Slaymaker v. Commissioner of Social Security

Filing 41

ORDER ON MOTIONS FOR SUMMARY JUDGMENT [DEs 37, 38]: that the decision is VACATED AND REMANDED to the Commissioner pursuant to sentence four of 42 U.S.C. 405(g); granting 37 Plaintiff's Motion for Summary Judgment and denying Defendant's 38 Motion for Summary Judgment. Signed by Magistrate Judge William Matthewman on 8/10/2017. (kza)

UN I
TED STATES DI
STRI COURT
CT
SOUTHERN DI
STRI OF FLORI
CT
DA
CA SE N O .15- 7 CI M A TTHEW M AN
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27
STEVEN M LARI
MORE

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NAN CY A . BERRY H I l
LL ,
Ac i Comm isone ofSoc a Se iy
tng
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i l curt
A dm i s r ton,
nit a i
D e e nt
f nda .
/

ORDER ON M O TI NS FO R SUM M ARY JUDGM ENT I 37.381
O
DES

THI CAUSE i beor t Cour upon Pl ntf,Ket R.Slyma rs (t antf )
S
s f e he
t
ai if ih
a ke ' çpli if',
Motonf Summay J
i or
r udgme wih Suppori M e a
nt t
tng morndum ofLaw ( 371 a De e nt
DE , nd f nda ,
Na y A.Ber l,Aci Commisone ofSoci Se urt Admi sr ton' (i fndan )
nc
ryhil tng
si r
al c iy
nitai s f e f'
De
M oton f r Summ a y J m e wih Suppori M e or ndum of Law a Opposton t
i o
r udg nt t
tng
m a
nd
ii o

P an ifs M o in f r S mma y J d me t ( 3 1 Plitf fld a Re y ( 4 ) t
litf
to o u r u g n DE 8 . an if ie
pl DE 0 o

Dee da tsRe p n e Thep rish v c n e td t ma itaej d ej rs ito S eDE
fn n ' s o s .
a t a e o s n e o g srt u g u idcin. e
e
20. Thei s sbef et Co ta e whehe t r or cont nss t ntale de et s
s ue
or he ur r
t r he ec d
ai ubsa i vi nc o uppor
t
t de a of bene is t Pl ntf a whehe t c r t lgalsa r ha be n a id.
he ni l
ft o ai if nd
t r he orec e
t nda ds ve e pple

Lambv Bowe 8 F. 698,701( t Ci.1 )
.
n, 47 2d
11h r 988 .

1Plsa tt F d rlRueo Ci l o e t e2 ()Na c A. ry ilten w a tn c mmiso e o So il
t u n o e ea l f viPrc dt 5d , n y Berh l h e cig o sin r f ca
r
r
,
S c rt wi b s b t ue a ap ryi ti cs . Fe R. v P. ()(1 nato d e n t baewh nap bi
e ui l e u si td s at n hs ae d. Ci. 25d t cin o s o a t e u lc
y, l
t
A

ofie who i apa t i anofi alc pa t di ,r ins o oher s c est hol ofiewhiet a i i
fc r
s ry n
fci a ciy es esg , r t wie eas o d fc
l he cton s

p n ig. Th ofc rss c es ri a t t al sbsiue a apa4 ' .
e dn
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1

1
.

FA C TS

On J y 23, 201 Pl ntf fld a Til 1 a ia i f a pe i of dia lt a
ul
3, ai if ie
te 1 pplc ton or
rod
s biiy nd
diabiiy i ur nc be tt, a s ri ad s b ly o -e d t o Jme 1 2 3 ( 3 )2 The
s lt ns a e nei s se t
ng ia ii n st ae f t , 01 . R. 0 .
t
a i ai wa de e i tal a upon r c i r ton. f Folowi a vi o hea i on
pplc ton s ni d nii ly nd
e onsde a i
#.
l ng
de
rng

J r 7,201 Admi srtveLa J
anuay
5,
nitai w udgeM ateHa vn- oode(he$ LJ' is d ade iin
ti r i W
t W ') sue
cso

o M ac 31 2 5 d n n Plitf srq s frb neis ( 2745 . A rq e tf rrv e
n rh , 01 , e yig anif e uet o e ft. R. - 1
e u s o e iw
wa fld wih t Ap e l Co n i a d n e o No e e 20 2 5. ( 17 . Plitf
s ie t he p as u cl nd e id n v mb r , 01 R. - ) an ifs
d t ls i s r di De e e 31 2 8 ( 3 1
ae a t n u e s c mb r , 01 . R. 0 .
A . H e rnc Te tm ony
ai
si

The ALJhed a vi o he rng on J nuay 7,201 ( 461 Pl ntf sat t thi
l
de a i
a r
5. R. . ai if t ed ha s
daeofbit wasOcobe 26,1 ma nghi f t yeaso1 a t tmeoft he rng. (
t
rh
t r
974, ki m ory r d t he i
he a i
R.
A c or ng t Pl i i f he obt ne a doc or t de ee i c r ac i m e ci
c di o a ntf ,
ai d
t a e gr n hiopr tc di ne. I
d.

Pl ntf t sii d t he wor d a a r saur nti J ne of 1 whiehe wa i s hool
ai if e tfe hat
ke t e t a n u
997
l
sn c .

g 5 ) Hee pan d t t i J n o 1 9 ,h wa e p re cn we k e so h slf sd ,i
R. 2 .
x lie ha,n u e f 9 7 e s x ein ig a n s n i e t i e n
hi lf ann,a ha s r hea che 1 Ac di t Pl i if he i rghtha
s et
nd d eve e da s. d.
cor ng o antf, s i - nded. I
d
Pl i ift sii d t the wor d a a c t rs r ce r pr en a i fom Oc o r200
antf e tfe ha
ke s usome e vi e es t tve r
t be
2

t r u h M ac o 2 0 . ( 6 - 7 . Pli tf sae ta h t e wo k d a ac r p a t rfr
h o g rh f 0 3 R. 6 6 1 anif ttd h t e h n r e s hio rco o
o e tny as ( 5 )
v r e e r. R. 2 .
Pli ift n t tfed as t hi me ca pr e . ( 5 . He saed t the has
antf he esi
o s di l oblms R. 31
tt ha
chr ni f tg a wasdi nos d wih i opa hi hype s
o c ai ue nd
ag e t di t c
r omni f Pli ift tfe t the
a. J. a ntf esii d ha
wa up a 8: or9: i t mor ng a hasditculy ge tng up i t m or ng be aus he
kes
t 00
00 n he
ni nd
fi t ti
n he
ni
c e

i tr ( 541 He s d t t he tke si ant a i pr c i d Amphea ne a
s ied. DE .
ai ha
a s tmul s nd s esrbe
tmi nd
2A lr f e
l eerncesaet t r cor oft adm i srtvepr ee ng fldby t Com misone i Doc Enty 1
r o he e d he
nita i oc di ie
he
si r n
ket r 7.

2

De r mphe a ne t ke p hi a ke durng t da
xtoa
t mi o e m wa
i he y.

Ac di t Pl ntf,whe he
cor ng o ai if
n

w a w o ki he had t t t ee na a da 1
s r ng
o ake hr
ps
y. d.

l a ton t t c oni f tgue,Pli ift tfe t the haspai tuoughouthi ba k.
n ddii o he hr c ai
a ntf esii d ha
n l
s c

I Hesae t a h g t h sb c a j td fe ue ty a d g t ma s g si o d rt alv ae
d
ttd h t e es i a k duse r q nl n es s a e n r e o le it
hsba k p i . ( 5 - 5 . Ac o d n t Plitf,hsb c p i p e e shm fo lfi g a
i c an R. 4 5 1
c r i g o anif i a k an r v nt i r m itn s
muc as he coul i he di notha t bac pai and s tm e ,whe i i m or s ver ,he
h
d f
d
ve he k n
ome i s
n ts
e e e

c n o l ta yhng a d c n o b n o e. ( 5 1 Plitf tsiid t th i p e cie
n n t i n ti n a n t e d v r R. 5 . an if e tfe ha e s rs rb d
f
Hydr
ocodonef hi bac pa n. 1 Ac or ng t Pl ntf,t Hydr odonet thet keswil
or s k i
d.
c di o ai if he
oc
ha
a
l
s tmesm a hi e mor tr d a c rbut t hi chr c f tgue. I
ome i
ke m ven
e ie nd onti e o s oni ai
d
Pli ift sii d t the a s ha a ey a de es i n,a i pr s rbe t g rc
antf e tfe ha
lo s nxit nd pr so nd s e c i d he ene i
ve son ofCymbala. 1
ri
t
d.

Th n Plitf tsiid a o thi c r a tn e s r e y ( 5 1 Plitf sae t a
e , anif e tfe b u s a p l u n l u g r . R. 6 . anif ttd h t
hi ca pa t me s ndr ei t l beternow.'
s r l ul l y om s t ot t
a
'

Bef et slge y,Pl i ift sii d t t
or he tr r antf e tfe ha

he ha numbnes i hi fnge s whih ha snc r ol d,buthe s i t he i notassr as
d
s n s i r , c s i e es ve
ad hat s
tong
he onc was 1
e
. d

Acc di t Pl ntf,i he doe a hi r ttve es c al wih hi l t
or ng o ai if f
s nyt ng epe ii , pe i ly t s ef

am,Stbot r E mlal . I Pli ifsaedt theas hasaii 'whihca eshi t
r t hes hi
i
ot' d
'
antf tt ha
lo
çcy' c us m o
t
wa t gr b a hi l ta
nt o a t s ef nnpi wih hi t
t t s humb. I
d

a e ry ons ta t ii i hi wrs.
nd a l
e rhrts n s it

He sa ed t the hasde oped t
tt ha
vel
endonii
ts

Pli ifa lged t the ha t qui wor ng bec e
a ntf le
ha
d o t ki
aus

hec dno l rpr swihhi t nare ne orhol ape s shea wihhi l tam. (
oul onge es t s he mi nce
d ron' d t s ef r
R.
56- .
571
Pl i if a s s a ed t t he w as di
a ntf l o t t ha
agnos d w ih dys oni i hi l f uppe e r m iy
e
t
t a n s et
r xt e t

be aus oft sr ke he has ha ( 571 Ac or ng t Pli if he has (i
c e he to s
d. R. . c di o antf
tnnume a e
r bl
he a om as'i hi br n,m a of w hi h ha bl
m ngi
' n s ai
ny
c ve ed. 1 Pl i t f t s ii d t t t dys oni
d. a n i f e tf e ha he t a

c u e h sh n t i u l pa t r i ' ( 58 .
a s s i a d o t r u nd u n n. R. 1
c
'
l addii t t media i he lse pr vi l Pl ntf sa e t t he a s tkes
n
ton o he
c tons
it d e ousy, ai if tt d ha
lo a
Dul tne a M eoxia f hi pan a sif s 1
oxei nd l c m or s i nd tfnes . d.

Pl ntf t tse t theas ha se a a. ( 601 Pl ntf sae t he c nnot
ai if esi d ha
lo s lep pne R. . ai if ttd hat a
r me be t l ttme t thef tg orwokeup f elng r r s d. 1
e m r he as i ha
el ood
e i efe he
d.
Ac di t Pl ntf,he c nnot peror a s tof wor be us he has t ha
cor ng o ai if
a
f m ny or
k ca e
o ve
pe i c na a k
rodi ps nd t
down tm e't
i ' l
uoughout t da a c nnot st f l pe i of tme
he y nd a
i or ong rods
i

b c u ehewil ala le ( 61 .
ea s
l fl se p. R. 1
Pli ifsae t th l e i l wabeo emo i gt Flrd i J neo 2 3. ( 6 1
ant ttd ha e i d n o
f
v
f r v n o oi a n u f 01 R. 2 .
Het tfe t thi wiem ove t Fl i whie heand t rtle chidr n r i d i I f
esiid ha s f
d o orda l
hei lr e l e ema ne n owa or
a f w m or m ont . 1 Pl ntf s i t the woul t t ki t s hooli t mor ng
e
e
hs d. ai if ad ha
d ake he ds o c
n he
ni

evey da durng t s tme a woul pik t m up fom day cae a
r y i hi i nd
d c he
r
r boutonc a wee (
e
k. R.
62- .
631
Ac or ng t Pl ntf,he oc sonaly brngshi c l e t t bussop now t tt y
c di o ai if
ca i l i
s hidr n o he
t
ha he

l e i Flrd , u hi wied e i mo td ys ( 6 1 P an ift si e t a h d e l td
i n o i a b t s f o s t s a . R. 4 . litf e tt d h t e o s i e
v
i
mi
hous hol c r a ti t hep wih m e lpr par ton,s h a o ni c a m ir vi
e d ho es nd res o l t a e ai uc s pe ng ans nd c owa ng
me s 1
al . d.

