Roddy v. Astrue

• Decision Date: 18 January 2013
• Docket Number: No. 12–1682.,12–1682.
• Parties: Linda K. RODDY, Plaintiff–Appellant, v. Michael J. ASTRUE, Commissioner of Social Security, Defendant–Appellee.
• Court: U.S. Court of Appeals — Seventh Circuit

705 F.3d 631

Linda K. RODDY, Plaintiff–Appellant,

v.Michael J. ASTRUE, Commissioner of Social Security, Defendant–Appellee.

No. 12–1682.

United States Court of Appeals,Seventh Circuit.

Argued Dec. 12, 2012.

Decided Jan. 18, 2013.

Timothy J. Vrana (argued), Attorney, Columbus, IN, for Plaintiff–Appellant.

Danielle A. Pedderson, (argued) Attorney, Social Security Administration, Office of the General Counsel, Region V, Chicago, IL, for Defendant–Appellee.

Before POSNER, ROVNER, and WOOD, Circuit Judges.

WOOD, Circuit Judge.

Linda K. Roddy suffers from a number of serious medical problems, including in particular severe lower back pain attributable to degenerative disc disease. Eventually, when her pain became unbearable, she stopped working and applied for disability insurance benefits under the Social Security Act. She was unsuccessful before both the Social Security Administration and an administrative law judge (ALJ), who found that there were jobs in the national economy within her capabilities, even though she no longer could perform her old job as a shift manager at a Taco Bell restaurant. The district court, reviewing the agency's decision under 42 U.S.C. § 405(g), found that substantial evidence supported the Commissioner's decision, and so Roddy has now turned to this court. We conclude that the ALJ made a number of errors in his consideration of the record; we therefore remand Roddy's case to the agency for further proceedings.

I

Roddy was born in 1964 and so by now is in her late 40s. She has suffered from degenerative disc disease, among other ailments, since 1999. From 1985 until 1999 she worked full-time, mostly as a shift manager at Taco Bell, and was largely untroubled by health problems. Her luck changed in 1999, when, at the age of 34, she was in a car accident. She went to an emergency room at that time complaining of pain in her neck, forehead, shoulders, and back. There she received pain medication and was released the same day. Unfortunately, however, her pain did not subside, and she began to have difficulty doing her job and even getting dressed in the mornings. A month later she sought treatment from a chiropractor, Richard Hilton, who saw her for about eight months but then referred her to a pain management specialist, Dr. Gary Wright. Before referring Roddy, Hilton noted that she had not experienced as much improvement as a typical patient would have.

Dr. Wright treated Roddy from November 1999 through 2006. During his first appointment with her, Dr. Wright took her medical history and performed a physical examination. Over the following year he treated her in several ways: he scheduled her for an assessment using magnetic resonance imaging (MRI); and he performed both a discography (an injection procedure that identifies the source of pain by putting pressure on discs in the spine) and a spinoscopy (a procedure used to study the movement of the spine). The MRI revealed mild to moderate degeneration of one of the discs in Roddy's lower spine as well as a tear in the cartilage around that disc. The discography indicated that the torn and degenerating disc in Roddy's lower back was the source of her pain. The spinoscopy demonstrated significant functional problems with the movement of her spine, especially as she was asked to carry heavier loads. Based on these findings, Dr. Wright diagnosed Roddy as suffering from several disorders of the spine, including degenerative disc disease and sacroiliitis (an inflammation of the joints in the lower back, see American Medical Association, Complete Medical Encyclopedia 1086 (Jerrold B. Leikin & Martin S. Lipsky eds. 2003)).

From 1999 through 2003, Dr. Wright performed over 36 procedures on Roddy's spine, including nerve-block injections and prolotherapy injections, but he was unable permanently to relieve her pain. He prescribed various pain medications for Roddy including Methadone and Oxycontin. At first the injections and pain medication substantially alleviated her pain for periods lasting three or four months, but these procedures became less effective over time, eventually providing only three or four weeks of relief. Dr. Wright also recommendedthat Roddy undergo a procedure called intradiscal electrothermal therapy to cauterize the nerve endings in her damaged disc. She was unable to do so, however, because her insurance carrier refused to pay for the procedure and instead suggested that she undergo spinal-fusion surgery. Dr. Wright disagreed with that idea because of Roddy's age, and Roddy followed his advice.

