WOODRING v. COLVIN

Filing 15

ENTRY ON JUDICIAL REVIEW - The final decision of the Commissioner is REMANDED for further proceedings consistent with this Entry as authorized by Sentence Four of 42 U.S.C. § 405(g). (See Entry.) Signed by Judge Tanya Walton Pratt on 3/19/2018.(BRR)

UNITED STATES DISTRICT COURT
SOUTHERN DISTRICT OF INDIANA
INDIANAPOLIS DIVISION
APRIL LYNN WOODRING,
Plaintiff,
v.
NANCY A. BERRYHILL, 1 Acting Commissioner
of the Social Security Administration,
Defendant.

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) Case No. 1:16-cv-02914-TWP-MPB
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ENTRY ON JUDICIAL REVIEW
Plaintiff April Lynn Woodring (“Woodring”) requests judicial review of the final decision
of the Commissioner of the Social Security Administration (the “Commissioner”), denying her
applications for Social Security Disability Insurance Benefits (“DIB”) under Title II of the Social
Security Act (the “Act”), and Supplemental Security Income (“SSI”) under Title XVI of the Act. 2
For the following reasons, the Court REMANDS the decision of the Commissioner for further
consideration.
I.
A.

BACKGROUND

Procedural History
On December 17, 2012, Woodring filed applications for DIB and SSI, alleging a disability

onset date of January 9, 2011, due to neck and shoulder pain, postural abnormalities,
spondylolisthesis, depression, anxiety, chronic obstructive pulmonary disease (“COPD”), asthma,
Nancy A. Berryhill is now the Acting Commissioner of the Social Security Administration (“SSA”). Pursuant to
Rule 25(d) of the Federal Rules of Civil Procedure, Nancy A. Berryhill is substituted for Commissioner Carolyn W.
Colvin as the defendant in this suit.

1

In general, the legal standards applied are the same regardless of whether a claimant seeks Disability Insurance
Benefits or Supplemental Security Income. However, separate, parallel statutes and regulations exist for DIB and SSI
claims. Therefore, citations in this entry should be considered to refer to the appropriate parallel provision as context
dictates. The same applies to citations of statutes or regulations found in quoted decisions.
2

and obesity. The claim was initially denied on April 5, 2013, and again on reconsideration on July
23, 2013. On August 15, 2013, Woodring filed a request for a hearing.
A hearing was held before Administrative Law Judge Jason C. Earnhart (the “ALJ”) on
April 1, 2015. Woodring was present and represented by counsel. Thomas A. Grzesik, a
vocational expert, appeared and testified at the hearing. On May 6, 2015, the ALJ denied
Woodring’s applications for DIB and SSI. Following this decision, on May 26, 2015, Woodring
requested review by the Appeals Council. On August 27, 2016, the Appeals Council denied
Woodring’s request for review of the ALJ’s decision, thereby making the ALJ’s decision the final
decision of the Commissioner for purposes of judicial review. On October 26, 2016, Woodring
filed this action for judicial review of the ALJ’s decision pursuant to 42 U.S.C. § 405(g).
B.

Factual Background
At the time of her alleged disability onset date, Woodring was thirty-six years old, and she

is now forty-three years old. Woodring attended formal schooling through the tenth grade, but she
did not complete her high school education and did not earn a GED. Prior to the onset of her
alleged disability, Woodring had an employment history working as a taxi driver, a
cashier/checker, and a meat counter clerk.
Woodring’s history of anxiety and depression dates back to at least September 2009 (Filing
No. 8-8 at 29). Woodring began experiencing severe anxiety and having panic attacks around May
2010. At that time, Woodring had an experience where her hands were shaky, she had chest pain
and shortness of breath, and she could not get out of her car. The anxiety subsided, but it came
back with more intensity in November 2010. She sought treatment for her anxiety from her
primary care physician. She was prescribed medication to address her anxiety, but it made her
sick, so she tried various other medications (Filing No. 8-7 at 17).

2

On January 10, 2011, Woodring experienced a panic attack and went to a hospital
emergency room to seek treatment (Filing No. 8-12 at 40, 46). She was discharged from the
emergency room and immediately began experiencing panic attacks again, so she sought additional
treatment the next day (Filing No. 8-13 at 85). She again went to the hospital emergency room on
January 14, 2011 because of anxiety and panic attacks (Filing No. 8-7 at 20). Throughout January
2011, Woodring went to various health care providers to seek treatment for her anxiety and
depression (Filing No. 8-8 at 25–29; Filing No. 8-13 at 83). On January 19, 2011, Woodring began
receiving consistent, regular therapy from licensed clinical social worker Abigail Michael (“Ms.
Michael”) for depression and anxiety (Filing No. 8-8 at 25).
On February 11, 2011, Woodring had an individual therapy session with Ms. Michael to
explore her past abuse and her anxiety. Id. at 33. She was referred to psychiatrist Alfredo J.
Tumbali, M.D. (“Dr. Tumbali”). Dr. Tumbali conducted a psychiatric evaluation of Woodring on
February 14, 2011 (Filing No. 8-7 at 17). Dr. Tumbali diagnosed Woodring with depressive
disorder and anxiety disorder and assigned her a global assessment of functioning (“GAF”) score
of 55. He recommended continued individual therapy with her therapist, and he prescribed new
medication. He noted that he would continue to see Woodring for medication management. Id.
at 18.
Woodring continued to receive individual therapy from Ms. Michael from March 1, 2011
into 2013 (Filing No. 8-8 at 36–53). She continued to exhibit depression, anxiety, and panic attacks
during that time period, however, there were periods of progression. During her therapy session
with Ms. Michael in July 2011, Woodring completed a cost/benefit analysis of returning to work.
She decided that she would ask her employer if she could return to work on a reduced schedule.
Id. at 42. During subsequent therapy appointments, she was anxious, agitated, and tearful.

