McGraw v. Commissioner of Social Security

Filing 18

OPINION BY TOM SCHANZLE-HASKINS, U.S. MAGISTRATE JUDGE: IT IS ORDERED that the Defendant Commissioner's Motion for Summary Affirmance (d/e 15 ) is ALLOWED; Plaintiff Thelma I McGraw's Motion for Summary Judgment titled Brief in Support of Motion for Summary Judgment (d/e 14 ) is DENIED; and the decision of the Commissioner is AFFIRMED. All pending motions are denied as moot. THIS CASE IS CLOSED. SEE WRITTEN OPINION. Entered on 6/22/2018. (MJC, ilcd)

E-FILED

Tuesday, 26 June, 2018 03:58:55 PM
Clerk, U.S. District Court, ILCD

IN THE UNITED STATES DISTRICT COURT
FOR THE CENTRAL DISTRICT OF ILLINOIS, SPRINGFIELD DIVISION
THELMA I. McGRAW,
Plaintiff,
v.
NANCY A. BERRYHILL,
Acting Commissioner
of Social Security,
Defendant.

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No. 17-cv-3165

OPINION
TOM SCHANZLE-HASKINS, U.S. MAGISTRATE JUDGE:
Plaintiff Thelma I. McGraw appeals from the denial of her application
for Social Security Disability Insurance Benefits (Disability Benefits) under
Title II of the Social Security Act. 42 U.S.C. §§ 416(i) and 423. This appeal
is brought pursuant to 42 U.S.C. § 405(g). McGraw filed a Motion for
Summary Judgment titled Brief in Support of Motion for Summary
Judgment (d/e 14). The Defendant Commissioner filed a Motion for
Summary Judgment entitled Motion for Summary Affirmance (d/e 15).
McGraw filed a Reply (d/e 17) to Defendant’s Motion for Summary
Judgment. The parties consented to proceed before this Court. Consent
to the Exercise of Jurisdiction by a United States Magistrate Judge and
Reference Order entered January 2, 2018 (d/e 13). For the reasons set
Page 1 of 42

forth below, the Commissioner’s Motion for Summary Judgment is
ALLOWED, McGraw’s Motion for Summary Judgment is DENIED, and the
decision of the Commissioner is AFFIRMED.
STATEMENT OF FACTS
McGraw was born on September 3, 1951. She secured a GED and
took some college courses. She previously worked as a
coordinator/receptionist—secretary. She alleged that she became disabled
on June 1, 2012 (Onset Date). She qualified for Disability Benefits through
December 31, 2015 (Date Last Insured). McGraw suffers from status post
breast cancer surgery and treatment, status post shoulder surgery and hip
surgery, left knee arthritis, diabetes, obesity, asthma, gastroesophageal
reflux disease (GERD), and vision impairments. Certified Copy of
Transcript of Proceedings before the Social Security Administration (d/e 11)
(R.), at 22, 24-25, 59, 61-62, 227.
In 2002, McGraw underwent right hip replacement surgery. R. 72.
She also underwent shoulder replacement surgery on each shoulder, one
in 2004 and the other in 2007. R. 71; see e.g., R. 490. She continued
working until April 2010. She retired at that time to take care of her
husband. She has not worked thereafter. R. 80, 227, 234.

Page 2 of 42

On March 13, 2011, McGraw underwent a chest x-ray due to a cough
and congestion. The x-ray showed some scarring in the left mid lung, but
no acute pulmonary abnormalities, and no other abnormalities. R. 354.
On January 24, 2012, McGraw saw Dr. Venu Reddy, M.D., for a
follow-up examination after a pulmonary function test (PFT), methacholine
challenge, sleep study, and chest x-ray. R. 577-79. McGraw reported that
she was not able to sleep well. She reported severe insomnia. The PFT
and methacholine challenge were normal. The sleep study showed no
evidence of obstructive sleep apnea. On examination, McGraw’s lungs
were clear bilaterally to auscultation. Dr. Reddy assessed cough with
unclear etiology, no evidence of sleep apnea, and moderate to morbid
obesity. R. 578.
On June 20, 2012, McGraw underwent a mammogram, which
identified lumps in her right breast. Subsequent biopsies established that
she had breast cancer. Later in June 2012, McGraw underwent a
lumpectomy, and then a right modified radical mastectomy and a
prophylactic left mastectomy. R. 472.
On August 31, 2012, McGraw saw Dr. Mark Khil, M.D., for evaluation
and consideration for radiation therapy. R. 473. McGraw reported that she
had no headaches, dizziness, blurry vision, or episodes of seizures or
Page 3 of 42

strokes. She reported a history of insomnia. On examination, McGraw
was 5 feet 3 ½ inches tall and weighed 288 pounds. Dr. Khil
recommended chemotherapy followed by radiation. McGraw had already
seen Dr. Christian El-Khoury, M.D., to schedule the chemotherapy.
McGraw agreed to Dr. Khil’s planned radiation therapy. R. 475.
On November 20 2012, McGraw saw nurse practitioner Lisa
Kauffman, CNP, for a follow-up visit during chemotherapy. McGraw was
receiving six cycles chemotherapy treatment every 21 days. McGraw
reported that she was feeling better, but had moderate fatigue. Her chest
x-ray taken November 14, 2012, was clear. McGraw reported numbness in
her toes. On examination, her lungs were clear to auscultation. Her blood
sugar was 178. Kauffman assessed breast carcinoma and fatigue. R. 38788.
On December 5, 2012, McGraw saw Dr. El-Khoury for a follow-up
during her chemotherapy treatments. McGraw’s toes hurt “without much
neuropathy.” The toes were slightly red and swollen. On examination,
McGraw’s lungs were clear. Dr. El-Khoury noted that McGraw would
receive her last chemotherapy treatment on December 20, 2012. R. 391.
On January 30, 2013, McGraw saw Dr. Raymond P. Smith, M.D. Dr.
Smith stated that McGraw received her last chemotherapy treatment on
Page 4 of 42

January 9, 2013. On examination, McGraw’s lungs were clear with no
rales, rhonchi, or wheezes. Her blood sugar was 168. McGraw reported
that she had her best night’s sleep in months. Dr. Smith stated that she
would continue the recovery from chemotherapy phase of her treatment.
R. 402.
On March 12, 2013, McGraw saw Dr. El Khoury for a follow-up.
McGraw was undergoing physical therapy for lymphedema. McGraw
reported not having much pain. She reported some pain in the left popliteal
area.1 She also had grade I neuropathy, which was improving. Her fatigue
was also better. R. 408. Dr. El Khoury planned a “Doppler” to see if she
had a popliteal cyst. R. 409.
Radiation therapy followed the chemotherapy. On April 3, 2013,
McGraw completed the radiation therapy. R. 477.
On April 29, 2013, McGraw saw Dr. Christopher Wagoner for a threemonth diabetes check. R. 523-26. McGraw’s A1c was “fantastic at 6.0.”2
McGraw denied having blurry vision. R. 523. On examination, McGraw
had normal breath sounds. She had a normal gait, no joint swelling,

1

The popliteal area is the posterior part of the knee. Dorland’s Illustrated Medical Dictionary (32d ed.
2013) (Dorland’s), at 1496.
2
The hemoglobin A1c test determines the percentage of red blood cells that are glycated, or covered
with sugar. The test reflects that average blood sugar level for the preceding two or three months. “A1c
test” available at www.mayoclinic.org/tests-procedures/a1c-test/about/pac-20384643, viewed March 20,
2018.

