Opinion ID: 857216
Heading Depth: 2
Heading Rank: 2

Heading: October 26, 2009 Hearing

Text: At the hearing with the ALJ, Pepper testified that she is married without children and the primary caregiver to her disabled husband, who suffers from schizophrenia. She is 5'1 and weighs approximately 170 pounds. She is a high school graduate and received secretarial training at a junior college. She is righthanded and has a driver’s license. The only restriction on her license is that she must wear glasses. Pepper stated that she worked as a unit secretary in surgery at McDonough District Hospital until she quit in 2002. Other employment during her 26 years at the hospital encompassed different tasks and positions but mainly included office clerk, data entry, microfilming, medical records, adult day care, and public relations. The ALJ asked Pepper about her physical impair- ments. Prior to December 31, 2007, Pepper testified that she had diabetes, hypothyroidism, allergies, asthma, angioedema, hives, neurocardiogenic syncope (fainting), bone spurs, arthritis in her lower back and left knee, bulging discs, mitral valve prolapse, a heart murmur, 14 No. 12-2261 aortic valve stenosis, and a hairline fracture in her right foot. Pepper’s counsel stated that Pepper also had hypertension, high cholesterol, diabetes mellitus, migraine headaches, urticaria (hives), crossed eyes, and temporomandibular joint disorder (jaw pain). The ALJ asked Pepper if these conditions affected basic work functions like standing and walking, to which Pepper said yes. Pepper testified that her back makes it difficult for her to sit “[f]or very long periods of time.” She also said that her back causes her difficulty when lifting, carrying, and bending. Then, after Pepper described the doctors she saw for her various physical ailments,3 the ALJ asked Pepper if any of the doctors put specific restrictions on her physical activities. Pepper said Dr. Max Rexroat, her podiatrist, gave her a walking limitation, but she could not provide more detail other than she was supposed to remain off her feet. Pepper also testified to weight gain as a side effect of the medications she took. Pepper was asked about a typical day. Pepper said she gets up at about 8:00 or 8:30 a.m., takes her medications with her breakfast, and gets her husband’s pills together. Pepper then turns her attention to her pets—one 3 Pepper specifically testified that, to help alleviate her symptoms, she received physical therapy through the VA hospital, where she was treated by Dr. Lefler, an internist, about two to three times a month from 1982 until 2003. Pepper also stated that she was referred to Dr. White, an orthopedist, for her knee in 1998, but he did not recommend any treatment. No. 12-2261 15 dog and four cats—from about 8:30 to 9:30. During that time, she feeds her animals and gives her dog his medication. After that, she takes her dog outside to play. She also gets a dog from a neighbor’s house to play with her dog. Pepper said she cleans her cats’ litter box during that time as well. Pepper spends the rest of the morning reading “papers.” Around noon, Pepper prepares lunch, which usually consists of “fix[ed] packaged stuff or TV dinners.” During the afternoon hours, Pepper said she looks at more papers and magazines, talks on the phone with insurance companies, and tries to watch Oprah Winfrey’s television show. While doing this, she stretches her back by bending over two pillows on her bed. She also uses this time to do laundry and visit her mother, who lives approximately 40 minutes away. She drives to see her mother one to three times a month. Around 4:30 p.m., Pepper brings in her pets and prepares dinner for herself and her husband. After dinner, Pepper spends the rest of the evening watching television, looking at more papers, and sorting through some boxes. She goes to bed around midnight. The ALJ asked Pepper more general questions about her daily life. Pepper testified that she can dress herself but has trouble putting on her shoes, pants, and shorts. She is able to manage most of her personal hygiene; however, she cannot wash her hair or clip her toenails because she is unable to bend over in the bathtub. Pepper also testified to being able to grocery shop by herself, though her husband does the household dishes and 16 No. 12-2261 sweeping. Pepper does physical therapy exercises at home. She sees her family every few months at holidays like Thanksgiving and Christmas. Pepper testified that she prefers to go out to eat with friends or family only when given at least a week or two weeks’ notice because she is afraid she might faint from fatigue. Pepper said she fainted approximately five times in 2007. She said her heart stops when she faints, and she worries that the people around her will not know what to do when it happens. When asked if she had any psychological conditions, Pepper said she was diagnosed with depression and possibly post-traumatic stress disorder. She said she does not trust people and would “rather be with [her] animals than people.” Pepper also has a fear of leaving her house because she is afraid of running into former co-workers. She does not belong to any social organizations or a church. Pepper said she received counseling for her psychological conditions during the relevant claim period, which included seeing someone with a Master’s Degree in Counseling about every month for an hour. Pepper said she has trouble concentrating at home because there is always something else to be done. She also has problems sleeping. Pepper was asked about her physical pain. She testified to having pain in her jaw joints, neck, and left lower back. She has trouble eating and chewing because of sharp pains she gets if she eats something chewy or opens her mouth too wide. She has neck pain on her left side that radiates into her armpit, elbow, and No. 12-2261 17 fingers. This pain occurs when she does certain things like sitting at the computer too long or lifting heavy boxes. Pepper experiences back pain or muscle spasms when she bends over or engages in a lot of activity. She also has trouble kneeling. Heat, ice, medications, and injections provide temporary relief. Pepper testified that she can lift a 17-pound bag of dog or cat food but tries not to lift more than 20 pounds. Prior to 2007, Pepper estimated that, during an eighthour day, she could walk one mile in 30 minutes, three times a day; stand for 15 minutes every hour; and sit for an hour and a half, three times a day. She would rather sit than stand, however, and walking on uneven surfaces bothers her back and knee. Pepper has trouble reaching the pedals in her car because of her height, but she said she can drive the car and operate the steering wheel without any problems—the limited range of motion in her neck makes it difficult to see traffic on her left side, but the condition has not caused a traffic accident. Pepper said her vision requires her to have a computer monitor “real close” to her so she can see it, and her neck requires it to be positioned to her right. She also has migraines two to three times a month, which cause “vomiting, nausea and troubles with sound and . . . bright lights.” Pepper said medicine makes them go away, but that “[i]t usually takes the day and sometimes into the next day.” Pepper testified that her migraines and depression would cause her to miss work more than three days a month. Pepper also testified that she could 18 No. 12-2261 not do any of her former jobs because she was “mentally, emotionally, and physically exhausted” prior to 2007. The ALJ questioned Frank Mendrick, a vocational expert (VE), at the end of the hearing. The ALJ asked the VE, hypothetically, whether Pepper would be able to perform any jobs if he found Pepper’s testimony fully credible and all the impairments were supported by the medical evidence. The VE said no because Pepper claimed she would have to miss more than three days of work per month and that number is beyond what is normally provided to an employee. Pepper’s counsel did not ask the VE any additional questions.