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Karki v. Colvin

United States District Court, E.D. New York

February 21, 2017



          SANDRA L. TOWNES United States District Judge.

         Plaintiff Sharada Karki seeks review of a final decision of the Commissioner of Social Security ("SSA"), denying Plaintiffs application for Social Security disability benefits and Supplemental Security Income benefits. Plaintiff seeks judgment on the pleadings under Federal Rule of Civil Procedure 12(c). (ECF No. 14.) The Commissioner opposes Plaintiff s motion and has also cross-moved for judgment on the pleadings under Federal Rule of Civil Procedure 12(b) and (c). (ECF No. 16.) Plaintiffs motion is granted to the extent that it seeks to reverse the ALJ's decision and remand for a new hearing and decision, and the SSA's cross-motion is denied.



         Plaintiff was born in Nepal on March 6, 1954. (31, 105.[1]) She came to the United States in 1979. (32.) From 1987 through 2003, Plaintiff worked at Goldman Sachs as a data entry clerk. (33, 128.) Subsequently, she worked as a teacher's aide from 2006 through 2009. (128.) Her disability onset date is December 1, 2009. (105.)

         A. Dr. Israel Samson, Plaintiffs Treating Internist

         Dr. Samson began treating Plaintiff in 2003. (131.) The Administrative Record contains his treatment notes from close to Plaintiffs onset date in December 2009 to early September 2011. (200.) Dr. Samson's treatment notes indicate that throughout this period, he had been treating Plaintiff for achalasia, "a disorder of the esophagus that makes it hard for foods and liquids to pass into the stomach, "[2] hypothyroidism, when the body lacks sufficient thyroid hormone thereby leading to a slower metabolism, [3] and hypertension. (201-61.) He also referred Plaintiff to a gastroenterologist, neurologist, cardiologist, ontorologist, and joint specialists, all of whom sent Dr. Samson their treatment notes after examining Plaintiff. (Id.)

         On December 9, 2009, Dr. Samson noted that Plaintiff complained of numbness in her tongue and burning in the back of her throat and tongue. (201.) The doctor diagnosed her with "severe reflux seondary [sic] to achalasia" and recommended a "GI"[4] follow-up. (Id.) He also noted that she had surgeries on her sinus and esophagus and has a history of hypothyroidism. (Id.) At the time, Plaintiff was taking the prescription medicines, Synthroid, which replaces a hormone normally produced by one's thyroid gland, [5] and Prilosec, to address acid reflux.[6] (Id.)

         During 2010, Plaintiff visited Dr. Samson every few weeks to be treated for her thyroid and blood pressure. (206-08, 215-16, 231-32, 234-35, 237). In addition, she complained of swelling on the left side of her neck and burning in her shoulders. (208, 234.) She continued to take her previously prescribed medications. Dr. Samson continued to diagnose her with hypothyroidism, hypertension, and achalasia. He also noted that Plaintiff had "white coat syndrome" after checking her blood pressure during a visit, which is when "blood pressure surges when measured in the doctor's office."[7] (207.) On May 24, 2010, Dr. Samson noted that Plaintiff was experiencing dizziness and would follow up with a neurologist. (226.) Her medication list now also included Domperidon, which is used to treat, inter alia, "complaints of the stomach, which occur with delayed emptying of the stomach, "[8] and Lisonopril for hypertension.[9] (Id.) On November 21, 2010, Dr. Samson treated her for sinus pressure and diagnosed her with nasal congestion. (234-35.) On December 26, 2010, six days after Plaintiff applied for social security benefits (II. infra), she followed up with Dr. Samson to continue her thyroid treatment.

         Throughout 2011, Dr. Samson continued to treat Plaintiff for the same symptoms and diagnosed her with the same conditions. (240, 244, 250-251, 257, 258, 260-61.) On February 20, 2011, the doctor noted that she was also taking Crestor, which is prescribed to treat high cholesterol, [10] and Benicar, which is prescribed to treat hypertension.[11] (240.) On May 22, 2011, Dr. Samson noted that Plaintiff was experiencing "constant chest pain" which improved when she was sitting but worsened at night, and was also suffering from pain "everywhere" due to arthritis. (244.)

