Crumpler v. Astrue

Filing 18

OPINION entered by Judge Sue E. Myerscough on 06/16/2014. SEE WRITTEN OPINION. Plaintiff Crumpler's Motion for Summary Judgment (d/e 14 ) is DENIED, and the Motion for Summary Affirmance filed by Defendant Commissioner of Social Security (d/e 16 ) is GRANTED. The decision of the Commissioner is AFFIRMED. This case is closed. (DM, ilcd)

E-FILED

Wednesday, 18 June, 2014 09:48:43 AM
Clerk, U.S. District Court, ILCD

IN THE UNITED STATES DISTRICT COURT
FOR THE CENTRAL DISTRICT OF ILLINOIS
SPRINGFIELD DIVISION
PAULA K. CRUMPLER,

)
)
Plaintiff,
)
)
v.
)
)
CAROLYN W. COLVIN, Acting
)
Commissioner of Social Security, )
)
Defendant.
)

No. 13-3022

OPINION
SUE E. MYERSCOUGH, U.S. District Judge:
Plaintiff Paula K. Crumpler appeals the denial of her
application for social security disability insurance benefits pursuant
to 42 U.S.C. § 405(g). Crumpler has filed a Motion for Summary
Judgment (d/e 14), and Defendant Carolyn W. Colvin,
Commissioner of Social Security, has filed a Motion for Summary
Affirmance (d/e 16). For the reasons set forth below, the decision of
the Commissioner is AFFIRMED.
I. STATEMENT OF FACTS
Crumpler was born on May 27, 1961. Application, R. 120.
She is divorced with three adult children. Tr., R. 39.

Crumpler completed high school. Tr., R. 41. Her prior
employment includes working as a service technician for a lawn
service; an owner and operator of a bar and restaurant; a
supervisor in a shipping and receiving department; and a traffic
manager. See Past Relevant Work History Summary, R. 200-202.
On October 13, 2009, Crumpler applied for disability
insurance benefits alleging she became disabled on January 15,
2009. Application, R. 120. For purposes of her application,
Crumpler was last insured on March 31, 2011, meaning she must
establish her total disability on or before that date. See, e.g.,
Bjornson v. Astrue, 671 F.3d 640, 641 (7th Cir. 2012) (noting that
“only if [plaintiff] was disabled from full-time work by [her last
insured] date is she eligible for benefits”).
Crumpler’s application was denied initially and on
reconsideration. R. 64, 65. Crumpler requested a hearing. See R.
79.
On June 6, 2011, Crumpler appeared and testified before
Administrative Law Judge (ALJ) Barbara Welsch. Bob Hammond,
the Vocational Expert, also testified. On August 2, 2011, the ALJ

Page 2 of 52

determined that Crumpler was not disabled. ALJ Decision, R. 2031.
Crumpler requested Appeals Council review. On November 6,
2012, the Appeals Council declined review. R. 11. On January 4,
2013, Crumpler’s request for an extension of time to file a civil
action was granted. R. 1. Crumpler filed this cause of action on
January 30, 2013.
A. Summary of the Medical Evidence
Crumpler first sought treatment for back pain on January 15,
2009, while living in Florida. She complained to Dr. Salesia
Alvarado that, a few weeks earlier, she experienced back pain and
pain radiating down both legs. R. 216. That day, the back pain
was not as bad, but Crumpler still had residual pain down her right
leg. R. 216.
An MRI performed on February 23, 2009 found disc
desiccation at L4-L5 with broad based disc protrusion (herniation)
impinging on the anterior spinal canal. R. 271. In addition, the
MRI showed disc degeneration at L5-S1 with broad based disc
protrusion (herniation) residing in the epidural fat. R. 271.

Page 3 of 52

In March 2009, Dr. Alvarado submitted an Attending Physical
Statement to Lincoln National Life Insurance Company (Lincoln
National) on behalf of Crumpler. R. 358 (dated March 2009). Dr.
Alvarado stated that Crumpler was unable to work as of February
19, 2009 due to her “herniated disc lumber spine.” R. 358. The
objective findings included an MRI, X-ray and positive straight-legraise test. R. 358. Dr. Alvarado also stated Crumpler could not lift
more than 10 pounds. Dr. Alvarado noted that Crumpler was
house confined and had regressed. Dr. Alvarado did not know
when Crumpler could return to work. R. 358.
On March 3, 2009, Dr. Alvarado referred Crumpler to Dr.
Mark Oliver of the Ocala Neurosurgical Center. R. 210. On March
6, 2009, Dr. Oliver examined Crumpler and her MRI. Dr. Oliver
believed Crumpler’s pain could be related to the exacerbation of
pre-existing osteoarthritis or muscular strain. R. 240. Dr. Oliver
recommended physical therapy. R. 238, 240.
In March and April 2009, Crumpler participated in physical
therapy. She was also issued a home transcutaneous electrical
nerve stimulation (TENS) unit to help her perform functional duties
throughout the house. R. 244. Physical therapy ceased after
Page 4 of 52

Crumpler began experiencing problems with her neck. See R. 25152. Although Crumpler returned to physical therapy on May 18,
2009, she was discharged on May 28 because she planned to return
to Illinois to be closer to family in the event she had surgery on her
back. R. 255.
On July 2, 2009, Crumpler saw Dr. Jose A. Espinosa,
Southern Illinois University Neurosurgery. R. 282. An EMG
(electromyography) nerve conduction study of the right upper and
lower extremities revealed evidence of mild right carpal tunnel
syndrome and “chronic mild right L5 radiculopathy (without
evidence of any active ongoing denervation of the L5 innervated
muscles at this time).” R. 279. Dr. Espinosa expressed his concern
that “surgery does not seem that it is going to improve her current
condition.” R. 281.
Dr. Espinosa referred Crumpler to Dr. Kristina Naseer for
evaluation in the pain clinic and possible epidural steroids. R. 281.
Crumpler saw Dr. Naseer and received transforaminal epidural
injections on two occasions. R. 290-91; 287. Crumpler reported
receiving no relief from the first injection. R. 287. The record does
not specifically indicate the effect of the second injection.
Page 5 of 52

