Dotson v. Commissioner of Social Security Administration
Filing
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OPINION AND ORDER: The decision of the Commissioner of Social Security is REMANDED for further proceedings consistent with this Opinion and Order. Signed by Magistrate Judge Andrew P Rodovich on 3/22/17. (cer)
UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF INDIANA
FORT WAYNE DIVISION
RYAN A. DOTSON,
Plaintiff,
v.
NANCY A. BERRYHILL,
Acting Commissioner of Social Security,1
Defendant.
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Case No. 1:15-cv-41
OPINION AND ORDER
This matter is before the court on the petition for judicial review of the decision of the
Commissioner filed by the plaintiff, Ryan A. Dotson, on February 5, 2015.2 For the following
reasons, the decision of the Commissioner is REMANDED.
Background
The plaintiff, Ryan A. Dotson, filed an application for Disability Insurance Benefits and
Supplemental Security Income on July 5, 2012, alleging a disability onset date of June 30, 2012.
(Tr. 17). The Disability Determination Bureau denied Dotson’s application on September 13,
2012, and again upon reconsideration on November 19, 2012. (Tr. 17). Dotson subsequently
filed a timely request for a hearing on November 30, 2012. (Tr. 17). A hearing was held on
August 6, 2013, before Administrative Law Judge (ALJ) Maryann S. Bright, and the ALJ issued
1
Nancy A. Berryhill is now the Acting Commissioner of Social Security. Pursuant to Rule 25(d) of the
Federal Rules of Civil Procedure, Nancy A. Berryhill should be substituted for Acting Commissioner Carolyn W.
Colvin as the defendant in this suit. No further action needs to be taken to continue this suit by reason of the last
sentence of section 205(g) of the Social Security Act, 42 U.S.C. § 405(g).
2
On January 8, 2016, this case was reassigned to Magistrate Judge Susan L. Collins upon the parties’
consent under 28 U.S.C. § 636(c), and then was reassigned to Magistrate Judge Andrew P. Rodovich. On August 5,
2016, the court ordered the parties to file any objection to Magistrate Judge Rodovich conducting all further
proceedings in this case. Because neither party filed an objection, this court finds that the parties voluntarily consent
to Magistrate Judge Rodovich under 28 U.S.C. § 636(c).
an unfavorable decision on September 13, 2013. (Tr. 17–29). Vocational Expert (VE) Dale A.
Thomas, Dotson, and Dotson’s ex-wife, Melissa Dotson, testified at the hearing. (Tr. 17, 23).
The Appeals Council denied review, making the ALJ’s decision the final decision of the
Commissioner. (Tr. 1–13).
The ALJ found that Dotson met the insured status requirements of the Social Security Act
through December 30, 2016. (Tr. 19). At step one of the five step sequential analysis for
determining whether an individual is disabled, the ALJ found that Dotson had not engaged in
substantial gainful activity since June 30, 2012, the alleged onset date. (Tr. 19). At step two, the
ALJ determined that Dotson had the following severe impairments: bipolar II disorder, panic
disorder without agoraphobia with mild panic attacks, posttraumatic stress syndrome (PTSD),
and obesity. (Tr. 20). At step three, the ALJ concluded that Dotson did not have an impairment
or combination of impairments that met or medically equaled the severity of one of the listed
impairments. (Tr. 20). Specifically, she found that he did not meet Listings 12.04 or 12.06. (Tr.
20).
In finding that Dotson did not meet the above listings, the ALJ considered the paragraph
B criteria for mental impairments, which required at least two of the following:
marked restriction of activities of daily living; marked difficulties in
maintaining social functioning; marked difficulties in maintaining
concentration, persistence, or pace; or repeated episodes of decompensation,
each of extended duration.
(Tr. 21-22). The ALJ defined a marked limitation as more than moderate but less than extreme
and repeated and extended episodes of decompensation as three episodes within one year or once
every four months with each episode lasting at least two weeks. (Tr. 21). The ALJ found that
Dotson had moderate restrictions in daily living activities. (Tr. 21). She noted that Dotson was
independent in his personal care but neglected his hygiene at times. (Tr. 21). Dotson testified
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that he received reminders from his mother-in-law to shower and that he relied on his ex-wife to
clean and grocery shop. (Tr. 21). However, the ALJ reported that Dotson was the primary
caretaker of his infant son. (Tr. 21).
The ALJ found that Dotson had moderate difficulties in social functioning. (Tr. 21).
When asked if he had ever been fired for problems getting along with others, Dotson testified at
the hearing that he was fired for having a sexual relationship with a coworker. (Tr. 21).
Dotson’s ex-wife testified that Dotson could not maintain a job for more than six months because
he did not get along well with others. (Tr. 21). However, the ALJ noted that Dotson left home
alone, worked part-time after the alleged onset date caring for adults with mental disabilities, and
interacted without issue with clients. (Tr. 21).
The ALJ concluded that Dotson had moderate difficulties in concentration, persistence,
or pace. (Tr. 21). Dotson testified to memory problems, but the ALJ indicated his memory
issues were moderate because he could handle a checkbook and he remembered pertinent
information about his past employment. (Tr. 21). Moreover, the ALJ found that Dotson had not
experienced any extended episodes of decompensation. (Tr. 21).
The ALJ concluded that Dotson did not satisfy the paragraph B criteria because his
mental impairments did not cause at least two marked limitations or one marked limitation and
repeated episodes of decompensation. (Tr. 22). Additionally, she concluded that Dotson did not
satisfy the paragraph C criteria because the record was devoid of evidence of episodes of
decompensation, potential episodes of decompensation, or an inability to function outside a
highly supportive living arrangement or his home. (Tr. 22).
The ALJ then assessed Dotson’s residual functional capacity (RFC) as follows:
the claimant has the residual functional capacity to perform
medium work as defined in 20 CFR 404.1567(c) and 416.967(c)
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except he is unable to engage in complex or detailed tasks, but can
perform simple, routine, and repetitive tasks consistent with
unskilled work; and is able to sustain and attend to task throughout
the workday. He is limited to work in a low stress job, defined as
having only occasional decision making required and only
occasional changes in the work setting. The claimant is further
limited from fast-paced work such as assembly line production
work with strict productivity requirements. He is limited to
superficial interaction with coworkers, supervisors and the public,
with superficial interaction defined as occasional and casual
contact not involving prolonged conversation or discussion of
involved issues. Contact with supervisors still involves necessary
instruction.
(Tr. 22). The ALJ explained that in considering Dotson’s symptoms she followed a two-step
process. (Tr. 22). First, she determined whether there was an underlying medically determinable
physical or mental impairment that was shown by a medically acceptable clinical or laboratory
diagnostic technique that reasonably could be expected to produce Dotson’s pain or other
symptoms. (Tr. 22). Then she evaluated the intensity, persistence, and limiting effects of the
symptoms to determine the extent to which they limited Dotson’s functioning. (Tr. 22–23).
