United States District Court, S.D. Iowa, Davenport Division
REPORT AND RECOMMENDATION
C. Adams, Chief U.S. Magistrate Judge.
Jared Stephenson seeks review of a final decision of the
Commissioner of the Social Security Administration
(“Commissioner”) denying his claims for
disability insurance benefits (“DIB”) under Title
II and Supplemental Security Income Benefits
(“SSI”) under Title XVI of the Social Security
Act, 42 U.S.C. §§ 401-34; 1381-85. This Court
reviews the Commissioner's final decision pursuant to 42
U.S.C. §§ 405(g) and 1383(c)(3). The case is before
the undersigned for report and recommendation pursuant to 28
U.S.C. § 636(b)(1)(B). The Court considers the matter
fully submitted on the briefs.
protectively filed his present claims for DIB and SSI
benefits claim on January 21, 2014, alleging disability since
October 15, 2007. (AR at 13, 80, 94, 108, 109). He alleged
disability due to a learning disorder and shakes and tremors.
(AR at 80). The Social Security Administration
(“SSA”) denied his claims initially and on
reconsideration. (AR at 92, 106, 108, 109, 123, 138, 140-150,
156-173). Stephenson requested an administrative hearing.
Administrative Law Judge (“ALJ”) Shreese M.
Wilson conducted an administrative hearing on September 29,
2015. Stephenson appeared with his attorney Michael DePree;
vocational expert Teresa McClain also appeared and testified.
The ALJ found Stephenson was not disabled on February 2,
2016. (AR at 10-32). Stephenson requested a review of the
ALJ's decision. (AR at 7). The Appeals Council denied the
request for review and the ALJ's decision became a final
decision on January 26, 2017. (AR at 1-5). Stephenson timely
filed the Complaint  in this case on March 1, 2017.
Educational and Vocational Factors
was 36 years old when he filed for benefits. (AR at 80, 94).
His highest level of education was the eleventh grade in high
school. (AR at 50). He had worked as a sandwich maker, ticket
taker, and hand packager. (AR at 340).
medical records are limited. On February 12, 2009, Stephenson
reported to Community Health Care (CHC) in Davenport, Iowa,
complaining of “spells” of dizziness and the
feeling of things moving, and that his limbs felt like they
were twitching. (AR at 357). He also reported his hands were
twitching all the time. The episodes had occurred six times
in the previous two months. He did not lose consciousness or
fall. He reported the episodes occurred when he was reading
after about five minutes of reading. (Id.) His
physical examination was normal but Dr. Oludamilola Ogunlesi
referred him for an EKG, CBC, CMP, thyroid stimulating
hormone, EEG and CT scan of the head. (Id.) The
doctor requested that Stephenson follow up after the tests
were done, but there is no record of any follow-up, only the
test results. (Id.) The CT scan performed February
23, 2009, showed sinusitis, but otherwise was negative. (AR
at 367). An EKG was normal, except for rate (AR at 368) and
labs were normal. (AR at 358-359).
was next seen at CHC on September 22, 2010, and had a lumbar
spine x-ray taken after he complained of back and left hip
pain. (AR at 366). In comparison to an x-ray taken March 17,
2009, no compression fracture or malalignment was seen and
there was an unchanged L5-S1 disk space narrowing, as well as
asymmetry of the left iliac wing which was consistent with a
“large incidental sessile osteochondroma.”
(Id.) There are no other records concerning this
visit. Stephenson followed up with a visit to the CHC clinic
on September 30, 2010, complaining of continued pain in his
lower back. (AR at 356). He told Dr. Ogunlesi he had pain
daily in his left lower back that he rated at 10/10 in
intensity. (Id.) No trauma had occurred and he had
not been doing any heavy lifting. (Id.) Stephenson
reported he sometimes had a tingling sensation in his left
leg below the knee, but no numbness. (Id.) Dr.
Ogunlesi reviewed the x-ray from September 22. On physical
examination, Stephenson had tenderness over the left lower
back immediately above the iliac crest, no midline tenderness
and negative straight leg raise bilaterally. Neurologically,
he was alert and oriented to time, place, and person and
sensation was intact to both lower extremities. Dr.
Ogunlesi's impression was low back pain most likely from
acute strain. He prescribed Flexeril and ibuprofen as needed
and did not believe there was a need for an MRI, as no
radicular symptoms were present. (Id.)
follow-up visit on October 7, 2010, Stephenson could
ambulate, but stated it did not feel normal when he walked,
that he needed to support himself when he initially got out
of bed in the morning, but then could walk without support.
