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Chua v. Saul

United States District Court, W.D. Arkansas, Fayetteville Division

January 2, 2020

ANDREW M. SAUL, [1] Commissioner Social Security Administration DEFENDANT



         Currently before the Court is the Report and Recommendation ("R&R") (Doc. 13) of the Honorable Erin L. Wiedemann, Chief United States Magistrate Judge for the Western District of Arkansas, filed in this case on October 22, 2019. The Magistrate Judge recommends affirming the Administrative Law Judge's ("ALJ") decision to deny Plaintiff Crista Chua's claim for disability insurance benefits ("DIB") under Title II of the Social Security Act. Ms. Chua filed objections to the R&R (Doc. 14), and the Court has now reviewed the entire case de novo, paying particular attention to those findings or recommendations to which objections were made. See 28 U.S.C. 636(b)(1)(C). For the reasons stated herein, Ms. Chua's objections are overruled, and the R&R is ADOPTED IN ITS ENTIRETY.

         I. BACKGROUND

         Ms. Chua filed her application for DIB on August 4, 2016, alleging an inability to work since June 2, 2016, due to narcolepsy with cataplexy, fibromyalgia, Hashimoto's disease, thoracic outlet syndrome, bilateral carpal tunnel syndrome, osteoarthritis, temporomandibular joint disorder, patella femoral syndrome, chronic headaches, and dizziness. Following an administrative hearing on November 15, 2017, the ALJ determined that Ms. Chua had the following severe impairments: degenerative disc disease of the cervical spine with radiculopathy, asthma, fibromyalgia, and depression. The other impairments claimed by Ms. Chua were not deemed severe. As for the severe impairments, the ALJ concluded that they did not meet or equal the level of severity of any impairment listed in the Listing of Impairments in Appendix I, Subpart P. According to the ALJ, Ms. Chua retained the residual functional capacity ("RFC") to do sedentary work, except that she could perform only simple tasks with simple instructions and could have only incidental contact with the public. With the help of Vocational Expert testimony, the ALJ concluded that there were jobs that existed in significant numbers in the national economy that Ms. Chua could perform, given her functional restrictions.

         In Ms. Chua's objections to the R&R, the first eleven pages are cut and pasted from her appeal brief. See Doc. 14, p. 1 ("Plaintiff re-iterates her arguments made in Plaintiffs Appeal Brief (Doc. 11)."). None of these arguments reference any portion of the R&R. Accordingly, the Court will not treat them as objections that require de novo review. See United States v. Azure, 539 F.3d 904, 909 (8th Cir. 2008) ("Matters referred to a magistrate judge under both sections 636(b)(1) and 636(b)(3) must be reviewed de novo by the district court when a party objects to a magistrate judge's findings." (emphasis added)).

         Beginning on page thirteen of her objections, Ms. Chua critiques specific portions of the R&R, and these will be treated by the Court as proper objections. First, Ms. Chua argues that her tension headaches were improperly deemed "non-severe" by the ALJ. Second, she objects to a finding that she was non-compliant with her doctors' orders. Third, she argues that the ALJ improperly viewed her receipt of unemployment benefits as a "discrediting factor" in her claim for disability. Fourth, she contends that the Magistrate Judge erred in failing to consider the opinion of Catherine Thomas, a vocational rehabilitation counselor with Arkansas Rehabilitation Services. Fifth, Ms. Chua disagrees with the ALJ's finding that she was "laid off' from a recent job; she argues instead that she left the job due to her medical conditions. Sixth, she objects to the ALJ's decision to discount Dr. Shannon Wipf's recommendations noted on a "Treating Physician's Migraine Headache Form." Seventh, Ms. Chua objects to the ALJ's rejection of Dr. Madhu Kalyan's medical opinions noted on a "Physical RFC Questionnaire." Relatedly, Ms. Chua argues that the work restrictions recommended by Drs. Wipf and Kalyan should have been credited by the ALJ in arriving at the appropriate RFC. The Court will address these objections in turn.


         A. Tension Headaches

         The substantial evidence in the record supports the ALJ's finding that Ms. Chua's tension headaches do not qualify as a severe impairment. The most recent evidence in the file on tension headaches was submitted by Ms. Chua's family practice physician, Dr. Wipf. She examined Ms. Chua on November 11, 2016, and on or around the same date, she filled out a form that Ms. Chua gave her entitled "Treating Physician's Migraine Headache Form." (Doc. 9, p. 281). Dr. Wipf struck through the words "Migraine Headache" on the form and wrote in the words "Tension Headache." Id. Ms. Chua then submitted this form in support of her application for social security disability benefits.

         Dr. Wipf's medical notes from November 11, 2016, state that Ms. Chua experiences tension headaches that start at her neck and spread like "a vice" on her head. Id. at p. 503. According Ms. Chua, these headaches last up to 72 hours and occur five days per week. Id. Ms. Chua also told Dr. Wipf that "[t]he headaches do not interfere with her ability to work." Id. When Dr. Wipf performed a physical examination on Ms. Chua, she noticed tenderness "at the C-spine paraspinous muscles and their extension to the musculature of the scalp diffusely." Id. at p. 504. Dr. Wipf offered to refer Ms. Chua to a neurologist to seek specialty treatment to combat the tension headaches, but Ms. Chua refused, citing money concerns. Id. In the end, Dr. Wipf assessed Ms. Chua as having "[c]hronic tension-type headache[s]" but noted that they were "not intractable." Id. at p. 504.

         As the ALJ remarked in his opinion, Ms. Chua's medical history is noticeably devoid of complaints about tension headaches after her November 2016 appointment with Dr. Wipf. For example, Ms. Chua saw Dr. Marat Grigorov, a neurosurgeon, on July 6, 2017, and complained of neck pain, numbness and tingling in her hands, and fatigue in her legs. These symptoms were all listed on Dr. Grigorov's report. He also noted that she had "no headache." (Doc. 9, p. 555). He examined her head and observed that there was "no tenderness or evidence of trauma." Id.

         On August 29, 2017, Ms. Chua again consulted with Dr. Wipf. During that visit, Dr. Wipf made detailed notes and listed many symptoms Ms. Chua had complained of in the past, as well as ones she noted currently. One of the symptoms listed was a "[t]ension-type headache." Id. at p. 564. However, in the "Assessment/Plan" section of Dr. Wipf's notes, the only complaints she addressed were the following: neck pain, hypothyroidism, fibromyalgia, hearing loss, asthma, and osteoarthritis. See Id. at p. 567. Dr. Wipf also prescribed medications for these conditions and gave Ms. Chua specific instructions. Importantly, "headaches" did not appear on the list.

         The Court agrees with the R&R that it is not credible that Ms. Chua suffered disabling tension headaches five days per week, to the degree that they interfered with her ability to work, but that she failed to specifically address this symptom and seek further treatment throughout 2017. Dr. Wipf's treatment notes confirm that the severity of these headaches is alleviated with certain medications, namely Cyclobenzaprine and Ibuprofen. Also, Ms. Chua admitted to Dr. Wipf that the headaches did not prevent her from working. For all these reasons, substantial ...

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