Lillquist v. Astrue

Filing 28

Enter MEMORANDUM, OPINION AND ORDER: Lillquists remaining arguments need not be addressed. For the reasons stated herein, the judgment of the ALJ is vacated and the case is remanded to the Commissioner for further proceedings not inconsistent with this opinion. Civil case terminated. Signed by the Honorable Virginia M. Kendall on 3/25/2015.Mailed notice(tsa, )

IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION
)
SYLVIA LILLQUIST,
)
)
Plaintiff,
)
v.
)
12 C 10206
)
MICHAEL J. ASTRUE, Acting Commissioner
)
Judge Virginia M. Kendall
of Social Security,
)
)
Defendant.
)
)
)
MEMORANDUM OPINION AND ORDER
Sylvia Lillquist seeks review of the Social Security Administration’s decision denying
her disability insurance benefits and supplemental security income benefits under Titles II and
XVI of the Social Security Act. See 42 U.S.C. §§ 423, 1381A. An Administrative Law Judge
(“ALJ”) determined that Lillquist is not disabled and thus not entitled to disability insurance
benefits or supplemental security income. The Social Security Appeals Council denied review,
thereby making the ALJ’s decision the final decision of the Commissioner of Social Security.
See Scrogham v. Colvin, 765 F.3d 685, 695 (7th Cir. 2014). Lillquist now seeks judicial review
of the Commissioner’s final decision pursuant to 42 U.S.C. § 405(g). For the reasons stated
below, the Court vacates the ALJ’s decision and remands the case for further proceedings not
inconsistent with this opinion.
BACKGROUND
Lillquist applied for disability insurance benefits and supplemental security income in
2009. In both claims, she alleged that her disability began on February 13, 2009. (R. 151). The
Social Security Administration initially denied those claims on September 3, 2009 and Lillquist
proceeded to a hearing before an ALJ on January 26, 2011. (R. 27). Represented by counsel,

Lillquist appeared at the hearing and testified. (Id.). Cheryl R. Hoiseth testified as an impartial
vocation expert at the hearing. (R. 8). On June 2, 2011 the ALJ issued a decision finding that
Lillquist was not disabled because she could perform light work that was limited to three to four
step simple unskilled work with repetitive routine tasks, so long as she had no contact with the
public and only occasional contact with coworkers and supervisors. (R. 14). The ALJ also noted
that Lillquist should avoid concentrated exposure to work hazards, including unprotected
heights, moving machinery, and temperature extremes. (Id.). The ALJ’s decision became the
Commissioner’s final decision when the Appeals Council denied review on October 26, 2013.
(R. 1). Lillquist now seeks judicial review of the ALJ’s decision.
A.

Medical Evidence

Lillquist was born on July 11, 1974. She was thirty-seven on the date of the hearing. She
lives with her seventeen year old daughter. (R. 32). Her mother and nephew also live in the
house, which her mother owns. (Id.). Lillquist suffers from fibromyalgia, obesity, disc bulging at
L5, early degenerative changes at C5-C6, and depression/anxiety disorder. (R. 10).
Treatment for Lillquist’s depression began in 2008 at a facility called Aunt Martha’s. (R.
334). The various treating physicians’ notes dated from April 2009 describe symptoms of
disturbed sleep, isolative behavior, anhedonia, and feelings of hopelessness. (R. 337). Doctors at
Aunt Martha’s also noted her obesity as well as stress surrounding her pending divorce. (R. 338).
On July 10, 2009, the Illinois Department of Disability Services referred Lillquist to Dr.
Hilger, a psychologist, for a competency evaluation. (R. 365-70). Lillquist reported to Dr. Hilger
that she was able to do housework, cook, drive, shop and care for herself. (R. 367). Dr. Hilger
diagnosed Lillquist with dysthymic disorder and anxiety disorder with a low average
intelligence. (R. 369). Dr. Hilger found that Lillquist’s general assessment functioning score was

