Eastridge v. Astrue

Filing 21

OPINION: Plaintiff Mary Eastridge's Brief in Support of Motion for Summary Judgment (d/e 17) is DENIED, and Defendant Commissioner of Social Security's Motion for Summary Affirmance (d/e 19) is ALLOWED. The decision of the Commissioner is affirmed. THIS CASE IS CLOSED. Entered by Magistrate Judge Byron G. Cudmore on 2/9/2012. (MJ, ilcd)

E-FILED

Thursday, 09 February, 2012 04:48:27 PM
Clerk, U.S. District Court, ILCD

IN THE UNITED STATES DISTRICT COURT
FOR THE CENTRAL DISTRICT OF ILLINOIS, SPRINGFIELD DIVISION
MARY C. EASTRIDGE,
Plaintiff,
v.
MICHAEL J. ASTRUE,
Commissioner of Social Security,
Defendant.

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No. 11-CV-3105

OPINION
BYRON G. CUDMORE, U.S. MAGISTRATE JUDGE:
Plaintiff Mary C. Eastridge appeals from the denial of her application
for Supplemental Security Income ( “Disability Benefits”) under the Social
Security Act. 42 U.S.C. § 1381a, and 1382c. This appeal is brought
pursuant to 42 U.S.C. §§ 405(g) and 1383(c). Eastridge has filed a Brief in
Support of Motion for Summary Judgment (d/e 17) (Motion for Summary
Judgment), and Defendant Commissioner of Social Security has filed a
Motion for Summary Affirmance (d/e 19) (Motion for Summary
Affirmance).1 The parties consented, pursuant to 28 U.S.C. § 636(c), to
have this matter proceed before this Court. Consent to Proceed Before a
United States Magistrate Judge, and Order of Reference entered
1

Eastridge has not filed a motion for summary judgment as required by the Local
Rules. Local Rule 8.1(D). The Court deems the brief filed by the Eastridge (d/e 17) to
be a motion for summary judgment.
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September 15, 2011 (d/e 15). For the reasons set forth below, the
Decision of the Commissioner is affirmed.
STATEMENT OF FACTS
Eastridge was born on November 17, 1959. R. 25. Eastridge
graduated from high school. Answer to Complaint (d/e 13),attached
Certified Transcript of Record of Proceedings Before the Social Security
Administration (R.) 26. She has no significant work history. She suffers
from back and joint pain.2 On June 2, 2006, Eastridge underwent an MRI
of her lumbar spine. The test showed multilevel canal narrowing including
degenerative facet ligamentum flavum hypertrophy associated with dural
sac narrowing which appeared to be moderate at L3-L4 with milder dural
sac stenosis at L4-L5, slight degenerative anterolisthesis of L4 and L5, and
degenerative facet arthropathy. At T11-T12 and T12-L1, there was disc
protrusions and mild dural sac narrowing. R. 490-91. On June 23, 2006,
Eastridge saw Dr. Philip C. Wilson, M.D., with complaints of numbness in
her legs and aching in her elbows. On examination, Dr. Wilson found that
Eastridge’s gait and stance were normal. Dr. Wilson stated that the MRI

2

Eastridge also allegedly suffered from limited intelligence, some mental
problems, diabetes, hepatitis C, and some esophageal problems. Eastridge does not
raise any issues on appeal related to anything other than her back and other
musculoskeletal problems. The Court therefore does not discuss the evidence or
analysis of the other conditions.
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showed significant spinal stenosis at multiple levels. R. 471. He
diagnosed her with hypertension and spinal stenosis of the back. R. 471.
Eastridge looked for work through the Illinois Department of Human
Services, Division of Rehabilitation Services (DRS). R. 43. On July 5,
2006, DRS issued a Closure Notification of a case file for Eastridge. The
Closure Notification stated that as of August 9, 2006, Eastridge’s case file
would be closed because, “Your disabilities prevent you from working in a
position that would meet your needs”. R. 467.
On September 25, 2006, Dr. Frank Jimenez, M.D., reviewed the
medical record and performed a Residual Functional Capacity
Assessment. R. 567-74. Dr. Jimenez opined that Eastridge could lift,
carry, push, and pull ten pounds occasionally and less than ten pounds
frequently, and could stand and/or walk at least two hours and sit about six
hours in an eight-hour day. R. 568. Dr. Jimenez opined that Eastridge
should never climb ladders, ropes or scaffolds; could occasionally climb
ramps and stairs, balance, stoop, kneel, crouch, or crawl; and should
avoid concentrated exposure to extreme cold, heat, wetness, humidity,
vibration, and hazards. R. 569-71. Dr. Jimenez stated that he considered
Dr. Wilson’s finding of significant spinal stenosis at multiple levels. R. 574.
On October 13, 2006, Eastridge saw Julie Barry, a certified nurse
practitioner associated with Dr. Wilson. R. 582. Eastridge reported diffuse
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pain in multiple areas, but most significantly in her lower back and legs.
She denied any numbness. Barry found that Eastridge had limited range of
motion in her neck; crepitation in her knees and elbows; limited back and
forward movement in her back; satisfactory lateral movement in her back;
full range of motions in her arms; and no joint redness, edema, or warmth.
Barry diagnosed spinal stenosis and osteoarthritis. Barry provided
Eastridge with a supply of Celebrex for pain. R. 582.
On November 21, 2006, Eastridge saw Barry. Eastridge reported
that since she started taking Celebrex she had only one episode of pain,
which occurred after physical activity. R. 580. Barry found limited range of
motion in Eastridge’s back, but full range of motion in her arms with no
swelling in any joints. R. 580. Barry referred Eastridge to a neurosurgeon.
On November 28, 2006, Barry completed a form for a state agency.
Barry noted diagnoses of osteoarthritis and spinal stenosis. She noted low
back pain radiating to the hips, diffuse pain elsewhere and stiffness;
numbness in the lower legs that increased with activity; minimal lumbar
tenderness; upright and guarded posture; limited neck and back range of
motion; no evidence of nerve-root compression; and normal ambulation
and gait. R. 590. Barry opined that Eastridge must alternate between
sitting and standing every ten to fifteen minutes. R. 591.