On September 9, 2009, Crumpler met with Dr. Glennon Paul
of Central Illinois Allergy & Respiratory Service, Ltd. Dr. Paul saw
Crumpler as a child for her allergic rhinitis and extrinsic asthma
but had not seen her in many years. R. 392. His physical
examination of Crumpler was unremarkable. See R. 392 (noting no
swelling of the extremities, no joint deformities, no focal weakness
or gross sensory deficit). Dr. Paul referred Crumpler to Dr. Timothy
VanFleet of the Orthopedic Center of Illinois for a lumbar disc
evaluation. R. 393.
Dr. Paul also completed a Physical Restrictions & Limitations
form for Lincoln National on Crumpler’s behalf. Exhibit 21F, R. 365
(dated September 9, 2009). Dr. Paul noted that Crumpler could not
stand, walk, sit, or drive for any hours in an 8-hour work day. R.
365. Crumpler could occasionally lift up to 10 pounds but could
never lift over 10 pounds. R. 365. Crumpler could not use her
hands for pushing or pulling or fine manipulation but could use her
hands for simple gripping and up to two hours of keyboarding. R.
365. Crumpler could not use her feet for repetitive movement like
foot controls. R. 365. Dr. Paul noted that Crumpler could never
climb, crawl, bend, or reach above shoulder. R. 365. Dr. Paul
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believed Crumpler could be exposed to weather 50% of the time but
never exposed to extreme cold, extreme heat, wet or humid
conditions, or atmospheric conditions. R. 365.
On September 18, 2009, Crumpler saw Dr. VanFleet. R. 31415. In his physical examination, Dr. VanFleet noted that Crumpler
had a difficult time ambulating across the floor secondary to an
antalgic gait. See Dorland’s Illustrated Medical Dictionary 97 (32nd
Ed. 2012) (defining antalgic as “counteracting or avoiding pain, as a
posture or gait assumed so as to lessen pain”). Crumpler had
palpable discomfort across the right low back area. R. 314-15. Dr.
VanFleet recommended strengthening exercises for Crumpler’s neck
and a lumbar discography for her back pain. R. 315.
Following the discography, Crumpler met with Dr. VanFleet,
who advised Crumpler that she had a “negative discography at two
levels, meaning they did not reproduce pain.” R. 311. Dr. VanFleet
explained that this meant there was a “high risk for not having
improvement.” R. 311.
Dr. Van Fleet suspected that the “pain generator is in the L5S1 level that would need to be addressed if we did the fusion at the
L4-5 level due to the actual degenerative nature would need to be
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addressed as well.” R. 311. Dr. Van Fleet advised Crumpler of the
risks of the procedure, including the risk that the procedure will not
improve her symptoms. R. 311.
On October 22, 2009, Crumpler underwent a transforaminal
lumbar interbody fusion of L4-L5 and L5-S1. R. 300-302.
Although the surgery initially seemed to relieve Crumpler’s pain on
the right side of her body, she began to experience pain in the left
lower extremity. See R. 310, 385.
On November 6, 2010, Crumpler saw Dr. VanFleet and
complained of pain into the lower extremity on the left side. R. 310.
She did not really have any complaints of back pain or pain in the
right lower extremity. R. 310. The radiographs demonstrated the
implants were well-positioned and everything appeared to be in
good position. R. 310. Dr. Van Fleet believed Crumpler had a “little
bit of BMP radiculitis.” R. 310; see also Stedman’s Medical
Dictionary 1622 (28th ed. 2006) (defining radiculitis as a synonym
for radiculopathy, which is a disorder of the spinal nerve roots).
Crumpler saw Dr. Paul several times in November 2009 for
wheezing, coughing, and shortness of breath. See R. 389
(exacerbation of COPD), 388 (exacerbation of asthma), 387
Page 8 of 52

(asthmatic bronchitis), 386 (asthmatic bronchitis). On November
23, 2009, Crumpler saw Dr. Paul and complained of low back pain
that radiated back down into her buttock area. R. 385. Dr. Paul’s
physical examination of Crumpler was unremarkable regarding her
musculoskeletal and neurologic condition. See R. 385 (noting no
joint deformities, no focal weakness, or gross sensory defect).
On November 25, 2009, Crumpler complained to Dr. Paul that
her back pain was still bothering her. R. 384. His physical
examination of Crumpler was unremarkable regarding her
musculoskeletal and neurologic condition. See R. 384 (noting no
joint deformities, focal weakness, or gross sensory defect).
By November 27, 2009, Crumpler referred to her back pain as
severe when she saw Dr. Paul. Again, Dr. Paul’s physical
examination of Crumpler was unremarkable regarding her
musculoskeletal and neurologic condition. See R. 383 (noting no
joint deformities, focal weakness, or gross sensory defect).
On December 2 and December 7, Crumpler reported to Dr.
Paul that she still had severe back pain. R. 382, 381 (severe back
pain radiating to the foot). By this time, Crumpler was prescribed
Lyrica (used for neuropathic pain); Flexeril (used to relieve skeletal
Page 9 of 52

muscle spasms); Vicodin (used to relieve moderate to severe pain);
and a Duragesic patch (used to relieve moderate to severe pain),
among other medications. See R. 385 (prescribing Lyrica and
Vicodin); R. 384 (prescribing Vicodin); R. 383 (prescribing Duragesic
patch); see also www.medical-dictionary.thefreedictionary.com (last
visited June 16, 2014).
On December 4, 2009, in between the two appointments with
Dr. Paul, Crumpler saw Dr. VanFleet. Dr. VanFleet’s notes reflect
that Crumpler reported “a little bit of discomfort across her back
still and some in the left leg.” R. 337. Crumpler reported that the
discomfort improved “mildly” and she “is feeling somewhat better at
this point in time.” R. 337. On December 4, 2009, Dr. Van Fleet
noted Crumpler could “move across the floor reasonably well.” R.
337. Dr. VanFleet noted Crumpler “will begin physical therapy for
strengthening and stretching.” R. 337.
On December 23, 2009, Crumpler began physical therapy
with Premier Physical Therapy & Sports Rehabilitation (Premier). R.
343. The Back Evaluation performed by Premier noted Crumpler
had a positive Faber, straight leg raise, and slump test. R. 344; see
also Shiner v. Colvin, 2014 WL 1767126, at *7 n. 23 (May 2, 2014,
Page 10 of 52

M.D. Penn.) (defining the Faber test as “a pain provocation test
which reveals problems at the hip and sacroiliac regions” and a
positive slump test as suggesting a herniated disc or nerve tension);
www.webmd.com/a-to-z-guides/straight-leg-test-for-evaluatinglow-back-pain-topic-overview (last visited June 16, 2014) (the test is
positive if the person experiences pain down the back of her leg
below the knee when the affected leg is raised). Crumpler had
tenderness on palpation to her left lumbar region. R. 345. The
assessment portion of the Evaluation states that Crumpler suffers
from low back pain and is severely limited in her lifestyle but is an
excellent candidate for rehabilitation. R. 345.
Crumpler attended physical therapy on December 30, 31,
2009, January 5, 7, 12, 14, 18, and 19, 2010, and February 1 and
2, 2010. R. 340-341. Crumpler was reevaluated on January 7,
2010.
On the reevaluation form, Crumpler’s score on the Oswestry
Disability Index (based on a self-report questionnaire) was 78%,
which put her in the “crippled” category. See, e.g.,
www.scientificspine.com/spine-scores/oswestry-disabilityindex.html (last visited June 16, 2014).
Page 11 of 52

The Evaluation also noted

that Crumpler continued to struggle with pain through the low back
and has radicular symptoms to her lower left extremity. R. 342.
On January 15, 2010, Crumpler saw Dr. VanFleet. Crumpler
told Dr. VanFleet that she was making progress and doing
reasonably well. She did have “some complaints of symptoms at
this point.” R. 336. Her biggest complaint was burning in her feet,
toes, and legs. R. 336. Dr. VanFleet thought it sounded
“neuropathic.” R. 336; see also Stedman’s Medical Dictionary 1313
(defining “neuropathic” as relating to neuropathy, which is a
disorder affecting any segment of the nervous system).
On physical examination, Dr. VanFleet found Crumpler had
good range of motion. R. 336. He recommended Crumpler
continue stretching and strengthening exercises. R. 336.
On February 1, 2010, Crumpler saw Dr. Paul and reported she
still had pain in the back radiating to the left foot. R. 378. Dr.
Paul’s physical examination indicated no joint deformities, focal
weakness, or gross sensory deficient. Dr. Paul prescribed fentanyl
patches, 50 mg. every three days, Lyrica, and Norco
(acetaminophen and hydrocodone for pain management), if needed.