Ne ,S e eBa s av c to a e p r, e t id. ( 6 2 Heca sfe Plitf sp s
xt tv s, o ain l x e ttsi e R. 7 .
f
lsiid an if a t
wor as a c r a or as hi hl s led w ih a SV P l lof 8 i t m e um e r i
k
hiopr ct
g y kil
t n
eve
n he di
xe tonalw or
k

c t gor an Pl ntf pa twor asa c t e s r i e r pr s nt tve as s led wih an SVP
a e y, d ai ifs s
k
usom r e v c e e e ai
kil
t
he
i
lve of5i t s de ay e ri c tgor ( 671 The ALJposed t vocatonalexpert
e l
n he e ntr xe tonal ae y. R. .

oul
k t he i ht xe tona e
nd y ve
a hy t tc l i w hi h a i vi
po he i a n
c n ndi dualc d wor a t lg e ri l lvela m a ha
addii llm ia i ,a t i vi lc d oc as ona l ba a
tona i t tons nd he ndi dua oul c i ly l nce,s oop,knee ,c ouc cr w l
t
l r h, a ,
4

a c i r mpsa sais neve c i l r ,r pe ,o s fol ,c n feque l ha e wih
nd lmb a
nd t r ,
r lmb adde s o s r ca f ds a r nty ndl t

b t h n s a s o l a od c n e tae e p u et h z r s ( 6 j Th ALJas sae
oh a d , nd h ud v i o c nrtd x os r o a ad . R. 8 . e
lo ttd
t tt i vi ua i t hypot tc lcoul pe f m smpl t ks a s e deaie t s ,up t
ha he ndi d l n he
hei a
d ror i e as nd om
t l d a ks
o
s m is le wo k. f Gi n t e f c s t vocai le r f
e -kil d r
#.
ve hos a t , he
tona xpe t ound t tt i vi lc d
ha he ndi dua oul
notpe f m pa tr lva wor a pe f r e orasg r l pe f m e i t na i le onom y.
ror
s ee nt k s r o m d
ene aly ror d n he tona c

Ho v r t ev c to a e p r sae t a t i dv d a c ul pef r o h rj b ,s c a
we e, h o ai n l x e t ttd h t he n ii u l o d ro m t e o s u h s
asor gef ciiy r nt lce k,af r tler nt lce k,orapa ki 1 ta tnda . f
t a a lt e a lr
u nitr e a lr
r ng o te nt #.
Ne ,t ALJpos d a hypot tca i whi h a i vi lc d do e r hi lse i
xt he
e
he i l n
c n ndi dua oul
ve yt ng it d n
t frthypot tca ,e e t tt i vi lha t ste r f ry-i m i e f onet t
he is
he i l xc pt ha he ndi dua d o i ve y o t fve nut s or
o wo

miu e , u c ud c n iu wo kngwhl s ae . ( 6 1 Thev c to a e p r sae t a
n ts b t o l o tn e r i
i e td R. 9 .
e
o ain l x e t ttd h t
i t i vi we e s lmie t n t y c d silpe f t postonsofa sor e f c lt
f he ndi dual r o i td, he he oul tl ronn he ii
t ag a iiy
r nt clr a a f niur r alc e k wih vit l z r e oson,and c d silpe f r t
e al e k nd ur t e ent l r t rualy e o r i
oul tl r o m he

posto ofpar ng l at nda wih aboutt per e e oson.
iin
ki ot te nt t
wo c nt r i
The t ALJ pos d a t r hypot tc l i whi a i vi l c d do e r hi
n, he
e
hid
he ia n
ch n ndi dua oul
ve yt ng

lse i t frthy t tc ,e e t y wer lm ie t s nt r wor i t a oflghtwor
it d n he is po he ial xc pt he
e i t d o ede a y
k nse d i
k.
1 The voca i l e r t sii d t t a pe s n s lmie c d pe f m a s mis led
d.
tona xpe t e tfe ha
r o o i t d oul ror
e -kil
occ ton ofdipa c rf mai e nc s r ceoruns led oc upai ofor rcer f f
upai
s t he or ntna e e vi
kil
c tons
de l k or ood

a db v r g o a a d e srwh lb l,n et, n c l tsc re p n e e g 6 - 0 .
n e ea e r n d r se o a es i s rs a d ol e or s o d nc . R. 9 7 )
a
B . M e c lRe or Evi e
di a c d denc
l r ac ng he de s on t de Pl i if s be is t A LJ r vi w e t m e c
n e hi
r ci i o ny a ntf
neft , he
e e d he di al
evi nc ofr c d, he r e tpori ofwhi h i s m a i e c onol i aly bel .
de e e or t el van
ton
c s um r z d hr og c l
ow
Pl i tf pr en e t D r Robe tH odge b nni i Jul of l
a n if es t d o .
r
egi ng n y
997, t
at went t ye r of
y- wo a s

age afe bei dicha ge fom t hos t S t m uli e i r c a al he r es lf
, tr ng s r d r
he
pial t h
wi
tpl nta r ni
morhag , e t

he i r i a ne e t VP s ,hit y ofm uli e hemorhage i i va i lr mus e
m pa ess nd gl c ,
hunt sor
tpl
r s nsde rous a ge
cl

g o p . g 3 4 . W h l i t h s ia,P an ifrc ie a v n rc o aitls u t (
r u s' R. 4 1
'
ie n he o p tl litf e ev d e tiulp rea h n . R.
3 6 . Plit fwa d a n s d wih Re d - lrW e e a d lf h mi r ss ( 3 4 . At
4 1 ani s ig o e t n u ose- b r n e t e pae i. R. 4 1
f
t stm e,Pl i ifhad pa n a ong hi rghtl rc s a up i o hi rghts derbl de. 1
hi i
antf
i l
s i owe he t nd
nt s i houl
a
d.
Dr Hodg a s s t tPli ifpr ba y had a i e c t lmus l s m duet et rsr n or
.
e s es ed ha a ntf o bl
n ntr osa
c e pas
o ihe tai
t way Pl i ifwasm o ng. I The doc orpr s rbed Pe c tasa ba kup t usng hea ,
he
antf
vi
d.
t
e ci
r oce
c
o i
t
m a s ,Tyl , ndAdvi t te thi pa n. I
s age enol a
l o ra s i
d
Pl ntf ss ntwasr m ove t r t e of 1
ai if hu
e
d owa ds he nd
997,and hi at ca pai i ove
s ypi l ns mpr d.

( 3 1 Ho ve,i J l o 1 9 ,Plitf d veo e i ra e lf-i e we k e s a d
R. 38 . we r n u y f 9 8 anif e lp d nce s d e tsd d a n s n
i r sng he da hes I A s a s
nc ea i
a c . d.
c n howe t tPli ifhad t ne hemorhage i t l t
d ha antf
wo w
r s n he ef
he s r s ori l I
miphe e, ubc tca . d

Pli ifwasalo di nos wih pari lsm pl s z es whih
a ntf
s ag ed t
ta i e eiur , c

we e p rily c nr le wi me iain Te r t . ( 3 9 . Plitf c mpli d ta hs
r atal o to ld t dc to , geol R. 3 2 anif o ane h t i
h
l f ha wassow a ha dt c r ,buto he t n t thewa cos t f lng ba k t nor .
e t nd
l nd r o ontol
t r ha ha
s l e o eei
c o mal

( 3 6 . Plitf c n iu d t t e g CT sa s whc c me b c n g tv b sd s te
R. 3 2 an if o tn e o md r o
c n , ih a
a k e aie e ie h
prvi l i ntfe c ver hema omas ( 500- .
e ousy de iid a nous
ngi . R. 031
I 2006,Pli ifwa ha ng pan a sif s i hi lf sde i udi hi ebow a
n
antf s vi
i nd tfnes n s e t i , ncl ng s l
nd

tu . ( 3 8 . Plitf wa t d h h d mid c r lt n e s n r me i h slf h n a d
h mb R. 2 1 an if s ol e a l apa u n l y d o n i et a d n
wa gi n as i t we r buttssf c pa t ls omewe ene tve ( 3291 Dr
s ve plnt o a , et or ar l unne yndr
r gai . R. . .

Ho g ij ce Pli tf wihase odt r le eh seb w srs . ( 3 2
d e n e td anif t tr i o eiv i lo te s R. 28 .
Pl ntf sare r pori pr blm swih f i ue i 2008,and s Dr Andr w Peeron.
ai if t td e tng o e
t atg n
aw .
e
t s

g 3571 Pli ifwa dignos d wih obsr ctve see a a a Dr.Pees n c
R. . antf s a e t
tu i l p pne nd
tro onduce
td
s e pol a see r or ngs afe Pl i if s w ie s a ed t t dur ng s e Pl ntf w as
om
ygr ph l p ec di
t r a ntf ' f t t ha , i l ep, ai i f
s i g pi f r a r a t ki i hi s e p. 1 A s a r ul of t r co di , Dr
nor ng, as ng o i , nd al ng n s l e
d.
es t
he e r ngs
.
6

Pee s r ommende t tPlitf us aConi usPostveAiwa Pr s e(ç
tron ec
d ha anif e
tnuo
ii r y esur $
CPAP')of1
' 5
be aus i e i naed Pl i ifs a a a pr de sa e REM i a1 postons f Pl i if
c e t lmi t
antf pne nd ovi d tbl
n 1 ii
or antf .

( 3 6 . Dr Pees n as rc mme e t a Plitf tyt l s weg ta d a o drs iao y
R. 5 )
. tro lo e o nd d h t an if r o o e i h n v i e prt r
de es a s I
pr s nt . d.

I Aprl of 2009, Pl ntf r pore i r asng pr e s wih f tgue t Dr Stve
n
i
ai if e td nc e i
obl m
t ai
o . e n

Ey n o a d wa pa e o aCPAP a an. ( 31 1 TheCPAP h le alvit Plitf s
a s n n s lc d n
g i R. 8 .
ep d l ae anif
e
se pn p o e . ( 43 1 Dr a s n as n td Plitf me r lp e o ls ,
le ig r blms R. 9 . .Ey n o lo oe an ifs mo y a s s r o s
a xey d prs in a d çn blt t c p wihdal a tvte . ( 31 1 Alo a ti t ,
n it , e e so , n s a iiy o o e t iy ciiis' R. 9 . s t h s i
i
'
me
Dr Ho g rc mme d dt a Plitf sa t rg lrd e a e ecs p og a ( 4 4 .
. d e e o n e h t an if tr a e u a it nd x r ie r rm. R. 3 1
The i Febr r of201 Pli ifpr e e t Uni r iy ofl
n, n
ua y
0, a ntf es ntd o
ve st
owa Hos t l & Clni
pias
i cs

wih c mplit ofi ce sn ftg e dfu ej itp i d fu e sif e s a d d fu e mu ce
t o an s n ra i g aiu , if s on an, if s tfn s , n if s s l
a h . g 3 8 . Plitf rp re ta hswo s ae sweeh sb c , n s a d eb ws l
c e R. 0 2 anif e o td h t i rt r a r i a k ha d , n lo . d
Pli ifnot t the g up gol be us ofhi wrs a el pan.
antf ed ha
ave
f ca e
s it nd bow i

A fe f l i
t r olow ng

hi doc o ' a c t exe c s Pl i if l t t nt pounds a ha l s pai sif s ,and
s t r s dvie o
r ie, antf os we y
nd d es
n, tfne s

f tgue whe he wa wa ki fve da a we k. 1 Howe r i Augus of 201 Pli if
ai
n
s l ng i
ys
e
d.
ve , n
t
0, antf

rq e tda dr c i e aseodij cin i hsrg teb w f rh span. ( 1 2 )
e u se n e ev d tr i n e to n i ih lo o i i R. 1 5 .
t s ai
nd l r ly
ge
I Fe u r of 201 Pli tf r pored fusr ton wih hi f tgue a ç ne al not
n br a y
2, a n if e t r ta i

f ei g wel o e t ep s s v r lmo t s ( 6 1 I Ap i o 2 2,Plitf we tt t e
e ln l' v r h a t e ea n h . R. 01 . n rl f 01 an if n o h
'
Emeg n y De a t n o M ec Me ia Ce tr ( 5 5 . P an ifrpo td t a h ha a
r e c p rme t f r y dc l ne . R. 5 1 litf e re h t e d
tni ehe dac andha ahit yofchr che dac . g 556J Pl ntf as rpo tdt t
e bl a he
d sor
oni a hes R. . ai if lo e re ha

h wa h vng dfe e tis e rc nl wi j i tpan a d 1w blo s g r I Plitf
e s a i ifr n su s e e ty t o n i n o o d u a . d an if
h
saed t t he t hydr
t t ha
ook
ocodo f t pan. I
ne or he i
d

Pli if ha a M Rl of hi hea done,
a ntf d n
s d

whi s d l tpl aea of ol he r
ch howe ' i e r s
mul
d morhage..but nj evi e of a e i art on
.g
o denc
cut nf c
7

d fu i ni g n . ( 6 0 .
if so ma i g' R. 9 1
'
l Aprlof 201 Pli if pr e e t Dr Hodge a n wih compl i s of i e s d
n
i
2, antf es nt d o .
gai t
ant
ncr a e

ftg ea dp i ( 9 5 9 2 . Dr Ho e n td t a t ema ymo aiisPli tf ha tid
aiu n an. R. 2 - 5 1
. dg oe h t h n d lte anif d re
di no wor t alevit hi pan,i l ng a ii l mm aore ,m e c ne a i pr s nt ,e c.
d t k o l a e s i ncudi nt-nfn
t i s dii , ntde es a s t

( 9 2 . P an ifc n iu dt s eDr Ho g wi t esmec mp an sa d sae t a h t a
R. 5 1 litf o tn e o e . d e t h n o lit n ttd h t e t n
h
c

n p a a o ta ytmea dj td e n' fe wel' g 9 9 . Dr Ho g n td t a i Plitf
a t b u n i n us o s t e l 1. R. 4 1 . d e oe h t f an if
'
S ul s d 1 l .o mor t t woul be ve y,ve y be fci t hi ove al he lh a
t d he 00 bs r
wo
e ha
d
r
r ne i al o s r l at nd
s at '
t us-'

l J y of201 Pli ifha l tappr m ael t nt fve pounds sa e t the wa
n ul
2, a ntf d os
oxi t y we y-i
, t t d ha
s

feig b te o e al b tsilh d s me ftg a d lw e eg ( 9 1 Ho ve,i
e l etr v r l, u tl a o aiue n o n r y. R. 46 . we r n
n
Aug tof 201 Pli ifwasagan f lng f tgue and ha ng pa n,a i or e Dr Hodge
us
2, antf
i ee i a i d
vi
i nd nf m d .

t the ha t ûly down a r s a hourort durng t da and i i r ly i e f rng wih
ha
d o 'a
nd e t n
wo i he y
t s eal nt r e i
t

h swo kt t ep itta h wo d r i h wilb a l t c nt et wo k. ( 9 3 .
i r o h on h t e n es f e l e b e o o i o r ' R. 4 2
nu
'
Pl ntf ha a X-ay ofhi l
ai if d n r
s umba s nepe f r d on Se e be 3,201 t a s shi
r pi
r o me
ptm r
2, o s es s
lf,l rl m ba pa n,whih s
e t owe u r i
c howe m id de ne a i c ngeswih dik s c nmw wi a
d l ge r tve ha
t s pa e
ng t

L4- . ( 4 9 .
L5 R. 6 1
P an ifb g ns en Dr P tro a an i Se tmb ro 2 2 frhsse p is s (
litf e a e ig . ee s n g i n p e e f 01 o i le sue . R.
7754 Dr Peeron notd t tPl ntf wass i had dr mout upon a eni wokeup
. . ts
e ha ai if
norng,
y
h
wak ng,
c
pe
g s i frar a d h dr sls lg a ng t ( 7 6 . Pl i ifr portd t tLyria hel d
apng o i, n a ete s e s t ih . R. 7 1 antf e e ha
pi
l d m l p. d. Dr
.
hi s e M el c m he pe hi ar s s e, and Zol dem he pe hi s ee I
m om ,
oxi a
l d s m om

Petr on saed t tPl ntf washavi s
e s t t ha ai if
ng ome s
omnolnce durng t da 1 l c
e
i he y. d. n ouns lng
ei

