Katenkamp v. Astrue, No. 7:2012cv00543 - Document 14 (W.D. Va. 2013)

Court Description: MEMORANDUM OPINION. Signed by District Judge Glen E. Conrad on 7/15/2013. (lab)

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rL ERZ:oFFl u.s. ST GOURT cE DI . ATR- OKQ, VA FI LFD I THE UNI N TED STATES DI STRI COURT CT FOR THE W ESTERN DI STRI OF VI I A CT RG NI R OAN O KE DI SI VI ON J 16 2 1 Ut 03 JU c ,zUay u.wg 's L# E . D E j rss . - VI CTORI I A QATEN K AM P, Ci lA cton N o. 7: 2CV00543 vi i 1 Pl i tf , a n if M EM OR ANDUM OPI ON NI CA ROLY N W . LVI , c i CO N A tng Com m i s one ofSo a Se urt si r ci l c iy, By: H onor bl G l n E.Conr d a e e a Chi fUnied St t D i t i tJ e t a es sr c udge Def nda . e nt Pl i ifhasf l d t s a ton c le ng t fna de s on oft Com m i s one of Soc a a ntf ie hi c i ha l ngi he i l ci i he si r il Se ur t de ng pl i ifs c ai f a perod ofdi a lt a di a lt i ur e be is t de c iy nyi a ntf l m or i s biiy nd s biiy ns mw neft m r t Soca Se lrt Ac ,asame d,42U. C.jj41 i a 423. J iditon oft sc ti he il cziy t nde S. 6() nd urs ci hi our s ptrua t j205( oft Ac, U. C.j405g) Asrtece byt me a a a g nt ls nt o g) he t42 S. ( . el td he mornda nd r ume s it d by t pa tes t i s s no be o e t co ta e w he he t Com m i s one ' fna ubm te he r i , he s ue w f r he ur r t r he s i rs i l de i i i s c s on s uppo t d by s t ntale de e,or whe he t r i ' re ubsa i vi nc t r he e s ' good ca e' as t nec s ia e us ' o e s t t rma ngt c et t Co si rf f t rc i rton.Se 42U. C.j405g) e ndi he as o he mmisone or urhe onsdeai e S. (. Thepl i if Vi t i Kae m p,wa bo n o M a c 7,1 antf, cora t nka s r n rh 962,a e nt ly c plt d nd ve ual om e e t t e f h gr i s hool Pl n if ha w or d prm a iy as a w a tes . She l tw or d on a he w l t ade n c . ai t f s ke i r l ir s as ke r ul ra s t i d ba i i 2008. On N ove be 1 2009,M s K a e m p f l a a i a i eg a nd us a ne s s n m r 6, . t nka ied n pplc ton f aperod ofdi a lt a di a lt i ur nc be is.Pl i ifalege t ts be m edi a e or i s biiy nd s biiy ns a e nett a ntf l d ha he ca s bl d Katenkamp v. Astrue Doc. 14 f a l f ' s of s t nta ga nf e pl e o N o be 15,2008, due t f br m ya gi or 1 ol m ubs a i l i ul m oym nt n vem r o i o l a, depr i ext em e pai and possbl cancerousl i i vagi ar She now m ai ai t esson, r n, i e es ons n nal ea. nt ns hat s ha r m a ne di a ed t t pr s nttm e. The r co d r ve st t M s K a e m p m e t he s e i d s bl o he e e i e r e al ha . t nkn t he i ed st us r rem ent oft Soci Securiy Actt ough t f h quart of2010,butnot nsur at equi s he al t hr he ourt er Dockets.Justia.com te e fe . S ez n r l 4 U.. j 41 ()a d4 3 a .Co s q e ty panifi e ildt a h r a tr e e eal 2 SC. j 6 i n 2 () n e u nl , li t s ntt o v f e pe i ofdi a lt a di a lt i tr nc be is o y i s ha e t bls d t t s be a e r od s biiy nd s biiy nsla e nett nl f he s s a i he ha he c m di a ed f a l f m s of s t ntalga nf e pl m e on or be or D e e be 31 201 Se s bl or l or ubs a i i ul m oy nt f e c m r , 0. e g neal 42U. C.j423() e rly S. a. M s Ka el mp' c am wa de edu ni ta c i r to andr onsde ai n.Shet n . t rka s l i s ni po niil onsde ai