United States District Court, N.D. West Virginia, Clarksburg
REPORT AND RECOMMENDATION
MICHAEL JOHN ALOI, UNITED STATES MAGISTRATE JUDGE.
February 27, 2017, Plaintiff Kevin Dwayne Barrett
(“Plaintiff”), by counsel Brian Bailey, Esq.,
filed a Complaint in this Court to obtain judicial review of
the final decision of Defendant Nancy A. Berryhill, Acting
Commissioner of Social Security (“Commissioner”
or “Defendant”), pursuant to Section 205(g) of
the Social Security Act, as amended, 42 U.S.C. § 405(g).
(Compl., ECF No. 1). On May 8, 2017, the Commissioner, by
counsel Helen Campbell Altmeyer, Assistant United States
Attorney, filed an answer and the administrative record of
the proceedings. (Answer, ECF No. 6; Admin. R., ECF No. 7).
On June 2, 2017, and June 28, 2017, Plaintiff and the
Commissioner filed their respective Motions for Summary
Judgment. (Pl.'s Mot. for Summ. J. (“Pl.'s
Mot.”), ECF No. 9; Def.'s Mot. for Summ. J.
(“Def.'s Mot.”), ECF No. 11). Following
review of the motions by the parties and the administrative
record, the undersigned Magistrate Judge now issues this
Report and Recommendation to the District Judge.
August 13, 2013, Plaintiff protectively filed his first
application under Title II of the Social Security Act for a
period of disability and disability insurance benefits
(“DIB”) and under Title XVI of the Social
Security Act for Supplemental Security Income
(“SSI”), alleging disability that began on
January 9, 2013. (R. 207). Plaintiff's earnings record
shows that he acquired sufficient quarters of coverage to
remain insured through December 31, 2016; therefore,
Plaintiff must establish disability on or before this date.
(R. 226). This claim was initially denied on September 24,
2013 (R. 100, 74) and denied again upon reconsideration on
November 19, 2013 (R. 130, 102). On December 2, 2013,
Plaintiff filed a written request for a hearing (R. 158),
which was held before United States Administrative Law Judge
(“ALJ”) Regina Carpenter on May 19, 2015 in
Morgantown, West Virginia. (R. 38). Plaintiff, represented by
counsel Brian Bailey, Esq., appeared and testified, as did
Larry Bell, an impartial vocational expert. (Id.).
On July 27, 2015, the ALJ issued an unfavorable decision to
Plaintiff, finding that he was not disabled within the
meaning of the Social Security Act. (R. 18-35). On February
7, 2017, the Appeals Council denied Plaintiff's request
for review, making the ALJ's decision the final decision
of the Commissioner. (R. 1).
was born on October 28, 1974. (R. 44). Although the hearing
transcript lists Plaintiff as stating he was forty-nine (49)
years old at the time of the hearing, (R. 44), his date of
birth indicates he was thirty-nine (39) years old at the
time, and thirty-eight (38) when he filed his first SSI
claim. (R. 207). He completed seventh grade (R. 46).
Plaintiff's prior work experience included painter for a
pipeline company, delivery truck driver/retail sales, rig
hand, lottery machine service technician/installer, golf
course maintenance worker. (R. 42-58). He was single at the
time he filed his initial claim (R. 207) and was single at
the time of the administrative hearing. (R. 45). He has no
dependent children. (R. 45). Plaintiff alleged disability
based on inability to strain due to his feeding tube,
“must clean tubes out because of no nose, trouble
speaking, dizzy spells, reconstructive surgeries are
needed.” (R. 102). His impairments were considered at
the initial level and determined to be amputation of the
nose, depression, and anxiety (severe), as well as obesity
and alcohol addiction disorder (non-severe). (R. 106).
Relevant Medical History
January 9, 2013, Plaintiff was “watching TV with [his]
family, when [he] promptly stood and walked out.” (R.
379). Approximately thirty (30) minutes later, police
contacted the family to advise that Plaintiff had shot
himself. Id. Plaintiff was taken to Stonewall
Jackson Hospital Emergency Department with multiple
self-inflicted gunshot wounds to the face. (R. 331-355). Dr.