Plitf,Dr Pees n sae t a f ain swi Eb tu tve se p a n a wh )a e a e u t l
an if . tro tt d h t s te t t o sr ci le p e o r d q aey
p
h
te e ma silbesee ' ( 780)
ratd y tl l py. R. .
'
8

l Oc obe of 201 Dr Kevi Ca e e pe f med slge y on Pli if t r medy hi
n t r
2, .
n p nt r ror
tr r
antf o e
s

o sr ciese pa ne , o sla h p rr p y a d ifro tr n t h p rr p y. ( 3 41
b tu tv le p a t n i r y e to h , n n ei r u biae y e to h R. 5 .
l
pos- r tve e m i ton by Dr r nt we wel a t doc or s
tope a i xa na i
.Ca pe er nt
l nd he
t ugge td Pli tf
se
a n if

sh d e a f lo u se p su y a tr h ra h d h s weg t l s g a. g 8 6 . On
c e ul o lw-p le td fe e e c e i ih os o l R. 9 1
Nove be 28, 201 Pl i if pr s nt d t Dr Ca pe e f a pos- r tve c c up
m r
2, antf e e e o . r nt r or
tope a i
he kc
ompl i ng of a snus i e ton,f tgue, s e mus e ,poor c
ani
i
nf c i
ai
or
cls
once r i a a co t nt
ntaton, nd
nsa

feigo b igc l . E 7 2 . Plitf rp re ta h wa wo kngonh sweg tl s wa
e ln f en o d R. 5 1 anif e o td h t e s r i
i ih os, s
no l rs i and wasr dy t m oves h. I
onge norng,
ea o
out
d
On Ocobe 23, 201 Pli if fr t pr e e t Dr m o hy Lot f s r a
t r
2, antf is es nt d o .Ti t
h or ha p nd

tr b i gp i i h slf t u
h o b n an n i e t h mb. ( 7 9 . Plitf c mpan d t a h swh l lf ha d fl
R. 5 1 an if o lie h t i oe e t n et
we k and wa ha d t move. 1 Dr 10 h opi t tPl ntf m a have l tTM C s no ts
a
s r o
d.
. .t
ned ha ai if y
ef
y vii

a e ry arl ts 1 The docor ga Pl i ifa c ts s t whih pr ded tm por r
nd a l t i. d.
ui
t
ve antf orione ho , c ovi
e
ay
r le . f Pli ifpr e e t Dr 10t ag n on N o mbe 1 201 a r ceve a he
ei f #. antf es nt d o . . h ai
ve r 2, 2, nd e i d not r

ij cin frp i i h slf t u
ne to o an n i e th mb. ( 7 6 .
R. 5 j
On De e be 1 201 Pli ifpr e e t t M a Clni f eva uai n ofpror
c m r 9, 2, a ntf es ntd o he yo i c or l to
i

c rbrlhe rh g . ( 8 0 . P an ifs da no e wee mu t e i ta e e rlc v mo s
ee a mo r a e R. 6 1 litf ig s s r li nr c r b a a e u
pl
he
mangi
omas ge ai e m yof s i lpai s o e a a f als zur dior r qui s e .
, ner lz d
a ca
n yndr m , nd oc ei e s de , e c nt

( 8 1 Ho ve , h p ysca o ie t tPlitf dd n th v a hso y c n itn wi
R. 61 . we r t e h iin pn d ha anif i o a e itr o sse t t
h
he e tr he orha c tl ngi t i be us t r wa no e de e of c ane orvi c r l
r dia y m r gi e a ecasa ca e he e s
vi nc
ut ous
s ea
i ve en .
nvol m t

l J nuay of201 Dr Hodget d Pli ift the ha çeal e use ( s ae of
n a r
3, .
ol antf ha
d l ly xha td hi) ra
r

e p rie wi h s h at is e a d ( s p o by b s sr e b te s cait (h y
x e ts t i e l su s n wa ) r ba l e t e v d y h pe ilss t e )
h
h
conne t hi wih.' ( 9321
ced m t ' R. .
9

On J nua y 8,201 Pli ifunde e a dignos i pol om nogr m wih Dr Pe e s
a r
3, antf
m nt a
tc ys
a
t . t r on

f re au to o hso tu tv se p a n a ( 3 0 . Th rc r n s we t a Plitf s
o v l ai n f i bsr ci e le p e . R. 5 1
e e o dig ho d h t an if
see a a wa postonaland t ti wa pr s ntwhe hewa i as neposton, t se p
l p pne
s ii
ha t s e e
n
s n upi
ii but he l e
t

a a ha i ove c
pne
d mpr d ompa e t Pli tf pror sud I On J nuar 15, 201 Dr
r d o a n ifs i t y. d.
a y
3, .
Pe e s not t Pli tf f l tlke a wr ck,'he ha pan i hi l ta m maki hi bi e
t r on ed hat a n if et di
e '
d i n s ef r
ng s c p
tghtn a hi l tebow hur,gr bbi a hi bo he ed hi ,he had s e l
i e nd s ef l
t a ng nyt ng t r
m
om owerba k pan,
c i

a dwa i a b d mo d i g n r l icudn i tb l y cy n ,a d a g r ( 7 5 3 1 Dr
n s n a o n e e a, n l ig nia ii , r i g n n e . R. 3 - 6 . .
t
P tro sae t a Plitf s i h sc r ncp i wa h st i is e' ( 7 6 . Dr Pees n
ees n ttd h t anif ad i h o i an s i i g su . R. 3 1
b
'
. tro
f
ound t tPli ifs se p a
ha antf le pnea wa m uc i pr d pos- p a now he o y had postona
s
h-m ove
to nd
nl
ii l

a n a g 7 9 . Dr Pees n o n d Sclal I ti y u ( an il ae d s be fo
p e . R. 3 1
. tro pie , t qe ry hnk o Plitfl r ia ld r m
g
wor ng a a c r pr c or a 1 wo d enc age you t ty t s l t busne s a go o
ki s hio a t nd
ul
our
o r o e l he i s nd
n
dia lt ' 1
s biiy. d.
'

0n J nua y 1 20l Pli if pr s nt t Dr Lot a i wih c
a r 5, 3, antf e e ed o . h gan t ompli s ofhi l t
a nt
s ef

tu b tei g hm a trte efcs o te trt ij ci n wo e of. ( 7 6 . P an if
h mb oh rn i fe h fe t f h is ne to
r f R. 4 J litf
r pored t thewa i al ofpai a us as i a lt tme. I
e t ha
s n ot
n nd ed plnt l he i
d

Pli ifsr s ed hi l t
a ntf te s
s ef

uppe e r m iy pan,i l ng i hi t b,r a or r a bi e a ea a e i ry. 1
r xte t i nc udi n s hum
adilf ea m, nd c p r nt ro l
d.

Dr Lot sa e t tPl i if ha l vel d a tc i t l tu r e r miy whe e n he wil
. h tt d ha antf d '
de ope
i n he ef ppe xte t
ri
l
hook hi t m b a ou hi a
s hu
r nd s nupi a i cea i t a mpi,a t twile c r e hi pa n.'
t s f l rng he r t nd ha l xa e bat s i '

Dr 10 h o ie ta Plitf lrp zo tc ma a trts prcu e ( anifs
. .t pn d h t an ips i a e imea a l rh i
t
i e l d s Plitf )
f toni asa c r a t r ' Il
unc i ng
hiopr c o .' 6

On Febr r 8,201 Dr Hodge and Dr 10t r f r e Pl i ift Dr M ihae Br
ua y
3, .
. . h e e r d antf o . c l ooks

f e uai of Pl nifs clo c pai s ome. ( 71 201 Pli if c ane of
or val ton
aitf lr ni n yndr
R. 4- . antf ompli d
f tgue, wea s , m os l i hi l f uppe e r m iy, nec pa n, m em or l s a e y,
ai
kne s
ty n s e t
r xt e t
k i
y os , nxi t
10

d p e so , a d se p dsu b n e . ( 71 - 7 . Plitf a p a e weld v lp d,
e rs in n le itr a c s R. 4 1 1
an if p e r d l e eo e
wel- i he and i no ac e dit es , but D r Br
lnours d,
n
ut s r s
. ooks not t Pl ntf was ove w e ght
ed hat ai if
r i .

( 71 1 Th d co c ncu e ta aS o dp rin' Plitf ss mp o ( t hslf am
R. 7 . e o tr o ld d h t t o o t 'of an if y t ms wi i e t r
g
o
h
s m)wee t oba y mor r ae t hi c r ner
pas
r s bl
pr
e eltd o s ental vous s tm lsons wih a deg e of
yse e i
t
re

s si d s a e a d po sbl s iur a t t ' ( 71 1 Dr Br o s o ie ta te e
patc ie s n
si y ez e ci y. R. 9 . . o k pn d h t h s
vi '
s m p om s co bi wih Pl i ifsse p a a,de es i m e or l s m e a f ton,a
y t , m ned t antf le pne
pr son, m y os , nt l unc i nd

ia iiy t tlrt c d ma e i t xr mey d fiul fr ( anif t f n t n i a y t p o
n b lt o oe ae ol, k t ç te l ifc t o Plitfj o ' ci n n y e f
e
u o
ganf e oy e . 1 The e or Dr Br
i ul mpl m nt' d.
'
r f e, . ooks r commende t Pl ntf s lhi pr tc
e
d hat ai if el s aci e
as a chiopr c or a lmove s h f s m pt c r ' bec us a wa m e clm ae a l s
r a t nd i
out or y om ontol' a e
r r i t nd es
sr s woul be bene i alt Pl ntf. f The doc or a s r om me d t tPl ntf sar
tes
d
fci o ai if #.
t lo ec
nde ha ai if t t
s
ome f r ofS o i pa te r ie s h a wa ki o c lng on a da l bass' l
om
t w m c xe cs uc s l ng r yc i
l
iy i . d.
'
I Fe ua y of201 Pl i ifpr e e t Dr Eli Sna l a lce e ps hol s,f
n br r
3, antf es ntd o . le vey, i ns d yc ogit or

ne r p y h lg c l e lain. ( 1 4 - 3 . Dr S a ey us d Plitf s p ir
u o s c oo ia vau t
o
R. 0 7 5 1
. n vl e
an if ro
n u o s c lgc l e au to fo 1 9 f r c mp rs n. g 1 47 . Pli t f rpo td
e r p y hoo ia v l ain r m 9 7 o o aio
R. 0 2
ani e re
f
pr e s wih m e y,ditc t l r ng new t s a pr edur s be ng e iy ditaced,
oblm
t
mor
fi uly ea ni
a ks nd oc e , i asl sr t

lsn h s tan o t o g t a d b ig f r ef l ( 1 48 . Afe tsig,Dr S a ey
o ig i r i f h u h , n en o g tu . R. 0 1
tr etn
. nvl
c ude t t Pl i if had a r d c tve de i is prm a iy i s d of pr es i a
oncl d ha antf
cquie ognii
fct i rl n pee
oc sng nd
s t i c enta i whi h a e s e Sn a s i ton wih a wi va it of ne ol c ,
usaned onc r ton, c r e n é s oc ai
i
t
de rey
ur ogial

g n r lme ia, n p y h arcd s r e s' ( 1 2 . Th r wa S o e i e c whas e e
e ea dc l a d s c iti io d r. R. 05 1
'
ee s i v d n e to v r
n
of a pa t r of r gul r c tve de i s h a w oul be s e i a s i i w ih a of t
te n
e a ognii
clne uc s
d
e n n s oc aton t ny
he

ne o- gene a i dior r ' I Dr Sna l opi d t t ç he viual s ta pe ce ual
ur de
r tve s de s. d.
'
. vey
ne ha t
t
s
pa il r pt

d fct f rb t ra o n , u g n ,a d s o t em t a weep e e ti 1 9 ,o emo t a tr
eiis o o h e s nig j d me t n h r- r h t r r s n n 9 7 n nh fe
t
t he r gi e s hag c eey rs ved. g 1 531 Howe r Dr Sna y
he morha c vent, dq ompltl e ol ' R. 052- .
'
ve , . vel
11

no e t tPl i ife re e m ode a e de e son a m ode a et m ode a el s ve ea ey,
t d ha antf xpe inc d
r t pr s i nd
rt o
r t y e r nxit

wh c ddn t p a p e e t ttetmeo te 1 9 e lain. ( 1 5 1
ih i o a pe r r s n a h i f h 9 7 vau to
R. 0 3 .
Pli ifpr s nt d t Dr Peer o a i i Aprlof201 wih c
antf e e e o . t s n ga n n
i
3 t ompl i s ofwor e ng
ant
s ni

ftg a dp i a ds rne si hslf a
aiue n an n o e s n i e t nn. ( 8 3 . Dr P tro sae t a Plitf sp i
R. 4 1
. ee s n ttd h t an if an
a s e swasti i hi f tgue. 1 Pl i ifr pore t the s d hi pr tc a hi
nd or nes
rggerng s a i
d. antf e td ha
ol s ac ie nd s

h u e ta h swiesa td aj bi F o ia a dt a hea dt k d wo db j nn hi wiei
o s ,h t i f tre o n lrd , n h t n he i s ul e oiig s f n
Fl i s
orda oon.

Dr Peer o not d t tPl ntf e re d dr i swhie drvi a
. t s n e ha ai if xpe ince owsnes
l i ng nd

. e on s
e ha antf tl
ey
whl sti g o ra i g ( 8 5 . Dr Petrs alo notd t tPl i if silhad nnxit but
i i n r e d n . R. 4 1
e t
no de e son orse p dit ba es l
pr s i
le sur nc . d

Howe ,t doc o a s satd t tPl ntf ne d
ver he t r l o t e ha ai if ede

t i e tea xit a d d p e so u d rc nr la d ra s s. ( 8 6 . Dr Pees no n d
o c t h n ey n e r sin n e o to n e se s' R. 4 1
g
'
. tro pie
t tPlitf wa S lal d s be fo gi)wo k a a c io r co . ( 8 1 Th d co
ha anif s ç e ry ia ld r m h s r s hr p a t r' R. 47 . e o tr
c
'
as notd t tt M a Clni wa c nc d t tPli tf di notha Re ose - e r
lo e ha he yo i c s onvi e ha a n if d
ve ndu- lr W be .