Dr. Wright also became convinced that Roddy's job at Taco Bell was aggravating her condition. He thus recommended numerous work restrictions, such as limiting her work and the weight she was required to carry. Taco Bell, however, did not adopt these restrictions, especially during busy times of the day. Dr. Wright imposed a final work restriction on Roddy in June 2002, stating that the most she could work would be six hours a day, five days a week. Over the following three years during which he treated Roddy, Dr. Wright never altered or revoked this restriction.

Between September 2003 and Roddy's final appointment in January 2006, Dr. Wright treated Roddy less frequently, because she had lost her health insurance and no longer could afford prescriptions or further procedures. During this period, Dr. Wright provided her with samples of Vioxx and other pain medications, but those drugs did not alleviate her pain. Despite her financial limitations, he scheduled her for another MRI, which produced results consistent with her first one. She also had a surgical consultation. The only additional procedures Dr. Wright performed between September 2003 and January 2006 were more nerve-block injections in November 2005.

In October 2003, Dr. Wright was deposed in connection with a lawsuit Roddy had filed stemming from her car accident. He reviewed the treatments he had given Roddy, his diagnosis of her condition, and his opinion about her ability to work. He also noted that her condition had deteriorated since he began treating her and that her pain had increased. When asked why, Dr. Wright explained that Roddy's insurance had refused to pay for intradiscal electrothermal therapy, and that without that procedure she could not obtain long-term relief from her pain. Her pain prevented her from exercising, and thus from building strength in her back muscles; this deconditioning in turn aggravated her existing problems. Dr. Wright predicted that Roddy's ability to work would diminish to the point that she would not be able to remain in the workforce.

Roddy filed her application for Social Security disability insurance benefits in November 2007, alleging disability beginning in November 2005 on account of headaches, dementia, torn discs in her spine, and pain in her back, neck, hips, knees, and shoulders. In connection with her application, Roddy was evaluated by an internist, Dr. Larissa Dimitrov, and two clinical psychologists, Susan Conners and Robert Kurzhals. The psychologists identified no serious medical conditions. Dr. Dimitrov examined Roddy and found that despite a somewhat decreased range of motion in her back, knees, and hips, she was able to walk normally, get on and off the examining table without difficulty, and was otherwise not disabled.

In 2008 the agency interviewed Roddy and her friend, Sharon Kemp, about Roddy's quality of life and ability to perform daily activities. Roddy asserted that because of the pain in her lower back, she had not worked since being fired by Taco Bell in 2005. Roddy explained that her condition had significantly impeded her daily activities and forced her to spend most of the day lying down on her couch and heating her back. She stated that bending at the waist caused her pain and that she could not sit for a long period of time or stand continuously for more than 20 to 30 minutes. As a result she could no longer play softball or exercise, she was forced to stop often to stretch while driving for more than a short distance, and her household chores were much more difficult to complete. Before she began experiencing back pain, Roddy was able to clean her mobile home in one day. By 2008, she said, she was unable to lift more than 10 pounds, had difficulty negotiating stairs, could not sweep and mop a single room in her home in the same day, completed her household cleaning only in intervals, and had to lie down to rest and stretch her back for an hour or more before finishing cleaning any one room. She usually limited herself to making sandwiches and microwaving meals to reduce the time she spent standing while cooking. Even doing laundry required her to lie down and rest her back between loads. She could, however, care for her dog and mow her lawn on a riding mower. Though Roddy visited with Kemp once a month, Kemp noted that they often had to stop playing cards or watching a movie so that Roddy could stretch her back.

Based on the record we have described, the state agency denied Roddy's claim initially and on reconsideration; Roddy then requested a hearing before an ALJ. At that hearing, which took place in 2010, Roddy and William J. Kiger, a vocational expert, testified. Roddy testified about her daily activities and noted that she now had a friend living with her to help around the house. Roddy still did some sweeping and dusting but no longer mopped. She could go grocery shopping, but after 30 minutes in the store she struggled to finish her shopping, and her friend had to assist her with putting the groceries away at home so she could lie down. Roddy's friend also assisted with laundry, cooking, and yard work, and helped Roddy dress. Roddy reported pain from sitting or standing for longer than 20 minutes and said that she had to lie down and stretch her back three times a day for an hour or two. Kiger testified that even if Roddy's condition required her frequently to alternate...