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On March 22, 2007, Eastridge saw Dr. Sunil Chauhan, M.D., a
neurologist, for treatment of back pain. R. 719. Dr. Chauhan found that
Eastridge had pain with a straight leg raising test, normal strength
and reflexes, intact sensation, no swelling, and normal gait. R. 720.
Dr. Chauhan reviewed the June 2006 MRI and noted some degenerative
changes in the lower back, but otherwise no impingement of the spinal
cord. R. 720. Dr. Chauhan recommended regular physical activity and
prescribed physical therapy. R. 720.
Eastridge saw Dr. Chauhan again on March 12, 2008. Dr. Chauhan
noted some pain in the left leg on straight leg raising, but no pain in the
right. Dr. Chauhan also observed normal strength and gait, motor and
sensory function. R. 767. Dr. Chauhan diagnosed chronic back pain, most
likely lumbosacral radiculopathy. R. 767-68. Dr. Chauhan noted that
Eastridge had extensive degenerative lower back disease but no evidence
of spinal cord compressions. R. 767. Dr. Chauhan noted that Eastridge’s
condition was stable. R. 768.
THE INITIAL HEARING
The Administrative Law Judge conducted a hearing on March 27,
2008. Eastridge appeared with counsel. John F. McGowan, Ed.D., also
appeared as a vocational expert. R. 20-67. Eastridge testified that she
lived alone in an apartment in Quincy, Illinois. Eastridge did not drive
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because she lost her license in 1985 due to a felony DUI. R. 25. Eastridge
graduated high school and had some training at a beauty school. R. 26.
She also started college, but stopped shortly after beginning. R. 27.
She last worked as a personal assistant for a neighbor. She worked
three hours a day. She stayed at the job for about three months. Before
that, she worked for a telemarketing company for about three months.
R. 26-27. She also worked at a factory briefly right after finishing high
school in 1978 and 1979. R. 28.
Eastridge was taking Celebrex, Ultram, and Skelaxin for pain. R. 2829. The medication upset her stomach so she also took Prevacid. R. 29.
Eastridge testified that she felt pain in her upper back like a numbness and
a burning from her waist down in her back. R. 45. Her hips and legs
ached down to the knee on the left side and down to the heel on the right.
R. 46. Eastridge testified that she felt this type of pain two to three times a
week. R. 46.
Eastridge testified that she usually got up in the morning at about
5:30 a.m. and went to bed at 10:30 p.m. R. 30. During the day, she went
across the street to visit with a neighbor two or three times a week. R. 32,
54. She also watched TV and listened to the radio. R. 36.
She went to the library to rent movies about once a week. R. 32.
She either walked to the library or took the bus. R. 31. Eastridge’s
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residence was twelve blocks from the library. Eastridge testified that she
had to stop a couple of times to rest during a walk to the library. R. 31.
Eastridge went to church regularly, about four times a week, for
worship, ladies group meeting, and Bible study. R. 33. She took the bus to
church. R. 34. She sang occasionally at church and helped with the
clothing ministry. R. 34. The church meetings usually lasted about two
hours. Eastridge testified that she became uncomfortable sitting for that
length of time and sometimes had to get up and move around. R. 55.
Eastridge did her own grocery shopping. She testified that she
leaned on the cart while shopping. She testified that shopping took about
an hour from the time she left home until she returned. R. 53-54.
Eastridge did her own household chores including cooking, cleaning,
and laundry. R. 32. She testified that she put off sweeping and mopping
as long as possible because of the pain. R. 47, 53. She also testified that
bending over caused pain. R. 47. She testified that she hurt her back the
day before the hearing when she stood for about an hour and a half
ironing. R. 36. She testified that she only washed a few clothes at a time.
She also took breaks while doing dishes. She would wash a sink load of
dishes and then take a break, and then wash another sink load. R. 54.
Eastridge testified that she could stand for an hour and a half before
her back would start hurting, she could sit for half an hour, and walk six
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blocks. R. 36-37. Eastridge testified that a gallon of milk was the heaviest
thing that she could lift. R. 35. She testified that her hands and fingers
sometimes went numb. R. 41. She testified that she could take care of her
personal hygiene and personal needs, such as dressing and bathing.
R. 40.
Eastridge testified that she looked for work through DRS, but they
could not find her a job. R. 43. Eastridge counsel noted that DRS made a
determination that her disabilities prevented her from working in a position
that would meet her needs. R. 43.
Eastridge testified that she had pain in one ankle because she
fractured it recently. R. 47. Her ankle still swelled some at the time of the
hearing. The ankle also hurt when the weather changed. R. 47. Eastridge
also had occasional fleeting ringing in her ears and dizziness. R. 48.
Eastridge testified that she had problems with stiffness in her neck.
R. 48. She stated that the stiffness went into her shoulders. She had
difficulty turning her head to the left or right. R. 49. She testified that her
neck and shoulders hurt two to three times a week. R. 49. She said that
washing her hair caused pain because of how she had to lift her hands to
her head. R. 49.
Eastridge testified that she had trouble with her elbows, wrists, and
feet. She said that her left elbow swelled. She said that she had shooting,
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stabbing pain in her wrists. She had the pain in both wrists, but more on
the left side. R. 50. Eastridge testified that she had numbness and burning
in her feet. R. 52. She said that sometimes her feet would go numb at
church if she stood for thirty minutes. R. 53. At least once, the numbness
traveled up to her ankle after she stood for an hour. R. 52-53. She
testified that it took two hours before she could feel her feet again. R. 53.
Eastridge testified that she had trouble sleeping. She woke up every
hour and a half. She was usually sweating when she woke up. R. 49. She
said that she had trouble sleeping three to four times a week. R. 50.
Vocational expert Dr. McGowan then testified. Dr. McGowan testified
that Eastridge had no past relevant work. R. 57. The ALJ then asked
Dr. McGowan:
[A]ssume that a hypothetical individual with Ms. Eastridge’s
age, education, and work experience would be limited to work
that –. . .
....
. . . frequently lift 10; occasionally lift 10. The person could
stand less than six hours out of an eight-hour work day, at least
two to four, I would say, with normal breaks – four being,
probably, the absolute max; sit at least six out of an eight-hour
work day; pushing and pulling limited to no greater than 10
pounds; should avoid climbing, generally – certainly ladders,
ropes, and scaffolds, and working at height, and unprotected
dangerous machinery, and unprotected heights; occasional
