Woodson v. Astrue

Filing 25

MEMORANDUM Opinion and Order. Signed by the Honorable Young B. Kim on 8/27/2010. (aac, )

Woodson v. Astrue

Doc. 25

UNITED STATES DISTRICT COURT N O R T H E R N DISTRICT OF ILLINOIS E A S T E R N DIVISION J O H N D. WOODSON, P la in tif f , v. M I C H A E L J. ASTRUE, C o m m is s io n e r of Social Security, D e f e n d a n t. ) ) ) ) ) ) ) ) )

C a s e No. 09 CV 8028 M a g is tr a te Judge Young B. Kim

A u g u s t 27, 2010

M E M O R A N D U M OPINION and ORDER B e f o re the court is John Woodson's motion for summary judgment challenging the d e n ia l of his applications for disability insurance benefits ("DIB") and supplemental security i n c o m e ("SSI") under the Social Security Act, 42 U.S.C. §§ 416(i), 423, 1381a, 1382c. Woodson claims that he is disabled by high blood pressure and hypertrophic cardiomyopathy, w h ic h cause him to experience severe chest pain, shortness of breath, and fatigue. For the f o llo w in g reasons, Woodson's motion is granted and this case is remanded for further p ro c e e d in g s consistent with this opinion: Procedural History W o o d s o n applied for SSI and DIB in May 2007, claiming that his disability began on S e p te m b e r 1, 2002. (A.R. 109, 117.) The Social Security Administration ("SSA") denied h is claim initially and on reconsideration. (Id. at 57-60.) Woodson then requested, and was g ra n te d , a hearing before an administrative law judge ("ALJ"). (Id. at 21.) The ALJ d e te rm in e d that Woodson is not "disabled" as defined in the Social Security Act and denied

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his claims for DIB and SSI. (Id. at 19.) When the Appeals Council denied review, (id. at 13 ), the ALJ's decision became the final decision of the Commissioner, see Schmidt v. Astrue, 4 9 6 F.3d 833, 841 (7th Cir. 2007). Woodson then filed the current suit seeking judicial re v ie w of the ALJ's decision. See 42 U.S.C. §§ 405(g), 1383(c)(3). The parties have c o n s e n te d to the jurisdiction of this court. See 28 U.S.C. § 636(c). Facts In 1986--when he was 20 years old--Woodson suffered blunt chest trauma while s e rv in g in the United States Army at Ft. McCoy, Wisconsin. (A.R. 32, 295-97, 306-07.) He w a s moving artillery when a 250-pound projectile fell off of a storage rack onto his chest, d a m a g in g his sternum and causing a myocardial tear and contusion. (Id. at 295, 306-07.) He u n d e rw e n t cardiopulmonary bypass surgery to repair the damage. (Id. at 306.) After being d is c h a rg e d from the Army in 1989, he went on to work several jobs, most recently as a h o u s e k e e p e r in a nursing home. (Id. at 32-34, 154.) He stopped working in 2002 because, h e says, he was experiencing chest pain and dizziness that rendered him disabled. (Id. at 33.) At his hearing before the ALJ in June 2008, Woodson offered both documentary and te s tim o n ia l evidence to support his claims. A. M e d ic a l Evidence

A lth o u g h Woodson claims a disability onset date of September 1, 2002, the first m e d ic a l evidence in the record--other than that related to the 1986 injury--is from May 2 0 0 7 , the month he first sought disability benefits. (A.R. 139.) On May 3, 2007, Woodson