n ec i r to he rquese a r eve a7:novohe rnga r viw beor a Admi srtveLaw J e.l a e td nd ec i d . . ai nd e e f e n nitai udg n n opi on da ed D e em be 20,2011 t La J ni t c r , he w udge al o de e m i d t M s.K a e m p i no s t r ne hat t nka s t dia e The La J e f s bl d. w udg ound t pl i if s f r fo s ve e i im e s i udi hat antf ufe s r m e r mpar nt , ncl ng fb o aga c r nck e dso otmao d pe sv d s re ,c io h e i, e e aie a xit ir my li,h o i n e ic mfl j r e rsie io d r shz p rn a g n r lz d n ey dior r wih pa c a tc ,r adi dior r an e s c a c hol a e Be a e of t s s de t ni ta ks e ng s de , d piodi l o bus . c us he e i pa nne s t La l ger e ha pl ntf w a di a edf rhe s r l ntwor asa wair s m i nt , he w ud ul dt t ai i f s s bl o rpa t e eva k tes . Ho weve ,t La J r he w udge f ound t tM s Ka e mp r t i d s t intf to lc pa iy f a ha . t nka e ane ufk e unci na a ct or lm ie r ng oflg w o k a tviy.TheLa J i t d a e i ht r c i t w udgeas e s pl i t f sr i ua f tona ca ciy s s ed a n i f es d l unc i l pa t asf l w s: olo Afe c r f co i rto oft e ier c d,t und sg fndst t t ough tr a e ul nsde ai n he ntr e or he eri ned i ha , hr t d t l t i ur t c ai a had t r i he a e as ns ed, he l m nt he esdualf nc i nalc pac t t pe f r u to a iy o r o m lg wor asdefne i 20CFR 404.567( exc ptt tt cli ntc dnomor iht k i dn 1 b) e ha he ama oul e t n occ s ona l knee ; r w l o c i b r m ps sais l de s r ,a s f ol . ha a i ly l c a ; r lm n , t r , ad r , opes nd ca f ds The c a m a c d ha no m o e t n m o r t ex ur t haz r and he ght . l i nt oul ve r ha de a e pos e o a ds i s Th cama t sl tdt smpl, o tn ,e ei v ,a k wi nalw sr s j b e li n wa i e o i e r u ie rp tt e t s s t mi i hi o te s o w ih no de son- a ng,c nge i w or s ti pr t ci i m ki ha s n k e tng, oduc i r t ,orwor pa e. ton a e k c ( 1 ) Gi n s har i f tona c pa t a atrc i rngM s Kae amp' a TR 5 . ve uc esdual unci l a ciy, nd fe onsdei . tnk s ge, e a i andprorwor e renc ,a wel a t tm onyfo avoc tonal xpe qt La J duc ton, i k xpe i e s l s esi rm a i e r he w udge co ndudedt t antf r t i ds t intf to l pa iyt pe f m s ve a s ci lg wor ha pli if e ane ufk e unci na ca ct o ror e r l pe t i ht k k r esexi tng i sgnii num beri henatonaleconom y ata1 r evanttm esprort t naton ol s i n i fcant nt i l el i i o enui i of i ur d sa us Acc di y,t La J ns e tt . or ngl he w udge uli t l r e t M s Kae mp wa not tma ey uld hat . tnka s di a e a t ts i noten il d t ape i ofdi a lt ordi a lt i ur ncebe ft .Se 20 s bl d, nd ha he s tte o rod s biiy s biiy ns a ne is e C. R.j 404.520() TheLa J e' opi on wasltrado e ast fna decson oft F. 1 g. w udg s ni ae ptd he i l ii he Co m i sone by t Soc a Se ur t Adm i s r ton' A ppe s Counc l H a ng e us e al m si r he i l c iy ni ta i s al i. vi xha t d 1 a ia ea nita i r m e es M s Ka e mp hasnow a aed t t sc t val bl dmi sr tve e di , . t nka ppe l o hi our. W hie pl i if m a be dia e f c rai f l antf y s bl d or e t n onns of empl m en ,t c uc a f cua oy t he r i l a t l de e m i ton i w he he pl i tf w a diabl d f a l or sofs t tal i ul m pl e .Se t r na i s t r a n if s s e or l f m ubsnn