Dotson application for disability benefits alleged that his bipolar disorder, borderline
personality disorder, PTSD, and obsessive-compulsive disorder rendered him disabled. (Tr. 23).
He reported on his Function Report that his anxiety caused memory and concentration problems,
difficulty completing tasks, and getting along with others. (Tr. 23). Specifically, he indicated
due to his anxiety at work he would cry in the parking lot and hide to call his wife. (Tr. 23). He
reported that his medications caused several side effects. (Tr. 23). Dotson testified that he was
the primary caretaker for his sixteen-month-old son with the help of his mother-in-law but that
she worked during the day. (Tr. 23). Also, he reported that he attempted suicide after an
altercation with his ex-wife but that he did not seek emergency treatment. (Tr. 23). He stated
that he relied on his ex-wife to care for the home, mow the lawn, and grocery shop. (Tr. 23).
4
Dotson’s ex-wife testified that they divorced because she could not afford the copays for
Dotson’s therapy, but that they continued to live as husband and wife. (Tr. 23). She stated that
Dotson would continuously call her from work because of his anxiety and occasionally his
anxiety caused him to miss work because he would not get out of bed. (Tr. 23). She indicated
that he was head-butted at work on August 14, 2011, and that his PTSD worsened after the
incident, which led to his termination. (Tr. 23). Additionally, she testified that Dotson cared for
their son, but that he required her assistance. (Tr. 23).
The ALJ found that Dotson’s impairments could cause some of his alleged symptoms,
but that he was not entirely credible regarding the intensity, persistence, and limiting effects of
the symptoms. (Tr. 23). Specifically, she gave Dotson’s testimony limited weight because there
were many inconsistencies between it and the record. (Tr. 23–24). For example, she found that
his work history, daily living activities, and the medical evidence was inconsistent with his claim
of disabling anxiety. (Tr. 23–24). The ALJ noted that Dotson worked part-time, including
skilled work after his alleged onset date, therefore, she found that his anxiety did not
significantly interfere with his ability to work. (Tr. 23-24). Also, despite receiving assistance
from his ex-wife and mother-in-law, the ALJ noted that Dotson was the primary caretaker for his
infant son. (Tr. 24).
The ALJ indicated that Dotson did not report any medication side effects at several
medication management visits despite claiming that all his medications caused side effects. (Tr.
24). Additionally, Dotson reported problems with hygiene, yet he appeared well-groomed and
reported taking four showers a day. (Tr. 24). The ALJ assigned little weight to Dotson’s exwife’s testimony because it lacked support from the medical records and she had a financial
interest in Dotson receiving benefits. (Tr. 24).
5
The ALJ then reviewed the medical evidence. (Tr. 24–26). She found that the record did
not demonstrate a long history of mental health treatment. (Tr. 24). She indicated that Dotson
first sought counseling in 2010 when his family experienced a traumatic event and that he began
taking depression medication in early 2011. (Tr. 24). On July 15, 2011, Dr. Heidi Ehrhardt
diagnosed Dotson with depression and bipolar disorder. (Tr. 24). In August of 2011, Dotson
began treatment with Dr. Jay Fawver. (Tr. 24). Dr. Fawver prescribed several medications and
Dotson was treated on a monthly basis at the Fawver Wellness Clinic through July 2012. (Tr.
24). Dotson testified that he stopped treatment with Dr. Fawver because he did not recommend
disability. (Tr. 24).
In August of 2012, Dotson began treatment with Dr. Samir Ishak who assessed him with
anxiety disorder and prescribed several medications. (Tr. 25). At Dotson’s follow up
appointment, he reported that he stopped using Abilify because it made him feel manic. (Tr. 25).
In October 2012, Dotson saw Dr. Ehrhardt again and complained of psychological and memory
problems. (Tr. 25). She recommended a neuropsychological evaluation and noted that Dotson
had lost consciousness after a patient pushed him down at work. (Tr. 25).
After Dr. Ehrhardt’s recommendation, Dotson saw neuropsychologist Christina
Stemmler, Psy.D. for complaints of disorientation, short-term memory loss, confusion, and
disorganization. (Tr. 25). Dotson denied having attention problems despite his history of
ADHD. (Tr. 25). He reported that his daily activities consisted of caring for his seven-monthold son and his horse. (Tr. 25). Dr. Stemmler found some memory and attention problems
during her mental status examination and diagnosed Dotson with cognitive disorder, bipolar II
disorder, ADHD, anxiety disorder, and a learning disorder. (Tr. 25). She concluded that Dotson
could be experiencing residual deficits from a traumatic brain injury and recommended further
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testing, more medication management, and psychiatric monitoring from Dr. Ishak. (Tr. 25). Dr.
Ishak treated Dotson and noted that he was not experiencing any side effects from his
medications. (Tr. 25). Dr. Ishak continued Dotson on his medications. (Tr. 25). Susan TielkerSharpe provided coping techniques during a counseling session after Dotson discussed his anger
issues, insecurities, belief that he was disabled, grief over his grandfather’s passing, and
dependency problems. (Tr. 25).
Dr. Stemmler performed a neuropsychological examination and recommended Dotson
receive ongoing monitoring from his treating physicians and mental health providers. (Tr. 25).
She supported Social Security disability temporarily, but she indicated that Dotson’s head injury
did not prevent him from returning to gainful employment. (Tr. 25). Dotson reported isolation,
neglecting his personal hygiene, worsening depression and anxiety, and failing to take his
diagnosed Lithium for two weeks. (Tr. 25). Dr. Ishak requested Dotson be hospitalized due to
his worsening depression symptoms and changes in behavior. (Tr. 25). Dr. Ishak assessed him
with bipolar affective disorder, posttraumatic stress disorder, and panic attacks without
agoraphobia. (Tr. 25-26). Dotson was hospitalized twice and discharged both times at his own
request. (Tr. 26).
Dotson underwent an independent psychological evaluation with Revathi Bingi, Ed.D.
who assessed him with bipolar disorder, most recent episode depressed, panic disorder with
agoraphobia, PTSD, and OCD. (Tr. 26). Dotson reported symptoms of panic attacks, feelings of
worthlessness, mind racing, excessive anger, poor focus, mood swings, and suicidal ideation.
(Tr. 26). However, the ALJ noted that he correctly interpreted proverbs, identified similarities
and differences between objects, recalled digits, and calculated simple math problems. (Tr. 26).
7
Dr. Ishak opinioned that Dotson was unable to hold employment, however, Dotson was
working at the time. (Tr. 26). Therefore, the ALJ assigned little weight to his opinion because
he had treated Dotson for only three months and his opinion was inconsistent with Dotson’s
current work activity. (Tr. 26). The ALJ assigned little weight to Dr. Fawver’s opinion that
Dotson should remain off work because his mood was unpredictable and unstable. (Tr. 26). The
ALJ concluded that Dr. Fawver had seen Dotson for only two months and that his limitations
were not long-term. (Tr. 26).
