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BROWN v. APFEL

January 14, 1998

WILHELMINA BROWN, Plaintiff,
v.
KENNETH APFEL, COMMISSIONER OF THE SOCIAL SECURITY ADMINISTRATION,1 Defendant.



The opinion of the court was delivered by: LARIMER

 INTRODUCTION

 This is an action brought pursuant to 42 U.S.C. § 405(g) to review the final determination of the Commissioner of Social Security that plaintiff was not disabled, and therefore, was not entitled to disability benefits. This Court finds that the Commissioner's decision was not supported by substantial evidence and accordingly remands the case for further proceedings consistent with this decision.

 PROCEDURAL BACKGROUND

 Plaintiff Wilhelmina Brown ("Brown") was born on October 7, 1958 and is presently thirty-nine years old. (T. 64). *fn2" On October 12, 1993, Brown applied for Social Security disability and Supplemental Security Income ("SSI") benefits. (T. 64-66; 87-90). She claimed that she was unable to work since April 12, 1993 due to "schizophrenia, left shoulder and neck problem". (T. 102). The Social Security Administration denied her applications initially on March 31, 1994 and Brown did not appeal. (83-86; 92-95). Brown reapplied for benefits under both programs on July 12, 1994. (T. 147-149; 193-194). Once again, Social Security denied these applications initially and upon reconsideration. (T. 152-192; 196-204).

 Plaintiff requested a hearing before an Administrative Law Judge ("ALJ") which was held on May 23, 1995. (T. 205; 32-63). Plaintiff appeared at the hearing and was represented by attorney David E. Ralph.

 On March 29, 1995, the ALJ issued a decision in which he found that plaintiff could still perform her past relevant work as a transportation aide and child care worker, and therefore was not entitled to disability benefits. (T. 18). On January 31, 1997 Social Security's Appeals Council issued the Commissioner's final decision. (T. 5-7). Because the Appeals Council refused to review the ALJ's decision, plaintiff commenced this action. Presently before the Court are the parties' motions for judgment on the pleadings pursuant to Federal Rules of Civil Procedure 12 (c).

 FACTUAL BACKGROUND

 A. Medical Evidence

 During the 1980's, Plaintiff apparently received long-term care from Dr. Kahn at Chemung County Mental Health Clinic. (T. 113-115). Throughout this period, and continuing, Brown received monthly injections of Prolixin Decanoate to control symptoms of her schizophrenia. *fn3" (T. 118, 122).

 In May 1991, she transferred her care to Family Services of Chemung County, when her former doctor stopped accepting Medicaid. (T. 119-23). These treatments included counseling sessions and continued injections. (T. 238-50). The record shows many short treatment sessions in which Brown was characterized as "normal". (See, e.g. T. 238, 239). Plaintiff continued with these treatments even after her hearing in March 1995. (T. 331-33).

 As part of the process to apply for disability benefits, plaintiff underwent at least two one-time medical evaluations. Dr. Jeffrey Donner, Ph. D., tested Brown in November 1993. (T. 229-30). Brown told the doctor that she took Haldol to control weakness on the left side of her body. *fn4" Dr. Donner reported that in the past, Brown had been treated and hospitalized for depression, although the record contains little independent evidence for this diagnosis. (T. 229). It is notable that Dr. Donner's report never mentioned Brown's treatment for schizophrenia. Dr. Donner concluded his report by finding that Brown suffered from a Personality Disorder not otherwise specified, with dysthymic, anxious, dependent and somatic features. (T. 230).

 In December 1993, Dr. Faiz Khan undertook a psychiatric examination, also as part of the Social Security process. (T. 140-41). Brown told Dr. Khan that she no longer heard voices, but that she was depressed and suffered from mood swings. (T. 140). She also told Dr. Khan that she was unemployed and had been fired from her last job due to a "misunderstanding" (Id.). Dr. Khan concluded his report with the statement that "it appears that patient had a problem with paranoid schizophrenia in the past which is in remission at this time because of her being on medications. Patient has been diagnosed as: Axis I Schizophrenia, paranoid, chronic, in remission. . ." (Id).

 Plaintiff's treating psychiatrist at Family Services of Chemung County was Dr. Rio Manzano. On several forms Dr. Manzano provided his opinion that Brown was incapable of working due to "schizophrenia, paranoid with acute exacerbations". (T. 265, 266). On January 31, 1995, Dr. Manzano wrote that Brown continued to be treated with individual therapy and psychiatric medications for schizophrenia. He added the following:

 
Our agency feels that Wilhelmina is not employable on a ongoing basis. When Wilhelmina becomes "stressed out" or feels overwhelmed, she has psychotic episodes. A structured activity, such as work, would be too much responsibility for Wilhelmina. Client also becomes very psychotic without her medication. Wilhelmina's mental health condition is chronic and she is not capable of working in a low stress job. I cannot see conditions changing in the future year.

 (T. 256).

 After the Administrative Law Judge issued his decision, Dr. Manzano provided one final letter, co-signed by Brown's therapist, Kelli Glynn and Jean Teitelbaum, the associate clinic director, for the Appeals Council's consideration. (T. 331-33). That report was a point-by-point refutation of the ALJ's decision. In particular Dr. Manzano defended Family Services' use of the word "normal" in their form evaluations. The letter stated that the word "described the patient's description of her symptoms. (T. 332). "'Normal' certainly does not mean that the patient is cured of her mental illness or that it is in remission, and it does not mean that the patient is actually functioning as does a normal person or has become a normal person." (Id.).

 Dr. Manzano also wrote:

 
It is my considered medical opinion that Wilhelmina Brown is not capable of working in any capacity, including her former employment as a child care worker or transportation aide. Her psychiatric diagnosis of schizophrenia is not in remission, and her symptoms are still present. Wilhelmina has extreme functional limitation in daily living, social functioning, with deficiencies in concentration and episodes of deterioration in a work-like setting. Wilhelmina has been evaluated many times by myself and our staff and is not capable of working. I can think of none of my patients who is more in need of SSI disability benefits to support her while she continues to receive treatment for her illness.

 (T. 333).

 B. Subsequent ...


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