i ga nf e oym nt e 42U. C.j423( ( .Theeaef ee nt ofpr whihmus bec i rdi ma ngs h S. d)2) r r our lme s oof c t onsdee n ki uc a a ay i. Th s ee nsa es mma ie a f l ws ()o j cieme ia f csa ciia n n lss e e lme t r u rz d s ol : 1 b e tv dc l a t nd lnc l o f ig ;2 teo no a c n l in o te tn p y iin ;3 s be tv e ie c o p y ia i n s ( )h piins nd o cuso s fraig h sca s ( ) u jcie vd n e f h sc l nd ma f ttonsofi i nt,a desrbe t oug acli ntst tmony' nd( t cama ' niesai mpanue s s ci d hr h ama ' esi , 4) he li nts a e uc ton, tonal sor rsdua s ls a a .Vie v. nc 438F. 11 115 60( h d ai vocai hit y,e i l kil, nd ge tk Fi h, 2d 57, 9- 4t Ci.1 ) Unde oo v. biof,298F. 8 851(t Ci.19 . r 971; m d Ri c f 2d 50, 4h r 62) A fe a r vi w of t r or i t s ca e t c r i una e t c ude t t t tr e e he ec d n hi s , he ou t s bl o oncl ha he Com m i s one ' tna dec son i s s i r s i l i i s uppor e b s t n i e d nc A sf t d y ubs a tal vi e e. ound byt A d i s r tve he m ni t a i La J w udge M s K a enkn p s f r f om s ve al fnie ph i ali pai nt . H o e , ihout , . t m uf e s r e r de i t ysc m nne s w ver w t goi i o a gr a de a l t co t le t tt La J ng nt ny e t t i, he ur be i ves ha he w udgepr r y co uded t tpl i t f s ope l ncl ha a n if phys c pr bl m sw e e nots s ve e ast ha pr ve ed pe f m a ofa lm ie r nge oflg i al o e r o e r o ve e nt r or nce i td a i ht wor a tviy, i t pe i prort t r i ton ofi ur d sa us Ther l obl m i t sc e k c i t durng he r od i o e m na i ns e t t . ea pr e n hi as c once nsM s Ka e m p' ps hi t i dif c te . r . t nkn s yc a rc fi uli s A sr fec ed a ve w he s a pled f be tt i 2009, a ntf c t d de es i a one e l t bo , n he p i or ne i s n pl i if ie pr son s oft c tons c rbutng t he di a lt he ondii onti i o r s biiy.W hie a n be ofea le r po t f om pl i if s l um r rir e rs r a ntf tea i physcansi c t t ts di notc r tng ii ndi a e ha he d ompli ofe i s an motonal ympt s t m e c not om , he dial es r ve l t t M s K a e e a ha . t nkam p bega t m a s h c pl i s a t tm e of a m edi al vi i on n o ke uc om a nt t he i c st Nove r5, 9.( 241.TheDia lt Deemi tonSeviesrfre M s. tnkmnpf mbe 200 TR ) sbiiy tr nai r c eer d Kae or aps hol c ls udy on M a c 1 201 Theps hol s , r M a v n A . a dne , r , ag e yc ogi a t r h 6, 0. yc ogit D . r i G r r J . di nos d rc re t mo e aemao d prsi d s r e;g n r lz d a xit ds r e wi pa i atc ; e u rn , d rt j r e e sve io d r e e aie n ey io d r t nc ta ks h r di dior r a e s calohola e ( 260 .W hiehenot ma ke i imenti ea ng s de; nd piodi c bus . TR ) l ed r d mpar n pl i if s c en r ton a m ode a e i paim e si pe s s e e a pac i t c i ca s ti a ntf ' onc t a i nd r t m r nt n r it nc nd e n he lni l e tng, t c t le t tt ps hol s ' r por s he our be i ves ha he yc ogi t s e t ugge t r i ual unc i lc pa t f s ef m s s s es d f tona a ciy or om or ofwokaci t ( 259) r tviy. TR .Abou sxmo hsltr onSe e r9, 0,M s Kae t i nt ae , ptmbe 201 . tnkampbe n ga t s e aps hi ti ta t Pi dm ont oe yc a r s t he e Com m uniy Se v c Clni Sheco i t r i es i c. ntnuedw iht ps hi ti t he yc a r c t e t e ,w ih vi is e r f orf ve w e ks The ps a rs ,D r N i hol s Ze t y,of e e a r a m nt t s t ve y our i e . ychi t it . c a lva frd wor ngdignossofshiophrni pr bl dioraniedtpe TR 26 .Hea s sdplitf s ki a i c z e a, oba e s g z y .