Dr. Bingi found that Dotson did not have significant problems with cognition, but that he
appeared to be dependent on his wife and assessed him with a Global Assessment of Functioning
(GAF) score of 45. (Tr. 26). The ALJ assigned some weight to Dr. Bingi because he conducted
a detailed psychological evaluation, but she discredited his opinion because he had met with
Dotson only once and a GAF score was not dispositive or proof of an ongoing disability for
Social Security purposes. (Tr. 26-27). The ALJ assigned great weight to the opinions of the
State agency psychological consultants who concluded that Dotson retained the ability to carry
out unskilled or semi-skilled tasks on a sustained basis in a competitive setting not requiring pace
or intense concentration. (Tr. 27).
There are several other GAF scores in the record and each score was given some weight.
(Tr. 27). The ALJ determined that the GAF scores showed that except for a brief period in July
of 2013 Dotson’s treatment providers reported that his social, occupational, and school
functioning were moderately impaired. (Tr. 27). The ALJ found the findings to be consistent
with Dotson’s daily activities, work history, and the opinions of the State agency psychological
consultants. (Tr. 27).
8
At step four, the ALJ found that Dotson was unable to perform any past relevant work.
(Tr. 27). Considering Dotson’s age, education, work experience, and RFC, the ALJ concluded
that there were jobs in the national economy he could perform, including electronics assembler
(8,000 jobs locally and 114,000 jobs nationally), laundry worker (4,800 jobs locally and 298,000
jobs nationally), and packer and hand packager (1,600 jobs locally and 56,000 jobs nationally).
(Tr. 28).
Discussion
The standard for judicial review of an ALJ’s finding that a claimant is not disabled within
the meaning of the Social Security Act is limited to a determination of whether those findings are
supported by substantial evidence. 42 U.S.C. § 405(g) (“The findings of the Commissioner of
Social Security, as to any fact, if supported by substantial evidence, shall be conclusive.”);
Moore v. Colvin, 743 F.3d 1118, 1120–21 (7th Cir. 2014); Bates v. Colvin, 736 F.3d 1093, 1097
(7th Cir. 2013) (“We will uphold the Commissioner’s final decision if the ALJ applied the
correct legal standards and supported her decision with substantial evidence.”). Courts have
defined substantial evidence as “such relevant evidence as a reasonable mind might accept to
support such a conclusion.” Richardson v. Perales, 402 U.S. 389, 401, 91 S. Ct. 1420, 1427, 28
L. Ed. 2d 852 (1972) (quoting Consol. Edison Co. v. NLRB, 305 U.S. 197, 229, 59 S. Ct. 206,
217, 83 L. Ed. 2d 140 (1938)); see Bates, 736 F.3d at 1098. A court must affirm an ALJ’s
decision if the ALJ supported her findings with substantial evidence and if there have been no
errors of law. Roddy v. Astrue, 705 F.3d 631, 636 (7th Cir. 2013) (citations omitted). However,
“the decision cannot stand if it lacks evidentiary support or an adequate discussion of the issues.”
Lopez ex rel Lopez v. Barnhart, 336 F.3d 535, 539 (7th Cir. 2003).
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Disability and supplemental insurance benefits are available only to those individuals
who can establish “disability” under the terms of the Social Security Act. The claimant must
show that he is unable “to engage in any substantial gainful activity by reason of any medically
determinable physical or mental impairment which can be expected to result in death or which
has lasted or can be expected to last for a continuous period of not less than 12 months.” 42
U.S.C. § 423(d)(1)(A). The Social Security regulations enumerate the five-step sequential
evaluation to be followed when determining whether a claimant has met the burden of
establishing disability. 20 C.F.R. §§ 404.1520, 416.920. The ALJ first considers whether the
claimant is presently employed or “engaged in substantial gainful activity.” 20 C.F.R. §§
404.1520(b), 416.920(b). If he is, the claimant is not disabled and the evaluation process is over.
If he is not, the ALJ next addresses whether the claimant has a severe impairment or combination
of impairments that “significantly limits . . . physical or mental ability to do basic work
activities.” 20 C.F.R. §§ 404.1520(c), 416.920(c); see Williams v. Colvin, 757 F.3d 610, 613
(7th Cir. 2014) (discussing that the ALJ must consider the combined effects of the claimant’s
impairments). Third, the ALJ determines whether that severe impairment meets any of the
impairments listed in the regulations. 20 C.F.R. § 401, pt. 404, subpt. P, app. 1. If it does, then
the impairment is acknowledged by the Commissioner to be conclusively disabling. However, if
the impairment does not so limit the claimant’s remaining capabilities, the ALJ reviews the
claimant’s “residual functional capacity” and the physical and mental demands of his past work.
If, at this fourth step, the claimant can perform his past relevant work, he will be found not
disabled. 20 C.F.R. §§ 404.1520(e), 416.920(e). However, if the claimant shows that his
impairment is so severe that he is unable to engage in his past relevant work, then the burden of
proof shifts to the Commissioner to establish that the claimant, in light of his age, education, job
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experience, and functional capacity to work, is capable of performing other work and that such
work exists in the national economy. 42 U.S.C. § 423(d)(2); 20 C.F.R. §§ 404.1520(f),
416.920(f).
First, Dotson has argued that the ALJ failed to consider all of his medically determinable
severe impairments. At step two, the claimant has the burden to establish that he has a severe
impairment. Castile v. Astrue, 617 F.3d 923, 926 (7th Cir. 2010). A severe impairment is an
“impairment or combination of impairments which significantly limits [one’s] physical or mental
ability to do basic work activities.” 20 C.F.R. §§ 404.1520(c), 404.1521(a); Castile, 617 F.3d at
926. Basic work activities include “the abilities and aptitudes necessary to do most jobs,” such
as “walking, standing, sitting, lifting, pushing, pulling, reaching, carrying, or handling.” 20
C.F.R. § 404.1521(b); Stopka v. Astrue, 2012 WL 266341, at *1 (N.D. Ill. Jan. 26, 2012).
“[A]n impairment that is ‘not severe’ must be a slight abnormality (or a combination of slight
abnormalities) that has no more than a minimal effect on the ability to do basic work activities.”
Social Security Ruling 96-3p, 1996 WL 374181, at *1. Courts have characterized step two as a
de minimis screening device that disposes of groundless claims. Johnson v. Sullivan, 922 F.2d
346, 347 (7th Cir. 1990); Elkins v. Astrue, 2009 WL 1124963, at *8 (S.D. Ind. April 24, 2009)
(citing Webb v. Barnhart, 433 F.3d 683, 688 (9th Cir. 2005)); see Stopka, 2012 WL 266341 at
*1 (listing cases supporting same).