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Woodring had been doing more driving, but during her therapy session in November 2011, she
reported experiencing another panic attack while driving and was fearful to drive. Id. at 46. In
July 2012, Woodring reported to Ms. Michael that she had been driving her mother to
appointments and had applied for some jobs. Id. at 51. Woodring attempted to work at a small
grocery store in December 2012, but she quit after the first day because of a panic attack. She also
experienced a panic attack in a Walmart parking lot and had to have her boyfriend take her home.
Id. at 65.
During this 2011 and 2012 time period, Woodring continued to receive treatment,
including medications, from Dr. Tumbali for her anxiety and depression. In June 2011, Woodring
reported increased anxiety. A mental status examination revealed an anxious mood. Dr. Tumbali
prescribed Xanax and Lexapro. Woodring appeared less anxious at her next appointment, and Dr.
Tumbali continued recommending outpatient therapy, which Woodring was receiving.

In

September 2011, Woodring stated that she still felt anxious, and her mental status examination
revealed a depressed and anxious mood. A mental status examination in November 2011 revealed
a less depressed and anxious mood. Woodring’s anxiety and depression seemed to be managed
by her ongoing therapy and medication throughout her visits with Dr. Tumbali through August
2012. At the October 2012 appointment, Woodring stated that she felt stressed, and the mental
status examination revealed a depressed and anxious mood. Dr. Tumbali prescribed Xanax and
Wellbutrin. In November 2012, Woodring appeared to be doing better, but by March 2013, she
had more anxiety, depression, and panic attacks (Filing No. 8-11 at 44–57).
On January 22, 2013, Woodring was admitted to a psychiatric hospital because of increased
depression. She was tearful and had stayed in bed over the previous two weeks with little regard
for self-care. She had been having suicidal thoughts with a plan to overdose. She was sleeping

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more than twelve hours a day, and when she was going to sleep, she wished that she would not
wake up (Filing No. 8-8 at 57). Woodring’s GAF score was 30 at admission. Psychiatrist Thomas
E. Kreider, M.D., diagnosed depressive disorder and personality disorder among other things. She
was treated with Wellbutrin and Xanax and discharged on January 25, 2013. Her GAF score was
45 upon discharge. Id. at 66, 68–69. After being discharged, Woodring resumed treatment and
therapy with Dr. Tumbali and Ms. Michael.
During her May 28, 2013 appointment with Dr. Tumbali, Woodring reported that she could
not drive because she still was having panic attacks. Her mental status examination revealed an
anxious mood (Filing No. 8-11 at 43). On August 6, 2013, Dr. Tumbali completed a
psychiatric/psychological impairment questionnaire regarding Woodring. He noted diagnoses of
anxiety disorder and depressive disorder. He opined that she had a GAF score of 55. He noted
the following clinical findings to support his diagnoses: appetite disturbance with weight change,
sleep disturbance, mood disturbance, emotional lability, recurrent panic attacks, anhedonia or
pervasive loss of interests, psychomotor agitation or retardation, feelings of guilt/worthlessness,
difficulty thinking or concentrating, suicidal ideation or attempts, social withdrawal or isolation,
decreased energy, intrusive recollections of a traumatic experience, persistent irrational fears,
generalized persistent anxiety, hostility and irritability, overall sad mood, excessive worry, racing
thoughts, and fear of crowded places. Woodring’s primary symptoms were panic attacks, anxiety,
avoidance of social situations, and lack of motivation. Dr. Tumbali opined that Woodring’s
prognosis was poor. He also opined that Woodring was markedly limited in the areas of
concentration and persistence, social interactions, and adaptation (Filing No. 8-9 at 94–101).
Woodring continued receiving treatment and therapy from Dr. Tumbali and Ms. Michaels,
and on March 23, 2014, she was admitted to the St. Vincent stress center because she was

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experiencing increased panic like symptoms and anxiety. She was fearful of leaving her home and
having panic attacks in public. She was experiencing shaking, shortness of breath, and an extreme
sense of dread. She had increased depression, crying spells, low energy, low confidence, and
difficulty sleeping. She was treated with various medications and discharged a few days later
(Filing No. 8-12 at 54–55). Woodring again returned to Dr. Tumbali and Ms. Michaels after her
discharge from the stress center. In March 2015, Ms. Michael completed a mental impairment
questionnaire similar to Dr. Tumbali’s psychiatric/psychological impairment questionnaire. Ms.
Michaels reached similar conclusions regarding Woodring’s impairments as those found by Dr.
Tumbali (Filing No. 8-13 at 71–75).
Approximately one year before she was admitted to the stress center but soon after filing
her applications for DIB and SSI, Woodring underwent a consultative psychological evaluation
with Michele Koselke, Psy.D. (“Dr. Koselke”), at the request of the Social Security
Administration. Woodring reported she had been unable to work because of depression and
anxiety with panic attacks. She discussed her bi-weekly counseling, explaining that it had been
helpful but had not eliminated her anxiety and depression. She also discussed her inpatient hospital
treatment from January 2013, explaining that it was not helpful and actually made her anxiety and
depression worse. Woodring noted that she had difficulty sleeping and had lost forty pounds in
the previous three months. Woodring’s mental status examination revealed clinical impressions
of anxiety disorder, alcohol dependence in remission, and poly-substance dependence in
remission, with a GAF score of 69. Dr. Koselke opined that Woodring was in the average range
for functioning, and she was able to focus for one hour, get along with others, and follow directions
(Filing No. 8-9 at 3–7).