( 2) sese anif GAF a be w ee 40 t 45. Shor l afe t a i sr tve hea i t Soci Se iy s t n o 1 ty t r he dm ni t a i rng, he al curt A dm i s r ton com m i sone a r c d r vi w by Dr Ga y Benne t a ps hol s . The nit a i si d e or e e . r t, yc ogit A dm i s r tve La J nit a i w udge i e pr t d D r Be t ' i eroga or r s nt r e e . nne ts nt r t y e pons s ast i c t t t es o o ndi a e ha pl ntf doe no s f r f om a i pa r e ls e unde A ppendi 1 t Subpa t P of t ai i f s t uf e r n m im nt i t d r x o r he A d i s r tve Re ato PM 404. m nit a i gul i ns 2 1The g obalas es mentoff toni , o GAF, sus dt rpo thec i ca s u me t t l s s unc i ng r i e o e r t lniin'j dg n of he s jc' o r le e offncinig. GAFsor bewen41a 5 i idiaieo srou s tmsor ube ts veallv l u to n A c e t e nd 0 s n ctv f ei s ympo any s i i r enti s al occupatonal ors erous mpaim n oci , i : choolf toni Amercan Ps a rc A s ociton, unc i ng. i ychit i s a i Dig osi a Sttsia M a a o M e al s de s48( t ed.e rv. 00) a n tc nd a itc l nu l f nt Dlor r 4h txt e 20 . 2I a cl mants f sfom an i paimentls ed underAppendi l t cl m anti de ed t be f ai uf er r m r it x he ai s em o di ed f al f msofs t i gai ulempl sabl or l or ubsantal nf oymentw ihoutr e enc t f or s asa educa i t ef r e o act s uch ge, ton, a pro wo ke pe in e S e20C. R. 40 1 20 d . nd ir r x re c . e F. j 4.5 ( ) 4 Thec t ncude t tt La J dg ste t e ofDr Bel e tsr por i nots our co l s ha he w u e' r am nt . m t' e t s uppore td by s t nta evi nc Furhe m o e t c t le st tD r Be t ' fndi a e i ons sen ubs a i l de e. t r r , he our be i ve ha . nne ts i ngs r nc i t t and t t hi c l i a e c r di t y. I m uch as i r m ai uncl a a t whe he M s ha s onc usons r onta c or nas t e ns er s o t r . K a e m pha de l t nkn d ve opedadi a i s blngps hi t i co tonprort t t r i tonofi ur d sa ts yc a rc ndii i o he e m na i ns e t tz , t c ti t d ca e'f rr m a oft sc s t t Commi so rf rf t rde opm e t he our tnds d goo us ' o e nd hi a e o he s i ne o urhe vel n a cons de a i nd i r ton. Fr t f c ofDr Be t' r po q i i ce rt tt ps hol s di no e m i M s om he a e . nne ts e r t s la ha he yc ogit d t xa ne . Ka e mp,a t tt SocilSe urt Ad i sr ton s i t d hi c me si a a tm ptt t nkn nd ha he a c iy m nita i olcie s om nt n n te o as e s t pr tve e f ctoft r pors fom t e mi ng medials c a t pli ifs s s he oba i fe he e t r he xn ni c our es s o a ntf e oi m tonalc ton and t wor r l td lmiai ns a s it d t r wih. Dr Be me tnot d ondii he k-e ae i t to s oca e he e t . r t e da n e icudn mao d p e sve d s r e ;g n r l e a xey d s r e 's hz p rn a ig os s n l ig j r e rsi io d r e eai d n it io d r c io h e i, z , dior ni dt a radi dior e .