Page 5 of 42

normal movement in all extremities, no joint instability, and normal muscle
strength and tone. McGraw’s feet were swollen. Her toes appeared
normal. R. 526. Dr. Wagoner noted that McGraw’s asthma was controlled.
He adjusted her insulin dosage. R. 526.
On May 2, 2013, McGraw saw Dr. Khil for a post-radiation treatment
follow-up. McGraw was stable and otherwise unremarkable. Dr. Khil
scheduled McGraw for a follow-up appointment in six months. R. 480.
On or about May 8, 2013, McGraw completed a Function Report—
Adult form. R. 264-71.3 She reported that she lived in a house with family.
She said she required “lots of rest.” R. 264. She said that in a usual day,
she showered and dressed, prepared meals for herself and her husband,
did simple housework and laundry, drove to laundromat, grocery, and
“many” doctors’ appointments for herself and her husband. R. 265. She
said she could not do “heavy housework, yard work, drive as much as
needed. Carry things heavy.” She said she had problems sleeping. R. 265.
McGraw said she prepared simple meals because she could not
stand for long periods. She said she washed dishes and performed “simple
cleaning,” laundry, and cooking. She said her sons and brothers did the
“heavy work,” yardwork, and carrying for her. R. 266. She said she could

3

McGraw did not date the form. The date on the transmittal letter is May 8, 2013.

Page 6 of 42

not do yardwork because she felt weak, she tired easily, and she often did
not feel well. R. 267. She went grocery shopping three times a week so
she could buy a “little bit at a time” because she could not carry much. R.
267. She rode scooters while in grocery stores. R. 270. She was able to
pay her bills, handle her own funds. R. 267.
She said her hobby was researching genealogies. She used a
computer to conduct this research. She did not use the computer more
than three times a week because she tired easily. She talked to friends
and relatives on the phone and went to church regularly. R. 268-69.
McGraw opined that she could not lift more than 10 pounds; she
could walk 50 feet before she needed to rest 10 to 30 minutes; she could
pay attention one to three hours; she finished what she started unless she
was tired; she could follow instructions and get along with authority figures;
and she could handle stress and changes in routine. R. 269-70.
On August 26, 2013, McGraw saw Dr. Christopher Wagoner, M.D.,
for a diabetes check. R. 501-05. Her blood sugar logs ranged from 141 to
377 with an average reading of 233. McGraw reported that she was
fatigued; but she had no shortness of breath, no wheezing, and no cough.
She reported joint pain and muscle aches; but no joint swelling, stiffness,
muscle weakness, or loss of strength. She had no headaches, no
Page 7 of 42

numbness, no tingling. R. 501. On examination, she had clear breath
sounds bilaterally, a normal gait, normal movement of all extremities, no
joint swelling, no joint instability, and normal muscle strength and tone. Dr.
Wagoner assessed stress and prescribed amitriptyline to reduce stress and
help McGraw sleep. R. 505.
The same day August 26, 2013, McGraw saw state agency physician
Dr. Joseph Kozma, M.D., for a consultative examination. R. 482-87.
McGraw reported that she last worked in April of 2009. She reported that
she had diabetes and her last A1c was 7.2. She reported she had diarrhea
after every meal. She said she was not able to walk a block. She said she
was unstable when she walked. She did not use a cane or crutches. R.
482. She reported that she had migraines occasionally. She said her
diabetes was poorly controlled. She said she had diabetic neuropathy in
her legs. R. 483.
On examination by Dr. Kozma, McGraw was 63 inches tall and
weighed 272 pounds. McGraw’s visual acuity was 20/20 with correction.
McGraw’s lungs were clear to percussion and auscultation. McGraw had
normal strength in her extremities. McGraw had decreased range of
motion in her shoulders. She had normal grip strength and normal finger
dexterity. Sensory examination and reflexes were normal. R. 484-85.
Page 8 of 42

McGraw could heel walk and toe walk. She could squat ¾ of the
way. Straight leg raising was 50 degrees bilaterally. She had a normal
gait. Dr. Kozma observed no instability in her walking. McGraw could use
her hands for both fine and gross manipulations. R. 485-86.
Dr. Kozma stated that McGraw “has a rather strong emotional
attachment to her various symptoms. She is rather convinced that they are
quite incapacitating.” R. 486. Her medical records indicated that her
hypertension and diabetes were not well controlled. R. 486.
On August 28, 2013, state agency physician Dr. B. Rock Oh, M.D.,
prepared a Physical Residual Functional Capacity Assessment of McGraw.
Dr. Oh opined that McGraw could occasionally lift 20 pounds and frequently
lift 10 pounds; could stand and/or walk six hours in an eight-hour workday;
could sit six hours in an eight-hour workday; could frequently climb stairs
and ramps; could occasionally climb ladders, ropes, and scaffolds; and was
limited in reaching overhead with her right arm. Dr. Oh opined that
McGraw had no other functional limitations due to her impairments. R. 9395
On September 9, 2013, McGraw saw Dr. Wagoner for a two-week
checkup after starting protonix for GERD. R. 489-93 On examination,
McGraw’s lungs had clear bilateral breath sounds and no cough. McGraw
Page 9 of 42

had a normal gait, no joint swelling, normal movement of all extremities, no
joint instability, muscle strength and tone were normal. R. 492. Dr.
Wagoner assessed essential hypertension, depression, GERD, and
insomnia. R. 493.
On February 18, 2014, McGraw completed another Function
Report—Adult form. R. 287-95. She reported that she lived alone in her
house. She said that she could not sleep for up to five days at a time. She
did not sleep well even when she went to sleep. She said she had no
stamina. She said she carried groceries “in stages” or she used a
children’s toy wagon to carry them. She said she did not have much
strength. R. 287.
She said that she shopped only for necessities. She also went to the
laundromat and visited her husband at the nursing home where he resided.
He husband had dementia. She said she could not drive for more than 45
minutes. She said her insomnia has gotten worse since the last report. R.
288.
McGraw reported that she prepared her own meals. She prepared
“quick simple things” because she could not stand for long periods. She no
longer prepared big family meals. She did laundry, dishes, and light
vacuuming with breaks. R. 289. She did no yardwork. R. 290. She drove
Page 10 of 42

