Hart v. Commissioner of Social Security

Filing 24

OPINION AND ORDER: The decision of the Commissioner of Social Security is AFFIRMED. Clerk DIRECTED to enter judgment in favor of Defendant Commissioner of Social Security and against Plaintiff Daniel L Hart III. Signed by Magistrate Judge Susan L Collins on 3/31/17. (cer)

UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF INDIANA
FORT WAYNE DIVISION
DANIEL L. HART, III,
Plaintiff,
v.
COMMISSIONER OF SOCIAL
SECURITY,
Defendant.

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CAUSE NO. 1:15-cv-00380-SLC

OPINION AND ORDER
Plaintiff Daniel L. Hart, III, appeals to the district court from a final decision of the
Commissioner of Social Security (“Commissioner”) denying his application under the Social
Security Act (the “Act”) for Disability Insurance Benefits (“DIB”) and Supplemental Security
Income (“SSI”).1 (DE 1). For the following reasons, the Commissioner’s decision will be
AFFIRMED.
I. PROCEDURAL HISTORY
Hart applied for DIB and SSI in September 2014, alleging disability as of January 1,
2011.2 (DE 11 Administrative Record (“AR”) 233-46). The Commissioner denied Hart’s
application initially and upon reconsideration. (AR 122-23, 146-57). On May 26, 2015, a

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All parties have consented to the Magistrate Judge. (DE 14); see 28 U.S.C. § 636(c).

Hart had previously filed an application for disability, which was denied on October 24, 2012, and he did
not appeal that decision. (AR 18). Administrative Law Judge William Pierson (“the ALJ”) viewed Hart’s alleged
onset date of January 1, 2011, as an implicit request to reopen his prior claim. (AR 18). The ALJ declined this
request, stating that “no new and material evidence has been offered that would establish good cause to reopen the
prior decision.” (AR 18). Accordingly, the ALJ found that the October 24, 2012, decision was final and binding,
and that the period prior to October 25, 2012, would not be readjudicated. (AR 18). Hart does not challenge the
ALJ’s decision in this respect.

hearing was held before the ALJ, at which Hart, who was represented by counsel, and a
vocational expert, Sharon Ringenberg (the “VE”), testified. (AR 41-83). On July 17, 2015, the
ALJ rendered an unfavorable decision to Hart, concluding that he was not disabled because he
was capable of performing a significant number of jobs in the economy despite the limitations
caused by his impairments. (AR 18-34). The Appeals Council denied Hart’s request for review
(AR 1-14), at which point the ALJ’s decision became the final decision of the Commissioner.
See 20 C.F.R. §§ 404.981, 416.1481.
Hart filed a complaint with this Court on December 14, 2015, seeking relief from the
Commissioner’s final decision. (DE 1). In this appeal, Hart advances just one argument—that
the ALJ improperly assessed the credibility of his symptom testimony. (DE 17 at 6-14).
II. FACTUAL BACKGROUND3
At the time of the ALJ’s decision, Hart was 25 years old (AR 34, 233); had a high school
education (AR 302) with some special education classes (AR 569-70); and had work experience
as a forklift operator, a loader and unloader, and a production worker (AR 363). Because Hart
does not challenge the ALJ’s findings concerning his physical impairments, the Court will focus
on the evidence pertaining to his mental impairments.
A. Hart’s Testimony at the Hearing
At the hearing, Hart testified that he has full custody of his three children, who all under
the age of four, and that he and his children live with his mother and grandmother. (AR 47-48).
He was receiving food stamps and had just been approved for Medicaid. (AR 48, 50, 62). He
lost his license in December 2013 after an accident, and he no longer drives, stating that it causes
3

In the interest of brevity, this Opinion recounts only the portions of the 691-page administrative record
necessary to the decision.

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him anxiety. (AR 49-50). His mother helps him care for his children, and his mother does all of
the cooking. (AR 59-61). He has two or three bad days a month where he does not get out of
bed and his mother and grandmother care for his children. (AR 64). He has a restraining order
against his ex-wife, and she is not involved in the children’s care. (AR 63).
Hart had worked after his alleged onset date. (AR 50-51). Most notably, from May 2011
to May 2012, he worked up to 35 hours a week unloading trucks and stocking shelves at
Walmart. (AR 51). During his employment with Walmart, Hart was taking medications “on and
off” and was not participating in any mental health treatment. (AR 67). Although Walmart
disciplined him for missing “a lot” of days, which he estimated was “an average of four days a
month,” it did not terminate his employment. (AR 52-54, 65-66, 286). Rather, he left Walmart
because he got what he thought was a “better job” at Family Dollar. (AR 52). Hart, however,
lost his job at Family Dollar within three weeks due to missing too many days. (AR 52-53).
Hart then worked at AZZ for a few months, but stated that he lost that job, too, for missing too
many days. (AR 54-55). After AZZ, he worked at Menards for a few months, again stating that
he had lost that job due to absenteeism. (AR 54-56). Several days before the hearing, Hart had
lost a job at a service station due to absenteeism. (AR 69). When asked why he missed so many
days at these jobs, Hart testified that his absences were all due to his anxiety and depression.
(AR 55-56, 69).
When asked why he thought he cannot work, Hart stated that he gets very anxious around
large groups of people, in that his chest starts hurting and he finds it hard to breathe. (AR 61,
64-65). He stated that he has hallucinations on occasion, indicating that they increase in
frequency the longer he is off his medications. (AR 61). He also indicated that he suffers from

