Wilkins v. Commissioner of Social Security

Filing 21

OPINION AND ORDER: AFFIRMING the decision of the Commissioner of Social Security. Signed by Chief Judge Theresa L Springmann on 2/8/2017. (lhc)

UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF INDIANA
FORT WAYNE DIVISION
MIKEL R. WILKINS,
Plaintiff,
v.
COMMISSIONER OF THE SOCIAL
SECURITY ADMINISTRATION,
Defendant.

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CAUSE NO.: 1:16-CV-91-TLS

OPINION AND ORDER
The Plaintiff, Mikel R. Wilkins, seeks review of the final decision of the Commissioner
of the Social Security Administration denying her application for Supplemental Security Income
(SSI). The Plaintiff claims that she would be unable to maintain substantial gainful employment
due to limitations brought about by her asthma, obesity, and type I diabetes.

PROCEDURAL HISTORY
In September 2012, the Plaintiff, at age nineteen, filed a claim for SSI, alleging disability
beginning on the application date. The state agency responsible for making disability
determinations on behalf of the Commissioner denied the Plaintiff’s claim initially and upon
reconsideration. The Plaintiff sought appeal of those determinations and filed a request for a
hearing before an Administrative Law Judge (ALJ). In May 2014, the Plaintiff, who was
represented by an attorney, appeared and testified at a hearing before the ALJ. A vocational
expert (VE) also testified. In October 2014, the ALJ issued a written decision, in which she
concluded that the Plaintiff was not disabled because she was capable of performing unskilled
light work as a cashier, retail marker, or sales attendant. The Plaintiff sought review of the ALJ’s

decision by the Appeals Council. In January 2016, the Appeals Council denied review, making
the ALJ’s decision the final decision of the Commissioner. See 20 C.F.R. § 404.981. The
Plaintiff seeks judicial review under 42 U.S.C. § 405(g).

THE ALJ’S FINDINGS
The Social Security regulations set forth a five-step sequential evaluation process to be
used in determining whether the claimant has established a disability. See 20 C.F.R.
§ 404.1520(a)(4)(i)-(v); see also 42 U.S.C. § 423(d)(1)(A) (defining a disability under the Social
Security Act as being 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”); id. § 423(d)(2)(A) (requiring an applicant to show that his “impairments are of such
severity that he is not only unable to do his previous work but cannot, considering his age,
education, and work experience, engage in any other kind of substantial gainful work which
exists in the national economy”). The first step is to determine whether the claimant is presently
engaged in substantial gainful activity (SGA). Here, the ALJ found that the Plaintiff was not
engaged in SGA, having never made any attempt at work, so she moved to the second step,
which is to determine whether the claimant had a “severe” impairment or combination of
impairments.
An impairment is “severe” if it significantly limits the claimant’s physical or mental
ability to do basic work activities. 20 C.F.R. § 404.1521(a). The ALJ determined that the
Plaintiff’s severe impairments were obesity, insulin-dependent diabetes mellitus, and asthma.

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The ALJ also discussed the Plaintiff’s depression, which was brought on by a stillborn birth in
May 2012, but concluded that it did not cause more than minimal limitations in the Plaintiff’s
ability to perform basic mental work activities for a twelve-month period.
At step three, the ALJ considered whether the Plaintiff’s impairments, or combination of
impairments, met or medically equaled the severity of one of the impairments listed by the
Administration as being so severe that it presumptively precludes SGA. See 20 C.F.R. Pt. 404,
Subpt. P, App. 1. The ALJ concluded that the Plaintiff’s impairments did not meet Listing 3.03
for asthma. Her diabetes did not meet a listing because there is no separate listing for diabetes,
and the Plaintiff did not have diabetic symptoms that met or equaled any listing under another
body system. The ALJ noted that there was no listing specifically addressing obesity, but that the
ALJ would consider the aggravating effects of the Plaintiff’s obesity on her other impairments.
Next, the ALJ was required, at step four, to determine the Plaintiff’s residual functional
capacity (RFC), which is an assessment of the claimant’s ability to perform sustained
work-related physical and mental activities in light of her impairments. SSR 96–8p, 1996 WL
374184, at *1 (July 2, 1996). The ALJ concluded that the Plaintiff had the RFC to perform light
work as defined in 20 C.F.R. § 416.967(b), which meant she could lift, carry, push, and pull
twenty pounds occasionally and ten pounds frequently, and that she could stand or walk for six
hours in an eight-hour day, as well as sit for six hours in an eight-hour day. For the Plaintiff’s
obesity, the ALJ imposed additional restrictions of avoiding concentrated exposure to wetness,
and hazards of unprotected heights and slippery work conditions, and also imposed limitations of
only occasionally climbing ramps and stairs, balancing, stooping, crouching, kneeling, or
crawling. The Plaintiff could never climb ladders, ropes, or scaffolds. To address the limitations