( 285) Basdont r porsa lbl f hi rviw, s ga ze ype; nd e ng s d r TR . e he e t vaia e or s e e Dr Be t unde t t e l t M s Ka e m p' c ton i t nns oft va i ls i s t . nne t r ook o va ua e . t nka s ondii n e he r ous i tngs e f t unde Rul 1 00 ofAppe x 1 oft Adm i sr tve Re ultons Si y saed,Dr orh r e 2. ndi he nitai g a i . mpl tt . Be m e t sm e c l nt r oga o yr s ns a ei l t ' di a i e r t r e po es r ncons se .A t i t nt onepoi , s a edt tç hee de nt he t t ha t vi nce t doesnotesa ih lsi lvesofi ime . ( 286) Howe r i alt ri er t y tbls itng e l mpar nt' TR ' . ve ,n ae ntrogaor rs e pons , heps hol s pr et yc ogit oduce tndi whi h cl a l i c t t tt pl i ifm ee sa ls e d i ngs c e r y ndi a e ha he a ntf t it d i ime unde Rul 1 03C.( 288) mpar nt r e 2. TR . l hi opi on, heA dm i s r tveLa J n s ni t ni ta i w udgea s s d Dr Be m e tsi e a or r s ns s es e . r t ' nt nog t y e po es as f l s: olow D r.G ar Bennet , PI D . eval ed s e of t cl m ants m edi r ds on y t A. , uat om he ai ' cal ecor N ove be 1 2011 He opi t t t c a m ml di not m e t a ls i l vel m r 5, . ned ha he l i t d e i tng e i pa r e butopi t the m e a i paim e sw oul m ode a el i e f r wih m i m nt ned ha r nt l m r nt d r t y nt r e e t he a tvii ofdaiy lvi ,s i lfmci ng;a co e r i perit nc and r c i tes l i ng' oc a l toni nd nc ntaton, sse e, pa .( bi 8 a 3 .Thi pori ofhi o ni i gi gea wegh be us i ce Exhi t F t ) s ton s pi on s ven r t i t ca e t i c it ntw ih m e c le de e of r c d.He a s opi d t t a i r as i s ons s e t di a vi nc e or l o ne ha n nc e e n cai ntsdal a i te c ul c us he t dec mpe ae.( bi 8Fa 5) Thi l ma ' iy ctviis o d a e r o o ns t Exhi t t . s pori n ofhi opi on i gi n ltl wei tbe us i i i ons s e w iht m e c l to s ni s ve ite gh ca e t s nc i t nt t he di a e d e of r c d,a i i l s vi enc e or nd t s m uppored.Addii ly. Dr Be t di not t tona l . nne t d pe s ly e mi t cai nt andhedi noti c t t thehadco i r d Dr r ona l xa ne he l ma , d ndia e ha nsde e . Gar ne ' e l t o a o ni whi h i c r r t hi ow n o ni d rs va ua i n nd pi on, c s onta y o s pi on. ( 1 -8. TR 7 1 ) The c tdoes not be i ve t t ce t i of t La J our le ha ra n he w udge' c m e s i wei ng Dr s om nt n ghi . Be t ' r po t es ppo t d by s bs a i e de e TheLa l ' co i r d i w orhy of t nne t s e r ar u r e u t ntal vi nc . w udge ns de e t t no e t tDr Beme tha no pe s ly e m i M s Ka e mp.Thec t le t tt sf ti ha . r t d t r onal xa ned . t nkn our bei ves ha hi ac s of bs ut l c e nce s nc i w a heSoc a Se urt A dm i s r tont t e e dpl ntf s a ol e yno ons que , i e t st i l c iy ni t a i ha r f ae ai i f c s t Dr Be t f c a e o . nne t or onduc ofa r co d r vi w a r s ns t pe tne i e r t i . The t e r e e nd e po es o r i nt nt r oga ores3 o yr s nl ea onabl c us on i t tt Com m i s one utlz Dr Be m e tt pe f m t f nc i ns e oncl i s ha he s i r ii ed . r t o r or he u to c tmpltdunde C. R. 404.5 a a 20C. R. 404.526() l hec tse re e one ae rzo F. j 1 204) nd F. j 1 c .nt our' xpeinc , a a a pr c i a m a t r t Co m i sone us ly r c ves a c i r r por s f om nd s a tc l te , he m s i r ua l e ei nd ons de s e t r none m i ng phys c answ ho c xa ni ii onduc r c d r vi w sand ofe o ni ast whe he ac a m a ' t e or e e f r pi ons o t r l i nt s c to m e t o e l a ls i u rAppe x 1 St t di f r nty, he f tt tD r Be t ondii n e s r qua s i tng nde ndi . a ed f e e l t ac ha . nne t di nota ualy s M s K a e d ct l ee . t nkam p,pr des no r as t di c e t hi opi on as t whe he ovi e on o s r di s ni o t r pli ifsps hiti i ime sme tore lalsi a ntf yc a rc mpa r nt e qua itng. Li ie, heLa J kew s t w udge' c m e t tDr Be t di noti c t t the c i r d D r s om nt ha . nne t d ndi a e ha onsde e . Gar r se l ton i e lym e ni e s O n t ve y fr t ge of sm e ca i er og or Dr dne ' va ua i s qua l a ngl s . he r is pa hi di l nt r at y, . 