2

65-70 “if not higher.” (Id.). Dr. Hilger concluded that Lillquist could perform a variety of semiskilled types of work similar to the types of work she had done in the past. (R. 370). Though
Lillquist has held a variety of positions, Dr. Hilger did not note which of Lillquist’s past jobs he
was referring to. Dr. Hilger reported that Lillquist put forth minimal effort during the
competency evaluation. (R. 369).
Six weeks later, on August 27, 2009, the Illinois Department of Disability Services
performed a psychological review and found that Lillquist’s mental impairments did not meet or
equal any mental listing and that Lillquist could perform simple one and two step tasks. (R. 387).
Dr. Hermsmeyer performed the evaluation. (R. 371). Dr. Hermsmeyer concluded that Lillquist
had mild limitations in her daily activities, that she suffered moderate limitations in her social
relationships, concentration, persistence, and pace, and that there was no evidence of
decompensation. (R. 381). The DDS evaluation indicated that Lillquist was partially credible.
(R. 383).
Lillquist’s treating physician, Dr. Shah, first examined Lillquist in September 2009. In
February 2010, Dr. Shah reported diagnoses of frequent headaches, hypercholesterolemia, and
depression. Dr. Shah noted at the time that Lillquist’s muscle strength in her hands, wrists,
fingers, forearms, and arms was normal. (R. 417). Dr. Shaw reported that Lillquist was able to
perform various everyday tasks, including opening doors, picking up coins and pens, using
zippers, tying shoes, and turning pages with both hands with no difficulty. (R. 420). In May
2010, Dr. Shah performed an examination of Lillquist and found that her pain was likely both
joint and muscle pain. (R. 438).
Lillquist was treated at the Ecker Center for Mental Health since at least March 2009.
(R. 408-12). Dr. Anwar and Dr. Kurilo treated her that year. (R. 411-13). In March 2009, Dr.

3

Kurilo wrote in a progress note that Lillquist had been experiencing anxiety and stress. (R. 413).
A few months later in June 2009, Dr. Kurilo remarked again that Lillquist displayed signs of
depression, lack of motivation, and weight gain. (R. 412). Dr. Kurilo also noted that Lillquist
suffered from insomnia. (Id.). Dr. Kurilo described Lillquist as “pleasant” and “cooperative” in
their interactions. (Id.). Later that year, in November 2009, Dr. Anwar saw Lillquist and reported
that Lillquist was struggling with the side effects of Cymbalta. (R. 411). Dr. Anwar also reported
that Lillquist was very depressed and had not been sleeping. (Id.).
By February 2010, Dr. Anwar reevaluated Lillquist and reported that her depression was
worsening. (R. 427). Dr. Anwar reported that he examined Lillquist and found her to be alert,
oriented, and cooperative, but he noted that her sleep had not been good, she felt tired, and her
concentration and memory were only fair. (R. 428). He also described her insight and judgment
as only fair. (Id.). In April, Dr. Anwar saw Lillquist for a follow-up appointment. This time, he
noted that her depression had continued to worsen and that her condition was getting to the point
where she could not function at all. (R. 431). She continued to see Dr. Anwar regularly and Dr.
Anwar continued to report strong depression and lack of motivation. (R. 431-33). Dr. Anwar
later completed a Medical Source Statement for Lillquist. (R. 434-37). He reported mild to
moderate limitations in all categories except the ability to ask simple questions and request
assistance, in which Dr. Anwar did not report any significant limitation.
The record contains a medical source statement dated June 2010, though it is not clear
what facility or physician prepared the document. (R. 566). The document states that Lillquist
could not sit, stand, walk, or lift more than five pounds. (R. 568). It also states that Lillquist must
lie down for seven hours each day. (Id.). This medical source statement states that Lillquist is not

