Opinion ID: 2973424
Heading Depth: 3
Heading Rank: 4

Heading: Report of Psychologist Morris (Ph.D.)

Text: At the ALJ’s request, Laura Morris, Ph.D., L.P., examined Kornecky in January 2003 and reviewed her social functioning and daily activities. Morris noted that Kornecky had little interest in social interaction and experienced conflict with her mother and brother. Morris also noted that Kornecky’s daily activities included making beds, washing dishes, cleaning bathrooms, crocheting, doing puzzles and crafts, listening to music, and reading. Morris described Kornecky as polite and pleasant, but nervous and restless; her speech was “copious,” she was difficult to redirect, and she was focused on herself. In tests, Kornecky repeated five digits forward and backward but could not remember items after a delay. She did subtract serial sevens from 100 and completed other calculations correctly, and she was able to identify large cities, famous people, and current events. Morris administered a personality test, which revealed that Kornecky suffered from chronic anxiety, tension, and worry that interfered with general functioning; lacked true assertive qualities and abilities but tended to be argumentative, demanding, and resentful when things did not go her way or when she felt threatened. Morris diagnosed GAD, dysthymic disorder, and personality - 14 - No. 04-2171 Kornecky v. Comm’r of Soc. Sec. disorder8 not-otherwise-specified with borderline and paranoid personality traits. Morris gave Kornecky a GAF score of 52, in the same 50-55 range as McGinnis’s exam two years earlier. Like Fine, Morris opined that Kornecky could understand, remember, and carry out instructions and make simple work-related decisions. Morris stated that Kornecky’s ability to interact appropriately with supervisors and co-workers and respond to routine changes in a work setting was “slightly restricted” and her ability to interact appropriately with the public and respond appropriately to work pressures was “moderately limited.” E. Report of Psychiatrist Lian (M.D.) and Physician’s Assistant Merrill Two months later, in March 2003, psychiatrist T. Lian, M.D., and physician’s assistant Donna Merrill examined Kornecky at the request of her attorney. Kornecky again reported stress related to her living situation. Lian apparently did not ask Kornecky about her daily activities. Lian and Merrill observed that Kornecky was sad and angry, exhibited “slightly pressured” speech and repetitive thoughts, and was defensive and self-centered. Kornecky was appropriately dressed, alert, oriented, and denied hallucinations or delusions. Lian diagnosed major depressive disorder, GAD, and personality disorder. They also could not rule out paranoid personality disorder or organic brain 8 “The essential feature of Dysthymic Disorder is a chronically depressed mood that occurs for most of the day more days than not for at least 2 years (Criterion A). . . . . During periods of depressed mood, at least two of the following additional symptoms are present: poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, and feelings of hopelessness (Criterion B).” DSM-IV-TR at 376-77. Personality disorder is “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.” Id. at 685. - 15 - No. 04-2171 Kornecky v. Comm’r of Soc. Sec. syndrome9 related to an unspecified head injury. Lian gave Kornecky a GAF 46 and recommended that she resume outpatient therapy and consider taking psychotropic medication. After the exam, Lian and Merrill completed a mental RFC assessment, concluding that she was “markedly limited” in seven of twenty areas of mental functioning, namely the ability to: • maintain attention and concentration for extended periods; • complete a normal workday and work week without interruptions from psychologically-based symptoms; • interact appropriately with the public; • accept instructions and respond appropriately to criticism from supervisors; • get along with co-workers and peers; • maintain socially appropriate behavior; • set realistic goals. Merrill commented that Kornecky had significant anxiety, depression and paranoid features, lacked insight into her stressors, had a labile (i.e. widely fluctuating) mood, and “clearly has issues from her past that continue to impede her progress.” F. Testimony of Vocational Expert The ALJ asked vocational expert Tim Shaner to posit someone of Kornecky’s age, education, and work experience who could perform simple, low-stress repetitive work that involved limited contact with the public and with co-workers. Shaner testified that such a person could work as a cleaner, laundry worker, hand-packer, machine operator, and assembler, and the ALJ found that there were over 90,000 such positions in the regional economy. 9 Organic brain syndrome is characterized by “a constellation of behavioral or psychological signs and symptoms including problems with attention, concentration, memory, confusion, anxiety, and depression caused by transient or permanent dysfunction of the brain.” STEDMAN’S at 1762. - 16 - No. 04-2171 Kornecky v. Comm’r of Soc. Sec.