United States District Court, E.D. Texas, Sherman Division
MEMORANDUM OPINION AND ORDER
CHRISTINE A. NOWAK, UNITED STATES MAGISTRATE JUDGE
brings this appeal under 42 U.S.C. § 405(g) for judicial
review of the final decision of the Commissioner of Social
Security (“Commissioner”) denying her claim for
disability insurance benefits and supplemental security
income [Dkt. 1]. After reviewing the Briefs submitted by the
Parties, as well as the evidence contained in the
Administrative Record, the Court finds that the
Commissioner's decision should be AFFIRMED.
PROCEDURAL HISTORY OF THE CASE
24, 2013, Karen Factory (“Plaintiff”) filed
applications for disability income benefits
(“DIB”) and supplemental security income
(“SSI”) under Titles II and XVI of the Social
Security Act (“Act”), alleging an onset of
disability date of September 27, 2012 [TR at 208-14].
Plaintiff's application was initially denied by notice,
and again upon reconsideration, after which Plaintiff
requested a hearing before an administrative law judge
(“ALJ”). Id. at 146-152, 161. The ALJ
conducted a hearing on November 5, 2014
(“Hearing”), and heard testimony from Plaintiff,
witness Quentin Salmond and Vocational Expert Donald Anderson
(“Mr. Anderson” or “VE”).
Id. at 63-92. Plaintiff was represented by counsel
at Hearing. Id. On February 17, 2015, the ALJ issued
his decision denying benefits, and found Plaintiff not
disabled at step five of the prescribed sequential evaluation
process (discussed infra). Id. at 45-62. On
August 21, 2015, the Appeals Council denied Plaintiff's
request for review, making the decision of the ALJ the final
decision of the Commissioner. Id. at 1-5.
October 20, 2015, Plaintiff filed her Complaint with this
Court [Dkt. 1]. On April 11, 2016, the Administrative Record
was received from the Social Security Administration
(“SSA”) [Dkt. 8]. On April 14, 2016, this case
was assigned to the undersigned by consent of all Parties for
further proceedings and entry of judgment [Dkt. 11].
Plaintiff filed her Brief on September 14, 2016 [Dkt. 26]. On
November 14, 2016, the Commissioner filed her Brief in
Support of the Commissioner's Decision [Dkt. 28].
STATEMENT OF RELEVANT FACTS
Age, Education, and Work Experience
was born on July 12, 1954, making her fifty-eight years of
age on the date of alleged onset, and sixty on the date of
determination [TR at 208]. Plaintiff completed high school.
Id. at 239-40. Her past relevant work experience is
in medical sales. Id. Plaintiff was a “person
of advanced age” on the date of decision. See
20 C.F.R. § 404.1563(e).
Summary of Relevant Medical Treatment
had dental implant surgery in September 2012. [TR at 308].
Thereafter, Plaintiff complained of “severely increased
pain along the left side of jaw” and reported
experiencing “dull, constant burning” pain and
numbness. Id. On November 8, 2012, Plaintiff
presented with these symptoms to neurologist Shari
Rosen-Schmidt, M.D. Id. It was determined that
Plaintiff was experiencing post-surgical infection requiring
treatment with antibiotics, and one implant was removed after
it was found to have been touching a nerve. Id.
Plaintiff further reported to Dr. Rosen-Schmidt that she had
a recent instance of blurred vision and had increased pain
when talking or chewing. Id. On examination, Dr.
Rosen-Schmidt noted decreased sensation in the fifth cranial
nerve (the trigeminal) with loss of sensation in the V1, V2,
and V3 distributions but no loss of strength or facial
symmetry. Id. at 309. Dr. Rosen-Schmidt assessed
trigeminal neuralgia, prescribed medications, and scheduled
an MRI examination. Id. at 310. On November 13,
2012, Plaintiff continued to complain of pain and Dr.
Rosen-Schmidt conducted a further examination. Id.
at 304. On December 13, 2012, Plaintiff again saw Dr.
Rosen-Schmidt, reporting that “[i]nstead of constant
pain, she has occasional intermittent pain” and
“hasn't had the stabbing headache in a very long
time.” Id. at 301. On March 14, 2013,
Plaintiff saw Dr. Rosen-Schmidt again and reported that she
“had another implant taken out 3 weeks ago, which
helped with her jaw pain tremendously.” Id. at
298. Plaintiff reported still being sensitive to contact on
her jaw, and could not stand contact with cold items.
