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Squeglia v. Berryhill

United States District Court, D. New Hampshire

February 28, 2017

Annette Squeglia
v.
Nancy A. Berryhill, Acting Commissioner of Social Security[1] Opinion No. 2017 DNH 036

          ORDER

          Joseph DiClerico, Jr., United States District Judge

         Annette Squeglia seeks judicial review, pursuant to 42 U.S.C. § 405(g), of the decision of the Acting Commissioner of Social Security, denying her application for disability insurance benefits under Title II of the Social Security Act, 42 U.S.C. § 423. Squeglia contends that the Administrative Law Judge (“ALJ”) erred in concluding that she was not disabled prior to her last insured date. Squeglia moves to reverse the decision. The Acting Commissioner moves to affirm.

         Standard of Review In 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); see also Fischer v. Colvin, 831 F.3d 31, 34 (1st Cir. 2016). “Substantial evidence is more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Castillo Condo. Ass'n v. U.S. Dep't of Housing & Urban Dev., 821 F.3d 92, 97 (1st Cir. 2016) (internal quotation marks omitted). “[S]ubstantial evidence does not mean either uncontradicted evidence or overwhelming evidence” but instead can be satisfied “even if the record arguably could justify a different conclusion.” Id. (internal quotation marks omitted).

         Background

         Squeglia applied for social security disability insurance benefits in February of 2011, alleging a disability beginning on January 1, 1995, caused by cyclical vomiting syndrome or stomach migraine, panic attacks, anxiety, and nausea. Her last insured date was June 30, 1998. Squeglia was thirty-five years old when her insured period expired. She completed the twelfth grade and had worked as an electronics assembler and solderer and as a waitress.

         Prior to her last insured date, Squeglia went to the emergency room in March of 1998 because of vomiting, abdominal pain, and diarrhea. Tests showed that her amylase level was elevated.[2] She improved while in the emergency room and reported that she was not in pain and felt fine. The abdominal x-ray done during that incident was normal.

         In December of 1998, Squeglia went to the emergency room because of abdominal pain. Squeglia reported a history of abdominal pain, nausea, and vomiting. On examination, Dr. Martinelli found that Squeglia's heartrate and rhythm were normal and her abdomen was not tender when she was examined while distracted. When Squeglia focused on the examination, however, she indicated that her abdomen was tender. The abdominal CT scan suggested pancreatitis but was otherwise normal.

         The next day Squeglia again went to the emergency room for abdominal pain. The examination, abdominal x-ray, and ultrasound were normal. Dr. Martinelli wrote that Squeglia appeared to have acute episodes of pancreatitis but that the presentation was atypical. A test done in January of 1999 to examine the bile ducts confirmed gastritis.

         Squeglia had another episode of pain, nausea, and vomiting in March of 2001. She was diagnosed with gastroenteritis. During an examination in April of 2002, Squeglia reported her prior abdominal pain and elevated amylase level, said she had had no continuing problem, and was taking medication for gastritis without symptoms. On examination, the provider found no acute distress and nothing out of the ordinary.

         On November 16, 2010, Dr. Kuo provided his opinion that Squeglia's symptoms met the criteria for cyclical vomiting syndrome, that her symptoms had increased recently, and that if she took hydromorphone at the onset the symptoms would stop. On June 16, 2011, Dr. Kuo reported that he was treating Squeglia for cyclical vomiting syndrome. In May of 2012, Nurse Practitioner Christoper Shaw provided an opinion that Dr. Kuo signed in which Shaw stated that Squeglia had both chromic abdominal pain syndrome and cyclical vomiting syndrome. Shaw thought it was likely that the illness could have caused Squeglia to miss work in the past and that the illness would continue to interfere with her ability to work.

         Squeglia's application for social security benefits was denied, and she requested a hearing before an administrative judge. The hearing was held on May 15, 2012. Squeglia appeared and testified at the hearing. Dr. Maimon, who is board certified in internal medicine with a subspecialty in gastroenterology, appeared and testified as an independent medical expert.

         Squeglia testified that she stopped working when she became ill with cyclical vomiting syndrome because she required so many bathroom breaks. She said that in 1995 she missed a few days of work each week because of the illness and that in 1998 she missed at least two days of work each month. She said that she was diagnosed with gastritis at Massachusetts General Hospital, where she had exploratory surgery that resulted in removal of her gallbladder and appendix.

         Squeglia also testified that despite medication she was unable to leave her home although she had managed to stay out of the hospital. While she gave details about her current condition, she said she did not remember details about her condition between 1995 and 1998.

         Dr. Maimon reviewed Squeglia's medical records and noted that there was little medical evidence between 1995 and Squeglia's date last insured in 1998. He discussed the medical records and noted that while pancreatitis is a medically determinable impairment, cyclical vomiting syndrome is not. Dr. Maimon said that Squeglia could have had cyclical vomiting syndrome before 1998 based on a 2015 doctor's report and that the medical records suggested a diagnosis of pancreatitis in 1998 and 1999 and irritable bowel syndrome in 2002. Dr. Maimon testified that because the record lacks any elevated lipase levels, it did not support chronic pancreatitis.

         Dr. Maimon found nothing in the record to substantiate Squeglia's claims of frequent illness during the relevant period and noted that it was unclear how often she was sick before 1998. Due to the lack of evidence, Dr. Maimon found it hard to assess Squeglia's residual functional capacity but thought she should not work near hazardous machinery and should be near a bathroom. Because of the lack of evidence prior to 1998, Dr. Maimon said he could only speculate about her residual functional capacity then. Currently, Dr. Maimon thought that Squeglia could work with some lifting, standing, and walking restrictions as long as she was near a bathroom.

         The ALJ found that Squeglia had a severe impairment due to pancreatitis/cyclical vomiting syndrome, which did not meet or equal a listed impairment, including Listing 5.00. The ALJ found that through her last insured date Squeglia had the residual functional capacity to do a full range of work at all exertional levels, as long as she avoided unprotected heights and dangerous machinery and had close proximity to a restroom. Although Squeglia could not perform her past work, the ALJ found that there were other jobs she could do, such as merchandise marker, subassembler, and routing clerk.

         Based on those findings, the ALJ concluded that Squeglia had not been disabled before her last insured date. Squeglia requested review of the ALJ's decision before the Appeals Council. On September 16, 2013, the Appeals Council denied review, ...


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