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caused by her asthma, the ALJ concluded that the Plaintiff had to avoid exposure to extreme
cold, and irritants such as fumes, odors, dust, gases, poorly ventilated areas, and chemicals.
In making these findings, the ALJ considered the Plaintiff’s testimony regarding the
symptoms caused by her diabetes, particularly her testimony that her sugar level is high about
four times per week, and that two to three times per week it would cause her to be unable to
work. The ALJ acknowledged that the Plaintiff’s medically determinable impairments could
reasonably be expected to cause the alleged symptoms. However, she did not find credible the
Plaintiff’s asserted inability to function two to three days per week. Rather, the ALJ thought that
the record supported potential absences of one day per month. The ALJ gave great weight to the
opinions of the state agency consultants that the Plaintiff could perform light work, but added
more restrictive postural limitations due to obesity, and limitations on pulmonary irritants due to
the Plaintiff’s asthma.
Although the Plaintiff had no past relevant work, at the final step of the evaluation, the
ALJ determined that the Plaintiff could perform work as a cashier, a retail marker, or a sales
attendant. These jobs were typically performed at the light level, and were unskilled. The ALJ
noted the VE’s testimony that an absence rate of one day per month would generally be
tolerated. “Thus, even if that limitation were added to the [Plaintiff’s] residual functional
capacity, [she] would not be precluded from all work.” (R. 26.)

STATEMENT OF FACTS
The Plaintiff has a high school diploma, but no employment history. She was nineteen
years old when she applied for SSI. The Plaintiff was diagnosed with diabetes in 2006 at the age

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of twelve and had suffered from chronic asthma for years. According to the Plaintiff, her
conditions became disabling on September 10, 2012.
Prior to this alleged onset date, the Plaintiff saw Dr. Pamela Thomas for treatment and
control of her diabetes. During her November 2010 visit, Dr. Thomas noted that the Plaintiff had
missed some of her appointments and seemed to be taking only half the prescribed insulin dose
based on pharmacy records. Further, Dr. Thomas observed that the Plaintiff’s glucometer
showed no useful blood sugar testing as the meter had the wrong date and time and the Plaintiff
had only done sporadic testing. Dr. Thomas commented that the Plaintiff was “non-compliant
with all aspects of her therapy.” (R. 226.) Dr. Thomas impressed upon the Plaintiff and her father
the importance of meal planning, administering adequate insulin doses, and checking blood
sugars four times per day.
The Plaintiff did not continue to see Dr. Thomas after 2010, but relied on her primary
care physician, Dr. Ashraf Hanna, to treat her diabetes. Her treatment records from December
2010 through 2011 show that she continued to experience wide fluctuations with her blood
glucose and also had occasional flare-ups of asthma symptoms. The Plaintiff reported that her
swings in blood sugar sometimes caused dizziness or headaches, but she denied experiencing
any tingling, numbness, fainting, or vomiting. (R. 306, 312, 325, 332, 346.) Still, the Plaintiff
went to the emergency room five times in 2011 for asthma attacks (R 360–418, 515, 541–88) and
episodes of severe hyperglycemia (R. 190, 250–61, 481–501). Each time she was treated with
steroids and/or intravenous insulin until she was stabilized and discharged within a couple of
days. (Id.)
After the Plaintiff learned she was pregnant with her first child in October 2011, she