The ALJ found that Dotson suffered from the severe impairments of bipolar II disorder,
panic disorder without agoraphobia with mild panic attacks, posttraumatic stress syndrome
(PTSD), and obesity. Dotson has argued that the ALJ failed to mention or discuss his medically
determinable impairments of obsessive compulsive disorder (OCD), borderline personality
disorder, and cognitive disorder. The ALJ acknowledged that Dotson’s application for disability
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benefits alleged that his bipolar disorder, borderline personality disorder, PTSD, and obsessive
compulsive disorder rendered him disabled. (Tr. 23). The ALJ briefly discussed Dotson’s
cognitive disorder. The ALJ noted Dr. Stemmler’s mental status examination findings and that
she assessed Dotson with cognitive disorder, bipolar II disorder, ADHD, anxiety disorder, and a
learning disorder. (Tr. 25). Also, the ALJ noted Dotson’s obsessive compulsive disorder after
review of Dr. Bingi’s psychological evaluation that assessed Dotson with bipolar disorder, most
recent episode depressed, panic disorder without agoraphobia, PTSD, and OCD. (Tr. 26).
A finding at step two that a medical condition is severe “is merely a threshold
requirement.” Hickman v. Apfel, 187 F.3d 683, 688 (7th Cir.1999). The ALJ’s classification of
an impairment as severe or non-severe is irrelevant past step two. All that is required of the ALJ
is to consider the impact of all the impairments, severe and non-severe, on Dotson’s ability to
work. See Raines v. Astrue, 2007 WL 1455890, at *7 (S.D. Ind. 2007). However, the ALJ
cannot ignore a line of evidence that suggests a disability. See Golembiewski v. Barnhart, 322
F.3d 912, 917 (7th Cir. 2003) (“[T]he ALJ may not ignore an entire line of evidence that is
contrary to the ruling . . . .”). Here, the ALJ found severe impairments at step two. The ALJ
proceeded beyond step two, therefore, no error resulted from a failure to label an impairment as
severe. See Raines v. Astrue, 2007 WL 1455890, at *7 (S.D. Ind. 2007). It is the claimant’s
burden to establish his ailments and their symptomology. Castile v. Astrue, 617 F.3d 923, 926
(7th Cir. 2010).
Dotson did not identify how the ALJ failed to consider his symptoms in combination or
how any errors at step two caused an error later in the process. Moreover, he did not meet his
burden to prove that the impairments were severe. Castile, 617 F.3d at 926. The ALJ found
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severe impairments, proceeded through the evaluation process, and considered the aggregate
effect of his impairments.
Next, Dotson has argued that the ALJ failed to engage in a legally sufficient step three
analysis. Dotson indicated that it was appropriate for the ALJ to consider Listing 12.04 and
12.06. However, he contends that the ALJ’s omission of Listing 12.02 for cognitive disorders,
Listing 12.04 for affective disorders, and 12.06 for OCD was legal error. Dotson further
contends that the ALJ’s omission of paragraph C criteria of Listing 12.02 and 12.04 was harmful
and reversible error.
For a claimant to show that he met a listed impairment, he must have demonstrated that
his impairment met each required criterion and bore the burden of proof in showing his condition
qualified. Maggard v. Apfel, 167 F.3d 376, 380 (7th Cir. 1999). A condition that met only some
of the required medical criteria, “no matter how severely,” cannot qualify as meeting a listing.
Sullivan v. Zebley, 493 U.S. 521, 530, 110 S.Ct. 885, 107 L.Ed.2d 967 (1990).
Section 12.00(A) of the social security regulations describes the structure of the Mental
Disorder Listings. To show that he met the Mental Disorder Listing, the claimant must have
submitted a set of medical findings that supported a diagnosis of one of the listed medical
impairments. After the claimant has met this burden, the court must assess the severity of the
impairment under paragraph B. 20 C.F.R. § 404.1520a(a). Paragraph B sets forth the
impairment-related functional limitations that are incompatible with the ability to do any gainful
activity. The claimant’s functional limitations are assessed by using the four criteria set forth in
paragraph B of the listings: Activities of daily living; social functioning; concentration,
persistence, or pace; and episodes of decompensation. Listing 12.00(C); 20 C.F.R. §
404.1520a(c)(3). Each functional limitation must be evaluated to determine the severity, taking
13
into consideration “all relevant and available clinical signs and laboratory findings, the effects of
[the] symptoms, and how [the claimant’s] functioning may be affected by factors including, but
not limited to, chronic mental disorders, structured settings, medication, and other treatment.” 20
C.F.R. § 404.1520a(c)(1). If the degree of limitation is none or mild in the first three categories
and none in the fourth, the impairment is not severe. 20 C.F.R. § 404.1520a(d)(1). Otherwise,
the court will proceed to determine whether the claimant met the criteria set forth by the Listing
for the specific mental impairment for which he was diagnosed.
The ALJ did not discuss whether Dotson met the paragraph A criteria, so it is proper for
the court to assume that he did meet the criteria. The ALJ found that Dotson had moderate
restrictions in daily living activities, social functioning, and with concentration, persistence, or
pace. (Tr. 21). Moreover, the ALJ found that Dotson had not experienced any extended
episodes of decompensation. (Tr. 21). Because the ALJ did not find two marked limitations or
one marked limitation and repeated episodes of decompensation, she concluded that Dotson did
not satisfy the paragraph B criteria. (Tr. 22).
Dotson has indicated that paragraph C for Listing 12.06 was not satisfied. Specifically,
with respect to Listings 12.02 and 12.04, “[t]he required level of severity for these disorders is
met when the requirements in both A and B are satisfied, or when the requirements in A and C
are satisfied.” 20 C.F.R. § 404, Subpt. P, App., §§ 12.02, 12.04. Dotson has argued that he
satisfied the paragraph C criteria of Listing 12.02 for cognitive disorders and Listing 12.04 for
affective disorders. To meet the C criteria the claimant must show:
Medically documented history of a [chronic organic mental disorder, for Listing
12.02 and chronic affective disorder, for Listing 12.04] of at least two years
duration that has caused more than a minimal limitation of ability to do basic
work activities, with symptoms or signs currently attenuated by medical or
psychosocial support and one of the following:
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1. Repeated episodes of decompensation, each of extended duration; or
2. A residual disease process that has resulted in such marginal adjustment
that even a minimal increase in mental demands or change in the
environment would be predicted to cause the individual to decompensate;
or
3. A current history of one or more years’ inability to function outside a
highly supportive living arrangement, with an indication of continued need
for such an arrangement.
20 C.F.R. Pt. 404, Subpt. P., App. 1, § 12.00.
The ALJ concluded that Dotson did not satisfy the paragraph C criteria because the record was
devoid of evidence of episodes of decompensation, potential episodes of decompensation, or an
inability to function outside a highly supportive living arrangement or his home. (Tr. 22).