balancing; avoid stooping; and, occasional crouching.
R. 57-58. The ALJ added that, “handling, fingering, and feeling are
unlimited” and “Person should avoid extremes of temperature” and “high
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humidity.” R. 58, 59. The ALJ then asked, “Well, with those limitations,
would there be work that a person could perform?” R. 60.
Dr. McGowan opined that such a person could perform “unskilled,
direct entry jobs within the sedentary area.” R. 61. Dr. McGowan opined
that a person with those limitations could work as an information clerk,
electronic assembly and semiconductor die assembly. R. 61-62.
After Dr. McGowan testified, the ALJ told Eastridge that he may send
her to see some doctors at the government’s expense for further
examination. R. 66. The ALJ then concluded the hearing. R. 67.
POST HEARING EXAMINATION
On May 17, 2008, Dr. Raymond Leung, M.D., performed a
consultative examination of Eastridge. R. 752-64. Dr. Leung found that
Eastridge had a full range of motion except in the low back with extension
limited to five degrees. Dr. Leung also found no spasms, a normal gait,
normal strength, normal sensation and reflexes, and no swelling.
Dr. Leung stated that Eastridge was able to manipulate a small object with
her hands fairly well. R. 754. Dr. Leung opined that Eastridge could lift
and carry up to twenty pounds occasionally and up to ten pounds
frequently, stand for four hours in an eight-hour day, walk for two hours in
an eight-hour day, and sit eight hours in an eight-hour day. R. 759-60.
Dr. Leung opined that Eastridge could frequently use her hand for
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reaching, handling, fingering, feeling, pushing, and pulling; frequently use
her feet to operate foot controls; and frequently balance. Dr. Leung opined
that Eastridge could occasionally climb ladders, scaffolds, ramps, and
stairs; occasionally stoop, kneel, crouch, and crawl; occasionally tolerate
unprotected heights, moving mechanical parts, and operate a motor
vehicle; and continuously tolerate extreme cold, heat, wetness, humidity,
and vibration. R. 760-63.
THE FIRST DECISION OF THE ALJ
The ALJ issued his initial decision on August 4, 2008. R. 137-145.
The ALJ followed the five-step analysis set forth in Social Security
Administration Regulations (Analysis). 20 C.F.R. §§ 404.1520, 416.920.
Step 1 requires that the claimant not be currently engaged in
substantial gainful activity. 20 C.F.R. §§ 404.1520(b), 416.920(b).
If true, Step 2 requires the claimant to have a severe impairment. 20 C.F.R.
§§ 404.1520(c), 416.920(c). If true, Step 3 requires a determination of
whether the claimant is so severely impaired that she is disabled
regardless of the claimant's age, education and work experience.
20 C.F.R. §§ 404.1520(d), 416.920(d). The claimant's condition or
combination of conditions must meet the criteria for one of the conditions
set forth in the Listings or be equal to the criteria in one of the Listings.
20 C.F.R. §§ 404.1520(d), 416.920(d).
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If the claimant is not so severely impaired, then Step 4 requires the
claimant not to be able to return to her prior work considering his Residual
Functional Capacity (RFC). 20 C.F.R. §§ 404.1520(e), 416.920(e). If the
claimant cannot return to her prior work, then Step 5 requires a
determination of whether the claimant is disabled considering her RFC,
age, education, and past work experience. 20 C.F.R. §§ 404.1520(f),
416.920(f). The claimant has the burden of presenting evidence and
proving the issues on the first four steps. The Commissioner has the
burden on the last step; the Commissioner must show that, considering the
listed factors, the claimant can perform some type of gainful employment
that exists in the national economy. Briscoe ex rel. Taylor v. Barnhart,
425 F.3d 345, 352 (7th Cir. 2005); Knight v. Chater, 55 F.3d 309, 313
(7th Cir. 1995).
The ALJ found that Eastridge met her burden at Steps 1 and 2. She
was not engaged in substantial gainful activity since June 23, 2006, the
alleged onset date of her disability, and that she suffered from severe
impairments from degenerative disc disease of the lumbosacral spine,
status-post left ankle fracture, and low average intelligence. R. 138, 143.
At Step 3, the ALJ found that none of Eastridge’s conditions or
combination of conditions equaled a Listing. R. 139, 143. The ALJ relied
on the treatment notes from Dr. Chauhan and Dr. Leung’s examination.
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The ALJ relied Dr. Chauhan’s finding of no spinal cord impingement and
recommendation of pain medication and physical therapy to support his
conclusion that her condition did not meet a Listing. R. 140. The ALJ also
relied on Dr. Leung opinions regarding Eastridge’s exertional limitations to
support his conclusion. R. 140. The ALJ acknowledged Dr. Wilson’s
diagnosis of significant spinal stenosis and Barry’s opinion that Eastridge
could sit or stand for only ten to fifteen minutes, but concluded that the
evidence from Drs. Chauhan and Leung was more persuasive. R. 139-40.
At Step 4, the ALJ found that Eastridge had the RFC to perform
sedentary work limited to simple, repetitive tasks. R. 140. The ALJ
proceeded to Step 5 since Eastridge did not have any relevant past work.
At Step 5, the ALJ relied on Dr. McGowan’s opinions to determine that
Eastridge could perform a substantial number of jobs in the national
economy. R. 141.
The ALJ acknowledged that Eastridge described symptoms to
Dr. Wilson and Barry to which she testified at the hearing. The ALJ,
however, found that the opinions of Dr. Chauhan outweighed the opinions
of Dr. Wilson and Barry. R. 141.
The ALJ further found that Eastridge’s claims of pain were not
credible. The ALJ found that Eastridge did not have signs typically
associated with chronic severe musculoskeletal pain, such as muscle
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atrophy, persistent muscle spasms, and neurological deficits. R. 142. The
ALJ further found Eastridge’s claims of limitations on her abilities due to
pain to be inconsistent with the medical evidence. R. 142. The ALJ also
discounted the DRS statement that Eastridge was not suitably employable
because the statements were not medical opinions and such agencies,
“only accept persons who seem willing to make the effort to succeed . . .
and will not goad someone who insists that she is not physically able to
make such an effort.” R. 142.
The ALJ acknowledged that Eastridge’s counsel asked for a
supplemental hearing in which he could examine Dr. Leung.3 The ALJ told
counsel to first submit written interrogatories, but counsel did not do so.
R. 143. The ALJ, therefore, did not hold a supplemental hearing. Based
on the ALJ’s, findings, the ALJ determined that Eastridge was not disabled.
Eastridge appealed the decision to the Appeals Council.
POST INITIAL DECISION MEDICAL EVIDENCE
Eastridge went to see Dr. Wilson again on November 4, 2008.
R. 825. Eastridge reported increased muscle cramping and also
complained of hand cramping. R. 825. Dr. Wilson found no tenderness
and full range of motion and equal strength in all extremities. R. 825.
3

