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Lawlor v. Berryhill

United States District Court, D. Vermont

April 25, 2017

TRACY LAWLOR, Plaintiff,
v.
NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.

          MEMORANDUM AND ORDER (DOCS. 10, 13)

          Hon. J. Garvan Murtha United States District Judge

         I. Introduction

         Plaintiff Tracy Lawlor (Lawlor) brings this action under 42 U.S.C. § 405(g) of the Social Security Act, requesting review and reversal of the Commissioner of Social Security's (Commissioner) denial of her application for disability insurance benefits. Pending before the Court are Lawlor's motion seeking an order reversing the Commissioner's decision (Doc. 10 (Doc. 10-1 Memorandum)), and the Commissioner's motion seeking an order affirming her decision (Doc. 13). Lawlor filed a reply. (Doc. 16.) For the reasons set forth below, Lawlor's motion to reverse is granted and the Commissioner's motion to affirm is denied.

         II. Background

         A. Procedural

         On June 13, 2012, Lawlor filed an application for disability insurance benefits alleging she became disabled as of January 1, 2008. (A.R. 149-55.) On November 1, 2012, her application was denied, id. at 87-89, and, on March 22, 2013, was denied again on reconsideration, id. at 99-101. Lawlor filed a timely request for an administrative hearing, id. at 103-04, which was held by Administrative Law Judge (“ALJ”) Thomas Merrill on April 14, 2014, id. at 27-56. Lawlor appeared with a representative at the hearing and testified. Id. On July 14, 2014, the ALJ issued a decision concluding Lawlor was not disabled from the alleged disability onset date of January 1, 2008, through the date of the decision. Id. at 11-21. The Appeals Council denied her timely request for review on December 8, 2015, and the ALJ's decision became the final decision of the Commissioner. Id. at 1-3.

         In February 2016, Lawlor timely filed this action. (Docs. 1-3.) She raises four challenges to the ALJ's decision: (1) the ALJ failed to properly consider her fatigue; (2) he failed to make findings regarding the effects of her medications and treatment on her functional abilities; (3) the ALJ erred in his determination of her residual functional capacity (“RFC”); and (4) he erred in evaluating the medical opinions of Dr. Tietz, her treating psychiatrist. (Doc. 10-1.)

         B. Medical History

         Lawlor was born July 23, 1968. (A.R. 149.) She has a high school education (GED), an LNA, and some college. Her past relevant work is as a warehouse worker and LNA. Id. at 31-32. She worked part-time as an LNA from 2008 until June 2012. Id. at 36. In November 2011, Lawlor was diagnosed with hepatitis C.[1] Id. at 37. She alleges disability as a result of anxiety and her hepatitis treatment. Id. at 32-33, 37-40.

         1. Psychiatric Treatment

         Since at least 1998, Lawlor has treated with psychiatrist Judith Tietz, M.D. (A.R. 917.) In February 2000, Lawlor asked Dr. Tietz to hospitalize her. Dr. Tietz assessed major depressive episode, severe, recurrent, without psychotic features, attention deficit disorder, and generalized anxiety disorder. She noted Lawlor's current medications of Ritalin and Klonopin, her prior trials of Prozac, Paxil, Zoloft, Effexor, and Serzone, and prescribed Wellbutrin. Id. at 894.

         In April 2005, Dr. Tietz noted Lawlor had begun working at Maplewood Nursing Home. In July, Lawlor reported she had felt overwhelmed but was doing better and Dr. Tietz provided counseling regarding vocational issues. (A.R. 857-58.) In August, her Ritalin prescription was increased from 5mg to 10mg. Id. at 856-57. In October 2006, Lawlor reported she was doing well but her anxiety was “so bad.” Id. at 851. In April 2008, Lawlor reported her panic was at a low level but had been high three weeks prior, she was not depressed, and restarted taking Ritalin she had discontinued while pregnant. Id. at 848.

         In April 2009, Dr. Tietz noted Lawlor was generally doing well, anxiety was even, and she was working per diem. She thought Lawlor's generalized anxiety disorder (“GAD”) could benefit from a low dose of clonazepam. (A.R. 847.) In February 2010, Lawlor reported she was sober. Id. at 846.