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delusions randomly throughout the day, in that he can be walking down the street and a person
pops up beside him and then the person is gone two seconds later. (AR 63).
Hart stated that his medications help control these symptoms, reporting that when he
takes his medications, the voices and hallucinations “were cut down to almost non-existent” or
about a half-hour per week. (AR 58-59). He had not taken any medications for the past six
months because he could not afford them, but he planned to resume his medications now that he
had Medicaid again. (AR 61-63).
B. Summary of the Relevant Medical Evidence
Hart first received mental health treatment in the third grade when he was prescribed
medications. (AR 667). Hart stopped treatment in 1996 at the age of 16 because he thought he
had “everything under control.” (AR 667).
In January 2011, Hart had an initial visit with Dr. Sylvia Rutten, a psychiatrist at the
Northeastern Center, telling her that he “has papers he needs filled out for disability and that’s
why he’s here.” (AR 667). He stated that his mental health had been worsening for the past
three or four years and that he had very little control over his temper. (AR 667). He complained
of insomnia, low energy, decreased concentration, feeling restless, paranoia, and worrying. (AR
667-68). He stated that he had suicidal ideation in the past and had attempted suicide twice; he
did not have any psychiatric hospitalizations. (AR 668). On exam, he demonstrated intact
memory; average intellect; and fair, but somewhat limited, judgment. (AR 668). Dr. Rutten
diagnosed Hart with major depressive disorder, recurrent; no psychosis, but rule out history of
psychosis; generalized anxiety disorder; history of ODD, possible conduct disorder; family
relational issues; and rule out antisocial personality disorder. (AR 669). She assigned him a

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current Global Assessment of Functioning (“GAF”) score of 50.4 (AR 669). She prescribed
Inderal, stated that she would consider adding additional medications in the future, and
recommended that he continue therapy. (AR 669). Hart, however, failed to follow through with
treatment at the Northeastern Center. (AR 648, 666).
In February 2011, Hart underwent a mental status examination by Michael Scherbinski,
Ph.D., for purposes of his disability application. (AR 596-600). He reported having extreme
anxiety in social situations; he stated that he blacks out occasionally when in groups of people
and wakes up chasing or hitting them. (AR 596). He also complained of mood swings,
depression, sleeplessness, and hallucinations. (AR 596). He hears voices in his head up to six
times a week and sees himself hurting others when he is angry. (AR 596). He does not want to
leave his room when feeling depressed. (AR 596). He indicated that he has difficulty regulating
his emotions, being around people, and maintaining employment. (AR 596). He denied any
current suicidal ideation or thoughts of self-harm. (AR 596). Upon mental status exam, Hart
showed no evidence of a thought disorder; his affect appeared anxious. (AR 598). His
performance on a mental status exam revealed average judgment and insight, and he was
compliant with all requests. (AR 600). He was able to maintain focus and concentration, and he

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GAF scores reflect a clinician’s judgment about the individual’s overall level of functioning. Am.
Psychiatric Ass’n, Diagnostic & Statistical Manual of Mental Disorders 32 (4th ed., Text Rev. 2000). A GAF score
of 41 to 50 reflects serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting) or any
serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job). Id. A GAF
score of 51 to 60 reflects moderate symptoms (e.g., flat affect and circumstantial speech, occasional panic attacks) or
moderate difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peers or coworkers). Id. A GAF score of 61 to 70 reflects some mild symptoms or some difficulty in social, occupational, or
school functioning, but “generally functioning pretty well.” Id.
“The American Psychiatric Association no longer uses the GAF as a metric.” Spencer v. Colvin, No. 13-cv1487, 2015 WL 684545, at *17 n.5 (C.D. Ill. Feb. 17, 2015) (citing Am. Psychiatric Ass’n, Diagnostic & Statistical
Manual of Mental Disorders 16 (5th ed. 2013)). However, the medical sources of record used GAF scores in
assessing Hart, so they are relevant to the ALJ’s decision. See id. (citing Bates v. Colvin, 736 F.3d 1093, 1099 (7th
Cir. 2013)).

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demonstrated appropriate communication and social skills throughout the examination. (AR
600). Dr. Scherbinski concluded that Hart’s abilities “would likely allow him to potentially gain
and/or maintain employment,” but that “given his mental health concerns, [he] may have
difficulty consistently meeting demands in a work environment.” (AR 600). Dr. Scherbinski
diagnosed Hart with social phobia (provisional) and assigned him a GAF of 63. (AR 600).
In March 2011, B. Randal Horton, Psy.D., a state agency psychologist, reviewed Hart’s
record and concluded that he had mild restrictions in activities of daily living, in maintaining
social functioning, and in maintaining concentration, persistence, or pace. (AR 603-15). Dr.
Horton concluded that Hart’s mental impairments were not severely limiting. (AR 615). J.
Gange, Ph.D., another state agency psychologist, affirmed Dr. Horton’s opinion in July 2011.
(AR 617).
Hart visited the emergency room for various physical ailments in August 2012,
November 2012, January 2013, May 2013, June 2013, July 2013, August 2013, and December
2013, and psychiatric review of systems were negative during those visits. (AR 413-14, 418-26,
429-32, 434-47.)
In July 2013, Hart returned to the Northeastern Center, stating that he needed to get
stable so that he could provide for his family. (AR 648-50, 660). He reported a depressed mood,
difficulty being around people, anger, fleeting suicidal ideation, broken sleep, racing thoughts,
intermittent homicidal ideation, and visual hallucinations. (AR 648, 660). Upon mental status
exam in August 2013, the clinician noted a depressed mood, normal psychomotor activity, flat
affect, organized thought processes, grossly intact cognition, limited insight and judgment, and
no current suicidal or homicidal thoughts. (AR 648-50). He was assigned diagnoses of bipolar