He described intermittent paresthesias in his left lower
extremity, but no incontinence. (AR at 355). On physical
examination, Dr. Ogunlesi noted erythematous in the left lower
back, negative straight leg raise on the right, but pain in
the lower back with straight leg raise to 60 degrees. Muscle
strength was 5/5 in both lower extremities and there was no
objective weakness or sensory loss. (Id.) Dr.
Ogunlesi recommended further evaluation with an MRI of the
lumbar spine and an x-ray of the left hip based on
Stephenson's complaint of pain with external rotation of
the left hip. (Id.)
was performed on October 14, 2010. (AR at 363). It showed
moderate to large central disk protrusion at ¶ 4-5 and
moderate-sized lateral disk protrusion extending in to the
neural foramen at ¶ 5-S1. (Id.) At a follow-up
exam on October 15, 2010, Dr. Ogunlesi noted that the MRI
showed a disc protrusion was compacting the lumbar nerve
root. (AR at 354). He recommended Stephenson see a
neurosurgeon for an opinion and started Stephenson on
Tramadol for his pain. (Id.) There are no records
concerning any follow-up on this medical issue.
medical record from Dr. Ogunlesi was from a visit on July 3,
2011, after Stephenson cut his finger. (AR at 352-353). The
cut was closed with stitches and Stephenson was discharged.
(Id. at 353).
records from Genesis Medical Center include an x-ray and
treatment after Stephenson sustained a rolling injury to his
right ankle on September 24, 2014. (AR at 446-50). Stephenson
also was seen at Community Health Care on January 21, 2015,
to assess his complaints of body tremors/shakes and low back
pain. Labs were drawn to assess his tremors with further
management dependent on results. (AR at 430-35). A lumbar
spine x-ray on January 28, 2015, was normal. (AR at 428,
Mental Health Records
presented at Vera French Community Mental Health Center on
August 4, 2014, complaining of depression. (AR at 390).
Richard Quarton, Ph.D., interviewed Stephenson, who at that
time was living with friends. He was unemployed “in
part due to his medical issues.” Dr. Quarton noted
Stephenson stammered at times, presented in a “somewhat
anxious way and had some pressured speech.”
(Id. at 390-91). Stephenson reported sleeping
problems. He was disheveled in appearance, oriented to
person, place, time, and situation, and demonstrated
unremarkable behavior and psychomotor behaviors. His speech
was slurred and he stammered. His affect was flat and his
mood labile, anxious, and depressed. Stephenson's memory
was intact, he had clear consciousness, and his intellect was
average. (Id. at 391). His attitude was discouraged,
attention was gained and maintained, reasoning and judgment
fair, and impulse control and insight poor. (Id.)
Stephenson's self-perception was realistic, his thought
processes logical, thought content unremarkable, and he was
not showing signs of suicidal or homicidal ideation.
(Id.) Stephenson had been referred by his disability
lawyer. He reported he was a social drinker, smoked
cigarettes, and occasionally smoked marijuana. (Id.)
Stephenson told Dr. Quarton he occasionally got angry and
would throw himself into walls and sometimes blurted out
negative comments to friends. Stephenson felt he was doing
better with his temper. (Id.) He reported it hurt to
walk and if he was active he experienced chest pains. He also
stated he would “space out and forget things” and
was a procrastinator. (Id.) Stephenson blamed
himself for his father's suicide, had some symptoms of
Adult ADHD, and cut himself as a youth. He was in foster care
as a child for unknown reasons. (Id.) Dr. Quarton
diagnosed Stephenson with Unspecified Depressive Disorder,
moderate and to rule out unspecified ADHD. The goal of
treatment was to assist with his depressive symptoms so they
did not impair his daily functioning. (Id. at 392).
August 13, 2014, Stephenson returned for therapy. (AR at
393). He was depressed and angry and Dr. Quarton tried to
identify the sources of Stephenson's anger. Stephenson
still stammered, but was more relaxed, had better mood, and
was more talkative. (Id.)
Bradley, ARNP conducted a Psychiatric Evaluation of
Stephenson on September 11, 2014. (AR at 395). His chief
complaint was that he had an anger problem and “people
say I'm depressed.” (Id.) Ms. Bradley
noted Stephenson had “tremors and twitches” in
the lower aspect of his face, which he reported he had had
since he was a child. (Id.) His past psychiatric
history included treatment at Vera French from the age of 9
for a diagnosis of ADHD, for which he received Prozac and
Ritalin. (Id. at 396). He reported three past
psychiatric hospitalizations at ages 13, 18, and in his early
20's when he had depression with suicidal ideation.