Eastridge also asked to examine psychologist Dr. Froman, Ed.D., at the
supplemental hearing. After the hearing, Dr. Froman provided a Consultative
Psychological Evaluation Report dated April 22, 2008. R. 745-51.
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Eastridge saw Dr. Wilson again on January 6, 2009. Dr. Wilson found no
tenderness in her joints and full range of motion and equal strength in her
upper extremities. R. 823. Eastridge next saw Dr. Wilson on April 7, 2009.
R. 821. Dr. Wilson found no tenderness in the low back and buttock
region, minimal tenderness to manipulation in the right knee, a somewhat
mobile right kneecap, a small amount soft swelling lateral to the patella,
and no redness. R. 821. On July 9, 2009, radiological tests showed
degenerative disc disease in the low back without acute fracture, endplate
osteophytes at multiple levels, and Grade I anterolisthesis of L3 on L4 and
L4 on L5. R. 830.
THE DECISION OF THE APPEALS COUNCIL
On April 10, 2009, the Appeals Council vacated the ALJ’s decision
and remanded the case for further proceedings. The Appeals Council
stated that the ALJ secured post hearing reports from Dr. Leung and
Dr. Froman and forwarded them to Eastridge’s attorney. The ALJ indicated
in the cover letter that if Eastridge wanted a supplemental hearing, she first
needed to state why the hearing was necessary and state the questions
that she would pose to the consultative examiners. R. 147. Eastridge’s
counsel did not respond. The Appeals Council stated that the ALJ was
required to grant the requested supplemental hearing under the
circumstances of this case. R. 147. The Appeals Council also held that
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the ALJ should have secured a medical expert to resolve the apparent
conflict between Dr. Wilson and Dr. Chauhan’s interpretation of the June
2006 MRI of Eastridge’s lumbar spine. R. 148.
The Appeals Council remanded the case with instructions to secure
evidence from a medical expert to clarify the nature and severity of
Eastridge’s impairments and to clarify the conflicting interpretations of the
June 2006 MRI; further consider Eastridge’s RFC and give appropriate
rationale and specific references to the record to support the ALJ’s
assessment; secure additional evidence from a vocational expert as
needed; and offer Eastridge a supplemental hearing. R. 148-49.
THE SUPPLEMENTAL HEARING
The ALJ held a supplemental hearing on August 20, 2009.
R. 68-130. Eastridge appeared via video conference with her counsel.
Dr. Morris Alex, M.D., appeared as a medical expert. Dr. Darrell W. Taylor,
Ph.D., appeared by telephone as a vocational expert. R. 68-71.
Eastridge testified that she still had dizziness and ringing in her ears.
She testified that the dizziness was a side effect of her muscle relaxant
medication. She stated that she suffered from dizziness three to four times
a day. R. 82. She also testified that she had pain in the middle of her neck
and shoulders along with numbness and a burning feeling. R. 82.