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disorder, depressed, severe, and post traumatic stress disorder (“PTSD”). (AR 650). He had a
current GAF of 50 and a GAF upon admission of 48. (AR 650).
In September 2013, Hart told a clinician at the Northeastern Center that he was having
decreased sleep and increased anxiety. (AR 646). He also reported having auditory and visual
hallucinations, as well as suicidal ideation, but he clarified that he did not want to hurt himself
due to his children. (AR 646). His mood was depressed and anxious. (AR 647). His memory,
attention, concentration, insight, and judgment were all good. (AR 647). His medications were
adjusted. (AR 647).
In October 2013, the Northeastern Center noted that there was no increase in Hart’s GAF
score, “as client is not fully engaged in individual therapy.” (AR 661).
In November 2013, Hart told a clinician at the Northeastern Center that he just wanted to
stay in bed all day. (AR 643). He was having trouble sleeping. (AR 643). He reported having
visual hallucinations up to four times a week. (AR 643). He had lingering thoughts of self harm,
but no thoughts of violence toward others. (AR 644). He had a depressed mood and a blunted
affect. (AR 644). The clinician adjusted his medications and indicated diagnoses of bipolar
disorder and PTSD. (AR 644).
In early December 2013, Hart reported to a clinician at the Northeastern Center that he
was just staying in bed. (AR 641). He stated that his hallucinations had lessened, but that they
increased if he missed a medication dosage. (AR 641). He reported suicidal ideation up to three
times a day and thoughts of violence toward others. (AR 641). His mood swings varied. (AR
642). His medications were adjusted. (AR 642).
Later in December 2013, Hart reported to Dr. Teresa Greiner at the Northeastern Center

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that he continued to have mood swings. (AR 639). His hallucinations decreased since being on
Invega, and he had no thoughts of hurting himself or others. (AR 639). His mood was anxious
and depressed, and his affect was quite flat. (AR 639). He had normal attention and
concentration, insight and judgment, and thought process. (AR 639). She assessed bipolar
disorder, mixed, with ongoing symptoms; and PTSD, with ongoing symptoms. (AR 640). She
adjusted his medications. (AR 640).
In January 2014, Hart told Dr. Greiner that his mood was better overall and although he
still had mood swings, they were significantly better. (AR 637). His mood was flat, but he had
normal thought process and content, intact memory and attention, and intact insight and
judgment. (AR 637). He had no suicidal or homicidal thoughts. (AR 637). Diagnoses included
bipolar disorder, depressed with psychotic features, improved with medication, but ongoing
residual symptoms; and PTSD, improving. (AR 638). Dr. Greiner adjusted his medications.
(AR 638).
In April 2014, Hart’s chart was closed at the Northeastern Center due to no engagement
of services since January 2014. (AR 663).
In July 2014, Hart returned to the Northeastern Center and underwent a psychiatric
evaluation by Dr. Greiner. (AR 634-35). She noted that he had quit coming to the clinic earlier
in the year and had gone off of his medications after he ran out of them, as he did not have
insurance. (AR 634). He reported worsening anxiety and panic attacks, particularly when
around crowds; worsening auditory and visual hallucinations; poor concentration; racing
thoughts; insomnia; mood swings; anger; irritability; paranoia; and suicidal and homicidal
thoughts. (AR 634). He had been in a fight a week earlier. (AR 634). A mental status exam

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revealed a flat affect and depressed mood, but intact attention, concentration, and memory. (AR
635). Dr. Greiner assigned him a current GAF of 50 and diagnoses of schizoaffective disorder
bipolar type and PTSD. (AR 635). She restarted his medications, and noting Hart’s problems
with medication compliance, she prescribed Invega Sustenna injections rather than Invega in
tablet form. (AR 635).
In August 2014, Hart reported decreased sleep, panic attacks, paranoia, and depression,
indicating that the Invega Sustenna injections were helping. (AR 630-33). He still, however,
could not stay in a grocery store due to his paranoia. (AR 630, 632). He had persecutory
delusions, but no hallucinations or suicidal ideation. (AR 630-33). Hart also visited the
emergency room in August 2014 due to a panic attack. (AR 484-85, 632).
In September 2014, Hart had a depressed mood, an appropriate affect, normal thought
processes, and no hallucinations or suicidal ideation. (AR 628-29). He was positive for
persecutory delusions. (AR 629). He demonstrated normal attention and concentration, intact
memory, and good judgment. (AR 629). His medications were adjusted. (AR 629). That same
month, Hart told a family practitioner that he was feeling nervous, depressed, and had insomnia.
(AR 469).
In October 2014, Dr. Horton, a state agency psychologist, reviewed Hart’s record and
concluded that he had a mild restriction in activities of daily living; moderate difficulties in
maintaining social functioning and in maintaining concentration, persistence, or pace; and no
episodes of decompensation of extended duration. (AR 104-08). More specifically, Dr. Horton
opined that Hart was moderately limited in: (1) carrying out detailed instructions; (2)
maintaining attention and concentration for extended periods; (3) completing a normal workday

