Ragauskas v. Colvin
| Decision Date | 18 November 2013 |
| Docket Number | No. 12 C 6333,12 C 6333 |
| Parties | LUKAS RAGAUSKAS, Plaintiff, v. CAROLYN W. COLVIN, Acting Commissioner of Social Security, Defendant. |
| Court | U.S. District Court — Northern District of Illinois |
MEMORANDUM OPINION AND ORDER
Plaintiff Lukas Ragauskas filed this action seeking review of the final decision of the Commissioner of Social Security (Commissioner) denying his application for Supplemental Security Income under Title XVI of the Social Security Act. 42 U.S.C. §§ 216(i), 223(d), 1614(a)(3)(A). The parties have consented to the jurisdiction of the United States Magistrate Judge, pursuant to 28 U.S.C. § 636(c), and Ragauskas has filed a motion for summary judgment. For the reasons stated below, the case is remanded for further proceedings consistent with this opinion.
To recover Supplemental Security Income (SSI) under Title XVI of the Social Security Act (SSA), a claimant must establish that he or she is disabled within themeaning of the SSA.2 York v. Massanari, 155 F. Supp. 2d 973, 977 (N.D. Ill. 2001). A person is disabled if he or she is unable to perform "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." 20 C.F.R. § 416.905(a). In determining whether a claimant suffers from a disability, the Commissioner conducts a standard five-step inquiry:
20 C.F.R. §§ 416.909, 416.920; see Clifford v. Apfel, 227 F.3d 863, 868 (7th Cir. 2000). Zalewski v. Heckler, 760 F.2d 160, 162 n.2 (7th Cir. 1985). "The burden of proof is on the claimant through step four; only at step five does the burden shift to the Commissioner." Clifford, 227 F.3d at 868.
Ragauskas applied for SSI on February 15, 2011, alleging that he became disabled on March 1, 2000, due to cystic fibrosis, attention deficit hyperactivity disorder (ADHD), and Wolff-Parkinson-White syndrome.3 (R. at 20, 63, 64, 89, 161). The application was denied initially and on reconsideration, after which Ragauskas filed a timely request for a hearing. (Id. at 20, 63-79, 86-101). On April 26, 2012, Ragauskas, represented by counsel, testified at a hearing before an Administrative Law Judge (ALJ). (Id. at 20, 31-52o). The ALJ also heard testimony from Violeta Laukinatis, Ragauskas's mother.4 (Id. at 23, 31-32, 49-52, 211).
The ALJ denied Ragauskas's request for benefits on May 7, 2012. (R. at 20-26). Applying the five-step sequential evaluation process, the ALJ found, at step one, that Ragauskas had not engaged in substantial gainful activity since February 15, 2011, the application date. (Id. at 23). At step two, the ALJ found that Ragauskas's cystic fibrosis with a history of pancreatic insufficiency, mild thyroidmegaly, and ADHD are severe impairments. (Id.). At step three, the ALJ determined that Ragauskas does not have an impairment or combination of impairments that meet or medically equal the severity of any of the listings enumerated in the regulations. (Id. at 23-24).
The ALJ then assessed Ragauskas's residual functional capacity (RFC)5 and determined that he has the RFC to perform light work, as defined in 20 C.F.R. § 416.967(b), "not involving concentrated exposure to respiratory irritants, temperature extremes, or humidity." (R. at 24). At step four, the ALJ determined that Ragauskas has no past relevant work. (Id. at 25). At step five, based on Ragauskas's RFC, age, education, and work experience, the ALJ used the Medical-Vocational Guidelines (Grid) to determine that there are jobs that exist in significant numbers in the national economy that Ragauskas can perform.6 (Id. at 25-26). Accordingly, the ALJ concluded that Ragauskas was not suffering from a disability as defined by the SSA. (Id. at 26).
The Appeals Council denied Ragauskas's request for review on July 26, 2012. (R. at 1-5). Ragauskas now seeks judicial review of the ALJ's decision, which stands as the final decision of the Commissioner. Villano v. Astrue, 556 F.3d 558, 561-62 (7th Cir. 2009).