4

able to do any work for any amount of time. The statement is signed, but the signature is illegible
(R. 572) and the physician did not include his or her name on the document. (R. 565).
In September 2010, Dr. Barclay of Sherman Hospital reported that Lillquist had
tenderness at all eighteen fibromyalgia points. (R. 448). Dr. Barclay prescribed a functional
capacity evaluation to be performed by a physical therapist. (Id.). Dr. Barclay concluded that she
was not able to provide any assistance to Lillquist, but referred her to a neurologist. (Id.).
Lillquist requested that Dr. Barclay write a note for her excusing her appearance at a court date
for a traffic citation. Dr. Barclay refused, reasoning that Lillquist’s ability to attend her medical
appointments implied that she was similarly able to appear in court. (R. 449). Dr. Barclay
reported that it was her opinion that Lillquist suffered from severe fibromyalgia. (R. 448).
Lillquist was treated at the Hills Healthcare Center in October and November 2010.
Examinations revealed no abnormalities. (R. 456-57). Lillquist reported to staff at Hills that her
pain was 4 out of 10 when she took her pain medication. (R. 455).
In December 2010, doctors at St. Alexius Medical Center performed a translaminar
epidural steroid injection to treat Lillquist’s lumbar degenerative disc disease. (R. 487). The
treating physicians’ notes report bulging at L3-L4 and L4-5, but did not document Lillquist’s
symptoms at the time of the procedure.
In January 2011, Therapist Heather Tod noted that Lillquist was quite seriously limited in
her daily functioning and, as a result, had been unable to attend therapy. Tod also reported that
Lillquist’s GAF score was 41 out of 100, indicating that she was “quite seriously limited in her
daily functioning.” (R. 605). Tod agreed to put therapy on hold until Lillquist was well enough to
attend appointments consistently. (Id.). Tod described Lillquist as “motivated for therapy.” (Id.).

5

Tod also noted that Lillquist’s impairments had prevented her both from attending therapy and
obtaining employment. (Id.).
B.

Employment History

Lillquist received a high school diploma and completed roughly a year of college. (R.
31). Before she sought Social Security benefits, Lillquist held a variety of jobs including cashier
at a casino, reservation representative at an airline, machine operator, and sales representative.
(R. 208). The parties agree that Lillquist is no longer able to perform any past relevant work and
has not worked since February 13, 2009. (R. 10, 19).
C.

Disability Claim and Hearing Testimony

Lillquist applied for disability insurance benefits and supplemental security income on
March 24, 2009, alleging disability beginning on February 13, 2009. (R. 151). The Social
Security Administration denied her claims on September 3, 2009 (R. 72) and her request for
reconsideration on March 16, 2010. (R. 81). Lillquist requested review by an ALJ and a hearing
was held on January 26, 2011. (R. 27). Lillquist, represented by counsel, appeared at the hearing
and testified. (Id.). Cheryl Hoiseth testified as a vocational expert. (Id.).
1.

Plaintiff’s Testimony

At the hearing, Lillquist testified that she suffered from fibromyalgia and depression, and
that the medications she took for fibromyalgia exacerbated her depression symptoms. (R. 40).
She also reported receiving steroid injections monthly at her fibromyalgia trigger points. (R. 38).
She described near-constant pain in her hands. She also complained of difficulty sleeping and
getting out of bed. She stated that she was able to make a sandwich and go shopping when she
feels well enough, but not every day. (R. 45). On many days she needs her daughter to perform
such tasks. (Id.). She uses her computer infrequently (R. 50) and plays games on her phone

6

frequently. (R. 57). At the hearing, Lillquist testified that she was experiencing a pain level of 6
out of 10. (R. 40). Lillquist additionally reported low self-esteem, difficulty concentrating, and
crying spells a few times weekly. (R. 40-41). Lillquist stated that she had panic attacks once or
twice a day for ten to fifteen minutes that render her unable to do anything during the attack. (R.
41). Two or three times a month Lillquist reported being too depressed to get out of bed at all.
(R. 44-45). Lillquist reported travelling with her daughter to visit colleges and filing the
necessary paperwork to obtain financial aid. (R. 47-48). She was able to use a zipper and to pick
up coins off a table. (R. 56).
2.

Vocational Expert Testimony

The Vocational Expert testified to Lillquist’s work history. Lillquist’s most recent work
was over two years prior to the hearing as an assistant manager from September 2008 to April
2009. (R. 59). The VE characterized her work as light, skilled work with an specific vocational
preparation (“SVP”) rating of 6 out of 9. 1 (Id.). The VE characterized Lillquist’s previous
position as a casino cashier, which she held over ten years prior to the hearing from 1993 to
2001, as sedentary, semi-skilled work with an SVP of 4. (R. 59-60). The VE characterized
Lillquist’s position as a reservation agent with an airline, which occurred even before the casino
position, as sedentary, skilled work with a SVP of 5. The VE described additional sedentary,
semi-skilled work and light skilled work in Lillquist’s past.
The ALJ inquired as to what jobs, if any, were available to a person with Lillquist’s
experience and limitations. (R. 60). Specifically, the ALJ asked the VE whether based on
Lillquist’s age, education, work experience, ability to lift 20 pounds occasionally, ten pounds
1

