United States District Court, S.D. Mississippi, Northern Division
REPORT AND RECOMMENDATION
F. KEITH BALL, Magistrate Judge.
Takeema Hughes brought this action to obtain judicial review of a final decision of the Commissioner of the Social Security Administration. Presently before the Court are Hughes's motion for summary judgment  and the Commissioner's motion to affirm . Having considered the memoranda of the parties and the administrative record, the undersigned recommends that Hughes's motion be denied and that the Commissioner's motion be granted.
I. Procedural History
Takeema Hughes received Supplemental Security Income (SSI) benefits as a child. When she reached the age of 18, the Social Security Administration reviewed her case and determined that benefits should cease. The determination was upheld upon reconsideration. She appealed and was granted a hearing before an administrative law judge (ALJ). The ALJ convened a hearing on April 24, 2012, but continued it in order that Hughes might obtain counsel. The ALJ reconvened the hearing on September 14, 2012, at which time Hughes remained unrepresented. The ALJ conducted the hearing on that date and issued a decision finding that Hughes is not disabled. The Appeals Council denied review, thereby making the decision of the ALJ the final decision of the Commissioner. Hughes then brought this appeal pursuant to § 205(g) of the Social Security Act, 42 U.S.C. § 405(g).
II. Evidence Before the ALJ
Takeema Hughes was born on July 28, 1992. She was placed in special education classes early in school. At the age of ten, Hughes was referred to Life Health Mental Health Center (Life Health) for behavioral problems and disruptive behaviors at home and school. As reported to Life Health, these behaviors included excessive talking, talking very loud, fighting with siblings, screaming, stubbornness, and failure to pay attention. R. 295. Takeema's mother also reported that she had an imaginary friend who told her to do things and that Hughes walked throughout the night and had nightmares. Id. Initial impression included an Axis I diagnosis of disruptive behavior disorder, NOS, and an Axis V diagnosis (Global Assessment of Functioning or "GAF") of 65. R. 297. Hughes began individual therapy to work on anger management and social interaction skills. In March of 2003, Hughes was admitted to Brentwood for several days for homicidal ideations towards peers, auditory hallucinations, aggression, and nightmares. R. 285. She was placed on Risperdal. Id. Discharge diagnosis was Axis I, oppositional defiant disorder; Axis II, borderline intellectual functioning; and a GAF of 61. R. 285. Thereafter she continued regular therapy at Life Health. The therapy focused on anger management, staying on task, following instructions, and social interactions. In 2004, she was prescribed Strattera in addition to Risperdal. R. 271.
Regular therapy continued until August of 2006, when Hughes was discharged from Life Health, apparently because she moved out of the service area. She returned three years later in September of 2009 with complaints of being easily angered, nervousness, and low self-esteem. R. 235. Her diagnosis at this time was Axis I, oppositional defiant disorder; Axis II, developmental arithmetic disorder; and Axis V, 65. R. 237.
In October of 2009 Hughes went to her school counselor after a student made a demeaning remark to her. Hughes reported to the counselor that she was having homicidal thoughts as a result of the encounter. R. 233. The therapist requested that she be seen at Life Health on an emergency basis. Id. Notes from her visit at Life Health the following day indicate that while she was still angry, she had no homicidal thoughts and no plan. R. 230. She and the therapist discussed anger control and the importance of a positive self-image. Id.
Notes from therapy at Life Health over the next several months show that she progressed in her self-confidence, anger management, and self-control. In June of 2010, she was discharged from Life Health, with the therapist stating that she had completed her therapy successfully and had achieved her treatment goals. R. 217-18.
In January of 2012, Hughes returned to Life Health. She reported that she had stopped taking her medication approximately three months earlier and was experiencing a return of insomnia, auditory hallucinations, and mood swings. R. 338. Impression included an Axis I diagnosis of psychotic disorder NOS and a GAF of 60. R. 341. Upon return to Life Health two months later, mental status exam was abnormal for constricted affect, paranoid thought content, auditory hallucinations, poor concentration, impaired attention span, impaired recent memory, and below average intelligence. R. 333-34. Hughes was prescribed Abilify. R. 34. Her diagnosis was Axis I, psychotic disorder, NOS; Axis III, Obesity; Axis IV, severe teasing at school and no friends; and Axis V, 50. R. 334.
Dr. Joseph Dunn performed a consultative psychological examination of Hughes on October 11, 2012. He observed that Hughes was uncooperative and put forth very little effort during the exam. R. 347. Dr. Dunn attempted to administer the WAIS-IV but discontinued after she achieved raw scores of zero on the first six subtests. R. 349. He also administered the Wide Range Achievement Test-Four but stated that these results likewise appeared invalid, as Hughes identified only one letter and one word on the entire test. Id. Dr. Dunn opined that while Hughes may have significant and even substantial limitations and may be functioning in the mildly mentally retarded range, this could not be concluded from testing. R. 349.
The record contains a special education assessment from Hughes's school dated October 16, 2008. At this time, Hughes was 16 years of age and in the tenth grade. The assessment states that Hughes was reading at the 4.3 grade level. R. 213.
At the hearing, Hughes testified that she spends most of her time watching television. R. 34. She has no outside activities, performs no chores, and has no friends because she cannot get along with people. R. 35-36. She gets along with her siblings "okay." R. 35. She cannot drive. R. 32. She is nervous all of the time and hears voices sometimes; the voices tell her to fight people. R. 33-34, 36. She takes medication for nerves and hearing voices, and she goes to therapy at Life Health every two weeks. R. 32-33.
Hughes's mother also testified at the hearing. She stated that her daughter completed high school and received a special education diploma. R. 37. She spends her time at home watching television, playing games on her phone, playing with dolls, and playing with her siblings. Id. She has no friends. R. 38. She can attend to her personal needs. R. 41. Prior to Takeema's admission to Brentwood, she was fighting at school and threatened her siblings with a knife, necessitating that her mother call the police. R. 39. During her last year of school, Takeema pulled a knife on a student. R. 40-41. Ms. Hughes stated that her daughter "likes to fight." R. 42.
III. The Decision of the ALJ and Analysis
In his decision, the ALJ worked through the familiar sequential evaluation process for determining disability. He found that Hughes has the severe impairments of obesity, a history of personality disorder, and borderline intellectual functioning. R. 15-16. At step three, the ALJ determined that Hughes does not have an impairment or combination of impairments that meets or medically equals a listed impairment in 20 C.F.R. Part 404, Subpart P, Appendix 1. R. 16-18. The ALJ found that Hughes has the residual functional capacity to perform light work as defined by 20 C.F.R. § 416.967(b), with the following limitations: She can only occasionally stoop, kneel, crouch, climb and crawl, she can understand, remember, and carry out only simple instructions, she can maintain attention for two-hour intervals, she cannot work at jobs requiring intense concentration, attention, and focus throughout the work day, she cannot work with the general public, and she can work only at jobs that require no more than occasional interaction with coworkers and supervisors. R. 18. At the final step of the analysis, the ALJ, relying upon the testimony of the VE, determined that ...