United States District Court, D. Vermont
OPINION AND ORDER
William K. Sessions III District Court Judge.
Ariana Breitmeyer-Schaal brings this action pursuant to 42
U.S.C. § 405(g) of the Social Security Act, requesting
review and remand of the decision of the Commissioner of
Social Security denying her applications for Disability
Insurance Benefits (DIB) and Supplemental Security Income
(SSI). Pending before the Court are Plaintiff's motion to
reverse the Commissioner's decision (ECF No. 17) and the
Commissioner's motion to affirm the same (ECF No. 25).
For the reasons stated below, Plaintiff's motion is
DENIED and the Commissioner's motion is GRANTED.
applied for DIB and SSI on June 1 and June 6, 2011,
respectively. Both applications were denied initially and
upon reconsideration. An ALJ issued an unfavorable decision
on January 16, 2013. The SSA Appeals Council subsequently
declined review, thus rendering the ALJ's decision the
final decision of the SSA Commissioner. Plaintiff is
proceeding in this case pro se.
Plaintiff's Medical History
31, 2008, at the age of 23, Plaintiff underwent Cesarean
section (C-section) surgery. Plaintiff reports that she was
fully functional before the surgery, but had not worked since
2006 because she was attending school. Adhesions resulting
from the C-section have allegedly left her in severe pain and
unable to exert physically. Plaintiff also claims that her
pain impedes her ability to concentrate.
months following her C-section, Plaintiff began developing
radiating pain in the right side of her abdomen. On March 31,
2009, she sought care at the Emergency Room at Stony Brook
Medical Center in New York. On April 23, 2010, after moving
to Vermont, she again sought Emergency Room services because
of her pain. At that time she was prescribed narcotics and
advised to make an appointment with an OB/GYN.
April 27, 2010, Plaintiff met with Dr. Kym Boyman, who became
her treating OB/GYN. Dr. Boyman performed an ultrasound but
was apparently unable to identify the source of the pain,
ruling out a prior ovarian cyst. In September 2010, Plaintiff
required immediate surgery due to an ectopic pregnancy. Dr.
Boyman performed the surgery and discovered multiple
adhesions of the uterus and the abdominal wall. While Dr.
Boyman was able to both photograph and cut through some of
the adhesions, the surgery was ended because Plaintiff began
to suffer blood loss.
a September 27, 2010 post-operative call from Dr.
Boyman's office, Plaintiff reported that she was still
sore. During an October 7, 2010 call, Plaintiff again
reported pain while doing certain activities such as grocery
shopping. Shortly thereafter she reported that she was moving
from one residence to another, and that her incision caused
her pain while she was packing and unpacking her belongings.
a November 2010 post-surgical follow-up, Dr. Boyman suggested
that internal stretching from the adhesions was causing
myofascial pain, meaning that the muscles surrounding the
adhesions were acting in ways that could cause additional
pain. Plaintiff was not taking medication at that time, and
reported feeling well overall.
December 2010, Plaintiff had an initial visit with primary
care physician Dr. Terry Cantlin. During that visit,
Plaintiff mentioned increased lower abdominopelvic
discomfort. A subsequent ultrasound showed a cyst on her
right ovary. In March 2011, Plaintiff visited gynecologist
Beth Vermont, M.D, who noted abdominal tenderness. Dr.
Vermont suggested hormonal therapy to shrink the cyst, but
Plaintiff believed the therapy might aggravate her migraines.
Dr. Vermont also suggested a diagnostic laparoscopy to try to
identify the source of pain.
2011, Plaintiff again complained to Dr. Boyman of significant
pain, at which time Dr. Boyman noted that pelvic pain was
prohibiting Plaintiff from working. Plaintiff applied for
SSDI in June 2011, and Dr. Boyman wrote a letter supporting
the application, stating that Plaintiff was “currently
unable to do any work due to significant pain.” Dr.
Boyman also noted her “hope and expectation that this
will not be a permanent condition.” Plaintiff contends
that Dr. Boyman's notes make clear that any optimism
about possible improvement was based upon the expected
success of physical therapy for the myofascial pain, and that
physical therapy was not expected to address the pain
resulting from the underlying adhesions.
2011, Plaintiff met with gynecologist Dr. Tanya Kalmar.
During that exam, Dr. Kalmar noted that Plaintiff's
abdomen was not tender and that she had no guarding or
rigidity. Plaintiff was also estimated to be 13 weeks
November 2011, state agency physician Dr. Carl Runge reviewed
Plaintiff's medical records. Dr. Runge determined that in
an eight-hour workday, Plaintiff could sit for six hours and
lift and carry up to ten pounds. He saw no limitations in her
ability to use her hands, climb stairs, balance, kneel,
crouch, or crawl. Dr. Runge also opined that Plaintiff would
need to change positions for five minutes every hour to
December 2011, Plaintiff met with gynecologist Dr. Lawrence
Slocki. Dr. Slocki reviewed her medical records, including
the pictures of her adhesions. Although he noted previous
pelvic pain, he reported that Plaintiff did not report having
much pain at that time. Aside from Plaintiff's obesity,
Dr. Slocki concluded that the physical examination was
had another C-Section on March 15, 2012. The operating
physician, Dr. Dina Levin, again removed some of
Plaintiff's adhesions. In April 2012, Plaintiff
complained of abdominal pain and requested a refill of her
oxycodone prescription. Dr. Levin noted that Plaintiff seemed
“awfully well” and that her wound was healing.
Approximately one week later, Plaintiff again complained of
pain, but Dr. Levin did not believe that the pain was from
the adhesions. Dr. Levin suggested physical therapy, and
expressed concern that ...