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R. 378. see also www.drugs.com/norco.html (last visited June 16,
2014).
On February 9, 2010, Crumpler was discharged from physical
therapy to a home program. R. 339. The Discharge Summary
notes that Crumpler did not meet her long term goals and progress
was slower than expected. R. 339. Crumpler continued to have
pain down her lower left extremity into the foot/ankle. However,
the pain in the right lower extremity that she had before surgery
was gone. R. 339. The Discharge Summary also notes that
Crumpler was limited by an apparent nerve issue in the lower left
extremity. R. 339.
On April 16, 2010, Crumpler saw Dr. VanFleet and
complained of intermittent numbness and pain to the left leg. R.
350. Crumpler described an area of pain across the left plantar
foot. In addition, Crumpler identified a new problem of numbness
and tingling to the ulnar aspect of the hands. R. 350.
Dr. VanFleet noted a positive Tinel’s sign at the elbow
bilaterally and no weakness of the hands. See Stedman’s Medical
Dictionary 1772 (defining Tinel’s sign as “a sensation of tingling . . .
along the course of a nerve when the latter is percussed”);
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www.webmd.com/pain-management/carpal-tunnel/physical-examfor-carpal-tunnel-syndrome (noting that the Tinel’s sign test is a
common test used to diagnose carpal tunnel syndrome) (last visited
June 16, 2014). Dr. VanFleet recommended Crumpler work on a
strengthening program for her back and wear elbow extension splits
at night. R. 350.
On April 22, 2010, Dr. Barry Mulshine of the Orthopedic
Center of Illinois saw Crumpler at Dr. VanFleet’s request regarding
Crumpler’s complaints of pain in her left foot. R. 352. Dr.
Mulshine’s physical examination indicated that Crumpler walked
with an antalgic gait. Crumpler had pain with light touch in the
area of the first web space and the ball of the foot. R, 352. Tinel’s
testing across the deep peroneal nerve and posterior tibial nerve
were both irritating and produced some radiating symptoms. R.
352. Crumpler had symmetric strength testing across the feet and
all tendon groups crossing into the ankle, although she seemed to
be tentative and showed some breakaway weakness. R. 352.
Dr. Mulshine’s assessment was that Crumpler had neurogenic
type pain in the left foot. R. 353; see also Stedman’s Medical
Dictionary 1313 (defining neurogenic as “[o]riginating in, starting
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from, or caused by, the nervous system or nerve impulses”). Dr.
Mulshine recommended Neurontin and Flector patches. R. 353; see
www.medicinenet.com/gabapentin-oral/article.htm (Neurontin, also
known as Gabapentin, may be used to treat nerve pain conditions)
(last visited June 16, 2014); www.rxlist.com/flector-patch-sideeffects-drug-center.htm (Flector patch used as a pain reliever) (last
visited June 16, 2014). If the pain persisted, Dr. Mulshine
suggested that consideration be given to an EMG. R. 353.
On May 14, 2010, Crumpler saw Dr. Paul and complained of
severe pain in the lumbosacral area and in the foot. Dr. Paul
recommended Crumpler continue the Norco. R. 376.
Also in May 2010, Dr. Paul completed an Attending
Physician’s Statement for Lincoln National on behalf of Crumpler.
Exhibit 21F, R. 363. Dr. Paul wrote that Crumpler’s diagnosis
included lumbar disc disease, nerve blockages, asthma, acid reflux,
and carpal tunnel. Dr. Paul did not mark whether Crumpler had
any physical limitations but marked the mental impairment as
“Class 4—Patient is unable to engage in stress situations or engage
in interpersonal relations.” In the “Functional capacity (American

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Heart Association)” portion of the form, Dr. Paul marked “Class 1
(no limitation).” R. 363.
Dr. Paul noted that Crumpler was house confined and he did
not expect her condition to change in the future. R. 364. Dr. Paul
did not mark any of the boxes relating to Activities of Daily Living
with which Crumpler needed assistance. R. 364. Dr. Paul listed
Crumpler’s restrictions as including no lifting, standing, or
repetitive movement. R. 364.
In July 2010, Dr. Paul’s treatment note reflected that
Crumpler was tender in the sacroiliac joints. R. 374. Dr. Paul gave
Crumpler a steroid xylocaine injection in the sacroiliac joint on two
sides. R. 374.
In August 2010, Dr. Paul completed another Attending
Physician’s Statement for Lincoln National on Crumpler’s behalf. R.
354. Dr. Paul listed the diagnosis as including lumbar disc disease,
chronic asthma, acid reflux, and an illegible diagnosis that may be
“right vertebral.” Exhibit 17F, R. 354. Dr. Paul classified
Crumpler’s physical impairments as “Class 4-Severe limitation of
functional capacity; incapable of minimum (sedentary) activity (74100%).” R. 354. Dr. Paul classified Crumpler’s mental
Page 16 of 52

impairments as “Class 2-patient is able to function in most stress
situations and engage in most interpersonal relationships (slight
limitations).” Dr. Paul marked “class 4 (Complete limitation)” with
regard to Crumpler’s functional capacity. R. 354. (Obviously in
stark contrast to the prior Attending Physician Statement of May
2010 which noted “Class 1 (no limitation).”)
Dr. Paul noted that Crumpler was house confined and that he
did not expect her condition to change in the future. R. 355. Dr.
Paul did not mark the Activities of Daily Living with which
Crumpler needed assistance but did mark “no” to the question
whether he expected the limitations to Crumpler’s ability to perform
activities of daily living to be permanent. R. 355.
In September 2010, Crumpler saw Dr. Paul for shoulder pain.
R. 373. Dr. Paul advised Crumpler to continue gabapentin for
severe back pain. R. 373. In October 2010, Crumpler told Dr. Paul
she continued to have severe back pain (R. 371) and shoulder pain
(R. 372). On October 22, 2010, Crumpler told Dr. Paul that the
gabapentin made her “loopy” so he reduced the dosage. R. 372.
In October or September 2010 (the form contains two different
dates) Dr. Paul completed a form titled “Back,” based on Listing
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1.04. See Exhibit 18F, R. 356-57. Dr. Paul checked boxes noting
“yes” or “no” answers. Dr. Paul indicated that Crumpler did not
have sensory loss, that spinal arachnoiditis had not been confirmed
by operative note or pathology report, and that spinal arachnoiditis
was not manifested by severe burning or painful dysesthesia. R.
356; see also www.webmd.com/pain-management/guide/painmanagement-arachnoiditis (defining arachnoiditis as “a pain
disorder caused by the inflammation of the arachnoid, one of the
membranes that surrounds and protects the nerves of the spinal
cord”) (last visited June 16, 2014). Dr. Paul responded “yes” to all
remaining questions, indicating that there was evidence of nerve
root compression, limitation of motion of the spine, reflex loss,
positive straight-leg raising, a need to change position more than
once every two hours, and that Crumpler had spinal stenosis
resulting in pseudoclaudication. R. 357; see also www.medicaldictionary.thefreedictionary.com/psuedoclaudication (defining
pseudoclaudication as painful cramps caused by spinal, neurologic
or orthopedic disorders) (last visited June 16, 2014). Dr. Paul also
marked “yes” to questions indicating that spinal stenosis had been
established by findings on appropriate medically acceptable
Page 18 of 52

imaging, resulted in chronic nonradicular pain and weakness, and
resulted in an inability to ambulate effectively. R. 356-57.
In February and March 2011, Crumpler complained to Dr.
Paul of the same back pain. R. 370 (February 4, 2011 physical
examination finding no joint deformities, focal weakness, or gross
sensory deficit); R. 369 (March 31, 2011 physical examination
finding no joint deformities, focal weakness, or gross sensory
deficit). In April 2011, Crumpler complained to Dr. Paul of lumbar
disc and foot pain. R. 377 (April 16, 2011 physical examining
finding tenderness and pain on abduction of the shoulder but
otherwise no joint deformities, focal weakness, or gross sensory
deficit).
In May 2011, Dr. Paul’s physical examination noted
tenderness over the lumbosacral area. R. 368. In June 2011,
Crumpler complained to Dr. Paul of pain down into the foot. Dr.
Paul’s physical examination noted falling arches but no other
unusual findings. R. 375 (June 25, 2011 physical examination
finding no joint deformities, focal weakness, or gross sensory
deficit).