Judicial review of the Commissioner's final decision is authorized by § 405(g) of the SSA. In reviewing this decision, the Court may not engage in its own analysis ofwhether the plaintiff is severely impaired as defined by the Social Security Regulations. Young v. Barnhart, 362 F.3d 995, 1001 (7th Cir. 2004). Nor may it "reweigh evidence, resolve conflicts in the record, decide questions of credibility, or, in general, substitute [its] own judgment for that of the Commissioner." Id. The Court's task is "limited to determining whether the ALJ's factual findings are supported by substantial evidence." Id. (citing § 405(g)). Evidence is considered substantial "if a reasonable person would accept it as adequate to support a conclusion." Indoranto v. Barnhart, 374 F.3d 470, 473 (7th Cir. 2004). "Substantial evidence must be more than a scintilla but may be less than a preponderance." Skinner v. Astrue, 478 F.3d 836, 841 (7th Cir. 2007). "In addition to relying on substantial evidence, the ALJ must also explain his analysis of the evidence with enough detail and clarity to permit meaningful appellate review." Briscoe ex rel. Taylor v. Barnhart, 425 F.3d 345, 351 (7th Cir. 2005).
Although this Court accords great deference to the ALJ's determination, it "must do more than merely rubber stamp the ALJ's decision." Scott v. Barnhart, 297 F.3d 589, 593 (7th Cir. 2002) (citation omitted). The Court must critically review the ALJ's decision to ensure that the ALJ has built an "accurate and logical bridge from the evidence to his conclusion." Young, 362 F.3d at 1002. Where the Commissioner's decision "lacks evidentiary support or is so poorly articulated as to prevent meaningful review, the case must be remanded." Steele v. Barnhart, 290 F.3d 936, 940 (7th Cir. 2002).
Ragauskas was first diagnosed with cystic fibrosis7 in 2000, at the age of eight. (R. at 394-95). In July 2008, his health was maintained with pancreatic enzymes, TOBI,8 azithromycin, and fat soluble vitamins. (Id. at 395). Ragauskas complained of morning nausea, but no vomiting. (Id.). In August 2008, he reported intermittent episodes of shortness of breath. (Id. at 298).
On March 29, 2010, Ragauskas began treating with Sean M. Forsythe, M.D. (R. at 392). Ragauskas's respiratory symptoms included dyspnea,9 cough, and sputum. (Id.). He kept his airway clear with Acapella therapy in the morning, the Vest for 20 minutes in the afternoon, and mucolytics—hypertonic saline and Pulmozyme.10 (Id.). His other medications included Azithromycin, Cephalexin, Levalbuterol nebulizer solution, Levoceterizine, Dihydrochloride, Omeprazole, Pancrecarb,Pancrelipase, sodium chloride hypertonic solution for nebulizer, Source Abdek, TOBI (15 days on, 15 days off), vitamins, and Voriconazole. (Id. at 392-93). Ragauskas reported that his exercise tolerance was slowly improving; he was able to walk with 10-pound weights every morning. (Id. at 392). Dr. Forsythe found that Ragauskas had very good lung function, encouraged him to increase his exercises, and discontinued Voriconazole. (Id. at 394).
On May 19, 2010, Ragauskas reported feeling well, although his nausea had returned. (R. at 389). His exercise tolerance was good. (Id.). On examination, Dr. Forsythe found that Ragauskas's spirometry and symptoms were stable and good. (Id. at 391).
On June 30, 2010, Ragauskas reported more GI problems—nausea, fatigue, shaky, feeling hot, sour feeling in his throat, and heartburn. (R. at 387-88). Although he just completed his most recent TOBI therapy, Ragauskas was coughing more. (Id. at 388). On examination, Dr. Forsythe found Ragauskas's pulmonary function "very slightly worse." (Id. at 389). Dr. Forsythe referred Ragauskas to his GI doctor to check for pancreatitis or gallbladder disease. (Id.).
On September 17, 2010, Ragauskas reported nausea most days; he wakes up with it and it persists all day long, sometimes accompanied by a gagging feeling in the back of his throat. (R. at 386). His respiratory symptoms were at baseline, but his exercise tolerance was poor—he had no energy. (Id.). Dr. Forsythe reviewed the GI doctor's report, which indicated that Ragauskas's nausea did not appear to have a GI cause. (Id. at 387). Dr. Forsythe concluded that the nausea may be sinusdisease, endocrine problems—Ragauskas has a history of adrenal insufficiency—or pulmonary disease. (Id.) He referred Ragauskas to an endocrinologist to determine if the nausea is caused by a sinus disease. (Id.).
On November 5, 2010, Ragauskas reported no improvements. (R. at 384). He had frequent nausea, no energy, worsening cough, and fair exercise tolerance. (Id.). He reported no improvements from escalating therapy for sinus disease. (Id. at 386). He continues to lose weight. (Id. at 384). On examination, Dr. Forsythe found normal lung function, with slightly increased symptoms. (Id. at 386). He advised Ragauskas to start his TOBI therapy early and referred him to another endocrinologist. (Id.). To determine if the nausea was a side-effect to Ragauskas's medications, Dr. Forsythe discontinued...
To continue reading
Request your trial