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was interviewed at an SSA field office. (Id. at 135-39.) The interviewer reported that W o o d so n had no difficulties in sitting, standing, walking, or breathing. (Id. at 138.) The f o llo w in g month, Woodson was examined at the SSA's behest by consultative physician D r. Jeffrey Ryan. (Id. at 188.) Woodson told Dr. Ryan that he had persistent pain at the site o f his 1986 surgery and that he was unable to walk more than 10 steps without becoming s h o rt of breath. (Id.) Dr. Ryan reported that Woodson walked into the examination center w ith his arm around his sister and that he had "great discomfort even in getting around" that w a s "consistent throughout the examination." (Id. at 189.) Dr. Ryan said that Woodson was " s ig n if ic a n tly dyspneic"--out of breath, in layman's terms, see STEDMAN'S MEDICAL D ICTIONARY 601 (28th ed. 2006)--and "unable to walk more than 15 feet unassisted." (Id.) Dr. Ryan further noted that Woodson could not perform a toe or heel walk, tandem gait, or s q u a t and rise. (Id.) Dr. Ryan diagnosed Woodson as having "significant severe shortness o f breath with uncertain cause," noting that the most common explanation would be p u lm o n a ry or cardiac. (Id. at 190.) T h re e weeks after Dr. Ryan examined Woodson, a medical consultant named D r. Robert Patey completed a residual functional capacity assessment based on his review o f Woodson's medical file. (A.R. 197-204.) Dr. Patey opined that Woodson could sit, stand, o r walk for six hours in an eight-hour workday without any postural, manipulative, or e n v iro n m e n ta l limitations. (Id. at 199-201.) In explaining his opinion, Dr. Patey questioned W o o d so n ' s credibility. (Id. at 204.) He said that Woodson's complaints of shortness of

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breath were not supported by any medical records. (Id.) He noted the contrast between W o o d so n 's presentation to the field interviewer, who said that he had no problem walking o r breathing, and Dr. Ryan's observations regarding Woodson's limitations. (Id.) Dr. Patey c o n c lu d e d that Woodson's complaints of chest pain "appear to be non-cardiac in nature" and " o u t of proportion to his history." (Id.) Dr. Patey said that the record showed that Woodson h a s hypertension which could warrant a functional limitation, but only to the extent that he s h o u ld be restricted to lifting and carrying 50 pounds occasionally and 25 pounds frequently. (Id.) On September 4, 2007, Woodson reported to an emergency room complaining of s e v e re chest pain that followed his attempt to do housework. (A.R. 243.) He was

h o s p ita liz e d for three nights and underwent a cardiac catheterization. (Id. at 209, 211.) He w a s diagnosed as having untreated hypertension and "moderate to severe asymmetric h yp e rtro p h y" with "grade 1 diastolic dysfunction." (Id. at 209.) His condition was also re f e rre d to as hypertrophic cardiomyopathy. (Id. at 213.) The hospital report states that w h ile he was hospitalized Woodson had several episodes of severe chest pain even at rest. (Id. at 240.). A cardiologist concluded that his symptoms were "most likely due to

u n c o n tro lle d hypertension or due to musculoskeletal etiologies." (Id. at 252.) Shortly after his hospitalization Woodson had a second interview at a Social Security f ie ld office, and again the interviewer found him to have no difficulties in sitting, standing, w a lk in g , or breathing. (A.R. 162.) In connection with that interview Woodson filled out a

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form reporting that his pain, fatigue, and weakness had all increased in the previous few m o n th s . (Id. at 165.) He reported having a limited ability to walk, no ability to climb stairs, a n d needing help dressing. (Id. at 168.) T h e most recent treatment records are from May and June 2008. On May 14, 2008, a nurse from the Jesse Brown Veteran Administration Medical Clinic reported that Woodson c o m p la in e d of having chest pain after doing housework two days earlier. (A.R. 285.) He to ld the nurse he had not had any chest pain or shortness of breath since that episode. (Id.) Progress notes from a June follow-up appointment state that Woodson was asymptomatic (he d e n i e d having shortness of breath), but that he had not taken his medications that day " b e c a u s e they make him sleepy." (Id. at 288.) The notes also state that Woodson "[h]as s o m e end organ disease." (Id. at 287.) B. W o o d s o n 's Testimony

D u rin g the hearing Woodson testified that he can no longer work because he has c h ro n ic chest pain, shortness of breath, and fatigue. (A.R. 36, 49.) Woodson described e x p e rie n c in g shortness of breath and fatigue on a daily basis. (Id. at 39, 44.) He said that h e can walk for only one or two blocks and can sit or stand for only about an hour before b e c o m in g fatigued. (Id. at 36, 44, 48.) He testified that he takes a total of six medications to treat his symptoms, and that the combination of medicine makes him drowsy. (Id. at 383 9 .) Woodson said that after he takes his medicine he falls asleep for two to four hours. (Id. a t 39.) He explained that he had not taken his medicine the morning of the hearing because