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Regarding her physical impairments, Woodring went to the hospital emergency room on
January 16, 2011 because of neck and back pain (Filing No. 8-7 at 30). On November 8, 2012,
Woodring was examined by Melissa M. Roche, M.D. (“Dr. Roche”), for chronic neck and shoulder
pain that had been going on for many years (Filing No. 8-8 at 8). Dr. Roche recommended physical
therapy, so Woodring was evaluated by Christie DeCraene, P.T., for physical therapy to address
her neck, shoulder, and upper back pain. Id. at 75. Following the evaluation, it was noted that
Woodring had T1 through T3 flexion dysfunction, pectoralis minor restriction, and postural
dysfunction. A physical therapy plan was established to correct these issues. Id. at 75–76.
Woodring participated in physical therapy about two times a week through November and
December 2012. Id. at 77–78.
In November 2012, Woodring underwent pulmonary function testing, which revealed
moderate obstructive airway disease. The objective results of the test were above listing level
severity. It was noted that Woodring had a significant response to and improvement with
bronchodilators (Filing No. 8-8 at 15–16). On December 11, 2012, Woodring went to Dr. Roche
for chest pain, a cough, and a sore throat. Dr. Roche noted that Woodring’s ongoing COPD was
exacerbated. Id. at 6. Progress notes from late 2012 and into early 2013 indicate that Woodring
continued to seek ongoing treatment and care for her chronic back and neck pain, as well as her
COPD and asthma. It was noted that physical therapy had been unsuccessful at resolving her back
and neck pain. Id. at 2–8. Chest x-rays in January 2013 revealed streaky perihilar densities with
associated peribronchial cuffing. Id. at 87. During her January 2013 visit with Dr. Roche, it was
noted that Woodring’s lungs were clear and respiration normal. It appeared that her medications
were helping her to improve her asthma and COPD. Id. at 4.

7

In June 2013, Woodring underwent a second pulmonary function test, which revealed a
moderate obstruction and mild upper respiratory restriction, with one measure below listing level
severity, but the test results had a variance (Filing No. 8-9 at 79–81). One month later in July 2013,
Woodring underwent a third pulmonary function test, which revealed results back above listing
level severity. Id. at 85–87.
In October 2013, Woodring saw Carleigh Wilson, D.O. (“Dr. Wilson”) because she was
experiencing shortness of breath, a cough, and shoulder and neck pain. Dr. Wilson noted that
Woodring’s COPD was stable but still an ongoing impairment, so she prescribed medications to
address the cough and any potential bronchitis (Filing No. 8-10 at 24–25).

Dr. Wilson

recommended that Woodring receive physical therapy to help with her back and neck pain, so she
started physical therapy again. Id. at 4–12. Dr. Wilson continued to treat Woodring through at
least June 2014 for her back and neck pain and COPD (Filing No. 8-13 at 33–43).
On December 6, 2013, Dr. Wilson completed a pulmonary impairment questionnaire for
Woodring. She noted Woodring’s diagnosis of COPD, and a good prognosis with the need to quit
smoking. Dr. Wilson noted clinical findings of shortness of breath, chest tightness, wheezing,
rhonchi, episodic acute bronchitis, fatigue, and coughing. Woodring’s primary symptoms were
back, shoulder, and neck pain as well as frequent respiratory infections. She also suffered from
acute asthma attacks precipitated by upper respiratory infections and cold air/change in weather.
Dr. Wilson opined that, during asthma attacks, Woodring was incapacitated for minutes to hours
at a time. Dr. Wilson further opined that in an eight-hour workday Woodring could sit for two
hours and stand/walk for one hour, and she could lift/carry up to ten pounds frequently. Dr. Wilson
opined that Woodring would need to take unscheduled breaks to rest every one to two hours for
about fifteen to twenty minutes. She was likely to have good days and bad days, and she was