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and workweek without interruptions from psychologically based symptoms and performing at a
consistent pace without an unreasonable number and length of rest periods; and (4) maintaining
socially appropriate behavior and adhering to basic standards of neatness and cleanliness. (AR
105-07). He was not significantly limited in the remaining mental categories. (AR 105-07). Dr.
Horton wrote that Hart handles change and stress poorly. (AR 108). However, Dr. Horton
further observed that Hart’s past employer represented that its only concern was Hart’s
attendance, as there were no concerns with his completing tasks, working with co-workers and
supervisors, concentration, safety, or asking for help. (AR 108). Dr. Horton concluded that
Hart’s reports were “partially credible” and that he could perform unskilled work. (AR 108).
Dr. Horton’s opinion was affirmed by F. Kladder, Ph.D., another state agency psychologist, in
January 2015. (AR 129, 132).
Hart visited the emergency room for various physical ailments in November 2014 and
December 2014, and psychiatric review of systems were negative during those visits. (AR 54454). In January 2015, Hart visited the emergency room for sinusitis; a review of systems was
“[p]ositive for multiple psychiatric issues.” (AR 542).
III. ANALYSIS
A. The Law
Under the Act, a claimant is entitled to DIB or SSI if he establishes an “inability to
engage in any substantial gainful activity by reason of any medically determinable physical or
mental impairment which can be expected to . . . last for a continuous period of not less than 12
months.” 42 U.S.C. §§ 416(i)(1), 423(d)(1)(A), 1382c(a)(3)(A). A physical or mental
impairment is “an impairment that results from anatomical, physiological, or psychological

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abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic
techniques.” 42 U.S.C. §§ 423(d)(3), 1382c(a)(3)(D).
The Commissioner evaluates disability claims pursuant to a five-step evaluation process,
requiring consideration of the following issues, in sequence: (1) whether the claimant is
currently unemployed; (2) whether the claimant has a severe impairment; (3) whether the
claimant’s impairment meets or equals one of the impairments listed by the Commissioner, see
20 C.F.R. § 404, Subpt. P, App’x 1; (4) whether the claimant is unable to perform his past work;
and (5) whether the claimant is incapable of performing work in the national economy.5 See
Dixon v. Massanari, 270 F.3d 1171, 1176 (7th Cir. 2001) (citations omitted); 20 C.F.R. §§
404.1520, 416.920. An affirmative answer leads either to the next step or, on steps three and
five, to a finding that the claimant is disabled. Zurawski v. Halter, 245 F.3d 881, 886 (7th Cir.
2001) (citation omitted). A negative answer at any point other than step three stops the inquiry
and leads to a finding that the claimant is not disabled. Id. (citation omitted). The burden of
proof lies with the claimant at every step except the fifth, where it shifts to the Commissioner.
Clifford, 227 F.3d at 868 (citation omitted).
B. The Commissioner’s Final Decision
On July 17, 2015, the ALJ issued the decision that ultimately became the
Commissioner’s final decision. (AR 18-34). The ALJ noted at step one of the five-step analysis
that Hart had worked at several jobs after October 2012 and that his income had exceeded the
level of disqualifying substantial gainful activity in at least a portion of 2013; however, because
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Before performing steps four and five, the ALJ must determine the claimant’s RFC or what tasks the
claimant can do despite his limitations. 20 C.F.R §§ 404.1520(e), 404.1545(a), 416.920(e), 416.945(a). The RFC is
then used during steps four and five to help determine what, if any, employment the claimant is capable of. 20
C.F.R. §§ 404.1520(e), 416.920(e).

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Hart’s other earnings had been minimal, the ALJ proceeded to the next step. (DE 21).
At step two, the ALJ found that Hart had the following severe impairments:
PTSD/anxiety, major depressive disorder/bipolar disorder/schizoaffective disorder, and history
of learning disorder. (DE 21). At step three, the ALJ concluded that Hart did not have an
impairment or combination of impairments severe enough to meet or equal a listing. (AR 25).
Before proceeding to step four, the ALJ determined that Hart’s symptom testimony was not
entirely credible (AR 29) and assigned the following RFC:
[T]he claimant has the [RFC] to perform a full range of work at all
exertional levels but with the following nonexertional limitations:
limited to simple, routine, and repetitive tasks that can be learned
with short demonstration or up to 30 days; can maintain the
concentration required to perform simple work tasks, can make
simple work-related decisions, and can complete simple work-like
procedures; limited to low stress jobs defined as requiring only
occasional decision-making and only occasional changes in the
work setting, but can tolerate predictable changes in the work
environment; can meet production requirements in an environment
that allows him to sustain a flexible and goal-oriented pace, but is
limited from fast-paced work such as assembly line production
work with rigid or strict productivity requirements; limited to
superficial interactions with coworkers and supervisors, with
superficial interaction defined as occasional and casual contact not
involving prolonged conversation; contact with supervisors still
involves necessary instruction; no work with the general public.
(AR 27).
Based on this RFC and the VE’s testimony, the Commissioner concluded at step four that
Hart was unable to perform any of his past relevant work. (AR 32). At step five, however, the
Commissioner found that there were a significant number of other jobs in the economy that Hart
could perform, including routing clerk, mail sorter, and retail marker. (AR 33). Accordingly,
Hart’s applications for DIB and SSI were denied. (AR 33-34).

