STANLEY A. BOONE, Magistrate Judge.
Teresa Marie Shaban ("Plaintiff") seeks judicial review of a final decision of the Commissioner of Social Security ("Commissioner" or "Defendant") denying her application for disability benefits pursuant to the Social Security Act. The matter is currently before the Court on the parties' briefs, which were submitted, without oral argument, to Magistrate Judge Stanley A. Boone.
Plaintiff suffers from hiatal hernia, hypothyroidism, restless leg syndrome, migraine headaches, Vitamin B-12 deficiency, irritable bowel syndrome, asthma, tendonitis of the right wrist, degeneration of the triangular fibrocartilage of the right wrist, and carpal tunnel syndrome ("CTS"). For the reasons set forth below, Plaintiff's Social Security appeal shall be granted.
Plaintiff protectively filed an application for a period of disability and disability insurance benefits on November 23, 2015, and a Title XVI application for supplemental security income on August 1, 2016. (AR 84.) Plaintiff's applications were initially denied on February 3, 2016, and denied upon reconsideration on March 23, 2016. (AR 99-102, 104-108.) Plaintiff requested and received a hearing before Administrative Law Judge Scot Septer ("the ALJ"). Plaintiff appeared for a hearing on November 16, 2017. (AR 32-74.) On April 23, 2018, the ALJ found that Plaintiff was not disabled. (AR 7-20.) The Appeals Council denied Plaintiff's request for review on November 28, 2018. (AR 1-3.)
Plaintiff appeared and testified at the November 16, 2017 hearing with counsel. (AR 38-63.) Plaintiff lives in a house with her husband and adult son. (AR 39.) They both work and her son is a full-time student. (AR 39.) Her husband is self-employed with a pest control business. (AR 39.) Plaintiff is 5' 3" tall and weighs about 130 pounds. (AR 39.) Over the previous twelve months her weight was as high as 150 pounds. (AR 40.) She has lost some weight because her stomach problems make it difficult for her to eat. (AR 30.) She also had the flu the previous week. (AR 40.) She had some diarrhea and cramping and within a few days could not get her head off the pillow. (AR 40-41.) She thought it was a cold, but it ended up being the flu. (AR 41.)
Plaintiff worked as a medical biller for an in-home health company from 2004 to 2006. (AR 42.) She worked in the office and it was pretty much light standard work. (AR 42.) She would put away supplies and did general office duties. (AR 42-43.) She would lift fifteen to twenty pounds. (AR 43.) Most of the day was spent sitting. (AR 43.) In 2007 and from 2008 to 2011, Plaintiff worked for Sierra Kings Health Care in the admitting department. (AR 43-44.) She would register patients that came in for lab services. (AR 44.) She was transferred to the emergency room as a unit clerk. (AR 44.) It was mostly desk work, but she also had to put supplies away and put paper in the printer. (AR 44.) She would lift fifteen to twenty pounds. (AR 44.) She also worked as a cardiac monitor. (AR 46.) She continued to work at the hospital until 2015 when she was terminated due to her health. (AR 45.)
In 2013, Plaintiff got carpal tunnel in her right hand. (AR 45.) Something fell off the desk and she tried to catch it and hurt her hand. (AR 45.) Her duties and work performance did not change after she hurt her hand. (AR 46.) Plaintiff started getting sick to her stomach in December 2013 and ended up having emergency surgery to clear a blockage and a hernia repair. (AR 46-47.) In April of 2014, she had a surgery to remove part of her stomach due to complications from a previous gastric bypass surgery. (AR 47.) She has had problems ever since this surgery. (AR 47.) Plaintiff had gastric problems after her bypass surgery, but it was not constant or debilitating like currently. (AR 47.) Her prior problems would only last about twenty-four hours. (AR 48.) Now Plaintiff takes a day or two longer to recover and it hits her harder. (AR 48.) She will be in bed barely able to raise her head or get up to go to the bathroom. (AR 48.) She used to be able to function somewhat, but now cannot function when her stomach acts up. (AR 48.)