8

likely to be absent from work more than three times per month. Dr. Wilson concluded that
Woodring would need to avoid temperature extremes, wetness, humidity, odors, fumes, dust,
perfumes, gases, chemicals, cigarette smoke, fluxes, and solvents/cleaners (Filing No. 8-12 at 24–
30).
At the hearing before the ALJ, Woodring testified that she has anxiety attacks
approximately two to three times per week even when taking medication. Her COPD and
breathing problems exacerbate her anxiety and vice versa. Woodring testified that during anxiety
attacks she experiences a racing heartrate, shortness of breath, nausea, shaking, dizziness, and
difficulty sleeping. Her anxiety attacks last an average of two to three minutes but can last up to
twenty minutes. She explained that after anxiety attacks she needed to lay down and sleep for two
to three hours. Woodring testified that she gets all worked up and dreads upcoming events (Filing
No. 8-2 at 71–73, 79–80, 87–88).
During the administrative hearing, the vocational expert (“VE”) was asked to consider an
individual of Woodring’s age, education, and work history who was limited to light work and who
could tolerate frequent exposure to extreme temperatures, wetness, humidity, atmospheric
conditions, and pulmonary irritants; limited to simple, routine, repetitive tasks with no fast-paced
production; work in no more than small groups with occasional interactions with co-workers and
supervisors and no interaction with the public; and only occasional changes in the work setting.
The VE testified that such an individual could not perform Wooding’s past work but could work
as a mail clerk, a house cleaner, or a routing clerk. The VE testified that if the individual were
further limited to sedentary work then they could work as an order clerk, a charge account clerk,
or a call out operator. However, if the individual was off task twenty percent or more in a given
work day or was absent from work at least one day per week, they would be precluded from all

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work. In addition, if the individual was unable to ask simple questions or request assistance, she
would be unable to perform any of the jobs identified (Filing No. 8-2 at 89–93).
II.

DISABILITY AND STANDARD OF REVIEW

Under the Act, a claimant may be entitled to DIB or SSI only after she establishes that she
is disabled. Disability is defined as the “inability to engage in any substantial gainful activity by
reason of any medically determinable physical or mental impairment which can be expected to
result in death or which has lasted or can be expected to last for a continuous period of not less
than 12 months.” 42 U.S.C. § 423(d)(1)(A). In order to be found disabled, a claimant must
demonstrate that his physical or mental limitations prevent him from doing not only his previous
work but any other kind of gainful employment which exists in the national economy, considering
his age, education, and work experience. 42 U.S.C. § 423(d)(2)(A).
The Commissioner employs a five-step sequential analysis to determine whether a claimant
is disabled. At step one, if the claimant is engaged in substantial gainful activity, he is not disabled
despite his medical condition and other factors. 20 C.F.R. § 416.920(a)(4)(i). At step two, if the
claimant does not have a “severe” impairment that meets the durational requirement, he is not
disabled. 20 C.F.R. § 416.920(a)(4)(ii). A severe impairment is one that “significantly limits [a
claimant’s] physical or mental ability to do basic work activities.” 20 C.F.R. § 404.1520(c). At
step three, the Commissioner determines whether the claimant’s impairment or combination of
impairments meets or medically equals any impairment that appears in the Listing of Impairments,
20 C.F.R. Part 404, Subpart P, Appendix 1, and whether the impairment meets the twelve month
duration requirement; if so, the claimant is deemed disabled. 20 C.F.R. § 416.920(a)(4)(iii).
If the claimant’s impairments do not meet or medically equal one of the impairments on
the Listing of Impairments, then his residual functional capacity will be assessed and used for the

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fourth and fifth steps. Residual functional capacity (“RFC”) is the “maximum that a claimant can
still do despite his mental and physical limitations.” Craft v. Astrue, 539 F.3d 668, 675–76 (7th
Cir. 2008) (citing 20 C.F.R. § 404.1545(a)(1); SSR 96-8p). At step four, if the claimant is able to
perform his past relevant work, he is not disabled. 20 C.F.R. § 416.920(a)(4)(iv). At the fifth and
final step, it must be determined whether the claimant can perform any other work in the relevant
economy, given his RFC and considering his age, education, and past work experience. 20 C.F.R.
§ 404.1520(a)(4)(v). The claimant is not disabled if he can perform any other work in the relevant
economy.
The combined effect of all the impairments of the claimant shall be considered throughout
the disability determination process. 42 U.S.C. § 423(d)(2)(B). The burden of proof is on the
claimant for the first four steps; it then shifts to the Commissioner for the fifth step. Young v. Sec’y
of Health & Human Servs., 957 F.2d 386, 389 (7th Cir. 1992).
Section 405(g) of the Act gives the court “power to enter, upon the pleadings and transcript
of the record, a judgment affirming, modifying, or reversing the decision of the Commissioner of
Social Security, with or without remanding the cause for a rehearing.” 42 U.S.C. § 405(g). In
reviewing the ALJ’s decision, this Court must uphold the ALJ’s findings of fact if the findings are
supported by substantial evidence and no error of law occurred. Dixon v. Massanari, 270 F.3d
1171, 1176 (7th Cir. 2001). “Substantial evidence means such relevant evidence as a reasonable
mind might accept as adequate to support a conclusion.” Id.
Further, this Court may not reweigh the evidence or substitute its judgment for that of the
ALJ. Overman v. Astrue, 546 F.3d 456, 462 (7th Cir. 2008). While the Court reviews the ALJ’s
decision deferentially, the Court cannot uphold the ALJ’s decision if the decision “fails to mention
highly pertinent evidence, . . . or that because of contradictions or missing premises fails to build