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began seeing endocrinologist Dr. David Sorg to help better control her diabetes. Dr. Sorg’s nurse
practitioner, Loretta Bazur-Persing, counseled the Plaintiff on nutrition, carbohydrate counting,
and proper calculations for insulin dosing. The Plaintiff continued to experience trouble
regulating her blood sugars. (R. 520, 555.) However, the Plaintiff had no severe hyperglycemic
incidents requiring treatment in the emergency room for almost an entire year, between October
2011 and September 2012. The Plaintiff was hospitalized, however, in May 2012 because she
lost her first child, who she delivered stillborn three weeks before her due date. (R. 102, 495.)
In early September 2012, the Plaintiff went to the emergency room for an asthma attack.
(R. 478–90.) The doctor noted that the Plaintiff experienced “remarkable improvement” from the
breathing treatments she received and the Plaintiff insisted on being discharged the same day. (R.
481.) Because her symptoms persisted, however, she returned to the emergency room the
following day and was admitted for two days until she stabilized. (R. 449–50, 459–60.) When
she was admitted, the doctors noted that her blood sugars had also spiked and that her sudden
onset of hyperglycemia was likely due to the steroids she had been prescribed in the emergency
room the day before. (R. 462.) The Plaintiff applied for SSI benefits three days after being
discharged. (R. 17.)
The Plaintiff was hospitalized twice more in October and December 2012 for similar
complaints regarding her asthma and hyperglycemia. (R. 404–07, 1068–71, 1084–87.) In
October 2012, she was admitted for two days and given intravenous insulin and intensive
breathing treatments until her sugars came down and her breathing returned to normal. (R.
404–07, 419–21.) The attending doctor noted that her asthma attack was likely triggered by a
change in the weather and that her hyperglycemia was again linked to the use of an inhaled

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corticosteroid. (R. 419–21.) Her December hospitalization was caused by an acute allergic
reaction to fish, which, in turn triggered respiratory distress and a breakout of hives. (R.1068–71,
1084–87.) While she was in the hospital, the doctors noted that her sugars were elevated but that
they were stabilized and adequately controlled with the insulin regimen in the hospital. (R.
1087.)
On December 4, 2012, the Plaintiff saw consultative examiner Dr. B.T. Onamusi. In
describing her activities, the Plaintiff told Dr. Onamusi that she could walk at a fast pace for 30
minutes before needing to stop and use her inhaler and was capable of doing housework,
laundry, and grocery shopping. Though she had not reported similar symptoms to her treating
doctors, the Plaintiff told Dr. Onamusi that she experienced symptoms of numbness and tingling
in her hands and feet and calf pain from her diabetes. The Plaintiff stated that, about once a
month, she experienced hypoglycemia and felt weak, lightheaded, irritable, and shaky, but that
her diabetes improved overall in 2012 compared to 2011. Dr. Onamusi noted that she had no
problems with her attention span or memory and could walk, squat, and kneel without issue and
had good grip strength. Based on his examination and review of her records, Dr. Onamusi opined
that the Plaintiff was capable of engaging in light work and noted that there was no clinical
evidence of micro or macrovascular complications from her diabetes.
Later the same month, consultative psychiatric examiner, Dr. Andrew Miller, examined
the Plaintiff. (R. 975–78.) He assessed a Global Assessment of Functioning score of 64,
indicating only mild symptoms.
In 2013, the Plaintiff became pregnant with her second child. The Plaintiff continued to
see Dr. Hanna, Dr. Sorg, and Nurse Practitioner Bazur-Persing for management of her asthma,

