United States District Court, D. Massachusetts
JENNIFER S. KEACH, Plaintiff,
NANCY A. BERRYHILL, Commissioner of Social Security, Defendant.
MEMORANDUM AND ORDER
ALLISON D. BURROUGHS U.S. DISTRICT JUDGE
Jennifer S. Keach (“Ms. Keach” or
“Claimant”) brings this action pursuant to
section 205(g) of the Social Security Act, 42 U.S.C. §
405(g), challenging the final decision of the Commissioner of
the Social Security Administration (the
“Commissioner”) denying her claim for Social
Security Disability Insurance (“SSDI”) benefits.
Currently pending are Claimant's motion to reverse the
Commissioner's decision denying her disability benefits
[ECF No. 21], and the Commissioner's cross-motion for an
order affirming the decision. [ECF No. 27]. For the reasons
described herein, the Court finds that the Administrative Law
Judge's decision was supported by substantial evidence
and therefore DENIES Claimant's motion to
reverse and remand and ALLOWS the Commissioner's
motion to affirm.
Statutory and Regulatory Framework: Five-Step Process to
Evaluate Disability Claims
Social Security Administration is the federal agency charged
with administering both the Social Security disability
benefits program, which provides disability insurance for
covered workers, and the Supplemental Security Income
program, which provides assistance for the indigent aged and
disabled.” Seavey v. Barnhart, 276 F.3d 1, 5
(1st Cir. 2001) (citing 42 U.S.C. §§ 423, 1381a).
Social Security Act (the “Act”) provides that an
individual shall be considered to be “disabled”
if he or she is:
unable to engage in any substantial gainful activity by
reason of any medically determinable physical or mental
impairment which can be expected to result in death or that
has lasted or can be expected to last for a continuous period
of not less than twelve months.
42 U.S.C. § 1382c(a)(3)(A); see also 42 U.S.C.
§ 423(d)(1)(A). The disability must be severe, such that
the claimant is unable to do his or her previous work or any
other substantial gainful activity that exists in the
national economy. See 42 U.S.C. §
1382c(a)(3)(B); 20 C.F.R. § 416.905.
evaluating a disability claim under the Act, the Commissioner
uses a five-step process, which the First Circuit has
explained as follows:
All five steps are not applied to every applicant, as the
determination may be concluded at any step along the process.
The steps are: 1) if the applicant is engaged in substantial
gainful work activity, the application is denied; 2) if the
applicant does not have, or has not had within the relevant
time period, a severe impairment or combination of
impairments, the application is denied; 3) if the impairment
meets the conditions for one of the “listed”
impairments in the Social Security regulations, then the
application is granted; 4) if the applicant's
“residual functional capacity” is such that he or
she can still perform past relevant work, then the
application is denied; 5) if the applicant, given his or her
residual functional capacity, education, work experience, and
age, is unable to do any other work, the application is
Seavey, 276 F.3d at 5 (citing 20 C.F.R. §
Keach filed her application for SSDI benefits on September
26, 2013. [R. 28]. She alleged that she became disabled on
September 26, 2013 due to narcolepsy. [R. 30, 43-45]. Her date
last insured was December 31, 2017. [R. 30].
Social Security Administration (the “SSA”) denied
Ms. Keach's application for SSDI benefits on November 14,
2013 [R. 94-96], and again upon reconsideration on March 20,
2014. [R. 98-100]. Thereafter, Ms. Keach requested an
administrative hearing [R. 104-05], which took place before
Administrative Law Judge (“ALJ”) Paul S. Carter
on March 31, 2015. [R. 249]. Ms. Keach, who was represented
by counsel, appeared and testified at the hearing.
Id. On June 10, 2015, the ALJ issued a decision
finding that Ms. Keach was not disabled. [R. 25, 32]. The SSA
Appeals Council denied Ms. Keach's Request for Review on
January 11, 2017. [R. 1-3, ECF No. 1 at 2]. On January 26,
2017, Ms. Keach filed a timely complaint with this Court,
seeking review of the Commissioner's decision pursuant to
section 205(g) of the Act. [ECF No. 1].
Keach was born in September 1973 and resides at 42 Tremont
Avenue in Taunton, Massachusetts with her boyfriend and two
children. [R. 47-48]. She graduated from high school and
studied criminal law at Massasoit Community College for two
years, but did not obtain a degree. [R. 49]. She then
completed schooling for massage therapy and obtained a
certification, which expired approximately five years ago.
[R. 50]. She testified that she receives support from her
boyfriend and $500 in food stamps. [R. 52].
February 26, 2013, neurologist Syed T. Ali, M.D. examined Ms.
Keach and diagnosed her with narcolepsy without
cataplexy. [R. 290]. Her physical, neurological, and
mental examinations were all normal. Dr. Ali ordered a sleep
study and an MRI of the brain. [R. 288-92]. On March 16,
2013, Hirschel D. McGinnis, M.D., conducted a brain MRI which
showed normal appearance and no abnormal findings. [R.
291-92]. On March 19, 2013, Ms. Keach had a sleep
consultation at Bristol Pulmonary and Sleep Medicine. [R.