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a logical bridge between the facts of the case and the outcome.” Parker v. Astrue, 597 F.3d 920,
921 (7th Cir. 2010) (citations omitted).
The ALJ “need not evaluate in writing every piece of testimony and evidence submitted.”
Carlson v. Shalala, 999 F.2d 180, 181 (7th Cir. 1993). However, the “ALJ’s decision must be
based upon consideration of all the relevant evidence.” Herron v. Shalala, 19 F.3d 329, 333 (7th
Cir. 1994). The ALJ is required to articulate only a minimal, but legitimate, justification for his
acceptance or rejection of specific evidence of disability. Scheck v. Barnhart, 357 F.3d 697, 700
(7th Cir. 2004).
III. THE ALJ’S DECISION
The ALJ first determined that Woodring met the insured status requirement of the Act
through December 31, 2015. The ALJ then began the five-step sequential evaluation process. At
step one, the ALJ found that Woodring had not engaged in substantial gainful activity since
January 9, 2011, her alleged disability onset date. At step two, the ALJ found that Woodring had
the following severe impairments: COPD, asthma, obesity, depression, and anxiety. At step three,
the ALJ concluded that Woodring did 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 ALJ then determined that Woodring had the following RFC:
[T]he claimant has the residual functional capacity to lift and/or carry 20 pounds
occasionally and 10 pounds frequently, stand and/or walk 6 hours in an 8 hour
workday, and sit for 6 hours in an 8 hour workday. The claimant is limited to
frequent exposure to extreme temperatures; wetness; humidity; and atmospheric
conditions, including pulmonary irritants. The claimant is further limited to simple,
routine, repetitive tasks; with no fast production pace; with the work limited to no
more than small groups; occasional interaction with co-workers and supervisors;
no in-person interaction with the public; and only occasional changes in the work
setting.
(Filing No. 8-2 at 33-34).

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At step four, the ALJ determined that Woodring was unable to perform her past relevant
work as a taxi driver, a cashier/checker, or a meat counter clerk because the demands of this past
relevant work exceeded Woodring’s RFC. At step five, the ALJ determined that there were jobs
that existed in significant numbers in the national economy that Woodring could perform. Having
determined that Woodring could perform work in other jobs in the economy, the ALJ determined
that Woodring was not disabled. Therefore, the ALJ denied Woodring’s applications for DIB and
SSI because she was found to be not disabled.
IV. DISCUSSION
In her request for judicial review, Woodring advances two arguments for remanding this
case to the ALJ for further consideration. First, Woodring argues that the ALJ erred by failing to
properly weigh the opinions of her medical providers. Second, Woodring asserts that the ALJ
erred by failing to properly evaluate her credibility.
A.

The ALJ’s Consideration of the Medical Opinions
Woodring explains that the medical opinion of a treating physician is entitled to

“controlling weight” if it is “well-supported by medically acceptable clinical and laboratory
diagnostic techniques and is not inconsistent with other substantial evidence.” Punzio v. Astrue,
630 F.3d 704, 710 (7th Cir. 2011) (citing 20 C.F.R. § 404.1527(d)(2)); Scott v. Astrue, 647 F.3d
734, 739 (7th Cir. 2011). “An ALJ who chooses to reject a treating physician’s opinion must
provide a sound explanation for the rejection.” Jelinek v. Astrue, 662 F.3d 805, 811 (7th Cir.
2011). If a treating physician’s medical opinion is not given “controlling weight,” the ALJ must
“consider the length, nature, and extent of the treatment relationship, frequency of examination,
the physician’s specialty, the types of tests performed, and the consistency and supportability of
the physician’s opinion.” Scott, 647 F.3d at 740.

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Woodring asserts that her case should be remanded for further consideration because the
ALJ did not properly weigh or explain his rationale for the weight given to the medical opinions
of the treating medical providers: Dr. Tumbali, Ms. Michael, and Dr. Wilson. Woodring also
asserts that the ALJ failed to state what weight he gave to the SSA’s own consultative psychologist,
Dr. Koselke.
1.

Dr. Tumbali

Concerning Dr. Tumbali’s medical opinions, Woodring argues that the ALJ erred by not
providing specific reasons for giving a treating physician’s opinions only little weight. Rather, the
ALJ provided only a conclusory finding that the opinion was not worthy of great weight, or even
controlling weight. Woodring asserts that Dr. Tumbali’s opinions were supported by medically
acceptable clinical findings and were not inconsistent with the record evidence. Thus, as a treating
physician, Dr. Tumbali’s opinion was entitled to controlling weight. Woodring points to the
clinical findings supporting Dr. Tumbali’s opinions of debilitating anxiety and depression:
appetite disturbance with weight change, sleep disturbance, mood disturbance, emotional lability,
recurrent panic attacks, anhedonia or pervasive loss of interests, psychomotor agitation or
retardation, feelings of guilt/worthlessness, difficulty thinking or concentrating, suicidal ideation
or attempts, social withdrawal or isolation, decreased energy, intrusive recollections of a traumatic
experience, persistent irrational fears, generalized persistent anxiety, hostility and irritability,
overall sad mood, excessive worry, racing thoughts, and fear of crowded places. Woodring argues
that these clinical findings support not only a finding of severe anxiety and depression but also Dr.
Tumbali’s opinion that Woodring was markedly limited in her functioning.
Woodring also asserts that the ALJ erred by relying heavily only on the GAF scores
between 50 and 59 because GAF scores have been rejected by the American Psychiatric