Page 19 of 52

B. Physical Residual Functional Capacity Assessment
On November 30, 2009, Dr. Lenore Gonzalez, a state agency
physician, prepared a Physical Residual Functional Capacity
Assessment. R. 327-334. Dr. Gonzalez reviewed the medical
records and concluded that Crumpler could occasionally lift and
carry up to 20 pounds; frequently lift up to 10 pounds; stand
and/or walk about 6 hours in a normal 8-hour workday; sit for 6
hours in a normal 8-hour workday; and push and/or pull an
unlimited amount of time. R. 328. Dr. Gonzalez based these
findings on the fact that, while Crumpler had a history of back
problems, the problems were treated surgically on October 22,
2009. Dr. Gonzalez noted that Crumpler currently complains of
pain into the lower extremity on the left side but does not complain
of any right lower extremity difficulty or any back pain. Dr.
Gonzalez also noted that radiographs demonstrate that the
implants are well-positioned. R. 328.
Dr. Gonzalez concluded that Crumpler could occasionally
climb, balance, stoop, kneel, crouch, and crawl. She also noted
that frequent postural changes will only aggravate the impairment.
R. 329.
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Dr. Gonzalez found no manipulative, visual limitations,
communicative, or environmental limitations had been established.
R. 330-31. Dr. Gonzalez also found Crumpler’s statements
regarding her symptoms partially credible but that the extent of the
limitations described by Crumpler exceeded that supported by the
objective medical findings. R. 334.
In April 2010, Dr. Calixto Aquino, a state agency physician,
affirmed the Evaluation, noting that all objective medical evidence
of record affirms the prior residual functional capacity
determination. R. 347-349.
C.

Summary of the Evidence Presented at the Hearing
On July 19, 2011, the ALJ held an evidentiary hearing.

Transcript, R. 38-63; see also 20 C.F.R. § 404.929 (providing that a
claimant may request a hearing at which the claimant may submit
new evidence, examine the evidence used in making the
determination, and present and question witnesses). Crumpler
appeared in person along with her attorney. Bob Hammond, the
Vocational Expert, was also present. See 20 C.F.R. § 404.1560(b)(2)
(noting that the agency may use the services of vocational experts).
The hearing lasted approximately 38 minutes.
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Crumpler testified she lives in a mobile home by herself,
although her daughter had lived with her from approximately
October 2010 to February 2011. R. 39, 46, 51. All three of
Crumpler’s children live nearby. R. 50.
Crumpler drove to the hearing that day in her truck. She
drives her truck to pick up things at the store and go to her doctor.
She estimated she drove once every couple of weeks. R. 47.
However, she testified that the last time she drove other than the
day of the hearing was a few days earlier when she went to the
store. R. 48.
Crumpler was not currently working. She last worked for
Middleton Lawn and Pest Control as a service technician. R. 41;
see also Disability Report, R. 149 (based on information provided by
Crumpler and indicating that Crumpler worked at Middleton from
May 2007 to January 2009). After Crumpler injured her back in
January 2009, she went on medical leave, then short-term
disability. R. 41-42; see also Tr. 40 (Crumpler testifying that she
was on long-term and short-term disability until April 2011).
Crumpler testified that she had a lot of back pain, foot pain,
and pain going down her legs and her arms. R. 44. The pain
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causes her to lose sleep. R. 44. She has also fallen a few times
because her legs give out on her. R. 44. The medications “take the
edge off” but she is still in pain. The medications also make her a
little dizzy, and she must lie down. R. 45; see also R. 53 (testifying
that the pain medications make her dizzy and sleepy).
Crumpler spends her day at home napping on and off because
she does not sleep well at night. R. 45. She spends most of the day
lying down. R. 51
Crumpler does not do any housework. Her son mows her
lawn, and her niece and daughter vacuum, dust, and clean the
bathrooms. R. 45. Crumpler has a dog, but her adult children take
care of the dog for her. R. 62.
Crumpler does not fix her own meals, but she can microwave
things. Crumpler cannot stand long enough to cook a meal. R. 46.
She makes coffee, but not a full pot because she has problems
pouring it. R. 45.
Crumpler goes grocery shopping but does not get the ‘heavy
stuff.” R. 46. Crumpler’s daughter “does the heavy stuff.” R. 46.
Family and friends visit Crumpler at the house. R. 47.
Crumpler goes outside and sits on the porch for a little bit when the
Page 23 of 52

weather is nice. R. 48. She bathes herself, dresses herself, combs
her hair, and brushes her teeth. R. 48. However, it takes her a
long time to do those things. R. 62. She has to sit down at least
five times during the hour and a half to two hours it takes her to get
ready. R. 62.
Crumpler smokes a half a pack to a pack of cigarettes a day.
R. 48. Her doctor has not talked to her about any connection
between smoking and the back pain. R. 48.
Crumpler uses the computer to check her email. She does not
play any games on the computer. R. 49.
Crumpler was out of state two weeks prior to the hearing to
see her boyfriend in North Carolina for one week. R. 49. Crumpler’s
daughter drove her. R. 49. About six months earlier, Crumpler
and her daughter drove to Lincoln, Illinois to the State park. R. 50.
Before undergoing surgery on October 22, 2009, Crumpler
had tried physical therapy and injections. R. 51.
Crumpler testified that she can sit in a regular office chair for
less than five minutes before she becomes extremely uncomfortable.
R. 51. At this point, Crumpler’s attorney told Crumpler her that, if
she needed to stand up, she could do so as long as she spoke into
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the microphone. It is unclear from the transcript whether Crumpler
remained standing:
A.

Okay. Yeah, can I stand up?

Q.

Yes.

ALJ:

That means you have to stoop—

CLMT:

Oh.

ALJ:

--talk into the mic.

CLMT:

Okay. I’ll just.

R. 51-52.
Crumpler further testified that she has problems standing and
cannot stand on her left foot at all without it hurting. R. 52.
Crumpler did not have the left foot pain prior to her surgery. R. 52.
If she stands too long, her feet swell, her left foot gets hard, and the
pain gets worse. R. 52. Crumpler did not believe that she could get
through an 8-hour workday by alternating sitting with standing
because she cannot sit very long or stand very long. R. 53.
Crumpler also testified that it is hard for her to walk any length.
She has to stop and sit because her foot gets hard and almost feels
like it is frostbitten all the time. She said she has to keep a sock on

Page 25 of 52

her foot and in the winter she has to wrap a heating pad and
blanket around her foot to stop it from hurting so much. R. 53.
Crumpler also stated she has pain in her lower back that goes
down her legs and her arms into her fingers. R. 53. Her fingers
tingle. R. 53. Crumpler has muscle spasms. R. 54. She uses a
TENS unit and medication for the muscle spasms. R. 54. She has
gotten nauseous and sick from the pain. R. 54
Crumpler gets a total of about 3 hours of sleep a night. She
takes Lorazepam, but she can only sleep for an hour before she is
awake again. R. 54
Crumpler puts a pillow behind her back when she is driving.
R. 54. She has difficulty being a passenger in the car because she
has to move around a lot. Her back gets hard and starts hurting.
R. 54
A good day for Crumpler is getting out of bed and being able to
walk. She has about three good days in a week. R. 55. Crumpler
currently sees Dr. Paul but cannot see him as often as she did
when she first started having back pain because she lost her
insurance. R. 55.

