United States District Court, D. New Hampshire
DiCLERICO, Jr., District Judge.
McGowen seeks judicial review, pursuant to 42 U.S.C. §
405(g), of the decision of the Acting Commissioner of the
Social Security Administration, denying her application for
supplemental security income. McGowen moves to reverse and
remand the decision, contending that the Administrative Law
Judge ("ALJ") erred in finding substantial
improvement following a closed period of disability, in
evaluating her treating source opinions, in interpreting raw
medical data for purposes of the residual functional capacity
assessment, and in finding her statements not entirely
credible. The Acting Commissioner moves to affirm.
reviewing the final decision of the Acting Commissioner in a
social security case, the court "is limited to
determining whether the ALJ deployed the proper legal
standards and found facts upon the proper quantum of
evidence." Nguyen v. Chater, 172 F.3d 31, 35
(1st Cir. 1999); accord Seavey v. Barnhart, 276 F.3d
1, 9 (1st Cir. 2001). The court defers to the ALJ's
factual findings as long as they are supported by substantial
evidence. § 405(g). "Substantial evidence is more than a
scintilla. It means such relevant evidence as a reasonable
mind might accept as adequate to support a conclusion."
Astralis Condo. Ass'n v. Sec'y Dep't of
Housing & Urban Dev., 620 F.3d 62, 66 (1st Cir. 2010).
McGowen applied for supplemental security income benefits in
March of 2012 when she was eighteen years old, alleging
disability due to chronic polycystic kidney disease, Type A,
and bipolar disorder. She later amended the onset date of
disability to March 6, 2012. She had completed the eleventh
grade and had no previous work experience.
medical history as presented in the parties' joint
statement of material facts begins in February of 2012 when
she was seen by Mary Gheen, APRN, for follow-up of her
bladder and bowel dysfunction. Nurse Gheen noted that
McGowen's condition caused her to have urinary urgency
and frequency with accidents. She found that the medication
Ditropan, prescribed to calm the bladder, was working well.
days later, McGowen had an appointment with Dr. Sarah Oxnard
to follow-up on her asthma. Dr. Oxnard found that
McGowen's asthma was mild but persistent and caused minor
limitations with activity. In March, her asthma was again
found to be mild but persistent.
early March of 2012, McGowen was hospitalized for a urinary
tract infection. X-rays showed that she had dilation of the
large and small bowels but not an obstruction. A kidney
ultrasound showed multiple cysts in both kidneys and an
Adam Weinstein, McGowen's nephrologist, wrote a statement
about McGowen's condition on March 9, 2012. He stated
that McGowen had polycystic kidney disease with high blood
pressure, urinary tract infections, and cyst infections. She
had developed severely enlarged cystic kidneys with chronic
pain that was sometimes severe to the point of being
went to the hospital on April 20 and April 26, 2012, for
abdominal pain. At the visit on April 26, the attending
physician found that her abdomen was tender and that she
appeared to be in pain. The CT scan of her kidneys showed
2, 2012, Dr. John MacEachran reviewed McGowen's medical
records and completed a physical residual functional capacity
assessment for purposes of her application. Dr. MacEachran
found that McGowen was capable of work at the light
exertional level with postural limitations. He noted that
McGowen was an eighteen year old who had polycystic kidney
disease that caused infrequent pain crises. He concluded that
the pain crises were not sufficiently frequent to preclude
full time work.
saw Dr. Weinstein on May 21, 2012. Dr. Weinstein noted that
she had had a pain flare-up because of a change in her living
situation but that had resolved. On examination, Dr.
Weinstein found some abdominal tenderness and otherwise
normal results. He noted that her right kidney had reduced in
size, both kidneys had cysts, her renal ultrasound was
stable, and her blood pressure was well-controlled. Dr.
Weinstein also found that McGowen no longer needed Dilaudid,
a pain medication.
22, 2012, Sandra Vallery, Ph.D., did a comprehensive
psychological profile of McGowen for Disability Determination
Services. McGowen reported a variety of psychological issues,
including six years of therapy and a diagnosis of bipolar
disorder. On examination, Dr. Vallery found that McGowen was
oriented, had average intelligence and knowledge, had fair to
good memory, and had other normal results. Dr. Vallery found
no evidence of psychosis or suicidal ideation. The results of
the mental status examination show no cognitive impairment.
Dr. Vallery concluded that McGowen could complete several
activities during a day, could pace herself and complete
tasks, could remember short and simple instructions but not
detailed instructions, could maintain attention but had
difficulty with concentration, could maintain attendance, and
could interact appropriately with supervisors.
1, 2012, Dr. Michael Schneider reviewed McGowen's records
and completed a Mental Residual Functional Capacity
Assessment. Dr. Schneider found that McGowen's records
showed she could understand, remember, and carry out short
and simple instructions; concentrate for two-hour periods;
keep a regular schedule; sustain full-time work; and tolerate
routine changes in a work setting.
10, 2012, McGowen went to the emergency room because of
abdominal pain. The examining physician found that she was in
mild to moderate distress, she was tender in the upper left
part of her abdomen, and she had swelling in her feet. A
series of abdominal tests showed a possible partial small
bowel obstruction. Also in July, Community Partners
discontinued her therapy, after she had not been in therapy
for ninety days, and noted her progress.
went to the emergency room on November 1, 2012, after four
days of flank pain. The attending physician found mild
abdominal tenderness and diagnosed renal colic. She saw Dr.
Weinstein on November 14, 2012, who noted that McGowen had
been doing reasonably well until she developed flank pain
during the past month. The renal ultrasound showed that her
kidney had decreased in size but that both kidneys had renal
cysts. McGowen's blood pressure was well controlled.
had an appointment with Priscilla Merrill, APRN, at Lamprey
Health Care, on January 30, 2013. Nurse Merrill found no