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Adkins v. Berryhill

United States District Court, D. Massachusetts

December 12, 2017




         The plaintiff, Deborah Lynn Adkins, seeks reversal and remand of a decision by the defendant, the Acting Commissioner of the Social Security Administration (“the Commissioner”), denying her Supplemental Security Income (“SSI”) and Disability Insurance Benefits (“DIB”). Doc. No. 13. The Commissioner seeks an order affirming her decision. Doc. No. 26. For the reasons that follow, Adkins' Motion to Reverse and/or Remand the Decision of the Commissioner is DENIED, and the Commissioner's Motion to Affirm the Commissioner's Decision is ALLOWED.

         I. BACKGROUND

         A. Procedural History

         In February of 2014, Adkins applied for SSI and DIB, alleging that she became disabled on June 1, 2012. A.R. at 11.[1] Her applications were denied initially on April 24, 2014 and upon reconsideration on August 11, 2014. Id On August 19, 2014, Adkins requested a hearing before an administrative law judge (“ALJ”). Id Adkins appeared, represented by counsel, and testified at her June 30, 2015 hearing, which also featured testimony by a vocational expert Amy Vercillo. Id.

         Thereafter, the ALJ issued a written decision denying Adkins' applications. Id. at 12. Adkins' timely request for review by the Appeals Council was denied, id., rendering the ALJ's determination the final decision of the Commissioner. Adkins filed this action appealing the Commissioner's decision on October 6, 2016. Doc. No. 1.

         B. Adkins' Physical Impairments

         In the paperwork accompanying her applications, Adkins claimed she suffered from severe physical impairments including thoracic outlet syndrome (“TOS”), Paget-Shroetter syndrome (“PSS”), transient ischemic attacks, and Raynaud's syndrome.[2] A.R. at 234. The administrative record contains the following relevant evidence regarding Adkins' alleged physical impairments:

• Adkins was in a “usual state of good health until December of 2007, ” when she began experiencing pain in her right arm and swelling. Id at 350.
• In December of 2007, Adkins was diagnosed with TOS with PSS resulting from it. Id at 37, 901. Adkins underwent surgery in 2008 and again in 2009 to treat the conditions. Id at 36, 898.
• After the surgeries, Adkins' swelling and pain initially decreased; however, her symptoms later returned with increased pain. Id at 350.
• From 2010 to 2012, Adkins continued to experience swelling, pain, and muscle spasms. Id at 61, 350. To manage these symptoms, Adkins participated in physical therapy. Id at 62. She also used muscle relaxers, blood thinners, and Heparin therapy. Id at 63-64.
• In May of 2012, Adkins graduated from Harvard University with a Bachelor of Science Degree.[3] Id at 39, 41-42. Adkins intended to continue her education with an additional two years of study at Northeastern University but was deterred by her daily pain. Id at 40.
• While a student, Adkins lived in Dorchester and commuted to school. Id. at 43-44. She took many of her classes online. Id She typically spent three hours at a time online to complete her assignments. Id at 44.
• During this time, Adkins lived at the Salvation Army Jubilee House. Id A requirement of living at the house is volunteer work. Id To fulfill this requirement, Adkins mentored and tutored students and performed office work “like answering the phones” and “hosting groups.” Id
• Adkins has had difficulty finding a medication routine that works for her. Initially, she used the muscle relaxer Tizanidine and the blood thinner Lovenox until the medications inflamed her liver, causing toxic hepatitis. Id at 63-64, 316. Adkins switched to a new blood thinner Coumadin but was unable to consistently reach proper blood thinness levels on the drug. Id She also used the medication Neurontin to manage her pain but developed edema (fluid retention) as a side effect and so discontinued its use. Id at 350. She tried a Butrans patch to help with chest pain, but experienced headaches, nausea and increased pain so discontinued the patch's use. Id at 382-83, 536.
• While a student at Harvard, Adkins also underwent Heparin therapy every three to four months to treat blood clots. Id at 66. The typical treatment lasted fifteen days. Id Adkins experienced side effects as a result of the treatment, including vomiting and generally feeling unwell. Id. at 67.
• Recently, Adkins has had “benefits with heat and Dilaudid, ” a pain medication. Id. at 350.
• On June 4, 2012, Adkins met with Dr. Dean Donahue at Massachusetts General Hospital (“MGH”), complaining of swelling and pain in her right hand. Id at 67, 453. At the visit, Adkins also reported a general decline in her ability to function and increased pain and muscle spasms, and expressed a fear “that she might not be able to commit 100% to work with her ongoing pain issues.” Id at 67-68, 453.
• At this time, Adkins increased her use of Dilaudid to manage her pain, but then “resumed her habit of taking [it] only [] for strong pain . . . and often [not] as all.” Id
• During the June 4, 2012 examination, Dr. Donahue found Adkins' range of motion to be normal, and found that she had five out of five in muscle strength in all major muscle groups except her right upper extremity which Dr. Donahue found to have four out of five strength. Id at 454. Dr. Donahue also found that Adkins is “able to deal with flare-up of pain . . . with limited amount of medication and medical support” and has “the ability to tolerate pain most days.” Id
• From 2012 to 2014, Adkins visited MGH and Beth Israel Pain Management Center dozens of times and saw numerous doctors, including Dr. Donahue, pain management physicians, vascular physicians, cardiologists, a neurologist, and a rheumatologist. Id at 68-69, 318-422, 415-19, 453-54, 529-35, 668-80, 907, 1416-19. The most significant of these visits, for the purposes of the issues presented here, are summarized in the paragraphs that follow.
• On November 11, 2012, Adkins visited the emergency department at MGH after experiencing severe abdominal pain while riding a recumbent bike at the gym. Id at 428. All of her laboratory tests were normal, and she was discharged. Id at 336-67.
• In March of 2013, Adkins again visited the emergency department at MGH, complaining of chest pain and dizziness. Id at 427-34. After she was discharged, she followed up with her pain management physician. Id. at 421. Her physician found her to possess full range of motion, normal gait, and sensation. Id at 421-22. In April of 2013, Adkins had another episode of chest pain. She visited MGH on April 24, 2013 and was found to have a normal MRI. Id. at 392.
• On April 29, 2013, Adkins returned to the emergency room complaining of chronic pain, chest pain, shortness of breath, blurred vision, and light headedness. Id at 312, 317. Her attending physician was unable to find the source of her pain. Id at 394. She was found to have normal range of motion, reflexes, and coordination; her lungs, heart, and chest were found to be normal; she was found to “abulate[] with steady gait;” and ...

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