Yurt v. Colvin

• Decision Date: 10 July 2014
• Docket Number: No. 13–2964.,13–2964.
• Citation: 758 F.3d 850
• Parties: Kip YURT, Plaintiff–Appellant, v. Carolyn W. COLVIN, Acting Commissioner of Social Security, Defendant–Appellee.
• Court: U.S. Court of Appeals — Seventh Circuit

758 F.3d 850

Kip YURT, Plaintiff–Appellant,

v.Carolyn W. COLVIN, Acting Commissioner of Social Security, Defendant–Appellee.

No. 13–2964.

United States Court of Appeals,Seventh Circuit.

Argued Feb. 24, 2014.

Decided July 10, 2014.

William L. Fouche, Jr., Law Office of William Fouche, Dallas, TX, for Plaintiff–Appellant.

Jared Christian Jodrey, Edward J. Kristof, Attorney, Social Security Administration Office of the General Counsel, Region V, Chicago, IL, for Defendant–Appellee.

Before FLAUM and ROVNER, Circuit Judges and KENDALL, District Judge. ^*

ROVNER, Circuit Judge.

Kip Yurt suffers from a psychotic disorder which causes him to experience, among other things, auditory hallucinations and bouts of uncontrollable rage. He also struggles with obsessive compulsive disorder, moderately severe chronic obstructive pulmonary disease (“COPD”), and chronic bifrontal tension headaches. As a result, he applied for Disability Insurance Benefits from the Social Security Administration, but an Administrative Law Judge (“ALJ”) denied his application. After the Appeals Council declined to review the ALJ's decision, Yurt sought review in the district court pursuant to 42 U.S.C. § 405(g). A magistrate judge affirmed the decision of the ALJ, and Yurt appeals, arguing principally that the ALJ erred by failing to include many of his medical limitations in the hypothetical that she posed to the vocational expert (“VE”). Yurt contends that the flawed hypothetical led the VE and the ALJ to erroneously conclude that he could be gainfully employed. For the reasons discussed below, we reverse the judgment of the district court and remand to the agency for further proceedings.

I.

Yurt applied for disability in February 2011, alleging disability beginning on August 4, 2010. The Social Security Administration denied both Yurt's claim and his request for reconsideration. On his application for a hearing with an ALJ, Yurt noted that he had worked in the past in various capacities as a cook and a janitor.¹ His final job at the “substantial gainful activity” level effectively ended in May 2010, when he had some sort of break with reality. He was taken to the emergency room and subsequently placed on medical leave for several months. Shortly after he returned to work in August 2010, he threatened a coworker with a knife, which led, unsurprisingly, to his termination.

Between the episode at the hospital in May 2010 and the date of his hearing with the ALJ on April 3, 2012, Yurt saw a number of different physicians and therapists and attempted at least one other job. The May 2010 incident occurred at Parkview Noble Hospital, where Yurt had worked in the kitchen for several years when he was found “wandering the halls” without any memory of how he had gotten there. After being taken to the emergency room, he was referred to a neurologist, Dr. Madhav Bhat, who treated him on July 1, 2010. Dr. Bhat suggested weaning Yurt off an anti-seizure medicine he had been taking and doubling the dosage of Prozac Yurt was already taking for depression. Dr. Bhat recognized that Yurt suffered from “[r]ecurrent episodes of altered awareness of surroundings,” and diagnosed Yurt's nearly daily recurring bifrontal pain in his head as a chronic tension headache. He concluded that Yurt should remain on medical leave from work for the time being.

Yurt returned to work that August, but reported that Parkview fired him shortly thereafter because “they were really afraid that he might hurt other people” and because he was accused of holding up a knife and threatening coworkers. On August 13, 2010, Yurt saw psychiatrist Dr. Frank Shao, who concluded that Yurt's frequent self-described “black outs” were difficult to diagnose precisely. Dr. Shao recommended that Yurt obtain a second opinion and prescribed Lamictal in slowly increasing dosages to help Yurt's “mood lability and violent behaviors.” He recognized that Yurt may have a “certain risk of violence to himself and others” because of his urges and history of aggression, but deemed the risk not to be “acute.” He assigned Yurt a Global Assessment of Functioning (“GAF”) score of 40 to 50.² This GAF score correlates with “[s]erious symptoms ... or any serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job).” Am. Psychiatric Ass'n, Diagnostic & Statistical Manual of Mental Disorders 32 (4th ed. text revision 2000).

Yurt then attempted to work part-time as a cook at St. Francis School. Although the record is short on specifics, it appears that Yurt lost this job on account of again threatening a coworker. This likely corresponds to the beginning of December 2010, when Yurt called Dr. Shao's office and reported grabbing a co-worker by the throat. He did not remember the details because he had blacked out.