3I t Law J f he udgebeleved t t r d wasi ompl e, and t tf t exami ton byanot i hat he ecor nc et ha urher na i her ment healh s als aswar ant t Law Judgeha f laut iyt r r M s K a e al t peci itw r ed,he d ul hort o equie . t nkam pt s i o ubm t t ane c ns t tvee mia in.Se 20C. R. 4 1 9( ) o w o ulai xa n to e F. j 04.5l a . 6 Bemwt lsedt dignos sofeedbyDr Gad ,a welasDr Gadne ' r por ( inaedas t it he a e fr . rner s l . r rs e tdesg t Exhi t5 ,a matr hec i r i ma nghi e l to Onc a i a acons tntutlz d bi F) s te s onsdeed n ki s vauain. e gan, s ula iie byt Soc a Sec iyAdmi sr ton, s lt Dee mi tonSe viespr de t r co dt Dr he i l urt nita i Diabiiy tr nai r c ovi d he e r o . Be t t t he w a e c e t r vi w a a s s Tha r cor c e r y i l d D r Ga dne ' nne t ha s xpe t d o e e nd s es . t e d l a l nc ude . r rs e r i rps hol ca r por . W hie i i t u t tD r Be t a co d gr a e s gni i an t t a le yc ogi l e t l t s r e ha . nne t c r ed e t r i fc ce o he lt rps hiti fndi ofDr Zet y,t f c r m anst tDr Ga dnerha a s r pore t t a e yc a rc i ngs . lva he a t e i ha . r d l o e td ha pl i if sc a ntf ' once r ton w a m a kedl i paie a t tm e ofc i c exa i ton. Thus t c t nta i s r y m r d t he i lni al m na i , he our c l onc udest tt La J ha he w udge' obs r a i t tD r Ga dne ' e l to a opi on ar c r r s e v ton ha . r r s va ua i n nd ni e onta y t Dr Be t ' e l ton a opi on co tt esa o ry br a m i l a ng g ne a i a i o . mw t s va ua i nd ni ns iut n ve l oad nd s e di e r lz ton. W he c i r f om a l t na pe s c i t s c e doe nota a t be ove l n ons de ed r ongiudi l r pe tve, hi as s ppe r o ry c pl x. Bas d o t a l e m edi alr c ds i s e st tM s K a e m p di notc pl i om e e n he vaiabl c e or , t e m ha . t nkn d om a n ofd e son dtrng t pe i i whi h s wasfr tte t d f medialpr e s Asr fe t d epr s i ti he rod n c he is r a e or c oblm . e lc e a bove t fr tno a i ofc pl i sofde es i a e y,a m e or l sw a on N ove be , he i s t ton om a nt pr s on, nxi t nd m y os s m r 5, 2009.W he s w a s n by Dr G a dne f m ont l t r t ps hol s di gnos d r c r nt n he s ee . r r our hs a e , he yc ogi t a e e ur e , mo eaemao de e sveds r e wihg n rl e n xeyds r r c o a idb a catc . d rt j r prsi io d r t e eai d n it iode a c mp n e yp ni ta ks z U pon clni a e m i to Dr G a d r not d m a ked i pa r e t i co e r to t i c l xn na i n, . r ne e r m i m n n nc nt a i n, houg he h e tm a e no m or t n m ode a e w or r l t d lm ia i i c e r ton,pe ss e e, nd pac si t d e ha rt k- e a e i t tons n onc nt a i r i t nc a e. A soft tday, he ps hol s opi d t tpl i ifc d peror sm pl a r pe ii t s a ha t yc ogi t ne ha a ntf oul f m i e nd e ttve a ks nd manti rgul atnda e.