to the nursing home daily to see her husband. She shopped only when
necessary. She could pay her bills and manage her funds. R. 290.
McGraw described her hobbies as “Reading, genealogies, TV,
grandkids.” She sat in a wheelchair when she went anywhere with her
grandchildren. She visited with others during the day, which included
eating with them and going to movies with them. She went regularly to
church, the nursing home, and the pharmacy. R. 291.
McGraw opined that the farthest distance she could walk was “to the
car.” She then had to rest 10 to 15 minutes. She had no problems paying
attention. She finished what she started “unless I fall asleep.” She could
follow instructions and get along with authority figures. She tried to handle
stress, but “when it is too much I cry.” She could handle changes in
routine. R. 292-93.
On February 24, 2014, McGraw’s aunt Marva Hurst completed a
Function Report—Adult—Third Party form. R. 299-306. Hurst said that
she spent two to five hours with McGraw daily. Hurst said they ate
together, watched television, and went shopping. She said McGraw could
not stand or walk very long before her knee gave out. She said McGraw
could not carry much and had a difficult time catching her breath. Hurst

Page 11 of 42

said McGraw spent her days going to the doctor, the pharmacy, the
laundromat, the nursing home, and visiting her. R. 299.
Hurst said McGraw had trouble sleeping. Hurst said McGraw had
difficulty bending to dress and wash herself. R. 300. Hurst said that
McGraw prepared her own meals, but did not take much time doing so.
Hurst said McGraw did her own laundry and “basic housework.” Hurst said
McGraw needed help carrying laundry to and from the laundromat. R. 301.
She said McGraw’s sons did the yardwork. She said McGraw used a
motorized grocery cart to shop for groceries. She said McGraw could pay
her bills and manager her funds. R. 302.
Hurst said that McGraw visited her husband daily. She said McGraw
also visited friends and family, including Hurst. McGraw also went to
church. McGraw had someone accompany her when she drove out of
town. R. 303.
Hurst opined that McGraw could lift a maximum of 10 pounds;
McGraw could not squat or bend; could not stand for long; and could walk
50 feet before needing to rest for 10-15 minutes. Hurst said McGraw could
pay attention, follow instructions, get along with authority figures, handle
stress, and handle changes in circumstances. R. 304-05.

Page 12 of 42

On March 26, 2014, state agency physician Dr. Michael Nenaber,
M.D., prepared a Physical Residual Functional Capacity Assessment of
McGraw. R. 103-05. Dr. Nenaber’s assessment was identical to Dr. Oh’s
assessment in August 2013.
On September 19, 2014, McGraw saw ophthalmologist Dr. Robert
Weller, M.D., for a diabetic eye examination. R. 703-05. McGraw’s visual
acuity was 20/30+2 in the right and 20/20 in the left. R. 703. Dr. Weller
diagnosed senile cataracts in both eyes and non-exudative senile macular
degeneration of the retina in the right eye. R. 703.4
On November 7, 2014, McGraw saw Dr. Wagoner for a three-month
diabetes check. R. 758-63. McGraw’s A1c was 6.0, no change from
previous check. McGraw reported headaches in the evenings sometimes.
The headaches resolved “quickly/spontaneously.” R. 758. On
examination, McGraw had clear bilateral breath sounds, normal gait, no
joint swelling or joint instability, normal movement of all extremities, normal
muscle strength and tone, and full range of motion in the extremities. R.
762. Dr. Wagoner adjusted McGraw’s diabetes medication. R. 762.

4

Non-exudative senile macular degeneration is age-related degeneration of the spot in the center of the
retina called the macula, also known as dry macular degeneration. Macular degeneration reduces the
person’s ability to see directly in front of the person. See National Eye Institute, “Facts About AgeRelated Macular Degeneration,” located at https://nei.nih.gov/health/maculardegen/armd_facts, viewed
March 20, 2018.

Page 13 of 42

On February 9, 2015, McGraw saw Dr. Wagoner for a three-month
diabetes check. R. 850-54. McGraw reported her blood sugar was running
120-130, and she was having headaches and fatigue. R. 850. On
examination, McGraw had normal breath sounds bilaterally, normal gait, no
joint swelling, normal movement in all extremities, no joint instability,
normal muscle strength and tone, and full range of motion in her
extremities. McGraw’s feet and toes were not swollen. McGraw had
normal tactile sensation with monofilament testing, normal position sense,
and normal vibratory sensation bilaterally. R. 853-54. Dr. Wagoner
assessed diabetes mellitus type II, controlled. R. 854.
On April 15, 2015, McGraw saw ophthalmologist and retina specialist
Dr. Kevin Blinder, M.D. McGraw’s vision was 20/50-2 in the right eye and
20/20 in the left. McGraw had cataracts in both eyes and sub-retinal fluid in
the right eye. Her retinas were attached in both eyes. She had no leakage
of fluid out of either eye. Dr. Blinder assessed cataracts in both eyes, right
worse than left; and possible central serous chorioretinopathy.5 Dr. Blinder
recommended removing the right cataract. R. 901.

5

Central serous chorioretinopathy is a build-up of fluid between the retina and the layer of tissue under
the retina called the choroid. American Association of Ophthalmology, author Daniel Porter, “What is
Central Serous Chorioretinopathy?,” located at www.aao.org/eye-health/diseases/what-is-central-serousretinopathy, viewed March 20, 2018.

Page 14 of 42

On April 28, 2015, McGraw saw ophthalmologist Dr. Robert Weller,
M.D., for a pre-operative visit. R. 875. On May 12, 2015, Dr. Weller
performed the surgical removal of McGraw’s cataract in her right eye. R.
996.
On June 3, 2015, McGraw saw Dr. Blinder. McGraw’s visual acuity
was 20/50-1 in the right eye and 20/40 in the left. Dr. Blinder found subretinal fluid in the right eye, but none in the left. Dr. Blinder’s impression
was possibly central serous chorioretinopathy and pseudophakia in the
right eye and cataract in the left.6 Dr. Blinder treated her right eye with an
injection. R. 909. The injection consent form stated that the diagnosis was
age-related macular degeneration. R. 911.
On July 22, 2015, McGraw saw Dr. Blinder. McGraw’s visual acuity
was 20/50 in the right eye and 20/40-2 in the left. Dr. Blinder’s examination
showed pseudophakia in the right eye and a cataract in the left. Dr.
Blinder’s impression was probable occult choroidal neovascularization of
the right eye versus central serous chorioretinopathy.7 On July 22, 2018,
Dr. Blinder again treated her right eye with an injection. R. 919.