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he wanted to be alert. (Id. at 39-40.) Woodson said that he told his doctor that the medicine w a s making him tired, but the doctor said "there's nothing that he can do about it." (Id. at 4 0 .) In fact, Woodson said the doctor told him that after he takes his pills he should "just go to sleep because there's nothing you can do, because it's going to make you sleepy re g a rd le s s ." (Id.) W o o d s o n testified that he has episodes of severe chest pain up to three times each w e e k , with each episode lasting 30 to 45 minutes. (A.R. 41.) He said that exertion, e s p e c ia lly walking, triggers his chest pain. (Id. at 42.) Woodson testified that his most recent e p is o d e happened two days before the hearing, when he was emptying the garbage outside. (Id. at 40-41.) He described his chest pain as a "sharp, bumping sensation" from his neck d o w n to his stomach. (Id. at 41.) Woodson said that he takes nitroglycerin pills to reduce th e chest pain, but the medicine does not resolve his pain completely. (Id. at 42-43.) He e x p la in e d that with each episode of chest pain he feels dizzy and has double vision. (Id. at 4 3 -4 4 .) Woodson testified that lately he had experienced chest pain almost every day, even w h ile sitting down. (Id. at 49.) C. M e d ic a l Expert's Testimony

T h e ALJ called Dr. Donald Chariss, an internist, to testify as a medical expert. (A.R. 5 1 , 105.) Based on his examination of the medical record, Dr. Chariss testified that Woodson

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has hypertension and "possibly angina."1 (Id. at 51.) He explained that he was unsure w h e th e r Woodson's chest pain should be diagnosed as angina because it could be "secondary to uncontrolled hypertension" or have a "musculoskeletal etiology." (Id. at 51.) Dr. Chariss s a id that Woodson had a "perfectly normal coronary angiogram" in 2007 and opined that his d ia s to lic dysfunction was probably caused by his uncontrolled high blood pressure. (Id.) As f o r Woodson's fatigue, Dr. Chariss testified that the only prescribed medication that would c a u s e drowsiness is metoprolol. (Id. at 52.) Dr. Chariss commented that if Woodson's m e d ic a tio n were causing the described level of fatigue, he could not "understand why the d o c to rs don't change his medication, because they can." (Id.) In fact, he said, metoprolol " c a n be easily substituted to something else." (Id. at 53.) Dr. Chariss opined that Woodson's im p a irm e n ts would limit him to work that is "somewhere between sedentary and light." (Id. a t 54.) D. A L J 's Decision

A f te r considering the proffered evidence, the ALJ concluded that Woodson is not d is a b le d . In so finding, the ALJ applied the standard five-step sequence, see 20 C.F.R. § 404.1520, which requires her to analyze: (1 ) whether the claimant is currently [un]employed; (2) whether the claimant h a s a severe impairment; (3) whether the claimant's impairment meets or e q u a ls one of the impairments listed by the [Commissioner], see 20 C .F .R . § 404, Subpt. P, App. 1; (4) whether the claimant can perform his past

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Angina is the medical term for severe chest pain. See STEDMAN'S MEDICAL DICTIONARY 8 5 (28th ed. 2006). 7

work; and (5) whether the claimant is capable of performing work in the n a tio n a l economy. C liffo r d v. Apfel, 227 F.3d 863, 868 (7th Cir. 2000) (quoting Knight v. Chater, 55 F.3d 309, 3 1 3 (7th Cir. 1995)). If at step three of this framework the ALJ finds that the claimant has a severe impairment which does not meet the listings, she must "assess and make a finding a b o u t [the claimant's] residual functional capacity based on all the relevant medical and other e v id e n c e ." 20 C.F.R. § 404.1520(e). The ALJ then uses the residual functional capacity (" R F C " ) to determine at steps four and five whether the claimant can return to his past work o r to different available work. Id. § 404.1520(f), (g). Here, the ALJ found at step one that Woodson had not engaged in substantial gainful a c tiv ity since September 1, 2002. (A.R. 16.) At step two the ALJ determined that Woodson h a s severe impairments consisting of hypertension and "chest pain with possible anginal c o m p o n e n t."2 (Id.) At step three the ALJ determined that none of Woodson's impairments m e e t or medically equal the listings, noting that "[t]he evidence does not suggest that the c la im a n t's hypertension has caused end organ damage." (Id.) T u rn in g to step four, the ALJ determined that Woodson has the RFC to perform the f u ll range of sedentary work as defined by the social security regulations. (A.R. 17.) In m a k in g that determination, the ALJ said that she gave greater weight to the opinion of

