The opinion of the court was delivered by: Honorable Michael A. Telesca United States District Judge
Represented by counsel, plaintiff Tara Graves ("Graves" or "Plaintiff") brings this action pursuant to Title XVI of the Social Security Act, seeking review of the final decision of the Commissioner of Social Security ("the Commissioner") denying her application for Supplemental Security Income ("SSI") benefits. For the reasons that follow, the Commissioner's decision is affirmed.
II. Factual Background and Procedural History
Plaintiff's initial application for benefits, filed on March 6, 2009, was denied. Benefits were denied again on May 25, 2011, following an administrative hearing before an Administrative Law Judge ("ALJ"). The relevant evidence of record is summarized below.
In her testimony at the hearing before the ALJ, Graves stated she graduated from high school with an Individualized Education Program diploma and, since adolescence, has been variously diagnosed with anxiety, depression, attention deficit hyperactivity disorder ("ADHD"), and a learning disability. Graves asserts that she is unable to work because of her anxiety, depression, and learning disability. Graves testified that she "can't even read . . . a baby book"; that she can only do basic math and most of the time has to use a calculator. (22).*fn1 She requires assistance in filling out job applications and is unable to pay for things on her own as she cannot count money. (22). Her last job was as a childcare worker with the Wayne County Action Program which she had to quit due to her severe anxiety. (23).
Graves testified that she requires consistent assistance from her grandmother and her caseworker to care for herself and her two children. (24). Her grandmother helps her read her mail. If Graves is not feeling good and cannot leave the house, her grandmother will go grocery shopping for her. (24-25).
Graves explained that she had been seeing Cathy Bump ("Bump"), a licensed social worker, twice a week for mental health therapy, but "she wasn't really helping" anymore. (26). Graves stated that for a while, Bump was writing to the Wayne Count Department of Social Services ("DSS") saying she was unable to work because of her bad anxiety and her inability to leave the house. (26). Now, however, Bump said that Graves "need[s] to go back to work because [Bump] can't help [her]." (26). Graves said that Bump was not listening to her problems but was "just assuming" things. (26).
Graves explained that she has suffered from anxiety since high school and would become anxious when asked to perform an academic task. (27). She explained, "I felt, like, I was going to fail, and everybody was watching me. 'Cause I can't read. And I can't spell at all. So, I just, broke down, just like I couldn't do it. And that's why I had real bad anxiety when I went to school." (27). The anxiety worsened after she had her son. (26). It is hard for her to breathe, her mouth gets "all tingly", and she "start[s] to . . . break down and cry", and she has to sit down because she feels as if she is going to pass out. (26). Those symptoms were why she left her daycare job. (26).
Graves stated that she "can't stop gaining weight". (27). She had been speaking with her doctor about undergoing gastric banding surgery. (27). She explained that her excess weight is causing her to have a lot of pains in her arms and hands, and that she has difficulty holding her eighteen-pound child for very long. (27). Graves takes medication for high cholesterol. (28).
B. Evidence Regarding Plaintiff's Mental Impairments
In eighth grade, Graves was classified as Multiply Disabled with Wechsler IQ scores of 85 (full scale), 84 (verbal), and 89 (performance). Looking at her total academic achievements in terms of grade equivalent, she was functioning at the 4.8 grade level at age seventeen. (154). In the eleventh grade, Graves was diagnosed with ADHD and medicated with Adderall. She was classified as having a learning disability in the areas of math, reading comprehension, basic reading skills, and written expression. (152).
Her overall reading ability, broad written language skills, and mathematics skills all were in the low range of ability. (155). Her Individualized Educational Program, completed at age nineteen, states that her memory for verbally-presented information was limited in all areas, as she became easily confused with multi-step directions and word problems. In mathematics, she had difficulty remembering and applying formulas, especially those that had been previously taught. (148). With guidance, however, Graves would complete assignments thoroughly, and she was "willing to try new approaches and strategies, often resulting in a better understanding of the concepts, as well as a reminder of her ability." (148). At that point in time, the plan was for Graves to continue to work at the Palmyra Community Center and apply for part-time employment at a local childcare center. (147).