6
Pseudophakia is the artificial lens implanted after cataract surgery. National Eye Institute, “Cataract |
Pseudophakia,” located at https://nei.nih.gov/faqs/cataract-pseudophakia, viewed March 20, 2018.
7
Choroidal neovascularization is the abnormal growth of new blood vessels in the choroid layer of the
eye under the retina, also known as wet macular degeneration. American Macular Degeneration
Foundation, “Wet Macular Degeneration,” located at https://www.macular.org/wet-amd, viewed March 20,
2018.

Page 15 of 42

On July 31, 2015, McGraw saw podiatrist Dr. Duane Hanzel, D.P.M.,
for thickened and discolored toenails, and a routine clinic follow-up of
diabetic feet. R. 836-40. On examination, McGraw had abnormal dorsalis
pendis pulse and abnormal capillary refill.8 She had normal response to
light touch and normal response to monofilament testing. R. 839. Dr.
Hanzel assessed peripheral neuropathy and debrided her toenails. R. 83940.
On September 3, 2015, McGraw saw Dr. Blinder. McGraw’s visual
acuity was 20/50+ in the right eye and 20/30 in the left. Examination
showed pseudophakia in the right eye and cataract in the left. Dr. Blinder’s
impression was central serous chorioretinopathy in the right eye, possibly
choroidal neovascularization; pseudophakia in the right eye; and cataract in
the left. McGraw agreed to undergo a laser treatment in her right eye in the
near future. R. 924.
On September 29, 2015, McGraw saw Br. Blinder. McGraw reported
that her vision was out of focus in both eyes at night. R. 929. McGraw’s
visual acuity was 20/60-2 in the right eye and 20/40+2 in the left. R. 934.

8
The dorsalis pendis pulse is the pulse on the top of the foot between the first and second metatarsal
bones. Dorland’s, at 1554. Capillary refill refers to applying blanching pressure to the toes and
measuring the time it takes for them to regain color. Abnormally long capillary refill time (greater than 3
seconds) indicates poor blood flow. University Foot & Ankle Institute, “Diabetic Food Exam: What to
Expect,” located at https://www.footankleinstitute.com/diabetic-foot-exam-what-to-expect, viewed March
20, 2018.

Page 16 of 42

McGraw had a laser treatment called photodynamic therapy in the right eye
to treat her central serous chorioretinopathy.9 R. 928.
On October 9, 2015, McGraw saw Dr. Hanzel for a routine follow up
on her diabetic feet and toenail disease. R. 820-24. On examination,
McGraw had abnormal dorsalis pedis pulse and abnormal papillary refill.
McGraw had normal response to light touch and normal response to
monofilament testing. R. 823. Dr. Hanzel assessed peripheral neuropathy
and debrided her toenails. R. 823-24.
On November 6, 2015, McGraw saw Dr. Blinder. McGraw reported
blurred vision, flashes, and light sensitivity in the right eye since October
23, 2015. McGraw’s visual acuity was 20/200 in the right corrected by
pinhole to 20/60-2; her acuity was 20/20-1 in the left. R. 935. Dr. Blinder’s
impression was cataract in the left eye; and in the right eye a round hole in
the macula portion of her retina, a retinal hemorrhage, central serous
choriorentopathy, a vitreous hemorrhage, posterior vitreous detachment
(PVD), and pseudophakia.10 McGraw underwent a laser panretinal

9

Photodynamic therapy involves injection of a light sensitive medicine into the arm. The medicine
collects in abnormal blood vessels behind the retina. A laser is directed into the eye. The medicine
reacts and creates clots in the abnormal vessels to prevent more vision loss. Johns Hopkins Medicine
Health Library, “What is Photodynamic Therapy for Age-Related Macular Degeneration,” located at
www.hopkinsmedicine.org/healthlibrary/test_procedures/other/photodynamic_therapy_for_agerelated_macular_degeneration_135,362, viewed March 20, 2018.
10
Posterior vitreous detachment occurs when the vitreous substance in the eye detaches from the retina.
American Academy of Ophthalmology, author Daniel Porter, “What is Posterior Vitreous Detachment,”
located at www.aao.org/eye-health/diseases/what-is-posterior-vitreous-detachment, viewed March 20,
2018.

Page 17 of 42

photocoagulation treatment to her right retina to treat the hole in the
macula.11 R. 936.
On December 9, 2015, McGraw saw Dr. Blinder. McGraw reported
that she no longer saw flashes and floaters in her right eye, but still had
constant blurry vision. On examination, McGraw had good laser scars
around the hole in her macula. McGraw’s visual acuity was 20/60 in the
right eye and 20/25 in the left. Dr. Blinder told her she was doing well at
this point and would see her in two months. R. 946.
On December 10, 2015, McGraw saw otolaryngologist Dr. Douglas
Phan, M.D., for a follow-up appointment for chronic mastoiditis. R. 106266. Dr. Phan noted that McGraw had the following active problems:
Active Problems
 Altered mental status
 Arthritis of left knee
 Asthma
 Balance problems
 Chronic daily headache
 Chronic mastoiditis
 Decreased level of consciousness
 Depression
 Diabetes mellitus type II, controlled
 Essential (primary) hypertension
 Gastroesophageal reflux disease
 Hyperlipidemia
 Ingrown toenail
 Insomnia
11

Dr. Bowen testified that photocoagulation treatment was a treatment in which Dr. Blinder used laser to
close the hole in McGraw’s macula portion of her retina. R. 45.

Page 18 of 42












Left knee pain
Locking of left knee
Onychauxis
Onychomycosis
Otitis externa
Peripheral neuropathy
Polyp, nasal sinus
Sensorineural hearing loss of both ears
Sinusitis, chronic
Sleep-wake cycle disorder

R. 1062 (emphasis in the original, diagnostic codes omitted). On
examination, Dr. Phan assessed mucocele of maxillary sinus. Dr. Phan
scheduled a CT scan without contrast of McGraw’s sinuses to document or
rule out the recurrence of the mucocele. R. 1065-66.12
On December 21, 2015, McGraw underwent a CT scan of her
sinuses. R. 1027-28. The CT scan showed normal sinuses with nasal
mucosal thickening. R. R. 1028.
On January 5, 2016, McGraw saw nurse practitioner Charlene
Young, FNP-C, complaining of problems sleeping and tiredness. R. 100710. On examination, McGraw had intact visual fields and visual acuity.
McGraw walked with a limp and used a cane. She had normal strength,
intact muscle tone, and no muscle atrophy. R. 1009-10. Young scheduled
a sleep study. R. 1010.

