Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-4_05-cv-04069/USCOURTS-arwd-4_05-cv-04069-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:405 Review of HHS Decision (SSID)

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IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

TEXARKANA DIVISION

BENNETT BRADFORD PLAINTIFF

v. Civil No. 05-4069

COMMISSIONER, SOCIAL SECURITY

ADMINISTRATION DEFENDANT

MEMORANDUM OPINION

Now on this 20th day of March, 2007, comes on for

consideration plaintiff Bennett Bradford's appeal for judicial

review of the decision of the Commissioner of the Social Security

Administration, denying him supplemental security income ("SSI")

benefits under the Social Security Act. 

1. The Court's role upon review of the decision of a Social

Security Administrative Law Judge ("ALJ") is to determine whether

the decision is supported by substantial evidence on the record as

a whole. Ramirez v. Barnhart, 292 F.3d 576 (8th Cir. 2002).

Substantial evidence is less than a preponderance but enough that

a reasonable mind would find it adequate to support a conclusion.

Id. The Court must consider not only the evidence supporting the

ALJ's decision, but also that which fairly detracts from it, and

must affirm if the record -- viewed as a whole -- contains

substantial evidence to support the decision. Id. The Court may

not reverse simply because the record also contains substantial

evidence that would have supported a contrary decision. Haley v.

Massanari, 258 F.3d 742 (8th Cir. 2001). 

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The burden rests on the claimant to prove that he has a

disability, mental or physical, that has lasted -- or can be

expected to last -- at least one year and that prevents him from

engaging in any substantial gainful activity. Pearsall v.

Massanari, 274 F.3d 1211 (8th Cir. 2001).

2. Bradford filed the application for benefits now under

consideration on October 23, 2003. At the time of the hearing

before the ALJ, on April 21, 2005, Bradford was 41 years old. He

had a 10th grade education, and no relevant past work experience,

apparently not having been gainfully employed since about 1990. 

The ALJ recognized that Bradford had been denied on two

previous applications for benefits, and denied an implicit request

to reopen those determinations, but did consider all past medical

evidence to the extent that it had bearing on Bradford's current

claim.

On June 24, 2005, the ALJ issued an unfavorable decision on

Bradford's claim. He found that Bradford has a seizure disorder

and "subjective allegation of shortness of breath with prolonged

heavy exertion," but that these impairments do not meet or

medically equal the impairments listed in Appendix 1, Subpart P,

Regulations No. 4. The ALJ then went on to determine Bradford's

residual functional capacity ("RFC").

The ALJ discredited Bradford's subjective complaints of

exertional and non-exertional impairments of such severity as to

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be disabling. He discredited the testimony of Bradford and his

mother that Bradford experienced seizures despite taking antiseizure medication as prescribed, because the medical evidence

indicated that Bradford did not take his medication as prescribed,

and repeatedly sought treatment for seizures when he had been off

his medication and drinking alcohol. Bradford did not attribute

his failure to take seizure medication to side effects or cost.

The ALJ discredited Bradford's testimony of severe headaches

following seizures because there was little evidence of treatment

for headaches and no physician had suggested a diagnostic workup

for them.

The ALJ also noted that none of Bradford's physicians had

made objective findings indicative of disability, nor had they

restricted him from all gainful activity.

The ALJ found that Bradford is capable of performing a

significant range of light work, which involves lifting no more

than 20 pounds at a time, and frequently lifting or carrying up to

10 pounds, along with "a good deal of walking or standing, or when

it involves sitting most of the time with some pushing and pulling

of arm or leg controls." He then posed a hypothetical question to

a Vocational Expert, asking whether there would be jobs in the

economy for a person of the age and educational level of Bradford,

who could perform light work which does not require climbing,

driving, or working at unprotected heights or near dangerous

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moving machinery. The Vocational Expert responded that such jobs

do exist in significant numbers, to include various assemblers,

production workers, semi-conductor processors, and fabricators.

3. Bradford contends that the ALJ erred in the following

respects:

* in finding his testimony less than fully credible;

* in finding that his only functional limitations were

seizure precautions (not working at unprotected heights

or around dangerous machinery);

* in finding he has the residual functional capacity to

perform a significant range of light work;

* in finding that there are significant numbers of jobs in

the national economy that he can perform; and

* in finding that he is not disabled.

The Commissioner contends that the decision made in

Bradford's case was without error, and should be affirmed.

