sharma, M.D., who performed an
echocardiogram on March 5, 2012. (Tr. 619). Dr. Sharma stated
that "subtle abnormalities cannot be excluded due to
poor image quality, " but reported no significant
abnormalities. (Id.). In a follow-up examination one week
later, Dr. Sharma categorized the results as
"normal." (Tr. 347). She noted that Martin was
"moderately overweight, " but in "no frank
distress." (Id.). Later that month, Dr. Sharma
administered a cardiovascular stress test using a treadmill,
which returned "[o]verall normal" results. (Tr.
February 12, 2012, Dr. John R. Knorr, D.O. performed an MRI
on Martin's lumbar spine which showed "[n]o focal
lumbar disc abnormality." (Tr. 413-14). On February 13,
2012, neurologist Dr. Gary Keilson, M.D. examined Martin
regarding her vertigo symptoms. (Tr. 442). Dr. Keilson noted
that Martin had stopped taking Topamax, claiming it caused
reflux. (Id.). Martin also reported that her prescription for
Zonegran "only helped a little bit." (Id.). Dr.
Keilson noted that studies of Martin's brain, cervical
spine, and thoracic spine were all unremarkable and that
Martin's sleep apnea responded to CPAP treatment. (Tr.
443). Upon examination, he found Martin's motor
functioning, strength, coordination, reflexes, and sensation
to be normal. (Id.). Martin's gait was mildly
broad-based, but not ataxic. (Id.). In a follow-up
examination conducted three months later, Dr. Keilson noted
that the cause of Martin's vertiginous episodes remained
unclear. (Tr. 500). Dr. Keilson opined that Martin "had
extensive workup in the past, has seen neurologist [sic] in
the past, she has had EEGs and brain scanning and this has
all been unrevealing." (Tr. 499).
2012, Martin received an annual physical examination from Dr.
Guarnieri. (Tr. 340-43). Martin reported abdominal pain, but
denied feeling any other pain, dizziness, weakness, numbness,
or symptoms of anxiety or depression. (Tr. 340-41). On
physical examination, Martin's cranial nerves,
deep-tendon reflexes, motor strength, and sensation were all
normal. (Tr. 341-42). Dr. Guarnieri advised Martin to eat
five to six servings of fruits and vegetables and to exercise
at least thirty minutes per day on a regular basis. (Tr.
2012, endocrinologist Dr. Richard Haas, M.D. examined Martin
regarding thyroid nodules. (Tr. 485). Dr. Haas reported that
Martin's thyroid nodules were the result of a
"benign multinodular goiter." (Id.). He noted that
the nodules had decreased in size during the prior two years
and reassured Martin that the diagnosis was benign. (Id.)
saw Dr. Guarnieri for a follow-up examination in November
2012. (Tr. 609-10). Martin denied experiencing any pain,
dizziness, weakness, numbness, or symptoms of anxiety or
December 2012, Martin received a consultative psychological
examination with Dr. David Nowell, Ph.D. (Tr. 492-98). Martin
reported she was not currently receiving any mental health
treatment. (Tr. 492). Dr. Nowell noted that Martin had
renewed her driver's license and was able to drive,
though did so infrequently. (Tr. 493). Dr. Nowell noted that
Martin managed her finances, but "prefer[red] to have
her husband review the details." (Id.) Additionally,
Martin reported that she could shop for groceries
independently, but preferred her husband's company.
(Id.). Her daily routine included feeding animals, watching
television, working on the computer, preparing breakfast, and
going to doctors' appointments. (Id.).
Nowell diagnosed Martin with PTSD and mild depression but
reported that Martin "appears to function in the high
average range of general ability." (Tr. 494, 497).
Additionally, he observed that Martin's speech and motor
functioning were normal. (Tr. 494). Martin achieved a 30 out
of 30 on a Mini Mental Status Examination. (Tr. 495). Dr.
Nowell tested Martin's memory and attention/concentration
and her performance fell "in the superior range, well
above average for her age." (Tr. 497). Her performance
was within normal limits for tests measuring her visual
perception, scanning, and sequencing. (Tr. 496-97). Dr.
Nowell surmised that Martin appeared capable of learning new
information, "manag[ing] simple to moderate
attention/concentration tasks, " and accepting
supervision. (Tr. 498). Dr. Nowell opined that Martin's
overall performance might be "below her premorbid
best" but "cannot be described as impaired."
February 2013, Martin was seen again by Dr. Guarnieri. (Tr.
606-08). Martin once again denied feeling pain, dizziness,