Eschenbrenner v. Kijakazi

CourtDistrict Court, E.D. Missouri
DecidedDecember 18, 2023
Docket4:22-cv-01200
StatusUnknown

This text of Eschenbrenner v. Kijakazi (Eschenbrenner v. Kijakazi) is published on Counsel Stack Legal Research, covering District Court, E.D. Missouri primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Eschenbrenner v. Kijakazi, (E.D. Mo. 2023).

Opinion

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MISSOURI EASTERN DIVISION

MICHELLE ESCHENBRENNER, ) ) Plaintiff, ) ) v. ) No. 4: 22 CV 1200 RLW ) KILOLO KIJAKAZI, ) Commissioner of Social Security, ) ) Defendant. )

MEMORANDUM AND ORDER This action is before the Court for judicial review of the final decision of the defendant Commissioner of Social Security denying the applications of plaintiff Michelle Eschenbrenner for disability insurance benefits (DIB) under Title II of the Social Security Act, and Supplemental Security Income (SSI) under Title XVI of the Act. The Court has reviewed the filings and the administrative record as a whole, which includes the hearing transcript and medical evidence. For the reasons set forth below, the decision of the Commissioner is reversed and remanded.

I. BACKGROUND Plaintiff was born on December 16, 1968, and filed her applications on November 12, 2018. (Tr. 103-04.) She alleged an amended December 15, 2018 onset date when she was 49 years old. (Tr. 39, 103-05.) In her Disability Report, she alleged disability due to scleroderma, an autoimmune disease that causes inflammation and fibrosis (thickening) in the skin and other areas of the body; neuropathy; knee and joint pain and swelling; numbness and tingling in her arms and hands; inflammatory arthritis; fibromyalgia; flexor

tenosynovitis, an inflammation of the protective sheath (synovial membrane) that surround the tendons); and Raynaud’s syndrome, a disorder that causes decreased blood flow to the fingers. (Tr. 305.) Her claims were denied initially, and on reconsideration, and she requested a hearing before an administrative law judge (ALJ). (Tr. 208-09.) On November 18, 2021, following a hearing, the ALJ concluded that plaintiff was not disabled under the Act. (Tr. 10-23.) The Appeals Council denied review. (Tr. 1-6.)

Accordingly, the ALJ’s decision became the final decision of the Commissioner subject to judicial review by this Court under 42 U.S.C. § 405(g). II. ADMINISTRATIVE RECORD The following is a summary of plaintiff’s medical and other history relevant to her appeal.

On November 5, 2018, Plaintiff saw rheumatologist, Farhat Shereen, M.D., reporting generalized pain in her bilateral hands and feet over the past six months and complaining she could not work. Dr. Shereen noted decreased strength in Plaintiff’s upper extremities. He believed she had synovitis, or inflammation of the synovial membrane, although examination of her hands was difficult due to tenderness. Dr. Shereen ordered

diagnostic testing for inflammatory arthritis, inflammatory muscle disease, and connective tissue disease. (Tr. at 378-79.)

- 2 - Plaintiff saw Dr. Sheeran again on December 10, 2018, with reduced strength and tenderness in her bilateral hands. Upon exam, she was able to make about 50-70 percent

of a fist, and she had developed flexion contractures of the metacarpophalangeal (MCP) (large knuckle) joints. She had symptoms of Raynaud’s syndrome in her hands. Dr. Sheeran noted an MRI of Plaintiff’s hands was significant for flexor and extensor tendon tenosynovitis suggestive of inflammatory arthritis. Dr. Sheeran referred Plaintiff to another rheumatologist, Mian Rizwan, M.D., for a second opinion. (Tr. at 370-71, 387-88.) Plaintiff saw Dr. Rizwan on January 3, 2019. She complained of bilateral hand pain.

A musculoskeletal exam revealed Heberden’s node, small bony growths on the joints closest to the fingertips; significant restriction in her range of motion in both hands, and evidence of acrocyanosis, a condition that causes hands or feet to turn bluish, white or gray in color. Dr. Rizwan ordered diagnostic testing and prescribed tramadol, a narcotic pain reliever. (Tr. at 433-40.)