Page 26 of 52

The ALJ also questioned Bob Hammond, the Vocational
Expert. R. 55. The ALJ asked the Vocational Expert the following
hypothetical:
[A]ssume an individual who is between 47 and 50 years
old, high school education, past relevant work as
described, an individual who would be limited to light
and sedentary work with the following exceptions: no
jobs which would require climbing of ladders, ropes,
scaffolds or work at unprotected heights, jobs that do not
require more than occasional stooping, bending, twisting,
no jobs that require working in a concentrated exposure
to respiratory irritants, including temperature. How
would these restrictions affect the performance of past
relevant work?
R. 55-56. The Vocational Expert testified that such individual
would be able to perform the requirements of Crumpler’s past
relevant work as a traffic manager, shipping and receiving
supervisor, and bookkeeper. R. 56. However, if a limitation on
prolonged walking were added, that would eliminate the shipping
and receiving supervisor position. R. 56.
The Vocational Expert noted a number of transferable skills
Crumpler acquired that would transfer to several positions
including cashier, production clerk, bill collector, and nonemergency dispatch (all sedentary positions). The Vocational
Expert also gave examples of unskilled entry-level jobs that fit the
Page 27 of 52

hypothetical, including no prolonged walking. R. 58. These jobs
included the following “light” positions: assembler II, order clerk;
and parking lot attendant; and the following “sedentary” positions:
information telephone clerk and charge account clerk/order clerk.
R. 58-59.
On examination by counsel, the Vocational Expert testified
that, in general, the jobs identified would provide a break at two
hours and at six hours for approximately 10 minutes, a 30 minute
break midway through the shift, one unscheduled break in the first
half of the shift, and one unscheduled break in the second half for
six minutes. R. 59. There would be more leeway on breaks for the
clerical type positions and the manager positions. R. 59-60.
The Vocational Expert further testified that if the hypothetical
given added the need to take five or more unscheduled breaks of
more than 15 minutes at a time during the day, all of the positions
would be precluded. R. 60. If the same individual would have to
miss three or more days a month due to pain and complications of
the medication, that would eliminate all of the positions at Specific

Page 28 of 52

Vocational Preparation 41 and below. However, Crumpler’s past
relevant work positions of bookkeeping, shipping and receiving
supervisor, and the manager position, would allow three days a
month after a probationary period of 30 to 90 days. R. 61. The
Vocational Expert agreed, however, that missing four or more days
a month during the probationary period would not be allowed. R.
61.
If the hypothetical claimant could stand for less than one hour
in an eight-hour workday, sit for less than one hour in an eighthour workday, and walk for less than one hour in an eight hour
work day, all of the positions would be precluded and there would
be no positions the hypothetical claimant could perform. R. 61.
D.

Summary of the ALJ’s Decision
On August 2, 2011, the ALJ issued her decision denying

Crumpler’s application for disability insurance benefits. The ALJ
followed the five-step analysis set forth in the Social Security

See Dictionary of Occupational Titles, Appendix C (“Specific Vocational
Preparation is defined as the amount of lapsed time required by a typical
worker to learn the techniques, acquire the information, and develop the
facility needed for average performance in a specific job-worker situation”); see
also Social Security Ruling (SSR) 00-4p (unskilled work corresponds with an
SVP of 1-2; semi-skilled correspondents to an SVP of 3-4; and skilled work
correspondents to an SVP of 5-9).
1

Page 29 of 52

Administration Regulations. 20 C.F.R. §§ 404.1520. The ALJ
found that Crumpler had not engaged in substantial gainful activity
since her alleged onset date (step one); Crumpler had the severe
impairments of degenerative disc disease post-fusion surgery, EMG
findings of mild right L5 radiculopathy, mild chronic carpal/cubital
tunnel syndrome, migraine headaches, and asthma (step two); the
impairments did not singly or in combination meet or medically
equal any listed impairment (step three); Crumpler was able to
perform her past relevant work of traffic manager and bookkeeper
(step four); and, in the alternative, even if Crumpler could not
return to her past relevant work, there were a significant number of
other jobs in the economy that Crumpler could perform (step five).
Specifically, at step three, the ALJ found that Crumpler did
not have an impairment or combination of impairments that met or
medically equaled one of the listed impairments in 20 C.F.R. Part
404, Part P, Appendix 1. In so finding, the ALJ did not give
controlling weight to the opinions Dr. Paul gave for the sole purpose
of supporting Crumpler’s disability with her insurance company. R.
23. The ALJ gave more weight to Dr. Paul’s actual findings in his
treatment notes.
Page 30 of 52

Between steps three and four, the ALJ determined that
Crumpler had the functional capacity to perform light2 and
sedentary3 work. The ALJ found that, due to the medication sideeffects, shortness of breath, and possible musculoskeletal pain
exacerbation, Crumpler should not climb ladders, ropes, or
scaffolds. R. 24. Due to back, leg, and foot pain, Crumpler should
not perform more than occasional bending, stooping, or twisting. R.
24. Due to possible asthma exacerbation, Crumpler should not
work in concentrated exposure to respiratory irritants including
temperature extremes. R. 24. Finally, due to possible leg/foot pain
exacerbation, Crumpler should not engage in prolonged walking. R.
24.
In determining Crumpler’s residential functional capacity, the
ALJ again did not give controlling weight to the opinions given by
Dr. Paul in his submissions to the insurance company. R. 28.
With respect to Crumpler’s subjective complaints, the ALJ found
that Crumpler had medically determinable impairments that could
2 This means lifting or carrying ten pounds frequently and 20 pounds occasionally, standing or
walking, off and on, for a six-hour workday, intermittent sitting, and using arms and hands to
grasp, hold, and turn objects. See 20 C.F.R. § 404.1567(b); Social Security Ruling 83-10.
3 This means lifting no more than 10 pounds at a time, standing or walking no more than 2
hours of an 8-hour workday, sitting six hours of an 8-hour workday, and for unskilled
sedentary jobs, good use of hands and fingers for repetitive hand-finger actions. See 20 C.F.R.
§ 404.1567(a); Social Security Ruling 83-10

Page 31 of 52

reasonably be expected to cause some of the symptoms. R. 24. The
ALJ also found, however, that Crumpler’s statements “concerning
the intensity, persistence, and limiting effects of the symptoms are
not credible to the extent they are inconsistent with the above
residual functional capacity assessment.” R. 24. Ultimately, the
ALJ found that the medical evidence, laboratory findings, and
Crumpler’s reported activities indicated that Crumpler’s functioning
was not as limiting as she alleged. R. 28.
At step four, and based on the residual functional capacity
and the testimony of the Vocational Expert, the ALJ found that
Crumpler could perform her past relevant sedentary work as a
traffic manager or bookkeeper as those jobs are usually performed
in the national economy. R. 29. Therefore, Crumpler was not
disabled.
The ALJ also made the alternative finding at step five that,
even if Crumpler could not perform her past relevant work, other
jobs existed in the national economy that Crumpler is able to
perform. In making this determination, the ALJ considered
Crumpler’s residual functional capacity, age, education, and past