( 8461
R. .
Pl i ifa s pr e ed t Dr Hodge agan i Aprlof201 co pl i ng ofpa n i hi
antf lo es nt o .
i n
i
3 m ani
i n s

ba k a a a ne f lngr td. g 925- . Dr Hodgenotdt tPl ntf wa abl
c nd nns nd ver eei ese R. 261
.
e ha ai if s e

t s l h sc io rci p a tc a wo l b mo i t Flrd s o ( 9 6 . Thed co
o el i hr p a tc rcie nd u d e vng o o i a o n. R. 2 )
o tr
pr s rbe Pl ntf mor hyd oc
e c i d ai if e r odonebe a et theped wih hi pan. I
c us ha l
t s i
d
On J
une 1 201 Pl ntf pr e e t Dr Chrsopher Snyde f chiopr c i
9,
3, ai if es nt d o .
it
r or r a tc
ea
m
te t n. ( 1 867 . Dr S d r sae t t Pl i if appear r l xed, had nor al
rame t R. 23 - 2
. ny e ttd ha antf
a bul ton, nor al ga t a good posur ( 1 . Pl ntf compli s wee i hi
m ai
m
i, nd
t e. R. 2431 ai ifs
ant r n s
bia e a c r c l r on a t ne k a e ef t ac c r on a t uppe bac a ea bia e al
l t r l e vi a egi t he c r a,l t hor i egi t he
r k r , lt r

t r i rgi a t l bac a e a biat a l rr on a t l
hoacc e on t he ower k r a, nd l erl umbe egi t he umbopel caea. (
vi r
R.
1 . Dr Snyde l d outa c e nsve te t ntpln f Pli ift ha c r aci
2631
.
r ai
ompr he i rame a or antf o ve hiopr tc
12

ma i ltv t ea y. ( 1 6 - 7 . Plitf c niue te tng wi Dr Sn d r u tl
npuaie h rp
R. 2 5 6 1
an if o tn d rai
t . y e ni
h
De e r20 4 f rhi s rne s a d sif e s fo hs p i g 1 4 - 2 . Ac o d n t
c mbe 1 o s o e s n tfn s r m i an. R. 2 8 6 1
c rig o
Pli if hewasha ng is sdoi ho e d c esbec us ofhi t s bld lf ar ' (
antf,
vi s ue ng ushol hor
a e
s s a e e t m. R.
di
'
1 .
2831
On J y 26,201 Pl i ifpr s nt t Dr Ta i Adiif a ne ol c le l ton of
ul
3, antf e e ed o . grd l or
ur ogi a vaua i

hs p e o s h so y o bltr lc r b a h mo r a e . ( 1 4 - 1 Dr Adl noe t a
i rviu itr f i ea ee rl e rh g s R. 1 3 47 . . ii td h t
a
Pli tf ha hi frtsr ke a ag 22 whe he wa lfi wei sa had wea s o hi l t
a n if d s is to t e
n
s itng ght nd
knes n s ef

sd , ihwa atiu e t bi tr l ee r l e rh g s ( 1 4 1 Dr Adl sae t a
ie whc s trb td o l ea c rb a h mo r a he . R. 1 3 . . ii ttd h t
a
d ov rte ls fv t sx y a s t e man p o lm t p te ti ha ig.. o e o sv r
t le h at i e o i e r , h
g
i r be he ain s vn .i n f e e e
s
de es i ' aong wih ge r pan i hi s de s kne s ebo s wrss nec a l r
pr son, l
'
t ne al i n s houl r , e , l w , it , k, nd owe
bac 1 As t doct no e Pl i if deveope f l s z e ac i t i hi l f ar
k. d.
he
or t d, antf
l d oca eiur tviy n s e t m
b we n t tme he had hi fr tand s cond e s
et e he i
s is
e
piodesoflf- i d we kne si 1 an 1
e tsde
a s n 997 d 998.
a l or s es dua
( 11 . Dr Adiirc
R. 444
. l e omme
nded t tPli iftke a l dos of Elvi f hi r i l
ha antf a
ow e

a e y, S c i ca i i omni a p ritn p i n e ig nac tc . ( 1 46 .
nxit i h s usng ns
whi
a nd e sse t an e dn
r ois' R. 1 1
'
Ac r ng t t docor getng Pl ntf s a ey a de e son under c r woul hep
co di o he
t , ti
ai if nxi t nd pr s i
ontol
d l

de r as Pl ntf da i f tgue. I
c e e ai ifs ytme a i
d

W he Pl i ifr t ned f ra f l up t Dr Adii
n antf eur
o olow- o . l,

Pli ifr pore t t at h t a ti ylne r duce Pl i ifs pai a hepe hi se p
antf e td ha , lhoug he mirpt i e
d antf
n nd l d m le

b te a nih,Plitf wa sile p re cn çe eed s bi ftg e' ( 1 41. Pli tf
etr t g t an if s t x ein ig s v r ia l aiu . R. 1 j anif
l
s
ng
'
a s r pored t t t El vi he ped w ih hi a et
l o e t ha he a l l
t s nxi y.

Dr Adii c ude t tPli if
. l oncl d ha a ntf

nd
s d con i hi dos of El vi f hi a e y a pai i a ton t t Buspar a
houl
tnue s
e
a l or s nxi t nd n, n ddii o he

Ve aa nehet f hi a ey, bee l t f na c eps g 11 . Dr Adiidi
nlfxi
ook or s nxit and vauaed or r ol y. R. 421
. l d
not t t Pl ntf s a e t t t hydr
e ha ai i f t t d ha he
ocodone he t kes hel w ih hi pa n and i r a e hi
a
ps t s i
nc e s s s
e r buthe di notw a t t t m uc of i. I
ne gy,
d
nt o ake oo
h
t d
13

A c or ng t D r A dii Pl i i fw a
c di o . l, a ntf s

f ly c mp in wih h s CP a n g t a wel ( 1 7 1 Al o g Plitf rp re
ul o la t t i AP t i h , s l. R. 1 9 . t u h an if e o td
h
f elng ftg durng t da i sil Pl ntf swie not t tPli ifwa l sa ousa
e i ai ued i he ytme tl, ai if
f ed ha antf s es nxi
nd

ls irtb ed rn te d yi . ( 1 8 1 Athi ne tf lo u ,Dr Ad l plc d P an if
e s ria l u i g h a t
me R. 1 0 .
s x o lw- p . ii a e litf
on Stat r f rhi da i f tg
r te a o s ytme ai ue. 1
d.

Plitf tle o t a Dia iiy Re o t Ad l o Aug s 2 , 2 3. E 21 - 1
anif ild u
sb l
t pr
ut n
u t 2 01
R. 2 21 .
Pl ntf lsed t f l ng physca a me a c tons t lm i hi a lt t wor
ai if it he olowi
i l nd nt l ondii
hat i t s biiy o
k:
d t a r lt d t he orha c sr , c oni f tgue ba k pans r pr son/ nxit
ysoni ea e o m r gi toke hr c ai , c
i , e es i a ey,
di o antf, t
ng
d p e so a dwrs p o e . ( 21 1 Accor ng t Pl i if he sopped worki because
e rsin, n it r blms R. 3 .
ofhi c ton. 1
s ondii
d.
Pl i ifs wie,M e e t Sl yma r complt a Suppl men alThid Pa t Anxit
antf' f
r dih a ke ,
eed
e t
r
ry
ey

Qu sin ar o Au u t2 ,2 3. ( 2 2 3 1 Mr .S a ma e sae t a Pli tf sa td
e to n ie n g s 8 01 R. 3 - 4 . s ly k r ttd h t anif tre
ha ng al ey at c a f ye r bef e wih t m os r c nt3- at c occ ng i t l t
vi rxi t ta ks ew a s or , t he
t ee
4 ta ks uni n he as

sxmo t s ( 2 3 . S es i t a srs a dp i c u e t atc sa t td e r lx to
i n h . R. 3 1 h ad h t te s n an a s d he ta k nd ha e p ea ain
t hni
ec ques a wal ng hel d t r le t s
nd
ki
pe o e ive he ympt s of a a t k. I
om
n tac
d

Durng a a t k,
i n tac

M r .Sl y a r s i t t Pli ifexpe i nc r ge and f u ta i a be om e fdg y and
s a m ke ad ha antf
re es a
r sr ton nd c s i et
ne v . 1
r ous d.

Alo on Augus 28,201 M r .Slym a rcompl t a Functon Re t Adul- Thid
s
t
3, s a ke
eed
i
port
r

Pa t ( 2 4 31 . Mr . a ma e a sre t tPlitf' c ndto h sma ehi ç n be
ry. R. 2 - 1
s Sly k r se td ha anifs o iin a d m % a l
u
t f n to i a1fc t o hslf. ( 2 4 . Ac o dngt h swie Pli tf c n o wo k a d
o u cin n 1 a es f i ie' R. 2 )
'
c r i o i f , anif a n t r n
c
nnno c rbut f l t ho ehol r s
t onti e uly o us d e ponsbiii s I
i lte . d

M r .Sl
s ayma rs i t on a da l
ke ad hat
iy

bass Pl i if w a up,ea s br a as , s e s r t afe l
i a ntf kes
t e kf t how r , es s t r unch f ç a l 2- hour , a
or û r y 3
ne
s ' nd
'

te e t dn e a d h l sterc lrn wi h wo k. g 2 5 . S e as sae t a s e
h n as in r n ep h i hi e t ome r R. 2 1 h lo ttd h t h
d
h
prm a iy c r f t i dogs a c l en butt t Pl i if hel whe he i a e. I
i r l a es or he r
nd hidr
ha a ntf
ps
n
s bl
d
1
4

M r.
s

Slym a r a lged t t Pli if se ps a1 t tme bu wa up tr d bec us he ne ha
a ke le
ha a ntf l e
1 he i
t kes
ie
a e
ver s
r tu see l
esf l l p. d

Howe r s saed t t Pl i if ha no pr em w ih pe s
ve , he t t ha antf s
obl
t r onalc r a
a e nd

d e no n e r mi d r t tk c r o p ro a n e o t tk me iains g 2 5 2 1
o s t e d e n es o a e a e f e s n l e ds r o a e d c to . R. 2 - 6 .
Furhe ,M r .Slym a rsa e t tt r ha bee no c nge i Pli ifsc ng ha t snc
t r s a ke tt d ha he e s n
ha
n a ntf ooki
bis i e

h sc n i o b g n. ( 22 1 Ac o dn t h swie Pli tf hepsafw tme awe k wih
i o dt ns e a R. 6 . c r ig o i f , anif l e i s e t
i
hous wor by doi lundr a doi dihe .
e k
ng a y nd ng s s

M r .Sl ymake sa edt tPl ntf i a e
s a
r tt ha ai if s bl

t d i e a c r c n g o tao e a d o c so ly s o s f rg o eis ( 2 7 . Ho v r
o rv a , a o u ln , n c a inal h p o r c re . R. 2 1
we e,
P an ifh sb e mo ef r ef wi bl p y n a trhsc n iin b g n. ( 2 8 . Mr .
litf a e n r o g tul t il a me t fe i o dto s e a R. 2 1
h
s

Sa ma e s i t tPlitf u e t b itrse i ma y mo e a tvte t a j twac ig
ly k r ad ha an if s d o e n eetd n n r ci iis h n us thn
tl vii a plyi vi o gmnes s h aspl yi gol a doi ya d wor I She notd
e e son nd a ng de
, uc
a ng f nd ng r
k. d.
e
t thi onl s a aci te a e ove t t e
ha s y ocil tvii s r
r he elphone oron t comput rbe us he doesnotgo
he
e ca e
outon a r ulr ba i . I Ac or ng t Pli ifs wie,hi c tons afe thi m e y,
eg a s s d.
c di o a ntf
f s ondii
f c s mor

c mpltn ts ,u i ghi h n s a d g tig ao g wi oh r . ( 2 2 S esae ta h
o eig a ks sn s a d , n e t ln t te s R. 29 . h ttd h t e
n
h
i ofen u bl t r a et pe enow,f ge st ngse iy,doesnotcomplt c t n t ks a
s t na e o elt o opl
or t hi
asl
e e erai as , nd

d e n t a l sr s wel g 2 9 3 1
o s o h nde te s l. R. 2 - 0 .
Plitf fle o taS p lme tlPan Qu sin ar o Aug s 31 20 3 ( 2 5 3 1
anif ild u u pe n a i e to n ie n u t , 1 . R. 3 - 7 .
Pli ifsae ta h h ss v r p i i hs lf a u pe b c ,a d lf h n . ( 2 5 .
ant ttd h t e a e ee an n i e t nn, p r a k n et a d R. 3 j
f
Ac or ng t Pl ntf,hi pa n i ca e by col expos e,sa ng,bendi sti i a ofie
c di o ai if s i s us d
d
ur tndi
ng, itng n n fc
c i,lf i and ca r ng. 1 Pl i if c a m e t thi pai l s s a lda e r da butt t
ha r i tng,
r yi
d. a ntf l i d ha s n a t 1 y, ve y y
ha

hi me c ton ( oc
s diai hydr odone,meoxia a a ti ylne t ovi ss r i . ( 2361
l c m, nd mirpt i ) d de ome elef' R. .
pr
'
Pli ifs d t tt m e c ton doe notc us hi a sde e f t . I
antf ai ha he dia i
s
a e m ny i fec s d

Be i m e cai
sdes di ton,

Pl ntf sa e t the hastid aTENS uni,c r pr c i mas a ,a physc t r py f hi
ai if t t d ha
re
t hio a tc
s ges nd
ial he a or s
pai I A cc di t Pl i if he ca onl pr p bas c f
n. d
or ng o a ntf ,
n y e
i oods bec us he c onl us one
a e
an y e
1
5

ha he c nno hep m uc wih hous c e ni he doesl undr he doe notdo any s
nd, n t l
h t
e l a ng,
a y,
s
hoppi
ng
be aus i i t pai ult wak,he has to e se pi he onl drve s tdit nc ,he
c e t s oo nf o l
r ubl l e ng,
y i s hor sa es
soppe doi s i la tvii st tc us d hi pa n,i i difc tt hep wih c l r be us
t d ng oc a c i te ha a e m i t s fi ul o l t hidca e ca e
lfi a plyi on t foorca e hi exteme pan,a he ge ss eafe a f w m i e of
itng nd a ng
he l
us s m
r
i nd
t or tr e
nut s

stigo sa dng ( 2 6 3 1
i n r tn i . R. 3 - 7 .
t
Alo o Aug t31 2 3 Plitf fl d o ta Fu ci n Re o t Ad l. ( 2 8 4 1
s n us , 01 , an if il u
e
n to p r- u t R. 3 - 5 .
l a ton t t lmiai Pl ntf lse i t Supplme a Pai Quetonnar dic s d
n ddii o he i ttons ai if itd n he
e ntl n si ie s use

a o ,P an ifs i hi c ndto sma e i ice sn l had rt p ro m hi j b b c us h
b ve litf ad s o i n k t n ra i gy r e o e f r s o e a e e
i
wo l S du t pain a dte r q ier s o an p. ( 2 8 . Plitf sae ta h wo l
ud t j s a te t n h n e ur et r a ' R. 3 ) anif ttd h t e ud
a
'
ha t tke a l s a t hour na ea h da 1 Ac or ng t Pli if he c n wak f
ve o a t ea t wop c y. d.
c di o a ntf,
a
l or
t t mi e be or nee ng t sop a r tand c n pay a tnton f t n mi esa a tme.
wen y nut s f e di o t nd es
a
te i or e
nut t i

g 2 3 . P an ifsae t t eus sab a efrhslf h n ( 2 4 .
R. 4 1 litf ttd ha h e r c o i e t a d. R. 4 1
Pli if fle outa Supplme a Fai Quesi mar on Augus 31 201 (
antf ild
e ntl tgue
tor ie
t , 3. R.

