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Guarente v. Berryhill

United States District Court, D. Massachusetts

August 23, 2017

NANCY A. BERRYHILL, Acting Commissioner of Social Security Administration, Defendant.


          Patti B. Saris, Chief United States District Judge.


         Plaintiff AnnaMarie Guarente seeks judicial review of the decision by the Social Security Administration (“SSA”) to deny her claim for Supplemental Security Income (“SSI”) benefits and Social Security Disability Insurance (“SSDI”) benefits. Plaintiff argues that: 1) the Administrative Law Judge (“ALJ”) failed to properly weigh the opinion of her treating ophthalmologist, and 2) the ALJ erroneously rejected the opinion of her treating podiatrist. For the reasons set forth below, the Court DENIES Plaintiff's motion to reverse the decision of the Commissioner. Docket No. 16. Defendant's motion to affirm is ALLOWED. Docket No. 20.


         At the time of the hearing before the ALJ on November 6, 2014, Plaintiff was fifty-three years old. R. 23. The ALJ denied Guarente's application for benefits on March 11. 2015. R. 29. Her request for reconsideration was denied on August 4, 2016. R. 1-4.

         I. Work History and Education

         Plaintiff has an Associate's degree. R. 41. At the time of the hearing, she worked as a part-time kitchen helper at a school five days a week from 10 A.M. to 1:15 P.M. This job required her to stand for three hours cooking, preparing food, and serving children. R. 41-42.

         II. Medical History

         Plaintiff alleges disability beginning March 31, 2011 due to high cholesterol, hypertension, neuropathy, retinopathy, diabetes, depression, and anxiety. R. 18, 74-75.

         On March 23, 2011, Dr. Sunil Rao, a retina specialist, evaluated Plaintiff for non-proliferative diabetic retinopathy in both eyes. R. 323. Dr. Rao's follow-up observations in December 2011, May 2012, and September 2012 indicated that Plaintiff's visual acuity remained stable. R. 316, 320, 495-96.

         On March 31, 2011, Plaintiff visited Dr. Meghan Sass for a follow-up appointment concerning her diabetes mellitus type II, which was diagnosed in 2006. R. 21, 308. Plaintiff reported walking for exercise, but she complained of some numbness and burning in her feet. R. 308. Dr. Sass observed normal movement of the extremities, intact sensation and motor function, as well as normal gait and station. R. 309. At a June 2011 appointment, Dr. Sass also noted poor control of Plaintiff's diabetes and indicated that treatment with insulin was necessary. R. 304.

         At a follow-up exam for cholesterol and hypertension on August 19, 2011, Dr. Lisa Bowie observed normal motor function, normal gait and station, and intact sensation and motor function. R. 350. Plaintiff did not complain of fatigue and reported walking for exercise. R. 350. The following month, Dr. Bowie noticed a slight decrease in vibratory sensation in the bottom of both feet but an overall normal gait and station, full motion in the extremities, and intact nerves R. 346. Plaintiff again did not complain of fatigue, muscle pain, weakness, or paresthesia.[1] R. 345. In November 2011, Plaintiff reported that she walked daily, improved her diet, and felt that her toe numbness improved. R. 299. Dr. Sass observed normal movement of the extremities and normal reflexes. R. 300. She also noted improvements in Plaintiff's blood sugar levels and saw no signs of significant neuropathy. R. 299.

         On August 24, 2012, Dr. E. Kelly McLaughlin, Plaintiff's treating podiatrist, noted discolored, thick, and painful toenails; limited ambulation from foot pain; and limited sensation. R 602-03. Plaintiff complained of toe pain, foot pain, and presented with paresthesia. R. 602. Dr. McLaughlin diagnosed Plaintiff with neuropathy and observed that her overall sensation was not intact. R. 603.

         In a November 2012 visit to Dr. Bowie for a routine follow-up. R. 332 Plaintiff noted that she walked for exercise and denied fatigue. R.332-33. Dr. Bowie observed poor control of Plaintiff's diabetes partly due to six weeks of non-compliance with medication and an incorrect insulin dosage. R. 334. In February 2013, Plaintiff complained to Dr. Bowie that she had back pain radiating into her right leg. R. 536. She denied fatigue, weakness, and paresthesia. R. 537. Dr. Bowie found full motion in the extremities, no issue with nerve or motor function, and normal gait and function. R. 538. However, Dr. Bowie noted that both Plaintiff's feet were hypersensitive to light touch. R. 538.

         On January 22, 2013, Plaintiff saw Dr. Magdalena Krzystolik for her retinopathy. R. 492. Dr. Krzystolik followed up with Plaintiff in March and July 2013. R. 491, 614. Plaintiff also visited Dr. Krzystolik in January and May 2014. R. 610, 612. Throughout this time Guarente had stable vision in both eyes even though she had severe non-proliferative diabetic retinopathy but there was no evidence of clinically significant macular edema in either eye. R. 611.

         In February 2014, Dr. Bowie saw improvements in Plaintiff's diabetes. R. 511. She also noted full motion in the extremities, normal sensation and motor function, intact nerves, as well as normal gait and station. R. 510. Plaintiff did not complain of fatigue, pain, weakness, or paresthesia. R. 509.

         In May 2014, Plaintiff complained to Dr. McLaughlin of lower extremity paresthesia, burning, and hyperesthesia. R. 595. Dr. McLaughlin concluded that Plaintiff had keratosis[2] and a pre-ulcer condition on her left big toe. R. 596. Dr. McLaughlin also observed intact sensation in the lower extremities. R. 596.

         III. Treating Physicians' Opinions

         A. Dr. Krzystolik's Medical Evaluation

         In October 2014, Dr. Krzystolik diagnosed Plaintiff with severe non-proliferative diabetic neuropathy in both eyes, but said: “at this time vision is good.” R. 649-50. Dr. Krzystolik noted Plaintiff could complete visual activities and had no exertional or postural limitations caused by her problems. R. 650. According to Dr. Krzystolik, Plaintiff could frequently stoop, crouch, climb ladders, and lift ten pounds frequently and more weight as tolerable. R. 650. Dr. Krzystolik does not address standing or walking.

         B. Dr. McLaughlin's ...

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