SVP ratings describe the amount of time necessary to acquire the skills necessary to do
a specific job at an average performance level. SVP is rated on a 1-9 scale and the higher the
rating, the more time it takes to develop the skills necessary for a given job.
7

frequently, stand and/or walk a total of six hours during an eight-hour workday and sit for at least
six hours. The ALJ asked the VE to limit her answer to work where that did not involve contact
with the public for work purposes, but did invovle occasional contact with coworkers or
supervisors. (R. 61). The VE determined that Lillquist could perform the tasks necessary to be a
housekeeper, which the VE described as light, unskilled work with an SVP 2. (R. 61). The VE
also found that Lillquist could be a cafeteria attendant, characterized as light, unskilled work
SVP 2. (Id.).
Lillquist’s attorney also examined the VE in the form of hypothetical questions. Under
questioning by Lillquist’s attorney, the VE testified that if an individual had to be off task 20%
of the time during a typical workday, no jobs in the economy would be available to that
individual. (R. 62). Furthermore, the VE testified that if Lillquist’s testimony that she was not
able to sit or stand for a full eight hour workday, even with a sit/stand option, was accurate, there
would not be any jobs available to her. (R. 63). The VE further testified that if Lillquist were
unable to work for two days a month all jobs would also be ruled out. (R. 65).
LEGAL STANDARD
The Social Security Act provides for judicial review of administrative decisions. See 42
U.S.C. § 405(g). Here, the ALJ’s decision became the final decision of the Commissioner of
Social Security when the Appeals Council declined review. See Scrogham v. Colvin, 765 F.3d
685, 695 (7th Cir. 2014). The Court therefore “examines the ALJ’s decision to determine
whether substantial evidence supports it and whether the ALJ applied the proper legal criteria.”
Allord v. Astrue, 631 F.3d 411, 415 (7th Cir. 2011). The scope of judicial review is quite limited.
“If the Commissioner’s decision is supported by substantial evidence, the court on judicial
review must uphold that decision even if the court might have decided the case differently in the

8

first instance.” Beardsley v. Colvin, 758 F.3d 834, 836 (7th Cir. 2014). “Substantial evidence is
such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.”
Id. (quoting Richardson v. Perales, 402 U.S. 389, 401 (1971)). The ALJ must build a logical
bridge between relevant evidence and the ALJ’s ultimate conclusion. See Moon v. Colvin, 763
F.3d 718, 721 (7th Cir. 2014).
DISCUSSION
In order to determine whether a claimant is disabled and thus eligible for disability
insurance benefits or supplemental security income, the ALJ applies a sequential five-step
inquiry. See 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4); Kastner v. Astrue, 697 F.3d 642, 646
(7th Cir. 2014). The inquiry asks: (1) whether the claimant is currently employed; (2) whether
the claimant has a severe impairment; (3) whether the claimant’s impairment is one that the
Commissioner considers conclusively disabling; (4) if the claimant does not have a conclusively
disabling impairment, whether he or she can perform the relevant work that he or she has
performed in the past; and (5) whether the claimant is capable of performing any work in the
national economy. See Kastner, 697 F.3d at 646. Here, the ALJ found that Lillquist had not
engaged in substantial gainful activity since February 13, 2009. (R. 10). The ALJ further found
that Lillquist had severe impairments, namely fibromyalgia, obesity, disc bulging at L5, early
degenerative changes at C5-C6, and depression/anxiety disorder. (Id.). Despite these findings,
the ALJ determined that the conditions did not meet the requirements for presumptive disability
at Step Three and moved on to assess Lillquist’s residual functional capacity (“RFC”). (R. 12).
The ALJ determined that Lillquist could perform light work as defined in 20 C.F.R.
§ 404.1567(b). (R. 14). The ALJ also determined that Lillquist could not perform any past
relevant work. (R. 19).

9

Lillquist attacks the ALJ’s decision on three grounds. First, Lillquist argues that the ALJ
erred in her credibility analysis. Second, Lillquist argues that the ALJ should have applied to
Special Technique at Step Three and found that her conditions met the requirement for a
presumptive disability. Finally, Lillquist argues that the ALJ’s RFC determination was
erroneous. This third argument necessarily overlaps with the first because the extent to which
Lillquist’s testimony is credible bears directly on the RFC determination.
A.