2 6 4 1 Ac o dn t Plitf,h i tr d fo t tmeh wa e u t t tme h g e t
4 - 8 . c r ig o anif e s ie r m he i e k s p o he i e o s o
b d a d h n psf r2 3 h u str ug o tt e da ( 2 6 . Plitf sae t a wh n h
e n e a o - o r h o h u h y. R. 4 1 an if ttd h t e e
wa sup he ne rf el r t d. f He a s saed t thei nott ki any m e ca i f hi
ke
ve e s ese
#.
lo t t ha
s
a ng
di ton or s

ftgue. ( 2471
ai
R. .
On Aug t31 201 Pl ntf as co ee a Supplme alAnxit Quesi ie
us , 3, ai if lo mpltd
e nt
ey
tonnar .
( 249- j He saed t he sa td ha ng a ey atc i t pr o yea a a haf
R. 51 .
tt hat tre vi nxit ta ks n he evius r nd l.
( 2491 Ac or ng t Pli if he expeinc ffee a ey ata ksi t pr e ng sx
R. . c di o antf,
re ed it n nxit tc n he ec di i
mont . ( 2501 He sae t tt at ks l t 20- mi es 1 Pl ntf s d t
hs R. .
ttd ha he tac as 30 nut . d. ai if ai he
a t cksa e c us d by sr s , s c l e a hi pe s a t y ar m a w or e by sr s a hom e
ta
r a e
t e s hi hidr n, nd s t , nd he e de
s
te s t
a hi pa n. 1 H ow e r s ee and m e c ton hel r i ve t s pt s of hi a t c .
nd s i
d.
ve , l p
di a i
p ele he ym om
s ta ks
16

1
d. Ac or ng t Pl ntf, hi a tc m a hi f el Sove whe med a hepls wih
c di o ai if s ta ks ke m e t r l
nd l e s t
i ndi doom , m a hi f e worhl s ,a he i uns e wha t do a how t do i. 1
mpe ng
' ke m e l t e s nd
'
s ur
to
nd
o
t d.
Pl ntf saed t thi a ey a tcks ma hi una e t t ke c r ofa hi ca e hi t
ai if t t ha s nxi t ta
ke m
bl o a a e
nyt ng, us m o

wo r , n c u ehm t wa t ose p. ( 2 1.
ry a d a s i o n t le R. 5 )
O n Se e be 24, 201 J l Pe e SDM , pe f m e a r i l f nctona ca c t
pt m r
3, oe r z,
r or d
es dua u i l pa iy

a s sme t o Plitf. ( 8 - 6 . M r Pee d tr n d ta Plitf s e rin l
se s n f anif R. 3 8 )
. rz eemie h t an if xeto a
lmia i we e t f l ng:occ i l lhi orc r ng t nt pot ,feque l lfi
i t tons r he olowi
asonaly i ng
aryi we y mds r nty itng
orca r ng tn pounds sa ng a orwal ng f at a ofsx hotr i an e g ryi e
, t ndi nd/
ki or ot l i
ls n
i hthourwor y,
kda

stig f rat tlo sx h t si a eg th u wo kd y a d t i td p s ig o p lig. (
it o oa f i ol n n ih - o r r a , n ml e u hn r uln R.
n
r
mi
8 1 Mr P r z d tr n d ta Plitf s po t rllmiai n wee o c so al ci n
3 . . ee eemie h t an if su a i tto s r c a in ly l g
mbi
r m psorsais ne rclm bi ldder ,r ,ors afol ,occ i ly baa ng,oc sona l
a
t r , ve i ng a s opes
c f ds
asonal lnci
ca i ly

so png o c so al k eig o c so al c o c ig, n o c so al c a ig ( 8 - 4 .
to i , c a in l ne ln , c a in l r u hn a d c a in ly rwln . R. 3 8 1
y
y
M r Pe e no e t t Pli if had no m a pultve comm u c i viual or envionm e al
. r z t d ha antf
ni a i ,
niatve, s ,
r
nt

lmiain . g 8 . l c n l in Mr P rzddn t k afn n a t P an ifsa ii t
i tto s R. 41 n o cuso , . e e i o ma e idig s o litf b ly o
t
pe f m hi pas r e ntwor buthe sa e t t ba e on t RFC,Pl ntf woul be a et
ror s t elva
k,
t t d ha , s d
he
ai if
d
bl o

pe f lghtwor ( 85 . He f Pli ift notbedia e f On t s medae,
ronn i
k. R. )
ound antf o
sbld. #.
he n
t
Dr Erc W ene ,a St t a nc cons t nt pe f m e a medi lps h c ula i ofPl i if
. i
i r
ae ge y
ula , ror d
ca/ yc ons t ton
antf

f rh sd sb ly d tr n t n. ( 7 - 2 .
o i ia ii eemiai
t
o
R. 9 8 1
On Oc obe 22,201 Pl ntf fle outa Dia lt Re t Appea ,cai ng t thi
t r
3, ai if ild
s biiy por
l l mi ha s
i o t c hy r om ni ha w o s ned a he w a tr d a 1t tm e,r quii m uli e na pe
di pa hi pe s
a d re
nd
s i e 1 he i
e r ng
tpl ps r

da g 254- . Pli ifalo alege t theha toubl sa ngawa a f i (
y. R. 591 antf s l d ha
s r e tyi
ke nd ocusng. R.
2541 Ac or ng t Pli if hi pe s rl i hi wihhi wiea c l e wa s frng
. c di o antf, s ronal eatons p t s f nd hidrn s ufei

d et hi a xeya de h u to ( 2 7 .
u o s n it n x a sin. R. 5 1
17

On De embe 4,2013,Pl i ifs r que tf r c i r ton ofhi diabiiy cli wa
c
r
antf e s or e onsde a i
s s lt a m s

d ne ( 8 - 0 1 Plitf came t à h si ip t i h p ro i ha wo sne ,h wa
e id. R. 8 1 2 . an if li d h t i do ahc y e s mn a d re d e s
awa tr d,he ha t t ke muli e na i a day i or t f ton, a t t t s wa
l ys ie
d o a
tpl ps n
n der o unci
nd ha hi s

afci hsc g iie a iiis g 8 1 Dr S e e W ie Ps D. f t ta,i a di o t
fe t i o ntv blte . R. 9 . . tv n s , y. , omd h t n d t n o
ng
i
Pli tf s pr vi di nos ,Pli if alo ha s ve e CVA,lt e f t of c r br s ul r
a n if
e ous ag es antf s d e r
a e fecs
e e ova c a

ds a e s v r c r n cftg es n r me a dn n s v r a xeyd s r e s ( 9 2
ie s , e e e h o i aiu y d o , n o -e ee n it io d r . R. 5 .
Th n Dr Da i Gu t np ro me ar sd lfmcin lc p ct a s sme t ( 9 1
e , . vd tma e fr d e iua t to a a a i s e s n . R. 8 .
y
Dr Gutman de e m i d t tPl ntf exe tona lmia i we e t f l ng:oc sona l
. t
t r ne ha ai ifs ri l i t tons r he olowi
ca i ly
lfi or ca r ng t nt pounds fe nty lfi o c r ng tn pounds sandi and/
itng
ryi we y
, r que l itng r aryi e
, t ng
or

wa ki f a t alofsx hour i a ei l ng or ot
i
s n n ghthour wor
kday,sti f r a t alofsx hour i a
itng o ot
i
sn n

eghthourwor y,a unlmie pus ng orpuli ( 981 Dr.Gutmandetnni t t
i kda nd i td hi
lng. R. .
t
e ned ha
Pl i ifs posur lm iatons we e oc asona l c i ng r mps or sais neve c i ng
antf'
t al i t i
r c i ly lmbi a
t r,
r lmbi
ldde s r s or s a f ds occ sonaly baa ng, occ i nal soopi occ i l
a r , ope ,
c fol ,
ai l
lnci
aso ly t ng,
asonaly

k e l g o c so lyco c ig a do c so al ca ig. ( 9 ) Dr Gu t n n tdta
n ei , c a inal r u hn , n c a in l rwln R. 9 . . t
n
y
ma oe h t
Pli if ha no m a pultve,communia i or viua lm ia i . 1 Howe r Pl ntf
antf d
ni a i
c tve,
s l i t tons d.
ve , ai if

h d e vr n na lmiain o a iigc n e tae e po tr t h z r s ( 9 - 0 1 Dr
a n io me tl i tto s f vodn o c n rtd x sze o a ad . R. 9 1 0 . .
Gu t nn tdt a Plitf sg i wa S ll u ta y b t(ewa la l t wako h esa
tma o e h t anif at s l dy nse d u h s be o l n e l nd
mi
t e wi o td fiut .3 g .1 0 . Dr Gu t nt ee o ef u dt a,c n ie igt ettlt
o s t u ifc ly' R 0 )
h
'
. tma h r f r o n h t o sd rn h o aiy
oft e de e Pl ntf s d be abl t f ton wihi t r src i ofhi RFC a wa
he vi nc , ai if houl
e o unc i
t n he e titons
s
nd s

notdia e g 1 021
s bld. R. 00- .
Pli if a n pr s nt d t Dr Adii i M a of201 f m a ge e of hi da i
antf gai e e e o . l n y
4 or na m nt
s ytme

ft u d e t se p a n a a d i o t c h pes mn a ( 1 1. Dr Adl n td t t
ai e u o le p e n dipahi y ro i . R. 28 1
g
. ii o e ha
3 Pl ntf ha a r ntyhada lm p i hi l tl si 1 , wh nh wa amost yer ol ( 3 7 .
ai if s ppa e l
i n s ef eg nce 976 e e s l two as d. R. 4 1

18

Pli tf was pr c i Adde al a Cy bala. I
a n if
es rbed
r l nd m t
d

Pl i if r c l ha c r l t l
antf e enty d a pa unne

r l a e s ge y i hi r ghtha f hi rght s de m ode a e y s r c r lt
e e s ur r n s i
nd or s i - i d,
r t l eve e a pa unne s om e
l yndr ,

a Pli if r pore sgnii nti pr m e i hi rg ha snc t s ge y. I l a
nd antf e td i fca m ove nt n s i ht nd i e he ur r
d. n
f l up vi i,Pl ntf r pore t ta i r as i hi Cymbat dos wa tea i hi wel
olowst ai if e td ha n nc e e n s
la e s r tng m l.

( 1 7 ) Ac o dn t Plitf,tej s h st p irtz hi tmea atni na dp o d d
R. 2 9 . c r ig o an if ( u t a o ro iie s i nd te to n r vie
h
h d e n tty t f c so 3 t ig a t e s me t h i a l t c nc n rt a d g tt ej b
e o s ' r o o u n hn s t h a i e s be o o e tae n e h o
me
done. 1 Dr Adiinot d t t Pl ntf t kes ca e of hi 2 c l e whie hi wie wo ks
' d.
'
. l e ha ai if a
r
s hidr n
l s f
r
durng t da buthe c nnotr a and t e c r ofhi ki a t s m e tme be aus d ski
i he y,
n
ed
ak a e
s ds t he a i
c eç
hi ds
r quie a l of at nton.
e r
ot
te i '
'

f
#.

l J y of 201 Dr Adii pr s rbed Pli if
n ul
4, .
l e ci
antf

de r mphea ne t t i addii t hi Addeal. ( 1 . Dr Adii notd i
xtoa
tmi o ake n
ton o s
r l R. 2771
. l e n
Dec mbe o 201 t Pl ntf wasbe tron t Cy bat t n on t Buspara Efe r a
e r f 4 hat ai if
te
he m la ha
he
nd f xo s

fra bot hi mood an hi pan. ( 1 . Howe r Pli ifr pored felng si ty
a s h s
d s i R. 2701
ve , antf e t e i lghl
a ousa wa i t sa tba on Cymbala i c bi i wih t Buspa . l
nxi
nd ntng o tr ck
t n om naton t he
r d
On Ju 20,201 Dr Snyde pe f med a X -ay ofPl i ifs s ne,whih i cae
ne
4, .
r ror
n r
antf pi
c ndi td
Pli ifha m id de ne a i dic die e a L3 L4,L4/ a LS LS;mode a edege r i
antf d l ge r tve s s as t /
L5, nd /
rt
ne atve
dic die s a T9/ 0,T1 / 1 a T11 T1 s f
s s a e t T1
0 T1 , nd
/ 2; pur onna i a T1 T1 m id de ner tve
ton t 0- 2; l ge ai

d s die s a C4 C5 C3C4, n C5 C6 a ds u f r to a C5 C7 g 1 0-2 .
ic s a e t / , / a d / ; n p r o main t - . R. 31 1 1
On Novembe 20,201
r
4,Dr Peer o wr e a l t dic sng Pli if' i s wih
. t s n ot
eter s us i
antf s s ues t
obs nz tve s e a a, i opa hi hy r om nol nc l t e f c s of sr
t c i l ep pne di t c pe s
e e, a e f e t
t oke w ih s tc l t
t pasi ef

he paess f ldysoni s ve ea ey,a modeae de esi wih s tc f us (
mi r i, oca t a, e r nxit nd
rt pr son t omai oc . R.
1 . Pl ntf ha l ts n Dr Peero i J y of201
3201 ai if d as ee . t s n n ul
4. 1 Acc di t Dr Petron,
d.
or ng o . es
Pl ntf s t i t c nt m ove e di or r of hi l f a m a ha ' was a r ul of hi pror
ai i f d gnii a
s
m nt s de
s e t r nd nd'
es t
s i

sr k . 1 . Dr Pees nn t dt a ti dio d rt k si i osi ef r( an it t wok i
to e d
. tro oe h t h s s r e s e t mp sbl o Plitfl o r n
ma
19

hi pr es i '
s of son.
'

Dr Pe e s a s not t tPl ntf s se p a
. t r on l o ed ha ai if le pnea waswe lteaed bu
l-r t
t

he wassilha ng ma ke y a r a se p sudi ,c imi E of
tl vi
r dl bno m l l e t es onfr ng t ound hy r omnol nc '
pr
pe s
e e.
'

1 . Ac o dig t Dr Pee s n,tid o ti h p ro oln ei d fiul t te ta tn st
d
c r n o . tro S q ipah c y es mn e c s ifc t o ra nd e d o
l
r pond po l t m e ca i . Hyperom nolnc m a l t
es
ory o di tons
s
e e kes ong enn e oymentdifc tas
mpl
fi ul
pai nt t nd t f l ase p a wo k a ge tr d a ha dit t wih s t i d
te s e
o a l l e t r nd t ie nd ve fkuly t usane
c e r to '
onc nt a i n.'

