Sult v. Commissioner of Social Security
AMENDED OPINION AND ORDER: The Court GRANTS in part and DENIES in part the relief requested in Plaintiff's Opening Brief DE 17 and REMANDS this matter for further proceedings consistent with this opinion. Signed by Magistrate Judge John E Martin on 10/7/19. (Copy mailed to pro se party - certified # 7019 1120 0001 9119 6916). (nal)
UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF INDIANA
KONI RENAE’ SULT,
ANDREW M. SAUL,
Commissioner of the Social Security
CAUSE NO.: 2:18-CV-237-JEM
AMENDED OPINION AND ORDER
This matter is before the Court on a Complaint [DE 1], filed by Plaintiff Koni Renae Sult,
pro se, on June 14, 2018, and Plaintiff’s Opening Brief [DE 17], filed November 26, 2018. Plaintiff
requests that the decision of the Administrative Law Judge be reversed and requests an award of
benefits. On December 27, 2018, the Commissioner filed a response. For the reasons described
below, the Court remands this matter for further proceedings.
On June 23, 2014, Plaintiff filed an application for benefits alleging that she became disabled
on December 4, 2013. Plaintiff's application was denied initially and upon reconsideration. On
March 14, 2017, Administrative Law Judge (“ALJ”) Romona Scales held a video hearing, at which
Plaintiff, with an attorney and a vocational expert (“VE”), testified. On July 27, 2017, the ALJ
issued a decision finding that Plaintiff was not disabled.
The ALJ made the following findings under the required five-step analysis:
The claimant meets the insured status requirements of the Social Security Act
through December 31, 2018.
The claimant has not engaged in substantial gainful activity since December
5, 2013, the alleged onset date.
The claimant has the following severe impairments: bilateral carpal tunnel
syndrome status post surgery; obesity; degenerative disc disease of the
cervical and lumbar spine status post lumbar and cervical fusions; and
The claimant does not have an impairment or combination of impairments
that meets or medically equals the severity of one of the listed impairments
in 20 C.F.R. Part 404, Subpart P, Appendix 1.
The claimant has the residual functional capacity (“RFC”) to lift and carry
up to 10 pounds occasionally and nominal weight frequently, stand and/or
walk for about 2 hours of an 8 hour workday and sit for about 6 hours of an
8 hour workday. She should be allowed to alternate between sitting and
standing for up to ten minutes each hour, but would remain on task at her
workstation. She can occasionally balance, stoop, crouch, kneel and climb
ramps/stairs. She is unable to crawl or climb ladders, ropes or scaffolds. She
is occasionally able to push/pull with the upper and lower extremities and
operate foot controls. She is unable to reach overhead bilaterally. She can
frequently handle, finger, and reach in all other directions. She is unable to
reach overhead bilaterally. She should avoid even moderate exposure to
extreme cold, vibrations, or workplace hazards such as slipper/uneven
surfaces, moving mechanical parts, and unprotected heights. She can
understand, remember, and carry out simple routine tasks and instructions;
maintain adequate attention and concentration for such tasks/instructions; is
limited to brief and superficial interaction with supervisors and occasional
and brief superficial interaction with the general public. She is to avoid tasks
requiring fast paced production or quotas and can manage the changes in a
routine work setting.
The claimant is unable to perform any past relevant work.
The claimant was 42 years old, which is defined as a younger individual age
18-44, on the alleged disability onset date. The claimant subsequently
changed age category to a younger individual age 45-49.
The claimant has at least a high school education and is able to communicate
Transferability of job skills is not material to the determination of disability
because using the Medical-Vocational Rules as a framework supports a
finding that the claimant is “not disabled,” whether or not the claimant has
transferable job skills.
Considering the claimant’s age, education, work experience, and residual
functional capacity, there are jobs that exist in significant numbers in the
national economy that the claimant can perform.
The claimant has not been under a disability, as defined in the Social Security
Act, from December 5, 2013, through the date of this decision.
The Appeals Council denied Plaintiff’s request for review, leaving the ALJ’s decision the final
decision of the Commissioner.
The parties filed forms of consent to have this case assigned to a United States Magistrate
Judge to conduct all further proceedings and to order the entry of a final judgment in this case.
Therefore, this Court has jurisdiction to decide this case pursuant to 28 U.S.C. § 636(c) and 42
U.S.C. § 405(g).