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Eastridge testified that her hands went to sleep every night when she
was in bed. She said that she would wake up in the morning and both
hands would be asleep. R. 83. She testified that the problems with her
hands became worse in the last six months. She also that her hands went
to sleep during the day. She testified that she dropped things now. She
testified that lifting a gallon of milk was painful and was the heaviest thing
she could carry. R. 83. She said that she had to use two hands to lift a
skillet. R. 84.
Eastridge testified that her elbows also hurt. She said that, “It felt like
somebody hit me with a hammer. That’s what it feels like, in both of them.”
R. 84. She said that she had these pains in her elbows three or four times
a week. She also said that she had swelling in her left elbow. R. 84.
Eastridge testified that she was experiencing more pain in her right
side in the hip area. She said the pain sometimes radiated into the back of
her legs. She said that she had this pain every day. She stated that she
did a lot of standing at home doing housework and the pain was
“excruciating.” R. 86. She said that she could sit for half an hour and
stand for ten or fifteen minutes. She testified that her feet went to sleep
when she stood. R. 86-87. Eastridge testified that her joints and her back
ached when the weather changed. R. 87.

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Eastridge testified that she had problems doing housework. She
testified that her kneecap slid to one side if she rubbed her leg against the
bed while making it. R. 89. She testified that she washed a sink load of
dishes for ten minutes and then had to rest. R. 90. She avoided
vacuuming, mopping, and sweeping because those chores hurt her back
and her wrists. R. 90. She testified that she could only perform those
chores for about five minutes and then would need to sit and rest.
R. 90-91.
Eastridge testified that she lay down two to three hours a day. She
testified that she has been lying down daily for about six months. R. 91.
Eastridge testified that she has not gone to a pain clinic. She testified
that she has not received any shots for pain. She testified that she was
supposed to perform physical therapy exercises on a body ball and water
therapy exercises. She testified that she could not work out on the body
ball by herself and she could not afford the water therapy. R. 93.
Dr. Alex then questioned Eastridge. Dr. Alex asked Eastridge if
anyone ever advised her to have any nerve conduction studies on her
hands. Eastridge testified no. R. 97. Dr. Alex asked if anyone advised her
where to place her hands while she was sleeping. Eastridge stated that
Barry told her not to put her hands above her head because of the effect of

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that position on her rotator cuff. R. 97. Finally, Dr. Alex asked Eastridge if
she ever went to vocational rehabilitation. Eastridge said no. R. 97-98.
Dr. Alex then testified. Dr. Alex summarized his review of Eastridge’s
medical records. R. 98-103. Dr. Alex noted the lack of notes in the
medical record concerning Eastridge’s complaints about her elbows, “and
that probably needs to be evaluated.” R. 99. Dr. Alex opined that there
was no evidence of spinal stenosis, and in particular, the June 2, 2006,
MRI, did not show signs of spinal stenosis. R. 100. Based on Eastridge’s
medical records, Dr. Alex opined that Eastridge could perform sedentary
work. R. 103.
On examination from Eastridge’s attorney, Dr. Alex explained that
anterolisthesis is the movement of one vertebra on the other. R. 106.
Dr. Alex testified that in his medical experience such movement could
cause pain up to a level of two to three on a scale of zero to ten.
R. 106-07. Dr. Alex testified that endplate osteophyte is an overgrowth of
bone. He testified that the development of endplate osteophytes was
consistent with back pain. R. 107.
Dr. Alex testified that his diagnostic impression of Eastridge’s
testimony about her hands falling asleep would be carpal tunnel syndrome.
R. 116. Dr. Alex testified that some people with numbness in their hands
have trouble handling, fingering, and manipulating objects. R. 116.
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Eastridge’s counsel then asked, “It’s your opinion she should have an EMG
done, a nerve conduction test?” Dr. Alex responded yes, but that was for
her physician to decide. R. 117.
Dr. Taylor, the vocational expert, then testified. The ALJ asked
Dr. Taylor the following question:
All right, if we were to assume a hypothetical individual of Ms.
Eastridge’s age, education, and work experience, and assume
that that person cold lift 10 pounds on occasion – or frequently;
and, could sit about two hours [INAUDIBLE] with normal
breaks; and could – excuse me – could sit six and could – with
normal breaks, and could stand at least two hours; and person
should avoid pushing and pulling on the bilateral lower
extremities; and never climb ladders, ropes, or scaffolds –
there’s some dizziness possibilities; could occasionally climb
ramps, stairs, balance, stoop, and crouch, and crawl; avoid
working overhead bilaterally, upper extremities; and should
avoid concentrated exposure to extreme cold and heat,
wetness and humidity, and full body vibration; and, should
avoid working at unprotected dangerous heights, nor around
unprotected dangerous machinery. And the person would be
limited to one- and two-step and/or repetitive type work. I
would take it this person could not perform any of the past
work.
R. 124. Dr. Taylor agreed that such a person could not do Eastridge’s past
work. Dr Taylor opined that such a person could perform sedentary,
unskilled jobs such as a hand packer and a production worker/assembler.
He opined that 1,900 hand packer positions existed in Illinois and 1,000
worker/assembler positions existed in the state. Dr. Taylor opined that if
the person could only sit for thirty minutes at a time, the number of