The ALJ’s Credibility Determination

Lillquist first argues that the Court should reverse and remand because the ALJ’s
credibility determination was deficient. An ALJ’s credibility determination is entitled to
deference and will be overturned only if patently wrong. Bates v. Colvin, 736 F.3d 1093, 1098
(7th Cir. 2013). The Court’s role in reviewing the ALJ’s credibility determination is to ensure
that the ALJ’s determination is reasoned and supported. Elder v. Astrue, 529 F.3d 408, 413 (7th
Cir. 2008). “An ALJ may not reject a claimant’s testimony about limitations on his daily
activities solely because his testimony is unsupported by the medical evidence.” Filus v. Astrue,
694 F.3d 863, 869 (7th Cir. 2012). The Court must uphold the ALJ’s credibility determination if
the ALJ provides “a detailed explanation of the evidence and [the ALJ’s] reasoning about
credibility.” Pierce v. Colvin, 739 F.3d 1046, 1050 (7th Cir. 2014).
Here, the ALJ discredited Lillquist’s testimony using the same boilerplate language that
the Seventh Circuit has repeatedly criticized. See, e.g., Minnick v. Colvin, 775 F.3d 929, 936 (7th
Cir. 2015) (collecting cases). The ALJ wrote: “I find that the claimant’s medically determinable
impairments could reasonably be expected to cause the alleged symptoms; however, the
claimant’s statements concerning the intensity, persistence and limiting effects of these
symptoms are not credible to the extent that they are inconsistent with the above residual

10

functional capacity assessment.” (R. 16). Without more, “[s]uch boilerplate language fails to
inform [the Court] in a meaningful, reviewable way of the specific evidence the ALJ considered
in determining that the claimant’s complaints were not credible.” Bjornson v. Astrue, 671 F.3d
640, 645 (7th Cir. 2012). The fact that the ALJ found Lillquist not to be credible only to the
extent that her statements were inconsistent with the ALJ’s own RFC suggests that the ALJ
reached the RFC first without considering Lillquists’s testimony and then used that
determination to assess Lillquists’s credibility; the reverse is proper. See Bjornson, 671 F.3d at
645.
The balance of the ALJ’s analysis does not render the boilerplate language harmless
because it does not “otherwise explain[] [the ALJ’s] conclusion adequately.” See Filius, 694 F.3d
at 868. The ALJ discussed Lillquist’s medical records, but did not explain why the cited excerpts
supported the conclusion that Lillquist’s testimony about the “intensity, persistence and limiting
effects” of the symptoms was not credible. Moreover, the ALJ’s analysis does not explain why
evidence consistent with the ALJ’s determination was given more weight than contrary evidence.
See Yurt v. Colvin, 758 F.3d 850, 860 (7th Cir. 2014) (ALJ cannot ignore or discount evidence
favorable to plaintiff’s claim); Bates v. Colvin, 736 F.3d 1093, 1099 (7th Cir. 2013) (“An ALJ
cannot rely only on evidence that supports her opinion.”). Although the ALJ need not mention all
of the evidence in the record in her opinion, the ALJ cannot ignore a line of evidence that
suggests a disability. Jones v. Astrue, 623 F.3d 1155, 1162 (7th Cir. 2010). “[A]n individual’s
statements about the intensity and persistence of pain or other symptoms or about the effect the
symptoms have on his or her ability to work may not be disregarded solely because they are not
substantiated by objective medical evidence.” Hall v. Colvin, --- F.3d ---, No. 14-2498, 2015 WL
727962 at *2 (7th Cir. Feb. 20, 2015) (quoting SSR 96-7p(4)).

