Windus v. Barnhart

• Decision Date: 15 November 2004
• Docket Number: No. 04-C-0499.,04-C-0499.
• Citation: 345 F.Supp.2d 928
• Parties: Paula WINDUS, Plaintiff, v. Jo Anne B. BARNHART, Commissioner of the Social Security Administration, Defendant.
• Court: U.S. District Court — Eastern District of Wisconsin

345 F.Supp.2d 928

Paula WINDUS, Plaintiff, v. Jo Anne B. BARNHART, Commissioner of the Social Security Administration, Defendant.

No. 04-C-0499.

United States District Court, E.D. Wisconsin.

November 15, 2004.

David G. Dreis, Milwaukee, WI, for Plaintiff.

Nora S. Barry, Milwaukee, WI, for Defendant.

DECISION AND ORDER

ADELMAN, District Judge.

Plaintiff Paula Windus seeks judicial review of the denial of her application for social security disability benefits. 42 U.S.C. § 405(g). Plaintiff alleged that she was unable to work due to liver disease, depression and anxiety, but her claim was rejected by an Administrative Law Judge ("ALJ") following a hearing. The Appeals Council denied plaintiff's request for review, making the ALJ's decision the final decision of the Social Security Administration for purposes of judicial review. See Flener v. Barnhart, 361 F.3d 442, 446 (7th Cir.2004).

Plaintiff argues that the ALJ's decision must be reversed because (1) the ALJ improperly evaluated the opinions of her treating physicians and ignored the opinions of several consulting physicians; and (2) the ALJ erred in evaluating her credibility. She asks that the matter be remanded for an award of benefits or, in the alternative, for reconsideration by a different ALJ. The Commissioner responds that the ALJ's decision was supported by substantial evidence and legally sound. The matter has been fully briefed and is ready for decision.

I. APPLICABLE LEGAL STANDARDS

A. Disability Standard

In order to obtain disability benefits under the Social Security Act, the claimant must be unable "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). The Administration has adopted a sequential five-step test for determining whether a claimant is disabled. 20 C.F.R. § 416.920(a)(4). Under this test, the ALJ must determine:

(1) Whether the claimant is currently engaged in substantial gainful activity ("SGA");

(2) If not, whether the claimant has a severe impairment;¹

(3) If so, whether the claimant's impairment(s) meets or equals one of the impairments listed in the Administration's regulations as being so severe as to preclude SGA;²

(4) If not, whether the claimant can perform her past relevant work;

(5) If not, whether the claimant can make the adjustment to other work.

Young v. Barnhart, 362 F.3d 995, 1000 (7th Cir.2004).

If the claimant makes the necessary showing at steps 1-3, she will be found disabled. If her impairment is not of such severity as to be presumptively disabling, the ALJ must consider whether the claimant possesses the residual functional capacity ("RFC") to perform her past work. Lechner v. Barnhart, 321 F.Supp.2d 1015, 1018 (E.D.Wis.2004). If not, the burden shifts to the Commissioner to demonstrate that the claimant can successfully perform a significant number of other jobs that exist in the national economy. Young, 362 F.3d at 1000. The Commissioner may carry this burden either by relying on the testimony of a vocational expert ("VE"), who evaluates the claimant's ability to perform work in the national economy in light of her limitations, or through the use of the "Medical-Vocational Guidelines," (a.k.a. "the Grid"), 20 C.F.R. Pt. 404, Subpt. P, App. 2, a chart that classifies a person as disabled or not disabled based on her exertional ability, age, education and work experience. Worzalla v. Barnhart, 311 F.Supp.2d 782, 787 (E.D.Wis.2004).

Disability claims based on mental disorders are evaluated in essentially the same manner as claims based on physical impairments. If the mental impairment is severe, the ALJ must determine whether it meets or equals any of the Listings. Wates v. Barnhart, 274 F.Supp.2d 1024, 1036 (E.D.Wis.2003). The Listings of mental impairments consist of three sets of "criteria" — the paragraph A criteria (a set of medical findings), paragraph B criteria (a set of impairment-related functional limitations), and paragraph C criteria (additional functional criteria applicable to certain Listings). The paragraph A criteria substantiate medically the presence of a particular mental disorder. The criteria in paragraphs B and C describe the impairment-related functional limitations that are incompatible with the ability to perform SGA. Lechner, 321 F.Supp.2d at 1018. There are four broad areas in which the ALJ rates the degree of functional limitation: (1) activities of daily living; (2) social functioning; (3) concentration, persistence, or pace; and (4) episodes of decompensation. 20 C.F.R. § 404.1520a(c)(3). The ALJ rates the degree of limitation in the first three functional areas using a five-point scale: none, mild, moderate, marked and extreme. The degree of limitation in the fourth area is evaluated using a four-point scale: none, one or two, three, and four or more. The last point on each scale represents a degree of limitation that is incompatible with the ability to do any gainful activity. § 404.1520a(c)(4). If the claimant satisfies the A and B, or A and C criteria, she will be considered disabled. Wates, 274 F.Supp.2d at 1036 (citing 20 C.F.R. Pt. 404, Subpt. P, App. 1, § 12.00).