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diabetes, and for prenatal care. Dr. Hanna’s treatment records from July through December 2013
consisted mainly of wellness check-ups and prenatal care. (R. 1288–1372.) Nurse Practitioner
Bazur-Persing’s August notes indicate that the Plaintiff checked her blood sugars at least four
times per day. “There is no real trend to her blood sugars, and they are really quite erratic
ranging from 123 to 497.” (R. 1259.) During another exam, it was noted that her ranges were
between 44 and 525, with her best values being “first thing in the morning.” (R. 1255.) Athough
the Plaintiff reported that she was eating right and closely monitoring her carbohydrates, BazurPersing thought that it was “clear from her blood sugars that something is not consistent” and she
was not convinced that the Plaintiff was following the prescribed regimen. (R. 1259, 1255–57;
see also R. 1257 (“It will be my hope that if we can hone in on the carbohydrate counting,
hopefully we can get better control of her diabetes during this pregnancy.”); R. 1261 (“I am not
always convinced that she is following the plan that we have set forth.”).) The Plaintiff said that
her high sugars occasionally caused headaches “but nothing that is concerning to her.” (R. 1260.)
By September 2013, one year after her alleged onset date, Ms. Bazur-Persing noted
marked improvement, although the Plaintiff still experienced some glucose swings. (R. 1229–31,
1250–52.) They continued to work on stabilizing her glucose levels in October 2013, but
Bazur-Persing suspected that the Plaintiff was still not accurately calculating her carbohydrate
intake. During her appointment on October 31, 2013, Bazur-Persing noted that, based on
information she had recently received from the nutritionist, the Plaintiff had been consuming
more carbohydrates than she had been led to believe and that these findings “likely explain the
inconsistencies [in] blood sugars versus food consumption as well as shed light on the difficulty
we have had helping the patient.” (R. 1204–05.) The Plaintiff denied any unusual headaches or

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change in her vision. She attributed her increased fatigue as a normal condition of her pregnancy.
Bazur-Persing also commented in her treatment note that she had been
very specific with the patient with regard to calling the clinic or myself should she
run into difficulty securing her medication or if she should have extremes in highs
or lows in her blood sugars. I have done this after every visit, but as of yet, the
patient does not call the clinic for guidance.
(R. 1206.) During subsequent visits with Bazur-Persing in November and December 2013,
Bazur-Persing noted that the Plaintiff denied unusual headaches or vision changes, and that she
had never complained of dizziness. (R. 1173–75, 1201–03.)
In 2013, the Plaintiff went to the emergency room five times for asthma attacks or
hyperglycemia. First, in February, the Plaintiff was admitted to the hospital after going to the
emergency room experiencing cold-like symptoms for several days. The doctors observed that
she did not have any wheezing or shortness of breath, but noted that her sugars were high. (R.
1045.) The Plaintiff reported that her sugars had been elevated for three or four days since she
started taking cough syrup, but stated that otherwise her sugars had “always been less than 200
or 150.” (Id.) She was treated with intravenous fluids, insulin and medication for her upper
respiratory infection and discharged the next day. (R. 992–93.)
The, she was treated on an outpatient basis in April (R. 1008–21), September (R.
1234–41), October (R. 1204), and November, 2013 (R. 1188–95), and discharged after she was
given breathing treatments and insulin. The April emergency room visit was prompted by upper
respiratory symptoms, but the Plaintiff also had high blood glucose. In September, the Plaintiff
had emergency room treatment for asthma and diabetes. In October, she reported to the
emergency room with abdominal pain and hyperglycemia. Her trip to the emergency room on
November 3, 2013, was prompted by shortness of breath that was not relieved with her nebulizer
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at home. The steroids that were administered raised her blood sugar.
The Plaintiff was hospitalized once more, in January 2014, for one night when her
asthma flared. Although her blood glucose was relatively low (195) when she was admitted (R.
1117), as had been the pattern, her steroid-based asthma treatments triggered hyperglycemia
during her hospitalization and her blood sugar spiked to over 400 (R. 1118). Although the
doctors recommended she stay for an additional day to get her blood sugar stabilized, the
Plaintiff insisted on going home to attend a previously scheduled appointment with her primary
care doctor. (R. 1118.) Her final appointment before her hearing was a visit with Bazur-Persing
on February 28, 2014. The nurse remarked that she felt “that how the patient tells me she is
eating is not necessarily true and often she might be eating or drinking things during the day that
would raise her blood sugar” and this had been confirmed by the nutritionist. (R. 1105.) This
treatment record also reflects that the Plaintiff had consistently denied any discomfort or altered
sensation in her extremities, had not experienced any unusual headaches recently, and her
asthma was well controlled; she rarely even needed her rescue inhaler. (R. 1106.)
At the May 15, 2014, hearing before the ALJ, the Plaintiff testified that she lives with her
father and younger brother and her infant daughter, who was born in December 2013. According
to Plaintiff, she spends her days taking care of her daughter, doing light housework, attending
medical appointments, taking walks, making meals, and socializing with friends and family. The
Plaintiff testified that she dropped out of high school in the eleventh grade because her diabetes
was so bad that she would often experience hyperglycemia and feel dizzy or faint at school. She
stated that the school nurse encouraged her to home school because of her medical conditions
and that she eventually obtained her high school diploma at age 20. The Plaintiff testified that