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The ALJ noted that Woodson had not submitted any evidence showing that he experienced s ym p to m s or received treatment prior to June 9, 2007. Accordingly, she determined that he h a d no medically determinable impairments before that date. (A.R. 16.) 8

Dr. Chariss than to that of Dr. Patey, the state agency medical consultant. (Id. at 18.) The A L J found Woodson less than credible, stating that his "presentation and allegations have c h a n g e d while the claim has been pending." (Id. at 17.) She noted that even when Woodson d id not take his medication his condition "has remained relatively stable" and that he only c o m p la in e d to his doctors about chest pain after engaging in "heavy exertion." (Id.) The A L J said that Woodson had "changed the emphasis of his complaints" at the hearing to focus o n the fatigue caused by his medications. (Id. at 18.) The ALJ highlighted Woodson's te s tim o n y that his doctor had told him to go to sleep when he felt drowsy, and concluded that " it is more likely that [Woodson] has not fully addressed the issue with his doctors because it is not as much of a problem as he testified." (Id.) The ALJ further concluded that W o o d s o n 's fatigue would not prevent him from performing sedentary work." (Id.) After c o n c lu d in g that Woodson could not perform any of his previous jobs, at step five the ALJ a p p lie d Medical-Vocational rule 201.27, see 20 C.F.R. § 404, Subpt. P, App. 2, to find that h e is not disabled. (Id. at 19.) Analysis In the current motion for summary judgment, Woodson argues that the ALJ ignored e v i d e n c e that was favorable to his claim and engaged in an improper credibility analysis. Specifically, he argues that the ALJ selectively discussed the medical evidence regarding his 2 0 0 7 hospitalization and improperly discounted Dr. Ryan's descriptions of the limiting e f f e c ts of Woodson's condition. Woodson also argues that the ALJ failed to apply the

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credibility factors set forth in the social security regulations and gave reasons for her c re d ib ility determination that are unsupported by the evidence. In response, the

C o m m is s io n e r argues that any error in the ALJ's review of the evidence was harmless and th a t the credibility determination is sufficiently supported to withstand judicial review. T h is court reviews the Commissioner's decision to ensure that it is supported by s u b s ta n tia l evidence. See 42 U.S.C. § 405(g); Craft v. Astrue, 539 F.3d 668, 673 (7th Cir. 2 0 0 8 ). "Substantial evidence is `such relevant evidence as a reasonable mind might accept a s adequate to support a conclusion." Craft, 539 F.3d at 673 (quoting Barnett v. Barnhart, 3 8 1 F.3d 664, 668 (7th Cir. 2004)). Although it is not this court's role to "nitpick" the ALJ's re a s o n in g , see Shramek v. Apfel, 226 F.3d 809, 811 (7th Cir. 2000), this court will reverse w h e re the ALJ's explanations lack record support, are based on legal error, or are articulated s o poorly that meaningful review is impossible, see Hopgood ex rel. L.G. v. Astrue, 578 F.3d 6 9 6 , 698 (7th Cir. 2009). W o o d s o n 's strongest argument is that the ALJ made several errors in assessing his c re d ib ility. Specifically, he argues that the ALJ failed to consider several of the factors set f o rth in SSR 96-7p, 1996 WL 374186, relied on mistakes of fact, and made unsupported a s s u m p tio n s in finding him not credible. Because the ALJ is in the best position to assess a witness's honesty, credibility determinations are given "special deference" and will be a f f irm e d unless "patently wrong." Powers v. Apfel, 207 F.3d 431, 435 (7th Cir. 2000). But th e court gives less deference where "the determination rests on `objective factors or