Dotson has argued that the potential for decompensation was evident in the treatment
notes and consultative examiners’ observations, as well as his and his ex-wife’s reports. He
indicated that the record supported the existence of a residual disease process that had resulted in
such marginal adjustment that even a minimal increase in mental demands or change in the
environment would be predicted to cause him to decompensate. Also, he contends that his
cognitive disorder and bipolar disorder are medically documented chronic mental disorders of at
least two years in duration.
The Commissioner indicated that the State agency doctors whom the ALJ gave great
weight did not agree that Dotson met or equaled a listing. Also, the Commissioner has reiterated
that Dotson’s ability to work past his alleged onset date was not reflective of the inability to do
any gainful activity as required for the Listing. However, the ALJ did not reference the doctors’
opinions or Dotson’s work history when considering the paragraph C criteria. Even if there is
evidence in the record to support the ALJ’s decision, principles of administrative law require the
15
ALJ rationally to articulate the ground for her decisions and confine the court’s review to reasons
supplied by the ALJ. Steele v. Barnhart, 290 F.3d 936, 941 (7th Cir. 2002).
Dotson has failed to cite specific evidence to support his assertion. However, the ALJ
failed to build a logical bridge that was persuasive. An ALJ must articulate, at a minimum, her
analysis of the evidence in order to allow the reviewing court to trace the path of her reasoning
and to be assured that the ALJ considered the important evidence. Wiszowaty v. Astrue, 861
F.Supp.2d 924, 934 (N.D. Ind. 2012). There is no analysis of the evidence relied on to support
the finding that Dotson did not satisfy paragraph C criteria. The ALJ may be able to articulate
support from the evidence for her decision, but she failed to do so. The ALJ has a duty to
develop the record fully before drawing conclusions and must adequately articulate her analysis,
so the court can trace her path of reasoning. Herron v. Commissioner of Social Sec., 788
F.Supp.2d 809, 818 (N.D. Ind. 2011). Therefore, this matter is remanded for the errors in the
Step 3 analysis that require a more comprehensive discussion of the evidence by the ALJ.
Dotson has argued that the ALJ’s credibility finding was patently wrong. This court will
sustain the ALJ’s credibility determination unless it is “patently wrong” and not supported by the
record. Bates v. Colvin, 736 F.3d 1093, 1098 (7th Cir. 2013); Schmidt v. Astrue, 496 F.3d 833,
843 (7th Cir. 2007); Prochaska v. Barnhart, 454 F.3d 731, 738 (7th Cir. 2006) (“Only if the trier
of fact grounds her credibility finding in an observation or argument that is unreasonable or
unsupported . . . can the finding be reversed.”). The ALJ’s “unique position to observe a
witness” entitles her opinion to great deference. Nelson v. Apfel, 131 F.3d 1228, 1237 (7th Cir.
1997); Allord v. Barnhart, 455 F.3d 818, 821 (7th Cir. 2006). However, if the ALJ does not
make explicit findings and does not explain them “in a way that affords meaningful review,” the
ALJ’s credibility determination is not entitled to deference. Steele v. Barnhart, 290 F.3d 936,
16
942 (7th Cir. 2002). Further, “when such determinations rest on objective factors or fundamental
implausibilities rather than subjective considerations [such as a claimant’s demeanor], appellate
courts have greater freedom to review the ALJ’s decision.” Clifford v. Apfel, 227 F.3d 863, 872
(7th Cir. 2000); see Bates, 736 F.3d at 1098.
The ALJ must determine a claimant’s credibility only after considering all of the
claimant’s “symptoms, including pain, and the extent to which [the claimant’s] symptoms can
reasonably be accepted as consistent with the objective medical evidence and other evidence.”
20 C.F.R. ' 404.1529(a); Arnold v. Barnhart, 473 F.3d 816, 823 (7th Cir. 2007) (“[S]ubjective
complaints need not be accepted insofar as they clash with other, objective medical evidence in
the record.”); Scheck v. Barnhart, 357 F.3d 697, 703 (7th Cir. 2004). If the claimant’s
impairments reasonably could produce the symptoms of which the claimant is complaining, the
ALJ must evaluate the intensity and persistence of the claimant’s symptoms through
consideration of the claimant’s “medical history, the medical signs and laboratory findings, and
statements from [the claimant, the claimant’s] treating or examining physician or psychologist,
or other persons about how [the claimant’s] symptoms affect [the claimant].” 20 C.F.R.
' 404.1529(c); see Schmidt v. Barnhart, 395 F.3d 737, 746–47 (7th Cir. 2005) (“These
regulations and cases, taken together, require an ALJ to articulate specific reasons for
discounting a claimant’s testimony as being less than credible, and preclude an ALJ from merely
ignoring the testimony or relying solely on a conflict between the objective medical evidence and
the claimant’s testimony as a basis for a negative credibility finding.”).
Although a claimant’s complaints of pain cannot be totally unsupported by the medical
evidence, the ALJ may not disregard an individual’s statements about symptoms solely based on
17
objective medical evidence. SSR 16-3p, at *53; see Moore v. Colvin, 743 F.3d 1118, 1125 (7th
Cir. 2014) (“‘[T]he ALJ cannot reject a claimant’s testimony about limitations on his daily
activities solely by stating that such testimony is unsupported by the medical evidence.’”)
(quoting Indoranto, 374 F.3d at 474); Carradine v. Barnhart, 360 F.3d 751, 754 (7th Cir. 2004)
(“If pain is disabling, the fact that its source is purely psychological does not disentitle the
applicant to benefits.”). Rather, if the
[c]laimant indicates that pain is a significant factor of his or her
alleged inability to work, the ALJ must obtain detailed descriptions
of the claimant’s daily activities by directing specific inquiries about
the pain and its effects to the claimant. She must investigate all
avenues presented that relate to pain, including claimant’s prior
work record, information and observations by treating physicians,
examining physicians, and third parties. Factors that must be
considered include the nature and intensity of the claimant’s pain,
precipitation and aggravating factors, dosage and effectiveness of
any pain medications, other treatment for relief of pain, functional
restrictions, and the claimant’s daily activities. (internal citations
omitted).
Luna v. Shalala, 22 F.3d 687, 691 (7th Cir. 1994); see Zurawski v. Halter, 245 F.3d 881,
887-88 (7th Cir. 2001).