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available positions would be reduced by fifty percent. R. 125. Dr. Taylor
opined that if the person could only sit for ten to fifteen minutes at a time,
then the person would not be able to work. R. 126. Dr. Taylor finally
opined that if the person had difficulty with gripping, grasping, and holding
small objects, then the person would not be able to perform the sedentary
work. R. 127.
At the end of the hearing, Eastridge’s counsel asked the ALJ to
confirm that Drs. Froman and Leung did not appear at the hearing. R. 128.
The ALJ confirmed that those two doctors did not appear. Eastridge’s
counsel asked the ALJ to order a nerve conduction study. The ALJ
declined. The ALJ stated that he could not order such a test because the
test involved sticking needles into the person. R. 127. The ALJ, however,
agreed to hold the record open for thirty days to allow Eastridge to have
such a test done. R. 127-28. The ALJ stated that he would wait to hear
from Eastridge’s counsel whether Eastridge would be going to get another
medical test. The ALJ stated that once everything was in, he would either
make a decision or send Eastridge to a doctor for another test. The ALJ
stated that his decision would be in writing. The hearing was then
concluded. R. 129. Eastridge did not submit additional medical evidence
after the hearing.

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THE FINAL DECISION OF THE ALJ
The ALJ entered his final decision on October 9, 2009. R. 12-18.
The ALJ recited the procedural history of the case and summarized the
Appeals Council’s decision and directive. The ALJ incorporated into the
decision by reference the summary of the testimony in the prior hearing, as
well as the medical evidence and opinions, set forth in the August 4, 2008,
decision. The ALJ also incorporated by reference the analysis of the
evidence set forth in the August 4, 2008, decision except to the extent
inconsistent with this decision. R. 14. The ALJ then discussed the
supplemental medical records and Eastridge’s testimony at the
supplemental hearing. R. 14-15.
The ALJ then discussed Dr. Alex’s testimony. The ALJ stated that
Dr. Alex found no impairment or combination of impairments that met or
equaled a Listing. The ALJ found that Dr. Alex resolved any differences of
opinion in the interpretation of the June 2006 MRI “in favor of Dr. Chauran’s
(sic) interpretation, saying that it showed nothing especially severe.” R. 15.
The ALJ summarized Dr. Alex’s other opinions and then stated that
Dr. Alex concurred that Eastridge should be limited to sedentary work.
R. 16. The ALJ then relied on Dr. Taylor’s opinions to support the
conclusion at Step 5 that Eastridge could perform 2,900 jobs in the state
economy. The ALJ in particular relied on Dr. Taylor’s opinion that she
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could perform half of those jobs even if she could only sit for thirty minutes
at a time. R. 16.
The ALJ relied on Dr. Alex to find no evidence of spinal stenosis.
The ALJ found “no evidence of carpal tunnel syndrome, frequent elbow or
other joint swelling, or chronic musculoskeletal impairment affecting
anything other than the lumbosacral spine.” R. 16.
The ALJ stated,
The claimant does not have most of the signs typically
associated with chronic, severe musculoskeletal pain such as
muscle atrophy, persistent or frequently recurring muscle
spasms, obvious or consistently reproducible neurological
deficits (motor, sensory, or reflex loss) or other signs of nerve
root impingement, significantly abnormal x-rays or other
diagnostic tests, recurrent positive straight leg raising or
inflammatory signs (heat, redness, swelling, etc.), or bowel or
bladder dysfunction. The medical evidence establishes no
inability to ambulate effectively or to perform fine and gross
movements effectively on a sustained basis due to any
underlying musculoskeletal impairment. The claimant requires
no cane, crutches, or other assistive device to stand or walk.
There is no documented evidence of nonexertional pain
seriously interfering with or diminishing the claimant’s ability to
concentrate. There is no documented evidence of any chronic
mental or mood disorder.
The claimant’s allegations of impairments, either singly or in
combination, producing symptoms and limitations of sufficient
severity to prevent the performance of all sustained work
activity is not credible. . . .