( 25 .Howe ratt tmes wasfrts e byt ps hitit i an e ar te nc TR 9) ve, he i he is e n he yc ars sx m o hs lt ,M s Kae m p was s d t ca a di g i of s hi phr ni pr bl i nt aer . t nkn ai o ny a noss c zo e a, oba y di or ni e t s ga z d ype. Dr Ze t y r pore a GA F cons d r bl be ow t tf m d by Dr Ga dne s x . lva e t d i e a y l ha ot . r ri m ont earler W hen asked by t Soci Securt A dm i staton t ass s t m eani oft hs i . he al iy ni r i o es he ng he 7 m e ca fndi a dignos sdocz nt d i t r cor Dr Be t r po td t tt e denc di l i ngs nd a e lme e n he e d, . nne t e re ha he vi e s uggesed t t e n m i m al i r s i m e t l d m a t ha ve ni nc ea e n n a e nds o c nge of e r nm e c d be r ha nvi o nt oul expe t d t c us M s K a erka p t d om pe a e. Dr Be t c ude asf l s c e o a e . t l m o ec ns t . nne t oncl d olow : The ei ac it nt a i ofs hi phr ni Dior ni dType,nt team e r s onsse di gnoss c zo e a, s ga ze i he r t nt r or fom Pi ec ds r edmont( 6f& 7f. The DSM -V de ci t s s ype of Exs ) I s rbes hi ubt s hi ophr ni t i l a i i ousons ta ong w ih a c i c z e a o nc ude n ns di e l t ontnuouscour e w ihout s t sg f tr mi sons Thi s e sc itntwih t e de e i t sr c d.M s i nikan e s i . s e m onsse t he vi nc n hi e or . Kae amp (i a r ca bl ofma gi s dal a tvii but1woul tnc sc) ppeas pa e na ng ome iy ci tes d pr c t ta i r s i me a d ndsc d c us dec edit ha n nc ea e n nt l ema oul a e ompe a i ns ton. ( 288 . Suc a a s s nts TR ) h n sesme upporsafndi ofalsedi ime t t i ng it mpar nt mderRul 1 03C of e 2. Appe x 1 ndi . l s m a y,gi n t pr e s on oft m e c le d e i t sca e t c tbe i ves n um r ve he ogr s i he di a vi enc n hi s , he our le t ti i es ci l i po t ntt obt i a r la e a c it ntm e c la s s en ast w he he ha t s pe aly m r a o a n e i bl nd ons se di a s es m t o t r pl ntf s s hi phr ni a r l t dior r ,a e no s s ve e a t m e or e la lse ai if c zo e a, nd e aed s de s r w o e r s o et qua it d i pa r e . A c r ngl t c ti i m i m nt4 co di y, he our tnds û good c us 'f r m a oft sca et t Com m i s o r a e ' or e nd hi s o he s i ne f f t rde opmen a c i r ton.Upon r m a bot sdeswilbe alowe t pr e or urhe vel t nd onsde a i e nd, h i l l d o es nt addii na e de e and a gt ne .l t Com m i s one i una e t de de t s c e i pl i i f s to l vi nc r u nt f he s i r s bl o ci hi as n a ntf f vorbas on t exi tng r c d,a w ih a o i t s e e a i t Com m i s one w il a ed he s i e or nd t ppr pr a e uppl m nt ton, he si r l e onduc as plm e ala i sr tvehe i t up e nt dm nita i arng. Theclr i die t t s nd c rii d co e oft so ni t alc e k s r ced o e e tfe pis hi pi on o 1 ouns lofr c d. e e or a t l, 3 l oA'Eo:'hs / V' dyo-uy201 . r ri s ' Chi Unied St esD it i Judge ef t at s r ct 4I Pl ntf scondii doesm ee ore f ai if' ton t quala lsi , i w ilalo beneces ar t det m i whet itng t l s s y o er ne her t condii mett dur tonalr r e soft Act l wilalobenecess r t det mi whet he he tons he a i equiem nt he . t l s a y o er ne hert condii r nde ed pl ntf t aly diabl prort t t mi ton ofi ur sat ton e r ai if ot l s ed i o he er na i ns ed t us.

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