11

The ALJ did not adequately explain why or how the evidence she cited bore on
Lillquist’s credibility with respect to intensity, persistence, and limiting effects of her symptoms.
The ALJ stated that Lillquist’s “activities of daily living are inconsistent with her statements
regarding limitation. She cooks, cleans, and does laundry, shops and goes to church.” (R. 19).
These statements, however are not inconsistent with any of Lillquist’s statements regarding
limitations. Lillquist testified that she sometimes goes to the store and sometimes cleans, but
often needs her daughter to do these things for her. Lillquist testified to being able to sit or stand
for a few hours at a time on good days, but needing to lie down for extended periods on bad
days. Not only are these statements insufficient to find Lillquist not to be credible, they also do
not undermine Lillquist’s stated limitations. Cf. Larson v. Astrue, 615 F.3d 744, 752 (7th Cir.
2010) (ability to maintain a small number of close friendships did not undermine testimony that
claimant was afraid to go out in public). Being able to perform occasionally the activities of daily
living is a far cry from being able to perform full time work. See Scrogham v. Colvin, 765 F.3d
685, 700 (7th Cir. 2014) (“sporadic performance [of household tasks or work] does not establish
that a person is capable of engaging in substantial gainful activity”) (alteration in original)
(internal quotation and citation omitted).
The ALJ’s statement that Lillquist had missed therapy appointments also does not bear
negatively on her credibility. (R. 19). The ALJ notes that Lillquist did not immediately make an
appointment to see a physical therapist when Dr. Barclay ordered physical therapy and that
Lillquist exercised only minimally and gained weight before her next visit. (R. 16). The ALJ also
discounted Lillquist’s testimony because she sometimes missed therapy appointments. (R. 19). It
is not immediately clear how Lillquist’s failure to schedule or attend her appointments promptly
have any impact on her credibility or the intensity, persistence, or limiting effects of her

12

symptoms and the ALJ did not give Lillquist the opportunity to explain the delay. See Myles v.
Astrue, 582 F.3d 672, 677 (7th Cir. 2009) (remand appropriate where ALJ did not consider
explanations for failure to keep up with treatment). In fact, the delay and lack of success at
therapy seem to weigh in favor of a higher level of impairment. Indeed, Lillquist’s therapist
herself agreed to postpone therapy sessions because Lillquist was, in her view, not well enough
to attend them. (R. 605).
The ALJ was also incorrect to discount Lillquist’s credibility because Dr. Hilger reported
that she had exhibited “minimal effort” during the evaluation that he performed. (R. 19).
Lillquist’s effort during her treatment and evaluation are relevant to her credibility, but here the
ALJ impermissibly ignored relevant evidence and relied too heavily upon one evaluation. Cf.
Rodriguez v. Colvin, No. 13 C 5683, 2015 WL 394098 at *4 (N.D. Ill. Jan 29, 2015) (efforts to
comply with medical advice and participate in treatment “are highly relevant” to ALJ credibility
determination). The ALJ did not, however, consider that Dr. Kurilo had previously noted that
Lillquist was cooperative during her interactions with Dr. Kurilo. (R. 412). Therapist Tod,
another individual who treated Lillquist, also reported that Lillquist was “motivated for therapy.”
(R. 605). Dr. Kurilo was a treating physician who had treated Lillquist for three years. (R. 18).
Dr. Hilger was a clinical psychologist retained to perform an evaluation for the Bureau of
Disability Determination Services. (R. 365). The ALJ did not provide a reason for discounting
Dr. Kurilo’s and Tod’s statements while crediting Dr. Hilger’s. This type of “cherry-picking”
from the record is impermissible. See Yurt v. Colvin, 758 F.3d at 859.
The ALJ’s flawed credibility analysis cannot be deemed harmless in this case. “An
erroneous credibility finding requires remand unless the claimant’s testimony is incredible on its
face or the ALJ explains that the decision did not depend on the credibility finding.” Pierce, 739

13

F.3d at 1051. Here, there is not a justification for the ALJ’s decision beyond that in the
credibility finding and Lillquists’s account of her pain “was not so contradicted by medical
evidence as to be incredible.” Id. Though it does not bear directly on the disposition of this
appeal, the Court notes that the impact of the ALJ’s credibility analysis is amplified here by the
VE’s testimony. The VE testified explicitly that no jobs would be available if any one of many
aspects of Lillquist’s account of her condition were credited. (R. 62). Because the credibility
determination has such a direct and substantiated impact on Lillquist’s entitlement to benefits,
the importance of a thorough analysis of the ALJ’s credibility determination was heightened. The
case is therefore remanded.
B.