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her experience in high school is what made her believe that she could not work. She said that she
did not want to get a job and start it if there was a chance she would have to stop working. The
Plaintiff described her hyperglycemic symptoms as body aches, tingling, nausea, and a “weird
feeling in [her] head.” (R. 49.) She said that she experienced these hyperglycemic episodes about
two or three times per week and that, when she did, she would call her doctor for instructions of
how to treat it—whether she should take extra insulin or drink water or both. (R. 49, 54.) The
Plaintiff testified that she would then wait two hours and if her blood sugars had not gone down,
she would go to the emergency room. (R. 50.) She added that when she did feel sick from these
sugar spikes, her family had to help her with the care of her daughter. (R. 50–51.) Regarding her
asthma, the Plaintiff admitted it was relatively well controlled. (R. 48, 57.)

STANDARD OF REVIEW
The decision of the ALJ is the final decision of the Commissioner when the Appeals
Council denies a request for review. Liskowitz v. Astrue, 559 F.3d 736, 739 (7th Cir. 2009). A
court will affirm the Commissioner’s findings of fact and denial of disability benefits if they are
supported by substantial evidence. Craft v. Astrue, 539 F.3d 668, 673 (7th Cir. 2008). Substantial
evidence is “such relevant evidence as a reasonable mind might accept as adequate to support a
conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971). It must be “more than a scintilla
but may be less than a preponderance.” Skinner v. Astrue, 478 F.3d 836, 841 (7th Cir. 2007).
Even if “reasonable minds could differ” about the disability status of the claimant, the court must
affirm the Commissioner’s decision as long as it is adequately supported. Elder v. Astrue, 529
F.3d 408, 413 (7th Cir. 2008).

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It is the duty of the ALJ to weigh the evidence, resolve material conflicts, make
independent findings of fact, and dispose of the case accordingly. Perales, 402 U.S. at 399–400.
In this substantial-evidence determination, the court considers the entire administrative record
but does not reweigh evidence, resolve conflicts, decide questions of credibility, or substitute the
court’s own judgment for that of the Commissioner. Lopez ex rel. Lopez v. Barnhart, 336 F.3d
535, 539 (7th Cir. 2003). Nevertheless, the court conducts a “critical review of the evidence”
before affirming the Commissioner’s decision, and the decision cannot stand if it lacks
evidentiary support or an inadequate discussion of the issues. Id.
The ALJ is not required to address every piece of evidence or testimony presented, but
the ALJ must provide a “logical bridge” between the evidence and the conclusions. Terry v.
Astrue, 580 F.3d 471, 475 (7th Cir. 2009). If the Commissioner commits an error of law, remand
is warranted without regard to the volume of evidence in support of the factual findings. Binion
v. Chater, 108 F.3d 780, 782 (7th Cir. 1997).