Snuffer noted that the injury was from a .243 caliber rifle,
and that Plaintiff's “nose [and] whole lower face
[we]re absent.” (R. 331). Plaintiff was transferred to
WVU (Ruby Memorial) Hospital, where he was admitted to the
Intensive Care Unit. (R. 366). Alison Wilson, M.D. related
that the report stated Plaintiff “shot himself in the
face twice, shot up from his chin, ” which resulted in
extensive injury to his lower and mid-face. (R. 365).
underwent surgeries to repair extensive mid-face lacerations
and a feeding tube was placed for nutrition and medication.
(R. 362). Operation revealed complete traumatic amputation of
the nose (R. 361) and complete loss of half of the upper lip;
complex facial lacerations to the soft palate and labial
mucosa, extending into the upper cheeks bilaterally. (R.
370). There were also “extensive comminuted fractures
 involving the nasal bones, hard palate, bilateral maxilla
and ethmoid bones, ” anterior subluxation of the right
temporomandibular joint. (R. 361). Fragments of metal and
tooth/bone were scattered throughout. Id. Plaintiff
was directed to follow up with Opthamology, ENT and Trauma
following his discharge on January 21, 2013 and to continue
psychological therapy as an outpatient. (R. 504).
followed up with WVU Opthamology on January 28, 2013, noting
excessive tearing from his eyes daily and numbness in his
cheeks. (R. 596-97). At that time it was noted that after ENT
consult Plaintiff's doctors “d[id] not feel that
there are options for repair of the bony structure of the
face at this time [because] there is no significant bone of
the mid-face which could be used to anchor an orbital
fracture repair.” (R. 599). Progress notes noted no
significant visual deficits and no significant pain. (R.
602). Plaintiff reported “drainage from his nose 
nearly continuously since the [injury which has] caus[ed] a
significant amount of crusting;” also, that
occasionally, food regurgitates from his mouth into his nose.
Id. Overall, Plaintiff was doing well. Id.
He was directed to follow up with Dr. Armeni in four weeks,
and advised that a nose prosthesis was a more viable option
for him than nasal reconstruction surgery, given the
extensive nature of his wounds. Id.
follow-up with Trauma on February 5, 2013, Plaintiff reported
no problems at that time and declined a referral to
psychiatry. (R. 604). At a follow-up with ENT on February 13,
2013, Plaintiff reported worsening nasal obstruction on both
sides, but much worse on the right. (R. 607). Dr. Armeni
dilated the left nasal passage due to partial obstruction and
trouble breathing. (R. 608). He thought Plaintiff would
likely need to have his right nose reopened if possible, and
a stent placed in it. Id. Although Plaintiff was
initially breathing well following the procedure, he reported
back to the Emergency Room later that day because he felt his
nasal passage was closing. Id. Plaintiff was
discharged to home with directions to be seen at the ENT
clinic. (R. 610). On February 19, 2013, Dr. Armeni placed a
nasal trumpet into Plaintiff's left nasal cavity to
prevent any further stenosis (narrowing) and discussed having
surgery to create a new nasal opening. (R. 616). Plaintiff
decided to hold off on surgery for the time being.
follow-up on March 15, 2013, Dr. Armeni noted that
Plaintiff's “right nasal cavity is completely
scarred and occluded anteriorly.” (R. 617). He removed
and cleaned the nasal trumpet, then sutured it back in place.
Id. At follow-up with Otolaryngology on March 29,
2013, significant swelling over his piriform aperture,
complete closure of the right-sided nasal passage, and the
development of granulation tissue around his left nasal
trumpet were observed. (R. 618). On May 2, 2013, Plaintiff
underwent surgery for recavitation of the right nasal cavity.
(R. 623). At follow-up with otolaryngology on June 24, 2013,
Dr. Armeni instructed Plaintiff he could start leaving the
splints out of his nose more frequently, for about half an
hour daily, and reinsert the nasal trumpets if he notices any
narrowing of the passage. (R. 641). Plaintiff was scheduled
for follow-up in two months, at which point Dr. Armeni noted
it would be appropriate to start discussing prosthetics.