Standard of Review
The Social Security Act authorizes judicial review of the final decision of the agency and
indicates that the Commissioner’s factual findings must be accepted as conclusive if supported by
substantial evidence. 42 U.S.C. § 405(g). Thus, a court reviewing the findings of an ALJ will reverse
only if the findings are not supported by substantial evidence or if the ALJ has applied an erroneous
legal standard. See Briscoe v. Barnhart, 425 F.3d 345, 351 (7th Cir. 2005). Substantial evidence
consists of “such relevant evidence as a reasonable mind might accept as adequate to support a
conclusion.” Schmidt v. Barnhart, 395 F.3d 737, 744 (7th Cir. 2005) (quoting Gudgel v. Barnhart,
345 F.3d 467, 470 (7th Cir. 2003)).
A court reviews the entire administrative record but does not reconsider facts, re-weigh the
evidence, resolve conflicts in evidence, decide questions of credibility, or substitute its judgment
for that of the ALJ. See Boiles v. Barnhart, 395 F.3d 421, 425 (7th Cir. 2005); Clifford v. Apfel, 227
F.3d 863, 869 (7th Cir. 2000); Butera v. Apfel, 173 F.3d 1049, 1055 (7th Cir. 1999). Thus, the
question upon judicial review of an ALJ’s finding that a claimant is not disabled within the meaning
of the Social Security Act is not whether the claimant is, in fact, disabled, but whether the ALJ “uses
the correct legal standards and the decision is supported by substantial evidence.” Roddy v. Astrue,
705 F.3d 631, 636 (7th Cir. 2013) (citing O’Connor-Spinner v. Astrue, 627 F.3d 614, 618 (7th Cir.
2010); Prochaska v. Barnhart, 454 F.3d 731, 734-35 (7th Cir. 2006); Barnett v. Barnhart, 381 F.3d
664, 668 (7th Cir. 2004)). “[I]f the Commissioner commits an error of law,” the Court may reverse
the decision “without regard to the volume of evidence in support of the factual findings.” White v.
Apfel, 167 F.3d 369, 373 (7th Cir. 1999) (citing Binion v. Chater, 108 F.3d 780, 782 (7th Cir.
At a minimum, an ALJ must articulate his or 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. See Scott v. Barnhart, 297 F.3d 589, 595 (7th Cir. 2002); Diaz v. Chater, 55
F.3d 300, 307 (7th Cir. 1995); Green v. Shalala, 51 F.3d 96, 101 (7th Cir. 1995). An ALJ must
“‘build an accurate and logical bridge from the evidence to [the] conclusion’ so that, as a reviewing
court, we may assess the validity of the agency’s final decision and afford [a claimant] meaningful
review.” Giles v. Astrue, 483 F.3d 483, 487 (7th Cir. 2007) (quoting Scott, 297 F.3d at 595); see also
O’Connor-Spinner, 627 F.3d at 618 (“An ALJ need not specifically address every piece of evidence,
but must provide a ‘logical bridge’ between the evidence and his conclusions.”); Zurawski v. Halter,
245 F.3d 881, 889 (7th Cir. 2001) (“[T]he ALJ’s analysis must provide some glimpse into the
reasoning behind [the] decision to deny benefits.”).
Plaintiff filed a single-page letter in lieu of an opening brief, requesting that this Court
reverse the ALJ’s decision. Plaintiff suggests in her letter that her attorney was unprepared and
failed to present her records at the administrative hearing. Plaintiff also argues that the ALJ erred
in assessing her symptoms, particularly her need to lie down and her “emotional outbursts,” and that
the ALJ erred in concluding she was disabled based on the medical evidence.
First, Plaintiff alleges that her attorney was “not prepared,” and failed to update the medical
record. The quality of a claimant’s representation may create a basis for remand. Smith v. Secretary
of Health, Ed. and Welfare, 587 F.2d 857, 860 (7th Cir. 1978) (citing Arms v. Gardner, 353 F.2d 197
(6th Cir. 1965)). At the hearing, Plaintiff’s counsel stated that he had difficulty uploading some of
Plaintiff’s medical record. AR 90. He stated that he had digitized more updated information and
would upload that information after the hearing. AR 92. The ALJ specifically noted a gap in the
record from 2015-2017, and asked the attorney for updated records from that time period. Id. The
ALJ stated that she would keep the record open for two weeks following the hearing to permit the
additional information. AR 93. Plaintiff seems to assume that her attorney never updated the medical
record, or that the failure to update the record before the hearing somehow prejudiced the ALJ
against her. However, the ALJ explicitly permitted counsel to update the record after the hearing,
and numerous medical records were added, including records from the time period noted by the ALJ.
See AR 2483-2778. Plaintiff’s letter has not shown that her counsel’s representation was inadequate.