The ALJ’s RFC Determination

Between steps three and four, the ALJ establishes the claimant’s residual functional
capacity, or RFC, in order to determine what type of work the claimant is able to do given her
limitations. The ALJ reached the following residual functional capacity determination:
After careful consideration of the entire record, I find that the
claimant has the residual functional capacity to perform light work
as defined in 20 CFR 404.1567(b) and 416.967(b) except
occasional climbing, balancing, stooping, crouching, crawling.
Claimant should have no contact with the public and only
occasionally contact with coworkers and supervisors. Claimant is
limited to three to four step simple unskilled work with repetitive
routine tasks. Claimant should avoid concentrated exposure to
work hazards to include unprotected heights and moving
machinery, and avoid concentrated exposure to temperature
extremes.
(R. 14). In reaching the RFC determination, the ALJ must evaluate all the evidence bearing on
the severity of a claimant’s symptoms, including pain, and must provide specific reasons for
discounting the claimant’s testimony concerning pain. Martinez v. Astrue, 630 F.3d 693, 697 (7th
Cir. 2011). “A treating physician’s opinion is entitled to controlling weight if it’s supported by

14

medical findings and consistent with substantial evidence in the record[.]” Bates v. Colvin, 736
F.3d 1093, 1099 (7th Cir. 2013).; see also 20 C.F.R. § 1527(c)(2). Even if the ALJ does not give
a treating physician’s opinion controlling weight, “the ALJ is not permitted to simply discard it.”
Scrogham, 765 F.3d at 697. In determining the weight to afford a treating physician’s opinion,
the ALJ must consider: “(1) the [l]ength of the treatment relationship and the frequency of
examination . . . ; (2) the [n]ature and extent of the treatment relationhip; (3) [s]uportability, i.e.,
whether a physician’s opinion is supported by relevant evidence, such as medical signs and
laboratory findings; (4) consistency with the record as a whole; and (5) whether the treating
physician was a specialist in the relevant area.” Id. (internal quotation marks omitted); 20 C.F.R.
§§ 404.1527(c)(2-5). The ALJ did not properly apply these factors here.
The ALJ erred in that the RFC determination was not supported by substantial evidence
because the ALJ unjustifiably discounted Dr. Anwar’s opinion The ALJ paraphrased correctly
that “Dr. Anwar is saying claimant cannot be around other people and cannot sustain
concentration and attention.” (R. 18). The ALJ discounted this assessment, however, because
Lillquist testified to going to church, helping her daughter with her financial aid forms, and using
the computer. (Id.). First, of these activities only going to church and going to the store involve
any sort of social interaction and Lillquist testified that she is not able to do either consistently.
Instead, she testified that her mother or daughter “often” had to shop for her because she was not
able to. (R. 45). Second, Lillquist testified that she helped her daughter to fill out a financial aid
application on the computer, not that she was able to use the computer frequently or for an
extended period of time. (R. 49). According to Lillquist, her daughter “did most of the work” on
the application. (Id.). These activities do constitute sustained concentration or attention and do
not undermine Lillquist’s account of her limitations or Dr. Anwar’s assessment.

15

The occasional social interaction about which Lillquist testified is not inconsistent with
Dr. Anwar’s assessment and does not justify affording it less than controlling weight. In reaching
the RFC determination, the ALJ noted that Dr. Anwar’s treatment notes documented a history of
“depression and anxiety with symptoms of crying spells, fatigue, sleep disturbance, panic
attacks, anhedonia, and sadness.” (R. 18). Dr. Anwar found that Lillquist had a substantial loss of
her ability to “understand, remember and carry out simple instructions; make judgments that are
commensurate with the functions of unskilled work such as make simple work related decisions;
respond appropriately to supervision, co-workers, and usual work situations; and deal with
changes in a routine work setting.” (Id.). In other words, Dr. Anwar’s assessment was “some
corroboration” of Lillquist’s testimony. The ALJ could have resolved doubts by ordering further
examination by an expert, but did not. The ALJ’s failure to inquire more deeply to resolve doubts
“leaves her determination that [Lillquist] is not disabled without a foundation in substantial
evidence.” Hall, 2015 WL 727962 at *2. The Court therefore remands the case to the ALJ to
explain more fully why Dr. Anwar’s opinion was not entitled to controlling weight.
CONCLUSION
Lillquist’s remaining arguments need not be addressed. For the reasons stated herein, the
judgment of the ALJ is vacated and the case is remanded to the Commissioner for further
proceedings not inconsistent with this opinion.

________________________________________
Virginia M. Kendall
United States District Court Judge
Northern District of Illinois
Date: 3/25/2015

16