Her symptoms start out as bloating and pain. (AR 48.) Then she will spend time in the bathroom and will have accidents. (AR 49.) She has a little pillow and will just curl up in a ball with the pillow on her stomach. (AR 49.) She has three to four bad days a week where she has to curl up with the pillow. (AR 49.) They have tried to modify her diet but one day she will eat something with no problem and the next day the exact same thing will throw her into a full attack. (AR 49.) On a bad day, Plaintiff stays in bed and does not go far from the bathroom. (AR 49.) This has been occurring since 2013 and the surgeries in 2014. (AR 50.) Between 2013 and the surgery in 2014, Plaintiff would be doubled over in pain and her husband would have to pick her up and carry her. (AR 50.)
These symptoms started around Thanksgiving 2013 and they did not discover the problem until December. (AR 50.) During these two weeks she was going to the hospital three, four, or five times a week. (AR 50.) She would have to take off running to the bathroom and would be there 20 to 30 minutes. (AR 50.) She would be in the bathroom crying in pain and would have to compose herself to go out and deal with patients. (AR 50.) She was getting written up at work during this time. (AR 50.) Plaintiff had surgery in 2013 and went back to work six weeks later. (AR 51.) She had another surgery in April 2014 and went back to work six weeks later. (AR 51.) She ended up going on state disability because of her stomach problems and having to work twelve-hour shifts sitting at the desk and not being able to move unless she had coverage. (AR 51.) She was terminated because of her symptoms and her carpal tunnel was getting worse. (AR 51-52.) She believes that she was terminated because of her stomach problems. (AR 52.) Whenever she went to a worker's compensation appointment, she would take her paperwork and her limitations would be commented on. (AR 52.) Plaintiff would be placed on modified duty for a period of time and would then go back on state disability. (AR 52.) They were trying to find other positions for her and she was applying for positions but nothing panned out. (AR 52.) After her six months of modified duty ran out, she did not try to work anywhere else. (AR 52-53.) Plaintiff did not think that she could work because she would need to be away from her desk for twenty minutes when her stomach acted up. (AR 53.)
During a typical day, Plaintiff will run out of steam faster than she used to, but she will do dishes and stuff like that. (AR 53.) A lot of times, she will not finish because she is too tired or her hand acts up. (AR 53.) She will get to the pots and pans and can not lift them so will leave them for her husband or son to finish. (AR 53.) She has difficulty opening jars and containers. (AR 53.) Plaintiff will go grocery shopping and do other things outside the home on a regular basis. (AR 53-54.) When she needs to get something heavy, like a case of water, she will have other customer or employees help her lift them off the shelf. (AR 54.) Her right hand is what keeps her from lifting things that are heavy. (AR 54.) Even bending over to lift something heavy can cause her to have stomach pain. (AR 54.)
Plaintiff has alternating bouts of diarrhea and constipation. (AR 54-55.) These happen fairly frequently and she can be constipated one minute and having explosive diarrhea within five minutes. (AR 55.) These episodes happen three to four days a week and can last the whole day. (AR 55, 57.) For the majority of these episodes, Plaintiff will stay in bed the whole day. (AR 57.)
Plaintiff had surgery for her right hand in April. (AR 57.) Prior to the surgery, her hand was totally weak. (AR 58.) She was not able to lift a gallon of milk or a cup of soda. (AR 58.) She had numbness and tingling in her wrist and pain in her hand. (AR 58.) She has trouble clasping her necklace. (AR 58.) There are times when Plaintiff is unable to help her husband with his paperwork on the laptop because it hurts. (AR 58.) She can use her hand to keyboard or wash dishes for about fifteen to twenty minutes before it starts hurting or feeling like she is going to drop something. (AR 58.) Her hand is getting better, stronger, since the surgery in April. (AR 59.) But she is starting to have symptoms in her left hand. (AR 59.) She is starting to feel weakness and her fingers will start cramping when she is typing a letter on her laptop. (AR 59.) This will happen after fifteen to twenty minutes of activity. (AR 59.)
Plaintiff gets daily migraine headaches during the fall and winter. (AR 59.) She is sensitive to barometric pressure and will get a headache when it is going to rain or is cloudy. (AR 59.) Plaintiff's migraines can trigger her abdominal pain because it starts with nausea. (AR 61.) Plaintiff can be in bed for two full days with a migraine headache. (AR 60.) She will lie down in her room with the lights off and a pillow over her head. (AR 60.) She will yell at her husband and son in the other room that they are too loud. (AR 60.) During the winter she will have headaches that keep her in bed twice a week. (AR 60.) During the summer and spring, she will have a migraine headache one or twice a month as long as there are no fires. (AR 60.) During the summer, she had asthma from the fires and the air really bothers her. (AR 59.)