Plaintiff argues in her letter that the ALJ failed to account for her “lay down-Crash time” in
finding that she was not disabled. When determining a claimant’s subjective symptoms, the ALJ
must consider a claimant’s statements about her symptoms, such as pain, and how the symptoms
affect her daily life and ability to work. See 20 C.F.R. § 404.1529(a); SSR 16-3p, 2017 WL 5180304
(October 25, 2017). The ALJ is not permitted to
make a single, conclusory statement that “the individual’s statements about his or her
symptoms have been considered” or that “the statements about the individual’s
symptoms are (or are not) supported or consistent.” . . . The 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 articulated so the individual and
any subsequent reviewer can assess how the evaluated the individual’s symptoms.
SSR 16-3p, 2017 WL 5180304 at *9. “[T]he absence of objective medical corroboration for a
complainant’s subjective accounts of pain does not permit an ALJ to disregard those accounts.”
Ghiselli v. Colvin, 837 F.3d 771, 777 (7th Cir. 2016); see also Moore v. Colvin, 743 F.3d 1118, 1125
(7th Cir. 2014) (“[T]he ALJ erred in rejecting [the plaintiff]’s testimony on the basis that it cannot
be objectively verified with any reasonable degree of certainty. An ALJ must consider subjective
complaints of pain if a claimant has established a medically determined impairment that could
reasonably be expected to produce the pain.”).
In this case, the ALJ’s analysis of Plaintiff’s headaches, and her need to take breaks, was
inadequate. Addressing Plaintiff’s symptoms generally, the ALJ found that “[t]he degree of the
claimant’s complaints are not supported by the treatment she has undergone or the objective
findings.” Addressing her headaches directly, the ALJ stated that “the claimant testified that she
experiences migraines 1-2 times per month,” but that a medical report from August 2016 noted she
had not had a migraine in six months. The ALJ also summarized a treatment note from December
2016 as indicating that Plaintiff was “doing well.”
Plaintiff’s complaints of headaches were more extensive than the ALJ suggested, and the
ALJ did not draw a logical bridge from the evidence to her conclusion that her complaints were “not
supported.” Plaintiff reported cluster headaches, occurring daily, dating back to her alleged date of
onset. AR 2259. She completed a headache questionnaire indicating that the headaches arose from
stress and concentrating, among other causes. She treated the headaches by taking medication, using
an ice pack or cold washcloth, and going into a dark, quiet room. AR 301. In August 2015, she
described that the headaches had “intensified recently.” AR 2282. In August 2016, Plaintiff reported
new migraine headaches, different in scope and intensity from the headaches she had previously
reported. See AR 2485, AR 2603. At that time, Plaintiff’s doctor noted that she had not had a
migraine for six months, but did not specifically address the cluster headaches. AR 2485. Plaintiff’s
migraines were treated with medication, and in December 2016, the treating physician noted that
it was “helping,” but that she still had mild headaches. AR 2544. The ALJ appeared to rely on this
report, and the physician’s note in the report that Plaintiff was “doing much better” and the
medication gave her no side effects, to conclude that Plaintiff’s complaints were unsupported. But
the ALJ did not explain why that report led to the conclusion that the migraine headaches – or the
cluster headaches – would not cause functional limitations. Smith v. Astrue, 467 F. App’x 507, 511
(7th Cir. 2012) (remanding where the ALJ’s opinion “tick[ed] off certain medical evidence, but did
not “specify how the evidence undermines [the plaintiff’s] credibility”). The fact that Plaintiff was
doing “much better” in December 2016 than in August 2016, when she reported a pain level of 8 out
of 10 with nausea and dizziness, was not a reason to discount Plaintiff’s complaints of headaches.
Neither the doctor nor the ALJ addressed whether Plaintiff would need to take breaks when she did
get headaches, leaving the Court without a “logical bridge” to the ALJ’s apparent conclusion that
they did not cause functional limitations. See O’Connor-Spinner, 627 F.3d at 618.
The ALJ also failed to adequately address Plaintiff’s mental faculties in the RFC. At step
two, the ALJ found that Plaintiff had mild limitations in understanding, remembering and applying
information, moderate limitation in interacting with others, and moderate limitations in
concentration, persistence and pace. The ALJ also found Plaintiff’s anxiety to be a “severe
impairment.” At step three, the ALJ concluded that Plaintiff could “understand, remember, and carry
out simple routine tasks and instructions; maintain adequate attention and concentration for such
tasks/instructions.” The RFC limited Plaintiff to “brief and superficial interaction with supervisors
and occasional and brief superficial interaction with the general public. She is to avoid tasks
requiring fast paced production or quotas and can manage the changes in a routine work setting.”