12

A mucocele is a dilatation of a cavity with accumulation of mucous secretion. Dorland’s, at 1185.

Page 19 of 42

On January 15, 2016, McGraw saw Dr. Hanzel for a routine follow-up
on toenail disease. R. 1056-60. On examination, McGraw had abnormal
dorsalis pedis pulse and abnormal capillary refill. McGraw had normal
response to light touch and normal response to monofilament testing. Dr.
Hanzel assessed peripheral neuropathy and ingrown toenail. R. 1059. Dr.
Hanzel debrided McGraw’s toenails. R. 1060.
On January 20, 2016, McGraw saw Dr. Wagoner for a three-month
diabetes check. R. 1049-54. McGraw reported swelling in her feet, ankles,
lower legs, and hands. McGraw said her left knee was “painful and
collapsing a lot.” R. 1049. On examination, McGraw had clear breath
sounds bilaterally, normal gait, no joint swelling, normal movement of all
extremities, no joint instability, normal muscle strength and tone, and full
range of motion in her extremities. Dr. Wagoner assessed that McGraw’s
diabetes was controlled. Dr. Wagoner changed McGraw’s asthma
medicine from daily Advair to Proair on an as needed basis. Dr. Wagoner
noted that McGraw, “apparently doesn’t even have evidence in the past of
asthma nor COPD anyway.” Dr. Wagoner noted that McGraw used a cane
and needed assistance with mobility. R. 1053-54.
On January 25, 2016, McGraw saw Dr. Phan for a follow up after the
CT scan of her sinuses. R. 1043-47. Dr. Phan noted that the CT scan
Page 20 of 42

showed that the mucocele has resolved. Dr. Phan assessed mucocele of
the maxillary sinuses resolved on follow up sinus CT. R. 1047.
On February 4, 2016, McGraw underwent a CT scan of her chest.
The scan showed nodules in her right lung, atelectasis at the lingula and
lung bases, and indications of air trapping. R. 1035.13
On February 19, 2016, McGraw saw Dr. Blinder. McGraw’s visual
acuity was 20/80+1 in the right eye and 20/25 in the left. R. 1093. The
condition of McGraw’s eyes had not changed since the last time Dr. Blinder
examined her. Dr. Blinder performed a photodynamic therapy treatment on
her right eye. R. 1094.
On March 21, 2016, McGraw saw Dr. Wagoner for a diabetes check.
R. 1098-1104. McGraw’s A1c “skyrocketed from 6.6 to 13.3. Hasn’t been
above 6.7 in over two years.” R. 1098. Dr. Wagoner said a recent sleep
study showed moderate to severe obstructive sleep apnea. She was
waiting for a CPAP machine to use at night. Dr. Wagoner said she saw a
pulmonologist for pulmonary nodules. A PFT was scheduled for April 18,
2016. R. 1098. McGraw was 5 feet 3 inches tall and weighed 265 pounds.
On examination, McGraw’s lungs were clear to auscultation. McGraw had

13

Atelectasis is incomplete expansion of the lungs. Dorland’s, at 171. Lingula of the lung is a projection
from the lower portion of the upper lobe of the left lung. Dorland’s, at 1060.

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normal range of motion, no joint swelling, normal muscle strength and tone.
Her gait was antalgic on the left. Dr. Wagoner told McGraw to continue
checking her blood sugar and return in three months. R. 1104.
THE EVIDENTIARY HEARINGS
The January 7, 2016 Hearing
On January 7, 2016, the Administrative Law Judge (ALJ) conducted
an evidentiary hearing. R. 55-88. McGraw appeared in person and with
her counsel. Vocational expert Alissa Smith also appeared. R. 57; see R.
327-28 (resume of Alissa Smith).
McGraw testified first. She said she was married. Her husband was
in a nursing home.14 She said she was 5 feet 3 ½ inches tall and weighed
273 pounds. McGraw lived in a house with a wheel chair ramp accessing
the entrance. R. 60-61.
McGraw used a cane at the hearing. She began using the cane a
month before the hearing. She indicated she had a torn meniscus in her
left knee. Her sons asked her to use the cane for stability when walking.
She made her doctor aware of the cane. R. 61-62.
McGraw had completed some college. McGraw said she last worked
as a coordinator/receptionist—secretary at the Illinois Department of

14

The medical records contain a notation that her husband died in February 2016. R. 1096.

Page 22 of 42

Human Services. The job ended in 2010. She said she was on her feet
two hours a day. The heaviest weight she lifted was 15-20 pounds. R. 62.
She stopped working when she retired from her job to take care of her
husband. R. 80.
McGraw testified she became disabled in June 2012 when she began
her treatments for breast cancer. R. 60. She related that the breast cancer
treatments lasted five months. She said that as a result of the
chemotherapy she developed neuropathy in her feet. She indicated, as a
result of the neuropathy, “In some instances I don’t feel things, and other
instances It’s like a burning sensation . . . .” R. 63. She said she
experienced these symptoms daily to some degree. She testified she has
fallen five or six times in the “last couple of years.” She indicated she has
also lost her balance but caught herself before she fell. R. 63-64.
McGraw testified that she was diagnosed with diabetes in 2003. She
began taking diabetes medication at that time. She was on insulin for three
years. She went off insulin in approximately 2007. She went back on
insulin in June 2012 when the cancer treatments started. She stayed on
insulin until 2015. Her doctor checked her A1c every three months. R. 64.
McGraw testified that her neuropathy affected her hands. She
indicated that her right middle finger locked up sometimes. The finger
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became painful. Her right hand was her dominant hand. She also testified
that she has lost the grip strength to open jars. She said her hands hurt
after she did “a lot of keyboarding.” She said she used a keyboard for 30
minutes a day now. She said her hands hurt severely after 30 minutes of
using a keyboard. She said she used to use a keyboard for three to four
hours a day working on genealogies. She also testified that her toes were
starting to lock up on her. R. 64-66.
McGraw testified that the chemotherapy treatments made her
insomnia worse. She said she would lie awake all night about six nights a
week. She would finally fall asleep between 4:00 a.m. and 6:00 a.m. She
would usually sleep until 11:00 a.m. She was regularly exhausted during
the day as a result her poor sleep. R. 67-68. She said the amitriptyline
initially helped her sleep, but the insomnia returned in a short time after her
body became used to the medicine. R. 67.
McGraw testified that she has had diarrhea on a daily basis since she
started the chemotherapy treatments. She indicated that she was
dehydrated as a result. She also testified that she always had an irritable
bowel. She testified that she treated her diarrhea herself with “fiber therapy
and stuff.” R. 69.