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Association as diagnostic tools for assessing functioning because of a GAF score’s questionable
probative value. Woodring points out that the Commissioner has diminished the value of using
GAF scores because the scores do not correlate to the severity requirements of the SSA’s mental
disorders listings. See 65 Fed. Reg. 50746, 50764–65 (Aug. 21, 2000).
The ALJ erred, Woodring argues, by giving greater weight to the opinions of nonexamining state-agency psychologists over the opinions of the treating psychiatrist. Woodring
notes that it appears from the record that the reviewing state-agency psychologists did not review
the full record and only considered the report from the SSA’s consultative examiner, Dr. Koselke.
Additionally, Woodring argues the ALJ erred by not giving any consideration to the factors for
weighing opinion evidence found in 20 C.F.R. § 404.1527 when weighing Dr. Tumbali’s opinions.
The ALJ did not consider the length, nature, and extent of the treatment relationship, frequency of
examination, Dr. Tumbali’s specialty, the types of tests performed, and the consistency and
supportability of Dr. Tumbali’s opinion.
The Commissioner responds that the ALJ fully explained his reasoning for the weight given
to Dr. Tumbali’s opinions, and this decision was supported by the medical opinions of the stateagency psychologists, Dr. Pressner and Dr. Shipley. Dr. Pressner relied on Dr. Koselke’s report
from Woodring’s mental status examination for his opinion that Woodring was able to perform
semi-skilled work without strangers or large groups. Dr. Shipley agreed with Dr. Pressner’s
opinion. The Commissioner argues that this is substantial evidence to support the ALJ’s decision
and to discount the weight given to Dr. Tumbali’s opinion.
The Commissioner further asserts that the ALJ sufficiently explained that Dr. Tumbali’s
clinical findings and treatment notes throughout the record undermined his later, more severe
findings, which led to the decision to give his opinions less weight. Additionally, while GAF

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scores do not correlate precisely with SSA functioning standards, the GAF scores are still helpful
in determining a claimant’s level of functioning. And the ALJ properly reduced the weight given
to Dr. Tumbali’s opinion of marked limitations because that opinion clashed with Dr. Tumbali’s
own finding of GAF scores of 55. Concerning the factors listed in 20 C.F.R. § 404.1527, the
Commissioner asserts that the ALJ’s “decision need only include good reasons for the weight
given to the treating source’s opinion rather than an exhaustive factor-by-factor analysis.”
Richards v. Colvin, 2016 U.S. Dist. LEXIS 9855, at *21 (N.D. Ind. Jan. 27, 2016). The ALJ’s
decision indicates that he considered the factors when determining the weight to give Dr.
Tumbali’s opinion. The ALJ properly considered the factors and explained that Dr. Tumbali’s
own treatment notes and assignment of a GAF score of 55 contradicted the opinion of marked
limitations, and thus, that opinion was given lesser weight.
The Court finds that the ALJ assigned great weight to Dr. Tumbali’s February 2011
diagnoses of anxiety and depression and GAF score of 55 (Filing No. 8-2 at 35). However, the
ALJ then gave little weight to Dr. Tumbali’s later assessments that Woodring suffered marked
limitations. Id. at 41. While the ALJ did not specifically list the clinical findings noted in Dr.
Tumbali’s later reports, it is clear that he considered those clinical findings when determining
Woodring’s limitations and how much weight to give Dr. Tumbali’s conclusions. The ALJ
explicitly described his comparison between Dr. Tumbali’s later conclusion and Dr. Tumbali’s
earlier findings as well as the clinical observations of Dr. Koselke and her opinions. The ALJ
explained the conflict between Dr. Tumbali’s opinion of marked limitations and the opinions of
the state-agency psychologists who determined a higher level of functioning. The ALJ was
justified in giving lesser weight to Dr. Tumbali’s later opinion based on his explanation that Dr.
Tumbali’s own treatment notes and assignment of a GAF score of 55 contradicted the later opinion.

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Furthermore, while the ALJ did not explicitly list the various factors of 20 C.F.R. § 404.1527, it
appears that those factors were considered as they were touched upon throughout the ALJ’s
decision.
Throughout the ALJ’s decision, he explained why greater weight was given to particular
opinions while lesser weight was given to Dr. Tumbali’s later opinion. These decisions were based
on the medical evidence. The Court may not reweigh the evidence or substitute its own judgment
for that of the ALJ. Overman, 546 F.3d at 462. The ALJ’s decision provided a path of reasoning
and built a logical bridge between the evidence and the conclusions. For these reasons, the Court
concludes that Woodring’s arguments about Dr. Tumbali’s opinions do not justify remand and
reconsideration.
2.

Ms. Michael

Next, Woodring argues the ALJ erred by ignoring the opinions of Ms. Michael based on
the fact that she was a licensed clinical social worker and not an “acceptable medical source.”
Woodring asserts that Ms. Michael’s opinions were consistent with the opinions of Dr. Tumbali,
and she had treated Woodring for anxiety and depression over a period of years, so her opinions
should have been considered and weighed rather than ignored. Woodring argues that the opinions
from non-acceptable medical sources should be considered in determining the severity of a
claimant’s impairment and how it affects the claimant’s ability to do work, citing 20 C.F.R. §
404.1513 and § 416.913. Woodring argues that the factors for weighing opinion evidence found
in 20 C.F.R. § 404.1527 and Social Security Ruling 06-03p support giving Ms. Michael’s opinions
great weight. Woodring asserts that the ALJ erred by failing to consider these factors and then
giving Ms. Michael’s opinions great weight.