(Id.) He also cut himself as a teenager and as a
young adult had stabbed his arm when he got angry.
(Id.) Stephenson reported he had an 11th grade
education and was in special education classes in high
school, but did not do well and had significant academic and
behavioral issues. (Id.) He was unemployed and last
worked at Burger King in 2008. (Id.) He reported
past arrests for verbal assault, public intoxication,
interfering with official acts, and failing to appear, but
had no legal constraints at the time of the evaluation.
(Id.) He reported pain in his left knee, but
otherwise no other physical problems. (Id.)
Stephenson reported past alcohol and marijuana use (as
recently as one to four months before the evaluation
respectively), drinking four to five caffeinated sodas daily,
and smoking approximately a half pack of cigarettes a day.
(Id. at 397). Stephenson told Ms. Bradley he had had
been physically and emotionally abused by his stepfather and
was molested by a cousin in the past. (Id.)
mental status exam, Stephenson was appropriately dressed and
groomed. (AR at 397). He was slightly restless and he had
some abnormal movements of his mouth and the lower aspect of
his face. (Id.) His mood was neutral and affect
slightly constricted, “appropriate to conversation, and
congruent with mood.” His speech was of “normal
rate, quantity, and volume” with some occasional
stuttering when he tried to express himself. (Id.)
Stephenson denied auditory hallucinations or paranoia, but
acknowledged some odd thoughts such as he should “kick
babies, ” thoughts on which he had not acted. His
thought processes were logical and goal-directed with no
loosening of associations. (Id.) He denied suicidal
or homicidal ideation, but admitted to past harmful thoughts
and attempts. (Id.) Stephenson was alert and
oriented with fair eye contact and minimal insight into his
current problem. He appeared to have fair to poor judgment.
(Id.) His gait and station were unremarkable. His
recent and remote memory were both impaired; his
concentration and attention span slightly impaired.
(Id.) Ms. Bradley could not determine whether
Stephenson's inability to spell “world”
backwards or to do serial 7's was based on his below
average intellectual functioning or was secondary to poor
concentration and attention. She could identify no language
impairments or barriers. Stephenson's abstractive
capacity was impaired and his intellectual functioning was
Bradley's impression was that Stephenson had “some
elements of Antisocial Personality Disorder, ”
unspecified depressive disorder, mild intellectual
disability, and history of ADHD. (AR at 397). She recommended
he start Zoloft along with Risperdal and he was to follow up
in four weeks to evaluate the effectiveness of the
medication. (Id. at 398).
returned to Vera French on October 9, 2014, to follow up on
his depression. (AR at 400). He reported his friends thought
he was more “mellow” and better, but he did not
like the medications. He had improved eye contact and
appeared less anxious. (Id.) Stephenson still had
sleep difficulties. His affect was “a bit
brighter” and he offered “more spontaneous
conversation.” (Id.) On mental status exam, he
was appropriately dressed and groomed and still slightly
restless, but improved from before. (Id.) His facial
movements appeared unchanged, but Stephenson thought they
were worse. His mood was neutral and affect a little
brighter. (Id.) His speech was normal rate,
quantity, and volume with some occasional stuttering. He
denied auditory hallucinations or paranoia and reported his
thoughts about kicking babies were gone. (Id.) His
thought processes were logical and goal-directed with no
loosening of associations. He denied suicidal or homicidal
ideation. Stephenson was alert and oriented with improved eye
contact. He demonstrated limited insight into his current
problem, his judgment was fair to poor. (Id. at 400-
01). Stephenson's gait and station were unremarkable. His
concentration and attention span were within normal limits
and he demonstrated no language impairments or barriers.
(Id. at 401). Ms. Bradley reduced the amount of
Risperdal in response to the complaint Stephenson's
tremors/tics were worsened to see if that reduced the
worsening, while remaining effective with respect to
“intrusive, negative thoughts.” (Id.)
His Zoloft prescription was continued and Ambien was added to
help with sleep issues. Stephenson was to return for a
medication check in a month. (Id.)
November 16, 2014, Stephenson reported for a scheduled
appointment at Vera French. (AR at 403). He reported improved
mood, he felt better and was “pleasantly surprised by
the improvement.” (Id.) He reported some
continued irritability after he ran out of medication, but
had been compliant with medication before running out.
