United States District Court, W.D. North Carolina, Asheville Division
MEMORANDUM OF DECISION AND ORDER
Reidinger, United States District Judge.
MATTER is before the Court on the Plaintiff's
Motion for Summary Judgment [Doc. 10] and the Defendant's
Motion for Summary Judgment [Doc. 14].
Plaintiff Amanda Parlier protectively filed her application
for disability insurance benefits on January 4, 2012,
alleging an onset date of March 1, 2009. [Transcript
(“T.”) 13, 152-53]. The Plaintiff's claim was
denied initially and on reconsideration. [T. 13, 66-95,
100-09]. Upon the Plaintiff's request, a hearing was held
on July 15, 2014, before Administrative Law Judge Kevin F.
Foley (“ALJ Foley”). On August 15, 2014, ALJ
Foley issued a partially favorable decision awarding the
Plaintiff benefits from October 25, 2011 through August 30,
2013, but denying benefits for the period thereafter through
the date of the decision. [T. 9-24]. The Appeals Council
denied the Plaintiff's request for review, thereby making
the ALJ's decision the final decision of the
Commissioner. [T. 1-6]. The Plaintiff has exhausted all
available administrative remedies, and this case is ripe for
review pursuant to 42 U.S.C. § 405(g).
October 26, 2011, the Plaintiff presented to an eye
specialist complaining of pain and lost vision in her right
eye. She was diagnosed with optic neuritis and referred to a
neurologist. [T. 216-18]. On December 1, 2011, the Plaintiff
was seen by neurologist Ryan Conrad, M.D., who noted on
physical examination that the Plaintiff had weakness in her
legs and hips bilaterally and that she complained of
weakness, numbness, pain, dizziness, fatigue, and loss of
vision. Dr. Conrad preliminarily diagnosed the Plaintiff with
multiple sclerosis (“MS”) but noted that such
diagnosis would need to be confirmed. [T. 284-88]. A lumbar
MRI performed on December 7, 2011, showed degenerative disc
disease at ¶ 4-5 and L5-S1. [T. 239]. A lumbar puncture
confirmed her diagnosis of MS. [T. 273]. The Plaintiff was
started on medications for MS, but she continued to complain
of severe fatigue, headaches, night sweats, and nausea while
on medication. [T. 290].
26, 2012, Dr. Conrad noted that the Plaintiff complained of
daily headaches and dizziness in addition to fatigue and
worsening depression. [T. 318]. Objectively, the Plaintiff
was noted to have an ataxic gait and problems with
parasthesias in her legs. [T. 319]. On July 2, 2012, a
residual functional capacity evaluation was performed
indicating that she showed severe pain and gait deviations
and fatigue when walking. [T. 328-29]. It was recommended
that the Plaintiff use a cane when walking due to fatigue,
weakness, and episodes of falling. [T. 329]. In 2013, the
Plaintiff's gait and balance problems continued with
objective signs of the inability to tandem walk, a positive
Romberg test, and falling or veering to the right when
standing and walking. [T. 471-504]. She also continued to
have blurry vision due to optic neuritis. [T. 354-55].
Conrad provided a medical source statement on April 22, 2013,
explaining that the Plaintiff's impairment would prevent
her from sitting, standing, or walking for more than two
hours at a time, and that she would need to take breaks of at
least 15 minutes, every half hour. He further opined that she
would rarely be able to lift up to ten pounds and would miss
more than four days of work per month. [T. 468-70].
August 30, 2013, the last date that the Plaintiff was seen by
Dr. Conrad, it was noted that the Plaintiff still had showed
objective signs of weakness in her legs as well as now in her
arms, along with continued ataxic gait, fatigue, memory loss,
depression, and parasthesias. [T. 473].
October 2013, the Plaintiff lost her Medicaid insurance
coverage. [T. 37]. After losing her insurance, the Plaintiff
was unable to continue treatment with her treating
physicians. On three occasions, however, she sought emergency
treatment for conditions unrelated to MS. On October 8, 2013,
the Plaintiff presented to the emergency room complaining of
painful itching and burning of her neck for three to four
days. She stated that she thought this could have been
shingles, and that the pain was as high as a 10 out of 10.
[T. 515-17]. The list of problems showed the Plaintiff's
MS diagnosis as “confirmed, ” but the physical
examination revolved around her neck pain complaint, and
there was no mention of any tests related to her MS or
relevant functional capacity. [Id.].
February 17, 2014, the Plaintiff presented to the emergency
room with abdominal pain and vomiting persisting for three
days and was diagnosed with a urinary tract infection. [T.
505, 510]. The examination notes indicate that the Plaintiff
reported a history of ovarian cysts, and that her mother had
a history of ovarian cancer, which was her main concern.
[Id.]. Dr. Matthew K. Schwarz, M.D. performed a
urinalysis and a transvaginal pelvic ultrasound. [T. 511].
There was no indication that Dr. Schwarz performed any other
tests that would indicate anything regarding the
Plaintiff's MS. [T. 505-12].
Plaintiff returned for a third emergency room visit on April
8, 2014, complaining of an abscess on her face that was
painful and had been present for three days. [T. 513]. She
also complained of a decrease in vision in her left eye,
which she explained was a symptom of her MS. [Id.].
The Plaintiff was examined by Robert Edward Driver, M.D. On
examination, Dr. Driver noted that the Plaintiff had normal
range of motion and strength and that she was alert and
oriented with no focal neurological deficit observed as well
as cooperative with appropriate mood and affect. Dr. Driver
prescribed her antibiotics for the abscess and advised her to
follow up in 48 hours. [T. 514].
Plaintiff was 30 years old at the time of the ALJ hearing in
July 2014. She obtained a GED and attended one year of
college. [T. 34]. She testified that she was married and had
three children in the home, ages 13, 11, and 9. She last
worked in October 2009. The only other earnings she had after
that time was when she did some babysitting for her
mother-in-law for approximately three months in 2011. [T.
Plaintiff testified that she lost her Medicaid after her
husband obtained a full-time job earning approximately $13.00
per hour. [T. 37-38, 58]. During the time period when the
Plaintiff was covered by Medicaid, she was prescribed a
number of medications, including Ampyra for balance and
walking; Nudexta for PBA; Amantadine for symptoms associated
with multiple sclerosis; as well as another prescribed drug
for chronic fatigue. [T. 51]. The Plaintiff's ...