Snuffer, D.O., treated Plaintiff as his primary care
physician and saw him at regular intervals. Progress notes
from October 16, 2013, note Plaintiff was “about the
same.” (R. 710). Plaintiff “still ha[d] a lot of
problems going out in public;” Dr. Snuffer hoped this
would improve once Plaintiff obtained a nose prosthesis. (R.
710-11). He was breathing better after having surgery to
remove most of the septum the previous month. Id. On
November 12, 2013, Plaintiff's family called Dr.
Snuffer's office for a referral “ASAP”
because Plaintiff was threatening to harm himself again and
they were concerned. (R. 709). They were instructed that
Plaintiff should go to United Summit Center
(“USC”) as a “walk-in for crisis.”
November 14, 2013, Plaintiff reported to USC seeking
treatment for depression, anxiety, and panic attacks. (R.
763). He presented as withdrawn, with a depressed mood and
blunted affect. Id. He reported “feeling very
depressed and experiencing mood swings . . . [and] crying
episodes that seem to happen for no reason.”
Id. He also reported feeling very anxious in public
places and having panic attacks “nearly every time he
leaves his home;” as a result, he only leaves his house
to attend doctor's appointments. Id. Plaintiff
reported getting only a few hours of sleep each night, but
has gone up to a couple of days without any sleep.
Id. Plaintiff stated that symptoms began in January
2013 after he went to his girlfriend's house to
“gather some of his things because they had gotten into
a fight and were breaking up.” Id. He stated
that his girlfriend told police that he had shot himself and
the incident reported as an attempted suicide, but he
“does not believe that he actually shot himself”
because he remembers boot marks on his face from being
kicked, and money being stolen from his wallet and truck.
Id. He reported continuing paranoia about seeing
“the people who attacked him.” Id.
Plaintiff's symptoms included “excessive anxiety
that is difficult to control, ” fatigue, difficulty
concentrating, and trouble sleeping. (R. 764). He was
diagnosed with Major Depressive Disorder (single episode,
moderate) and Generalized Anxiety Disorder. Id.
Plaintiff exhibited mild dysfunction in self care (Domain I)
and activities of community life (Domain II), and moderate
dysfunction in social, interpersonal and family relationships
(Domain III) and concentration and task performance (Domain
December 4, 2013, Plaintiff returned to USC presenting with a
depressed mood and congruent affect, and fair hygiene and
grooming; he was alert and oriented. (R. 768). Plaintiff
reported that his depression and anxiety had been “much
worse the last five months.” Id. His anxiety,
panic attacks, and insomnia had not improved. Id. He
was to discontinue Prozac, Amitriptyline and Buspar, and
start taking Zoloft and Vistaril instead. (R. 769).
Snuffer noted at follow-up on December 19, 2013 that
Plaintiff had “a lot of drainage from posterior nasal
passages, ” was still anxious, and was not going out
much. (R. 708).
March 10, 2014, Plaintiff reported to USC for follow-up. He
reported that therapy had been helpful for him and his
depression had improved with medication, but he still
occasionally felt hopeless and helpless, occasionally had
suicidal thoughts, and was still experiencing a lot of
anxiety. (R. 765). He was still getting only two to three
hours of sleep per night. Id. His symptoms included
depressed mood, loss of interest, insomnia, fatigue, guilt,
excessive anxiety, and difficulty concentrating. (R. 766).
His symptoms continued to “cause significant distress
in social functioning.” Id.
April 15, 2014, Plaintiff reported to Dr. Snuffer that he was
“less anxious [and] getting out a little better by
himself.” (R. 705). Dr. Snuffer noted that Plaintiff
“took a trip to Mississippi to see a girl and did
well.” (R. 704).
follow-up with USC on June 16, 2014, Plaintiff appeared more
talkative than before. (R. 761). He reported that his
depression had been improving; he was sleeping more (about
six hours per night) and his energy had “somewhat
improved.” Id. Anxiety was still a problem,
however, especially around people; he had had one panic
attack recently. Id. He reported that he had been
getting out more, had gone to Mississippi to visit a friend,
and was working at a friend's car detailing shop.