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C. The ALJ’s Credibility Determination Will Be Affirmed
Hart’s sole argument on appeal is that the ALJ improperly analyzed the limiting effect of
his mental health symptoms. Hart’s challenge is two-fold—that the ALJ failed to apply the
proper analytical framework when assessing his symptom testimony, and that the ALJ’s
credibility determination is not supported by substantial evidence and is based on factual and
logical flaws. Ultimately, Hart’s arguments do not warrant a remand of the ALJ’s credibility
determination.
1. Applicable Law
The regulations describe a two-step process for evaluating a claimant’s symptom
testimony. SSR 96-7p, 1996 WL 374186, at *2 (July 2, 1996);6 see 20 C.F.R. §§ 404.1529,
416.929. First, the ALJ must determine whether there is an underlying medically determinable
physical or mental impairment—that is, an impairment that can be shown by medically
acceptable clinical and laboratory diagnostic techniques—that could reasonably be expected to
produce the claimant’s pain or other symptoms. SSR 96-7p, 1996 WL 374186, at *2 (July 2,
1996); see 20 C.F.R. §§ 404.1529, 416.929. This finding “does not involve a determination as to
the intensity, persistence, or functionally limiting effects of the individual’s symptoms.” SSR
96-7p, 1996 WL 374186, at *2 (July 2, 1996). If the record does not allow the ALJ to make such
a finding, then that ends the inquiry, for a finding of disability cannot be made solely on the basis
of the claimant’s symptoms, even if they appear genuine. SSR 96-7p, 1996 WL 374186, at *2

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Social Security Ruling 96-7p was superseded by Social Security Ruling 16-3p in March 2016, see SSR
16-3p, 2016 WL 1119029 (Mar. 16, 2016), but Social Security Ruling 96-7p governed at the time the ALJ issued his
decision, and both parties refer to Social Security Ruling 96-7p in their brief. Accordingly, SSR 96-7p applies to
this case. Notably, the Commissioner retained in SSR 16-3p the same two-part analytical framework as articulated
in SSR 96-7p.

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(July 2, 1996).
Second, if the medical evidence shows the existence of an underlying impairment that
could be reasonably expected to produce the claimant’s symptoms, the ALJ must evaluate “the
intensity, persistence, and functionally limiting effects of the symptoms . . . to determine the
extent to which the symptoms affect the individual’s ability to do basic work activities.” SSR
96-7p, 1996 WL 374186, at *1 (July 2, 1996); see 20 C.F.R. §§ 404.1529(c), 416.929(c); see,
e.g., Clifford, 227 F.3d at 871 n.6. For this purpose, “whenever the individual’s statements about
the intensity, persistence, or functionally limiting effects of pain or other symptoms are not
substantiated by objective medical evidence, the [ALJ] must make a finding on the credibility of
the individual’s statements based on a consideration of the entire case record.” SSR 96-7p, 1996
WL 374186, at *2 (July 2, 1996). In doing so, the ALJ must consider, in addition to the
objective medical evidence: the claimant’s daily activities; the location, duration, frequency, and
intensity of the claimant’s symptoms; factors that precipitate and aggravate the symptoms; the
type, dosage, effectiveness, and side effects of any medication the claimant takes to alleviate
symptoms; treatment, aside from medication, the claimant has received; and any other measures
the claimant uses to relieve symptoms. SSR 96-7p, 1996 WL 374186, at *3 (July 2, 1996); see
20 C.F.R. §§ 404.1529(c), 416.929(c).
Because the ALJ is in the best position to evaluate the credibility of a witness, his
determination is entitled to special deference. Powers v. Apfel, 207 F.3d 431, 435 (7th Cir.
2000). If an ALJ’s determination is grounded in the record and he articulates his analysis of the
evidence “at least at a minimum level,” Ray v. Bowen, 843 F.2d 998, 1002 (7th Cir. 1988)
(citation omitted), creating “an accurate and logical bridge between the evidence and the result,”

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Ribaudo v. Barnhart, 458 F.3d 580, 584 (7th Cir. 2006) (citation omitted), his determination will
be upheld unless it is “patently wrong.” Powers, 207 F.3d at 435; see Carradine v. Barnhart,
360 F.3d 751, 754 (7th Cir. 2004) (remanding an ALJ’s credibility determination because the
ALJ’s decision was based on “serious errors in reasoning rather than merely the demeanor of the
witness . . . .” (citation omitted)). “[Because] the ALJ is in the best position to observe
witnesses, [courts] usually do not upset credibility determinations on appeal so long as they find
some support in the record and are not patently wrong.” Herron v. Shalala, 19 F.3d 329, 335
(7th Cir. 1994) (citations omitted).
2. The ALJ Adequately Applied the Two-Step Analytical Framework in Assessing
Hart’s Symptom Testimony
When assessing Hart’s symptom testimony, the ALJ acknowledged and set forth the twostep process described above. (AR 28). Therefore, it is apparent that the ALJ understood the
proper analytical framework to employ when assessing Hart’s credibility. Then, when issuing
his credibility determination, the ALJ summarized:
After careful consideration of the evidence, the undersigned finds that the
claimant’s medically determinable impairments could reasonably be expected to
cause some of the alleged symptoms; however, the claimant’s statements
concerning the intensity, persistence and limiting effects of these symptoms are
not entirely credible for the reasons explained in this decision. The claimant’s
allegations are credible in so far as they are consistent with the above noted
[RFC].
(AR 29). As to “the reasons explained in [the] decision” (AR 29), the ALJ cited the objective
medical evidence, Hart’s treatment history, the consistency of his statements, the medical source
opinions, information from other sources, his work history, and his daily activities. (AR 21-32).
In challenging the ALJ’s application of the two-step framework, Hart argues that the ALJ