Page 32 of 52

work experience, and the Vocational Expert’s testimony. R. 29-30.
Therefore, the ALJ found Crumpler was not disabled. R. 30.
Crumpler requested Appeals Council review. On November 6,
2012, after considering additional evidence, the Appeals Council
declined review.
II. LEGAL STANDARD
To be eligible for benefits, a claimant must suffer from a
disability, defined as the “inability to engage in any substantial
gainful activity by reason of any medically determinable physical or
mental impairment which can be expected to result in death or
which has lasted or can be expected to last for a continuous period
of not less than 12 months.” 42 U.S.C. § 423(d)(1)(A). An
individual is considered disabled if her impairments are of such a
severity that she is not only unable to perform her previous job but
cannot, in light of her age, education, and work experience, engage
in any other kind of substantial work existing in the national
economy. 42 U.S.C. § 423(d)(2)(A).
When the Appeals Council denies review, the ALJ’s decision
becomes the final decision of the Commissioner. Getch v. Astrue,
539 F.3d 473, 480 (7th Cir. 2008). This Court reviews the ALJ's
Page 33 of 52

decision to determine whether it is supported by substantial
evidence. See 42 U.S.C. § 405(g); Skinner v. Astrue, 478 F.3d 836,
841 (7th Cir. 2007). 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), quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197,
229 (1938). In conducting 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) (finding that additional evidence submitted
to the Appeals Council could not be used as a basis for finding
reversible error where the Appeals Council denied the claimant’s
request for review based on that evidence).
This Court must accept the ALJ's findings if they are
supported by substantial evidence and may not reweigh the
evidence or substitute its judgment for that of the ALJ. Delgado v.
Bowen, 782 F.2d 79, 82 (7th Cir. 1986). The Court will not reverse
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) (“It is only when the ALJ’s
determination lacks any explanation or support that we will declare
Page 34 of 52

it to be “patently wrong” . . . and deserving of reversal”) (citations
and quotations omitted). The ALJ must articulate at least
minimally her analysis of all relevant evidence. Herron v. Shalala,
19 F.3d 329, 333 (7th Cir. 1994).
III. ANALYSIS
On appeal, Crumpler argues the ALJ failed to properly
articulate her decision to deny benefits and, therefore, the ALJ’s
decision is not supported by substantial evidence. Specifically,
Crumpler argues: (1) the ALJ failed to evaluate the opinions of her
treating physician, Dr. Paul, consistent with the regulations and (2)
the ALJ’s credibility determination was patently wrong. Crumpler
asserts that these errors undermine the ALJ’s residual functional
capacity finding and render the Vocational Expert’s response to the
hypothetical question insufficient as a matter of law to support the
ALJ’s denial of benefits.
A.

The ALJ Evaluated Dr. Paul’s Opinions Consistent with the
Regulations
Crumpler first argues that the ALJ failed to evaluate Dr. Paul’s

opinions consistent with the regulations. Crumpler asserts that the
ALJ failed to give appropriate weight to Dr. Paul’s opinions despite
Page 35 of 52

the fact that no examining source rendered an opinion contrary to
Dr. Paul’s opinion and the only contrary opinion was that of a nonexamining state agency consultant whose opinion predated a
significant portion of the record before the ALJ. Although unclear,
this appears to be an argument that the ALJ should have afforded
Dr. Paul’s opinions controlling weight. Crumpler also argues that
even though the ALJ found that Dr. Paul’s opinion did not warrant
controlling weight, the ALJ should have weighed the medical
opinion based on the factors set for at 20 C.F.R. § 404.1527(d)
(2011).
1.

The ALJ’s Decision Not to Afford Dr. Paul’s Opinions
Controlling Weight is Supported by Substantial Evidence

A treating physician’s opinion is entitled to controlling weight
if it is “well-supported by medically acceptable clinical and
laboratory diagnostic techniques and is not inconsistent with other
substantial evidence” in the record. 20 C.F.R. § 404.1527(d)(2)
(2011); Ketelboeter v. Astrue, 550 F.3d 620, 625 (7th Cir. 2008)
(recognizing that while a treating physician has been able to observe
the claimant over a long period of time, the opinion may be
unreliable if the physician is sympathetic with the claimant). The
Page 36 of 52

ALJ must give good reasons for not giving the treating physician’s
opinion controlling weight. Schmidt v. Colvin, 545 Fed. App’x 552,
557 (7th Cir. 2013) (unpublished disposition). The ALJ may
discount a treating physician’s opinion where that opinion is
internally inconsistent, inconsistent with the opinion of the
consulting physician, or based solely on the subjective complaints
of the patient. Ketelboeter, 550 F.3d at 625.
In this case, the ALJ gave a number of reasons for refusing to
give controlling weight to the opinions Dr. Paul expressed in the
forms submitted to Lincoln Financial (Exhibits 17F, 18F, and 21F).
The ALJ found that Dr. Paul accepted every subjective symptom of
Crumpler and his opinions were not supported with medical
findings. R. 23 (citing examples from the record). The ALJ
indicated she gave more weight to the objective medical findings in
the treatment notes than the opinion evidence. R. 23.
The ALJ also refused to give controlling weight to Dr. Paul’s
opinions because Dr. Paul provided little to no explanation for his
finding of total disability or his conclusion that Crumpler’s was
unable to sustain even sedentary work. R. 28. The ALJ noted that
Dr. Paul was not a specialist, and his opinions relating to the
Page 37 of 52

inability to work were inconsistent with his own treatment notes as
well as the objective record. R. 28 (citing examples from the record,
including Dr. Paul’s treatment notes reflecting unremarkable
examinations and no evidence in the treatment notes of nerve root
compression yet Dr. Paul marked on the insurance forms that
Crumpler had nerve root compression). The ALJ believed Dr. Paul
was a “sympathetic doctor attempting to help” his patient receive
disability benefits. R. 23.
The reasons given by the ALJ for not giving controlling weight
to Dr. Paul’s opinions are adequate and supported by substantial
evidence. See Ketelboeter, 550 F. 3d at 625 (substantial evidence
supported the ALJ’s decision to give greater weight to the stateagency opinions than the opinions of the claimant’s treating
physician where the record contained little objective evidence to
support the severity of the claimant’s self-reported symptoms and
the physician’s conclusions about the limitations were based almost
entirely on the claimant’s subjective complaints; the physician’s
opinions were also internally inconsistent); Schmidt v. Astrue, 496
F.3d 833, 842 (7th Cir. 2007) (finding the ALJ’s decision not to give
controlling weight to treating physician’s opinions was reasonable
Page 38 of 52

where the physician’s treatment notes were inconsistent with his
conclusion that the claimant could not perform sedentary work);
Schaaf v. Astrue, 602 F.3d 869, 875 (7th Cir. 2010) (rejecting the
claimant’s argument that the because the ALJ did not point to
contradictory evidence, the treating physician’s finding must be
well-supported; the ALJ discounted the treating physician’s opinion
because the ALJ found the doctor did not explain his opinion and
the treatment notes did not clarify the doctor’s reasoning).
Dr. Paul’s opinions were inconsistent with his own treatment
notes. With only two exceptions when Dr. Paul found some
tenderness, Dr. Paul’s physical examinations of Crumpler were
unremarkable. Compare R. 368 (Dr. Paul’s May 4, 2011treatment
note indicating Crumpler had tenderness over the lumbosacral
area) and R. 374 (Dr. Paul’s July 23, 2010 treatment note noting
tenderness in the sacroiliac joints) with R. 369 (Dr. Paul’s March
31, 2011 treatment note indicating no joint deformities, focal
weakness, or gross sensory deficit) and R. 375 (Dr. Paul’s June 25,
2011 treatment note indicating no joint deformities, focal weakness,
or gross sensory deficit). Nothing in Dr. Paul’s treatment notes