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She testified that her vision became worse after the chemotherapy.
She indicated she had cataracts and fluid behind the retina in her right eye.
She said she had injections and laser treatments in her right eye. R. 70.
She said she had problems reading. She could read for about 30 minutes.
After that, she said, “I can’t see the print with that eye.” R. 71.
McGraw testified that she had shoulder replacement surgery on both
shoulders. The first was in 2004 and the second was in 2007. R. 71. She
said she experienced pain moving her arms up high. She said she could
not handle anything when her right hand was up high. She said she
experienced pain daily in her right shoulder. She took hydrocodone as
needed for the pain. She said she took hydrocodone only when the pain
was very severe. R. 71-72. McGraw said she had right hip replacement
surgery in 2002. R. 72. She said that she did not file for disability because
of these surgeries. She only filed after she started her chemotherapy in
2012. R. 80.
McGraw said the pain in her shoulders and hip have increased since
she stopped working in 2010. She opined that she could sit in a chair for
an hour at a time. She said she could carry packages or bags from her car
to her house, but then had to sit down for 30 minutes to rest. R. 72-73.

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McGraw testified that she has had migraine headaches for years.
She said she had migraine headaches about once every two or three
months. Each headache usually lasted a couple of days. She took Tylenol
or ibuprofen and “put up with it for a couple of days, if it’s just a regular
headache.” R. 73. She said she had sinus infections about every other
month and her sinuses hurt all the time. She used nasal sprays and allergy
medication to treat her sinuses. R. 74.
McGraw said that on a usual day she spent time on the computer.
She also drove to her own doctors’ appointments and took her
granddaughter to her doctors’ appointments. McGraw also saw her
husband every day in the nursing home. R. 75. She stayed at the nursing
home an hour to an hour and a half each day. She could sit comfortably for
an hour to an hour and a half. R. 75. She also read and watched
television. She said that she used to sew, but she could not thread a
needle now. R. 78.
McGraw testified that she experienced fatigue since her
chemotherapy treatments. She said that she had problems concentrating.
She took longer to work crossword puzzles and other puzzles than
previously. She has had trouble remembering the correct spelling of words

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and remembering telephone numbers. She said that she was on
antidepressants after she had breast cancer treatments. R. 75-76.
McGraw testified that she lived by herself prior to the fall of 2015.
She said that in the fall of 2015, she started living with her son because she
could not afford winter utilities. McGraw did not get any help doing
household chores when she lived by herself. She said, “Actually, it would
be more to the truth is that a lot of things just didn’t get done.” R. 77. She
said she did her own laundry, but was exhausted thereafter. She did her
own grocery shopping, but her sons or grandchildren carried the groceries
into the house for her. She went shopping at stores that had scooters
available to customers. R. 77-78.
McGraw said she had “a little bit of a side effect” from her
amitriptyline. She took it to help her sleep and to help with her neuropathy.
She said she did not have side effects from her other medications. R. 7879. She did not describe the side effect.
The ALJ asked McGraw why she could not return to her former
coordinator/receptionist—secretary job. McGraw said it would be hard to
work the computer. She could not use a computer for more than 30
minutes because “I get to the point where I can’t see what I’m reading.”
She said she spent more than half her time on the computer in her old job.
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She said she would also have problems keyboarding for that long. She
also said she would have problems putting files in the lower drawers of the
file cabinets. She also said she would have pain in her shoulders from
lifting and carrying files and supplies. She said she was also on her feet
about an hour to an hour and a half during the workday. She said she had
to stand for extended periods. She said she could not stand for extended
periods now. R. 80-83.
Vocational expert Smith then testified. Smith opined that McGraw’s
coordinator/receptionist—secretary job fit within the receptionist title in the
Department of Labor’s Dictionary of Occupational Titles (DOT). The job
was sedentary and semi-skilled. R. 85. Smith opined that the DOT
receptionist job would generally require lifting 10 pounds occasionally and
five pounds frequently, sitting for six hours a day, and standing and/or
walking two hours a day. R. 85. The job would require frequent reaching,
but much less than occasional overhead reaching. The job would require
frequently handling and occasional fingering. R. 85-86. The job would not
have any environmental requirements. R. 87.
The ALJ asked Smith about the visual requirements of the
receptionist job. Smith testified that the DOT did not address the visual
requirements of the DOT receptionist job. Smith opined that a person
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would need to be able to read a computer screen. Smith opined the person
would frequently need near visual acuity. R. 87.
Smith opined that the person would not be able to work if she missed
more than two or three days of work per month, or if she was off-task more
than 25% of the time. R. 87. The hearing then concluded.
The May 12, 2016 Hearing
On May 12, 2016, the ALJ held a second evidentiary hearing. R. 4154. McGraw appeared in person and with her counsel. Medical expert Dr.
Stephen Bowen, M.D., also appeared. R. 43.
The ALJ called the second hearing to secure expert testimony from
Dr. Bowen. Dr. Bowen was board certified in ophthalmology. R. 43-44; see
R. 959-61 (Dr. Bowen’s curriculum vitae). Dr. Bowen reviewed McGraw’s
medical records. Based on that review, Dr. Bowen summarized McGraw’s
ophthalmic records from her medical records. R. 44-46. Dr. Bowen opined
that McGraw’s visual impairments did not meet or equal any impairment
listed in the Social Security Administration’s Listing of Impairments, 20
C.F.R. Part 404 Subpart P, Appendix 1 (Listing). R. 46-47.
Dr. Bowen opined that McGraw would have some work-related visual
limitations due to her eye impairments:
There would be some limitation, Your Honor, and that would be
probably with depth perception. The individual has very good
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left eye vision. The right eye vision is not very good because of
the macular changes. So, that individual would have gross
stereoscopic depth, but fine depth where putting small objects
in holes or putting something in a slit in the screw, or doing very
fine work would be very difficult for this person because of the
blurring in the right eye. And also, this person has had multiple
surgical procedures on the right eye, and so there should be no
exposure to toxins or dust or fumes, which could irritate the
right eye. All other types of work should be available for this
person, solely from the eye standpoint, Your Honor.
R. 47. Dr. Bowen opined that McGraw would not have problems with near
vision acuity because her left eye had good visual acuity when she wore
her glasses. R. 47. When asked about McGraw’s blurred vision in her
right eye, Dr. Bowen stated, “[N]ormally, people with a blurred one eye will
learn to function pretty adequately if the other eye is really very good, which
it is in this case.” R. 50. Dr. Bowen stated that he was only opining on
McGraw’s work related limitations due to her visual impairments. R. 52.
The hearing concluded after Dr. Bowen testified.
THE DECISION OF THE ALJ
The ALJ issued his opinion on June 14, 2016. R. 22-34. 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,
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Step 3 requires a determination of whether the claimant is so severely
impaired that she is disabled regardless of her age, education and work
experience. 20 C.F.R. §§ 404.1520(d), 416.920(d). To meet this
requirement at Step 3, the claimant's condition must meet or be equal to
the criteria of one of the impairments specified in the Listings. 20 C.F.R. §§
404.1520(d), 416.920(d). If the claimant is not so severely impaired, the
ALJ proceeds to Step 4 of the Analysis.
Step 4 requires the claimant not to be able to return to her prior work
considering her age, education, work experience, and Residual Functional
Capacity (RFC). 20 C.F.R. §§ 404.1520(e) and (f), 416.920(e) and (f). 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(g),
404.1560(c), 416.920(g), 416.960(c). 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. 20 C.F.R.
§§ 404.1512, 404.1560(c); Weatherbee v. Astrue, 649 F.3d 565, 569 (7th