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The Commissioner responds that Ms. Michael’s opinions are owed no deference and only
limited consideration according to SSR 06-03p because Ms. Michael is not an acceptable medical
source. The Commissioner asserts that opinions from “other sources” cannot establish medically
determinable impairments, are not entitled to controlling weight, and may be rejected simply
because they clash with opinions from acceptable medical sources. The Commissioner argues that
the ALJ reasonably explained that Ms. Michael’s opinion deserved little weight because she was
not an acceptable medical source and her opinions regarding Woodring’s limitations and inability
to work clashed with the opinions of the state-agency psychologists, who are acceptable medical
sources.
The Court concludes that the decision of the ALJ provides an adequate explanation,
supported by evidence, of the ALJ’s consideration of Ms. Michael’s opinions and the weight given
to them. The ALJ explained that Ms. Michael’s opinions were considered and given little weight
or not given significant weight. The ALJ further explained that an August 2013 letter from Ms.
Michael was of little value because it explained no specific limitations to Woodring’s work
abilities and instead stated in conclusory fashion that she was unable to work (Filing No. 8-6 at
59). The ALJ also explained that Ms. Michael’s mental impairment questionnaire was given little
weight because she is not an acceptable medical source and, in the ALJ’s view, the limitations
were not consistent with the record evidence (Filing No. 8-2 at 41). The ALJ’s consideration and
discussion of Ms. Michael’s opinions was sufficient in light of her status as a non-acceptable
medical source. Therefore, the Court determines that Woodring’s arguments concerning Ms.
Michael’s opinions do not warrant remand.

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3.

Dr. Koselke

Woodring also argues that the ALJ erred by failing to state what weight was given to the
opinion of the SSA’s own consultative psychologist, Dr. Koselke. Woodring asserts that Dr.
Koselke opined she could focus for only one hour, and the ALJ failed to take that into consideration
when determining disability. The Court determines that this argument lacks merit. As the
Commissioner correctly points out, Woodring misreads the report from Dr. Koselke, which opined
that Woodring’s “ability to focus for one hour is good.” (Filing No. 8-9 at 7.) It is clear that Dr.
Koselke was describing Woodring’s ability to focus well during her one hour evaluation, not
limiting Woodring to an ability to focus for only one hour. Additionally, the Court notes that the
ALJ described how much he relied on Dr. Koselke’s opinion throughout his decision; although the
ALJ may not have used the terms “great weight” or “little weight,” a review of the decision shows
that the ALJ relied on and gave weight to Dr. Koselke’s opinions. Woodring’s brief argument
concerning Dr. Koselke’s opinions do not warrant remand.
4.

Dr. Wilson

Lastly, Woodring argues that the ALJ’s consideration of Dr. Wilson’s opinions was
erroneous and warrants remand. She points out that the ALJ gave mixed weight to Dr. Wilson’s
opinions, giving great weight to the opinion regarding lifting and environmental limitations with
only little weight given to the opinion regarding unscheduled breaks and missing days of work.
Woodring argues that the ALJ erred by not explaining whether he considered or gave any weight
to Dr. Wilson’s opinion regarding Woodring’s sitting, standing, and walking limitations. Quoting
Whitney v. Schweiker, Woodring asserts that “an ALJ must weigh all the evidence and may not
ignore evidence that suggests an opposite conclusion.” 695 F.2d 784, 788 (7th Cir. 1982).

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Woodring further argues that the ALJ did not identify what specific evidence contradicted
Dr. Wilson’s opinion about unscheduled breaks and absences from work, and the ALJ did not
explain any inconsistency between the evidence and Dr. Wilson’s opinion. She asserts that the
factors for weighing opinion evidence found in 20 C.F.R. § 404.1527 were not considered by the
ALJ when reviewing Dr. Wilson’s opinions, and those factors support giving Dr. Wilson’s opinion
greater weight. Woodring also asserts the ALJ erred when he gave some weight to the nonexamining state-agency physician’s opinion, whose review of the record was limited to older
evidence predating July 22, 2013, which did not include Dr. Wilson’s more recent opinions.
Additionally, the ALJ did not cite any medical evidence supporting his conclusion that Woodring
could sit for six hours and stand/walk for six hours during an eight-hour workday. There was no
evidence to support that conclusion, and nothing contradicted Dr. Wilson’s more restricted medical
opinion. Thus, Woodring asserts, the ALJ erred in his review of and conclusions about Dr.
Wilson’s opinions.
The Commissioner responds that the reviewing court looks at the ALJ’s decision as a
whole, and in this case, the ALJ’s decision as a whole adequately explains why he gave certain
portions of Dr. Wilson’s opinions great weight and other portions little weight. The ALJ discussed
the objective evidence of pulmonary impairments such as the pulmonary tests and physical
examinations, and this objective evidence clashed with Dr. Wilson’s opinion of more extreme
pulmonary impairments and limitations. The Commissioner notes that the more recent progress
notes from Dr. Wilson’s treatment of Woodring shows improvement in Woodring’s breathing and
lungs. The Commissioner asserts the ALJ provided an adequate explanation for his decision to
give little weight to portions of Dr. Wilson’s opinions.