On January 21, 2019, Plaintiff saw Dr. Shereen. On examination, Plaintiff had synovitis in her MCP and PIP joints, moderate to severe pain in her hands, and her skin seemed to be tight. Her feet and lumbar spine were tender, and her upper extremity strength was four out of five. Plaintiff had reduced grip strength and she was able to form a fist to 50 to 70%. She was very reluctant to take a disease-modifying antirheumatic drug

(DMARD), until she saw Dr. Rizwan again in light of possible side effects. (Tr. 381-82.) Plaintiff returned to Dr. Rizwan on January 24, 2019, and reported continued pain and discomfort in her hands, feet, and knees. Examination showed continued acrocyanosis - 3 - and decreased range of motion in her hands. Dr. Rizwan diagnosed scleroderma and prescribed hydroxychloroquine, an anti-rheumatic. (Tr. at 451, 453, 462.)

On March 7, 2019, Plaintiff saw Dr. Rizwan with continued reports of widespread pain. Her hand exam was similar to prior exams, with continued restricted range of motion. Dr. Rizwan added methotrexate, an immunosuppressant, to her regimen. (Tr. at 470, 475.) On April 10, 2019, Plaintiff saw Dr. Rizwan with complaints of numbness in her arms. She was unable to make a firm fist and had diffuse hand swelling. Dr. Rizwan increased Plaintiff’s methotrexate and ordered a nerve conduction test. (Tr. at 483, 492.)

On June 14, 2019, Plaintiff reported she was beginning to feel better after starting on methotrexate. Despite her improvement, she continued to report numbness and tingling in her fingers, as well as ongoing muscle tenderness. A hand exam reflected continued significant restriction in range of motion in her hands. (Tr. at 497-500.) Plaintiff saw Dr. Rizwan on September 5, 2019, for a fracture to her left arm from

a fall. Her hand swelling and stiffness had improved. By December 5, 2019, she was using a sling under orthopedic supervision. She continued to have pain and discomfort in her bilateral wrists and some Heberden’s node. Notes state her “joint swelling had completely resolved” and her range of motion was “pretty much back to normal on most part.” (Tr. 510-16, 523, 525.)

Plaintiff saw Dr. Rizwan for follow up on April 10, 2020, reporting pain in her hands but that she had “improved a lot” since her last visit and that the numbness in her hands

- 4 - was “very mild.” She reported she had run out of some of her medications about two months earlier, and her joint pain had since increased. (Tr. at 626.)

On August 14, 2020, Plaintiff saw Dr. Rizwan. A hand exam indicated she had developed multiple small nodules over her proximal interphalangeal (PIP) (middle knuckle) and distal interphalangeal DIP (fingertip knuckle) joints since her last visit. She denied joint pain or stiffness. On examination, the nodules were not tender, and she had no synovitis. Her strength was five out of five. Dr. Rizwan thought the nodules could be due to her medications, so he discontinued methotrexate, and prescribed leflunomide, a

DMARD, used to treat moderate to severe rheumatoid arthritis. (Tr. at 635-40.) On September 10, 2020, nonexamining State agency consultant, Richard Tipton, M.D., opined that Plaintiff was capable of performing a range of “light” work. He opined she could lift and carry 20 pounds occasionally and 10 pounds frequently, and she could stand, walk, or sit 6 hours in an 8-hour workday. He assessed several postural and

environmental restrictions. As to her hands, Dr. Tipton opined she would be limited to “frequent” reaching laterally and overhead on the left side. She could “occasionally” finger and feel due to Raynaud’s and inflammatory arthritis … so as to not exacerbate her symptoms. (Tr. at 79-84, 95-100, 115-122, 136-143.) Plaintiff saw Dr. Rizwan for follow up on November 11, 2020. She said she felt

like the nodules in her hands were better. She reported she could not tolerate leflunomide because it was causing gastrointestinal side effects. She also reported she had self-

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