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Cir. 2011); Briscoe ex rel. Taylor v. Barnhart, 425 F.3d 345, 352 (7th Cir.
2005).
The ALJ found that McGraw met her burden at Steps 1 and 2. She
had not worked since her alleged Onset Date of June 1, 2012. She had
severe impairments of status post breast cancer; status post shoulder
surgery; status post hip surgery; left knee arthritis; diabetes mellitus;
neuropathy; obesity; asthma; and vision impairments diagnosed as
cataract-left eye, chorioretinal scars-left eye, round hole-right eye, vitreous
hemorrhage-right eye, central serous choriorenopathy (CSR)-right eye,
retinal hemorrhage-right eye, vitreous syneresis-both eyes, posterior
vitreous detachment (PVD)-right eye, and psuedophakia-right eye.15 R. 24.
At Step 3, the ALJ determined that McGraw’s impairments or combination
of impairments did not meet or equal a Listing. R. 26-27.
At Step 4, the ALJ determined that McGraw had the following RFC:
After careful consideration of the entire record, the undersigned
finds that, through the date last insured, the claimant had the
residual functional capacity to perform sedentary work as
defined in 20 CFR 404.1567(a) except that the claimant has the
following additional limitations: lift, carry, push, or pull 10
pounds occasionally and five pounds frequently; stand and/or
walk two hours in an eight-hour day; sit for six hours in an
eight-hour day; occasionally climb ramps and stairs; never
climb ladders, ropes, or scaffolds; occasionally stoop, kneel,
crouch, and crawl; and frequently reach, handle, and finger.
15

Vitreous synersis is shrinkage or detachment of the vitreous fluid. See Dorland’s, 1855,

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The claimant would also need to avoid dust, gases, fumes, poor
ventilation, and hazards, such as dangerous machinery or
unprotected heights. She had the ability for frequent near
visual acuity but no depth perception.
R. 27-28. The ALJ determined that McGraw’s hip and shoulder surgeries
were not debilitating. The ALJ relied on the fact that McGraw worked for
several years after her hip and shoulder surgeries; she also retired in 2010
to take care of her husband, not because she could no longer perform the
requirements of her work. The ALJ found that she could perform sedentary
work described by the RFC with these conditions because she did so for
years. The ALJ found that the limitations caused by her cancer treatment
were temporary, lasting less than 12 months, and so, did not cause
permanent functional limitations. The ALJ relied on the lack of medical
evidence showing that most of her other impairments worsened after the
cancer treatment. The only worsening impairments that affected her
functional abilities were neuropathy and her visual impairments. The
neuropathy examinations by Drs. Wagoner and Hanzel showed that she
still had sensation in her feet. See R. 823, 839, 854, 1059. The medical
evidence cited by the parties and the ALJ did not mention any neuropathy
in her hands. The ALJ also relied on her daily activities which showed that
she drove daily, did her own housework, did her own laundry, went to
church, and visited with friends and family. The ALJ also relied on Dr.
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Kozma’s consultative examination and the opinions of Drs. Oh, Nenaber,
and Bowen. The ALJ relied on Dr. Bowen’s opinions for the finding that
McGraw could frequently use her near visual acuity even with her eye
impairments. R. 28-33.
At Step 4, the ALJ found that McGraw could perform her prior work
as a receptionist as that job was generally performed in the national
economy. The ALJ relied on the RFC and the opinions of vocational expert
Smith. The ALJ found that McGraw was not disabled at Step 4. R. 33-34.
McGraw appealed. On June 1, 2017, the Appeals Council denied her
request for review. The decision of the ALJ then became the final decision
of the Defendant Commissioner. R. 1. McGraw then filed this action for
judicial review.
ANALYSIS
This Court reviews the Decision of the Commissioner to determine
whether it is supported by substantial evidence. 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 findings if they are supported by substantial
evidence, and may not substitute its judgment or reweigh the evidence.
Jens v. Barnhart, 347 F.3d 209, 212 (7th Cir. 2003); Delgado v. Bowen, 782
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F.2d 79, 82 (7th Cir. 1986). This Court will not review the ALJ’s evaluation
of statements regarding the intensity, persistence, and limiting effect of
symptoms unless the evaluation is patently wrong and lacks any
explanation or support in the record. See Pepper v. Colvin, 712 F.3d 351,
367 (7th Cir. 2014); Elder v. Astrue, 529 F.3d 408, 413-14 (7th Cir. 2008);
SSR 16-3p, 2016 WL 1119029, at *1 (2016) (The Social Security
Administration no longer uses the term credibility in the evaluation of
statements regarding symptoms). 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 ALJ must “build an accurate and logical
bridge from the evidence to his conclusion.” Clifford v. Apfel, 227 F.3d 863,
872 (7th Cir. 2000).
The ALJ’s decision is supported by substantial evidence. The
medical evidence shows that McGraw’s cancer treatment was less than 12
months and the functional limitations caused by the treatment was also less
than 12 months. A person’s functional limitations are within the definition of
a disability unless the medically determinable impairment must be expected
to last for a continuous period of not less than 12 months. 42 U.S.C. §
416(i)(1).