Plaintiff's medications made her drowsy and she is on stomach medication because her stomach is sensitive. (AR 61.) Plaintiff takes pain medication for her right-hand pain. (AR 61.) One doctor told Plaintiff that he did not want to put her on medication for irritable bowel syndrome because it can block the signs of an intestinal blockage. (AR 61.)
On a daily basis, Plaintiff uses the restroom every hour to an hour and a half. (AR 55.) Plaintiff had an accident when she was in Walmart. (AR 55.) She made it to the bathroom and was in there for ten to fifteen trying to figure out what to do. (AR 55-56.) The episodes happen randomly. (AR 57.) Plaintiff will have about four accidents a month. (AR 56.) Plaintiff keeps a bag with a clean pair of underclothes and pants in her car in case she has an accident while out. (AR 57.)
Gail L. Maron, a vocational expert, also testified at the hearing. (AR 63-72.)
The ALJ made the following findings of fact and conclusions of law.
(AR 11-19.)
To qualify for disability insurance benefits under the Social Security Act, the claimant must show that she is unable "to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 423(d)(1)(A). The Social Security Regulations set out a five-step sequential evaluation process to be used in determining if a claimant is disabled. 20 C.F.R. § 404.1520;
Congress has provided that an individual may obtain judicial review of any final decision of the Commissioner of Social Security regarding entitlement to benefits. 42 U.S.C. § 405(g). In reviewing findings of fact in respect to the denial of benefits, this court "reviews the Commissioner's final decision for substantial evidence, and the Commissioner's decision will be disturbed only if it is not supported by substantial evidence or is based on legal error."
"[A] reviewing court must consider the entire record as a whole and may not affirm simply by isolating a specific quantum of supporting evidence."
Plaintiff contends that the ALJ improperly rejected the opinion of treating physician, Dr. Rubio, regarding Plaintiff's abdominal symptoms and failed to provide clear and convincing reasons to reject Plaintiff's symptom testimony. Plaintiff contends that the ALJ assumes that Plaintiff can hold herself until she reaches the restroom and ignored the fact that she described the accidents in a manner which requires a change of clothing. Further, Plaintiff contends that close proximity to the bathroom does not address her limited functioning during flareups and does not address her need for breaks and absenteeism. Plaintiff argues that the ALJ was required to give greater weight to her treating physician than to the opinion of the consultative or state physicians.
Defendant counters that the ALJ summarized Dr. Rubio's opinion in detail and explained that he gave the opinion little weight because the limitations were not supported by the record and there was no evidence to support that Plaintiff would need extra bathroom breaks where her testimony was that she had four accidents per month. Defendant argues that the limitation is contrary to Dr. Rubio's own treatment notes which indicate that she was gaining weight and was experiencing no bloody diarrhea, hematemesis, melena, or hematochezia and that Dr. Rubio assessed Plaintiff's irritable bowel syndrome as stable, noting that she was eating and drinking okay. Defendant also argues that the ALJ properly found Plaintiff's symptom testimony to be inconsistent with the record. The record indicates that Plaintiff was being treated for a wrist injury but her qualified medical examination findings were generally normal and the ALJ reasonably questioned whether Plaintiff stopped working due to medical impairments or for some other reason. Further, Defendant contends that the ALJ relied on Plaintiff's wide range of activities of daily living and that her testimony was inconsistent with the medical evidence.
Plaintiff replies that Defendant merely restated the reasons provided by the ALJ that are insufficient to reject Dr. Rubio or her testimony. Further, Plaintiff argues that the ALJ cited reasons that were not relied on by the ALJ which cannot be used to affirm the ALJ's findings.
Plaintiff argues that the ALJ erred by rejecting Dr. Rubio's opinion that Plaintiff needed extra breaks to use the bathroom finding that the opinion lacks record support and it was not entirely consistent with her testimony that she had four accidents per month. Plaintiff argues that the ALJ took Plaintiff's description of her symptoms out of context. Defendant counters that the ALJ properly considered the medical evidence which did not support the limitations opined.
The weight to be given to medical opinions depends upon whether the opinion is proffered by a treating, examining, or non-examining professional.
