Disabilities: DM (diabetes mellitus) with neuropathy, history of stroke (CVA) with resultant ataxic gait, anemia with severe fatigue, recent diagnosis of prostate cancer, and kidney disease
Notice of Decision: Fully Favorable
Administrative Law Judge: D. Kevin Dugan
Office of Disability Adjudication & Review (ODAR): Fort Lauderdale, Broward County, Florida & Palm Beach County, Florida
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In a consultative exam dated June 16, 2007, Dr. John Catano, MD, reported that the claimant had an ataxic gait, left sided hemiparesis, and was unable to walk on heels or toes, or tandem walk. Dr. Catano's assessment of the claimant's condition included history of CVA, vertebrobasilar ischemia, with ataxic gait; left side hemiparesis; and diabetes (Exhibit 4F). On April 12, 2008, Dr. Fraser completed a Listing questionnaire and stated that the claimant had suffered a central nervous system vascular accident that resulted in significant and persistent disorganization of motor function in 2 extremities, resulting in sustained disturbance of gross and dexterous movements, or gait and station remaining more than 3 months post-vascular accident. Dr. Fraser noted that the claimant had been unable to work since September 2, 1999.
Dr. Fraser reported that he had been treating the claimant for 10 years. Dr. Fraser reported that the claimant was not able to lift and carry 10 pounds on a frequent basis, but could occasionally lift and carry 10 pounds. Dr. Fraser stated that the claimant's symptoms included weakness and fatigue, and noted that his prognosis was "guarded". Dr. Fraser reported that the claimant could sit, stand, and walk less than 2 hours total in an 8 hour workday. The undersigned gives controlling weight to the opinion of Dr. Fraser because it is consistent with the record, and is well supported by clinical notes and medical testing. If a treating physician's medical opinion is well-supported and not inconsistent with the other substantial evidence in the case record, it must be given controlling weight; i.e., it must be adopted (Social Security Ruling 96-2p).
After considering the evidence of record, the undersigned finds that the claimant's medically determinable impairments could reasonably be expected to produce the alleged symptoms, and that the claimant's statements concerning the intensity, persistence and limiting effects of these symptoms are generally credible.
The State agency medical opinions are given little weight because another medical opinion is more consistent with the record as a whole and evidence received at the hearing level shows that the claimant is more limited than determined by the State agency consultants. Furthermore, the State agency consultants did not adequately consider the claimant's subjective complaints or the combined effect of the claimant's impairments.
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