314-15]. Certified physician's assistant
(“PA-C”) Beth Mastria conducted the consult and
documented Ms. Keach's complaints. Id. She
recorded that Ms. Keach complained of postnasal drip, sinus
congestion, chest pain/pressure, gastroesophageal reflux,
nausea, dysuria, arthralgia, and vision change. [R. 314]. The
physical examination was normal and PA-C Mastria recommended
an additional sleep study, diet, exercise, and weight
reduction. [R. 315].
Keach had a follow-up appointment with Dr. Ali on March 26,
2013. [R. 293-97]. He conducted a physical examination, which
was normal, and Ms. Keach denied having any pain, anxiety, or
other symptoms. [R. 293-96]. He noted new problems with
caffeine excess, narcolepsy without cataplexy, and recorded
an improvement in her chronic tension type headache.
27, 2013, George Chilazi, M.D. examined Ms. Keach and noted
she was doing “tremendously well, without any
complaint, ” and the physical exam conducted that day
was “completely unremarkable.” [R. 487-89]. On
May 29, 2013, Jennifer F. Miley, NP, examined Ms. Keach and
documented her complaints of fatigue, chest pains, and
frequent headaches, although the physical exam was normal.
[R. 298-302]. NP Miley recorded problems associated with
chronic tension type headache and narcolepsy without
cataplexy. [R. 301]. She noted Ms. Keach's scheduled
sleep consultation for July, and indicated she should not
drive when feeling tired. Id.
7, 2013, PA-C Mastria examined Ms. Keach after she presented
with daytime hypersomnolence. [R. 316]. Ms. Keach reiterated
complaints of postnasal drip, sinus congestion, cough,
diarrhea, gastroesophageal reflux, dysuria, and dizziness,
but the physical exam was overall normal. [R. 316-17]. On
July 31, 2013, Ms. Keach underwent a sleep study evaluation
which was recorded by PA-C Mastria. [R. 480]. PA-C Mastria
wrote that “[t]his is a patient with significant
snoring, but no obstructive sleep apnea. However, the
frequency of her arousals do not completely explain her
significant excessive daytime sleepiness.” [R. 481].
Treating physician Imad J. Bahhady, M.D. also conducted a
sleep study on August 16, 2013 and stated that Ms. Keach had
severe hypersomnia, “suggesting the possibility of
narcolepsy, ” and recommended increased sleep time,
improvement in sleep hygiene, and a follow-up appointment.
August 19, 2013, NP Miley examined Ms. Keach a second time.
[R. 303-06]. Ms. Keach complained of fatigue and sleep
disorder, although the physical examination was normal. [R.
304-05]. NP Miley wrote that Ms. Keach's chronic tension
type headache had been well-controlled with B complex,
although her fatigue due to narcolepsy continued. [R. 306].
On August 22, 2013, PA-C Mastria examined Ms. Keach and noted
largely the same diagnosis and complaints as were present at
the June visit. [R. 318-19]. PA-C Mastria recommended Nuvigil
for Ms. Keach's narcolepsy, taking scheduled naps daily,
keeping a regular sleep schedule, and avoiding driving long
distances. [R. 319].
September 24, 2013, Ms. Keach visited Dr. Bahhady. [R.
322-23]. She presented with fatigue, but Dr. Bahhady wrote
that she was doing better with Nuvigil. [R. 322, 464]. He
also noted possible cataplexy “during sig emotions,
” but none recently. [R. 322]. The physical examination
was normal, and he recommended continued use of the
medication. [R. 323]. He also indicated that Ms. Keach could
take one nap in the “pm” and instructed her to
keep a regular schedule. Id.
November 11, 2013, state-agency physician Phyllis Sandell,
M.D. reviewed Ms. Keach's medical records and completed a
disability determination explanation. [R. 73-81]. Although
Dr. Sandell indicated that Ms. Keach had narcolepsy, she
opined that she did not have any exertional limitations,
postural limitations, visual limitations, communicative
limitations, or environmental limitations other than that she
should avoid heights and hazardous equipment and drive with
caution. [R. 77-78]. She concluded that Ms. Keach retained
the residual functional capacity
(“RFC”) to perform her past relevant work as a
collection clerk, massage therapist, rural carrier associate,
and child caretaker, and was therefore not disabled. [R.
March 5, 2014, state-agency physician Herbert Kushner, M.D.,
also reviewed Ms. Keach's medical records and completed a
disability determination explanation. [R. 82-92]. He
indicated that she suffered from narcolepsy which causes
daytime sleepiness, but that her neurological exam was
normal. [R. 87]. He detailed the credibility of her
allegations and indicated that she described no discrete
physical limitations except for the need to nap, which can be
remedied by adjustments in medication. Id. Dr.
Kushner completed a physical RFC assessment and opined that
Ms. Keach had no exertional limitations, manipulative
limitations, visual limitations, communicative limitations,
or environmental limitations, except that she should avoid
heights and hazardous equipment and should not drive. [R.
88-90]. He recorded her postural limitations caused by
cataplexy as follows: she can never climb ladders, ropes, or
scaffolds; she can frequently ...