Paul v. Social Security Administration

CourtDistrict Court, D. Massachusetts
DecidedFebruary 26, 2021
Docket1:20-cv-10108
StatusUnknown

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

Bluebook
Paul v. Social Security Administration, (D. Mass. 2021).

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF MASSACHUSETTS

_______________________________________ ) VANIA PAUL, ) ) Plaintiff, ) Civil Action No. ) 20-10108-FDS v. ) ) ANDREW SAUL, Commissioner, ) Social Security Administration, ) ) Defendant. ) _______________________________________)

MEMORANDUM AND ORDER ON PLAINTIFF’S MOTION FOR ORDER REVERSING THE COMMISSIONER’S DECISION AND DEFENDANT’S MOTION FOR ORDER AFFIRMING COMMISSIONER’S DECISION

SAYLOR, C.J. This is an appeal from the final decision of the Commissioner of the Social Security Administration denying an application for social security disability insurance (“SSDI”) benefits. Plaintiff Vania Paul alleges that she became disabled on October 23, 2016, after various impairments rendered her unable to work. She submitted medical records indicating that she suffers from various ailments, including back pain and depression. She now disputes the Commissioner’s holding that she is not “disabled” within the meaning of the Social Security Act. Pending before the Court is Paul’s appeal and the Commissioner’s motion to affirm. For the reasons stated below, Paul’s motion to reverse and remand will be denied and the Commissioner’s motion to affirm will be granted. I. Background

The following is a summary of the evidence as stated in the administrative record (“A.R.”) and the parties’ relevant memoranda. A. Education and Occupational History Vania Paul was born on July 10, 1968, and is currently 52 years old. (A.R. 1625). She has a high-school education and has completed some college. (Id. at 1625, 1671). She alleges that her disability began on October 23, 2016, and that she has not engaged in any substantially

gainful activity since the alleged onset date. (Id. at 1617). On July 19, 2017, at the age of 48, she filed an application for disability insurance. (Id. at 1615, 1762-63). Prior to the onset of her disability, Paul worked as a respiratory therapist. (Id. at 1625). A respiratory therapist is listed in the Dictionary of Occupational Titles (“DOT”) as a medium exertion and skilled position with a Specific Vocational Preparation of 6. (Id.). She reported that she has not worked since October 23, 2016. (Id. at 1617). She briefly returned to work after the September 12, 2016 incident that she contends caused her disability, but then left work again on Family and Medical Leave Act (“FMLA”) leave. (Id.). B. Medical History

Prior to the alleged onset of her disability, Paul had a history of back pain but was able to work. (Id. at 1620). Medical records from Dedham Medical Associates indicate that in November 2014, she was being treated for lower-back pain with radiation after a motor-vehicle accident that occurred in July 2014. (Id. at 1620-21). She was being treated with a medication regimen to provide pain relief. (Id. at 1621). The following month, Dr. Qiao Ting Kuang noted that her right-side leg pain was improving with chiropractic treatment. (Id.). An MRI conducted in October 2014 revealed a small right paramedian disc herniation with subtle mass effect on the right SI nerve root around the level of L5-SI. (Id.). That MRI presented similar results to a scan conducted in February 2012. (Id.). In December 2014, Dr. Jennifer Millen examined Paul and recommended that medication as well as injection would be beneficial. (Id.). In January 2015, Paul received a right S1 epidural steroid injection. (Id.). On May 13, 2015, Nurse Practitioner Hazel Dunn reported that Paul had been out of work for several weeks and had tenderness in her lower back. (Id.). Her leg numbness, however, had been resolved with Neurontin, and her dosage of Percocet was decreased. (Id.).

In July 2015, Dr. Kuang examined Paul again and noted that she reported that she was still experiencing pain. (Id.). Her prescription for Naproxen had been changed to Mobic, which helped reduce her use of Percocet. (Id.). Following that appointment, she was instructed to stop taking Percocet and instead take morphine and also Oxycodone as needed. (Id.). On September 12, 2016, the accident occurred that caused her alleged disability. (Id.). Paul had been attempting to sit in a chair but missed and fell to the ground. (Id.). She was treated at the Carney Hospital emergency room for complaints of right lower-back pain radiating down her legs after falling at work. (Id.). There was no head injury or loss of consciousness. (Id.). A musculoskeletal examination revealed that she had a full range of motion and no

deformity with only mild lumbar tenderness. (Id.). Lumbar x-rays were also negative. (Id.). A MRI showed a mild disc bulge at L5-S1 contacting and potentially irritating the bilateral S1 nerve roots in their lateral recesses, along with mild left facet degenerative joint disease that was producing mild left foraminal stenosis and potentially irritating the left L5 nerve root as well. (Id.). After several hours of observation, Paul reported improvement in her condition. (Id.). She had full range of motion, was neurovascularly intact, and her strength was intact. (Id.). She was diagnosed with sciatica, prescribed Percocet, and advised to follow-up with her primary-care physician. (Id.). On September 23, 2016, Dr. Michael Gieger of Neurosurgical Consultants saw Paul for complaints of constant lumbar region pain in the midline and on the right. (Id.). An examination of her upper and lower extremities showed normal inspection and palpation, range of motion, muscle strength, tone, and stability. (Id.). Dr. Gieger diagnosed spondylosis with radiculopathy in the lumbosacral region and right-sided sciatica, and recommended a L5-S1 facet block and transforaminal epidural steroid injection at the right L5-S1 region. (Id. at 1622). Her immediate,

recent, and remote memory appeared normal. (Id.). Her mood and affect were also normal and appropriate for the situation. (Id.). Dr. Gieger did not notice any difficulties with judgment and insight, and her capacity for sustained mental activity and abstract thinking showed no abnormalities. (Id.). At a return visit on November 22, 2016, Paul reported significant pain. (Id.). At a visit on December 23, 2016, she reported walking with a cane. (Id.). On January 11, 2017, Paul was seen by Dr. James Nairus for an independent medical examination. (Id.). During her examination, she reported that she had not received spinal injections to treat her pain, although Dr. Gieger had referred her to a pain specialist. (Id.). She

also stated that she was not currently undergoing active treatment and had not received specific treatment since the work injury in September 2016. (Id.). She was taking Cymbalta for depression and Ultram for pain. (Id.). She reported that she was still experiencing right lower- back pain that radiated on the right from her buttock to her foot. (Id.). After examination, Dr. Nairus noted right paraspinal tenderness. (Id.). Paul would not flex her lumbar spine at the waist when asked. (Id.). She had diffuse weakness with 4/5 strength in all muscle distributions in the right lower extremity that, according to Dr. Nairus, did not appear to fit into any specific nerve root distribution. (Id.). Dr. Nairus also noted possible symptom magnification. (Id.). Paul had normal strength in her left extremities, normal sensation in all dermatomes, and normal symmetric reflexes in both lower legs. (Id.). Dr. Nairus noted she was positive for sciatica in her right leg. (Id.). He diagnosed chronic lower-back pain with lower-extremity radicular symptoms from a degenerative disc and a mild bulge at the level of L5-S1, and recommended lumbar spine injections. (Id.). In January 2017, Dr. Gieger suggested an anterior lumbar interbody fusion. (Id.).

Pending workers compensation approval, he recommended an epidural steroid injection. (Id.). At that time, Paul again reported walking with a cane. (Id.).

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Paul v. Social Security Administration, Counsel Stack Legal Research, https://law.counselstack.com/opinion/paul-v-social-security-administration-mad-2021.