         On May 24, 2011, while continuing to treat Plaintiff, Dr. Samson submitted a Multiple Impairment Questionnaire. (192-99.) Dr. Samson noted Plaintiffs diagnosis of "achalasia" and "arthritis" with "pain in neck / arm / back." (192.) To the extent that the Court can read the handwritten notes, Dr. Samson also noted that her prognosis is "fair not improving, " and that his diagnosis is supported by "multiple upper endoscopies"[12] and "UGI series"[13] (192, 193), but there are no copies of or notations regarding endoscopies or GI series in the Administrative Record. Dr. Samson reported that her symptoms of "chest pain, " "burning pain, " and pain in her "mid sternum, " are "present & consistent, " and occur "daily multiple times, " again, as best as the Court can determine from the handwritten notes. (193, 194.) He ranged her pain level as 9 and her fatigue level as 4. (194.) In an eight-hour day, she can sit only one hour and stand/walk not at all or no more than one hour. (Id.) He does not recommend that she have a job that requires sitting continuously and that she has to get up and move around hourly. (Id.) He also recommended that she not have a job where she has to stand/walk continuously. (195.) She cannot lift or carry any weight. (Id.) She does not have significant limitations in repetitively reaching, handling, fingering, or lifting. (Id.) He further diagnosed that her symptoms would likely increase if she is placed in a competitive work environment, and that her condition would interfere with her ability to keep her neck in a constant position. (196.) He assessed that her pain, fatigue, and other symptoms are constant and severe enough to interfere with her attention and concentration, that her symptoms will last at least 12 months, that emotional factors do contribute to the severity of her symptoms, and, as best as the handwritten notes can be read, described her emotional factors as "severe pain arthritis &, " the rest is illegible. (197.) The doctor does not consider Plaintiff to be a malingerer. (Id.) He estimates that Plaintiff would be absent more than three times a month from work on average as a result of her impairments. (198.)

         Despite these findings, Dr. Samson noted that Plaintiff can tolerate moderate work stress, that he does not think that Plaintiffs impairments would produce "good" and "bad days, " and that Plaintiff will not need to take unscheduled breaks to rest at unpredictable intervals during an eight-hour workday. (197, 198.) There is no record that the ALJ noticed or attempted to resolve what appears to be an inconsistency in Dr. Samson's opinion.

         A few weeks later, on July 10, 2011, Plaintiff complained to Dr. Samson of a sore throat and burning in her throat and on her skin. (250.) The doctor noted that it might be mouth sores. (251.) A July 26, 2011, colonoscopy report revealed internal hemorrhoids. (257.) An August 1, 2011 Echo report appeared normal. (258.) Dr. Samson's last treatment note in the Administrative Record is dated September 4, 2011, when he continued to treat Plaintiff for blood pressure and cholesterol. (260-61.) Plaintiff continued to complain about burning in her tongue. (260.) She also complained of experiencing difficulty swallowing. (Id.) Dr. Samson recommended a GI follow-up in three months and checking on her "labs." (261.) Dr. Samson had also received the results of Plaintiff s blood work between August 15, 2010 and May 22, 2011, all of which were normal. (230, 233, 236, 239, 242-43.)

         B. Dr. Steven Kadish, Plaintiffs Treating Gastroenterologist

         At some point, Dr. Samson referred Plaintiff to Dr. Kadish, a gastroenterologist, who also began treating Plaintiff in 2003. (130.) The Administrative Record contains his treatment notes from January 2010 through July 2011. (262.) In sum, his treatment notes indicate that throughout this period, Dr. Kadish treated Plaintiff for achalasia and dysphagia, [14] which he noted as causing Plaintiff to have difficulty swallowing solids and liquids as well as causing Plaintiff to experience chest pain. Dr. Kadish also treated Plaintiff for arthritis.

         More specifically, on January 20, 2010, Dr. Kadish noted that two attempts at a motility study[15] for Plaintiff were unsuccessful because they had trouble placing the catheter. (203.) He noted that Plaintiffs symptoms had worsened when she stopped taking Nexium (for acid reflux) in preparation for the motility study. (Id.) Her symptoms were sour taste in her mouth, solids and liquids getting stuck because she had trouble swallowing, and pain in her teeth and head. (Id.) Plaintiff can push down the solids with liquids, but then she regurgitates the liquids. (Id.) Plaintiff told Dr. Kadish that since her surgery, she has been able to keep solids down, but liquids continue to cause her difficulty. (Id.) Dr. Kadish recommended that she return to taking Nexium and increased her dosage. Dr. Kadish diagnosed her as "status post a Heller myotomy[16] for achalasia." (Id.) He also noted her blood pressure at 146/96, which is high.[17] (Id.)