         In January 2011, Dr. Tietz noted she was less anxious though she had an episode of panic, felt fatigued on clonazepam so the dose was lowered, and was prescrbed Xanax. (A.R. 845.) On March 17, Lawlor was very anxious, overwhelmed, and tearful. She had taken more of her clonazepam and ran out early, so Dr. Tietz doubled her Xanax. Dr Tietz's mental status exam noted she was very tearful, upset, agitated, but goal-directed and no evidence of psychosis. She assessed her GAD as “quite severe at this time, as she has pulled the rug out from under herself by stopping the Klonopin.” She directed Lawlor to restart Klonopin. Id. at 843. By March 31, she was feeling better, restarted clonazepam so was less anxious, and continued on Xanax and Ritalin. In May, her anxiety was up. Id. at 843. In July, she called Dr. Tietz reporting she was panicky and had run out of Klonopin because she was taking too much. Id. at 842. In September, she reported she felt overwhelmed at times but was not depressed and had social anxiety. Lawlor cancelled her December appointment. Id. at 381.

         In January 2012, Dr. Tietz noted Lawlor had discontinued taking clonazepam and had been diagnosed with hepatitis C. Her mood was good and GAD stable. (A.R. 381.) In July, Lawlor reported she was very anxious, fearful, and could not leave the house. Dr. Tietz assessed GAD with panic disorder and agoraphobia. Id. at 380. In August, she was anxiously anticipating very bad side effects from her hepatitis treatment and would stay on lorazepam which was working well. Id. at 502. In October, Lawlor reported she was responding to her treatment, was moody but denied feeling depressed, and had increased her lorazepam dose to 8mg per day. Dr. Tietz discussed the risk of this behavior and the importance of using another agent to lower her anxiety. She assessed the irritability may be a mood disorder and instructed she limit her lorazepam to 4mg per day. Id. at 501. In November, Lawlor reported using more lorazepam than prescribed and running out. Id. In December, she denied depression but was very anxious and in excruciating pain. She had lowered interest and was fearful and overwhelmed. Dr. Tietz assessed GAD worsened by hepatitis treatment and mood disorder. Id. at 500.

         In March 2013, Dr. Tietz and Lawlor spoke by phone. Lawlor reported she was not sleeping, was extremely anxious, and felt overwhelmed. The plan was to consider Seroquel. (A.R. 809.) In May, Lawlor reported her anxiety was “sky high, ” Seroquel knocks her out but makes it hard to breathe, she had a short fuse and was agitated. Dr. Tietz noted she had fair judgment and insight, was oriented with intact memory and focused attention and concentration, low mood and unstable, tearful affect. She diagnosed mood disorder, GAD and panic, and noted her anxiety was worsened by hepatitis treatment. Id. at 804-05. In September, Lawlor reported she continued to struggle with sadness and grief following her father's death, her anxiety was high, she did not like to leave the house, and her husband did most of the shopping because of her panic attacks. Dr. Tietz noted psychomotor agitation, fair judgment and insight, was oriented with intact memory and focused attention and concentration, low mood and anxious affect, and was overusing lorazepam and clonazepam. Dr. Tietz added Valium to her prescriptions. Id. at 802-03. In December, Lawlor reported her anxiety had been very high, she used marijuana to lower her anxiety but then does not get out, rarely leaves the house, and was sleeping all day. Dr. Tietz noted she had good judgment and insight, was oriented with intact memory and focused attention and concentration, unstable mood. She diagnosed GAD, ADD, and cannibus abuse, recommended considering medical marijuana, and noted current medications were Valium and Seroquel. Id. at 800-01.

         On February 13, 2014, Dr. Tietz noted Lawlor continued to deal with panic and agoraphobia, rarely leaving the house except for appointments, does not attend to activities of daily living, and spends most of the day in bed. She reported she was easily overwhelmed by people and activity. (A.R. 840.) Dr Tietz noted obesity and hepatitis C, fair judgment and insight, oriented, intact memory, scattered attention and concentration, low mood and tearful affect. She assessed ADD, panic disorder, agoraphobia. Her current medications were Valium, Seroquel and Ritalin. Dr. Tietz noted her lifelong anxiety and panic and that she was very limited in her ability to leave the home. Id. at 840-41. On March 10, 2014, Lawlor reported her anxiety was “sky high.” She does not walk her children to the bus, her husband does all the grocery shopping, and she spends much of her day in bed. ...


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