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fundamental implausibilities rather than subjective considerations.'" Indoranto v. Barnhart, 3 7 4 F.3d 470, 474 (7th Cir. 2004) (quoting Clifford, 227 F.3d at 872). The ALJ must explain th e credibility evaluation with specific reasons that are supported by the record, see Brindisi e x rel. Brindisi v. Barnhart, 315 F.3d 783, 787 (7th Cir. 2003), and must "build a logical b rid g e between the evidence" and her conclusion, Villano v. Astrue, 556 F.3d 558, 562 (7th C ir. 2009). Here the ALJ stated that Woodson's "statements concerning the intensity, persistence a n d limiting effects of [his] symptoms are not credible to the extent they are inconsistent with th e residual functional capacity assessment for the reasons explained below." (A.R. 17.) But in the discussion ensuing "below," the ALJ never addresses Woodson's descriptions of the lim itin g effects of his impairments beyond his complaints of fatigue. As Woodson points o u t , SSR 96-7p requires an ALJ to take a number of factors into account in assessing a c la im a n t's credibility, including the claimant's descriptions of his symptoms, any measures h e uses to treat those symptoms, and his daily activities. 1996 WL 374186, at *5. Woodson te s tif ie d that he has difficulty walking more than a couple of blocks, that he has to lie down f o r much of the day, and that he can only do minor chores and even then only when spaced o u t in small segments so he does not become fatigued. (A.R. 47-48.) His testimony finds s u p p o rt in Dr. Ryan's observations regarding his shortness of breath and difficulty walking e v e n 15 feet, yet the ALJ did not address those statements, let alone explain why she found th e m not credible. Moreover, the ALJ's conclusory statement that she rejected Woodson's

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descriptions of his symptoms "to the extent they are inconsistent with the residual functional c a p a c ity assessment" raises the concern that she discounted his credibility simply because h is testimony did not mesh with her view of his RFC. As the Seventh Circuit has made clear, f in d in g statements that support the RFC credible and disregarding statements that do not " tu rn s the credibility determination process on its head." Brindisi, 315 F.3d at 787-88. The A L J is required to assess a claimant's credibility before developing the RFC. Id. at 788. Given the ALJ's failure to analyze Woodson's testimony regarding his symptoms and daily a c tiv itie s , this court cannot be sure that she evaluated his credibility independently rather than d is m is s in g his testimony to the extent that it did not fit neatly within her RFC assessment. See id. Woodson also persuasively argues that the ALJ misstated the record and engaged in im p e rm is s ib le speculation in rejecting his complaints of fatigue. The ALJ faulted Woodson f o r what she called the change in emphasis of his complaints from chest pain and shortness o f breath in his initial applications, to fatigue caused by his hypertension medication at the h e a rin g . (A.R. 18.) But Woodson complained of fatigue in disability reports he submitted in June and September 2007, and again to his treating physician in 2008. (Id. at 149-50, 165, 2 8 8 .) More importantly, Dr. Chariss testified that Woodson's hypertension medication, m e t o p r o lo l, could cause him to experience fatigue. (Id. at 52.) In June 2007 Dr. Ryan re p o rte d that Woodson was not taking any medication. (Id. at 189.) In fact, the record shows th a t Woodson's hypertension was uncontrolled as late as his September 2007 stay at Stroger

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Hospital. (Id. at 252.) Following that hospitalization, Woodson reported that his doctor at S tro g e r had prescribed metoprolol. (Id. at 167.) After he started taking metoprolol, W o o d so n 's treating physician noted that his medication was making him sleepy. (Id. at 288.) Thus the "change in emphasis" in Woodson's complaints of fatigue--to the extent there was o n e -- is consistent with the timing of the new prescription for metoprolol, a medication that th e medical expert testified could cause fatigue. (Id. at 52.) The ALJ ignored that evidence a n d assumed that the change in emphasis meant Woodson was exaggerating his fatigue, c o n c lu d in g that "it is more likely" that Woodson did not describe the same level of fatigue to his doctor. (Id. at 18.) But that comment reflects nothing more than the ALJ's