Here, Dr. Rubio's opinion is contradicted by the opinion of the consultative examiner, Dr. Wagner, therefore the ALJ was required to provide specific and legitimate reasons to reject Dr. Rubio's opinion.
The ALJ considered Plaintiff's treatment at the Adventist Health Center from March of 2015 through October 2016. (AR 15.)
(AR 15.) The ALJ further considered,
(AR 16-17.)
The ALJ gave little weight to Dr. Rubio's July 2017 opinion. (AR 17.) The ALJ found that the record did not support the exertional limitations and although Dr. Rubio stated that Plaintiff needed extra breaks to use the bathroom, this was not entirely consistent with her testimony that she had four accidents per month. (AR 17.) The ALJ found that requiring proximity to a bathroom would minimize such events. (AR 17.)
The ALJ also considered that Plaintiff had a consultative examination with Dr. Wagner in September of 2017 (AR 17, 739-749.) Plaintiff complained of experiencing symptoms of alternating constipation and diarrhea with bowel urgency and stated she had a hiatal hernia. (AR 17, 739.) Dr. Wagner observed that Plaintiff was able to get on and off the examination table with ease, her abdomen was soft, minimally tender, and non-distended. (AR 17, 740-741.) Plaintiff was diagnosed with gastric bypass with some nausea, vomiting, and alternating constipation and diarrhea, and asthma mild to moderately well-controlled. (AR 17, 743.) It was Dr. Wagner's opinion that Plaintiff had the residual functional capacity to lift and carry 50 pounds occasionally and 25 pounds frequently; stand and walk up to 6 hours in an 8-hour workday; and sit without restriction. (AR 17, 743.) Plaintiff could climb ramps and stairs frequently; and ladders and scaffolds occasionally. (AR 17, 743.) Plaintiff should avoid prolonged exposure to dust, odors, fumes, and pulmonary irritants as well as temperature extremes. (AR 17, 743.)
The ALJ considered that Plaintiff had upper gastrointestinal x-rays in October 2017 that confirmed the small hiatal hernia and postsurgical changes consistent with gastric bypass, but there was no evidence of bowel obstruction, leak or opacification of the gastric remnant. (AR 18, 941.)
Here, the ALJ set out a detailed and thorough summary of the medical evidence and the conflicting opinions. The ALJ then stated his opinion as to weight that he was providing to the differing opinions and his reasons why. The ALJ can meet his burden of setting forth specific and legitimate reasons to reject a physician's testimony "by setting out a detailed and thorough summary of the facts and conflicting clinical evidence, stating his interpretation thereof, and making findings."
The ALJ rejected the limitations opined by Dr. Rubio because he found that the exertional limitations were not supported by the medical record. Plaintiff argues that Dr. Rubio's opinion is consistent with Plaintiff's testimony that she has flare ups with her stomach pain and stays in bed for days at a time with very little ability to function. (ECF No. 16 at 10-11.) However, Plaintiff points to no medical evidence in the record that would support the functional limitations opined by Dr. Rubio.
While Dr. Rubio opined that Plaintiff could occasionally lift 5 pounds and never lift 10 pounds; can sit 20 minutes before needing to lie down or recline due to fatigue, pain, and stress; and needs to lie down or recline about 2 hours in an 8 hour work day; can sit about 1 hour in an 8 hour workday; and can walk less than 1 hour in an 8 hour workday, (AR 700); on medical examination, Plaintiff generally had normal examination findings, including normal muscle strength and range of motion and normal gait, with occasional abdominal tenderness or wrist pain that improved. (AR 325, 343, 367-368, 386-387, 406, 431, 444-445, 456-457, 464, 502-503, 525, 543, 559, 580, 608, 672, 674, 677, 681, 684, 686, 693, 705, 723, 730, 740-743, 766-770, 783, 786, 788, 790, 793, 795, 797, 798, 800, 802-803, 805, 848-849, 865, 868, 893, 909, 914, 920, 927, 933, 944-945.) The ALJ noted that Plaintiff initially had restrictions in pulling and lifting with her right hand in her disability case. (AR 15.) The ALJ also found that her that her symptoms improved and she had good grip strength and no atrophy. (AR 15-16.) The ALJ could reasonably find that the examination findings do not support the severity of the functional limitations opined by Dr. Rubio. Inconsistency with the objective findings in the medical record is a specific and legitimate reason to reject a physician opinion.
