Muntz v. Astrue

540 F. Supp. 2d 411, 2008 U.S. Dist. LEXIS 20894, 2008 WL 706790
CourtDistrict Court, W.D. New York
DecidedMarch 17, 2008
Docket6:07-cr-06020
StatusPublished
Cited by20 cases

This text of 540 F. Supp. 2d 411 (Muntz v. Astrue) is published on Counsel Stack Legal Research, covering District Court, W.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Muntz v. Astrue, 540 F. Supp. 2d 411, 2008 U.S. Dist. LEXIS 20894, 2008 WL 706790 (W.D.N.Y. 2008).

Opinion

DECISION AND ORDER

DAVID G. LARIMER, District Judge.

INTRODUCTION

This is an action brought pursuant to 12 U.S.C. §§ 105(g) and 1383(c)(3) to review the final determination of the Commissioner of Social Security (“the Commissioner”) that William K Muntz (“plaintiff’) is not disabled under the Social Security Act (“the Act”) and, therefore, is not entitled to a period of disability and Disability Insurance benefits. The parties have both filed motions for judgment on the pleadings pursuant to Fed.R.Civ.P. 12(c). (Dkts. # 4, # 5).

For the reasons discussed below, plaintiffs motion is granted, the Commissioner’s motion is denied, and the case is remanded for the calculation and payment of benefits.

FACTUAL AND PROCEDURAL BACKGROUND

Plaintiff applied for Social Security Disability benefits on August 25, 2003, alleging disability as of February 4, 2003 due to, inter alia, a back injury. (T. 59-61). At the time of his application, plaintiff was 44 years old. (T. 59). His education includes two years of college without a degree. (T. 79). His past relevant work was as an insurance and investments salesperson from 1987 until February 4, 2003. That work involved meeting with clients at their homes, and carrying a computer. Plaintiff also periodically worked as a Prudential Company manager, responsible for recruiting new sales persons. (T. 256-257).

Plaintiff applied for disability benefits after sustaining back injuries as the result of a fall at work on January 9,2003. (T. 124). Plaintiff attempted to resume work for another month, but found that he was “so spaced out” on the pain medications prescribed for him that it was impossible to responsibly handle the complicated financial matters that his position required. (T. 257). His last day worked was February 4, 2003. (T. 255).

Since his fall, plaintiff has treated continuously with his doctors at the Greece Medical Center, including Dr. Deshmukh, Dr. Lebowitz and Dr. Silberstein. On January 10, 2003, Dr. Deshmukh found that plaintiffs straight leg raising test was positive on the right at 40 degrees, and that plaintiff had decreased strength in his right foot and great toe. Sensory exam was significantly diminished on plaintiffs right side, as was his knee jerk reflex. Sciatica was noted, and Dr. Deshmukh recommended an MRI of plaintiffs lumbar spine. (T. 124).

On January 29, 2003 and May 7, 2003, plaintiff saw Dr. Lebowitz, who opined that plaintiff was temporarily totally disabled and should be referred to neurosurgery. He noted that plaintiff moved slowly, had diminished trunk flexion, a straight leg raising test that was positive at 30 degrees on the right side, and complained that his right leg was periodically “giving out.” (T. 125-127). He diagnosed plaintiff with cervical and lumbar radiculopathy (disorder of the spinal nerve roots) with an L3-L4 disk herniation toward the right side. (T. 186).

On July 8, 2003, plaintiff consulted with Dr. Silberstein and opted not to undergo surgery, concluding that the risks outweighed the potential benefits. Dr. Silber-stein noted plaintiffs low back pain, secondary to lumbar disk herniation and chronic neck pain. (T. 184).

*414 On November 5, 2003, plaintiff was examined by Dr. Yu, a State agency medical consultant. Dr. Yu opined that plaintiff was capable of sedentary work, with certain limitations, illegible on the report. (T. 157).

On January 5, 2004, plaintiff treated with Dr. Lebowitz and reported prickly sensations in his left thigh. He complained that he often dropped things due to numbness in his hands. Plaintiffs hand strength and mobility were found to be diminished. Plaintiff remained on Perco-cet, a narcotic analgesic, for pain. (T. 183)

On January 23, 2004, plaintiff followed up with Dr. Lebowitz, reporting electric-shock-like sensations in his left leg, and pain in his neck, arms and lower back. (R. 182).

On March 23, 2004, plaintiff, now on multiple pain medications including Neu-rontin, Percocet, Ambien, Nortriptyline and Flexeril, continued to complain of leg pain and electricity-like sensations. He reported difficulty with driving more than short distances, or walking, and was beginning to feel depressed. His lower back remained tender, back flexion and straight leg raising were limited, and his leg strength and sensation were diminished. (T. 180-181). Additional medications for depression and pain, Fluoxentine and Oxy-codone, were prescribed. (T. 178-179). Additional visits with Dr. Lebowitz showed plaintiffs condition to be largely unchanged. (T. 176-177, 206).

On August 16, 2004, plaintiff began treating with Dr. Apostol. Dr. Apostol’s objective findings included tenderness over the cervical and upper thoracic spine, diminished deep tendon reflexes in the upper extremities, left hand grasping weakness, and neck and low back pain with meralgia paresthetica (burning or tingling pain along the thigh, caused by nerve entrapment). Dr. Apostol prescribed a back brace, physical therapy and continued medication. (T. 208).

On January 14, 2005, plaintiff presented to Dr. Apostol reporting intensification of the sensations in his right leg and episodes of buckling at the knees from weakness. Dr. Apostol diagnosed a decreased right knee reflex and weakness in the lower extremities, especially on the right side. Plaintiff continued to utilize a cane in order to walk, and Dr. Apostol recommended a back brace for stability. Plaintiff was instructed to use Effexor XR, an antidepressant, and Oxycontin and Percocet. (T. 242).

On April 7, 2005, Dr. Apostol noticed that plaintiff was dragging his right foot, and investigated a possible foot drop diagnosis. On examination, plaintiff had decreased flexion in his right foot and decreased muscle mass, suggestive of having originated as the result of problems with his back and neck. Dr. Apostol suggested an orthopedic brace for plaintiffs right foot, and refitting of his back brace. (T. 230).

On June 23, 2005, having been fitted with an orthotic for the right foot and a back brace, plaintiff reported some improvement in his ambulation, but continued to have pain and intermittent cramping in his lower back, right hand and lower extremities which were not responding well to the usual pain medications, causing difficulty sleeping and accomplishing daily activities. (T. 221, 223). Dr. Apostol suggested increasing plaintiffs Oxycontin and Percocet, and opined that “he continues to be on total disability secondary to his back and neck pains as well as associated foot drop and possibly now also de Quervain’s Tenosynovitis (inflammation of tendons in the wrist) on the right.” (T. 221).

On May 1, 2003, plaintiff was seen by Maureen Mahoney, a physicians’ assistant, for evaluation of his back and right leg *415 pain. Upon examination, plaintiffs right foot, toe and great toe demonstrated weakness, and right knee jerk was diminished.

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Bluebook (online)
540 F. Supp. 2d 411, 2008 U.S. Dist. LEXIS 20894, 2008 WL 706790, Counsel Stack Legal Research, https://law.counselstack.com/opinion/muntz-v-astrue-nywd-2008.