In addition, when the ALJ discounts the claimant’s description of pain because it is
inconsistent with the objective medical evidence, she must make more than “a single, conclusory
statement . . . . The determination or decision must contain specific reasons for the weight given
to the individual’s symptoms, be consistent with and supported by the evidence, and be clearly
3
The Social Security Administration updated its guidance about evaluating a claimant’s symptoms. See SSR
16-3p, 2016 WL 1119029 (effective March 28, 2016). SSR 16-3p superseded SSR 96-7p and removed the term
“credibility” from the Administration’s policies. SSR 16-3p at *1. The new policy clarifies that an ALJ should not
examine a claimant’s character similar to an adversarial proceeding when evaluating the claimant’s subjective
symptoms. SSR 16-3p at *1. Although SSR 16-3p post-dates the ALJ hearing in this case, a regulation that clarifies
rather than changes existing law is appropriate on appeal. Pope v. Shalala, 998 F.2d 473, 482–83 (7th Cir. 1993),
overruled on other grounds by Johnson v. Apfel, 189 F.3d 561 (7th Cir. 1999). Because SSR 16-3p clarifies the
Administration’s policies, this court will evaluate the ALJ’s findings under the Administration’s new guidance. See
Roper v. Colvin, 2016 WL 3940035, at *3 (N.D. Ill. July 21, 2016) (finding it appropriate to consider the new
regulation on appeal).
18
articulated so the individual and any subsequent reviewer can assess how the adjudicator
evaluated the individual’s symptoms.” SSR 16-3p, at *9; see Minnick v. Colvin, 775 F.3d 929,
937 (7th Cir. 2015) (“[A] failure to adequately explain her credibility finding by discussing
specific reasons supported by the record is grounds for reversal.”) (citations omitted); Zurawski,
245 F.3d at 887; Diaz v. Chater, 55 F.3d 300, 307–08 (7th Cir. 1995) (finding that the ALJ must
articulate, at some minimum level, her analysis of the evidence). The ALJ must “build an
accurate and logical bridge from the evidence to her conclusion.” Zurawski, 245 F.3d at 887
(quoting Clifford v. Apfel, 227 F.3d 863, 872 (7th Cir. 2000)). A minor discrepancy, coupled
with the ALJ’s observations is sufficient to support a finding that the claimant was incredible.
Bates, 736 F.3d at 1098. However, this must be weighed against the ALJ’s duty to build the
record and not to ignore a line of evidence that suggests a disability. Bates, 736 F.3d at 1099.
The ALJ found that Dotson’s statements concerning the intensity, persistence, and the
limiting effects of some of his symptoms were not entirely credible. (Tr. 23). Dotson has argued
that the ALJ failed to base her credibility analysis on the totality of evidence in the record,
identified natural variations in symptoms as inconsistencies, and made generalizations about his
veracity.
First, the ALJ found that Dotson’s daily activities were not suggestive of an individual
with disabling anxiety. The ALJ noted that Dotson was the primary caretaker for his infant son
for several hours a day. (Tr. 24). The Seventh Circuit has cautioned ALJs from equating a
claimant’s care for a family member with an ability to work. Beardsley v. Colvin, 758 F.3d 834,
838 (7th Cir. 2014). Also, the ALJ found Dotson incredible based on his testimony that he
worked part-time after the alleged onset date as a Bed Checker at Lutheran Life Villages and as a
Residence Supervisor at the Mentor Network of Indiana. The VE indicated that his work as a
19
Residence Supervisor had a Specific Vocational Preparation (SVP) level of 6 and was considered
skilled work. (Tr. 23). Dotson was on the job for fourth months, part-time, and earned less than
$3000.00.
Dotson has argued that the ALJ should have considered this an unsuccessful work
attempt and that it should not have served as a negative credibility factor. Dotson has cited CFR
404.1575 as his authority, which does not apply because it pertains to individuals who are selfemployed. The ALJ noted that Dotson did work after the alleged disability onset date, but this
work activity did not rise to the level of substantial gainful activity. (Tr. 19). However, the ALJ
explained that Dotson’s part-time employment was indicative that his anxiety did not
significantly interfere with his ability to perform the work. (Tr. 24).
It was proper for the ALJ to consider Dotson’s daily activities as a factor when assessing
the credibility of his claims. 20 ' C.F.R. 404.1529(c). The ALJ properly included in Dotson’s
daily activities his ability to perform part-time work after his alleged onset date for several
months. See Berger v. Astrue, 516 F.3d 539, 546 (7th Cir. 2008) (“Although the diminished
number of hours per week indicated that [the claimant] was not at his best, the fact that he could
perform some work cuts against his claim that he was totally disabled.”). The ALJ did not
conclude that his part-time work demonstrated that he had the sufficient residual mental ability to
work full time, rather his anxiety did not interfere with his ability to perform his work. See
Eisaman v. Astrue, 2012 WL 3028040, at *10 (N.D. Ind. 2012).
The ALJ noted that Dotson made inconsistent statements about his hygiene. He testified
that he had problems with hygiene, yet the treatment notes described him as well-groomed.
Moreover, the records indicated that Dotson reported that he took four showers a day to help
with his anxiety. Also, Dotson testified that he had side effects from all the medications, but his
20
medication management visits showed no side effects reported. (Tr. 24). Dotson has argued that
a person who suffers from a mental illness will have better days and worse days, so a snapshot of
any single moment says little about his overall condition. Punzio v. Astrue, 630 F.3d 704, 710
(7th Cir. 2011).
Dotson contends that the ALJ misunderstood his mental health history. The ALJ
indicated that the medical evidence of record did not reflect a long history of mental health
treatment. (Tr. 24). Dotson indicated that his mental health treatment started during his
childhood and that he reported his history to his numerous providers. The ALJ did omit
evidence of mental health issues dating back to the 1990’s. The Commissioner has argued that
the ALJ referred to Dotson’s treatment as an adult, before the alleged onset date. The ALJ cited
evidence of counseling in 2010, medication for depression in early 2011, and his diagnosis of
depression, likely mild bipolar, in 2011. (Tr. 24). The ALJ also noted that Dotson began
treatment with Dr. Fawver in August 2011 and went to the Fawver Wellness Clinic on a monthly
basis for medication management. (Tr. 24). The ALJ continued to discuss treatment history
with Drs. Ishak and Stemmler. Finally, the ALJ reported that Dotson’s continued counseling
with Susan Tielker-Sharpe from April 19, 2012 through May 22, 2013. The ALJ minimally
articulated her findings regarding Dotson’s mental health treatment.
Dotson has argued that the ALJ treated the switch from Dr. Fawver to another doctor as
an improper inconsistency. Dotson testified that he stopped seeing Dr. Fawver when he decided
to seek disability because he did not recommend disability. Dotson indicated that the ALJ failed
to inquire into if Dr. Fawver did not recommend disability in general or with respect to Dotson.
However, the Commissioner noted that the ALJ did not cite Dotson’s leaving Dr. Fawver as a
basis for impugning his credibility.
21
Although the ALJ could have further explained her credibility finding it was not patently
wrong. The ALJ provided sufficient support to build a logical bridge from the evidence to her
credibility determination that Dotson could perform a range of activities, therefore he could do
more than he claimed. Pepper v. Colvin, 712 F.3d 351, 369 (7th Cir. 2013). However, because
this matter is being remanded on a separate issue, the ALJ may further explain her credibility
determination on remand. Specifically, she may address the issues Dotson has presented with
her credibility finding.
