Stephens v. Commissioner of Social Security
Filing
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OPINION AND ORDER The final decision of the Commissioner of Social Security denying plaintiff Adam Douglas Stephens application for Social Security Disability benefits is AFFIRMED. The Clerk shall enter judgment in favor of defendant and against plaintiff. ***Civil Case Terminated. Signed by Judge Philip P Simon on 8/31/18. (kjp)
UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF INDIANA
SOUTH BEND DIVISION
ADAM DOUGLAS STEPHENS,
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Plaintiff,
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vs.
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NANCY BERRYHILL, Acting Commissioner )
of the Social Security Administration,
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Defendant.
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3:17CV570-PPS
OPINION AND ORDER
Adam Douglas Stephens appeals the denial of his application for disability
insurance benefits by the Commissioner of the Social Security Administration.
Stephens was 35 years old on the date he alleges he became disabled, November 1, 2013.
After a hearing on January 26, 2016, an administrative law judge issued a decision on
March 15, 2016, finding that Stephens retains the residual functional capacity to perform
light work with certain limitations. The ALJ found that Stephens has severe
impairments of degenerative disc disease, history of umbilical hernia repair, diabetes,
hypertension, hyperlipidemia, obesity, gout, obstructive sleep apnea,
depression/bipolar disorder and generalized anxiety disorder. [AR at 27.]1 Stephens
previously worked as a die casting machine operator, a recycler, a warehouse worker, a
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The administrative record [AR] is found in the court record at docket entry 9, and consists of
744 pages. I will cite to the pages of this AR according to the Social Security Administration’s Bates
stamp numbers rather than the court’s Electronic Case Filing page number.
fertilizer driver, a customer service representative and an assistant manager. [AR at 36.]
Stephens asks me to reverse the ALJ’s decision and remand for further
proceedings by the Social Security Administration. My review of the ALJ’s decision is
deferential. I must affirm it if it is supported by substantial evidence, meaning “‘such
relevant evidence as a reasonable mind might accept as adequate to support a
conclusion.’” McKinzey v. Astrue, 641 F.3d 884, 889 (7th Cir. 2011) (citation omitted). I
can’t reweigh the evidence or substitute my judgment for that of the ALJ. Minnick v.
Colvin, 775 F.3d 929, 935 (7th Cir. 2015). But these standards do not mean that I “will
simply rubber-stamp the Commissioner’s decision without a critical review of the
evidence.” Clifford v. Apfel, 227 F.3d 863, 869 (7th Cir. 2000).
When considering the evidence, “an ALJ is not required to provide a complete
and written evaluation of every piece of testimony and evidence, but ‘must build a
logical bridge from the evidence to his conclusion.’” Minnick v. Colvin, 775 F.3d 929, 935
(7th Cir. 2015), quoting Schmidt v. Barnhart, 395 F.3d 737, 744 (7th Cir. 2005). This means
that an ALJ’s decision must offer an explanation of the rationale from the evidence to
his or her conclusions “sufficient to allow us, as a reviewing court, to assess the validity
of the agency’s ultimate findings and afford [the claimant] meaningful judicial review.”
Moore v. Colvin, 743 F.3d 1118, 1121 (7th Cir. 2014).
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Discussion
Treating Psychiatrist Dr. Kalapatapu
Stephens raises two issues in this appeal. First, he contends that the ALJ failed to
give appropriate weight to the medical opinion of Dr. Umamaheshwara Kalapatapu, his
treating psychiatrist. The opinion in question takes the form of the Mental Impairment
Questionnaire Dr. Kalapatapu completed on February 24, 2015. [AR 679-683.] Stephens
acknowledges that the ALJ included six non-exertional limitations in his RFC findings,
all of which are intended to accommodate Stephens’ mental and emotional conditions.
[DE 14 at 13.] These included that Stephens is:
limited to understanding, remembering, [and] carrying out simple,
routine repetitive tasks, consistent with unskilled work (defined as
occupations that can be fully learned within a short period of time of no
more than 30 days, and require little or no judgment to perform simple
tasks), with the ability to sustain those tasks throughout the eight hour
workday without frequent redirection to task; no sudden or unpredictable
workplace changes in terms of use of work tools, work processes or work
settings, and if there are workplace changes, they are introduced
gradually; only occasional work in close proximity to others to minimize
distractions; only casual/superficial/brief interactions with others,
including supervisors, coworkers, and the general public, meaning that
successful performance of job duties involves primarily working with
things or objects and not people although incidental interactions with
others or incidental proximity to others is tolerated; no exposure to
intense/critical supervision; and is best suited to working alone, in semiisolation from others, or as part of a small group.