4. The Administrative Record reflects the following

significant facts:

* On August 3, 1992, Dr. Lowell Harris noted that Bradford

had been seen in the emergency room "with what his

family called a seizure." All test results were within

normal limits, and Dr. Harris was not certain that

Bradford had had a seizure, but he prescribed 100 mg. of

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Dilantin, or phenytoin, is an anti-epileptic drug. Abrupt withdrawal from the 1

drug can precipitate seizures. Alcohol consumption can affect the usefulness of the

drug. Dizziness and headache are recognized adverse reactions. Physicians' Desk

Reference, 1995 Ed.

"A chronic lung disease originating from a soil fungus. 2

"Ictal" means "[r]elating to or caused by a stroke or seizure." Stedman's Medical 3

Dictionary, 28th Ed.

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Dilantin , three a day, divided into morning and evening 1

doses.

* On November 23, 1992, Dr. Harris - finding no medical

basis for Bradford's complaints of abdominal pains and

vomiting - noted that "I really think what he needs to

do is to get on an exercise program and get back to

work. He swears there is no way he can ever work but I

think that is partly in his mind."

* On May 14, 1993, Dr. Harris noted that Bradford

complained of "nonspecific symptoms such as sharp pains

in his head, weakness, poor appetite." X-ray showed

"the old scarring in the upper lungs that probably is

secondary to his blastomycosis that he never did get 2

complete treatment for."

* On May 17, 1993, Bradford was admitted to the hospital

"post seizure with a postictal state," thought to be 3

related to fever. 

* On June 4, 1993, Bradford was hospitalized with severe

headache and fever. He was discharged with a diagnosis

of fungal meningitis. The History and Physical done at

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this admission noted that Bradford "had some seizure

activity in August of 1992 but none since that time

until now." 

* On August 26, 1993, Bradford went to the emergency room

following a seizure, and Dr. Timothy Wilson noted that

he had "stopped taking his medications approximately 3

weeks ago." The diagnosis was "[s]eizure disorder

status post seizure secondary to stopping medication,"

and the plan was to get back on the Dilantin regimen

that Dr. Harris had prescribed.

* On April 17, 1994, Bradford went to the emergency room

complaining of seizures. He told the nurse that he had

had seizures in the past but had never been medicated

for them. The Physician's Assessment noted that

Bradford had had seizures several times in the past,

usually after drinking alcohol. The diagnosis was

seizure activity secondary to acute alcoholism. He was

discharged with the specific instruction "do not drink

alcohol."

* On December 11, 1996, Bradford underwent a physical

examination in connection with an application for Social

Security disability benefits. His alleged impairments

were seizures (once a month) and headaches (following

the seizures). He was taking no medications at the

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time. The examiner's diagnosis was "Grand mal epilepsy

uncontrolled."

* On February 23, 1998, Bradford went to the emergency

room with complaints of epigastric pain of about a

week's duration. Dr. James Forest-Lam noted "a history

of seizures, a history of alcohol, heavy consumption,"

with reported "seizure like activities, which probably

was not a seizure . . . [i]t appeared to be psychogenic

seizure." Bradford reported having a seizure "many

months ago," and having stopped taking anti-seizure

medication "months ago." He was instructed to "abstain

from alcohol use."

* On April 1, 1999, Dr. Joseph Greenspan examined Bradford

for the Texas Rehabilitation Commission, specifically

evaluating "seizures and breathing problems." Bradford

reported "approximately two seizures per month," and

denied "taking or having been prescribed seizure

medication." He was on no medications at that time.

Dr. Greenspan noted Bradford's history of "heavy alcohol

consumption," and assessed his seizures as "probable

withdrawal seizures."

* On October 11, 1999, Bradford was admitted to the

hospital, where Dr. Edward Hord noted a history of

seizure disorder, noncompliance with medications, and "a

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An epileptic ictal phenomenon perceived only by the patient, or a subjective 4

symptom that appears at the onset of a migraine headache. Stedman's Medical Dictionary,

28th Ed.

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history consistent with alcohol abuse." He was "unsure

whether this was a seizure disorder or alcohol

withdrawal." The History and Physical for that

admission noted that Bradford reported two or three

seizures a week which he said were "unrelated to alcohol

consumption," but that he drank "three to four beers a

day as he can afford it." During that hospitalization,

Bradford had an electroencephalogram, which was reported

as normal. He was discharged on Dilantin, 100 mg. twice

a day.