Id. Therapist notes from that session indicate his
GAF score was still at 50, and he was still exhibiting
depressed mood and excessive anxiety with associated symptoms
and distress in social functioning. Id.
August 14, 2014, Dr. Snuffer noted that Plaintiff was
“still having occasional drying and closure of nasal
septum, ” but was otherwise doing okay with his facial
wounds. (R. 702). As to anxiety, Plaintiff was “still
anxious about going [out] in public.” Id.
follow-up at USC on July 27, 2015, however, Plaintiff
reported increased depression and withdrawal, suicidal
thoughts, and “some fleeting homicidal thoughts.”
(R. 783). He stated that he had gotten a prosthetic nose, but
that “the glue will not hold it on
appropriately.” (R. 783). He reported he was no longer
“working at his friend's detailing shop due to the
amount of people that come and go and the level of his
anxiety.” Id. “He still experiences some
anxiety, especially around people . . . he has not left the
house very often . . . his energy ‘comes and
goes.'” Id. By October 25, 2015, Plaintiff
presented with “mild symptoms of panic, agitation,
oppositional behavior, moderate symptoms of depression,
anxiety, hopelessness, helplessness, apathy, change in
energy, distractibility, loss of interest, sleep disturbance,
motivation, engagement, poor concentration, suspiciousness,
obsessive/intrusive thoughts, and severe withdrawal.”
(R. 785). He reported a slow decrease in depression and
anxiety, and less frequent suicidal and homicidal thoughts -
most recently, a “couple weeks ago.” Id.
He reported that he tries to avoid leaving the house if at
all possible. Id.
Consultative Psychological Examination
August 20, 2013, Morgan D. Morgan, M.A. completed a
consultative psychological examination of Plaintiff
consisting of a mental status examination and a clinical
interview. (R. 642-648). Plaintiff was cooperative, but
presented as “rather tentative and self-conscious,
especially frustrated.” (R. 646). Morgan noted having
reviewed “eight pages of medical documents from WVU
Healthcare System [relating] to [Plaintiff's] facial
injuries from shooting and treatment of [same].” (R.
643). Morgan also noted that he was “unclear as to
whether [Plaintiff] just could not remember shooting himself,
or was in denial, or actually did not shoot himself in the
face.” (R. 646).
found Plaintiff's immediate and recent memory to be
within normal limits; his remote memory was mildly deficient.
(R. 647). Plaintiff's insight was mildly deficient, and
his judgment poor. (R. 644). His mood was dysphoric and
anxious; his affect restricted. Id. Morgan found
Plaintiff's social functioning and persistence to be
moderately deficient; his concentration within normal limits;
and his pace mildly deficient. (R. 647). Morgan diagnosed
Major Depressive Disorder (single episode, severe, without
psychotic features, with anxiety features), and Alcohol Use
Disorder (mild, in remission). (R. 646). Morgan opined that
Plaintiff's prognosis was “poor.”
Disability Determination at the Initial
16, 2013, agency reviewer Caroline Williams, M.D. reviewed
Plaintiff's records and completed a physical residual
functional capacity (“RFC”) assessment. (R. 80).
Williiams found the following exertional limitations:
Plaintiff could occasionally lift and/or carry fifty (50)
pounds; frequently lift and/or carry twenty-five (25) pounds;
stand, walk, and/or sit for about six (6) hours in an eight
(8) hour workday; and unlimited pushing and/or pulling. (R.
81). As to postural limitations, Williams found Plaintiff
could frequently climb ramps, stairs, ladders, ropes, and
scaffolds; and frequently balance, stoop, kneel, crouch, and
crawl. (R. 81). No manipulative, visual, or communicative
limitations were found. Id. As to environmental
limitations, Plaintiff could have unlimited exposure to
wetness, humidity, noise, vibration, and extreme heat; but
should avoid concentrated exposure to hazards and extreme
cold, and avoid even moderate exposure to fumes, odors,
dusts, gases, and poor ventilations. (R. 82). The narrative
explanation accompanying these limitations noted, in relevant
part, that otolaryngist records indicated normal examination
results and “excellent” breathing with nasal
trumpets, and that Plaintiff “appears to be recovering
without complications since most recent surgery on [May 2,
2013] . . . Should [claimant] cont[inue] to recover [without]
complications, it is expected that he should be able to, at
least, perform activities as described in this RFC.”