ANALYSIS
The Plaintiff presents two issues for review. First, she complains that the ALJ “failed to
properly address SSR 96-7p and ignored evidence supportive of [the Plaintiff’s] subjective
symptoms.” (Pl.’s Br. 7, ECF No. 12.) The Plaintiff describes the second issue as a failure to
address all the evidence, both in favor of and against a finding of disability:
The ALJ failed to address the implications of Wilkins’ fluctuating symptoms
associated with her severely uncontrolled diabetes mellitus and that she has
several “bad days” each week where her functional abilities are decreased, likely
resulting in excessive absences from steady employment. Just because she did not
go to the emergency room every time her blood sugars were too high does not
mean that Wilkins suffered no negative symptoms any other day. Remand is
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necessary to properly address Wilkins subjective reports of good versus bad days
and the impact this would have on her employability.
(Id.)
The Court finds that the two issues, as presented by the Plaintiff, are related. The
Plaintiff’s claim of disability rests mainly on her allegations concerning the frequency and
severity of the symptoms associated with her diabetes. The overriding issue is whether the ALJ
adequately supported her decision not to credit the Plaintiff’s testimony that she would be unable
to work two to three days per week due to functional limitations caused by high blood sugar.
The regulations and SSR 96-7p set forth the Agency’s policy for evaluating a claimant’s
symptoms and assessing the credibility of her statements.1 The Plaintiff argues that the ALJ’s
credibility assessment was cursory and failed to specifically articulate her consideration for any
of the factors listed under SSR 96-7p. (Pl’s Br. 10–15.) According to the Plaintiff, the ALJ
merely offered a boilerplate explanation and a brief summary of the evidence and testimony
without properly articulating her reasons for discounting the Plaintiff’s allegations. The Court
does not agree. Although the ALJ’s decision included the much-criticized boilerplate language,
simply using it “does not automatically undermine or discredit the ALJ’s ultimate conclusion if
[she] otherwise points to information that justifies [her] credibility determination.” Pepper v.
Colvin, 712 F.3d 351, 367–68 (7th Cir. 2013). Put differently, the ALJ’s use of boilerplate

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SSR 96-7p was recently replaced with a new ruling, SSR 16-3p, Evaluation of Symptoms in
Disability Claims, which more closely follows the Agency’s regulatory language regarding symptom
evaluation. See SSR 16-3P, 2016 WL 1119029, at *1 (Mar. 16, 2016). The substantive aspects of SSR
16-3p do not apply retroactively, so SSR 96-7p still governs this case. However, SSR 16-3p clarifies
SSA’s existing policy by explicitly stating that an ALJ need not discuss all of the regulatory factors that
she considers, except as she finds them pertinent to the case. Id. at *7 (“If there is no information in the
evidence of record regarding one of the factors, we will not discuss that specific factor in the
determination or decision because it is not relevant to the case”).

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language is reversible error only if she did not also give sufficient reasons, grounded in evidence
in the record, to support her ultimate determination. See id.; cf. Zurawski v. Halter, 245 F.3d 881,
887 (7th Cir. 2001) (noting that SSR 96-7p requires specific reasons for the credibility finding,
and that it is not sufficient for the ALJ to make a single, conclusory statement about credibility
but neither is it sufficient to simply recite the regulatory factors).
One of the claims the Plaintiff made during the May 2014 hearing was that she frequently
called Dr. Sorg’s office to get instructions when her blood sugar was high.
Q.
A.

When [your blood sugar] gets that high, what do you do?
I call my doctor. I’ll get to the phone, call my doctor, and I’ll see what she
tell me. She might say take some extra insulin; she might say drink a lot of
water; or do both. I call back in two hours. If it’s not back to where it’s
supposed to be at, I go to the ER. Because lately it’s been going down, but
it shoot right back up a lot.

(R. 49–50; see also R. 55 (testifying that she calls the doctor’s office two to three days per
week).) The ALJ noted this testimony, but reasoned that the records did not corroborate the
Plaintiff’s account. The ALJ wrote:
A treatment entry from October 31, 2013, states that Dr. Sorg urged the claimant
to call his office if she experienced extreme highs or lows in her blood sugars. He
noted that he had done this after every visit, but as of yet, the claimant had not
called the clinic for guidance (Ex. 8F). The evidence in the record does not show
any calls to Dr. Sorg after October 2013 either.
(R. 23.)2 This analysis of specific testimony refutes the Plaintiff’s argument to this Court that the
ALJ offered only boilerplate language without explaining which of the claimant’s statements
were not credible. The Plaintiff argues that, just because the Plaintiff “did not go to the hospital

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Additionally, because the Plaintiff’s medical records did not reflect that she had made such
telephone calls, the ALJ gave the Plaintiff’s counsel additional time to submit evidence regarding whether
it was the doctor’s practice to log such telephone calls. The record does not appear to have been
supplemented with this evidence.