Thus Dr Peeron conc ude t Pl ntf was û s bl d fom hi
, . t s
l d hat ai if
s a e r
di
s

Pr e son.
of s i '
'
A LJ D e i i n
c so

Th ALJis d h rd cso o Plitf cam f rb neiso M ac 3 ,2 5 (
e
sue e e iin n anifs li o e ft n r h 1 01 . R.
2 - 5 . Th ALJe p an dtefv -tp s q e ta e au to p o e sf rd tr nigwh t r
74 1
e
x lie h i ese e u nil v lain r c s o eemi n ehe
a i vi i dia ed. ( 30- . She f
n ndi dual s s bl
R. 321
ound t t Pl ntf me t i urd saus
ha ai if t he ns e tt
r quie
e r ment of t Soc a Se rt Ac t ough De mbe 31 201 a ha note
s he
i l cu iy t hr
ce r , 8, nd d
ngage i
d n

s b tn il anf a tvt sn eJ n 1 2 3,h alg do -e d t . ( 3 2 TheALJte
u sa ta g i ul cii ic u e , 01 te le e n s t ae R. 2 .
y
hn
f nd t t Pli if s f s fo t f l ng s r i r e s l bos c als
ou ha antf ufer r m he olowi eve e mpaim nt ; um a r pondyl i,
oss
obe iy,sa uspos biae a ce e alhe orha tnos
st tt
t l tr l r br m r ge, e ynovii ofbia e alha a m i t,lt
ts
lt r
nds nd ss ae
e f ct of c r br s ul die e, obsnltve see a a, i opahi hype s ni chr c
fe s
e e ova c ar s as
t c i l p pne di t c
r om a, oni
f tg s ome,de es i dio de ,and anxit dior . f The ALJ a s f
ai ue yndr
pr sve s r r
e y s der J.
l o ound t t
ha

Pli if had t f l ng non- e r or no m e ca l de e m i bl i i nt : or ni
antf
he olowi
s ve e
t di ly t r na e mpanne s ga c
men a dio de a m id dysoni
t l s r r nd l
t a.
The ALJ next f d t t Pli if does not have an i im e or combi ton of
oun ha a ntf
mpar nt
nai
i pa r e s t t m e t or m e ca l e l t s ve iy of one of t lsed i pa r e s i 20
m im nt ha
es
di ly qua s he e rt
he i t m im nt n

CFR Pat404,Subpa tP,Appendi 1 ( 331 The ALJ not t tShe r c d doesnot
r
r
x . R. .
ed ha ç e or
t

e tbiht a ( anifsp ysc li ar n s me to me ial e ua t erq rme t o a y
sa ls h t Pli t ' h ia mp ime t) e r dc ly q l h e uie n s f n
f
20

s ton oft Litng of l paime s i Appe x 1 Subpa tP,Reg a i No.4,i l ng
ec i
he si
m r nt n
ndi ,
r
ultons
ncudi
Se ton 104. I
ci . ' d
'
Furhe ,t ALJ f
t r he
ound t t Pl ntf s me a i par e s t onsde e sngl a i
ha ai if
nt l m im nt ç i r d i y nd n
c
c
ombi ton,do notme torme c l e
nai
e
di aly qualt c ie i oflsi 1 0 o 1 06.' 1 The
he rt ra itngs 2.4 r 2. 5 d.
ALJ t n e uaed t f f tona a e oft ç r gr ph B' c ie i oft lsi . f
he val t he our unc i l r as he ç a a
pa
' rt ra he itngs #.

Th ALJc ncu e ta çb e a s ( anifs me tli ime t d n tc us a la tt
e
o ld d h t s l c u e Pli t l n a mpar n s o o a e t e s wo
g
f
S ke lmia i orone t a ke lm iaton a ie a e e s
mar d' i t tons
m r d' i t i nd r pe t d' piodesofde om pe a i e h
c
ns ton, ac

o e tn e d rto ,te taa rp B'ciei ae n tstsid. ( 3 2 Th ALJ te
f x e d d u ai n h p r g a h
rtra r o aife ' R. 4 . e
'
hn
f
ound t tt e de f ie t e tbls t pr s nceofa oft ç r gr ph C'c ie i oft
ha he vi nce a ld o sa ih he e e
ny he l a a
pa
' rtra he
ls i . 1
i tngs d.

Ne ,t ALJc etd ar i lf nci ca ciy Cç ' asesmenta f
xt he
ompl e esdua u tonal pa t RFC' s s
)
nd ound
t tPl ntf ha t r i lf ncto lca ciy t pe f m lg wo k a de i d i 20 C. R.
ha ai if s he esdua u i na pa t o ror i ht r s fne n
F.

404.567*)
1
.

Spe fc ly,t ALJsaed t tPli ifc d é ca i l baanc soop,
cii a l he
t t ha a ntf oul s sonaly l e, t
oc

kne l c ouc c awl a ci b r
e , r h, r
nd lm amps or sar ,'butwas una e t c i b l dde s r ,or
t is'
bl o lm a r , opes
s fol . l
ca f ds d

Fu t r t ALJsa e t tPl ntf ç e r st o i n t ste r 45m i e
rhe , he
t t d ha ai if i quie he pto o i ve y
r
nut s

f up t t m i e ,but he c n c i wor whie s at ' a û an pe f r fe nt
or
o wo nut s
a ontnue
k
l e ed,' nd ç
c
r o m r que

h n ln wih t e b ltrlh n . ( 3 3 j Ho v r t e ALJ f u d t tPlitf mu t
a di g t h iae a a ds' R 4- 5 . we e , h
'
o n ha anif s
a o d c nc nr td e po u e t h z r s g 3 1 Fial,t ALJ sae t a Plitf i a
v i o e tae x s r o a ad . R 5 . n l he
y
ttd h t an if û n
c
pe f smpl a r i t s ,aswela a f w deaied t ks'
ronu i e nd outne a ks
l s e
t l as .'

TheALJ a t t d t t
tese ha

s ha cons de e a1 of Pl ntf ' s pt s a S he e ent t whi h t e s pt s c n
he d
i rd 1
ai if s ym om nd i
t xt
o
c hes ym om a

ra o a yb a c p e a c nsse t t teo j cieme ia e i e c a oh re ie c , a
e s n bl e c e td s o itn wih h be tv d c l v d n e nd te vd n e' s
'
we la aloft opi on e de . 1
l s 1 he ni vi nce d.
The A LJ t n f l e t t s e pr es - fr t det r i ng w he he t r i a
he olow d he wo- t p oc s is , e m ni
t r he e s n
21

underyi de e m i bl physca or m e ali paim e t t coul r s bl be e c e t
l ng t r na e
i l
nt m r nt ha
d ea ona y
xpe t d o
pr
oduce Pl ntf' pan orot r s
ai ifs i
he ympt s a t n e ua i t i e iy,perit nc a
om , nd he val tng he nt nst
sse e, nd
lm ii e f c sofPl ntf ss
i tng fe t
ai if ympt st de e m i t e e t whih t lmi hi f tons
om o t r ne he xtnt o c hey i t s unci .
1 The ALJ f und t tthe cai nts me c l de e m i bl i par nt c d r s bl
d.
o
ha t l ma ' di aly t r na e m ime s oul ea ona y
t
be e
xpeced t c us t al ge s
t o a e he le d ympt ;howe r t cai a ' sa e e sconc r ng t
oms
ve , he l m nts tt m nt
e ni he
i enst pe sse and lm ii e f t of t s s m pt s a e notc e bl f t r s ns
nt iy, r itnce
i tng fecs
he e y om r
r di e or he ea o
e ai d i t s de son.' 1 The ALJ t n we t ough t va i m e c lr or i
xpl ne n hi cii ' d.
he
nt hr
he rous di a ec ds n

deal g 35- .
ti. R. 371
I tr soft o ni evi nc ,t ALJ e aned t ts ga s tnta weghtt
n em
he pi on de e he
xpl i
ha he ve ubsa il i o

t opi o oft Stt a ncy physca m e cne c ula ,buta s f
he ni n
he a e ge
i l di i ons t nt
lo ound t tPli ifha
ha antf d

C d iin ll tto i bltr lh ndi . ( 3 1 M o e v r a fr a Plitf s Sae
d dto a i ains n iaea a l ' R. 7 . ro e , s a s anif tt
a
mi
ng '
age y m e al heat co ula s t ALJ f
nc
nt
lh ns tnt , he
ound t t t r o ni ns wer s
ha hei pi o
e uppore by
td

s b tn il vd n e b tçn gvng g an its alg to ss me b n ftoft ed u t ( ALJ
u sa ta e ie c , u i ii plitf'j l ain o e ei h o b , t
i
e
he

fu d)t tP litf i mo e l td t a s g etd b t e c ns tn s i tnnso c g iie
o n ha an iq s r i e h n u g se y h o ul t n e
mi
a
f o ntv
f n to . ( 3 1 F rhe,t ALJ a sg e ç ey l t weg t't te o ii n o Dr
u ci n' R. 8 . u t r he
'
s in d s r i l ih ' o h pn o f .
v
te
Andr w Peeron, . ,Pli tf sphyscin. 1
e
t s M D. a n if
ia
d.
The ALJ ne c l d t t consde i Pl i ifs RFC, Pl ntf was una e t
xt onc ude ha ,
i rng antf
ai if
bl o
pe f
ronn hi pas r l va wor be us i e ee hi RFC. I The ALJ not d t t t s
s t e e nt k ca e t xc ds s
d.
e ha hi
c uson was s
oncl i
uppored by t he i t tmony of t voc tonale r.
t
he arng esi
he a i
xpe t

The ALJ
,

h we e, i n t ta te eweelg two kj b t a e s i sg fc n n mbesi t en to a
o v r d d oe h t h r r ih r o s h t xit n iniia t u r n h ain l
e
conomy t t Pli if c d peror i l ng sor ge f iiy r nt l clr f niur r nt
ha antf oul
f m, nc udi t a aclt e a e k, ur t e e al

clr orpaki 1 atnda . ( 391
ek, r ng ot te nt R. .
Fi ly,t A LJ f
na l he
ound t t Pl ntf t s notbe n unde a di a lt a defne i t
ha ai i f s
ha
e
r
s biiy, s i d n he
22

S ca Se u iyAc, r m J ne1 2 3,h o ht ed t o t i d cso ' ( 4 1
o il c rt tfo u , 01 tr ug h ae f hs t iin. R. 0 .
'
D. Addii lEvi nceSubm itd t Appe l Counc la Aooea ' Cot i De i i
tona
de
te o
as
i nd
ls mc l c son
Subs quen t t hea i i fontoft ALJ Pli if s ntt Appe l Counci ne
e
t o he rng n r
he
, antf e he
as
l w
upda e me c r co ds o Aug t 11 201 t t we e no pr e e on t dae of hi l t
t d di al e r n
us , 5 ha
r t es nt d
he t
s as

h ai i fo to teALJ ( 6,1 2 -4 1 Th r c r we efo Dr Ta rdAd ld td
e rng n r n f h
. R. 3 2 1 49 . e e o ds r r m . g i ii ae
J r 5,201 t oug M a c 11 201 J Goggi D . M .daed Fe a y 4,2015 t o h
anua y
5 hr h r h , 5; ohn
n P.
t
bnzr
hr ug
Aprl1 201 Dr J e W i r bi da e M a c 26,201 t o h J 4,2015;Dr Ant ny
i 5, 5; . os ph e z ki t d r h
4 hr ug une
. ho
Af d t d Aprl7,201 t ough Augus 3,201 a Oass Chropr tc a W elnes ,I
ong a e
i
5 hr
t
5; nd
i
i ac i nd
l s nc.
da ed Apr l6,201 t oug J y 21 201 1
t
i
5 hr h ul , 5. d.

Fr M ar h 26,201 t oug J 4,201 Pli ifpr s nt d t Dr J e W ir biki
om
c
4 hr h une
5 antf e e e o . os ph e z c

a dDr Ro e t rse a F o iaOrh pa dcSp cait f rh swrs a drg th n p i (
n . b r Fo etr t l rd to e i e ilss o i it n ih a d an. R.
1 42- 1 Thedocor dignos dPli ifwihmodeaey s veecapaltl ls ome,a
3 76 .
t s a e antf t
rtl e r r lnne yndr
nd

Plitf r c i d a rg t c r a t n e r la e E 1 6 1 6 , 1 7 1 Plitf wa as
anif e eve
ih ap l u n l ee s . R. 3 4, 3 8 3 6 . anif s lo
dignos d wih rg wrs endonii,Dt Quevan' tnos ts a a t ii. g 1 0,
a e t iht itt
ts
r i s e ynovii, nd rhrts R. 35

1 5 1 Plitf r c i e seod ij cinsf rh sha d a d wrs pan. ( 1 4 1 2 5
3 6 . anif e ev d tr i n e to o i n n it i R. 3 7, 35 - 3
1 1
376 .
Pl n if s w Dr Adii a n fom J r 5,201 t ough M a c 11 201 f hi
aitf a
. l gai r
anua y
5 hr
r h , 5 or s

c o c bac pan, o tuci se p a a,i opahi hy r omni , a de e sve dior r
hr ni
k i bsr tve l e pne di t c pe s
a nd pr s i
s de .

g 1 2 1 Dr Adl sae ta Plitf wa o y s enghm manyf rto lw- pt gvehm
R. 3 2 . . ii ttd h t anif s nl e i i il o i lo u o i i
f
rtlsont pan medsa t si a s' g 1 231 Plitf wa tki Cymbat f hi
eil he i
nd he tmulnt. R. 3 . anif s a ng
'
la or s
ba k pan,whih a s heped wih hi mu i y and de e son,i addii t t Buspa . I
c i
c lo l
t s
et
pr s i n
ton o he
r d
M or r t Adde a l a Dextoa phe a ne we e he pi wih Pl ntf s f tgue. 1
eove , he
r l nd
r m t mi
r l ng t ai if ai
d.
Ho ver i Aprlof2015,a trDr Af di no wa t t ke ove pr c i ng Adde alt
we , n
i
fe . ong d t nt o a
r es rbi
rl o
23

Plitf, . ii ic ag dPlitf fo h sp a c . g 1 2 )
an if Dr Ad ld s h r e an if r m i r die R. 3 9 .
Fr Fe ua y 4,
om br r 2015t ough Aprl15,2015,Pli ifalo s w Dr J Goggi f rhi
hr
i
antf s a
. ohn
n o s

h e p i c u e b pa trfs ii a dh lu rgd s ( 1 314 1
e l an a s d y lna a cts n alx i iu . R. 3 - 0 .
Pl i ifpr entd t Dr An hony Af fom Aprl7,201 t o h Augus 3,201 f r
antf es e o . t
ong r
i
5 hr ug
t
5 o
t tc arhy unc i dr de nde e,ce v c la l
esiul
pof ton, ug pe nc
r i a nd umbars
pondyl i ,nec t a i ,a
oss
k, hor c c nd

1w b c p i a d hy ro i wi se p a n a ( 1 7 ) Plitf h d a M RIo hi
o a k an, n pes mn a t le p e . R. 3 8 . an if a n
h
f s
t a c s ne pe f m e i Aprl of 201
hor ci pi
ror d n
i
5,whi s
ch howe mid de
d l gene a i dic die e
r tve s s as

Sh o g o tt lwe t o a i s i e g e ts a T1 - 2' ( 1 3 1 Pl i if alo had an
i r u h u he o r h rcc p n r aet t 1T1 . R. 4 2 . antf s
t
'
M Rlofhi ce vi ls ne done,whih s
s r ca pi
c howed mid dege r tve dic die e a C4- a C5l
ne ai
s s as t 5 nd
6
a mulie lde ne ai s
nd
tl ve ge r tve pondyl i wih m id t mode ae bia e aldege r tve f a i l
oss t l o
r t lt r
ne a i or m na

n ro n g 1 3 - 1 Fial, Plitf h d a MRI o h s lmba s ie s o n
ar wig. R. 4 0 31 . n ly anif a n
f i u r pn h wi g
de ner tvedic die s a mulie de ner tve s
ge ai
s s a e nd
tlvel ge a i pondyl i;û s a ldit ll f f a i l
oss û m l sa e t or m na
a
pr r son wih as ocit a a tarc usng m id t m ode a e dit lf n na na r ng o
otu i
t s aed nnul r e a i
l o
r t sa or mi l rowi n
t l f w ih pr bl m id a m e oft e tng ne' r ' a L3- a ( s a ldit l f
he e t t oba y l but nt he xii
l oot' t 4; nd t m l s al e t
ve
a

f a na pr r i .wiho e de e of a me or i nge nt' ( 1 291 Dr
ormi l otuson.. t ut vi nc
but nt mpi me .' R. 428- . .

