United States District Court, D. Massachusetts
ORDER AND MEMORANDUM ON PLAINTIFF'S MOTION FOR
ORDER REVERSING DECISION OF COMISSIONER (DOCKET NO. 15) AND
DEFENDANT'S MOTION FOR ORDER AFFIRMING DECISION OF
COMMISSIONER (DOCKET NO. 19)
TIMOTHY S. HILLMAN DISTRICT JUDGE
an action for judicial review of a final decision by the
Commissioner of the Social Security Administration
(“Commissioner”) denying the application of
Colleen Oliveras (“Plaintiff”) for Disability
Insurance Benefits (“DIB”) and Supplemental
Security Income (“SSI”). Plaintiff has filed a
Motion for Order Reversing the Decision of the Commissioner
(Docket No. 15), and the Commissioner has filed a cross
Motion to Affirm the Commissioner's Decision. (Docket No.
15). For the reasons set forth below, Plaintiff's motion
(Docket No. 15) is granted and
Defendant's motion (Docket No. 19) is
21, 2015, Plaintiff filed for disability benefits under Title
II and Title XVI, alleging disability beginning July 2, 2014.
(AR 206-19). Her claim was denied at the initial and
reconsideration levels. (AR 103-30). Subsequently, Plaintiff
requested and received an administrative hearing. (AR
146-47). On April 3, 2017, Administrative Law Judge Kim K.
Griswold (“ALJ”) concluded that Plaintiff was not
disabled (AR 11-23).
Appeals Council denied Plaintiff's request to review the
decision, and the ALJ's decision therefore became the
final decision of the Commissioner. (AR 1-4). Plaintiff has
exhausted her administrative remedies, and this case is
therefore now ripe for review under 42 U.S.C. 405(g).
March 7, 2014, Plaintiff saw Dr. Shubhada Javlekar, her
primary care physician. Dr. Javlekar noted that
Plaintiff's past medical history was significant for
psoriasis, scoliosis, and that she had a history of chronic
low back pain. Dr. Javlekar also reported that Plaintiff had
Crohn's disease and could not tolerate nonsteroidal
anti-inflammatories. Plaintiff was taking Percocet 5/325 mg
four times per day for her back pain. On examination,
Plaintiff had no edema, no point tenderness in her spine, and
minimal sensitivity on the bilateral paraspinal muscle and
lumbosacral area. In addition, her deep tendon reflexes were
intact. (AR 381-82).
2, 2014, Plaintiff again saw Dr. Javlekar for a follow-up to
monitor her blood pressure. She had “[n]o abdominal
pain, nausea, vomiting . . . diarrhea [or]
constipation.” (AR 368). The examination showed no
abnormalities, and her Crohn's was “stable.”
February 7, 2015, Plaintiff again treated with Dr. Javlekar
for low back pain. Plaintiff claimed that her back pain
flared up because her work involved standing for long
periods. Dr. Javlekar noted that her Crohn's “has
been OK.” Further, Plaintiff denied abdominal pain,
nausea, vomiting, heart burn, diarrhea, or constipation. Dr.
Javlekar's revealed no edema and she reported that
Plaintiff's chronic low back pain and Crohn's were
well controlled on her current medications. She described
Plaintiff as “medically stable.” (AR 352-54).
24, 2015, Plaintiff again treated with Dr. Javlekar. Dr.
Javlekar noted: “The patient has a history of
Crohn's disease. She is on Humira. She follows up with
Dr. Papper periodically. She has been experiencing some
trouble related to fistulas and she is going to set up the
appointment. As far as her low back pain she takes Percocet
up to four times a day as needed. She tries to space them
out. Usually, the pain is under control enough for her to
carryout day-today activity; otherwise, she has difficulty
doing so.” On examination, Dr. Javlekar found Plaintiff
was not in any acute distress. Plaintiff's abdomen was
soft and nontender and her bowel sounds were normal. Further,
her extremities showed no edema. Dr. Javlekar additionally
reported that Plaintiff's blood pressure was adequately
controlled, and that Plaintiff stated that she periodically
has some discomfort in the rectal area secondary to her
Crohn's disease. (AR 329-30).