* On October 20, 1999, Dr. Hord noted, during a follow-up

visit from the October 11 hospitalization, that Bradford

had been taking only one 100 mg. Dilantin a day, and had

been having episodes of "aura , which usually precedes 4

his seizures." Dr. Hord suggested he take 300 mg. of

Dilantan daily.

* On November 17, 1999, Bradford consulted Dr. Hord with

the chief complaint "I need my seizure medicines." He

also asked Dr. Hord about applying for Social Security

benefits. Dr. Hord refilled the prescription for

Dilantin, and directed Bradford to the Social Security

office to fill out an application.

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* On February 7, 2000, Dr. Green completed a Treating

Physician's Report For Seizure Disorder. He indicated

that Bradford had two seizures a month, although the

most recent reported seizure had been in December, and

noted that Bradford had started taking Dilantin, 3 times

a day, in October.

* On February 18, 2000, Bradford was seen in the emergency

room after having a seizure. Dr. Malcolm MacHauer noted

that Bradford gave a history of "breakthrough

occasionally despite taking his Dilantin. He is a noncompliant on Dilantin though and felt taking levels of

this would be worthless. He drinks very heavily,

moderate alcohol ingestion on a chronic basis. Doesn't

really believe his seizure is related to his alcoholism.

He hasn't really slowed down his consumption of any

significance." Bradford was intoxicated when he

presented to the hospital, and told the nurse that he

"has not been taking Dilantin." He was discharged with

a prescription for Dilantin, which Dr. MacHauer noted in

the chart "I doubt he will even get filled."

* On August 15, 2000, a chart note at the AHEC clinic

indicated that Bradford had had a seizure a week or so

before, and had been "out of seizure med[ication] &

can't afford it (has been out 'about' 2 mo[nths]." The

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assessment on that visit included non-compliance with

medications and alcohol abuse, and the plan was to

restart Dilantin 300 mg. a day.

* On August 16, 2000, a chart note from an unidentifiable

source indicates that Bradford "came in today to get

assistance [with] his Dilantin. He was under the

impression that he could get his medicine free at this

clinic. . . . I will assist [with patient] medicine as

nec[essary]."

* On August 29, 2000, a chart note indicated that Bradford

was not taking Dilantin, and not having seizures. He

was at the office for a pain in his side. The chart

indicated that Bradford said that he could "get Dilantin

for $12/month but chooses not to."

* On October 24, 2003, Bradford filled out a Disability

Report, in which he indicated that his ability to work

was limited by seizures, lightheadedness, and dizziness,

and that he never knew when these conditions would

occur. Dilantin had been prescribed. In a Disability

Supplemental Interview Outline completed that same day,

Bradford indicated that he suffered from unusual

fatigue, and required a two-hour nap daily. He

indicated that he took Dilantin 100 mg. three times

daily, and that it made him sleepy. He also stated that

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he had pain in his head that would last a "couple

hours," caused by standing a long time. He indicated

that he could stand or walk for three hours before

experiencing pain, and sit for four to six hours.

* In an undated Pain Report, Bradford indicated that he

experienced throbbing pain in his head whenever he had

seizures, lasting two hours or longer. He attributed

this pain either to the seizures themselves, or to

hitting his head when falling during a seizure. He

indicated that he had been taking Dilantin three times

a day, every day, since 1993, with side effects

including dizziness, instability, and that it kept him

from "moving around" at times.

* In an undated Daily Activity Questionnaire, Bradford

indicated that he avoided physical labor or walking long

distances because he never knew when a seizure would

come on, and being hot or tired or moving around a lot

triggered the seizures. 

* On January 16, 2004, Bradford filled out a Statement of

Claimant, in which he indicated that he could not tell

when a seizure was coming on, and when he came to after

a seizure, he would wake up with a "heavy headache,"

dizzy, weak, shaky, and unstable. He indicated that he

had had two seizures in the past month, and that he was

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taking phenytoin and Dilantin.

* On February 5, 2004, Bradford saw Dr. Roshan Sharma on

referral from the Texas Rehabilitation Commission. His

chief complaints were headaches and seizures. Frequency

of seizures was recorded as twice a week in one place,

twice a month in another. Other than that, Bradford

reported that "he had been fine." Bradford gave a

history of seizures since 1993, and "does not know if

there was an initiating factor." He was taking no

medications at the time, stating that he could not

afford them, but also stated that he had no side effects

from any medications. He reported that he was not

drinking alcohol at all, having stopped a year ago. Dr.

Sharma found no functional restrictions, and indicated

that "[p]rognosis and compliance with proper therapy is

good."