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R. 17. Based on the opinions of Dr. Alex and Dr. Taylor, and this credibility
finding, the ALJ found that Eastridge was not disabled at Step 5.4
Eastridge appealed the decision. The Appeals Council denied the
request for review on February 10, 2011. Eastridge then brought this
action for judicial review.
ANALYSIS
This Court reviews the ALJ's Decision to determine whether it is
supported by substantial evidence. In making this review, the Court
considers the evidence that was before the ALJ. Wolfe v. Shalala, 997
F.2d 321, 322 n.3 (7th Cir. 1993). Substantial evidence is “such relevant
evidence as a reasonable mind might accept as adequate” to support the
decision. Richardson v. Perales, 402 U.S. 389, 401 (1971). This Court
must accept the ALJ's findings if they are supported by substantial
evidence, and may not substitute its judgment for that of the ALJ. Delgado
v. Bowen, 782 F.2d 79, 82 (7th Cir. 1986). The ALJ must articulate at least
minimally his analysis of all relevant evidence. Herron v. Shalala, 19 F.3d
329, 333 (7th Cir. 1994). The Court must be able to “track” the analysis to

4

The ALJ noted that Eastridge would be disabled under the Social Security
Medical-Vocational Guidelines once she became 50 years of age. See 20 C.F.R. Part
404, Subpart P, Appendix 2, Rule 201.12. The ALJ suggested that she consider filing a
new application for Disability Benefits, as well as appealing this decision. R. 17.
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determine whether the ALJ considered all the important evidence. Diaz v.
Chater, 55 F.3d 300, 308 (7th Cir. 1995).
In this case, the ALJ’s decision is supported by substantial evidence.
The opinions of Drs. Chauhan, Alex, and Leung support the ALJ’s findings
at Step 3 and his RFC finding at Step 4. The opinions of vocational experts
Drs. McGowan and Taylor support the finding at Step 5 that Eastridge
could perform a substantial number of jobs in the national economy. In
particular, Dr. Taylor found that Eastridge could perform 2,900 jobs that
exist in Illinois, and that even if she could only sit for thirty minutes at a
time, she could perform half of those jobs, or 1,450. The Seventh Circuit
has determined that 1,450 jobs meets the Commissioner’s burden at Step
5 to show that the person could perform a substantial number of jobs in the
national economy. See Liskowitz v. Astrue, 559 F.3d 736, 743
(7th Cir. 2009) (1,000 is considered a significant number of jobs).
Eastridge argues that the ALJ did not comply with the Appeals
Council February 4, 2009, remand order because Dr. Leung and
Dr. Froman did not appear at the supplemental hearing to testify, because
Dr. Alex’s testimony at the medical testimony was inadequate and Dr. Alex
was abrasive and uncooperative, and because the ALJ did not provide
sufficient rationale for his RFC finding.

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The Appeals Council reviewed the October 5, 2009, decision and
denied the request for review. The Appeals Council, thus, determined that
the ALJ sufficiently complied with the February 4, 2009, remand order.
This Court will not disturb that finding. Furthermore, this Court does not
have authority to decide whether the ALJ complied with the administrative
remand from the Appeals Council. This Court has authority to decide
whether the decision of the Commissioner was supported by substantial
evidence. 42 U.S.C. § 405(g). This Court should not and will not second
guess the Appeals Council on administrative procedural matters.
In addition, the Court finds nothing in the record that would preclude
Dr. Alex’s testimony from providing substantial evidence to support the
decision of the ALJ. Eastridge criticized Dr. Alex’s age and experience, but
her counsel stated on the record that he reviewed Dr. Alex’s resume and
had no objection to him testifying as a medical expert. See Motion for
Summary Judgment, at 16-17; but see R. 95-96. Any objections to
Dr. Alex’s qualifications are, thus, waived. Eastridge also complains that
Dr. Alex was abrasive, uncooperative, and did not answer some questions.
The transcript shows Eastridge’s attorney was effectively cross-examining
Dr. Alex about the medical opinions to which he had already testified at the
hearing, and Dr. Alex was responding in a typical manner to such cross