September 23, 2013, agency reviewer Paula Bickham, Ph.D.
reviewed Plaintiff's records and completed a psychiatric
review technique (“PRT”) and Mental Residual
Functional Capacity (“MFRC”) assessment. (R. 79,
83). Bickham found Plaintiff had mild limitations in
activities of daily living; moderate difficulties in
maintaining social functioning; moderate difficulties in
maintaining concentration, persistence, or pace; and no
episodes of decompensation. (R. 80). As to concentration and
persistence limitations, Plaintiff was moderately limited in
his ability to work in coordination with or in proximity to
others without being distracted, and moderately limited in
his ability to complete a normal workday and workweek without
interruptions from psychologically based symptoms and to
perform at a consistent pace without an unreasonable number
and length of rest periods. (R. 83). As to social functioning
limitations, Plaintiff was markedly limited in his ability to
interact appropriately with the general public and moderately
limited in his ability to maintain socially appropriate
behavior and to adhere to basic standards of neatness and
cleanliness. (R. 84). As to adaptation limitations, Plaintiff
was moderately limited in his ability to respond
appropriately to changes in the work setting. Id.
The following narrative explanation accompanied these
The claimant is being evaluated under 12.04, 12.06 and 12.09.
He appears mostly credible. The recent CE observed moderate
limits [with social functioning] and persistence. IQ and
Cognistat did not reflect memory or concentration deficits.
Recent [office visit] with his new [primary care provider]
indicated increased anxiety in public and isolation at home.
The claimant did not allege limits based on cognitive or
[social functioning] on the [Adult Function Report]. He
completed the form independently.
Please see the PRTF for the initial case discussion.
The claimant retains the ability to learn and perform
work-like activity with no contact [with] the general public.
Disability Determination at the Reconsideration
November 15, 2013, agency reviewer Narendra Pankshak, M.D.
reviewed the prior RFC assessment and affirmed it as written.
(R. 111). Pankshak noted in the narrative explanation, in
part, that there was “no new [medical evidence of
record] to suggest increased functional limitations, [and
that claimant's] gunshot injury  seems to be healing
and he is awaiting prosthesis.” (R. 110). On November
12, 2013, agency reviewer Philip Comer, Ph.D. reviewed the
prior PRT and MFRC assessments and affirmed them as written.
(R. 112). Comer noted in the narrative explanation, in part,
that he had “reviewed evidence in [the] file, [and
that] new [medical evidence of record] does not indicate
additional significant mental/emotional limitations.”
April 24, 2015 Tony Goudy, Ph.D. conducted a psychological
evaluation of Plaintiff, including a Clinical Interview,
Mental Status Examination, and psychological testing. (R.
770-776). Dr. Goudy reviewed Plaintiff's medical records
from United Summit Center, Morgan's consultative
examination report, and progress notes from Dr. Snuffer. (R.
Goudy observed that Plaintiff's appearance was striking
pursuant to his missing nose, long beard, and mustache. (R.
773). Hygiene and personal care appeared “fair.”
Id. Plaintiff was cooperative, but “somewhat
reserved.” Id. His speech was relevant and
coherent, but he did not generate any spontaneous
conversation during the interview. Id. Plaintiff was
generally oriented to time, place, person, and circumstance.
Goudy observed that Plaintiff's affect was blunted, and
he described his mood as “nervous.” (R. 773). Dr.
Goudy noted a history of suicidal ideation, in addition to
Plaintiff's gunshot wound being self-inflicted according
to witnesses and the police report, though Plaintiff does not
remember it. (R. 774). As to perception, Plaintiff denied
hallucinations but admitted a history of paranoid ideation
especially in public. Id. Immediate memory was
intact; recent memory was moderately to markedly impaired,
and recent memory was not significantly impaired.
