United States District Court, N.D. Indiana, South Bend Division
BOBBIE J. DIXON, Plaintiff,
CAROLYN W. COLVIN, Acting Commissioner of Social Security, Defendant.
OPINION AND ORDER
PHILIP P. SIMON, Chief District Judge.
Plaintiff Bobbie Dixon appeals the decision by an administrative law judge to deny her application for Social Security disability benefits. Dixon says that the ALJ's decision disregarded the opinion of her treating psychologist and was not otherwise based on substantial evidence. For the reasons outlined below, I will affirm the decision of the ALJ.
Dixon applied for Social Security Income (SSI) on February 28, 2011, alleging a disability onset date of August 15, 2010. (DE 17 at 3; R. at 15.) Dixon's claim worked its way to the ALJ, who held a hearing on July 16, 2012. (R. 15, 36.) The ALJ issued an unfavorable decision on August 17, 2012 (R. 30), and that decision was affirmed by the Appeals Council. (DE 17 at 3-4.)
The Medical Evidence
Dixon's medical history includes both mental and physical impairment. As the ALJ put it at the start of the hearing, "[d]epression, anxiety, and schizoaffective disorder are the main psychological impairments. She also has a cervical spine impairment that limits her in some fashion. I would emphasize I think that the majority of her problems that we're here for today are psychological in nature." (R. 40; see also, R. 20-21.) Nonetheless, the ALJ "specifically considered whether [Dixon's physical] impairment causes more than a minimal effect on [her] ability to perform basic physical work activities." (R.17.) Dixon's opening brief does not raise physical limitations in support of her claim. Dixon's attorney asked about physical limitations very briefly during the hearing. (R. 54.) Two state agency physicians reviewed the medical evidence through March 2011 and opined that Dixon "did not suffer from any severe physical impairments." The ALJ gave these opinions great weight because they were consistent with the record. (R. 28.)
To set the stage, I note that the deficiency in Dixon's claim is less the symptoms and more a lack of the necessary medical evidence. This isn't to say whether the symptoms would qualify for benefits if the evidence were available, but rather that it is impossible to evaluate that counterfactual scenario. Dixon applied for SSI in February 2011, alleging an onset date in August 2010. But Dixon's description in her brief of her medical treatment doesn't start until nine months after she first filed for disability benefits. In other words, Dixon filed for disability benefits as of August 2010 claiming a psychiatric disorder, but didn't seek treatment for that disorder until May 2011, when she saw Dr. Loren Burton at Oaklawn Psychiatric Center for therapy. What's more, Dr. Burton didn't see Dixon regularly until after April 2012, which the ALJ considered significant. (R. 26.)
Dr. Burton's records from May 2011 note that Dixon was "being treated for panic attacks, schizoaffective disorder, and generalized anxiety disorder." (R. 362.) Dr. Burton noted that case management services might be in order, and that therapy was necessary, writing that Dixon was scheduled to return in two weeks for therapy. The session notes don't include Dr. Burton's assessment of how long Dixon might have been impaired or suffering from her conditions, or how long they were expected to continue. (Id. ) Dixon's regular visits to Dr. Burton began almost a year later, only three months before the ALJ held the hearing in this case.
On March 16, 2011, Dixon completed a "Function Report" for herself. (R. 160-67.) She completed another one on April 3. (R. 179-86.) On March 17 Dixon's daughter Kelsey Dixon completed a Third Party Function report at the Disability Determination Bureau's Request. (DE 17 at 4; R. 170-77.) This report noted Dixon's difficulty completing household and personal care tasks independently, her issues paying attention, and her anxiety. Kelsey completed another one on May 3. (R. 196-203.)
Before 2011, records detailing Dixon's mental and emotional issues are sparse, as the ALJ noted. (R. 22-23.) An August 2010 record doesn't reference any mental issues, and is limited to things like family history of hypertension. It is true that Dixon was prescribed Xanax and Pristiq in April 2009, but there was no explanation in the record as to why. There had been a gap in medication from 2007 to 2009. (R. 22.) Office notes began in February 2010, and they note that Dixon had applied for SSI benefits and had been denied. Dixon had a GAF score of 65. There was more activity in Dixon's medication regimen starting in March 2010 with a visit to Dr. Curry. (R. 23.) In March 2011 Dixon saw psychologist Carol Singler, Ph.D., and discussed her work and medical history, and her social interaction. Dixon said "[s]he dresses, grooms and bathes without assistance and reminder." "She denied a psychiatric history, " but said she'd been diagnosed with bipolar disorder because of "massive mood swings." Dixon denied being a victim of emotional, physical, or sexual abuse. Dixon reported having a few friends, and that she "had a boyfriend and he was paying the bills for me but he went back to Michigan City about six months ago but he still helps me out." Dr. Singler assessed a GAF score of 64. (R. 23-24, 285-88.)
Dixon saw Dr. Vivek Prasad at Oaklawn on June 30, 2011, for medication review and followup. (DE 17 at 5; R. 316.) Dr. Prasad noted that Dixon was taking Prozac, Ambien, and Xanax, which her primary care provider Dr. Curry had started her on "four or five months ago." (R. 316.) Dixon reported various symptoms, including decreased sleep, mood swings, irritability, and panic attacks. Dr. Prasad diagnosed schizoaffective disorder, assessed a GAF of 55, and changed Dixon's medication regimen. (R. 316-17.) Dr. Prasad described Dixon as having "a disheveled appearance, " but "good eye contact and a pleasant and cooperative attitude, " with a logical, concrete, and goal-directed thought process. (R. 317.) Dr. Prasad also noted a "chronic history of panic attacks and mood swings." (R. 316.)
Dixon returned to Dr. Prasad on August 11, 2011, for medication and followup. She complained of irritability, but had good eye contact and a thought process that "was logical, concrete, and goal directed." She had no hallucinations. (R. 313-14.) Dr. Prasad wrote that Dixon was going to follow up with Ann Hofsommer before seeing Dr. Prasad again in three months. (R. 314.) The ALJ noted that the record contains notes from a visit to Dr. Curry on August 23, 2011, about an ankle injury sustained "3 week(s) ago at work." (R. 24.)
On November 3, 2011, Dixon saw social worker Ann Hofsommer. (R. 340-41.) Dixon complained of "[c]hronic panic attacks, [a]goraphobia, auditory and visual hallucinations, significant mood swings with depression lasting 3-4 days." (R. 340.) Hofsommer noted that Dixon had been referred to individual therapy "which she attended once and then dropped out." (R. 340.) A few days later, on November 8, Dixon saw Dr. Prasad. She reported that she hadn't been sleeping for the last three months. She said she had gone to the emergency room for fainting about 6 to 8 weeks before. Dixon was found to be potassium-deficient, and had begun taking supplements. (The record doesn't state whether the fainting was attributed to the potassium deficiency.) "She denied any outright auditory or visual hallucinations or manic behaviors." (R. 338.) Dixon's medication regime was altered again. (Id. )
On April 4, 2012, Dixon returned to Dr. Prasad. Prasad described Dixon as disheveled, malodorous, reeking of cigarette smoke, and with an irritable affect, but making "good eye contact." Dixon reported not sleeping well. Dr. Prasad described her thought process as "illogical[, ] denying any benefit from any of the medications she has tried, " with "limited to poor insight and judgment into her condition and need for medications and followup." (R. 335.) Dr. Prasad assessed a GAF score of 55. (R. 336.) Dixon said her medications were not working well. She reported walking a mile per day, but she had ...