(Id.) Stephenson reported his friends noticed when
he had not taken his medication. His eye contact was improved
and the tremors of his hands and lower jaw were minimal,
Stephenson reporting they had improved with the reduction of
Risperdal. (Id.) He denied intrusive thoughts, his
affect was improved and he demonstrated some humor.
Stephenson did not like the medications and did not know if
he wanted to feel “mellow.” (Id.) He
continued to have sleep difficulties and stopped taking
Ambien as it was not helping. He requested an alternative
sleep medication. (Id.) On mental status exam,
Stephenson was appropriately dressed and groomed. His
psychomotor activity was within normal limits with continued
abnormal movements of his mouth and lower aspect of his face,
unchanged from his initial visit. (Id.) His mood was
euthymic, affect full, congruent with mood and appropriate to
conversation. His speech was normal rate, quantity, and
volume with some stuttering. He denied auditory
hallucinations or paranoia and his past odd thoughts remained
absent. His thought processes were logical and goal-directed
with no loosening of associations. He denied suicidal or
homicidal ideation. (Id.) Stephenson was alert and
oriented with good eye contact, much improved. He had some
insight into his current problem and fair judgment. His gait
and station were unremarkable. His concentration and
attention span were within normal limits and there were no
language impairments or barriers. (Id. at 404). Ms.
Bradley's impression was that Stephenson was much
improved, less depressed, smiled easily, and had improved eye
contact. (Id.) They discussed increasing his dosage
of Zoloft to address the irritability and started Trazodone
for sleep. (Id.)
returned to Vera French on December 4, 2014, for a scheduled
appointment. (AR at 407). He reported increased difficulties
after he ran out of his medication for about a week and did
not know how to get it refilled. He felt more restless and
irritable and his tics/twitches were more pronounced.
(Id.) He felt the increase in Zoloft and addition of
Trazodone had helped. (Id.) On mental status exam,
Stephenson was appropriately dressed and groomed with
restless and fidgeting psychomotor activity and some abnormal
movements of his mouth and lower aspect of his face, which
were more prominent than his last visit. (Id.) His
mood was anxious with constricted affect, congruent with mood
and appropriate to conversation. His speech was normal rate,
quantity, and volume with some stuttering. He denied auditory
hallucinations or paranoia, intrusive thoughts/delusions. His
thought processes were logical and goal-directed with no
loosening of associations. He denied suicidal or homicidal
ideation. (Id.) Stephenson was alert and oriented
with fair eye contact and some insight into his current
problem. His judgment was fair. His gait and station were
unremarkable. His concentration and attention span were
within normal limits and he had no language impairments or
barriers. (Id.) Ms. Bradley reviewed with Stephenson
how to get refills and reviewed the importance of compliance
with medications. (Id. at 408).
December 9, 2014, individual therapy visit, his first with
Dr. Quarton since mid-August, Stephenson requested referral
to another therapist. (AR at 411). His mental status was
presented for a scheduled appointment at Vera French on
January 19, 2015. (AR at 413). He reported doing “much
better” after getting back on his medications. Ms.
Bradley noted he appeared much more relaxed and his
tics/tremors had improved. He felt his medication was
beneficial, but was still having sleep problems.
(Id.) On mental status examination, Stephenson was
appropriately dressed and groomed. His psychomotor activity
was within normal limits with some abnormal movements of his
mouth and lower aspect of his face unchanged from his initial
visit. (Id.) His mood was neutral with full affect,
congruent with mood and appropriate to conversation. His
speech was normal rate, quantity, and volume with some
occasional stuttering. He denied auditory hallucinations,
paranoia, or intrusive thoughts. His thought processes were
logical and goal-directed with no loosening of associations.
He denied suicidal or homicidal ideation. (Id.)
Stephenson was alert and oriented with good, improved eye
contact and some insight into his current problem. His
judgment was fair. His gait and station were unremarkable.
His concentration and attention span were within normal
limits and there were no language impairments or barriers.
(Id.) Ms. Bradley increased his dosage of Trazodone
for sleep and increased his dosage of Zoloft. (Id.
scheduled appointment at Vera French on February 16, 2015,
Stephenson reported doing “pretty well” with an
episode of going out with his brother, drinking alcohol, and
getting into a fight. (AR at 416). He was feeling calm and
was pleased with his medications, except Trazodone was not
helping with sleep. His mental status examination was
consistent with the previous month. (Id.) Ms.
Bradley maintained Stephenson's dosages of Risperdal and
Zoloft, discontinued Trazodone, and added a prescription for
Restoril for sleep. (Id. at 417).