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examination. The Court sees no basis to conclude that ALJ could not
Dr. Alex’s testimony in making his determination.
The ALJ also provided a sufficient rationale for his RFC finding. The
ALJ explained that in his first decision RFC finding was based on the
opinions of Drs. Chauhan and Leung. See R. 140-41. The ALJ
incorporated that analysis into the second decision by reference. The ALJ
further explained that the RFC finding was supported by Dr. Alex’s
opinions. See R. 16. The ALJ provided a sufficient rationale for the RFC
finding.
Eastridge next challenges the ALJ’s credibility findings. This Court
will not review the credibility determinations of the ALJ unless the
determinations lack any explanation or support in the record. Elder v.
Astrue, 529 F.3d 408, 413-14 (7th Cir. 2008). Eastridge complains that the
ALJ relied on Drs. Alex and Chauhan rather than Dr. Wilson and Berry.
The Court will not re-weigh the evidence. See Delgado v. Bowen,
782 F.2d at 82 (Court may not substitute its judgment for ALJ). In this
case, the testimony of Dr. Alex, the medical evidence from Dr. Chauhan,
and the opinions of Dr. Leung supported the ALJ’s RFC finding. That
evidence meets the standard of substantial evidence.
Eastridge also complains about the ALJ’s credibility finding with
respect to Eastridge’s testimony. The ALJ, however, explained the basis
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for that finding. As quoted above, the ALJ found no objective medical
evidence that typically is present when a person has debilitating pain.
Eastridge argues that this quoted explanation is mere boilerplate and not a
real explanation. The Court agrees that the first decision contains
remarkably similar language. See R. 141-42. The repeated use of the
same language, however, begs the question. The question is whether the
ALJ provided an explanation of his credibility finding and whether the
explanation is supported by the evidence. The evidence supports the
ALJ’s explanation that Eastridge did not have typical signs of debilitating
pain.
In addition, other evidence supports the credibility finding. The
medical opinions of Drs. Alex and Leung were inconsistent with Eastridge’s
testimony about her physical limitations. Eastridge’s own testimony was
inconsistent. She testified at the first hearing that she could stand for an
hour and a half before her back would start hurting. R. 36. At the second
hearing she testified that she could only stand for ten to fifteen minutes
before she had to sit or lie down. R. 86-87. Given the medical evidence
and the inconsistency in Eastridge’s testimony, the Court will not disturb
the ALJ’s credibility findings.
Eastridge next argues that the ALJ erred by not developing the
record. Eastridge testified at the second hearing about problems with her
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hands and elbows. Dr. Alex stated that her testimony was consistent with
carpal tunnel syndrome. Eastridge had not undergone EMG or nerve
conduction testing to determine whether she had carpal tunnel syndrome.
Eastridge asked the ALJ to order a nerve conduction study and the ALJ
declined. The ALJ stated that he could not order the test because it
involved stick needles into Eastridge. The ALJ, however, held the record
open to allow Eastridge to have tests performed and submit reports.
Eastridge did not. Eastridge argues that the ALJ erred by not ordering a
study to see if Eastridge had carpal tunnel syndrome.
The ALJ has an obligation to develop the record. Sims v. Apfel,
530 U.S. 103, 110-11 (2000). The Court, however, gives deference to the
ALJ’s determination of the amount of evidence needed to decide a case.
The Court will reverse if the ALJ’s decision regarding additional medical
examinations only if the ALJ abused his discretion. Poyck v. Astrue, 414
Fed.Appx. 859, 861 (7th Cir. 2011); see Kendrick v. Shalala, 998 F.2d 455,
458 (7th Cir. 1993).
Eastridge was also represented by counsel. When a claimant is
represented by counsel, the Court may assume that the claimant has
presented the strongest case that she could and that the ALJ adequately
developed the record. Hawkins v. Chater, 113 F.3d 1162, 1167-68
(7th Cir. 1997); Glenn v. Secretary of Health and Human Services,
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814 F.2d 387, 391 (7th Cir. 1987). Because she was represented by
counsel, Eastridge had the burden to introduce some objective evidence
that further development of the record was required. Hawkins, 113 F.3d at
1167.
Eastridge presented no objective evidence that additional evidence
was necessary. The only evidence was Eastridge subjective complaints
about her hands and elbows. The medical evidence in the record showed
that Eastridge had normal grip strength in both hands and generally no
swelling or tenderness in the elbows. Even as late as January 6, 2009,
Dr. Wilson found no tenderness in her joints and full range of motion and
equal strength in her upper extremities. R. 823.
The ALJ also stated that he was not authorized to order a
nerve conduction study. This appears to be correct. The ALJ only had
the authority to order another consultative examination. 20 C.F.R.
§ 404.1527(c)(3). The consulting physician would have then needed to
determine that a nerve conduction study was required and that such an
invasive test would not have posed a significant risk of harm to Eastridge.
20 C.F.R. § 1519m.
The ALJ, however, did not cut off Eastridge’s opportunity to present
some objective evidence. The ALJ held the record open for thirty days to
allow Eastridge to provide additional medical evidence. When Eastridge
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submitted no evidence during this thirty-day period, the ALJ could have
properly concluded that Eastridge decided not to pursue her disability claim
based on carpal tunnel syndrome.
Eastridge argues that she could not afford to get a nerve conduction
study. Eastridge emphasizes that received her medical care through a free
clinic. Eastridge was, however, able to secure an MRI of her back in 2006,
an examination by a neurologist in 2007 and 2008, and additional
radiological tests in 2009. The ALJ could have reasonably concluded that
Eastridge’s doctors could secure additional medical tests if the tests were
medically necessary. Given the lack of objective evidence of carpal tunnel
syndrome and the ALJ’s willingness to keep the record open to give
Eastridge the opportunity to present additional medical evidence, the Court
finds no abuse of discretion in the ALJ’s development of the record.
Eastridge finally argues that the ALJ erred in dismissing the
vocational expert Dr. Taylor’s testimony that she would have been
unemployable if she could only sit for ten to fifteen minutes at a time or if
she could not grip or manipulate small objects. The Court finds no error.
Eastridge testified twice that she could sit for thirty minutes at a time.
See R. 36-37, 86-87. The ALJ could, thus, properly disregard the expert’s
answers to Eastridge’s hypothetical questions about a person who could
only sit for ten to fifteen minutes at a time. The ALJ also could disregard
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the answers to the hypothetical questions about the inability to grip or
manipulate objects because the medical evidence showed normal grip
strength. The Court finds no error in the ALJ’s evaluation of the vocational
experts’ testimony.
WHEREFORE, Plaintiff Mary Eastridge’s Brief in Support of Motion
for Summary Judgment (d/e 17) is DENIED, and Defendant Commissioner
of Social Security’s Motion for Summary Affirmance (d/e 19) is ALLOWED.
The decision of the Commissioner is affirmed. THIS CASE IS CLOSED.

ENTER: February 9, 2012
s/ Byron G. Cudmore
BYRON G. CUDMORE
UNITED STATES MAGISTRATE JUDGE

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