United States District Court, E.D. Arkansas
JOE VOLPE, Magistrate Judge.
The following recommended disposition was prepared for U.S. District Judge J. Leon Holmes. A party to this dispute may object to this recommendation in writing. An objection must be specific and state the factual and/or legal basis for the objection. An objection to a factual finding must identify the finding and the evidence supporting the objection. Objections must be filed with the Clerk of the Court no later than 14 days from the date of this recommendation. The objecting party must serve the opposing party with a copy of an objection. Failing to object within 14 days waives the right to appeal questions of fact. If no objections are filed, Judge Holmes may adopt the recommended disposition without independently reviewing the record evidence. An objecting party who seeks to submit new, different, or additional evidence, or to obtain a hearing for that purpose, must address the following matters as part of written objections: (1) why the record before the magistrate judge was inadequate, (2) why the evidence was not presented to the magistrate judge, and (3) details and/or copies of any testimony and/or documents to be proffered at a hearing. Based on this submission, Judge Holmes will determine the need for a hearing.
John William Armstrong seeks judicial review of the denial of his application for disability benefits. The application flowed from injuries sustained in a motor vehicle accident, after Mr. Armstrong fell asleep returning home from work. His vehicle left the road and struck a tree. Mr. Armstrong sustained severe facial injuries. His vision is now impaired.
The Commissioner's decision. After considering the application, the Administrative Law Judge (ALJ) determined Mr. Armstrong has severe impairments - loss of peripheral vision, post traumatic stress disorder (PTSD), adjustment disorder with depressed mood, and borderline intellectual functioning - but he can do some unskilled work. Because a vocational expert identified work within defined parameters,  the ALJ determined that Mr. Armstrong is not disabled and denied the application.
After the Appeals Council denied a request for review, the ALJ's decision became a final decision for judicial review. Mr. Armstrong filed this case to challenge the decision. In reviewing the decision, the Court must determine whether substantial evidence supports the decision and whether the ALJ made a legal error. This recommendation explains why substantial evidence does not support the decision and why the case should be remanded.
Mr. Armstrong's allegations. Mr. Armstrong challenges all aspects of the ALJ's decision. Most of his arguments are based on the limitations immediately following the accident, but his more persuasive arguments are based on the residual effects of his injuries. Mr. Armstrong contends impaired vision and frequent headaches prevent him from working, balance issues and dizziness interfere with walking, and traumatic brain injury causes confusion and memory loss. He contends the ALJ failed to consider the combination of his symptoms. He argues that the ALJ failed to fully and fairly develop the evidence as to mental retardation. For these reasons, he maintains substantial evidence does not support the ALJ's decision.
Applicable legal principles. For substantial evidence to support the decision, a reasonable mind must accept the evidence as adequate to support the ALJ's determination about Mr. Armstrong's ability to work. The ALJ determined that Mr. Armstrong can work at all exertional levels with the following limitations: (1) work that does not require excellent vision, peripheral vision, or reading print smaller than newspaper print; and (2) unskilled, simple, repetitive tasks, without fast pace production requirements, and requiring simple, direct, concrete supervision. The first set of limitations (the vision limitations) responds to impaired vision; the second set (the mental limitations)- responds to intellectual functioning. The question before the Court is whether a reasonable mind would accept the evidence as adequate to show Mr. Armstrong can work with these limitations.
Whether substantial evidence exists. In determining a claimant's ability to work, the ALJ must "establish, by competent medical evidence, the physical and mental activity that the claimant can perform in a work setting, after giving appropriate consideration to all of [his] impairments." A reasonable mind would not accept the evidence in this case as adequate to support the ALJ's determination because the determination does not consider all of Mr. Armstrong's impairments; specifically, the residual effects of traumatic brain injury.
Traumatic brain injury. "Traumatic brain injury...is a physical injury to brain tissue that temporarily or permanently impairs brain function." In addition to multiple facial fractures, Mr. Armstrong sustained traumatic brain injury when he crashed into the tree: a subdural hematoma, an intraparenchymal hematoma, a pneumocephalus, and a hemorrhage in the right suprasellar cistern. Mr. Armstrong was so severely injured that he was unable to breathe on his own. The brain injury prevented surgeons from repairing the fractures.
After being on a ventilator for six days, surgeons performed a tracheostomy and removed the ventilator. Two days later, after the brain injuries stabilized, surgeons repaired the facial fractures using metal hardware. Mr. Armstrong remained hospitalized for seven more days. Two months after the injuries, diagnostic imaging showed no hematoma or hemorrhage.
After brain injury resolves, residual effects can linger for weeks or months; in severe cases, the effects may be permanent. Symptoms include headache, dizziness, double vision, difficulty with coordination and balance, mental confusion, behavior changes, memory loss, cognitive deficits, depression, stuttering, and emotional outbursts. Mr. Armstrong complains about these symptoms. Despite the severity of Mr. Armstrong's injuries and his numerous complaints, the ALJ focused on vision loss and intellectual functioning. Both impairments flow from traumatic brain injury.
Impaired vision. Mr. Armstrong had no vision problems before the accident,  but after the accident, he lacked peripheral vision and he saw double; that is, his eyes were no longer aligned to work together and he saw two images. The ALJ included vision limits in determining Mr. Armstrong's ability to work, ...