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or call her doctor every time her blood sugar is high does not mean that she does not suffer
multiple days of symptoms associated with hyperglycemia.” (Pl.’s Br. 15.) While this may be
true, the Plaintiff herself stated that she called Dr. Sorg’s office when her blood sugar got too
high, and that she went to the emergency room if she could not get it down after talking to the
nurse practitioner. Yet, Dr. Sorg’s office has no records of such calls in the entire year following
the Plaintiff’s alleged onset date, despite the repeated invitation from the doctor to call.
Additionally, she only went to the emergency room for blood-sugar-related events three times
after her initial evaluation with Dr. Sorg, all which occurred while she was pregnant. The ALJ’s
discussion of the treatment records is a specific reason in support of her determination that the
Plaintiff’s assertions about her symptoms were not entitled to be taken at face value.
The ALJ noted that the Plaintiff’s total hospitalizations (15 days in two years) did not
support the Plaintiff’s allegations of inability to function two or three days a week. She also
noted that the Plaintiff had not required diabetes related treatment in a hospital facility since
October 30, 2013, which was nearly a year before the ALJ’s written decision. The ALJ stated
that, although Dr. Sorg’s notes indicated that the Plaintiff periodically had blood sugar readings
in the 300s and did not go to the hospital, the record did not establish the functional limitations
of those high readings. This Court’s review of the treatment notes bears this out. It was
appropriate for the ALJ to consider the Plaintiff’s statements to her medical providers. The ALJ
also highlighted the Plaintiff’s most recent record of diabetes treatment, an appointment with
nurse practitioner Bazur-Persing on February 28, 2014. The ALJ noted that “Bazur-Persing
stated that the claimant does not necessarily give accurate reports of her eating and often might
be eating and drinking items that would raise her blood sugar.” (R. 24.) The ALJ may deem an

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individual’s statements less credible if medical reports or records show that the individual is not
following the treatment as prescribed. See SSR 96–7p, 1996 WL 374186, at *7; Craft, 539 F.3d
at 679. However, such evidence should not negatively affect an individual’s credibility if there
are good reasons for the failure to complete the plan. Craft, 539 F.3d at 679. Therefore, an ALJ
may need to question the individual at the administrative proceeding to determine whether there
are good reasons the individual did not seek medical treatment or fully comply with prescribed
treatment. Shauger v. Astrue, 675 F.3d 690, 696 (7th Cir. 2012). Here, the Plaintiff did not admit
to poor compliance. Instead, as noted in the ALJ’s decision, the Plaintiff testified that she ate
right, drank fluids, and walked to control her blood sugar. (R. 22.) Accordingly, it would not
have been logical for the ALJ to ask her to justify her noncompliance.
The Plaintiff faults the ALJ for failing to investigate the impact of the Plaintiff’s
dependence and the side effects of increased dosages of drugs. (Pl.’s Br. 13.) However, the
Plaintiff did not attempt to present any evidence related to the impact of her medications, and
does not attempt to highlight to this Court what she believes might have been discovered. The
Plaintiff has the burden of proof regarding her functional limitations, and the Court does not find
any error in the ALJ’s failure to investigate.
The inconsistent statements, lack of recorded symptoms in the medical records to match
the Plaintiff’s testimony, and the failure to adhere to dietary restrictions is relevant evidence that
a reasonable person might accept as adequate to support the conclusion that the Plaintiff was not
incapacitated by high blood sugar two to three days per week. The AJL explained her
adverse-credibility finding with specific reasons “supported by the record.” Minnick v. Colvin,
775 F.3d 929, 937 (7th Cir. 2015); Prochaska v. Barnhart, 454 F.3d 731, 738 (7th Cir. 2006)

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(“Only if the trier of fact grounds his credibility finding in an observation or argument that is
unreasonable or unsupported . . . can the finding be reversed.”). She has “explain[ed] her
decision in such a way that allows [the court] to determine whether she reached her decision in a
rational manner, logically based on her specific findings and the evidence in the record.”
McKinzey v. Astrue, 641 F.3d 884, 890 (7th Cir. 2011). This Court does not reweigh the
evidence or substitute its judgment for that of the ALJ’s.

CONCLUSION
For the reasons stated above, the decision of the Commissioner is AFFIRMED.
SO ORDERED on February 8, 2017.
s/ Theresa L. Springmann
CHIEF JUDGE THERESA L. SPRINGMANN
UNITED STATES DISTRICT COURT

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