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Bell v. Berryhill

United States District Court, W.D. New York

January 9, 2018

NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.

          DECISION AND ORDER [1]


         On March 4, 2016, the plaintiff, Tracey Ann Bell, brought this action under the Social Security Act (“the Act”). She seeks review of the decision of the Acting Commissioner of Social Security (“the Commissioner”) that she was not disabled within the meaning of the Act. Docket Item 1; Tr. 18-25. On October 26, 2016, this Court referred this case to United States Magistrate Judge Michael J. Roemer. Docket Item 7. On September 30, 2016, Bell moved for judgment on the pleadings, Docket Item 6, and on December 12, 2016, the Commissioner responded and cross moved for judgment on the pleadings, Docket Item 9.

         On October 25, 2017, Judge Roemer issued a Report and Recommendation (“R&R”) finding that Bell's motion for judgment on the pleadings should be denied and that the Commissioner's cross motion for judgment on the pleadings should be granted. Docket Item 12. On November 8, 2017, Bell objected to the R&R. Docket Item 13. The Commissioner did not file a response to Bell's objection. Oral argument was held on January 3, 2018, and this Court reserved decision. Docket Item 18. For the reasons stated below, this Court adopts the R&R, denies Bell's motion, and grants the Commissioner's cross motion.



         On August 22, 2012, Bell applied for Social Security Disability Insurance benefits (“SSDI”). Tr. 127-28.[2] She claimed that she had been disabled since August 2011 due to chronic immune thrombocytopenic purpura, chronic iron deficiency, back and sciatic nerve injury, knee injury, confusion, some memory loss, and uneven gait. Tr. 139. On November 15, 2012, Bell received notice that her application was denied because she was not disabled under the Act. Tr. 79. She requested a hearing before an administrative law judge (“ALJ”), Tr. 86-87, which was held on February 6, 2014, Tr. 30. The ALJ then issued a decision on April 11, 2014, confirming the finding that Bell was not disabled under the Act. Tr. 29. Bell appealed the ALJ's decision, but her appeal was denied, and the decision then became final. Tr. 1. On March 4, 2016, Bell filed this action, asking this Court to review the ALJ's decision. Docket Item 1.


         Although this Court adopts Judge Roemer's excellent recitation of the evidence, it provides the following summary to focus on the medical evidence most relevant to Bell's objections. Bell was examined by several medical providers, but three are of particular significance to the claim of mental impairment at issue here-Gregory Fabiano, Ph.D.; J. Echevarria, M.D.; and Bela Ajtai, M.D.

         On October 23, 2012, Dr. Fabiano conducted a psychiatric evaluation of Bell. Tr. 244. He noted that Bell denied any symptoms of depression, anxiety, mania, or other thought disorders, but that she did complain of memory-related problems. Tr. 245. Dr. Fabiano observed her demeanor, appearance, thought process, and memory; he found that she was responsive to questions, that she was cooperative, and that her memory seemed intact. Tr. 245-46. He concluded that “the results of the examination do not appear to be consistent with psychiatric problems that would be significant enough to interfere” with daily functioning. Tr. 247.

         Two weeks later, on November 7, 2012, Dr. Echevarria, a state agency physician, reviewed Bell's medical records and completed the standard psychiatric review technique form. Tr. 271. Relying on Dr. Fabiano's evaluation, the lack of any psychiatric hospitalizations, and the absence of any psychiatric-related treatments, Dr. Echevarria found that Bell had no medically-determinable impairment. Tr. 283.

         Finally, in May 2013 at the request of Bell's treating primary care physician, Tr. 372, Dr. Ajtai conducted a neurological review. He evaluated Bell's cognitive functioning and memory loss based on her self-reported symptoms. Id. At the initial consultation on May 8, Dr. Ajtai noted that Bell had some delayed-recall difficulties, and he ordered an MRI to rule out cerebral volume loss, microbleeds, and lesions. Tr. 374. But after reviewing the MRI, Dr. Ajtai found that it was a “[n]ormal MRI scan of the brain.” Tr. 371. Dr. Ajtai did note the “[p]rominence of the Meckel's cave bilaterally, ” but he also noted that this may simply be an anatomical variant, Tr. 371, and referred to this finding as “incidental[].” Tr. 376. After Bell's follow-up visit on June 10, 2013, Dr. Ajtai reported that he “could not find any obvious progressive cause” of the memory loss, Tr. 376, and he recommended “regular brain exercises” and “vitamin supplementations” for any lingering cognitive difficulties, Tr. 378. He also recommended a follow-up MRI with contrast media, Tr. 378, but there is no evidence in the record that Bell ever had that test done.


         In denying Bell's application for SSDI, the ALJ analyzed her claim under the Social Security Administration's five-step evaluation process for disability determinations. See 20 C.F.R. Section 404.1520. The ALJ found that Bell had the following severe impairments: degenerative disc disease of the lumbar spine; obesity; chronic immune thrombocytopenic purpura with low platelet count; and a history of seizure disorder. Tr. 20. Notably, Bell's claimed memory loss and cognitive dysfunction were not included on the list. Id. Because the ALJ found Bell's severe impairments not to be medically equal to the impairments in Appendix 1 of the Commissioner's regulations, the ALJ analyzed Bell's residual functioning capacity (RFC).

         As part of the RFC, the ALJ considered Bell's subjective mental symptoms, the various medical opinions, the MRI results, and Bell's life activities. Tr. 21-24. The ALJ noted that the neurological testing showed a delayed response but that the MRI and objective testing were negative. Tr. 24. The ALJ also found that the psychiatric evaluations did not evidence any issue with attention, concentration, or memory. Id. Although the ALJ found that Bell had some severe impairments as noted ...

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