         Her March 4, 2010, pathology report appeared normal to Dr. Kadish. (265.) But her motility study on the same date noted "failed swallows and an isobaric or common cavity pressure patterns throughout, " with "limited or no relaxation of the LES .... The LES pressures changed inappropriately and there were inappropriate timed swallows." (266.) The diagnosis again was achalasia. (Id.)

         On April 2, 2010, Dr. Kadish noted Plaintiffs symptoms as "intermittent episodes of chest discomfort that can radiate to her stomach or to her jaw." (209.) He noted that Plaintiff "had undergone a recent extensive GI evaluation including an upper endoscopy as well as a repeat motility study and barium studies, " and noted the results of the motility study. (Id.) He also observed that Plaintiff had "minimal epigastric discomfort, " and was "in no significant distress." (Id.) Although he advised Plaintiff to see Dr. Vohra again, Plaintiff refused because she did not want to have surgery again. (Id.) Dr. Kadish noted that Dr. Vohra had informed him that "there was no surgical intervention but suggested that she follow-up." (Id.) Dr. Kadish gave Plaintiff a trial drug that was not yet approved in the United States, advised her to see Dr. Samson for her chest pains, and to eat small meals and eat and drink at separate times. (210.)

         Handwritten notes at the end of the April 2010 treatment notes indicate that on May 21, 2010, Plaintiff experienced "pain less chest pain-comfortable" and "pain in jaw-when wakes up in AM R forehead (going to Neurologist)." (269.) Dr. Kadish's typed treatment notes for May 21, 2010, diagnose Plaintiff as "status a helimyotomy...." (270.) He also noted that her chest pain is still present but "is markedly diminished with Domperidone." (Id.) However, Dr. Kadish noted, upon examining Plaintiff "she continues to have some discomfort.... Perhaps there is a muscoskeletal component to this. (Id.) In any event, she seems to have improved on the Domperidone and I have increased the Domperidone to 20 mg. (Id.) I have also asked her to have small meals and eat and drink at separate times." (Id.)

         Handwritten notes on Dr. Kadish's May 21, 2010 treatment notes indicate that on July 7, 2010, Plaintiff complained to him that she had been feeling well until two days ago when heaviness in her chest returned, similar to what she had experienced in the past. (271.) These notes indicate that Plaintiff is taking Domperidone three times a day, that she appears well, that there is chest tenderness, that she should increase Domperidone to four times a day and take two Motrin. (Id.) There are no more treatment notes from Dr. Kadish for the rest of 2010.

         On January 12, 2011, approximately a month after Plaintiff had filed for social security benefits, Dr. Kadish continued to treat Plaintiff for chest pain. (238.) After taking Advil for a month, Plaintiffs chest "discomfort" was alleviated. (Id.) But the discomfort returned after she stopped taking Advil, which was preventing Plaintiff from standing for an extended period of time. (Id.) This is the first and only time that difficulty with standing for extended periods of time is mentioned by any of Plaintiff s treating physicians. Plaintiff still experienced difficulty swallowing which would resolve only after she drank water. (Id.) Dr. Kadish's exam indicated "significant for pain" on both sides of her lower ribs and her chest wall. (Id.) He noted that her symptoms were caused by arthritis and motility disorder of her esophagus. (Id.) He recommended Tylenol or Advil for the arthritis and that she continue with Prilosec and Domperidone. (Id.)

         About four months later, on May 24, 2011, Dr. Kadish noted that Plaintiff had a history of "an achalasia repair" and that she was complaining about chest pain that goes to her jaw, and leg pain that is worse when she wakes up in the morning. (248.) The doctor diagnosed that her chest pain "is associated with dysphagia to liquids and solids but can also occur in the absence of eating." (Id.) Dr. Kadish increased Plaintiffs Domperidone intake to four times a day. (Id.) His exam revealed "chest discomfort to palpation, " but otherwise "no significant distress." (Id.) Dr. Kadish continued to diagnose her as "status post surgery for achalasia. She in all likelihood has a component of a continuing motility disorder, which may be contributing to her chest discomfort." (Id.) In addition to seeing a cardiologist, Dr. Kadish recommended that Plaintiff see a rheumatologist. (Id.) On July 26, 2011, Dr. Kadish performed a colonoscopy on Plaintiff that revealed internal hemorrhoids. (257.) There are no treatment notes from Dr. Kadish for the rest of 2011.