Plaintiff argues that the ALJ erred by providing greater weight to the opinion of Dr. Wagner since Dr. Rubio was Plaintiff's treating physician. A treating physician's opinion is entitled to controlling weight on the issue of the nature and severity of the claimant's impairment where it is well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in the record. 20 C.F.R. § 404.1527(c)(2). "If there is `substantial evidence' in the record contradicting the opinion of the treating physician, the opinion of the treating physician is no longer entitled to `controlling weight.'"
Here, the ALJ considered the treatment relationship with Dr. Rubio, but found that his opinion was not consistent with the medical record as a whole. Further, the ALJ gave significant weight to Dr. Wagner's opinion, finding it to be based on a through and well documented examination and because Dr. Wagner was board-certified in internal medicine. (AR 17-18.) Where the treating physician's opinion is contradicted by the opinion of an examining physician who based the opinion upon independent clinical findings that differ from those of the treating physician, the nontreating source itself may be substantial evidence, and the ALJ is to resolve the conflict.
Plaintiff argues for a different result, but where there are contradictory opinions in the record, it is for the ALJ to determine credibility and resolve the conflict.
Plaintiff also contends that the ALJ erred in rejecting her testimony regarding the severity of her symptoms. Plaintiff argues that the ALJ erred in rejecting her level of impairment due to records concerning her asthma and her right arm. Defendant counters that the ALJ properly found that Plaintiff's symptom complaints were not supported by the record, it appears that Plaintiff was let go from her last job for reasons not exclusively due to her impairments, and that Plaintiff's daily activities were inconsistent with the alleged severity of her impairments.
"An ALJ is not required to believe every allegation of disabling pain or other non-exertional impairment."
Then "the ALJ may reject the claimant's testimony about the severity of those symptoms only by providing specific, clear, and convincing reasons for doing so."
The ALJ found that Plaintiff's statements about the intensity, persistence, and limiting effects of her symptoms were inconsistent with and unsupported by the evidence. (AR 19.) Defendant contends that the ALJ provided multiple reasons to reject Plaintiff's allegations of total disability. First, the ALJ found that Plaintiff reported that she was let go from her last job which suggests that her current unemployment is not exclusively due to her disability. However, Plaintiff testified that she was terminated because her symptoms and her carpal tunnel were getting worse. (AR 52.) They were trying to find other positions for her but nothing panned out and her modified duty ran out. (AR 52.) The Court finds that the fact that Plaintiff was terminated from her prior job is not a clear and convincing reason to reject her credibility.
Defendant further contends that the ALJ found that Plaintiff was capable of performing a wide range of daily activities. There are two grounds to use daily activities for an adverse credibility finding.
The ALJ did not make any specific findings as to Plaintiff's daily activities and their transferability so the Court finds that the ALJ must have found that Plaintiff's daily activities contradict her symptom testimony. Defendant argues that Plaintiff engages in a large range of daily activities that contradicts her claim of total disability. However, "[t]he mere fact that a plaintiff has carried on certain daily activities . . . does not in any way detract from her credibility as to her overall disability."
Defendant argues that Plaintiff's ability to engage in a largely normal range of activities supports the ALJ's inference that proximity to the bathroom should minimize her reported four accidents per month. But Plaintiff testified that three to four times per week she has episodes that go from constipation to explosive diarrhea. The ALJ did not address Plaintiff's testimony and the Court is constrained to review those reasons that the ALJ provided in finding the claimant's testimony not credible.
Similarly, the ALJ found that Plaintiff's testimony was inconsistent with the medical record, but the ALJ did not set forth any testimony by Plaintiff or explain why it was inconsistent with the medical record. Here, the Court finds that the ALJ did not set forth sufficiently specific findings to support the conclusion that Plaintiff was not credible such that this court could conclude the ALJ rejected Plaintiff's testimony on permissible grounds.
Plaintiff seeks to have this action remanded for payment of benefits and Defendant seeks remand for further proceedings. The ordinary remand rule provides that when "the record before the agency does not support the agency action, . . . the agency has not considered all relevant factors, or . . . the reviewing court simply cannot evaluate the challenged agency action on the basis of the record before it, the proper course, except in rare circumstances, is to remand to the agency for additional investigation or explanation."