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materially erred by failing to make an explicit finding whether his testimony was consistent with
the objective medical evidence, before going on to consider his treatment history, the
consistency of his statements, the medical source opinions, information from other sources, his
work history, and his daily activities. As Hart parses the analytical framework, once the
claimant shows that he has a medically determinable impairment that can reasonably cause his
alleged symptoms, “the Commissioner is required to muster substantial evidence showing that
the claimant’s allegations are inconsistent with the objective evidence and he is not disabled.”
(DE 17 at 8). More to the point, Hart argues that the ALJ may only consider other
evidence—such as medical source opinions, information from other sources, daily activities,
medication, and treatment—“if a disability determination or decision that is fully favorable to the
individual cannot be made solely on the basis of the objective medical evidence.’” Curvin v.
Colvin, 778 F.3d 645, 648 n.3 (7th Cir. 2015) (quoting SSR 96-7p, 1996 WL 374186, at *1 (July
2, 1996)).
The Commissioner disagrees with Hart’s parsing of the two-part analytical framework in
SSR 96-7p. The Commissioner emphasizes that there is no requirement that an ALJ make an
explicit statement as to whether the objective medical evidence supports the asserted intensity
and persistence of a claimant’s symptoms. Rather, the Commissioner urges that “[a]ll that is
required is that the decision ‘contain specific reasons for the finding on credibility, supported by
the evidence in the case record,’ which is ‘sufficiently specific to make clear to the individual
and to any subsequent reviewers the weight the adjudicator gave to the individual’s statements
and the reasons for that weight.’” (DE 22 at 6 (quoting SSR 96-7p, 1996 WL 374186, at *4
(July 2, 1996))).

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The Court agrees with the Commissioner. In fact, Hart even concedes in his reply brief
that there is no authority requiring an ALJ to make an explicit finding as to whether objective
medical evidence supports the asserted intensity and persistence of his symptoms. (DE 23 at 2).
Rather, as Hart acknowledges, “[i]n rendering a decision, the ALJ must build a logical bridge
from the evidence to his conclusion.” (DE 23 at 2 (quoting Haynes v. Barnhart, 416 F.3d 621,
626 (7th Cir. 2005))). The Seventh Circuit Court of Appeals has not asked for more when
considering an ALJ’s credibility determination, explaining that “an ALJ’s credibility assessment
will stand as long as [there is] some support in the record.” Berger v. Astrue, 516 F.3d 539, 546
(7th Cir. 2008) (alteration in original) (citation omitted); see generally Buckhanon ex rel. J.H. v.
Astrue, 368 F. App’x 674, 678-69 (7th Cir. 2010) (“[T]idy packaging” is not required in ALJs’
decisions because the courts read them “as a whole and with common sense.” (citations
omitted)); Fisher v. Bowen, 869 F.2d 1055, 1057 (7th Cir. 1989) (“No principle of administrative
law or common sense requires us to remand a case in quest of a perfect opinion unless there is
reason to believe that the remand might lead to a different result.” (citations omitted)).
Therefore, to the extent that Hart suggests the ALJ’s application of the two-step
credibility framework—that is, the ALJ’s failure to make an explicit finding concerning whether
his symptom testimony is consistent with the objective medical evidence—by itself, requires a
remand, that assertion is unpersuasive. It is readily apparent that the ALJ implicitly found that
the objective medical evidence, standing alone, is insufficient to substantiate Hart’s symptom
testimony. Nor can the Court fault the ALJ for this finding, considering that Hart alleges an
onset date of January 2011 and there is a more than two-year gap (after February 2011 until
August 2013) in the objective medical evidence after his alleged onset date.

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3. The ALJ’s Credibility Determination Is Supported by Substantial Evidence,
Adequately Articulated, and Not Patently Wrong
Setting aside the ALJ’s application of the two-step framework, Hart alleges several other
material flaws in the ALJ’s credibility determination. These include: (1) that the ALJ
selectively reviewed the objective medical evidence; (2) that the ALJ impermissibly drew a
negative inference from Hart’s failure to seek treatment without first exploring his explanation
for that failure; (3) that his work history supports, rather than undermines, his symptom
testimony; and (4) that his caring for his three young children does not contradict his symptom
testimony. The Court will address each of these arguments in turn.
As to the objective medical evidence, Hart argues that some of his mental status
examinations from August 2013 through September 2014 reveal positive findings consistent with
his assertion of disabling mental health symptoms. Specifically, he cites findings from various
notes reflecting “depressed, anxious, blunted, irritable, or manic moods; persecutory delusions;
anger; limited insight and judgment; suicidal and homicidal thoughts; poor grooming; paranoia;
psychomotor retardation; flat affect; decreased eye contact; decreased concentration; slow
speech with ‘vague responses’; violent thoughts; flashbacks; racing thoughts; auditory and visual
hallucinations; and dissociation.” (DE 17 at 9 (citing AR 628, 630, 633-34, 636-37, 639, 641-44,
646, 648-49, 651-52)). Hart contends that the ALJ ignored this line of evidence reflecting more
severe symptoms, instead selectively summarizing that Hart had a depressed mood, a flat affect,
and that he improved with medications. (DE 17 at 9-10 (citing AR 29-30)).
“An ALJ has the obligation to consider all relevant medical evidence and cannot simply
cherry-pick facts that support a finding of non-disability while ignoring evidence that points to a