Afnga miitrd lmb rfc tij cinsa d c r ia j n ij cinst Plitf. ( 1 8 ,
o d n see u a a e n e to n e vc l oit n e to o an if R. 3 0
1 1 1 I addii t s engDr Af Pl ntf c i getngc r aci teame
382, 388 . n ton o e i
. ong, ai if ontnued ti hiopr tc r t nt

wi Dr S y e tu g J l o 2 5 ( 1 3 - 9 .
t . n d r lou h uy f 01 . R. 4 7 4 1
h
On Nove be 20, 201 he Appea s Counci de e Pli ifs r que t f r vi w
m r
5,t
l
l nid a ntf' e s or e e
be aus i f und no r as unde t r l t r vi w t A LJ S de s on da e Apr l 1 201
c e t o
e on
r he u es o e e he
' ci i
td
i , 5.

g 1.
R. 1
l.
I

M O TI N S FO R SUM M A RY JUD G M E N T
O

l hi M oton f Sum m a y J
n s
i or
r udgm e w ih Suppor i M e or ndum of Law ,Pl i if
nt t
tng m a
a ntf
24

ma e t man ag me t. ( 3 2 Fis, ea g st a t ALJe rd b fiig t weg
k s wo i r u n s DE 7 . rt h r ue h t he
re y al o ih
n
t eo no so h se n nngp y iin ( . t a dDr Br o ) fii t p o ies fce t
h piin f i x mii h sca s Dr Loh n . o ks, al o r vd ufiin
ng

rt n l fr rj cig t o i in o a c ns laie e n nig p ysca ( .Pees n) a d
ai ae o ee tn he p no f o u ttv x mi n h iin Dr tro , n
o
a o tn t eo i o o an n e mi n s u c . ( 3 ,p 1 - 8 . Ne t Plitf a srs
d pi g h pnin f o -xa nig o re DE 7 p. 3 1 j
x , an if se t
t tt ALJ e r d i d e rng a unf vor e c e biiy fndi nots
ha he
re n t nde i n a abl r di lt i ng
r
uppore by s t nta
td
ubsa i l

e de eofrc d. ( 37,pp.18 1 . Theeor Pli ifas t tt sCour rves t
vi nc
e or ' DE
'
- 91
rf e, antf ks ha hi
t e re he
de al of Pli ifs a ia i f dia lt be is a r nd t s m a tr f f t r
ni
antf
pplc ton or s biiy neft nd ema
hi
te or urhe

a miitaiep o e d n s g 3 , 1 1
d nsrtv r c e i g . DE 7 p. 9 .
l Def nts M o i f Summar J
n
enda '
ton or
y udgmentwih Suppori M e andum of La
t
tng mor
w
a Opposton t Pl ntf s M oton f Summ a y J
nd
ii o ai if
i or
r udgmen , s a gues t t s tntal
t he r
ha ubsa i

e d n es p rst eweg t h tt eALJg v t t me ia o i o so rc r . g 3 , p
vie c u po t h ih t a h
a e o he dc l pnin f e o d DE 8 p .
4 9 . Dee d n ne tcamst a t eALJSfn igt a Plitf salg to we eno e t ey
-)
fn a t x li h t h
' i dn h t anif le ains r t ni l
r
ce il wa s p o tdb s b tnil vd nc . ( 3 , p. - 3 . Th r f r, f n a taks
r dbe s u p re y u sa ta e ie e DE 8 p 9 1 q
ee o e Dee d n s
t eCo r t afr t eCo sine' d cso ( 3 , .1 1
h u t o fim h mmiso rs e iin. DE 8 p 4 .
Plitf fld a Re l ( 4 ) t Dee d n ' M oin f r Su r J d me t
an if ie
py DE 0 o fn a ts to o mmay u g n
m ant i ng alofhi a g e s Pl i ifcli st tt ALJe r usy ac or s t nta
i ani 1
s r um nt . antf am ha he
roneo l c ded ubsa i l
we g t t opi on oft Stt a nc physc lm e ci cons t twhie gi ng ver ltl
i ht o he ni
he a e ge y
ia
di ne
ulan
l vi
y ite
we g t Pl ntf s te i physca Dr Peeron,a f lng t dic s t opi onsofDr
i ht o ai if r atng
i in, . t s
nd aii o s us he ni
.

Loh a d Dr Br ks g 4 ,p. 1. Plitf as a s rs t a t e ALJ dd n tp o d
t n . oo . DE 0
) an if lo se t h t h
i o r vie
s bsa ta e ie c i s p r o h rn g tv c e i l yfn i go Plitf. ( 4 , . 1
u tn il vd n e n u po t f e e aie rdbit d n f an if DE 0 p 6 .
i

25

11
1.

LEGAL ANALYSI
S

J cal r viw of t f c ua fndi i dia lt ca es i lm ie t dee m i ng
udi i e e
he a t l i ngs n s biiy s s i t d o tr ni
whe he t Co mi sone ' de son i ts
t r he m s i rs cii s tuppore by s t ntalevi nc a ba e on pr r
td
ubsa i
de e nd s d
ope
lgalsa r . Subsa i le de e i mor t n a s i il a i s h r e te denc a a
e
tnda ds
t nta vi nc s
e ha
c ntla nd s uc elvan vi e s

ra ona e pe s woul a ce a a
e s bl ron
d c pt s dequae t s
t o uppor a c uson. 42 U. C.j 405g)
t oncl i '
'
S.
( ;

Cr w o d v Co ' o c Se . 3 3 F.3 1 5 ,1 5 ( 1h Ci. 00 )( e c ra (n en l
a f r . mm r fso . c, 6
d 1 5 1 8 1 t r 2 4 p r u im) itr a
ctton omit )(uoi fe sv Calahan,1 F.3d 1
iai
ted q tng wi . l
25
436,1 ( 1h Ci.1 ). Co t
439 1 t r 997 )
urs

ma n t( e i etef csa e rweg tee ie e o s siue (h i) u g n f rta o
y o t cd h a t n w, e ih h vd nc , r ub tt t t er j d me t o h t f
d
te g mmiso e j' Ph lis v Ba n a t 3 7 F.3 1 3 1 4 ,n.8 ( 1h Ci.2 0 )
h co sin r.
' il . r h r, 5
p
d 2 2, 2 0
1t r 0 4
( u tn Blo s rhv He ke , 0 F. d 1 3 ,1 9( 1hCi.1 8 :.
q oi g o d wo t . c lr 7 3 2 2 3 23 1 t r 9 3
The r src i sanda d of r vi w s t outa
e titve t r
e e e
bove a is onl t fndi off t No
pple
y o i ngs
ac .
pr s
e umpton ofva i t a t he t t Com mi sone ' c usonsoflw. Br
i
ldiy tac s o he
s i rs oncl i
a
own v Sulian,
. lv

921 F.2d 1
233,1 ( 1h Ci.1 ) M ari v.Sulian,8 F.2d 1
236 1 t r 991; tn
lv 94
520,1 29 ( t Ci.
5 11h r

1 9 ) tf ( mmiso e 'j fi r t a p y te c re t1w o t pr vd te rve ng
9 0 . dhe Co sin rs al e o p l h o r c a r o o ie h e iwi
u
cour wih s fcint r as ng f detr i ng t pr r lgala l i ha be n c
t t ufi e e oni or e m ni he ope e
nayss s e onduc e
td

ma d tsr v ra. Igr m v Co ' o oc S c Ad n,4 6 F.3 1 5 ,1 0 ( 1h Ci.
n ae e es l' n a . mm r fs . e . mi . 9
'
d 2 3 26 1 t r
2 0 )( u tn Co neisv Sulv n, 3 F. d 1 4 1 454 ( 1hCi.1 91)
0 7 q o ig r lu . lia 9 6 2 1 3, 1 -6 1 t r 9 ).
Soc a Se urt r ultons esa ih a fve-t p s que il a yss t a ve a a fnal
i l c iy eg a i
t bls
i se e nta nal i o ni t i

d tnniaino d sbit . 2 C. R. 40 1 20 2 C. R. 41 .2 ( )( Th ALJmu t
ee n to f ia l y 0 F. j 4.5 ; 0 F. j 69 0 a -9. e
i
s
fr tde e newhe he t c am a i pr s ty empl
is t nni
t r he l i nt s e en l
oyed. I s a fndi ofnon- s biiy i
f o, i ng
dia lt s

ma a t i r c l . 20C. R.j404. 20( . I t s ond se t ALJmus
de, nd he nquiy oncudes
F.
15 b) n he ec
tp, he
t
det nni w he he t cl m a s f r fom a s ver i pa r ent or c bi ton of
e ne
t r he ai nt uf e s r
e e m im
om na i
i pa r e s l t A LJ f nds t t cl i a doe not s f r f om a s ve e i paim en or
m i m nt . f he
i
ha a m nt
s
uf e r
e r m r t
26

c
ombi ton ofi r t ,t n a fndi ofnon- s biiy r s t ,a t i r e . 20
nai
mpaimen s he
i ng
dia lt e uls nd he nquiy nds

C. R. 4 4.5 ()
F. j 0 1 20c .
Stp tz er quiest ALJt c
e h e e r he
o ompaet cama ' sve ei nnents t t ei
r he li nts e r mpai t) o hos n
t lsi of i ime s 20 C. R. j 404.520( , s r P, appe x 1 Ceran
he itng
mpar nt.
F.
1 d) ubpa t
ndi . ti

i ime t ae s s v r ,wheh rc n iee ao o i c n u cin wih ohe i ime t,
mpar ns r o e ee
te o sd r d lne r n o j n to t t r mpar ns
t t i t y a e esabls
ha , f he r t ihed,t r ultonsr quiea fndi ofdia lt wihoutf t ri r
he eg a i e r i ng
s biiy t
urhe nquiy
i o t cai ntsa lt t pe f r ot rwor Se Gi on v Hec l r 762 F. 1 6,1 8,
nt he l ma ' biiy o r o m he
k. e bs . k e ,
2d 51 51

n.1 ( 1h Ci.1 . I t i r
1 t r 985) f he mpaimentmees o eq l a lsed i nne ,dia lt i
t r uas it mpai nt s biiy s
pr ume a be ksaea r d. 20C. R.j40 1 d)
es d nd net r wade
F.
4.520( .
St p f i ve a de e m i ton of whe he t cl i a ' i pa r e spr ve hi or
e our nvol s
t r na i
t r he a m nt s m im nt e nt m

herfom pero ng hi orherpas r l va wor I t cli ntca
r
f nni
s
t e e nt k. f he a ma
nnotpe f m hi o he
ror
s r r

p s r lv n wo k, te a prma f ce c s of d s blt i etbls e . 2 C. R. j
a t ee a t r h n
i a i ae
ia ii s sa ih d 0 F.
y
40 1 20( . Thebur nt n s fst t ALJt s w a se fvet t depiet cli nts
4.5 e)
de he hit o he
o ho t tp i ha, s t he ama '
i ime s he ors i a e t pe f m wor i t na i ec
mpa r nt,
he s bl o ror
k n he tonal onom y i lghtoft cli a '
n i
he am nts

RF a e e u ain,a d wo k e p re c . 2 C. R.j 4 4.5 0 9;Phi is 3 7 F.3 a
C, g , d c t
o n
r x e in e 0 F.
0 12 4
lp , 5
l
d t

1 9 I o d rt d tr n wh t rt ecama th st a iiyt a j tt o h rwok i t e
23 . n r e o eemie ehe h li n a he blt o dus o t e r n h
natonale
i
cono y,t ALJ may e t r a y t M edi lVoca i lGui i ,20 C. R.pt
m he
ihe ppl he
ca
tona
delnes
F.
.
40 s .P,a z,orutlz t as it e ofa voc tonale r. See Phil ,357 F.3d a
4 ubpt
pp.
iie he ssanc
ai
xpe t
li
ps
t
1 40.
239-

The Elve h Cicui has e t ihe a t ee pa tE i sa r 't be utlz by t
e nt r t
sabls d hr
r i n tnda d' o
pa
iied
he
A LJ w he a c ai antt i t te t bls di a lt t oug hi or her ow n t s i ony of pa n or
n lm
res o d s a ih s biiy hr h s
e tm
i

o h rs b e tv s mp o . Hotv Sulv n 9 F.2 1 21 1 23 ( 1h Ci.1 91 . Th
t e u j cie y t ms'
' l . lia , 21 d 2 , 2 1 t r 9 )
e
sa d r rq ie $ 1 e i e c o a u d ryng me ia c n to a d et r ( )o j cie
tn ad e ur s t ) v d n e f n n e li
(
dc l o diin n i
he 2 b e tv
27

me ia e ie c t a c nf mst sv rt o t alg dpanaii gfo t a c n iin o ( )
dc l vd n e h t o i he e e i f he le e i rsn r m h t o d t r 3
r
y
o

t a te o j cieyd tr n dme ia c n iin i o s c as v rt ta i c n b ra o by
h t h b e tv l eemie d c l o dto s f u h e eiy h t t a e e s na l
e p ce t gv rs t t e alg d p i ' 1 . Mo e v r Sth cama ts s b e tv
x e td o ie ie o h le e an. d
'
r o e , t l e li n ' u j cie
l
t si ony s ppo td by medialevi nc t ts tsi t sanda d i is l s tci tt s
e tm
u re
c
de e ha a ites he t r s te f ufi en o uppor
t
a fndi ofdia lt ' I
i ng
s biiy. d
'

The ALJ mus s ii a l expl n why he ors i de i ng t
t pecfc ly
ai
he s c di o

ds rdts c tsi n ,a d Sfalr t a t u aet er a o sfrds r dtn s be tv p i
ice i u h e t y n t liu e o ri lt h e s n o ice iig u j cie an
mo
g
c
tsi ony r quies a ama t oflw,t tt t tmony bea e e astue. I
e tm
e r ,s
ter a ha he esi
cc pt d r ' d
'
W he hert A LJ e r d i f lng t a e st opi ons ofD r Lot a D r Br
t he
r e n aii o ddr s he ni
. h nd . ooks

