Lambert v. Berryhill

• Decision Date: 19 July 2018
• Docket Number: No. 17-1627,17-1627
• Citation: 896 F.3d 768
• Parties: Paul LAMBERT, Plaintiff–Appellant, v. Nancy A. BERRYHILL, Acting Commissioner of Social Security, Defendant–Appellee.
• Court: U.S. Court of Appeals — Seventh Circuit

896 F.3d 768

Paul LAMBERT, Plaintiff–Appellant,

v.Nancy A. BERRYHILL, Acting Commissioner of Social Security, Defendant–Appellee.

No. 17-1627

United States Court of Appeals, Seventh Circuit.

Argued February 28, 2018

Decided July 19, 2018

Meredith E. Marcus, Attorney, Daley Disability Law, Chicago, IL, for Plaintiff–Appellant.

Joshua P. Dehnke, Attorney, Alison Talbert Schwartz, Assistant Regional Counsel, Social Security Administration, Office of the General Counsel, Region V, Chicago, IL, for Defendant–Appellee.

Before MANION, SYKES, and HAMILTON, Circuit Judges.

Sykes, Circuit Judge.

Paul Lambert appeals the denial of Disability Insurance Benefits for chronic back pain. The Social Security Administration denied his application initially and on reconsideration, and an administrative law judge ("ALJ") concluded that Lambert suffers from degenerative disc disease that is severely impairing but not disabling. Lambert challenges the ALJ’s decision to give little weight to the most recent opinions of his treating neurosurgeon and to discredit his own testimony about the severity of his pain and extent of his limitations. We reverse and remand for further agency proceedings.

I. Background

Lambert applied for benefits in 2012 at age 41 alleging disabling lower back pain since 2011, an onset date that he later amended to 2013. Yet his back problems started long before then. In 2004 discs in his lumbar spine were surgically fused with a rod. In 2008 surgeons repaired the rod. Still, Lambert held several jobs over the years.

In 2010 Lambert began experiencing back pain "most of the time" and thereafter also had "intermittent" pain down his left leg that often caused him to fall. By late 2012 Lambert had tried various treatments, including steroid injections in his spine and pelvis, chiropractic care, medication, and physical therapy. Nothing produced lasting relief, though hydrocodone helped ease the pain. Medical imaging revealed no postsurgical complications or other explanation for his persistent pain. Several neurosurgeons found the cause unclear; three said further surgery was not an option.

In September 2012 a pain specialist attributed Lambert’s pain to degenerative disc disease or joint disease of the lower lumbar spine. Months later he diagnosed Lambert with failed back syndrome (meaning he experienced continuous pain despite surgeries) and recommended that he accept his chronic pain and proceed with a pain-management program instead of seeking a surgical cure. The pain specialist also recommended that Lambert consider behavioral therapy to learn coping skills. Lambert followed this advice, but in early 2013 the pain specialist referred him to a neurosurgeon to find the source of the left-leg pain that by this time was causing daily falls.

Neurosurgeon Kamajit Paul began treating Lambert in June 2013 and initially recommended a conservative course of steroid injections to determine if his pain was caused by dysfunction in the left sacroiliac joint. (The sacroiliac joints connect the pelvis to the lower spine and support the weight of the upper body when a person stands. Sacroiliac Joints , MAYO CLINIC , https://www.mayoclinic.org/diseases-conditions/sacroiliiitis/multimedia/sacroiliac-joints/img-20005962 (last visited June 28, 2018).) The pain specialist administered three injections but continued advising Lambert to accept his chronic pain and moderate his activities. Because the injections provided only several hours of relief, Dr. Paul believed Lambert had dysfunction in his left sacroiliac joint and recommended surgery to fuse it. But he cautioned that the surgery offered no guarantee of improvement and that Lambert would still experience some back and leg pain and would "never be 100%."

Dr. Paul performed the left-joint fusion in October 2013, and Lambert’s condition initially started to improve. In November Lambert reported minimal pain. After a month of physical therapy, he underwent a functional assessment in January 2014. He was able to walk without an assistive device and reported "improved function at home and in the community." His physical therapist recommended allowing him to return to work with some lifting restrictions, and Dr. Paul released Lambert to light-duty work.

But Lambert’s relief was short-lived. In February 2014 he returned to Dr. Paul, now reporting pain on his right side. Dr. Paul was "not sure what [was] happening" and sent Lambert back to his pain specialist. Testing revealed potential dysfunction in the right sacroiliac joint.