         On January 11, 2012, Dr. Kadish provided an Impairment Questionnaire for Gastrointestinal Disorders. (278-83.) The doctor indicated that he began treating Plaintiff on either July 6, 2004 or 2009 (the handwriting is unclear), that he last examined her on January 10, 2012, and that he saw her every few months. (278.) He opined that Plaintiff has achalasia and dysphagia, that she is in pain, that she gets chest pain because of food between a level one and two, and maybe has arthritis, that her experience of these symptoms is frequent, that she cannot tolerate even low stress because of work, that she will have good days and bad days, and is likely to be absent from work more than three times a month. (279-83.) He did not note how many hours, if any, that Plaintiff can sit, stand, and walk in an eight-hour workday, and whether it is medically necessary for her to not sit in a work setting. (281.) He opined that Plaintiff can occasionally lift or carry up to but no more than five pounds. (282.)

         C. Dr. Ellen Braunstein, Plaintiffs Treating Neurologist

         Dr. Braunstein, a neurologist, treated Plaintiff in 2010. On April 29, 2010, Plaintiff complained to Dr. Braunstein about "burning pain" and that her "whole body aches." (217-18.) Dr. Braunstein diagnosed that esophagitis was causing pain on the top of Plaintiff s head. The doctor recommended a brain MRI and EEG, "and a Neurotrax evaluation for cognitive functioning with headaches." She also noted that Plaintiff had a history of thyroid disease, reflux esophagitis, and sciatica.

         In early May 2010, Dr. Braunstein received a report that Plaintiffs MRI results were normal, "MRI brain without contrast" (219-20), as were the results of Plaintiff s EEG. (221.) Later that month, Dr. Braunstein performed a Brief Cognitive Assessment Battery test[18] on Plaintiff which also yielded normal results. (222-225.) On May 18, 2010, Dr. Braunstein noted that Plaintiff is "doing OK, except that every now and then when she gets the reflux esophagitis, she gets the burning sensation up her neck and into her head, " and that the pain in her lower back has returned but is getting better with rest. (295.) Test results dated May 21, 2010, indicated that Dr. Braunstein found Plaintiffs results to be "within normal limits." (297-98.) Test results dated May 25, 2010, noted that Dr. Braunstein found that if Plaintiff were to move her head too quickly, she will experience "oscillopsia (movement of the visual field)." (300.) Dr. Braunstein nonetheless concluded that the results were "within normal limits." (Id.)

         On June 24, 2010, Dr. Braunstein noted that Plaintiff is still experiencing stiffness on the top of her head, but it is also "beginning to feel a little better, " and that the area is tender. (227.) The doctor also found that Plaintiff has "a lot of pain limitation within the cervical region" and "paraspinous muscle spasms ...." (Id.) Dr. Braunstein prescribed Flexeril 10 mg, "a muscle relaxant, "[19] and noted that because of Plaintiff s history with "reflux esophagitis, " she did not prescribe an anti-inflammatory. (Id.) Dr. Braunstein's medical file includes a two-page "Patient Analysis" on Plaintiff that lists the following as "Transaction Description" from April 29, 2010, through June 24, 2010: headaches, "memory disturbance and neuropsychological testing, seizures/convultions, demyelination, vertigo of central origin, and hemisensory loss/paresthesian/numbness/tingling. (288-89.)

         D. Dr. Sheldon Genack, Plaintiffs Examining Otolaryngologist

         Dr. Genack treated Plaintiff only on January 6, 2010. (202.) The doctor noted Plaintiffs history of esophageal spasm, that she underwent laparoscopic fundoplication[20] in 2006, and that she told him that she had had thee sinus surgeries for polyps, the last one in 2001. (Id.) His examination confirmed "prior endoscopic sinus surgery." (Id.) Plaintiff complained to Dr. Genack of experiencing pain over her cheeks and diffuse scalp tenderness for about a month. (Id.) The doctor observed scalp tenderness but found no swelling. (Id.) He recommended autoimmune blood work to determine the cause of the "scalp tenderness, " which he noted may be related to "some autoimmune condition or fibromyalgia ...." (Id.) Dr. Genack suggested that Plaintiff try Prednisone, an anti-inflammatory, [21] beginning at 40 mg "with a taper over eight days." (Id.)