2. Non-Physician Treating Sources
Beginning in September 2007, Graves sought treatment from the Wayne Behavioral Health Network ("WBHN") for treatment of her adjustment disorder with mixed anxiety. (234-36). Graves attended individual counseling sessions with licensed social worker Bump until November 2007. (235). Bump noted that Graves attended counseling appointments until she signed Graves' disability papers for the DSS in November 2007. (235, 293). Graves cancelled her next appointment and missed all subsequent appointments. (235). In her notes, Bump stated that she only sent out a "three month note" for disability benefits, as she was "having doubts about [Graves'] credibility." (236). Bump closed Graves' case on January 15, 2008. (236). In a discharge summary completed that date, Bump assessed that Graves' global assessment of functioning ("GAF") score was 54 (234),*fn2 which signifies moderate symptoms or moderate difficulty in social, occupational or school functioning.
On January 24, 2008, Graves, who was pregnant with a due date of March 23, 2008, returned to the WBHN and indicated that she wanted to re-start counseling with Bump due to continuing problems with depression, anxiety, and panic attacks. (221). Graves explained that she had missed several appointments because her grandmother had been unable to drive her. In her treatment notes from February 25, 2008, Bump indicated that Graves was having feelings of anxiety and panic when in public because she thought people were making comments about her weight and body-piercings. (221). Graves told Bump that there were periods of time when she would oversleep and cry a lot because she felt overwhelmed. (221). Graves was not presently having thoughts of suicide but reported having fears of car wrecks and other catastrophes. (221).
The WBHN records indicate that Graves started cognitive behavioral therapy with Bump on March 17, 2008, for forty-five minutes biweekly with the goals of increasing her insight, decreasing her symptoms, and increasing her ability to participate in the community. (230). Psychiatric evaluation was recommended after the birth of Graves' baby. The next appointment was scheduled for late April 2008. (221).
The WBHN records are rather sparse. Bump completed a diagnostic review on July 2, 2008, stating as follows: Axis I (Clinical Syndromes/V Codes): DSM 300.00, Anxiety D/O NOS; Axis II (Developmental/Personality Disorders): DSM 799.99, Diagnosis Deferred; and Axis III (Physical Discords/Conditions): DSM 278.0, Obesity. (231). Psychosocial and environmental factors that affected Graves' diagnosis were her pregnancy, social problems, and lack of family support. (221).
The next treatment note in the WBHN records is dated October 21, 2008, and is a "Review" of Graves' case which reads, in pertinent part, as follows:
She now reports Panic Attacks-chest pains and trouble breathing in large places with lots of people. Tara reports a history of problems sleeping and crying spells.
She also reports irrational fears-car crashes and other catastrophes. She denies leaving the house much due to these fears. Her baby is due in about 3 weeks. . . . She is working with DSS and the Wayne ARC-LIVES pro[gram].
They will help her find work after her baby is born. Tara gave no indication of psychosis denied current SI or HI.
She appears to be somewhat intellectually limited, has fair judgment and poor insight. Tara behaves socially more like a young teenager than her stated age. Tara does admit to worrying, having trouble getting up, becoming angry easily and feeling overwhelmed although she appears calm. . . . Symptoms are moderate-she avoids leaving home but will with assistance. . . . Symptoms mild to moderate. Symptoms once [sic] when in community. Continue to assess cause. Initial diagnosis: Anxiety DO, NOS. (229). Also in the October 21st note, Bump observed that Graves' attitude was cooperative; her speech was spontaneous; her thought form was focused; her mood was anxious though her affect was appropriate; her orientation and memory were intact though concentration was impaired, and her insight and judgment were poor. (228-29). Bump assessed Graves' symptoms at that time as mild-to-moderate and diagnosed Graves with anxiety disorder, not otherwise specified ("NOS"). (229).
The only other records from Bump or the WBHN are Psychiatric Report (Employment) forms which were completed on Graves' behalf for the DSS from November 2007 to January 2011. (293-299). In August 2008, April 2008, and October 2008, Bump indicated that Graves was not capable of working in any capacity due to her anxiety disorder, not otherwise specified. (294-296). In October 2009 and May 2010, Bump indicated that Graves was not capable of working in any capacity due to her panic disorder with agoraphobia. (297).
In January 2011, Bump gave diagnoses of anxiety NOS and depression NOS. (299). However, Bump determined that Graves was capable of returning to work full-time. (299). Five months later, a new individual, Debbie Dinson-Moore, LMS, completed the Psychiatric Report (Employment) form for Graves, stating that she could not work in any capacity due to her "anxiety" and "limited cognitive abilities". (301). It appears that these Psychiatric Report ...