Dotson made brief arguments regarding the ALJ assigning little weight to Dotson’s exwife’s testimony and the assessment of his GAF scores. Dotson contends that the ALJ
overlooked his ex-wife’s testimony. Also, he has argued that the ALJ improperly dismissed the
lower GAF scores without any legally sufficient reasoning. However, the court finds that Dotson
has waived this argument for lack of development. Claimant's mere mention of facts pertinent to
a claim of impairment does not qualify as having raised an issue. See DeSilva v. DiLeonardi,
181 F.3d 865, 867 (7th Cir.1999) (“A brief must make all arguments accessible to the judges,
rather than ask them to play archaeologist with the record.”); Central States, Southeast and
Southwest Areas Pension Fund v. Midwest Motor Exp., Inc., 181 F.3d 799, 808 (7th Cir.1999)
(arguments not developed in any meaningful way are waived); Bollas v. Astrue, 694 F.Supp.2d
978, 990 (N.D. Ill. 2010).
Dotson has argued that the ALJ gave little weight to the treating and consulting
physician’s opinions, while crediting the opinions from non-examining physicians. A treating
source’s opinion is entitled to controlling weight if the “opinion on the issue(s) of the nature and
severity of [the claimant’s] impairment(s) is well-supported by medically acceptable clinical and
laboratory diagnostic techniques and is not inconsistent with the other substantial evidence” in
22
the record. 20 C.F.R. ' 404.1527(d)(2); see Bates v. Colvin, 736 F.3d 1093, 1099 (7th Cir.
2013); Punzio v. Astrue, 630 F.3d 704, 710 (7th Cir. 2011); Schmidt v. Astrue, 496 F.3d 833,
842 (7th Cir. 2007). The ALJ must “minimally articulate her reasons for crediting or rejecting
evidence of disability.” Clifford v. Apfel, 227 F.3d 863, 870 (7th Cir. 2000) (quoting Scivally v.
Sullivan, 966 F.2d 1070, 1076 (7th Cir. 1992)); see 20 C.F.R. ' 404.1527(d)(2) (“We will
always give good reasons in our notice of determination or decision for the weight we give your
treating source’s opinion.”).
“‘[O]nce well-supported contradicting evidence is introduced, the treating physician’s
evidence is no longer entitled to controlling weight’ and becomes just one more piece of
evidence for the ALJ to consider.” Bates, 736 F.3d at 1100. Controlling weight need not be
given when a physician’s opinions are inconsistent with his treatment notes or are contradicted
by substantial evidence in the record, including the claimant’s own testimony. Schmidt, 496
F.3d at 842 (“An ALJ thus may discount a treating physician’s medical opinion if the opinion is
inconsistent with the opinion of a consulting physician or when the treating physician’s opinion
is internally inconsistent, as long as she minimally articulates her reasons for crediting or
rejecting evidence of disability.”); see, e.g., Latkowski v. Barnhart, 93 F. App’x 963, 970–71
(7th Cir. 2004); Jacoby v. Barnhart, 93 F. App’x 939, 942 (7th Cir. 2004). If the ALJ was
unable to discern the basis for the treating physician’s determination, the ALJ must solicit
additional information. Moore v. Colvin, 743 F.3d 1118, 1127 (7th Cir. 2014) (citing Similia v.
Astrue, 573 F.3d 503, 514 (7th Cir. 2009)). Ultimately, the weight accorded a treating
physician’s opinion must balance all the circumstances, with recognition that, while a treating
physician “has spent more time with the claimant,” the treating physician may also “bend over
backwards to assist a patient in obtaining benefits . . . [and] is often not a specialist in the
23
patient’s ailments, as the other physicians who give evidence in a disability case usually are.”
Hofslien v. Barnhart, 439 F.3d 375, 377 (7th Cir. 2006) (internal citations omitted); see Punzio,
630 F.3d at 713.
Such evidence may contain medical opinions, which “are statements from physicians
and psychologists ... that reflect judgments about the nature and severity of a claimant's
impairment(s), including symptoms, diagnosis and prognosis,” physical and mental restrictions,
and what the claimant can still do despite his or her impairments. 20 C.F.R. § 404.1527(a)(2).
Medical opinions are to be weighed by the process set forth in 20 C.F.R. § 404.1527(c).
Dotson began treatment with Dr. Fawver on August 11, 2011, and was treated on a
monthly basis at the Fawver Wellness Clinic for medication management. (Tr. 24). On October
4, 2011 and October 10, 2011, Dr. Fawver opinioned that Dotson should remain off work
because his mood was not predictable or stable and indicated that he would reevaluate Dotson at
the next appointment. The ALJ assigned little weight to Dr. Fawver’s opinion because at the
time he had treated Dotson for only two months and the limitations given to Dotson were not
long term. (Tr. 26). The record indicated that Dr. Fawver and/or nurse practitioners from the
Fawver Wellness Clinic continued to treat Dotson from August 2011 to July of 2012 on a
monthly basis. At subsequent visits, Dotson reported that he had reduced his work by half
because all he wanted to do was lay around. Dotson described his symptoms as worsening
despite medication and engaging in psychotherapy. (Tr. 333).
Dotson began seeing Dr. Ishak who assessed him with anxiety disorder on August 29,
2012. The ALJ assigned little weight to Dr. Ishak’s opinion that Dotson was unable to hold
employment because he had treated him for only three months. (Tr. 26). Also, the ALJ
indicated that Dr. Ishak’s opinion was contradictory with Dotson’s work history because he was
24
currently working part-time. (Tr. 26). In July of 2012, Dotson reported that he was working on
a part-time basis, but by December of 2012 he no longer was employed. The ability to work a
few hours each week is significantly different from having the ability to work full-time. Larson
v. Astrue, 615 F.3d 744, 752 (7th Cir. 2010). Dr. Ishak saw Dotson again on April 22, 2013 and
recommended hospitalization due to worsening depression symptoms and marked changes in his
behavior. (Tr. 25). The record indicated that Dr. Ishak treated Dotson from August 2012 until at
least July of 2013.
The ALJ assigned little weight to the opinions of Drs. Fawver and Ishak because of the
length of treatment. Also, Dr. Ishak’s opinion was inconsistent with Dotson’s work history. A
treating source opinion is entitled to controlling weight if it is (a) well supported by medically
acceptable clinical and laboratory diagnostic techniques and (b) not inconsistent with other
substantial evidence in the record. 20 C.F.R. ' 404.1527(c)(2). The opinions need not be
supported by all the evidence, there only needs to be no substantial contradictory evidence.
POMS DI 24515.004.B.1. An ALJ “must offer ‘good reasons' ” for discounting a treating
physician's opinion. 20 C.F.R. § 404.1527(d)(2)); Campbell v. Astrue, 627 F.3d 299, 306 (7th
Cir. 2010). The ALJ has failed to offer good reasons.