         E. Dr. Lori Cohen, Plaintiffs Examining Oral and Maxillofacial Specialist

         Dr. Cohen, an oral and maxillofacial specialist, also treated Plaintiff only once, on July 19, 2010. (229.) Dr. Cohen noted Plaintiffs symptoms as experiencing a burning sensation in her throat and mouth for the past two weeks, which pain was acute at night while she was in bed. Plaintiff experienced the same symptoms about a year earlier that had resolved itself. (Id.) The doctor asked Plaintiff how Plaintiff addressed her GERD, a digestive disorder, [22] including whether Plaintiff sleeps with her head elevated. (Id.) Dr. Cohen noted that Plaintiff is in Dr. Kadish's care for gastric reflux disease, and that she suffers from spasm of the esophageal sphincter and has had surgery for it. (Id.) Dr. Cohen recommended that Plaintiff alter her eating and sleeping habits, prescribed Xanax (used to treat anxiety disorders, panic disorders, and anxiety caused by depression), [23] and recommended Pepcid AC, an over-the-counter medication used to address heartburn. (Id.)

         F. Dr. Eric Steinberg, Plaintiffs Examining Cardiologist

         Dr. Steinberg, a cardiologist, examined Plaintiff only once, on June 13, 2011, after the Agency rejected her application for benefits. (249.) Dr. Steinberg noted Plaintiffs symptoms as

new onset/progressive right greater than left-sided chest pains that are described as a pressure like sensation and at times can be as intense as 흏. Symptoms are aggravated with touching/pressing over the focal area of discomfort and also when sleeping and lying in a lateral recumbent position. She does describe working for 9 months near the World Trade Center site shortly after 9/11, but has not had any other prior WTC exposure related symptoms ....

(Id.) The doctor noted that Plaintiff had "atypical chest pain syndrome, history of significant esophageal disease and normal cardiac oath from 2002-suspect noncardiac related symptoms (EG/GI/musculosketetal) but will also screen for possible underlying structural cardiovascular component." (Id.) Dr. Steinberg further noted that Plaintiff had received Botox injections and sees Dr. Kadish after undergoing a GI surgical procedure by Dr. Vohra in 2006. (Id.) He recommended an echocardiogram, carotid Doppler, and "exercise nuclear stress test." (Id.) He also encouraged Plaintiff to pursue diet and exercise programs and to see Dr. Kadish for a GI follow-up visit. (Id.)

         G. Dr. Bruce Stein, Plaintiffs Examining Rheumatologist

         Dr. Stein, a specialist in arthritis and rheumatology, examined Plaintiff on January 18, 2012. (304.) Dr. Stein noted Plaintiffs symptoms as chest pain, deep breathing, drying in eyes and mouth, extreme fatigue, headache, muscle pain and stiffness in her right forearm, left forearm, bilateral shoulders and thighs, and that "[t]he condition has existed for 12 months." (Id.) He also noted her history with numbness on her tongue and burning in the back of her throat and tongue. (Id.) Dr. Stein further noted that Plaintiffs "past medication history is significant for hypothyroidism as well as a surgical history on her esophagus." (Id.) He diagnosed Plaintiff with fibromyalgia, [24] dysphasia, and hypothyroidism, and noted that the resulting "muscle pain and fatigue" make her "unable to work at this time and indefinitely." (Id.) This is the earliest treatment note indicating a diagnosis of fibromyalgia, although earlier notes have reflected related symptoms.