Page 39 of 52

supports the extent of limitations he identified in his submissions
to Lincoln National, and Dr. Paul did not explain his findings.
Dr. Paul’s opinions were also inconsistent with the other
objective evidence in the record. Dr. Mulshine diagnosed Crumpler
with neurogenic type pain in her left foot but did not see any
mechanical or structural abnormality in the foot. R. 352 (Dr.
Mulshine report). In addition, Dr. VanFleet’s treatment notes did
not support the extent of limitations identified by Dr. Paul in his
submissions to Lincoln National. See, e.g., R. 336 (Dr. VanFleet
January 2010 treatment finding Crumpler had good range of
motion); R. 337 (Dr. VanFleet December 4, 2009 treatment note
wherein Crumpler reported mild improvement and a “little bit of
discomfort” in her back, and Dr. VanFleet noted Crumpler could
“move across the floor reasonably well”).
The Court notes, however, the ALJ made one error. The ALJ
stated that Dr. Paul marked on Exhibit 18F (R. 356-57) that
Crumpler had sensory deficit, contrary to his treatment notes. R.
23. However, Dr. Paul marked that Crumpler did not have sensory
deficient on Exhibit 18F. The Court, nonetheless, finds sufficient
support for the ALJ’s decision not to afford Dr. Paul’s opinion
Page 40 of 52

controlling weight despite that error. See, e.g., Spencer v. Astrue,
776 F. Supp. 2d 640, 649 (N.D. Ill. 2011) (finding that credibility
determination was not undermined by flaws in the ALJ’s reasoning
so long as there was some support in the record for the ALJ’s
determination).
Crumpler cites Parker v. Astrue, 597 F. 3d 920, 921 (7th Cir.
2010), in support of her argument that the ALJ erred in not giving
Dr. Paul’s opinion controlling weight because no examining doctor
rendered an opinion contrary to Dr. Paul and the only contrary
opinion was that of the state agency consultant who never
examined Crumpler and whose opinion predated a significant
portion of the record before the ALJ. Crumpler also argues that
the ALJ did not “see fit to mention” the report by the nonexamining
physician.
In Parker, all of the professionals who examined the claimant
were unanimous that the claimant had “severe, nearly constant,
debilitating physical pain, and two of them advised that she can
barely walk.” Parker, 597 F. 3d at . The ALJ nonetheless found
that the claimant could stand and sit for six hours during a
workday. Id. The ALJ noted no objective evidence supported the
Page 41 of 52

claimant’s allegations of extreme pain and that the doctors’
statements about the claimant’s pain was based solely on the
claimant’s subjective complaints. Id. at 922.
The Seventh Circuit reversed, finding that the only thing that
cast doubt on the claimant’s complaints were reports by two
nonexamining physicians that the administrative law judge did not
even mention. Parker, 597 F. 3d at 92 (also noting that the
Chenery doctrine prevented the agency’s lawyers from defending the
agency’s decision on grounds the agency did not embrace). The
Seventh Circuit also noted that pain does not always have a
verifiable source:
It would be a mistake to say “there is no objective
medical confirmation of the claimant’s pain; therefore the
claimant is not in pain.” But it would be entirely sensible
to say “there is no objective medical confirmation, and
this reduces my estimate of the probability that the claim
is true.” The administrative law judge said the first, not
the second.
Parker, 597 F. 3d at 923.
Parker is distinguishable from this case. Unlike Parker, all of
the doctors did not find Crumpler had the severe limitations noted
by Dr. Paul. Moreover, unlike Parker, the ALJ in this case did
mention the state agency physical evaluation that assessed
Page 42 of 52

Crumpler with the ability to perform a limited range of light
exertional work. R. 27 (ALJ decision), citing Ex. 11F, 14F (R. 327334, 347-349).
In sum, the Court finds the ALJ adequately explained her
decision not to give controlling weight to Dr. Paul’s opinions and her
decision is supported by substantial evidence.
2.

The ALJ Applied the Relevant Factors When Determining
the Weight to Give Dr. Paul’s Opinion

Crumpler also argues that the ALJ erred when she considered
only whether Dr. Paul’s opinion should be afforded controlling
weight under the regulations without applying the other relevant
factors.
When an ALJ does not give a treating physician’s opinion
controlling weight, the ALJ considers a number of factors to
determine how much weight to give the opinion. Henke v. Astrue,
498 Fed. App’x 636, 640 n. 3 (7th Cir. 2012) (unpublished
disposition); 20 C.F.R. § 404.1527(d) (2011). Those factors include
the length of the relationship and frequency of examination; the
nature and extent of the treatment relationship; support from
medical signs and laboratory findings, consistency with the record
Page 43 of 52

as a whole; and the degree of specialization by the treating
physician. 20 C.F.R. § 404.1527(d).
In this case, the record demonstrates the ALJ considered the
relevant factors even if she did not explicitly mention each one. See
Schreiber v. Colvin, 519 Fed. App’x 951, 959 (7th Cir. 2013)
(unpublished disposition) (noting that it was clear that the ALJ was
aware of and considered many of the § 404.1527(c)(2) factors even if
the ALJ did not explicitly weigh each factor); Henke, 498 Fed. App’x
at 640 n. 3 (finding it sufficient that the ALJ noted two of the
relevant factors). The ALJ noted the length and nature of Dr. Paul’s
treating relationship with Crumpler. R. 23. While Dr. Paul had
treated Crumpler as a child, he had not treated her for many years
and only recently began treating her again in September 2009. One
of the forms completed by Dr. Paul for Lincoln Financial was
completed shortly after he began treating Crumpler as an adult.
See R. 365 (Exhibit 21F).
The ALJ also examined whether Dr. Paul’s opinions had
support from medical signs and laboratory findings and whether
the opinions were consistent with the record as a whole. R. 28
(finding the opinions inconsistent with Dr. Paul’s own treatment
Page 44 of 52

notes and the objective record). The ALJ noted that Dr. Paul’s
opinions were inconsistent with other medical evidence in the
record. R. 28 (citing evidence).
Crumpler argues that the ALJ failed to acknowledge that Dr.
Paul’s opinions were internally consistent with one another.
However, his opinions were not internally consistent.
On the September 2009 form, Dr. Paul noted that Crumpler
could not stand, walk, sit, or drive for any hours in an 8-hour work
day. Exhibit 21F, R. 365. On the May 2010 Form, Dr. Paul did not
mark that Crumpler had any physical impairments but listed Class
4 mental impairments (unable to engage in stress situations). He
also marked that Crumpler had no limitation on functional capacity
(marking “Class 1 (No Limitation)”). Exhibit 21F, R. 363. On the
August 2010 form, Dr. Paul marked that Crumpler had no change
in condition but marked that Crumpler’s physical impairments were
severe and that Crumpler was incapable of sedentary activity.
Exhibit 17F, R. 354 (marking physical impairments as “Class 4”
and functional capacity as “Class 4 (Complete limitation)”). Dr.
Paul also marked that Crumpler only had slight limitations with

