Fischer v SSA

2014 DNH 227
CourtDistrict Court, D. New Hampshire
DecidedOctober 30, 2014
Docket13-cv-463-PB
StatusPublished
Cited by3 cases

This text of 2014 DNH 227 (Fischer v SSA) is published on Counsel Stack Legal Research, covering District Court, D. New Hampshire primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Fischer v SSA, 2014 DNH 227 (D.N.H. 2014).

Opinion

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE

Gloria Gean Fischer

v. Civil No. 13-cv-00463-PB Opinion No. 2014 DNH 227 Carolyn Colvin, U.S. Social Security Administration, Acting Commissioner

MEMORANDUM AND ORDER

Gloria Gean Fischer seeks judicial review of a ruling by

the Commissioner of the Social Security Administration (“SSA”)

denying her application for Disability Insurance Benefits

(“DIB”). For the reasons I discuss below, I conclude that the

Administrative Law Judge (“ALJ”) erred by failing to consult a

medical advisor before determining that Fischer was not disabled

as of her date last insured. Thus, I vacate the Commissioner’s

decision and remand for further administrative proceedings.

I. BACKGROUND1

A. Relevant Medical and Other Documentary Evidence

Fischer was 41 years old when her insured status expired on

1 Sections A and B of the background section are taken substantially from the parties’ Joint Statement of Material Facts (Doc. No. 10). See L.R. 9.1(b). Minor stylistic and substantive changes have been made, and citations to the administrative transcript have been omitted. March 31, 1998, and she was 56 years old on June 28, 2013, when

the ALJ denied her claim. Fischer has a GED and she previously

worked as a hairdresser, a retail store owner, and an operator

of a small basket-making company.

1. Medical Evidence

On October 1, 1996, Fischer visited the Exeter Hospital

Pain Clinic complaining of increasingly severe left buttock and

left leg pain that began when she was injured after a fall in

June 1996. The pain was worse with standing or sitting, and it

woke her up at night. She also described transient paresthesias2

in L4-5 and S13 distributions. On examination, Fischer had full

range of motion in the lumbar spine,4 tenderness in the spinous

process in T2-T55 and at L4-5, and unusual paraspinal tenderness.

2 Paresthesia is an abnormal touch sensation, such as burning, prickling, or formication, often in the absence of an external stimulus. Dorland’s Illustrated Med. Dictionary (Dorland’s) 1404 (31st Ed. 2007). 3 The symbols L4 and L5 refer to two of the five vertebrae that comprise the lumbar vertebrae, which are the five vertebrae between the thoracic vertebrae and the sacrum, a wedge-shaped bone lodged between the two hip bones. Dorland’s, supra note 2, at 1362, 2079. The symbol S1 refers to one of the five fused sacral vertebrae that form the sacrum. Id. at 1362. 4 The lumbar spine is that portion of the spine comprising the lumbar vertebrae. Dorland’s, supra note 2, at 1774. 5 The symbols T2 and T5 refer to two of the twelve vertebrae that comprise the thoracic vertebrae, which are situated between the She had good flexion and extension of her lower extremities, and

she was able to toe and heel walk. Straight leg raise testing

was positive at 90 degrees on the right and left. An MRI showed

a bulge at L4-5. The attending physician diagnosed Fischer with

sciatica6 secondary to lumbar strain and administered an epidural

steroid injection.7 On January 6, 1998, Fischer underwent an MRI

of her cervical spine to assess neck pain that was radiating to

her left shoulder. The MRI was normal.

Fischer’s insured status expired on March 31, 1998.

In October 1998, Fischer underwent an X-ray of her left hip

and pelvis to rule out a bone abnormality or sacroilitis.8 That

lumbar and cervical vertebrae, giving attachment to the ribs and forming part of the posterior wall of the thorax. They are designated by the symbols T1 through T12. Dorland’s, supra note 2, at 2079. 6 Sciatica is a syndrome characterized by pain radiating from the back into the buttock and into the lower extremity along its posterior or lateral aspect, and most commonly caused by protrusion of a low lumbar intervertebral disk; the term is also used to refer to pain anywhere along the course of the sciatic nerve. Dorland’s, supra note 2, at 1703. 7 “Epidural” means situated upon or outside the dura mater, which is the outermost, toughest, and most fibrous of the three membranes covering the brain and spinal cord. Dorland’s, supra note 2, at 580, 639. 8 Sacroiliitis is inflammation in the sacroiliac joint, which is located between the sacrum (the triangular bone just below the 3 study was also normal.

On March 31, 2004, Fischer visited Dr. Frank Graf,

complaining of poor results from epidural blocks. 9 On

examination, Fischer exhibited marked sensitivity in the sciatic

notch on her left side, and she also had pain on passive range

of motion of the hip joints. Dr. Graf noted that her X-rays and

MRIs did not indicate any hip joint problem or sacroiliac joint

problem, and her MRI of the lumbar spine suggested some

degenerative disc changes with annular bulge but no disc

herniation. 10 He recommended a pelvic examination with her

internist, Dr. Braese, and an appointment with a physical

therapist.

On May 27, 2004, Fischer underwent a physical therapy

evaluation for a questionable diagnosis of piriformis syndrome11.

lumbar vertebrae) and ilium (the expansive superior portion of the hip bone). Dorland’s, supra note 2, at 1362, 1687. 9 An epidural block is regional anesthesia produced by injection of the anesthetic agent into the epidural space. Dorland’s, supra note 2, at 230. 10 Herniation is the abnormal protrusion of an organ or other body structure through a defect or natural opening in a covering, membrane, muscle, or bone. Dorland’s, supra note 2, at 862. 11 Piriformis syndrome is compression of the sciatic nerve by the piriformis muscle, causing pain. The Merck Manual 2635 (18th 4 Under the History section of the report, it was noted that

Fischer had fallen off of a ladder seven years earlier onto her

left hip with a twisting motion as she fell, and she had

experienced problems with her left buttock and leg ever since.

She had been treated with physical therapy, which did not help a

great deal. Fischer complained that over the preceding few days

she felt a constant pain in the left buttock and down into the

lateral aspect of the leg, which she rated at a 7 on a scale of

0-10. While attempting to work out the pain, she had also been

experiencing numbness and tingling in her left arm. She also

noted that she began taking Ambien during the past week because

the pain was making it difficult for her to sleep. The

therapist administered a number of specific low back tests,

including a piriformis test that yielded a “markedly positive”

result on her left side and a straight leg raise that was

positive for left lower back burning.

On August 14, 2004, Fischer underwent an MRI of the lumbar

spine to evaluate complaints of left flank pain that radiated to

the left leg. Fischer then underwent a second MRI of the lumbar

spine on December 15, 2005.

Ed. 2006). 5 On December 7, 2006, Fischer underwent an operation to

implant a dual Octrode lead for a spinal cord stimulation trial.

On September 4, 2009, Fischer’s treating primary care

physician, Dr. Braese, noted that Fischer reported to him that

she had two jobs and was happy and active.

In 2010, Fischer began to regularly visit the Rye

Interventional Spine Medicine seeking treatment for her back,

leg, and foot pain. At these visits, Fischer would usually

complain of a persistent pattern and history of back and left-

sided leg and foot pain that had originated around 1995 and

1996.

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2014 DNH 227, Counsel Stack Legal Research, https://law.counselstack.com/opinion/fischer-v-ssa-nhd-2014.