Pl i if cai s t t t ALJ co plt y f ie t a es t opi ons of Pl i ifs
antf l m ha he
m e el al d o ddr s he ni
antf

e a nng p y iins Dr Loh a d Dr Br o ,r s li i h r u er r ( 3 ,p 1 1
x mii h sca , . t n . o ks e utng n amf l ro . DE 7 . 3 .
Ac or ng t Pl ntf,Dr Br
c di o ai if . ooks o ni n on Pl i ifs hype s nol nc s d ha be
' pi o
antf '
rom e e houl ve en

ad ese bec us i wasc itntwiht opi onsofDr Adiia Dr Peeron. ( 37,p.
dr s d a e t
onsse t he ni
. l nd . t s
DE
houl ve ddr s d . h'
ni
M or r Pl i if a s t t t t ALJ s d ha a es e Dr Lot s opi on
eove , antf s ers ha he
r r ng Pli tf sm a pultvelmia i ,s ii aly i Pli if sl tuppe e r miy. 1
ega di
a n if
ni a i i t tons pecfc l n antf ef
r xte t
d.
Pl ntf alo as e t t t Pl n ifs lmia i i hi lf upper e r miy s d ha bee
ai if s s rs ha aitf i t ton n s e t
xte t houl ve
n

p e e tdi ah poh tc l ot v c to le p r d rngteh a igbeo eteALJ ( 3 ,
r sn e n y t eia t he o aina x e t u i h e rn f r h
. DE 7
p.1 1 Plit ff rh rag e ta rma d wo d n tb a wa tf lc re tv e ecs . (
5 . ani u te r u s h t e n ul o e
f
seu o rcie x r ie DE
4 , 2.
0 p. )
Ac or ng t De e nt t ALJ ha good r as t nota
c di o f nda , he
d
e on o
doptt opi onsofDr Lot
he ni
. h

and Dr Br . ( 38,p.71 Dee tcl mst tDr Lot sa Dr Br 'opi ons
. ooks DE
. fndan ai ha . h' nd . ooks ni
t tPl i i fw a di a ed w e e no s
ha a ntf s s bl
r t uppored by t evi nce bec us Pl ntf ke w o ki f
t
he de
a e ai i f pt r ng or

m on hsafe he s t physcansa bec us he t ca e ofhi ki whie hi wie wor d.
t
tr aw he
ii
nd a e
ook r
s ds l s f
ke
Furhe , ef nta guest tD r Lo h' opi on t tPl ntf coul notpe f m wor a a
t r D enda r
ha . t s ni ha ai if
d
r or
k s
28

c r acor be us of hi lf hand i im e was i c tr t be us l ubs que
hiopr t
ca e
s et
mpar nt
na c la e ca e i e nt
s
ne ol c lt t do noti c t t tPl ntf ha s t nta wen sorpan i t lf a or
ur ogi a ess
ndi a e ha ai if d ubsa i l knes
i n he e t nn

oh rn u oogc li ar n si telh am a trh sc r a t n e r la es r ey' ( 3 ,
te e r l ia mp ime t n h e r fe i ap l u n l ee s u g r . DE 8
'
p 8.
.)
Pl i if i c r c t t t A LJ di no a e s t opi ons of Pl i if s e m i ng
a ntf s or e t ha he
d t ddr s he ni
a ntf
xn ni

physc a , Dr Lot a Dr Br ks ç ALJ m us consde a 1 m e c l opi ons i a
ii ns . h nd . oo . $
An
t
i r l
di a
ni
n
cli a ' ca er c d,t t rwih ot r e nte de e. M ccl k n v Soc Se Admi ,
am nts s e or oge he t her elva vi nc '
'
ur i . . c.
n.

6 5 F d. p 9 0 9 2 ( 1h Ci. ol lctn 20C. R.j4 4.5 (). Th ALJmus sae
2 e Ap x. 6 , 6 1 t r z s tiig
F.
0 1 27b )
e
t tt
wih pm i ulrt wha wei ,i a i g ve t t dif r tm e ca opi o a t ALJ'
t
c a iy
t ght f ny, s i n o he fe en
di l ni ns nd he
S

ra o s t rf r Wis h lv Co ' o So .Se . 6 F.d 1 7 ,1 7 ( 1h Ci.2 1 .
e s n heeo . n c e . mm r f c c, 31 3 1 6 1 9 1 t r 01 )

t e i i i p sb et tt e ALJ c n ie e a rj ce me ia o i ins C t o tce ry
k n f t s osil ha h
Ev
o sd r d nd ee td d c l p no , wih u lal
a t u ae gou dsf rs c a rj ci n we c n o d tr ne wh t rte ALJSc ncu in
ri ltd r n o u h ee to , a n t ee mi
c
ehe h
' o lso s
weertona a s
r ai l nd uppore by s t ta e de e.' Hi sv Comm ' o .Se . 585Fe
td ubsanil vi nc '' me .
r fsoc c,
d.
Appx. ,765( 1h Ci.201 ( i Wi c ,631F. a 11 .
758
1 t r 4) quotng ns hel
3d t 79)
He e, t ALJ c
r he
omplt l f ie t a es t opi ons of Pli ifs e m i ng
e ey al d o ddr s he
ni
a ntf
xa ni
physcins Dr Lot a Dr Br . M or over t ALJ di no cie t a oft r cor of
i a , . h nd . ooks
e , he
d t t o ny
he e ds
Dr Lo h orDr Br
. t
. ooksi he dic son ofPl ntf' me c lhit y. The e or i i no c e r
n r s us i
ai ifs di a sor
r f e, t s t l a
t t u r i d t wha ext nt i a al,t A LJ a l d t opi ons of D r 1 0 h a Dr
o he nde s gne o
t e , f t l he
na yze he ni
. , t nd .

Br o s Th o i in o Dr Loh ( 7 6,7 6 5 1a d Dr Br o s ( 71 - )c ul h v
o k . e p no s f . t R. 4 5 - 9 n . o k R. 4 20 o d a e
pos i y c nged t out
sbl ha
he come oft ALJ' d ii n. Howe r t de i i is d by t ALJ
he
S ec so
ve , he c son s ue
he
neve onc m en i t na e of D r Lot or Dr Br
r e
tons he m
. h
. ooks Be us Dr Lot a D r Br ks
.
ca e . h nd . oo
w e e Pl i if sexn i ng phys c a ,t ALJ' f iur t a es t i opi ons was r ve sbl
r a ntf
m ni
i i ns he
S a l e o ddr s he r ni
e ri e
er o . A s a r ul,t Cour i ç bl t de e m i w he he t A LJ' c us ons a
rr
es t he
tss
una e o t r ne
t r he
S oncl i
boutt
he
29

m e ca opi ons a e s
di l ni
r uppore by s t nta e de e. f at766. Thus t c e m us be
td
ubsa il vi nc ' #.
'
, he as
t
r nde on t tbass Se Be ris v.Col n,CASE NO.1 23860- V- M ON TON,201
ema d
ha
i. e r o
vi
4Cl SI
6

W L 5661 *1 ( D. a Se .30,
634, 2 S. Fl. pt 2016)
.
B . W he he t A LJ e r i c vi t opi on of
t r he
r ed n i nc he ni
Pl ntf st e tnz phvs ci n. r Pe er o ve v ltl w ei
ai i f r a i
i a D . t s n. r ite ght

Pl i if c e t tt ALJ ere i a sg ng ver ltl we ghtt t o ni n of
antf ont nds ha he
r d n s i ni
y ite i
o he pi o

P an ifste tn p y iin, . tro ( 3 ,p 1 1 Dee d n camst tt eALJS
litf raig h sca Dr Pee s n. DE 7 . 5 . fn a t li ha h
'
de ii t gi Dr Pe e s s opi on ltl weght wa s
c son o ve . t r on'
ni ite i
s uppore by s t nta e de e.
td
ubsa il vi nc

g 3,.1
DE 8 p 5 .
I t s c e,i i unclarwha we g t ALJ g t Pl i if se
n hi as t s
e
t i ht he
ave o antf xami ng physc a ,
ni
ii ns
Dr Lot a Dr Br ,i a
. h nd . ooks f ny. Tha e r di t t r nd oft c e a sa e a
t ror c aes ema
he as s t t d bove i
n
Se ton 11 A. The ef e,o r mand,t ALJ s d a s r evauat Dr Pee s sopi on
c i 1,
r or n e
he
houl l o e- l e . tr on'
ni
afe c
tr onduc i a pr r a l i a a s s m e oft opi ons a te t e r cor ofDr
tng
ope na yss nd s e s nt he ni
nd r am nt e ds
.
Lot a Dr Br
h nd . ooks See Ber i s, 6 W L 5661 at#1
.
r o 201
634
4.

C. W het rt ALJEred i he c e biiv fndi ofPl ntf
he he
r n r r di lt i nz
ai if
Pl ntf contnds t tt ALJ f ie t S ope l c i r t e de of r or of
ai if
e
ha he
a ld o ç
pr ry onsde he vi nce
ec d
Pl i ifs s r hy r omnolnc t Hol f t s and SSR 96- p i fndi Pl ntf not
antf eve e pe s
e e, he
t acor ,
7 n i ng ai if

c e il a d n t ds be . ( 3 ,p.1 1 De e d n a srs ta t e ALJS tn i t t
rdb e n o ia ld' DE 7
'
8 . fn a t se t h t h
' i dng ha
Pl i ifsa lga i we e notc edi e was s
antf le tons r
r bl
uppore by s t nta e de e be us Pli tf
td
ubsa i l vi nc ca e a n if

d ald t p o i e o j ci me ia o oh re d n e t s p o th ss be tv c mplit o
c ie o r v d b e tve d c l r t e vie c o u p r i u j cie o ans f
f
diablngpai ' g 38, 1 .
s i
n.' DE p. 0q
Thet eepa tpan sa r r r :$ 1 e de eofa unde l ng me c c ton
hr - r i tndad equies 1 ) vi nc
(
n
ryi
dial ondii

a d et e ( )o j cie me c le d n et tc n i t e sveiy o t e alg d pan aiig
n ih r 2 b e tv dia vie c ha o fnns h e rt f h le e i rsn
30

fo t a c n iin o ( )t a teo j cieyd tr n d me ia c n iin i ofs has v rt
r m h t o dto r 3 h t h be tv l eemie dc l o dto s uc e eiy
t t i ca be r as
ha t n
e onabl e c e t gi rs t t alege pan. Hol,921 F.2d a 1
y xpe t d o ve ie o he l d i '
'
t
t 223.
The A LJ a t s ed t t s ha cons de e a l of Pl i if s s pt s a S he ext t t whi h
te t ha he d
i rd l
a ntf ym om nd t
t
en o
c

t s s mpo c n r a o a l b a c pe a c n itn wih t e o j cie me ia e ie c
hee y tms a e s n b y e c e td s o sse t t h be tv dc l vd n e
a d oh re i e c , a wela alo t e o no e ie c . ( 3 1 S e t n f lwe t e
n te v d n e' s l s l f h piin vd n e R. 5 . h he ol d h
'
o
t se pr e s frt de e m i ng whe hert r i a unde l ng deenni bl physc or
wo-t p oc s - is , t r ni
t
he e s n
ryi
t na e
ial
m e a i r nt t t c d r s bl be e
nt l mpaime ha oul ea ona y
xpec e t pr
t d o oduc Pli ifs pan or ot r
e a ntf
i
he
s
ympt , a t n e l tng t i e iy,pe sse e and lmii e f c s of Pl ntf s
oms nd he vaua i he nt nst
r itnc ,
i tng fe t
ai if
s
ympt
oms t de e mi t e e t whi h t y lm i hi f nci . f The ALJ f
o t r ne he xtnt o
c he i t s u tons #.
ound t t
ha
Pli ifs t
antf ' ' c l dee mi bl i r
medialy tr na e mpaiment c d r as bl be expe t d t c us t
s oul e ona y
c e o a e he
a l ge s pt s howeve ,t c ai a ' s a em e s conc r ng t i enst pe s senc a
le d ym om ;
r he l m nt s t t nt
e ni he nt iy, r i t e nd
lm ii e f ct of t s s pt s a e not c e bl f t r s ns e a ned i t s dec son.
i tng f e s he e ym om r
r di e or he ea o xpl i
n hi
ii '
'

Howe r a ALJ' de e m i ton ofcr di lt S a be a f t by t lc ofa f ly
ve , n
S t r na i
e biiy ç y
m
feced
he a k
ul
de l d r or a s d be r viie on r mand.' Be ros 201 W L 5661
veope ec d, nd houl
e st d
e
'
ri , 6
634 a *1
t 5.
Alhough t ALJ f l d t pr pe pr edur r gar ng he cr di lt de e m i ton of
t
he
olowe he o r oc e e di
r e biiy t r na i
Pl ntf,t ALJ S c i ai of t addii l medi l o ni n e de e on r ma a
ai if he
' onsder ton
he
tona
ca pi o vi nc
e nd, s
dic s d a
s us e bove,wilr r t ALJ io r e ua e t c e biiy oft Pl ntf ba e upon
l equie he
t e- val t he r di lt
t
he ai if s d
t e ie y of t r cor '
he ntr t
he e d.
'

The ef e,t Cour fnds t tt ca e s d be r
r or he
ti
ha he s houl
eman
ded

f t ALJt ma anew cr di lt deenni ton ofPli ifba e upon ar vi w oft e ie
or he
o ke
e biiy t nai
a ntf s d
e e
he ntr
r cor 1
e d. d.
lV .

C O N CLU SIO N

l lghtoft f r goi i i he eby O R D ERE D AN D A DJU D G ED t tt de s on i
n i
he o e ng, t s r
ha he ci i s
31

VACATED AND REM ANDED t t Commisone purua t s nt ef of42 U. C j
o he
s i r s nt o e enc our
S.
405g) wih i tuci f t ALJt hol afrhe heai t f l c i ra dic st
( , t nsr tons or he
o d u t r rng, o uly onsde nd s us he
opi onsofPli ifse mi ng physc a ,Dr Lot a Dr Br ,t r - vaua et opi on
ni
antf xa ni
ii ns . h nd . ooks o e e l t he ni
of Pl ntf s tea i physcin, Dr Pe e s n, a t r - l t Pli ifs c e biiy i
ai if r tng
ia
. t r o nd o e evauae antf
r di lt n

a c da wih t sOr . The Cour e e s no opi on ast wha t uli ae de i i of
c or nce t hi der
t xpr s es
ni
o
t he tm t c son
t Co r s i r s ul be on r m a
he m hisone ho d
e nd. Ac or ngl Pl n ifs M oton f Sum ma y
c di y, aitf
i or
r

J d me t wi S p o t M e rn u o La ( 3 ) i h r b GRANTED, a d
u g n t u p ri
h
ng mo a d m f w DE 7 s e e y
n
Def nda ' M oton f Summ a y J m e wih Suppori M emor nd
e nts
i or
r udg nt t
tng
a um of La a
w nd

Op o iint Plitf' M oi nf rS mma yJ d me t( 3 Ji h r b DENI
p sto o anifs to o u r u g n DE 8 s ee y
ED.

OD/E ADAJDE iCabstePlBa,a Ba Cut
RE J N DUGDnh eaWsa ehPl ehon,
R
ê
mr tm c m c y

Foiati
lr ,hs
d

c o Au ut2 1 .
E? f g s, 0 7

W I AM M A TT EW M AN
LLI
UN I
TED STA TE M A GI
STRATE J G E
UD

32