In late March 2014, Dr. Paul completed an assessment of Lambert’s functional abilities. He diagnosed bilateral joint dysfunction and stated that Lambert experienced continued pain in his right sacroiliac joint and lower back. He opined that in a competitive work situation, Lambert could sit for at least six hours out of eight, stand for 30 minutes at a time (up to two hours total), and walk one block at a time (if allowed to shift between these positions at will). Dr. Paul also noted, however, that Lambert’s prognosis was guarded and that he "may develop problems in the upper lumbar spine."

In April 2014 Dr. Paul surgically fused Lambert’s right sacroiliac joint. Lambert returned to physical therapy and in early June reported that his preoperative pain had resolved. But later that month Lambert told his physical therapist that the pain on the left side of his lower back had returned; he said it was minimal but interfered with sleep. A week later Lambert said the pain had worsened and now prevented him from walking as far as he could just weeks before. In July 2014 Lambert told Dr. Paul that he had been experiencing pain—exacerbated by activity—for as long as four weeks. X-rays revealed intact surgical hardware without abnormality, so Dr. Paul thought the pain did not stem from the recent fusion. He directed Lambert to proceed with a previously scheduled functional assessment.

In late July 2014, Lambert’s physical therapist performed the functional assessment and observed a "significant decrease" in his capabilities since the January assessment. The July assessment revealed that Lambert had "significant limitations" in sitting, standing, and walking; he required position changes every 15 minutes; and he had a limp that grew more severe as he walked. The physical therapist opined that Lambert’s work tolerance "would be low to sedentary" and recommended that he follow up with a physician.

Dr. Paul examined Lambert once more at the end of July 2014. Lambert had pain and restricted motion in his back but normal coordination with no muscle atrophy or weakness. Based on his examination and the therapist’s functional assessment, Dr. Paul said Lambert was limited to 15 minutes of sitting or standing at a time and needed to change positions frequently. He concluded that Lambert’s "functional capacity [was] markedly reduced to the extent that ... he cannot do even sedentary work." Dr. Paul again referred Lambert to the pain specialist because his back pain could not be controlled by surgery. In August Dr. Paul opined that Lambert "would not be able to tolerate a work situation" because his "persist[ent] low back pain" had worsened, is severe, and is not expected to improve.

At an August 2014 hearing before an ALJ, Lambert testified that in 2011 he fell down the stairs in his home and his employer laid him off so he could obtain unemployment-insurance benefits without having to search for work while he "figured out what was going on." The ALJ voiced concern over Lambert’s receipt of unemployment benefits after his alleged onset date. Lambert then orally amended his onset date to January 1, 2013.

Lambert testified that he could not sit, stand, or walk for more than 15 minutes without a lot of pain in his lower back. He said that nothing entirely relieved the pain, including hydrocodone, Vicodin, and participation in the pain-management program. He had stopped doing housework, used a mounted seat while showering, and needed his wife’s help putting on and removing his socks. Lambert testified that around the time of his first sacroiliac joint surgery in the fall of 2013, he had started taking college classes online in the hope of possibly working as a music teacher—but his pain had progressed so much since March 2014 that he could not focus and had to withdraw from classes scheduled for fall 2014.

The ALJ applied the standard multistep analysis, see 20 C.F.R. §§ 404.1520(a), 416.920(a), and concluded that Lambert was not disabled after the amended onset date of January 1, 2013. As relevant here the ALJ determined that Lambert was severely impaired by degenerative disc disease ; that he nonetheless had the residual functional capacity ("RFC") to perform sedentary work with specified limitations; and that based on the testimony of a vocational expert, he was capable of working as a sorter, assembler, order clerk, or office helper.

In delineating Lambert’s RFC, the ALJ concluded that Lambert’s alleged symptoms were caused by medically determinable impairments, but that the severity of his pain and his claimed functional limitations were "not substantiated by the medical and other evidence of record." The ALJ also said that Lambert’s receipt of unemployment benefits after the initial alleged onset date and his subsequent attempt to "moot" the issue by amending his onset date "reflect[ed] adversely on his credibility."

The ALJ gave "little weight" to Dr. Paul’s opinions from July and August 2014. They were, in the ALJ’s view, inconsistent with his March 2014 opinion and his objective findings. The ALJ also characterized Dr. Paul’s opinion that Lambert would not be able to tolerate a work situation as a legal conclusion reserved to the Commissioner. On the other hand, the ALJ gave "considerable weight" to two opinions of state agency consultants who reviewed Lambert’s medical records in August 2012 (before the amended onset date) and April 2013 (four months after the amended onset date) and...