The Ninth Circuit has "devised a three-part credit-as-true standard, each part of which must be satisfied in order for a court to remand to an ALJ with instructions to calculate and award benefits: (1) the record has been fully developed and further administrative proceedings would serve no useful purpose; (2) the ALJ has failed to provide legally sufficient reasons for rejecting evidence, whether claimant testimony or medical opinion; and (3) if the improperly discredited evidence were credited as true, the ALJ would be required to find the claimant disabled on remand."
"A claimant is not entitled to benefits under the statute unless the claimant is, in fact, disabled, no matter how egregious the ALJ's errors may be."
Further, Plaintiff argues that her inability to work is due to her bouts of constipation and diarrhea, however the medical record does not support the severity of her alleged symptoms. While Plaintiff has complained of mild to moderate stomach pain, which she describes as cramping or colicky, and vomiting, she fairly consistently has reported no diarrhea or constipation which is inconsistent with her testimony that she experiences these symptoms four times a week. (AR 322, 340, 365, 384, 404, 429, 454, 500, 522, 540, 577, 605, 721, 905, 917, Further, as noted in the record from her visit with Dr. Rubio on October 12, 2016, there are no subjective findings that things are actually getting worse she's actually gaining weight and not losing weight, did not have any bloody diarrhea or hematemesis nor melena or hematochezia. (AR 905.) On October 25, 2016, Plaintiff reported to Dr. Win that her stomach was a bit upset, but not too bad. (AR 944.) On November 14, 2016, Plaintiff reported she had no complaints other than a sinus infection. (AR 686.) On December 24, 2016, Plaintiff reported no gastrointestinal symptoms. (AR 683.) Although Plaintiff complained at several appointments of abdominal symptoms and that her symptoms made her unable to work, (AR 679, 681, 847), on June 2, 2017, Dr. Mittal found that Plaintiff had irritable bowel symptom without diarrhea. (AR 865.) On June 15, 2017, Physician's Assistance Das noted that the diagnosis of nausea, vomiting, and epigastric pain was based on Plaintiff's subjective complaints, (AR 695), and that Plaintiff claimed to have nausea and vomiting, (AR 698).
On August 8, 2017, Plaintiff was seen in the ER complaining of abdominal pain that had started three weeks prior. (AR 703.) Test results suggested a UI and there was no evidence of an acute abdominopelvic pathology. (AR 705-709.) On August 18, 2017, Plaintiff was seen in the ER for abdominal pain and reported that she had been told by the GI specialist the day before the she had an ulcer. (AR 867.) She was complaining of abdominal pain and vomiting. (AR 868.) On September 14, 2017, Plaintiff was seen complaining of abdominal pain and vomiting and reported no change in her bowel movements. (AR 923.) She reported that she was using medical marijuana for the pain and that she did not have abdominal pain that day, but some mild discomfort with no vomiting. (AR 923 The Court finds that this evidence requires this matter to be remanded for the ALJ to further develop the record on whether Plaintiff's limitations are severe as she testified at the hearing. Based on the evidence in the record showing inconsistencies between Plaintiff's testimony and the medical record, the Court cannot find that Plaintiff is entitled to benefits. Accordingly, the Court finds that this matter should be remanded to the Commissioner for further consideration of Plaintiff's symptom testimony.
The Social Security regulations require the Commissioner to set forth a discussion of the evidence, and the reason or reasons upon which the decision is based. 42 U.S.C. § 405(b)(1)). The ALJ is advised that the agency must explain its reasoning in order for the Court to be able to perform a meaningful review. To meet the burden, the ALJ must "specifically identify the testimony [from a claimant] she or he finds not to be credible and . . . explain what evidence undermines the testimony."
Based on the foregoing, the Court finds that the ALJ erred by failing to provide clear and convincing reasons to reject Plaintiff's symptom testimony. Accordingly, IT IS HEREBY ORDERED that Plaintiff's appeal from the decision of the Commissioner of Social Security is GRANTED and this matter is remanded back to the Commissioner of Social Security for further proceedings consistent with this order. It is FURTHER ORDERED that judgment be entered in favor of Plaintiff Teresa Marie Shaban and against Defendant Commissioner of Social Security. The Clerk of the Court is directed to CLOSE this action.
IT IS SO ORDERED.