[AR at 29-30.] Stephens agrees that “[t]hese restrictions were consistent with most of
the limitations opined by Dr. Kalapatapu” but argues that the ALJ should have adopted
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more of the doctor’s opinions. [DE 14 at 13.]2
These additional opinions of Dr. Kalapatapu (expressed by checking boxes in the
questionnaire) include that Stephens is “unable to meet competitive standards” in
“sustain[ing] an ordinary routine without special supervision” and has “no useful
ability” to “complete a normal workday and workweek without interruptions from
psychologically based symptoms” or to “perform at a consistent pace without an
unreasonable number and length of rest periods.” [AR at 681.] The others are that
Stephens has “marked” deficiencies of concentration, persistence or pace, and that Dr.
Kalapatapu would anticipate that Stephens’ impairments or treatment would cause him
to be absent from work more than four days per month. [AR at 681, 682.] Stephens
argues that these additional limitations demonstrate that he is unable to maintain
competitive work. [DE 14 at 14.]
Because Dr. Kalapatapu is a treating physician, “his opinion on the nature and
severity of [Stephens’] medical condition is entitled to controlling weight if it is well
supported by medical findings and consistent with other record evidence.” Lambert v.
Berryhill, 896 F.3d 768, 774 (7th Cir. 2018), citing 20 C.F.R. §404.1520c(a) (2017). Here,
instead the ALJ gave only “limited weight” to Dr. Kalapatapu’s opinions that Stephens
“is unable to meet competitive standards or has no useful ability to function in several
areas to do unskilled work.” [AR at 35.] The ALJ gave at least six reasons for not fully
2
I note that the ALJ found Stephens “more limited in social functioning than determined
by State agency psychologists” and so “included additional social limitations to consider
problems the claimant may have interacting with others.” [AR at 35.]
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crediting Dr. Kalapatapu’s opinions.
First, the ALJ questioned the consistency of Dr. Kalapatapu’s conclusion that
Stephens could manage benefits in his own interest, despite his other conclusions that
Stephens had “moderate restriction of activities of daily living, marked limitation in
maintaining social functioning, marked limitation of concentration, persistence, pace
and four or more repeated episodes of decompensation within a 12-month period, each
of at least 2 weeks duration, and he would be absent from work more than four days
per month.” [AR at 35.] Although the inconsistency the ALJ found might be debatable,
this is only the first of the reasons he gives for partially discounting the extremity of Dr.
Kalapatapu’s opinions. Related to this first reason is the ALJ’s later observation that
there is a glaring lack of support in the medical record for Dr. Kalapatapu’s finding that
Stephens had experienced four or more episodes of decompensation, each of
considerable length. This quite serious finding is unsupported when the record shows
no hospitalizations or visits to the emergency room for mental health issues. [Id.]
The ALJ also noted that at the time he rendered his opinion, Dr. Kalapatapu had
been treating Stephens monthly for only 6 months and even then reported good
prognosis with treatment. [Id.] From the beginning, Dr. Kalapatapu repeatedly
evaluated Stephens’ prognosis as good, [AR at 473, 734, 725, 674, 716, 707, 698, 689, 45],
and over the longer course of treatment, improvement was reflected in Dr. Kalapatapu’s
evaluation of Stephens’ condition initially as “severe” [AR at 471, 721, 720] but later as
“moderate” [AR at 672, 711, 702, 693, 684, 43]. The ALJ further explained his evaluation
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of Dr. Kalapatapu’s opinion by citing repeated notations in Dr. Kalapatapu’s treatment
notes that, besides occasional depressed mood or affect, Stephens had normal mental
status examinations. [Id., citing AR Ex. 6F, 13F and 14F.] The normal psychiatric
examinations reported by Stephens’ family doctor are also noted, as well as the
“findings by Bowen Center indicating few abnormalities.” [Id.] These contrary
indications by other doctors, the ALJ says, “render[] Dr. Kalapatapu’s opinion less
persuasive.” [Id.]
