The opinion of the court was delivered by: Paul Barbadoro United States District Judge
Marcia Marie Swanburg seeks judicial review of a decision by the Commissioner of the Social Security Administration ("SSA") denying her applications for disability insurance and supplemental security income benefits. Swanburg contends that the Administrative Law Judge ("ALJ") who considered her application did not adequately assess the medical opinion of Swanburg's treating provider and that the ALJ's assessment of her mental residual functional capacity is not supported by substantial evidence. For the reasons provided below, I grant Swanburg's motion to reverse the Commissioner's decision and remand the case for further administrative proceedings.
Swanburg applied for disability insurance and supplemental security income benefits on December 2, 2008, when she was thirty-three years old. She alleged a disability onset date of September 1, 2008, due to a variety of physical problems, as well as problems with depression, post-traumatic stress disorder (PTSD), mixed personality disorder, and panic attacks. After obtaining her GED, Swanburg completed two years at a community college. Her past work consisted of positions in real estate as a customer service agent, an escrow officer, and a relationship manager at a title company.
Swanburg first reported problems with depression in October 2008. At the time, she was having problems with her teenage sons and her husband had left her. She reported increased suicidal ideation and unhappiness with her living situation. Her doctor diagnosed Swanburg with bipolar disorder, and opined that she also may have borderline personality disorder and complex PTSD. He recommended hospitalization.
Swanburg was hospitalized on October 19, 2008, for suicidal ideation. She had cut herself with a steak knife the day prior to her admission. Her global assessment of functioning (GAF) score upon admission was 30-35.*fn2 She was discharged on October 26, 2008, with a GAF of 50-55.*fn3
Following her discharge, Swanburg's doctor noted that she was doing well on a medication regimen. She experienced some anxiety, but medications helped calm her down. At a follow-up appointment in January 2009, however, Swanburg reported that she had stopped taking two of her medications. Tr. 309. She did not like the way one medication made her feel and did not think the other one was working. Id. She also had not established care with a counselor. She denied feeling suicidal, was alert and oriented, made good eye contact, and answered questions appropriately.
In January 2009, Dr. Thomas Stearns examined Swanburg. Tr. 302. She complained of emotional lability, sleep disturbance, obsessive rumination, anxiety, and fear. She was able to accomplish some daily tasks and to seek support from her grandmother. Dr. Stearns encouraged Swanburg to push herself to engage in daily activities. At a follow-up appointment later that month, Swanburg reported deterioration in her mood and a decline in her ability to engage in daily activities beyond taking care of her children. Tr. 441.
Dr. Richard Root examined Swanburg on April 22, 2009, on behalf of the SSA. He opined that Swanburg was capable of understanding and remembering simple instructions within a supportive work setting; maintaining communication and relationships with very supportive peers, supervisors, and family members; sustaining attention and concentration adequate to do simple tasks; and tolerating stress common to very supportive work settings. Dr. Root opined that Swanburg would have difficulty coping with demanding and emotionally involved relationships; with handling difficult tasks, particularly ones involving levels of emotionality; and with competitive, emotionally demanding settings. Dr. Root recommended that a guardian be appointed to help manage any funds awarded to Swanburg.
On May 8, 2009, Dr. Michael Schneider completed a mental residual functional capacity ("RFC") assessment on behalf of the SSA. Based on his review of Swanburg's records, including Dr. Root's report, Dr. Schneider concluded that Swanburg retained the ability to understand, remember, and carry out short, simple instructions without special supervision. He further concluded that she could maintain adequate attention for such instructions and that she could complete a normal work week in an environment where supervision was not overly critical. Dr. Schneider also found that Swanburg could interact appropriately with peers and supervisors and that she could accommodate changes in a work setting.
In August 2009, Swanburg had an appointment with Margaret Mayer, a licensed clinical social worker. Ms. Mayer opined that Swanburg had a moderate limitation in carrying out activities of daily living, a mild to moderate limitation in her ability to cope with change, and a marked limitation in the area of interpersonal functioning. Ms. Mayer also noted problems with concentration and task completion, as reported by Swanburg. Ms. Mayer assigned a GAF of 48.*fn4
The following month, Swanburg was hospitalized because she had cut herself following an argument with her husband. Subsequently, she went to the emergency room twice with complaints of depression secondary to family issues, unemployment, and monetary problems. During an emergency room examination in October 2009, she was fully alert and oriented. Her mood, affect, thought process, insight, and judgment at that time were normal. She was discharged in good condition. During her November emergency room visit, Swanburg cut herself while at the hospital and had to be placed in restraints. The lacerations were superficial and appeared to have been inflicted to gain attention.
From September 2009 until May 2010, Swanburg received mental health treatment from Dr. Marianne Marsh at Monadnock Family Services. In October 2009, Dr. Marsh completed a bipolar disorder mental health source document. Dr. Marsh stated that Swanburg suffered from severe psychiatric symptoms on a constant basis and opined that Swanburg was "quite disabled" and unable to work. Tr. 490. Specifically, she indicated that Swanburg was severely limited in her ability to deal with work stress, constantly limited in her ability to handle work demands, and constantly limited in her ability to focus, organize, and timely complete work tasks. Id. Dr. Marsh noted that Swanburg was experiencing manic, hypomanic, depressive, and mixed episodes. Id. She opined that ...