Phillips v. Astrue

413 F. App'x 878
CourtCourt of Appeals for the Seventh Circuit
DecidedDecember 23, 2010
DocketNo. 10-1898
StatusPublished
Cited by69 cases

This text of 413 F. App'x 878 (Phillips v. Astrue) is published on Counsel Stack Legal Research, covering Court of Appeals for the Seventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Phillips v. Astrue, 413 F. App'x 878 (7th Cir. 2010).

Opinion

ORDER

Marla Phillips applied for disability insurance benefits and supplemental security income, claiming that she was disabled by major depression, borderline personality disorder, and other physical impairments. The Social Security Administration denied her claim, and a magistrate judge, presiding by consent, upheld the agency’s decision. Phillips appeals, arguing primarily that the Administrative Law Judge erred by discounting the opinions of her treating doctors, improperly weighing the evidence of her mental illnesses, and discrediting her testimony. Because we conclude that the ALJ’s decision is not supported by [879]*879substantial evidence, we reverse and remand for further proceedings.

Background

Phillips is 30 years old. At the age of four, her father allegedly molested her and tried to drown her in the bathtub, and since then she has been treated for depression and other mental impairments. She spent five years in counseling as a child, and at the age of ten, she made her first of at least six attempts to commit suicide with drugs or by cutting her wrists. At one point she was hospitalized for six weeks for psychiatric treatment.

Phillips worked beginning at age 15 as a housekeeper, clerk, and certified nurse’s assistant. But by December 2004 her physical and psychiatric impairments had left her unable to work, and she applied for disability benefits. Three times in the 25 months immediately preceding that application, Phillips had been hospitalized for suicidal ideation or attempted suicide.

The first of these incidents was in November 2002 when, at age 22, Phillips was admitted to Harrisburg Medical Center in southern Illinois, complaining of severe depression and suicidal ideation. At the time her Global Assessment of Functioning (“GAF”) score was 20 to 25, indicating serious impairments in her ability to function and a danger that she might hurt herself or others. The severity of her symptoms led the examining psychiatrist to conclude that Phillips, who until this episode had been enrolled in a college nursing program and working as a nursing assistant, would “require an extensive treatment plan” and was “a good candidate for a partial hospitalization program.” The psychiatrist noted that Phillips had been dropped from the nursing program because her depression had led to poor attendance. She also had been fired from her job after a misdemeanor arrest for receiving $1900 in unauthorized food stamps, which she maintained were for her son, who was then two years old and living with her mother. Phillips remained at the hospital for twelve days until doctors found a workable combination and dosage of antipsychotic drugs.

Just ten days after her discharge, however, Phillips was readmitted to Harrisburg following two successive suicide attempts — first overdosing on her antidepressants and then, when that did not work, slashing her wrists. Phillips cried throughout the interview as she told the same psychiatrist who had treated her in November that she had “no desire to do anything,” that she didn’t have any will to live, and that she “just can’t get rid of it.” The psychiatrist observed that Phillips had embraced the view that her situation was hopeless and that eventually she would succeed in killing herself. He recommended that planning be done “to facilitate the patient’s entering a group home or similar kind of arrangement” because her “high degree of suicidality and lethal potential makes her a very difficult case to manage.” Her depression gradually subsided after more adjustments to her medications, and by the time she was discharged after eight days, her GAF score had increased from 20 to 50, still showing that she suffered from serious symptoms.

Then in July 2004, after relocating to Kansas, Phillips was admitted to Mount Carmel Regional Medical Center for severe depression and suicidal ideation. Doctors there noted that Phillips presented with hypersomnolence, refusing to get out of bed for her intake evaluation and declining to participate in any psychological testing or therapy sessions. This led one psychologist to conclude that Phillips “appear[ed] to be treating her hospital stay as more of a vacation than a treatment program.” Her medications were [880]*880adjusted, though, and her condition improved by her discharge eight days later.

In January 2005, following her return to southern Illinois and about a month after she applied for disability benefits, Phillips again was hospitalized at Harrisburg when she attempted to take her life by cutting her wrist. Dr. Aline Gilbert-Johnson, a psychiatrist, noted that Phillips experiences bouts of serious depression a few times a year, each time lasting three weeks to two months. He adjusted her medications, adding Wellbutrin (because “that’s the only antidepressant she hasn’t tried yet”), Ability (used to treat schizophrenia, bipolar disorder, and depression) and Tegretol (for bipolar disorder). Her GAF score on admission had been 30, indicating serious impairments in her ability to function, but this had increased to 70, reflecting mild symptoms, by the time she left.

After her discharge, Phillips continued outpatient treatment with Mohamed Elsamahi, a physician’s assistant at Harrisburg with a Ph.D. in Philosophy, and Dr. Rakesh Chandru, a psychiatrist at the Egyptian Health Department. On February 14, 2005, Phillips reported to Elsamahi that she had insomnia, had been crying when depressed, and was hearing voices. Elsamahi noted in his file that Phillips had “improved 50%” but her affect was still restricted. On that same day Phillips also participated in a “comprehensive mental health assessment” at the Egyptian Health Department. The assessment was completed by Amy Bates, a social worker on staff, but reviewed and signed by Dr. Chandru. Bates concluded that, although Phillips’s ability to care for herself was not impaired by her mental-health issues, she had moderate impairments in social and educational/vocational functioning and a serious impairment related to her “symptom distress.”

On March 5, 2005, Phillips was admitted to Harrisburg because of “homicidal ideation and auditory hallucinations telling her to kill people.” Phillips reported feeling angry and agitated and terrified of the voices she was hearing. She was still taking Wellbutrin, Ability, Trazodone, and Tegretol for her depression, as well as Klonopin for panic attacks, and Atarax for anxiety. Dr. Gilbert-Johnson increased her dose of Ability, and after the adjustment he noted that she “made good improvement.” Her GAF on admission had been 40, indicating a major impairment in several areas of functioning, and before her discharge three days later it had increased to 75, reflecting only transient symptoms or normal reactions to stress.

On March 18, 2005, Dr. David Warshauer, a state-agency clinical psychologist, examined Phillips. Her affect, he reported, was one of “agitated depression,” and she cried while explaining how she “feels that she has failed as a mother” and “has nothing to live for.” He commented that her GAF was 45, indicating a serious impairment in functioning, and opined that her “borderline personality disorder is quite severe.”

In May 2005, Dr. Lionel Hudspeth, a state-agency psychologist, assessed Phillips’s mental residual functional capacity based upon the medical record. Dr. Hudspeth acknowledged her diagnoses of a depressive disorder and a borderline personality disorder characterized by persistent disturbances in mood or affect, intense and unstable interpersonal relationships, and impulsive and damaging behavior.

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