Later that same month, he was admitted to the hospital for psychiatric evaluation. Dr. Shao reported that Yurt was hearing voices telling him to “kill people” and that he was afraid to go outside because the voice in his head (which he called “Alex”) was instructing him to “randomly hurt people.” Dr. Shao described Yurt as “disheveled” and assessed his GAF score to be between 25 to 30. This corresponds to behavior that is “considerably influenced by delusions or hallucinations or serious impairment in communication or judgment (e.g., sometimes incoherent, acts grossly inappropriately, suicidal preoccupation) or inability to function in almost all areas (e.g., stays in bed all day; no job, home, or friends).” Id. Dr. Shao recommended inpatient treatment for what he expected would be one to two weeks. He also increased Yurt's dosage of Celexa (an antidepressant) and continued him on Lamictal (an anticonvulsant used to treat both epilepsy and bipolar disorder) as well as Seroquel (another medication for bipolar disorder). Despite Dr. Shao's estimation that Yurt would need between one and two weeks of inpatient treatment, Yurt checked out of the hospital approximately two days later, denying auditory hallucinations, homicidal or suicidal ideations, delusions, or depression.

In January 2011, Yurt saw Dr. Kenneth Ogu for a psychiatric evaluation. Dr. Ogu noted that Yurt described having command hallucinations, sleep difficulty, racing thoughts and obsessive compulsive thoughts. He diagnosed Yurt with psychosis, not otherwise specified as well as “Rule out Bipolar I Disorder” and “Rule out Intermittent Explosive Disorder.” Yurt asked if his anti-psychotic medications (he was taking three) could be changed because they did not seem to be working for the voices. Dr. Ogu agreed and set out a plan for reducing some medications and adding several others.

Yurt was again admitted for psychiatric inpatient care on January 25, 2011. He continued to complain of auditory hallucinations—specifically the voice of “Alex” which Yurt described as “so strong” that he could no longer control it. This time Dr. Shao recommended hospitalizing Yurt to keep him from hurting others as a result of the auditory hallucinations. Dr. Shao again opined that Yurt had a GAF of 25 to 30. Here again, Yurt was released from the hospital two days later. At that time, Dr. Shao recorded a slightly higher GAF score of 35 to 40. This corresponds to “[s]ome impairment in reality testing or communication (e.g. speech is at times illogical, obscure, or irrelevant) or major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood (e.g. depressed adult avoids friends, neglects family, and is unable to work[.] )” Am. Psychiatric Ass'n, Diagnostic & Statistical Manual of Mental Disorders 32 (4th ed. text revision 2000). After his January 2011 stay in the hospital, Yurt was taking the following medications on a daily basis: 40 milligrams of Prozac for depression; 100 milligrams of Lamictal (used for treating bipolar disorder); 500 milligrams of Depakote for mood stabilization; 1 milligram of Klonopin (used for treating epilepsy and panic disorders) at bedtime; 10 milligrams of Ambien at bedtime; and an increased dosage of 2 milligrams of Risperdal for psychosis.

In April 2011, Yurt met with the psychologist selected by the Disability Determination Bureau, Revathi Bingi, Ed.D. After evaluating Yurt, she concluded that he appeared to “have great difficulty managing his symptoms” in spite of good family support. She observed that Yurt's “hallucinations, paranoia and anger appear to be restricting his life” and that his quality of life “appears to be very poor.” She assigned him a GAF of 45, which, as described above, represents “[s]erious symptoms ... or any serious impairment in social, occupational, or school functioning[.]” Id. That same month, Yurt began meeting for therapy with Rachel DeFrancesco, M.A. She identified Yurt's issues as “anxiety, depression, employment, interpersonal problems, psychosis, [and] sleep.” She characterized Yurt's prognosis as “fair,” and described him as suffering from “severe” symptoms but possessing a “strong motivation to gain understanding.”

In May 2011, state agency psychologist Ken Lovko reviewed Yurt's file for a mental residual functional capacity assessment (“RFC”). As relevant here, Dr. Lovko checked boxes indicating that Yurt was “moderately limited” in his ability to: (1) understand and remember detailed instructions; (2) carry out detailed instructions; (3) perform activities within a schedule and maintain regular attendance; (4) perform at a consistent pace and complete a normal workday and workweek; (5) interact appropriately with the general public; (6) get along with coworkers or peers; and (7) maintain socially appropriate behavior. Dr. Lovko then opined that although Yurt's diagnosis was “serious and consistent with severe impairments,” his functioning did not suggest that he had lost the capacity for unskilled work. Dr. Lovko also noted that Yurt's GAF score of 60 (given by Dr. Ogu in January 2011) indicated only ...