s p e c u la tio n . That there are non-drowsy alternatives to a medication does not mean that the a lte rn a tiv e is available to Woodson. There could be any number of reasons why a doctor w o u ld not substitute a drug, from insurance coverage issues to the compatibility of the a lte rn a t iv e with the patient's other treatments. Instead of exploring that background with W o o d so n or the medical expert, or recontacting Woodson's physician for an explanation, the A L J assumed Woodson was lying. Credibility determinations based on ALJ conjecture c a n n o t withstand judicial review. See Giles ex rel. Giles v. Astrue, 483 F.3d 483, 488 (7th C ir. 2007); Blakes on behalf of Wolfe v. Barnhart, 331 F.3d 565, 569-70 (7th Cir. 2003); W h ite ex rel. Smith v. Apfel, 167 F.3d 369, 375 (7th Cir. 1999) (noting that speculation is "no s u b s titu te for evidence").

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The Commissioner defends the ALJ's credibility determination in part by highlighting th e discrepancy between Woodson's presentation to the Agency interviewers--who observed n o abnormalities in his walking, standing, or breathing--and his presentation to Dr. R ya n -- w h o reported that Woodson was unable to walk more than 15 feet without help. The C o m m is s i o n e r points out that Dr. Patey, the consulting physician, discounted Woodson's c re d ib ility based on that discrepancy. Those are good points, and reasons that might have p ro v id e d a solid basis for an adverse credibility finding had the ALJ discussed them. But the A L J did not discuss that discrepancy or cite it as a reason to mistrust Woodson; instead, she f o c u s e d on the perceived shift in his complaints from pain and shortness of breath to fatigue. This court is limited to reviewing the reasons that appear in the ALJ's decision and cannot a f f irm based on reasons that the ALJ could have given but didn't. See SEC v. Chenery C o r p ., 318 U.S. 80, 87-88 (1943); Larson v. Astrue, __ F.3d __, 2010 WL 3001209, at *5 (7 th Cir. Aug. 3, 2010). Accordingly, the discrepancy the Commissioner partly relies on c a n n o t be used here. Less persuasive is Woodson's argument that the ALJ improperly ignored, m isin te rp re te d , and misstated medical evidence that supports his claims. In particular, W o o d so n faults the ALJ for omitting any discussion of the observations reported by the c o n s u ltin g examiner, Dr. Ryan, who described Woodson as having difficulty walking even 1 5 feet without assistance, as experiencing significant shortness of breath during the e x a m in a tio n , and of having "great discomfort even in getting around." (A.R. 189.) The ALJ

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did not address those observations explicitly, instead summarizing Dr. Ryan's report as f o llo w s : When [Woodson] was seen by the consultative examiner in June 2007 the c la im a n t appeared dyspneic and in a good deal of pain but findings on e x a m in a tio n were relatively mild. The examiner heard crackles, suggesting a c a rd ia c issue, but there were no other findings showing congestive heart failure a n d his chest x-ray was negative. Pulmonary function testing revealed only a m ild restriction, pre-broncodilation." (Id. at 17.) The Commissioner asserts that this passage is an "accurate summary" of D r. Ryan's findings and argues that the ALJ was not required to mention every detail of D r. Ryan's report in explaining her decision. (R. 22, Def.'s Resp. at 8.) A lt h o u g h Woodson is correct that an ALJ may not ignore a whole line of evidence th a t favors the claimant, it is equally true that the ALJ need not mention every detail of the m e d ic a l record that supports the claimant. See Denton v. Astrue, 596 F.3d 419, 425 (7th Cir. 2 0 1 0 ). Under the substantial evidence standard, this court's job in reviewing the ALJ's d e c is io n is to ensure that the ALJ considered the relevant medical evidence and reached a lo g ic a l conclusion that is supported by the record. Id.; Berger v. Astrue, 516 F.3d 539, 544 (7 th Cir. 2008). Here, while the ALJ may have described Dr. Ryan's observations in broad s tro k e s, she did not ignore them. She acknowledged Dr. Ryan's observations of Woodson's s h o rtn e s s of breath and difficulty walking when she highlighted his report that Woodson was " d ys p n e ic and in a good deal of pain." Nor did the ALJ state--as Woodson argues h e re -- th a t she rejected his observations because Dr. Ryan could not determine their origin. Rather, the ALJ reasonably weighed Dr. Ryan's observations against his other medical 15