However, even if the ALJ properly refused to assign controlling weight, she still was
required to determine what weight to assign to their opinions. “If an ALJ does not give a treating
physician's opinion controlling weight, the regulations require the ALJ to consider the length,
nature, and extent of the treatment relationship, frequency of examination, the physician's
specialty, the types of tests performed, and the consistency and supportability of the physician's
opinion.” Moss v. Astrue, 555 F.3d 556, 561 (7th Cir.2009) (citing 20 C.F.R. §
404.1527(d)(2)). These factors are to be applied after the ALJ has determined that a treating
25
source will not be given controlling weight. See 20 C.F.R. ' 404.1527(c)(2). The
Commissioner has argued that the ALJ was not required to detail every reason for discounting a
treating physicians report. However, the ALJ’s decision failed to make clear that she was aware
of and considered the other factors.
Dotson saw Dr. Stemmler who assessed him with cognitive disorder not otherwise
specified, bipolar II disorder, ADHD, anxiety disorder, and learning disorder. She supported
Social Security disability temporarily so Dotson could focus on his mental health care, but she
indicated the nature of his head injury did not prevent him from being able to return to work.
(Tr. 25). The ALJ did not assign any weight to her opinion, but did note it. The ALJ must
determine what, if any, weight the treating physician’s opinion is to be given. Moss v. Astrue,
555 F.3d 556, 561 (7th Cir.2009). If the treating physician is not given controlling weight, the
ALJ cannot simply disregard the opinion without further consideration and analysis. Campbell
v. Astrue, 627 F.3d 299, 308 (7th Cir. 2010) (“Even if an ALJ gives good reasons for not giving
controlling weight to a treating physician’s opinion, she has to decide what weight to give that
opinion.”).
The ALJ assigned some weight to Dr. Bingi because he performed a detailed
psychological evaluation. (Tr. 26). He diagnosed Dotson with bipolar disorder, most recent
episode depressed, panic disorder without agoraphobia, PTSD, and OCD. Dr. Bingi had met
with Dotson only once. He assessed Dotson with a Global Assessment of Function (GAF) score
of 45. A GAF rating of 41-50 reflects “serious” impairment in social, occupational, or school
functioning. However, the ALJ noted that the GAF score was not dispositive for Social Security
disability purposes. The Commissioner indicated that Dr. Bingi’s opinion underlined that of the
State agency reviewing doctors that found Dotson could carry out unskilled or semi-skilled tasks
26
on a sustained basis in a competitive setting not requiring rapid pace or intense concentration.
(Tr. 27). However, the circuit court has made clear that what matters are the reasons articulated
by the ALJ. Spiva v. Astrue, 628 F.3d 346, 353 (7th Cir. 2010); Larson v. Astrue, 615 F.3d 744,
749 (7th Cir. 2010).
The ALJ’s weighing of medical evidence is conclusive if it was minimally articulated and
supported by substantial evidence in the record. See Elder v. Astrue, 529 F.3d 408, 415 (7th Cir.
2008); See Skinner v. Astrue, 478 F.3d 836, 841 (7th Cir.2007) (substantial evidence “must be
more than a scintilla but may be less than a preponderance.”). A contradictory opinion of a nonexamining source, like State agency psychological consultants does not by itself suffice. See
generally Gudgel v. Barnhart, 345 F.3d 467, 470 (7th Cir. 2003). The ALJ assigned little
weight to the treating source opinions of Drs. Fawver and Ishak based upon their short-term
treating relationship with Dotson, yet credited the State agency psychological consultant with
great weight who never established a treating relationship with Dotson. The ALJ failed to offer a
“good reasons” for discounting the medical sources’ opinion. See Larson v. Astrue, 615 F.3d
744, 749 (7th Cir. 2010) (quoting 20 C.F.R. § 404.1527(d)(2)). On remand the ALJ should
revisit the weight given to the medical opinions.
Finally, Dotson has argued that the vocational findings are based on legal error and not
supported by substantial evidence. SSR 96-8p explains how an ALJ should assess a claimant’s
RFC at steps four and five of the sequential evaluation. In a section entitled, “Narrative
Discussion Requirements,” SSR 96-8p specifically spells out what is needed in the ALJ’s RFC
analysis. This section of the Ruling provides:
The RFC assessment must include a narrative discussion describing how the
evidence supports each conclusion, citing specific medical facts (e.g., laboratory
findings) and nonmedical evidence (e.g., daily activities, observations). In
assessing RFC, the adjudicator must discuss the individual’s ability to perform
27
sustained work activities in an ordinary work setting on a regular and continuing
basis (i.e., 8 hours a day, for 5 days a week, or an equivalent work schedule), and
describe the maximum amount of each work-related activity the individual can
perform based on the evidence available in the case record. The adjudicator must
also explain how any material inconsistencies or ambiguities in the evidence in
the case record were considered and resolved.
SSR 96-8p (footnote omitted). Thus, as explained in this section of the Ruling, there is a
difference between what the ALJ must contemplate and what she must articulate in her written
decision. “The ALJ is not required to address every piece of evidence or testimony presented,
but she must provide a ‘logical bridge’ between the evidence and her conclusions.” Getch v.
Astrue, 539 F.3d 473, 480 (7th Cir. 2008) (quoting Clifford v. Apfel, 227 F.3d 863, 872 (7th Cir.
2000)); see Moore v. Colvin, 743 F.3d 1118, 1123 (7th Cir. 2014). Although the ALJ does not
need to discuss every piece of evidence, she cannot ignore evidence that undermines her ultimate
conclusions. Moore, 743 F.3d at 1123 (“The ALJ must confront the evidence that does not
support her conclusion and explain why that evidence was rejected.”) (citations omitted). “A
decision that lacks adequate discussion of the issues will be remanded.” Moore, 743 F.3d at
1121.
Dotson has argued that the ALJ failed to consider his ability to sustain the activities cited
in the RFC finding throughout an eight-hour day, five days a week. Dotson contends that the
evidence shows he was unable to sustain a 9-20 hour per week part-time schedule and the added
stress of a 40-hour week would not to be sustainable, as agreed by his doctors. The
Commissioner has indicated that the ALJ apprised the VE of Dotson’s residual function capacity
and both considered his ability to sustain the activities cited in the RFC. In hypothetical
questioning to the VE, the ALJ did include work-related limitations to account for Dotson’s
impairments to the extent that they were supported by medical evidence. Because this matter is
being remanded on separated issues, the ALJ should also reconsider her step five finding.
28
Based on the foregoing reasons, the decision of the Commissioner is REMANDED for
further proceedings consistent with this order.
ENTERED this 22nd day of March, 2017.
/s/ Andrew P. Rodovich
United States Magistrate Judge
29
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