Id. Concentration was markedly impaired, based on
serial sevens and other task performance. Id.
Intellectual functioning was in the low average range, based
on the interview, academic history, and prior test results.
Id. Judgment was significantly impaired, based on
hypothetical assessment and further supported by a history of
same, including “the incident where he shot his nose
Goudy administered the Beck Depression Inventory-II (BDI-II),
on which Plaintiff's score of 52 indicated severe levels
of depression. (R. 774). Plaintiff highest-rated symptoms
included sadness, pessimism, feeling like a failure, guilt,
feeling as though he is being punished, self-criticalness,
difficulty making decisions, feelings of worthlessness,
irritability, and fatigue. Id. On the Beck Anxiety
Inventory (BAI), Plaintiff's score of 44 indicated severe
levels of anxiety. Id. Plaintiff's highest-rated
symptoms included inability to relax, fear of the worst
happening, heart racing, feeling terrified, nervousness,
feelings of choking, shakiness, fear of losing control, and
fear of dying. (R. 774-75).
Goudy diagnosed Major Depressive Disorder, Recurrent, Severe;
Generalized Anxiety Disorder, and Panic Disorder without
Agoraphobia. (R. 775). He considered Plaintiff's
treatment records which showed a “steadily
declin[ing]” emotional state since January 2013, a
continued inability to maintain emotional control despite
ongoing psychological treatment and medication, continuing
severe psychiatric impairment reflected in low GAF scores,
continued severe depression and anxiety, moderate to marked
impairment in recent memory and marked impairment in
concentration. Id. Dr. Goudy opined that Plaintiff
had mild impairment in activities of daily living, marked
impairment in social functioning due to panic attacks and
paranoia, marked impairment in concentration, persistence,
and pace (particularly around groups of people), and one
episode of decompensation (attempted suicide by gunshot in
January 2013). (R. 776). Dr. Goudy opined that in considering
12.04 A.1.A, 12.06 A.1, and 12.06 A.3, “Mr. Barrett
meets a listing based on a combination of psychological
factors.” (R. 775). Goudy also provided an explanation
for differences in his findings compared to the prior
It is important to note here that although the Morgan
evaluation did not find marked impairment in concentration,
Mr. Barrett's severe anxiety and paranoia around others
would likely render his ability to concentrate as markedly
impaired in the workplace. Moreover, as he feels intense
paranoia in public and has increasingly isolated himself
because of it, his social functioning would also be markedly
impaired. Mr. Barrett's inability to maintain emotional
stability has been consistently and longitudinally documented
in the records from United Summit Center. Consequently, he
would be expected to miss multiple workdays per week due to
Statement from Treating Physician Dr. Snuffer
4, 2015, Dr. Snuffer wrote a letter to Plaintiff's
counsel responsive to the issues of “any information or
opinion [he] may have regarding [Plaintiff's] ability to
make visits or trips out of the State of West Virginia and as
to his capacity for employment.” (R. 777). Dr. Snuffer
opined that Plaintiff's facial injury has
“certainly created or perhaps aggravated a preexisting
extremely severe anxiety disorder[, and that Plaintiff]
continues to have extreme difficulty adjusting to his post
injury features.” Id. Dr. Snuffer noted that
Plaintiff appears to be in some denial about the
self-inflicted nature of his injury, as he continues to
maintain that he is not sure what happened. Id. Dr.
Snuffer advised that he has no personal knowledge of
Plaintiff taking any trips; only that Plaintiff had said that
he made a trip to Mississippi to see a girl. Id.
However, Dr. Snuffer added he now doubts that Plaintiff ever
made such a trip because he has observed in subsequent visits
that Plaintiff claims to participate in activities or events
that the people who accompany him indicate are not in fact
occurring. Id. Dr. Snuffer believed Plaintiff may be
attempting to appear to be more “normal.”
Snuffer noted that Plaintiff's attempts to repair his
teeth and obtain a prosthetic nose had been unsuccessful. (R.