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disability finding.” Denton v. Astrue, 596 F.3d 419, 425 (7th Cir. 2010) (citing Myles v. Astrue,
582 F.3d 672, 678 (7th Cir. 2009)); see also Campbell v. Astrue, 627 F.3d 299, 306 (7th Cir.
2010). “The ALJ must evaluate the record fairly.” Golembiewski v. Barnhart, 322 F.3d 912,
917 (7th Cir. 2003). “But an ALJ need not mention every piece of evidence, so long [as] he
builds a logical bridge from the evidence to his conclusion.” Denton, 596 F.3d at 425 (citing
Getch v. Astrue, 539 F.3d 473, 480 (7th Cir. 2008)).
Here, when considering the medical evidence, the ALJ first noted that there was no
objective medical evidence after February 2011 until July 2013 (AR 30)—a point which Hart
does not challenge. The ALJ then observed that Hart presented to the Northeastern Center for
care in July 2013 after a more than two-year gap in treatment, and he was placed on medications.
(AR 29 (citing AR 648-50, 660-61)). The ALJ noted that a December 2013 note indicated that
once back on medications, Hart’s hallucinations lessened, but that if he missed a dose, his
hallucinations increased. (AR 29 (citing AR 641)). The ALJ further observed that by January
2014 Hart’s mood and mood swings were significantly better with medications, but he then
failed to return for treatment. (AR 29 (citing AR 637)). The ALJ noted that six months later, in
July 2014, Hart returned for care after he had been off of his medications and his anxiety,
depression, and delusions had increased. (AR 29 (citing AR 635)). The ALJ observed that at
this visit, Hart’s attention and concentration were intact, but “[o]n the other hand, affect was flat,
and mood was depressed.” (AR 29 (citing AR 635)). The ALJ then stated that “while symptoms
continued over the next two months (medication adjustments were made), by August 20, 2014,
[Hart] reported that mood was 6/10 and that Invega was helping ‘some’”; however, he again
failed to return for treatment after September 2014. (AR 30 (citing AR 630)).

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It is true that the ALJ did not articulate every symptom or finding in the Northeastern
Center’s records for the period of August 2013 through September 2014. For example, the ALJ
did not mention that at his July 2014 visit, Hart also reported auditory and visual hallucinations
and paranoid delusions, as well as intermittent suicidal and homicidal thoughts without intent.
(AR 635). But having said that, the ALJ’s summary of the medical evidence was not unfair. See
Golembiewski, 322 F.3d at 917. It is obvious that the ALJ considered all of the evidence of
record, as he cited the records throughout his decision. (See AR 29-30). Ultimately, the ALJ
deduced that Hart’s symptoms significantly improved with medications (AR 32), which Hart
admitted at the hearing (AR 58-59), but that he often failed to seek treatment or otherwise
comply with treatment (AR 32). Accordingly, the ALJ went on to consider Hart’s reasons for
failing to consistently seek and comply with treatment. In that an ALJ “must only minimally
articulate his or her justification for rejecting or accepting specific evidence of disability,” the
ALJ in this instance sufficiently met this “lax standard” with respect to the medical evidence
from August 2013 through September 2014. Berger, 516 F.3d at 545 (citation and internal
quotation marks omitted).
Hart next argues that the ALJ violated SSR 96-7p by impermissibly drawing a negative
inference from his failure to seek treatment without first inquiring into and considering his
explanation for that failure. See Craft v. Astrue, 539 F.3d 668, 679 (7th Cir. 2008) (“[T]he ALJ
‘must not draw any inferences’ about a claimant’s condition from [the claimant’s failure to seek
treatment] unless the ALJ has explored the claimant’s explanations as to the lack of medical
care.” (quoting SSR 96-7p, 1996 WL 374186, at *7 (July 2, 1996)). Hart acknowledges that the
ALJ considered that his “treatment has been limited due to the lack of insurance and money”

20

(AR 29), but Hart emphasizes that he provided this reason to the ALJ only as to why he stopped
treatment at the Northeastern Center in 2014. (AR 50). As Hart sees it, the ALJ should have
inquired about his reasons for limited treatment during January 2011 to July 2013 before
inferring that his limited finances was the only reason for his limited treatment throughout the
entire period.
Hart’s argument is unpersuasive. The ALJ considered Hart’s testimony concerning his
limited finances and lack of insurance, as well as that Hart stated he had recently been approved
for Medicaid and would be returning for care to the Northeastern Center. (AR 28; see AR 50
(“Q Now, are you receiving treatment through the Northeastern Center still? A I would if I had
insurance.”)). The ALJ observed, however, that no additional records were ever submitted to
show that Hart actually had, in fact, renewed treatment at the Northeastern Center once he had
Medicaid. (AR 30). The ALJ also noted that Hart’s noncompliance could only be partially
explained by a lack of funds because Hart was frequently given medication samples. (AR 2930).
Furthermore, although it is true that “people with serious psychiatric problems are often
incapable of taking their prescribed medications consistently,” Martinez v. Astrue, 630 F.3d 693,
697 (7th Cir. 2011), here the ALJ accurately observed that Hart was employed by Walmart from
May 2011 to May 2012 (AR 28) and that when Hart did visit the emergency room between
October 2012 and December 2013, none of these records reflect complaints or observations of
mental illness (AR 30 (citing AR 413-21, 422-47)). These facts diminish any argument that
Hart’s mental illness rendered him incapable of complying with his medications. In any event,
Hart’s failure to seek and comply with treatment was just one of several factors that the ALJ
considered when assessing Hart’s symptom testimony.
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Next, Hart challenges the ALJ’s consideration of his work history when discounting his
symptom testimony. The ALJ found that Hart’s employment at Walmart for one year after his
alleged onset date was “inconsistent with ongoing, problematic absenteeism” (AR 31),
particularly considering that Hart was not participating in mental health treatment at the time and
that he was taking medications only “on and off.” (AR 25). But Hart suggests that his work
history supports, rather than undermines, his symptom testimony. He states that he was fired by
Family Dollar in 2012 after just three weeks due to absenteeism, fired by AZZ in 2013 for either
fighting or absenteeism, fired by Menards in 2014 after one month due to absenteeism; and
recently fired from his job at a gas station also for absenteeism. (AR 52-55, 69, 342). He adds
that although he was not fired by Walmart, he was disciplined for missing work “a lot” of days,
which he estimated was “an average of four days a month.” (AR 53-54, 65-66, 286).
Although the Seventh Circuit has held that a claimant’s poor work history may not count
against him when the evidence demonstrates that his medical impairments prevented him from
working, see Sarchet v. Chater, 78 F.3d 305, 308 (7th Cir. 1996), here the ALJ concluded that,
due to discrepancies in the record, Hart did not demonstrate that his mental illness kept him from
working. (AR 21, 26, 28-32). The ALJ first observed that although Hart testified that he was
fired from AZZ due to absenteeism, in earlier function reports both he and his wife stated that he
was fired due to fighting with a coworker. (AR 21 (citing AR 55-56, 329, 339, 383)). Second,
although Hart testified that his anxiety and depression were the only reasons for his absenteeism
at all of his jobs (AR 56), the ALJ observed that of his three absences and one late arrival
recorded by Menards, one was due to the death of a friend and another was due to hurting his
back. (AR 31). Menards further indicated that there were no problems with Hart’s performance,
his ability to get along with others, his ability to work without excessive breaks, or his ability to
22