As with physical impairments, if the claimant's mental impairment does not meet or equal a Listing, the ALJ must evaluate the claimant's mental RFC. See 20 C.F.R. Pt. 404, Subpt. P, App. 1, § 12.00; 20 C.F.R. § 404.1520a(c)(3). The RFC assessment "complements the functional evaluation necessary for paragraphs B and C of the listings by requiring consideration of an expanded list of work-related capacities that may be affected by mental disorders." 20 C.F.R. Pt. 404, Subpt. P, App. 1, § 12.00. Under SSR 85-16, Residual Functional Capacity For Mental Impairments, "this evaluation includes consideration of the ability to understand, to carry out and remember instructions and to respond appropriately to supervision, coworkers, and customary work pressures in a work setting." See also POMS DI 25020.010B.3 (stating that the mental ability to perform unskilled work includes the ability to remember work-like procedures, understand and remember instructions, maintain attention, maintain regular attendance and be punctual, sustain an ordinary routine without special supervision, work in coordination with or proximity to others, make simple work-related decisions, complete a normal workday without interruptions from psychologically based symptoms and perform at a consistent pace without an unreasonable number and length of rest periods, ask simple questions or request assistance, accept instructions and respond appropriately to criticism from supervisors, get along with coworkers or peers without unduly distracting them or exhibiting behavioral extremes, respond appropriately to changes in a routine work setting, and be aware of normal hazards and take appropriate precautions).

B. Review of ALJ's Decision

Under § 405(g), the district court's review is limited to determining whether the ALJ's decision is supported by "substantial evidence" and based on the proper legal criteria. Scheck v. Barnhart, 357 F.3d 697, 699 (7th Cir.2004). The ALJ's findings of fact, if supported by substantial evidence, are conclusive. Id. Substantial evidence is such relevant evidence as a reasonable person could accept as adequate to support a conclusion. Kepple v. Massanari, 268 F.3d 513, 516 (7th Cir.2001).

If the ALJ commits an error of law, however, reversal is required without regard to the volume of evidence in support of the factual findings. Binion v. Chater, 108 F.3d 780, 782 (7th Cir.1997). The ALJ commits such an error if he fails to comply with the Commissioner's Regulations and Rulings. Brown v. Barnhart, 298 F.Supp.2d 773, 779 (E.D.Wis.2004) (citing Prince v. Sullivan, 933 F.2d 598, 602 (7th Cir.1991)).

The ALJ's decision must also demonstrate the path of his reasoning, and the evidence must lead logically to his conclusion. Rohan v. Chater, 98 F.3d 966, 971 (7th Cir.1996). While the ALJ need not discuss every piece of evidence in the record, he must provide at least a glimpse into his reasoning. Zurawski v. Halter, 245 F.3d 881, 889 (7th Cir.2001). Even if enough evidence exists in the record to support the decision, the court cannot uphold it if the reasons given by the ALJ do not build an accurate and logical bridge from the evidence to the result. Hodes v. Apfel, 61 F.Supp.2d 798, 806 (N.D.Ill.1999) (citing Sarchet v. Chater, 78 F.3d 305, 307 (1996)).

Finally, ALJs "must not succumb to the temptation to play doctor and make their own independent medical findings." Rohan, 98 F.3d at 970. "The medical expertise of the Social Security Administration is reflected in regulations; it is not the birthright of the lawyers who apply them." Schmidt v. Sullivan, 914 F.2d 117, 118 (7th Cir.1990).

II. FACTS AND BACKGROUND

Plaintiff was 42 years old at the time of her hearing, with previous work experience as a bartender and waitress. She dropped out of school in the 11th grade and had not obtained a GED, though she was able to read and write. She lived with her boyfriend, Chuck Johnson, and her cat. (Tr. at 359-60.)

Plaintiff alleged disability due to liver disease secondary to a long history of alcohol abuse, depression and anxiety. The medical evidence before the ALJ pertaining to those conditions was as follows.

A. Medical Evidence

1. Treating Sources

a. Physical Impairments

On August 17, 2000, plaintiff was admitted to Froedert Memorial Hospital complaining of abdominal pain, jaundice, nausea, diarrhea and blurred vision. A CT scan of her abdomen revealed a markedly enlarged and nodular liver, consistent with acute hepatitis and early cirrhosis. Ascites (accumulation of fluid)³ was present in the abdomen. Plaintiff told the doctor that she drank four to five beers per day...