Id. On examination, Dr. Rosen-Schmidt continued to
observe decreased sensation in the V3 distribution.
Id. at 299. Plaintiff also seemingly ceased using
her prescribed pain medication in this timeframe.
Id. at 300.
underwent physical therapy from April to June 2013, with no
significant changes in her condition. Id. at
315-325. During this time, Plaintiff saw Dr. David Garza for
complaints of depression, crying spells and decreased
concentration. Id. at 358. Plaintiff also complained
of other symptoms such as loss of vision to Dr. Garza and
other medical providers. Id. at 407, 431.
Thereafter, Cary Conaway, Ph.D., performed a psychological
evaluation of Plaintiff. Id. at 329-34. On August
30, 2013, Plaintiff reported to Dr. Conaway that she was in
“constant pain” due to her trigeminal nerve being
severed, and that the pain rendered her unable to focus or
concentrate. Id. at 330. On examination, Dr. Conaway
observed that Plaintiff demonstrated “average
persistence and effort, ” that Plaintiff's
“ability to maintain focus and concentration is not
significantly limited.” Id. at 331-33. The
records further reflect that Plaintiff displayed a
“flatness of affect and limited display of emotion,
” but “no confusion or reduction in
awareness.” Id. at 332-33. Dr. Conaway
diagnosed Adjustment Disorder with Depressed Mood, noting
depression and irritability relating to her current medical
condition. Id. at 334. Plaintiff also saw
psychiatrist Aaron Van Wright, M.D., during this same time
frame, for medication management of her depressive problems.
Id. at 401-03. After trying several different
medications, Plaintiff reported discontinuing her medications
and Dr. Wright recommended Plaintiff return as needed.
Id. at 401-08. In this same vein, Plaintiff saw
Stephanie Jones, M.D., on November 8, 2013, for pain
management follow-up. Id. at 422-23. Plaintiff
reported discontinuing all medications for her depressive
conditions. Id. Then, on November 17, 2014,
Plaintiff saw Padraig O'Suilleabhain, M.D., for pain
complaints, reporting sharp jaw pains “maybe a couple
of times a day, ” but she can also “go a couple
of days without it.” Id. at 450. At this time,
Plaintiff reported taking only Ibuprofen for her pain.
Id. On examination, Dr. O'Suileabhain observed
no facial paralysis or abnormal muscle movements, with
reduced sensitivity in the mandible and increased sensitivity
on her left temple. Id. at 451. Dr.
O'Suileabhain opined that Plaintiff's sensation loss
was unlikely to be corrected, but that Plaintiff might
consider surgical intervention to try to manage her sudden
recurrences of pain. Id.
Hearing, Plaintiff testified extensively regarding her
symptoms and complaints of pain. Plaintiff testified that a
dental accident had completely changed her life, that she
experienced unpredictable, chronic pain in her mouth and that
it felt like “a knife is stuck in [her] lip. [Her]
teeth hurt. [Her] mouth hurts. [Her] neck hurts. [She has]
stabbing, phantom pains that come uncontrollably.”
Id. at 69. Plaintiff testified she also experiences
blurred vision. Id. Plaintiff explained that her
pain is unpredictable, and varies in intensity from day to
day. Id. at 69, 71. Plaintiff stated that her pain
is more intense with rainy or cold weather, and that she
frequently develops headaches from the pain in her mouth.
Id. at 70. Plaintiff went on to explain regarding
the pain in her teeth, “if you have one toothache but
when you have a whole row of teeth hurting you can't, I
can't concentrate for long periods of time.”
Id. at 71. Plaintiff reported that speaking causes
more pain and that nothing can touch her face without severe
pain. By way of example, she explained that her husband
cannot kiss her due to the pain, that the wind touching her
causes pain, and that she cannot sleep at night because even
the bed covers touching her face cause significant pain.
Id. at 70. Plaintiff also reported that her fingers,
hand and neck are often numb. Id. Plaintiff was
specifically asked how often she had pain, to which she
responded “[n]ot every day but most days the pain is
there. . . . On some days I feel ...