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Woodring did not point to any authority requiring the ALJ to consider every aspect of Dr.
Wilson’s opinions, such as the sitting, standing, and walking limitations, and that any such error
was harmless because the medical opinions about her breathing did not support limitations to
sitting, standing, or walking. The Commissioner argues an ALJ does not need to rely on medical
opinions to determine a claimant’s functioning, citing to Diaz v. Chater, 55 F.3d 300, 306 n.2 (7th
Cir. 1995). And in any event, the ALJ balanced Dr. Wilson’s opinion about sitting limitations
against the opinion of the state-agency doctor, Dr. Brill, who opinioned that Woodring had no
exertional limitations.
The Court first notes that the Commissioner’s suggestion that Diaz stands for the
proposition that an ALJ does not need to rely on medical opinions to determine a claimant’s
functioning is incorrect. The footnote in Diaz discussed an argument that the ALJ should have
relied solely on physicians’ opinions, but the court explained that an ALJ must consider the entire
record including both medical and non-medical evidence when determining the RFC. Diaz, 55
F.3d at 306 n.2. The Court further notes that the ALJ did not balance Dr. Wilson’s opinion about
sitting limitations against the opinion of the state-agency doctor. The ALJ failed to analyze the
specific sitting, standing, and walking limitations that were in the record and that suggested greater
limitations than the ALJ determined were necessary. The ALJ should have at least minimally
discussed those opinions from Dr. Wilson when determining the RFC.
An additional problem exists in the ALJ’s decision concerning his treatment of Dr.
Wilson’s opinions. The ALJ specifically states that he gave “great weight” to Dr. Wilson’s
environmental limitations—“the need to avoid temperature extremes, wetness, humidity, and
pulmonary irritants.” (Filing No. 8-2 at 40.) Yet the ALJ’s RFC states that Woodring could have
“frequent exposure to extreme temperatures; wetness; humidity; and atmospheric conditions,

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including pulmonary irritants.” Id. at 33. The ALJ provides no explanation for this inconsistency.
The ALJ failed to consider (or at least discuss) certain medical evidence from Dr. Wilson that
opposed his decision and also failed to explain any rationale for giving great weight to Dr. Wilson’s
environmental limitations while contradicting those limitations in the RFC.

These errors

concerning the ALJ’s treatment of Dr. Wilson’s opinions warrant remand for further consideration.
B.

The ALJ’s Credibility Assessment of Woodring
Because of the Court’s decision above to remand this case for further consideration, the

Court only briefly addresses the second argument raised by Woodring. She argues that this case
should be remanded because the ALJ failed to properly evaluate her credibility. She asserts that
the ALJ used boilerplate language to discount her credibility, and he failed to fully consider the
factors listed in SSR 96-7p when determining her credibility. Woodring also asserts that the ALJ
erred in his analysis of Woodring’s desire to return to work, her receipt of unemployment benefits,
and her ongoing smoking habit as it pertains to her credibility. She argues the ALJ was wrong in
his consideration of her treatment and the effectiveness of her treatment.
In response, the Commissioner explains that, when reviewing credibility determinations,
the courts “merely examine whether the ALJ’s determination was reasoned and supported. It is
only when the ALJ’s determination lacks any explanation or support that [the court] will declare
it to be patently wrong and deserving of reversal.” Elder v. Astrue, 529 F.3d 408, 413–14 (7th Cir.
2008) (citations and quotation marks omitted). The Commissioner explains that the ALJ noted
several inconsistencies between Woodring’s subjective complaints and testimony and the other
evidence in the record regarding her medical conditions, activities, and functioning. Those
inconsistencies reasonably undermined Woodring’s credibility. The Commissioner also asserts
the ALJ appropriately considered Woodring’s treatment and the medical records that indicated

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treatment was effective when considering her credibility. Further, the Commissioner argues the
ALJ was justified in reducing Woodring’s credibility based on her sworn statements that she could
work (when seeking unemployment benefits) but not work (when seeking disability benefits).
The Commissioner is correct in that the evidence supports the ALJ’s credibility
determination, and the explanation for the credibility determination is more than adequate. The
credibility analysis was rational and supported. Woodring’s credibility argument appears to be a
disagreement with how the ALJ weighed and viewed the evidence. However, as noted above, the
Court does not reweigh the evidence, and importantly, when reviewing credibility determinations,
the “ALJ is in the best position to determine the credibility of witnesses, and we review that
determination deferentially. We overturn a credibility determination only if it is patently wrong.”
Craft, 539 F.3d at 678 (citations omitted). There is nothing in the ALJ’s credibility determination
that is patently wrong that requires reversal and remand.
V.

CONCLUSION

For the limited reason set forth above, the final decision of the Commissioner is
REMANDED for further proceedings consistent with this Entry as authorized by Sentence Four
of 42 U.S.C. § 405(g).
SO ORDERED.
Date: 3/19/2018
DISTRIBUTION:
Michael G. Myers
[e-mail]
Kathryn E. Olivier
UNITED STATES ATTORNEY’S OFFICE
[e-mail]

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