778). As a result, Plaintiff's appearance gives him
“extreme anxiety, ” to the point of
“moderate to severe agoraphobia, and usually not going
out in public” alone. Id. Dr. Snuffer further
noted that a “near 40 pound weight gain from September
2013 to the end of 2014” led him to suspect Plaintiff
is “quite depressed and inactive.” Id.
Dr. Snuffer concluded:
Overall, in spite of his assertions to me of engaging in
activities, I find Kevin to be extremely impaired and limited
from a psychological standpoint. His facial features and
difficulty with swallowing and breathing only add to his
misery. I do not believe he can sustain any type of
employment at this time.
Psychiatric Review Technique
April 4, 2016, Dr. Jourdan Aromin, a treating psychiatrist,
completed a Psychiatric Review Technique form with
accompanying narrative explanation. (R. 791). His opinion was
based on his own longitudinal psychological treatment of
Plaintiff, which he began in October 2015 at Dr.
Snuffer's request, as well as his review of
Plaintiff's medical records. (R. 803). Aromin observed
that Plaintiff “has presented with significant levels
of anxiety and depression at all sessions.”
Id. Moreover, he “continues to be in
denial” about the fact that his gunshot wound was
self-inflicted, maintaining that he was shot by some other
unknown person. Id. Aromin opined that Plaintiff was
“faced with an extremely unfortunate incident and
residual emotional condition for which he ha[s] only a
minimal, immature coping capacity.” Id. Aromin
pointed to Plaintiff's tendency to “deal with
stress by creating and voicing fantasy activities” such
as visiting friends in other states, or participating in
hunting or traveling activities - none of which he has
actually done. Id. Rather, “these proved to be
activities he had only observed on television and 
fantasized himself into.” Id. Aromin explained
that “[b]y using this primitive coping defense, Kevin
is able to push away or obtain some escape from his traumatic
and intrusive thoughts surrounding the gunshot wound to his
Aromin opined that Plaintiff met listings 12.04 and 12.06.
(R. 791). As to listing 12.04, Affective Disorders, Dr.
Aromin noted mood disturbance accompanied by anhedonia,
appetite disturbance with change in weight, sleep
disturbance, difficulty concentrating or thinking, thoughts
of suicide, and delusions or paranoid thinking. (R. 794). As
to listing 12.06, Anxiety-Related Disorders, Dr. Aromin noted
generalized persistent anxiety accompanied by motor tension,
autonomic hyperactivitiy, apprehensive expectation, vigilance
and scanning; a persistent irrational fear of a specific
activity or situation resulting in a compelling desire to
avoid it; recurrent obsessions or compulsions that are a
source of marked distress; and recurrent and intrusive
recollections of a traumatic experience that are a source of
marked distress. (R. 796). Dr. Aromin opined that Plaintiff
had moderate to marked restriction of activities of daily
living; marked difficulties in maintaining social
functioning; marked difficulties in concentration (and
particularly) persistence and pace; and one or two episodes
of decompensation, each of extended duration. (R. 801). Dr.
Aromin further opined that Plaintiff's chronic mental
conditions had lasted at least two years, caused more than a
minimal limitation of ability to do any basic work activity
(with symptoms or signs currently attenuated by medication or
psychosocial support), and were accompanied by such marginal
adjustment that even a minimal increase in mental demands or
change in the environment would be predicted to cause the
individual to decompensate. (R. 802). Dr. Aromin's
narrative explained that:
Kevin continues to have marked difficulties in maintaining
his social functioning. He prefers to isolate himself and
avoids contact with others as much as possible. Continues
social contact and interaction aggravates his anxiety and
depression. Kevin is additionally somewhat limited in his
activities of daily living, even within his home. He often
demonstrates poor hygiene and comes to his sessions in soiled
clothes. His limitation in activities can approach marked
limitation if those activities require him to be outside the
sphere of his home. His discomfort around other[s], due to
the physical deformity of his face, makes activities such as
shopping, banking, or other types of even minimal public
interaction quite difficult for him. In areas of useful
concentration, persistence and pace, I would note that in
session with Kevin he has demonstrated adequate
concentration, but from his descriptions of his activities,
he has markedly limited persistence and page. I would predict
that, given his difficulty in other areas, with even minimal
additional pressure, his concentration would be expected to
deteriorate into markedly limited.