As the Seventh Circuit Court of Appeals has explained, a limitation to unskilled work is
generally insufficient to account for moderate limitations in concentration, persistence, or pace
because “[t]he ability to stick with a task over a sustained period is not the same as the ability to
learn how to do tasks of a given complexity.” O’Connor-Spinner, 627 F.3d at 620-21 (“In most
cases . . . employing terms like ‘simple, repetitive tasks’ on their own will not necessarily exclude
from the VE’s consideration those positions that present significant problems of concentration,
persistence and pace.”); see also Stewart v. Astrue, 561 F.3d 679, 684-85 (7th Cir. 2009) (rejecting
the contention “that the ALJ accounted for [the plaintiff]’s limitations of concentration, persistence,
and pace by restricting the inquiry to simple, routine tasks that do not require constant interactions
with coworkers or the general public”).
In this case, the record indicates that Plaintiff had the kind of difficulties that could not be
accounted for by a limitation to simple tasks and brief interactions. Plaintiff stated that due to her
anxiety, she had difficulty being around other people or out in public, and needed to know ahead of
time if she was going out in public, to “prepare herself mentally.” AR 124. She reported “a lot” of
crying spells, AR 116, and her husband indicated in a third-party function report that she “can’t
really handle” stress. AR 320. Plaintiff also testified that she did not take her medications on the day
of the hearing, because they affected her concentration and made her “hazy.” AR 119-120. Despite
the ALJ’s general statement that “the degree of the claimant’s complaints are not supported by the
treatment she has undergone or the objective findings,” she never cited any medical evidence
contradicting those allegations, or gave any reasons why they should be deemed as “not supported.”
The ALJ noted that Plaintiff’s concentration appeared intact during a consultation with a
psychiatrist, but did not address the evidence that Plaintiff would struggle to maintain that level of
performance consistently enough to maintain a job. See Jelinek v. Astrue, 662 F.3d 805, 813-14 (7th
Cir. 2011) (concluding that limitations to unskilled work did not “address the impact of the mental
limitations . . . which . . . limited [the plaintiff]’s ability to maintain regular work attendance, to carry
out instructions, and to deal with the stresses of full-time employment”); Craft v. Astrue, 539 F.3d
668, 677-78 (7th Cir. 2008) (finding that a limitation to unskilled work did not account for
limitations in concentration, pace, and mood swings); see also Punzio v. Astrue, 630 F.3d 704, 710
(7th Cir. 2011) (“[A] plaintiff who suffers from mental illness will have better days and worse days,
so a snapshot of any single moment says little”).
Because the Commissioner’s decision is reversed, the Court considers whether to award
benefits or remand the case for re-hearing by an ALJ. An award of benefits is appropriate if all
factual issues have been resolved and the record supports a finding of disability. Briscoe, 425 F.3d
at 356. In this case, although the ALJ did not adequately support her conclusion that Plaintiff’s
complaints of headaches were “not supported,” the record does not clearly show that Plaintiff’s
headaches made her unable to work. Similarly, while the ALJ’s analysis did not properly account
for Plaintiff’s testimony regarding her limitations in concentration and need to take breaks, that
testimony does not conclusively show that she could not work. Plaintiff’s psychological evaluation
with Dr. Gary Durak indicated a diagnosis of “Generalized Anxiety Disorder, Moderate,” but did
not address whether she could work. Although the ALJ’s analysis was inadequate, remand for
benefits is not appropriate. See Allord v. Astrue, 631 F.3d 411, 417 (7th Cir. 2011) (affirming
reversal for re-hearing, rather than an award of benefits, where “contradictory inferences could be
drawn from the physicians’ testimony”); Campbell v. Shalala, 988 F.2d 741, 744 (7th Cir. 1993)
(“the record is not so clear that we can award or deny benefits on appeal”).
On remand, the Court directs the ALJ to conduct a thorough analysis of the medical
evidence, and solicit additional opinions if appropriate. See Myles v. Astrue, 582 F.3d 672, 678 (7th
Cir. 2009) (“On remand, the ALJ should consider all of the evidence in the record, and, if necessary,
give the parties the opportunity to expand the record so that he may build a ‘logical bridge’ between
the evidence and his conclusion.”). The ALJ must also analyze Plaintiff’s subjective complaints in
the manner prescribed by SSR 16-3p, explaining which symptoms he or she finds consistent or
inconsistent with the evidence, and draw a “logical bridge” between the evidence and his or her
For the foregoing reasons, the Court hereby GRANTS in part and DENIES in part the
relief requested in Plaintiff’s Opening Brief [DE 17] and REMANDS this matter for further
proceedings consistent with this opinion.
SO ORDERED this 7th day of October, 2019.
s/ John E. Martin
MAGISTRATE JUDGE JOHN E. MARTIN
UNITED STATES DISTRICT COURT
All counsel of record
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