As this explanation demonstrates, the ALJ’s weighing of Dr. Kalapatapu’s
opinions takes into account the duration and frequency of treatment, the consistency of
the opinions with the doctor’s own record, and whether other medical evidence
supports the opinions, all of which are regulatory factors to be weighed under 20 C.F.R.
§404.1527(c)(2). As Stephens acknowledges, the ALJ gave considerable weight to Dr.
Kalapatapu’s opinions to the point of concluding that Stephens’ mental health
warranted significant non-exertional functional limitations. I conclude that the ALJ
gave good reasons for discounting Dr. Kalapatapu’s opinions to the extent that they
suggested a severity of mental health problems that is at odds with the medical record.
The degree to which the ALJ relied upon Dr. Kalapatapu’s conclusions about the nature
and severity of Stephens’ condition is supported by substantial evidence in the record,
as explained by the good reasons the ALJ provided in his decision.
Sleep Apnea and Fatigue
The other challenge Stephens makes to the ALJ’s decision is that the ALJ failed to
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consider the severity of Stephens’ sleep apnea and the resulting fatigue, which he says
supported a conclusion that he is unable to sustain full-time competitive employment.
[DE 14 at 16.] It is true that Stephens repeatedly complained to his doctors that he had
difficulty sleeping and suffered from fatigue. [DE 14 at 17.] The ALJ noted that a sleep
study in July 2014 recommended that Stephens regularly use a CPAP machine [AR at
32] because “the application of continuous positive airway pressure at a pressure level
of 10 results in control of the patient’s obstructive sleep apnea syndrome and oxygen
desaturation.” [AR at 415.] At his hearing before the ALJ, Stephens admitted that he
uses the CPAP machine “maybe two to three hours a night, but not like I’m supposed to
every night,” explaining only that it’s “very difficult to get used to.” [AR at 84.]
Before me, the Commissioner’s position is that the ALJ’s decision is not subject to
reversal on this issue because the record discloses that Stephens’ impairment of sleep
apnea is controlled by the use of a CPAP machine and Stephens is choosing not to
comply with that available treatment. [DE 15 at 8.] Stephens has filed no reply
memorandum responding to that contention. Although the ALJ’s decision does not
discuss Stephens’ hearing testimony acknowledging his failure to comply with his
doctor’s recommendation to use the CPAP machine regularly, the record before me
does not support a remand for further consideration of the issue, because Stephens’
brief fails to acknowledge his lack of compliance and offers no justification for it. Social
Security regulations provide that “[i]f you do not follow the prescribed treatment
without a good reason, we will not find you disabled[.]” 20 C.F.R. §404.1530(b). This is
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because “controllable” or “self-inflicted” conditions do not entitle one to benefits.
Prochaska v. Barnhart, 454 F.3d 731, 737 (7th Cir. 2006); Barrett v. Barnhart, 355 F.3d 1065,
1068 (7th Cir. 2004). Stephens fails to demonstrate reversible error in the ALJ’s
conclusions concerning his sleep apnea.
Conclusion
My role is not to determine from scratch whether or not Stephens is disabled and
entitled to benefits. Instead, my review of the ALJ’s findings is deferential, to determine
whether the ALJ applied the correct legal standards and whether the decision is
supported by substantial evidence. Shideler v. Astrue, 688 F.3d at 310; Castile v. Astrue,
617 F.3d 923, 926 (7th Cir. 2010); Overman v. Astrue, 546 F.3d 456, 462 (7th Cir. 2008).
After that, I “must affirm the ALJ’s decision even if reasonable minds could differ about
the ultimate disability finding.” Brown v. Colvin, 845 F.3d 247, 251 (7th Cir. 2016).
Because substantial evidence supports the Commissioner’s findings, they are
conclusive. 42 U.S.C. §405(g). For the reasons I’ve explained, Stephens has not
demonstrated that the ALJ failed to build a logical bridge from the evidence to his
conclusion that Stephens does not qualify for disability, or otherwise committed
reversible error. The Commissioner’s final decision must be affirmed.
ACCORDINGLY:
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The final decision of the Commissioner of Social Security denying plaintiff Adam
Douglas Stephens’ application for Social Security Disability benefits is AFFIRMED.
The Clerk shall enter judgment in favor of defendant and against plaintiff.
SO ORDERED.
ENTERED: August 31, 2018.
/s/ Philip P. Simon
PHILIP P. SIMON, JUDGE
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