Page 45 of 52

regard to her mental impairments. Id. (marking “Class 2”). Clearly,
these documents are internally inconsistent.
Finally, Crumpler argues the ALJ erred by finding that Dr.
Paul was not a specialist. R. 28. Crumpler argues this finding was
in error because Dr. Paul is a specialist in internal medicine and
immunology.
However, Dr. Paul did not give an opinion on an issue of
internal medicine or immunology, his area of specialty. See 20
C.F.R. § 404.1527 (“We generally give more weight to the opinion of
a specialist about medical issues related to his or her area of
specialty than to the opinion of a source who is not a specialist”).
In fact, Dr. Paul referred Crumpler to Dr. VanFleet, an orthopedist,
for her back problems. Therefore, the ALJ correctly found that Dr.
Paul was not a specialist in the area on which he was offering an
opinion.
The ALJ applied the relevant factors when determining the
weight to give Dr. Paul’s opinions.
B. The ALJ’s Credibility Determination is Not Patently Wrong
Crumpler next challenges the ALJ’s credibility finding.
Crumpler argues that the ALJ’s explanation for discrediting
Page 46 of 52

Crumpler’s testimony was meaningless boilerplate. Crumpler also
asserts that the ALJ failed to consider all of the relevant factors.
Crumpler states that the one factor the ALJ did consider—
Crumpler’s daily activities—were misrepresented and the ALJ
improperly imputed to Crumpler the ability to perform sporadic
daily activities as showing that she could work on a regular and
continuous basis.
This Court will not reverse the credibility determinations of the
ALJ unless the determinations lack any explanation or support in
the record. Simila v. Astrue, 573 F.3d 503, 517 (7th Cir. 2009).
Moreover, an ALJ’s credibility determinations are entitled to “special
deference.” Schomas v. Colvin, 732 F.3d 702, 708 (7th Cir. 2013).
“SSR 96-7p provides a two-step test for adjudicators to follow
when evaluating a claimant’s symptoms such as pain.” Maske v.
Astrue, 2012 WL 1988442, at *11 (N.D. Ill. 2010), citing SSR 96-7p,
Titles II and XVI: Evaluation of Symptoms in Disability Claims;
Assessing the Credibility of an Individual’s Statements, 61 Fed. Reg.
34483, 34484-85 (July 2, 1996). First, “the adjudicator must
consider whether there is an underlying medically determinable
physical or mental impairment(s) . . . that could reasonably be
Page 47 of 52

expected to produce the individual’s pain or other symptoms.” SSR
96-7p., 61 Fed. Reg. at 34484. Second, if there is such an
impairment, “the adjudicator must evaluate the intensity,
persistence, and limiting effects of the individual’s symptoms to
determine the extent to which the symptoms limit the individual’s
ability to do basic work activities.” Id. at 34485; see also 20 C.F.R.
§ 404.1529 (detailing how a claimant’s symptoms will be evaluated).
If the claimant’s statements about her symptoms are not
substantiated by objective medical evidence, the “adjudicator must
make a finding on the credibility of the individual’s statements
based on a consideration of the entire case record.” 61Fed. Reg. at
34484; see also Doering v. Astrue, 2012 WL 1418851, *3 (N.D. Ill.
2012) (“An ALJ may not discredit a claimant’s subjective complaints
of pain and limitations solely because of a lack of corroborating
medical evidence”). The ALJ must consider the individual’s daily
activities; the location, duration, frequency, and intensity of the
individual’s pain or other symptoms; factors that precipitate and
aggravate the symptoms; medication taken to alleviate the pain or
symptoms; treatment received for relief of the pain or other
symptoms; and other measures the individual uses to relieve the
Page 48 of 52

pain or symptoms. Id. at 34485; see also Sienkiewicz v. Barnhart,
409 F.3d 798, 804 (7th Cir. 2005) (noting that while an “ALJ may
not disregard an applicant’s subjective complaints of pain simply
because they are not fully supported by objective medical evidence
. . . a discrepancy between the degree of pain claimed by the
applicant and that suggested by medical records is probative of
exaggeration”).
As noted above, the ALJ found that while Crumpler’s
“medically determinable impairments could reasonably be expected
to cause some symptoms,” Crumpler’s “statements concerning the
intensity, persistence and limiting effects of these symptoms are not
credible to the extent they are inconsistent with the above residual
functional capacity assessment.” R. 24. Although the Seventh
Circuit has criticized the use of such “boilerplate language,” the
inclusion of that language is harmless if the ALJ otherwise
adequately explains her conclusion. Filus v. Astrue, 694 F. 3d 863,
868 (7th Cir. 2012).
In this case, the ALJ explained her conclusion. The ALJ
noted that Crumpler testified she could only sit for five minutes but
was able to take a car trip from Illinois to North Carolina two weeks
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prior to the hearing, took a car trip from Florida to Illinois in July of
2009 (Ex. 5F, p.3; r. 282) and sat at the hearing for longer than five
minutes. R. 24.
The ALJ also detailed the medical evidence, which she found
did not demonstrate medical findings to support the degree of
symptoms identified by Crumpler. R. 24. The ALJ noted that
although Crumpler testified she has poor grip, she is able to smoke
10 to 20 cigarettes a day and manipulate the cigarette package and
her cigarettes. She is also able to use a home computer. Further,
she exhibited no weakness in her hands at the April 16, 2010
examination with Dr. VanFleet. R. 25, citing R. 350 (Dr. VanFleet
treatment note).
After detailing the medical records, the ALJ concluded that
Crumpler’s physical impairments did limit Crumpler’s overall level
of functioning but that the evidence did not establish that the
impairments are disabling. R. 28. The ALJ stated that the medical
evidence, laboratory findings, and Crumpler’s reported activities
indicate her functioning is not as limiting as she alleges, and the
ALJ did not find the testimony of the claimant – that she was

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unable to sustain any full-time work activities – supported by the
record. R. 28.
The ALJ noted that Crumpler lived independently with a small
dog, drives a truck, shops for groceries, fixes light meals, makes
coffee, walks around, goes on-line to send emails, sits on the porch,
and otherwise sits, stands, walks throughout any eight hour period.
R. 28. Crumpler also traveled to North Carolina two weeks prior to
the hearing to see her boyfriend and recently went to Lincoln,
Illinois, to drive through a state park. Crumpler testified that she
has help with housework, likes to nap, and takes longer to take
care of her personal hygiene. R. 28. The ALJ found that Crumpler
engages in daily activities that demonstrate the ability to sit, stand,
walk, lift light items, and otherwise perform work-like activity and
has not demonstrated with credible evidence that she is unable to
sustain such activity in a full-time job. R. 28.
The ALJ properly relied on the objective medical evidence and
other evidence that contradicted the credibility of Crumpler’s
claims. Arnold v. Barnhart, 473 F. 3d 816, 823 (7th Cir. 2007)
(wherein the ALJ relied on the neutral medical expert’s testimony
and the fact that the claimant’s daily activities showed he only had
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mild restrictions, among other factors); Mueller v. Astrue, 860 F.
Supp. 2d 615, 633 (N.D. Ill. 2012) (noting that the claimant’s
“subjective complains were not required to be accepted insofar as
they clashed with other, objective medical evidence in the record”).
Crumpler also argues the ALJ misrepresented her daily
activities but does not identify the misrepresentations. Therefore,
she has forfeited this argument.
Because the ALJ provided specific reasons for her credibility
finding, and those reasons are supported by the record, the ALJ’s
credibility determination will not be overturned.
IV. CONCLUSION
For the reasons stated, Crumpler’s Motion for Summary
Judgment (d/e 14) is DENIED, and the Motion for Summary
Affirmance filed by Defendant Commissioner of Social Security (d/e
16) is GRANTED. The decision of the Commissioner is AFFIRMED.
This case is closed.
ENTER: June 16, 2014
FOR THE COURT:
s/Sue E. Myerscough
SUE E. MYERSCOUGH
UNITED STATES DISTRICT JUDGE
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