concentrate. (AR 31 (citing AR 342-44)).
Additionally, the ALJ noted that although Hart testified that he missed an average of four
days a month at Walmart (AR 65-66), records from Walmart indicate that he missed, on average,
no more than one day per month during the year in which he was employed there (AR 30 (citing
AR 284-95)). The ALJ also considered that after working at Walmart for one year, he left
Walmart only because he “thought [he] had a better job” at Family Dollar (AR 52; see AR 286),
which the ALJ found inconsistent with Hart’s claim of ongoing, problematic absenteeism. (AR
31). Accordingly, on this record, the Court cannot fault the ALJ’s conclusion that Hart’s work
history undercut his symptom testimony, at least to some extent. See Simila v. Astrue, 573 F.3d
503, 519 (7th Cir. 2009) (considering claimant’s work history when discounting his credibility);
SSR 96-7p, 1996 WL 374186, at *5 (July 2, 1996) (directing the ALJ to consider a claimant’s
“prior work record and efforts to work” as part of the credibility determination).
Finally, Hart takes issue with the ALJ’s conclusion that his ability to be the primary
caregiver for his three young children undermines his claim of disabling mental symptoms. (AR
25). Hart contends that the ALJ ignored the fact that his mother and grandmother help care for
his children, particularly on his bad days. But the ALJ did not ignore this evidence; rather, the
ALJ specifically stated that Hart had full custody of his children and that his mother and
grandmother assist him at times. (AR 25). The ALJ simply concluded that Hart’s “ability to
care for three children under the age of three, even with help, attests to a higher level of
persistence” than Hart described. (AR 26 (emphasis added)). Furthermore, Hart testified that
when he was still married, his wife refused to care for the children and his mother stayed with
them only when he was working. (AR 25, 63-64). As such, the ALJ’s observation that Hart
“has had primary responsibility for three very young children throughout the period at issue” is
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an accurate representation of the record.7 (AR 25, see also AR 31); see Schmidt v. Barnhart, 395
F.3d 737, 746-47 (7th Cir. 2005) (stating that an ALJ is entitled to consider a claimant’s
performance of daily activities as a factor in the credibility assessment); 20 C.F.R. §§
404.1529(c)(3), 416.929(c)(3).
Moreover, the ALJ ultimately did credit Hart’s symptom testimony in significant part.
To accommodate his mental impairments, the ALJ assigned him an RFC with a host of mental
restrictions, including simple, repetitive tasks; low-stress jobs; no fast-paced work; superficial
interactions with coworkers and supervisors; and no contact with the general public. (AR 27);
see, e.g., Vincent v. Astrue, No. 1:07-CV-28, 2008 WL 596040, at *16 (N.D. Ind. Mar. 3, 2008)
(affirming the ALJ’s credibility determination where he discredited the claimant’s symptoms
only in part).
In sum, an ALJ’s credibility assessment will stand as long as there is some support in the
record. Berger, 516 F.3d at 546 (affirming the ALJ’s credibility determination because it was
not “patently wrong” or “divorced from the facts contained in the record” (citation omitted)). In
this instance, the ALJ built an adequate and logical bridge between the evidence of record and
his conclusion about the credibility of Hart’s symptom testimony, see Ribaudo, 458 F.3d at 584,
and his conclusion is not “patently wrong,” Powers, 207 F.3d at 435. Therefore, the ALJ’s
credibility determination will stand.

7

Hart also argues that the ALJ ignored that he told the Northeastern Center that his “kids are his safety,”
and although he has had suicidal ideation at times, he would not hurt himself due to his kids. (AR 643, 646).
However, an ALJ “need not address every piece of evidence in [his] decision.” Sims v. Barnhart, 309 F.3d 424, 429
(7th Cir. 2002) (citation omitted). This comment does not rise to “an entire line of evidence that is contrary to the
[ALJ’s] ruling.” Terry v. Astrue, 580 F.3d 471, 477 (7th Cir. 2009) (“Although an ALJ need not discuss every piece
of evidence in the record, the ALJ may not ignore an entire line of evidence that is contrary to the ruling.” (citations
omitted)).

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IV. CONCLUSION
For the foregoing reasons, the decision of the Commissioner is AFFIRMED. The Clerk
is directed to enter a judgment in favor of the Commissioner and against Hart.
SO ORDERED.
Entered this 31st day of March 2017.
/s/ Susan Collins
Susan Collins,
United States Magistrate Judge

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