August 27, 2015, Plaintiff filled out a Function Report in
connection with her application. She reported that she cares
for her five children, with help from her mother. Plaintiff
indicated that she must dress and bathe slowly due to her
back pain and uses the bathroom frequently due to her
Crohn's. Plaintiff further reported that she prepares
meals for herself and her children daily, goes shopping,
drives, and attends to her children's schools. She said
she has difficulty with physical activities due to her back
pain but reported no problems paying attention, following
instructions, or getting along with others. (AR 262-69).
October 2, 2015, Plaintiff saw Dr. Raul Endriga for a
consultative physical examination. On examination, Dr.
Endriga noted that Plaintiff had no tenderness on pressure
over the spinal rea and no muscle spasms. Movements of the
back were normal and there was no tenderness on twisting
movements. Examination of the abdomen showed that it was soft
and non-tender with normal bowel sounds, there was no
evidence of ascites, and the liver and spleen were not
palpable. The rest of the examination was unremarkable. (AR
December 11, 2015, Plaintiff treated with Michael Richards,
PA-C, for her Crohn's disease. PA-C Richards noted that
Plaintiff's symptoms had primarily been abdominal pain
and diarrhea. That day, Plaintiff reported that abdominal
pain had not been an issue, it was only occasional and
short-lived when it did occur. Plaintiff reported
experiencing nausea in the evening about one a week, which
was relieved by a bowel movement. She further reported that
diarrhea occurred perhaps twice a month and could last all
day. She was taking Tylenol No. 3 for her back pain and
believed that might cause the diarrhea. According to
Plaintiff, her biggest concern over the past couple of months
was diffuse joint pain with stiffness in the morning in her
elbows, wrists, and knees. On examination, Plaintiff was
sitting comfortably in no accuse distress. Abdominal exam
showed positive bowel sounds, soft, non-tender,
non-distended, with no masses and no hepatosplenomegaly.
Ultimately, PA-C Richards concluded that Plaintiff's
Crohn's appeared to be well-controlled on Humira, which
she tolerated well. (AR 412).
same day, PA-C Richards filled out a Medical Source
Statement. He indicated that Plaintiff has a history of small
bowel Crohn's, with symptoms under “fair-good
control.” In addition, PA-C Richards reported that
Plaintiff randomly has “breakthrough” symptoms
causing pain and diarrhea which last all day and that she
cannot work during these episodes. (AR 400).
December 15, 2015, PA-C Richards filled out a Crohn's and
Colitis Residual Functional Capacity questionnaire. He
reported that Plaintiff had chronic diarrhea, but no pain. In
addition, Plaintiff's symptoms were seldom severe enough
to interfere with attention and concentration, and emotional
factors did not contribute to her symptoms. In PA-C
Richards's opinion, Plaintiff would
“possibly” need to take restroom breaks hourly,
with minutes of advanced notice needed for a restroom break.
Finally, PA-C Richards opined that Plaintiff would likely be
absent from work about three days per month due to her
Crohn's. (AR 401-405).
December 18, 2015, Dr. Javlekar filled out a Medial Source
Statement. She indicated that Plaintiff could frequently
lift/carry less than 10 pounds, that Plaintiff could
stand/walk less than 2 hours per day, and that Plaintiff must
periodically alternate between sitting and standing to
relieve pain or discomfort. Dr. Javlekar additionally noted
that Plaintiff could only occasionally climb and balance and
never kneel crouch, crawl, or stoop. Finally, Dr. Javlekar
noted that Plaintiff had limited ability to perform fine
manipulation and that cold temperatures exacerbate her
symptoms. (AR 406-409).
the initial and reconsideration determinations, the State
Agency consulting physicians concluded Plaintiff had no
severe impairments. (AR 103-14; 117-28).
Court may not disturb the Commissioner's decision if it
is grounded in substantial evidence. 42 U.S.C. 405(g);
1383(c)(3). Substantial evidence exists when there is
sufficient evidence that a reasonable person could agree with
the conclusion. Rodriguez v. Sec'y of Health &
Human Servs., 647 F.2d 218, 222 (1st Cir. 1981). Thus,
this Court must uphold the Commissioner's findings
“if a reasonable mind, reviewing the evidence in the
record as a whole, could accept it as adequate to support his
conclusion, even if the administrative record could support
multiple conclusions.” Ortiz v. Sec'y of Health
& Human Servs., 955 F.2d 765, 769 (1st Cir. 1991)
(quotation marks and citation omitted).