findings in evaluating Woodson's condition. Significantly, Dr. Ryan did not provide an o p in io n as to what functional limitations result from Woodson's condition nor did he provide any opinion that contradicts the ALJ's conclusion that Woodson can perform sedentary work. Woodson's argument essentially boils down to his belief that the ALJ should have placed m o re weight on Dr. Ryan's observations than on his other findings, but it is not this court's ro le at this phase to re-weigh the evidence. See Powers, 207 F.3d at 434-35. Because the A L J 's decision assures the court that the ALJ considered Dr. Ryan's observations along with th e other objective medical evidence, her decision not to describe those observations in detail o r ascribe to them the weight Woodson prefers does not amount to reversible error. W o o d s o n also argues that the ALJ misinterpreted the medical evidence stemming f ro m his 2007 hospitalization. He bases this argument on the ALJ's notation that testing d u rin g his hospitalization "revealed moderate to severe asymmetric hypertrophy with grade I diastolic dysfunction, but his ejection fraction and systolic function were normal." (A.R. 1 7 .) Woodson cites studies showing that normal ejection fraction and systolic function can b e consistent with hypertrophic cardiomyopathy, and argues that the "but" in the ALJ's s e n te n c e shows that she misunderstood his medical condition. Woodson makes too much o f the ALJ's sentence construction and asks this court to engage in the kind of nitpicking that th e substantial evidence standard prohibits. See Shramek, 226 F.3d at 811. The ALJ did not s a y that she discounted the evidence of his cardiomyopathy because of the normal ejection f ra c tio n and systolic function results or otherwise held those results against him. On the

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contrary, the ALJ simply gave an accurate recitation of the results of Woodson's e c h o c a rd io g ra m , and nothing in her decision demonstrates that she placed undue weight (or a n y weight, really), on the ejection fraction and systolic function results. M o re troubling is the ALJ's comment that the record "does not suggest that the c la im a n t's hypertension has caused end organ damage." (A.R. 16.) As Woodson points out, h is treating physician noted in June 2008 that his hypertension has caused "some end organ d is e a se ." (Id. at 287.) The ALJ's comment likely reflects an oversight, and one that this c o u rt might disregard in other circumstances, but coupled with the errors in the credibility d e te rm in a tio n , it raises doubts regarding whether the ALJ adequately reviewed the most re c e n t medical evidence. See, e.g., Ribaudo v. Barnhart, 458 F.3d 580, 584 (7th Cir. 2006). Accordingly, the comment adds another thumb on the scale weighing toward a remand. See L o p e z ex rel. Lopez v. Barnhart, 336 F.3d 535, 540 (7th Cir. 2003). This court recognizes that this is a close case--as Dr. Patey pointed out, there c e rta in ly is record evidence that could support a finding that Woodson's claims lack c re d ib ility. But given Woodson's 2007 hospitalization, Dr. Ryan's observations regarding th e limiting effects of his condition, and the objective evidence showing that Woodson has h yp e rtro p h ic cardiomyopathy which could cause the symptoms he describes, his claims are n o t frivolous, and accordingly this court cannot overlook the ALJ's mistakes on the basis of h a rm le s s error. See Parker v. Astrue, 597 F.3d 920, 924 (7th Cir. 2010); Allord v. Barnhart, 4 5 5 F.3d 818, 821 (7th Cir. 2006); Sarchet v. Barnhart, 78 F.3d 305, 309 (7th Cir. 1996).

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On remand, the ALJ should reevaluate Woodson's credibility in light of the concerns h ig h lig h te d above. C o n c lu s io n For the foregoing reasons, Woodson's motion for summary judgment is granted and th e case is remanded for further proceedings consistent with this opinion. ENTER:

_________________________________ Y o u n g B. Kim U n ite d States Magistrate Judge

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