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The medical evidence also supports the finding that McGraw’s
limitations due to her hip and shoulder surgeries did not change due to the
cancer treatment. She testified that these limitations worsened since 2010,
but abundant medical evidence contradicted that testimony. Numerous
medical examinations showed that she had full strength. McGraw also was
very active, going to see her husband and her aunt daily; going to her own
doctors’ appointments; taking her granddaughter to her appointments;
going to church; doing housework; and visiting with family and friends. All
of this evidence together provided substantial evidence that her limitations
due to her shoulder and hip surgeries were consistent with the RFC.
The only two permanent impairments that became worse since 2010
were her neuropathy and her eyesight. Substantial evidence supported the
ALJ’s conclusion that the neuropathy was consistent with the RFC. No
medical evidence cited by the parties or the ALJ mentioned neuropathy in
her hands. The medical evidence only indicated that she had neuropathy
in her feet and toes. Drs. Wagoner and Hanzel found that she still had
good sensation in her feet. R. 823, 839, 854, and 1059. This evidence,
combined with the other examinations that found a normal gait, normal
muscle tone, and normal strength in her extremities provided substantial

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evidence to support the ALJ’s conclusion that the limitations due to her
neuropathy were consistent with sedentary work described in the RFC.
Dr. Bowen provided substantial evidence to support the ALJ’s
determination in the RFC that McGraw had the ability to use her near visual
acuity frequently. Dr. Bowen opined to as much. R. 48, 50. The medical
records also consistently showed that McGraw had corrected near visual
acuity to 20/20 or almost 20/20 in her left eye.
Vocational expert Smith opined that a person with McGraw’s RFC
could perform the job of receptionist as it was generally performed in the
national economy. This opinion, combined with the RFC finding, provided
substantial evidence for the ALJ’s determination at Step 4 that McGraw
could return to her prior work. The ALJ’s decision was supported by
substantial evidence.
McGraw argues that the ALJ erred in not addressing all of the
impairments listed during her December 10, 2015 office visit with Dr. Phan.
The ALJ is not required to address every piece of evidence. He must build
a logical bridge from the material evidence to his findings. Clifford, 227
F.3d at 872. Impairments are only material if they affect a claimant’s
functional abilities to perform work activities. The ALJ identified and
addressed McGraw’s impairments that affected her functional ability to
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perform work activities. He was not required to talk about all impairments.
There was no error.
McGraw argues that the ALJ erred in relying on Dr. Bowen’s
opinions. She argues that his opinions were inconsistent with the treatment
notes of Dr. Blinder. The Court disagrees. Dr. Bowen did not challenge
any of Dr. Blinder’s diagnoses, and Dr. Blinder did not opine on McGraw’s
ability to use her near vision acuity to perform work activities. McGraw also
argues that the ALJ cherry-picked Dr. Bowen’s opinions. The Court again
disagrees. The ALJ fairly stated Dr. Bowen’s opinions. Those opinions
provided substantial evidence for the ALJ’s finding that McGraw could
frequently use her near vision acuity to perform work activities. There was
no error.
McGraw challenges Dr. Bowen’s reliance on his experience in
coming to his opinions. The ALJ is not bound to follow rules of evidence,
such as rules regarding expert opinion evidence, but may be guided by
them. 20 C.F.R. § 498.217(b). The Social Security regulations, however,
define medical opinions, in relevant part, as “statements from acceptable
medical sources that reflect judgments about the nature and severity of
your impairment(s), including . . . what you can still do despite

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impairment(s) . . . .” 20 C.F.R. § 1527(a)(1). Dr. Bowen’s opinion
regarding McGraw’s ability to use her near visual acuity was a medical
opinion under this definition. The ALJ, therefore, did not err in accepting
Dr. Bowen’s opinions.
McGraw argues that the ALJ failed to address her neuropathy in her
hands. McGraw’s claim that her finger locked up and that she could not
use her hands due to neuropathy was not established by objective medical
evidence. McGraw did not cite any diagnosis by any acceptable medical
source that McGraw had neuropathy in her hands. Dr. Hanzel diagnosed
neuropathy in her feet and toes. E.g., R. 823. McGraw cited nothing in the
medical records that identified neuropathy in her hands. To the contrary,
Dr. Kozma’s examination showed no limitations on her ability to use her
hands. The ALJ noted that Dr. Kozma’s examination indicated McGraw
had no difficulty using her hands and fingers for gross and fine
manipulations, had good finger dexterity, and had good grip strength. R.
31. The ALJ’s findings regarding McGraw’s ability to use her hands was
supported by substantial evidence.
McGraw argues that the ALJ erred because the combination of her
pain, depression, anxiety, migraines, and fatigue rendered her unable to

Page 39 of 42

sustain work on a continuing basis. The Court disagrees. The ALJ
addressed all of these impairments in his decision. Substantial evidence
supported the ALJ’s assessment of the effect on McGraw’s ability to
perform work activities. McGraw essentially asks the Court to reweigh this
evidence. This Court will not do so. See Jens, 347 F.3d at 212.
Finally, McGraw argues that the ALJ erred in finding that she could
work because she would need to miss work too often for medical
appointments. The vocational expert Alissa Smith opined that a person
with McGraw’s age, education, experience, and RFC could not work if she
missed more than two to three days per month. McGraw included a count
of her appointments in her Motion. According to her Count, she had 126
medical appointments and hospitalizations from June 8, 2012, through
December 21, 2015, which averaged 3.6 per month. Brief in Support of
Motion for Summary Judgment, at 13-15. She argues that the ALJ erred in
failing to take the frequency of her appointments into consideration in
determining that she could work.
The Commissioner notes that many of these appointments were
related to her temporary impairments due to cancer treatment which

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concluded in April of 2013. The Defendant indicates approximately 50 of
the 126 medical appointments were related to cancer treatment.
Defendant’s Memorandum in Support of Motion for Summary Judgment, at
10. He also argues that frequency of the appointments is not proof that
McGraw would have needed to miss an entire day of work for the
appointments. Id. at 10. The Court agrees. The sheer number of
appointments alone does not establish that she would need to miss work
more than two or three days per month. In reviewing the Plaintiff’s
summary of medical visits, it appears that some medical visits listed are for
laboratory blood draws which would take a relatively short period of time.16
If McGraw had been working after completing the cancer treatments, she
could have combined some appointments, scheduled appointments on her
days off or during her lunch hour. The frequency of appointments alone
does not establish error. The ALJ did not err.
THEREFORE, IT IS ORDERED that the Defendant Commissioner’s
Motion for Summary Affirmance (d/e 15) is ALLOWED; Plaintiff Thelma I
McGraw’s Motion for Summary Judgment titled Brief in Support of Motion

16

For instance, Plaintiff lists four doctor visits in July of 2013. Plaintiff’s Brief in Support of Motion for
Summary Judgment, at 14, entries 53, 54, 55, and 56. (Entry 56 lists July 26, 2017 as the applicable date,
however, the record citation is to a doctor’s visit on July 26, 2013. TR. 507) Two of these four
appointments or doctor’s visits appear to be blood test results. (Entries 54 and 55) A blood draw does
not equate to missing a day of work.

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for Summary Judgment (d/e 14) is DENIED; and the decision of the
Commissioner is AFFIRMED. All pending motions are denied as moot.
THIS CASE IS CLOSED.
ENTER: June 22, 2018
s/ Tom Schanzle-Haskins
TOM SCHANZLE-HASKINS
UNITED STATES MAGISTRATE JUDGE

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