* On February 23, 2004, Dr. Walter Buell completed an RFC

evaluation on Bradford, finding no restrictions on his

activity other than seizure precautions.

* On April 21, 2005, Bradford filled out a form indicating

that he was currently taking Dilantin for seizures.

That same day he testified before the ALJ that he had

been taking Dilantin for "[g]ive or take around about

two or three" years, but that he had one or two seizures

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a week in spite of the medication.

* On June 24, 2005, the ALJ issued his unfavorable

decision. Also on June 24, 2005, Bradford was admitted

to the emergency room following a seizure. He had not

taken his Dilantin in four weeks, which he said was due

to inability to pay for it. He also said that he had

had a seizure three weeks ago. He was discharged with

instructions to take Dilantin "as ordered."

* On September 16, 2005, the Appeals Council denied

Bradford's request for review, making the decision of

the ALJ the final decision. This appeal followed.

5. The Court finds no error on the part of the ALJ in

finding Bradford's testimony less than fully credible. Bradford

had told several medical care providers in the past that he had

never been prescribed medication for his seizures - which was

untrue - and testified to the ALJ that he had been on the

medication for only two or three years, when he had actually been

prescribed the medication repeatedly and consistently for some

twelve years. He testified that he had one or two seizures a week

despite being on the medication. This is not consistent with his

history, which is one of hospital visits for seizures following

periods of time when he had not been taking his medication. There

is no question that he did not stay on the Dilantin regimen as

prescribed, and that failure also weighs against his crebidility.

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Guilliams v. Barnhart, 393 F.3d 798, 800 (8th Cir. 2005).

Bradford also gave inconsistent reports about side effects

from the Dilantin, sometimes saying it made him sleepy, sometimes

saying he had no side effects. He testified that his past alcohol

use was "[p]robably around about two cans or three cans a week,

something like that, every other week," when his medical records

indicate heavy alcohol consumption, alcoholism, and the strong

possibility that his seizures were triggered by alcohol. He

testified that no doctor had told him that the seizures were

related to alcohol use, which is not consistent with the medical

records.

The Court defers to the ALJ's credibility evaluation, because

the ALJ is in a better position to evaluate credibility,

Guilliams, supra, and there is certainly substantial evidence in

the record as a whole to support the ALJ's finding that Bradford

is not a credible witness.

6. The Court also finds no error in the ALJ's determination

that Bradford was capable of light work with no functional

limitations except the seizure precautions of not working at

unprotected heights or around dangerous machinery, and that he

could perform a significant range of light work. None of

Bradford's many treating physicians, nor any reviewing physicians,

imposed any work-related limitations on him other than seizure

precautions. Additional limitations could only be based on

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Bradford's testimony, which was not fully credible.

Notwithstanding that, the ALJ did find that Bradford should do no

more than light work, with lifting restrictions consistent with

what Bradford said he could do.

7. Nor did the ALJ err in finding that there are

significant numbers of jobs in the national economy that Bradford

can perform. The ALJ posed a proper hypothetical to a qualified

Vocational Expert, and relied on his testimony in this regard.

8. Finally, the ALJ did not err in finding that Bradford

was not disabled at any relevant time period. While recognizing

that Bradford suffered from seizures, the ALJ also took into

account that Bradford was noncompliant with his seizure

medication, and continued to drink alcohol. Both are factors

known to trigger seizures in susceptible persons. The evidence

strongly suggests that had Bradford quit drinking alcohol and

taken Dilantin as prescribed, he might very well have avoided

seizures altogether, or at least would have reduced their

frequency. The record does not record hospital visits for

seizures at times when Bradford was taking Dilantin. If the

seizures were to stop, the associated headaches and dizziness

would also likely stop. Impairments that are amenable to

treatment are not disabling. Hutton v. Apfel, 175 F.3d 651, 655

(8th Cir. 1999). 

While there are suggestions in the record of other conditions

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which have, in other circumstances with other claimants, been

found disabling (degenerative disc disease, shortness of breath,

fatigue), there is no substantial evidence that any of these

conditions was disabling to this claimant in the time period for

which benefits were sought.

9. For the foregoing reasons, the Court finds that the

decision of the Commissioner in this matter should be affirmed,

and Judgment to that effect will be entered concurrently herewith.

IT IS SO ORDERED.

 /s/ Jimm Larry Hendren 

JIMM LARRY HENDREN

UNITED STATES DISTRICT JUDGE

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