         On February 1, 2012, Dr. Stein, provided an Impairment Questionnaire for Fibromyalgia. (306-11.) The doctor noted that Plaintiff suffers from "gastric reflux" and "osteoarthritis, " as best as the handwritten notes can be read, and that her prognosis is "fair." (306.) To the extent that the Court can read the barely-legible handwritten notes listing "the positive clinical findings" and the "location where applicable, " the notations say "pain in upper torso" and "fatigue." (Id.) Dr. Stein further noted that her resulting symptoms are fatigue and joint pain in her spine, chest, shoulders, arms, hands, fingers, hips, legs, ankles, knees, and feet, that Plaintiff has trouble sleeping, that her pain is constant and at a level eight, that she is taking prescribed medications, and that her impairments will last at least 12 months. (307-08.) Dr. Stein noted that she can sit or stand/walk only two hours in an eight-hour day. (309.) He further recommended that Plaintiff not sit continuously in a work setting, that she must sit within 15 minutes, that she can occasionally lift or carry zero to five pounds, and that she cannot tolerate even "low stress" jobs. (Id.) He based this recommendation on the fact that Plaintiff has "pain & fatigue [that] is exacerbated by stress." (310.) Dr. Stein also noted that "anxiety forces flare up of joint pain, " that she will need to take a break every half-an-hour in an eight-hour workday and rest every 15 minutes before returning to work, she will have good and bad days, she will be absent from work more than three times a month, and that the following conditions will limit her at work: psychological, need to avoid wetness, limited vision, need to avoid temperature extremes, no pushing or pulling, need to avoid fumes, gases, humidity, heights, and no kneeling, bending, or stooping. (310-11.)

         H. Dr. Benjamin Levine, Plaintiffs Treating Joint Specialist

         Although Dr. Levine treated Plaintiff on a monthly basis from December 12, 2011, to February 3, 2012 (313), the Administrative Record does not contain any treatment notes from him. The record does contain his Impairment Questionnaire for Fibromyalgia that is dated February 6, 2012. (313-18.)

         In the Questionnaire, Dr. Levine diagnosed Plaintiff with "GERD, esophageal ..., hypothyroidism, and LBP." (313.) Like Dr. Stein, Dr. Levine found that her prognosis is Fair but added that she is "not likely to return to previous functional state." (Id.) As best as the handwritten notes can be read, his "positive clinical findings" are that she has "diffusepain" and "lower back pain." (Id.) The Court cannot read the handwritten notes indicating the "laboratory and diagnostic test results" that support Dr. Levine's diagnosis. (314.) He lists Plaintiffs symptoms as "diffuse pain, " "TMJ, " and "GERD." (Id.) He finds that Plaintiffs impairments are "reasonably consistent" with the physical and emotional impairments that he listed in the Questionnaire. (Id.) Dr. Levine found that pain is constant and in her thoracic spine and chest, as well as her shoulders, arms, hands, fingers, hips, legs, ankles, knees, and feet. (314-15.) He also found that her impairments will last at least 12 months. (315.) Dr. Levine noted that she can sit only one hour in an eight-hour day, and should either not stand or walk or stand or walk for no more than an hour. (316.) Dr. Levine further recommended that Plaintiff not sit continuously in a work setting, that she must move around every 15 minutes, that she can occasionally lift or carry less than five pounds, and can never lift or carry more than five pounds. (316.) He also noted that Plaintiff cannot tolerate even "low stress" jobs because she "needs to move around" and because her joint pain "limits her ability to do physical activities." (316-17.) Dr. Levine found that depression may contribute to the severity of her symptoms and functional limitations. (Id.) He also found that she will need to take a break every 15 minutes in an eight-. hour workday and rest five to ten minutes before returning to work; that she will have good and bad days; that she will be absent from work more than three times a month; and that her work will be limited by requirements that refrain she refrain from any kneeling, bending, or stooping. (317-18.) 2009 is the earliest date that Dr. Levine estimates these symptoms and limitations apply. (318.)

         I. Plaintiff Applies for Benefits in December 2010

         On December 20, 2010, Plaintiff filed applications seeking social security disability insurance ("DIB") and supplemental security income ("SSI") benefits. (105-13.) In her undated Disability Report (124-35), the following conditions are listed as limiting her ability to work: hypertensive cardiovascular disease, hypertension, fibromyalgia, and hypothyroidism. (127.) The following physicians are listed as those with relevant medical records:

• Dr. Steven Kadish, who treated her for "digestive disorders" and "acid reflux" from January 2003 to October 2010 (130);
• Dr. Jonathan Klahr, who treated her for "fibromyalgia" from January 2003 to October 2010 (131); and
• Dr. Israel Samson, who treated her for "hypertension" and "hypothyroidism" from January 2003 to September 2010 (131-32.)

         On January 18, 2011, Plaintiff submitted a Work History Report (155-63) stating that she used to lift less than ten pounds in both jobs, and that as a data entry clerk, she walked for an hour, stood for an hour, sat for three hours, ...

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