February 18, 2015, during a scheduled appointment at Vera
French for individual therapy with Jerry Lowe, LISW,
Stephenson reported having problems with grief during the
month of January, a year after his mother died. (AR at 419).
They discussed his issues with his father's death by
suicide and Lowe provided support. (Id.) Lowe noted
no change in Stephenson's mental status. (Id.)
a March 5, 2015, individual therapy session with Mr. Lowe,
Stephenson had no change in mental status. (AR at 421). He
reported he had received a letter from disability seeking
specific information. He reported some interaction with his
paternal uncle's family, that he was watching television
and movies a great deal, and not going to sleep until 4:30
a.m. and sleeping until 9:30 or 10 a.m. (Id.)
Medical Source Opinions/Evaluations
consultative examination reports were part of the
administrative record, including one from a prior benefits
April 22, 2009, Dr. Phillip L. Kent, licensed psychologist,
assessed Stephenson. (AR at 452-56). Dr. Kent noted
Stephenson had no prior treatment history. (Id. at
452). In an Adult Function Report provided to Dr. Kent,
Stephenson indicated he was living in his grandfather's
basement and was unemployed. He reported sleeping four hours
a day, having difficulty with motivation, wearing the same
clothes for a week, and did not have a driver's license.
He liked to watch movies, play games, or go to the bar and
watch wrestling. (Id.) Dr. Kent took a psychosocial
history from Stephenson, which included a sporadic work
history and use of marijuana when he had the money.
(Id. at 453). On mental status examination,
Stephenson was casually dressed in sweatpants and a hooded
sweatshirt, maintained poor eye contact and chewed gum,
slouched in his chair and had “somewhat of a defiant
attitude.” (Id. at 454). His facial expression
was flat and body movements appeared slowed. His affect was
blunted and he experienced mood swings, from depression and
not wanting to do anything to anger expressed in punching
walls and throwing things. (Id.) He reported three
hospitalizations. (Id.) Dr. Kent noted Stephenson
did not have problems with attention span during the
interview, his thinking was notably concrete, and
intelligence appeared dull. (Id.) He lacked insight
and blamed others for his problems. Dr. Kent noted
Stephenson's fingers and fingernails were dirty, his
clothes appeared to have been worn for several days and he
needed a shave. (Id.) No obvious memory impairments
were displayed nor were there unusual thought content or
signs of psychosis. (Id.) Dr. Kent administered the
Wechsler Adult Intelligence Scale-Fourth Edition on which
Stephenson put forth “adequate effort.”
(Id.) His full scale IQ was 72. His overall
intellectual functioning fell in “the borderline range
of intellectual functioning” and was consistent with
his low academic achievement and behavior problems in school.
The test results also indicated Stephenson thought
“quite slowly compared to the general
population.” (Id. at 455). Based on his
interview and the test results, Dr. Kent assessed Stephenson
with bipolar disorder, NOS, cannabis abuse, borderline
intellectual functioning, personality disorder, NOS with
negativistic and antisocial traits. His GAF was 55.
(Id. at 456). Dr. Kent referred Stephenson to a
local mental health center to address his mood disorder.
(Id.). He indicated Stephenson did not appear to be
impaired in his ability to understand directions, although he
might have some difficulty remembering due to working memory
and attention problems. Dr. Kent found it
“noteworthy” Stephenson was able to work at a
fast food restaurant for nearly a year as an indication that
“if he really wants to, he likely is able to get along
at least superficially with supervisors, co-workers, and
exercise adequate judgment.” (Id.) Dr. Kent
did not believe he could handle cash benefits. (Id.)
Roger Mraz, Ph.D., conducted a psychological evaluation on
April 2, 2014. (AR at 373-76). Dr. Mraz took a history
similar to Dr. Kent's. (Id. at 373-74). On
mental status exam, he noted Stephenson arrived on time and
was “somewhat disheveled.” (Id. at 374).