(R. 803). Dr. Aromin also agreed with and endorsed Dr.
Goudy's opinion, including his findings of severe
emotional disturbance in anxiety and depression, that the
severity of Plaintiff's conditions met listings 12.04 and
12.06. (R. 804). Dr. Aromin additionally felt Plaintiff's
situation was “quite fragile” and demonstrated
that “even minimal increase in mental demands or other
changes would likely cause him to further withdraw and
compensate.” Id. While Dr. Aromin has
continued to encourage Plaintiff to try return to work, there
has been “some slow progress” to date.
Id. Ultimately, Dr. Aromin opined that Plaintiff has
not been able to work since his injury in 2013, and is not
yet prepared to return to a work environment at this time.
ALJ hearing held on May 19, 2015, Plaintiff testified that he
was single and had no children. (R. 45). He lives with his
parents. Id. He has a driver's license and has
no difficulty driving. (R. 45-46). He completed seventh grade
in high school and does not have a GED or any other type of
schooling or training. (R. 46). He has no income at this
time, but receives food stamps and a medical card.
testified that he has not worked since January 2013. (R. 47).
The ALJ questioned Plaintiff about information in the file
that indicated that he had “been working for a detail
shop owned by a friend.” Id. Plaintiff
testified that he had not worked there, but had “[gone]
over there a couple of times, ” as his friend was
trying to help Plaintiff with social issues. Id.
Plaintiff testified that he “went over there about
three or four times and hung out with him [but] that was
it.” Id. Plaintiff testified that he did not
earn any money for being at his friend's shop, and he
does not know why his doctor's notes stated that he was
“working when he is needed at his friend's car
detailing shop in Clarksburg.” (R. 48).
his work history, Plaintiff testified that he last worked in
2012 at Pro-Guard Eastern Division, a pipeline company, at
which he painted above-ground pipeline pad assemblies. (R.
48-49). Prior to that he was employed from 2009 to 2011 at
Home Warehouse of Clarksburg, where he drove a delivery truck
and did in-store retail sales. (R. 49). In this job,
Plaintiff operated a forklift and lifted siding and windows
between one hundred to one hundred and fifty (100 - 150)
pounds. (R. 54). Prior to that, he worked for Maximum Well
Service as a rig-hand on a service rig. (R. 50). In 2006
Plaintiff was employed through Winan's, a temp agency
through which he worked at Home Warehouse. (R. 50-51). In
2003, Plaintiff worked for Woodward Video as a service
technician and installer of the West Virginia Lottery
machines and video poker machines. (R. 51). In this job,
Plaintiff lifted a hundred pounds, and it required 40 hours
of training to get the necessary technician certificate. (R.
53). In 2001 and 2002, Plaintiff worked for Morgan
Development Corporation doing golf course maintenance. (R.
response to questions from his attorney, Plaintiff testified
that his psychological diagnoses included depression and
anxiety. (R. 55). He testified that these conditions affect
him in that he “pretty much ha[s] no social activities
[and] can't make [him]self function to contribute to
social activity.” Id. He rarely leaves his
house; “usually the only time [he] do[es] is if some of
[his] famiy is with [him], and that's not very
often.” Id. Plaintiff testified that he lives
with his parents because “[he] do[es]n't trust
[him]self to be alone” as a result of suicidal and
homicidal thoughts he has. (R. 56). Plaintiff further
testified that these pervasive thoughts affect his ability to
Q Why do you live with your mom and dad?
A I myself, I don't trust myself to be alone.
Q And why don't you trust yourself to be alone?
A Because I do have suicidal thoughts.
Q And have you ever had thoughts about killing other people?
A Yes, sir.
Q These types of thoughts that's coming from this
anxiety, what - how do these thoughts affect your ability to
concentrate, say on a 30-minute television program?
A I can, I can watch 30 minutes of TV and tell you nothing
Q Why can't you tell me anything about it?
A I'll just, it's just like I'll watch it, but