His speech was easy to understand and his thoughts
goal-directed, with no evidence of loose associations or
tangential thinking. His mood was depressed and affect
restricted. (Id.) Stephenson scored 21 out of 30 on
the Mini Mental State Exam. On the Beck Depression
Inventory-II, Stephenson chose moderate to severe symptoms of
depressions. (Id.) He reported a long history of
anger control problems. (Id.) On the Connors Rating
scale, Stephenson reported significant problems with
attention span, hyperactivity and impulsivity. (Id.
at 375). He had problems focusing his attention concentrating
and remembering, and was easily distracted. He said he was
impulsive and said and did things without thinking. Dr. Mraz
found Stephenson's math skills at the early elementary
school level and his reading and writing skills at late
elementary school level. (Id. at 375). The results
of the evaluation were consistent with a childhood diagnosis
of ADHD and depression. His symptoms of Intermittent
Explosive Disorder had a negative impact on his
employability. Although Stephenson had moderate problems with
delayed memory and working memory, he could remember and
follow simple instructions, although the prior evaluation
indicated an impairment in processing speed. (Id.)
Dr. Mraz found his judgment to be poor and questioned
Stephenson's ability to manage funds, particularly in
view of his history of substance abuse. (Id.) His
final diagnosis was Intermittent Explosive Disorder, Major
Depressive Disorder, Attention-Deficit/Hyperactivity
Disorder, Combined Type, Cannabis and Alcohol Abuse and
Nicotine Dependence with Antisocial Personality Traits.
(Id. at 376).
on April 19, 2014, Dr. Stanley Rabinowitz, M.D., saw
Stephenson for a physical examination. (AR at 378-84).
Stephenson's chief complaint was “shakes and
twitches.” (Id. at 380). He reported he had
complained of these for years. Previous CT scan and EEG had
been normal. (Id.) About two years before the
examination he also started having left lower extremity
numbness and low back pain, which radiated down his left leg
and was prominent with activity. (Id.) He only took
Ibuprofen for relief. His educational and social history were
the same as reported to Drs. Kent and Mraz. (Id.) On
physical examination, his speech was clear and
understandable, hearing grossly normal, and he walked without
help of an assistive device. (Id. at 381).
Stephenson was obese. Range of motion testing of his joints
and spine was performed; all were within normal limits.
(Id. at 378, 384). Stephenson demonstrated no active
joint inflammation, deformity, instability, contracture or
paravertebral muscle spasm. (Id. at 382). Straight
leg raising was negative at 90 degrees both sitting and
supine. (Id.) Grip in both hands was normal and
Stephenson's digital dexterity was not impaired. He had
no difficulty getting up and down from the examining table,
but had “mild difficulty” squatting
three-quarters of the way down. His cranial nerves II-XII
were grossly intact. (Id.) His reflex and motor
strength testing was normal and there was no evidence of
atrophy. (Id.) On mental status exam, Stephenson was
fully oriented, his memory intact and his appearance
appropriate. (Id.) He had no behavioral difficulties
during the examination and was able to relate during the
examination. (Id.) Dr. Rabinowitz believed
Stephenson could handle his own funds. His final impression
was history of tremulousness, etiology undetermined; chronic
low back pain with questionable left lower extremity
radiculopathy; history of learning disability; history of
polysubstance abuse that was inactive and exogenous obesity.
hearing on September 29, 2015, Stephenson was 38 years old.
(AR at 45). He was 5'11” and weighed 289-290
pounds. He was right handed, but also used his left hand.
(Id. at 46). Stephenson was single and had two
children that he did not see; he had recently signed over
parental rights to one child. (Id. at 46-47). He
lived in a mobile home with friends. (Id. at 47). He
did not have a driver's license and had never had one.
(Id. at 47-48). Stephenson was transported by one of
his roommates and before that by his mother. (Id. at
48). He smoked cigarettes and smoked marijuana, although not
as often as he did not have the money to buy it.
(Id. at 48-49). He estimated he smoked it once a
month and only drank alcohol at poker games, which he had
quit playing. (Id. at 49). In the last year he had
played about five games when he got spotted money to get into
the game. (Id.) Stephenson completed the eleventh
grade and did not get his GED. (Id. at 50). The
source of income to run the household where he lived was
income from his roommates and food stamps from Stephenson.
Stephenson had a state medical card which he obtained after
talking to his attorney the first time, maybe May 2014.
(Id. at 50-51).
past, Stephenson had worked as a ticket taker for security
companies and worked as a cook in a fast food restaurant. (AR
at 51). The last time he worked was 2008 or 2009.
(Id. at 52).
time of hearing Stephenson was not taking pain medication for
his back. (AR at 52- 53). He last saw a doctor for his back
about a month before the hearing, but was told there was
nothing wrong. (Id. at 53). No physical therapy or
medication was prescribed. (Id. at 54). The pain
fluctuated from his lower back to his left leg. There was
nothing that caused his back pain to be more severe, but he
was not as active now. (Id.) ...