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Mark L. v. Saul

United States District Court, N.D. Indiana, South Bend Division

June 21, 2019

MARK L.,[1] Plaintiff,
ANDREW M. SAUL, Commissioner of Social Security, Defendant.



         Mark L. applied for social security disability benefits, alleging that he became disabled when he severely broke his left leg just below the knee. He alleged that even after the break healed, he had limited use of his leg and continued to experience significant pain. On remand from a previous appeal, an administrative law judge found that Mr. L. had severe impairments that included complex regional pain syndrome, and that he had a number of physical limitations relative to his ability to use his leg. The ALJ also found, though, that Mr. L. retained the capacity to perform several jobs. Thus, Mr. L.'s claim was again denied and he again appealed. Because the ALJ's decision did not acknowledge or account for a Social Security Ruling that governs the analysis of complex regional pain syndrome, the Court reverses and remands for further proceedings.


         In September 2012, Mr. L. jumped down about four feet off of a deck. The landing shattered Mr. L.'s left tibial plateau-the bone that forms the bottom of the knee joint. Two weeks later, Mr. L. underwent surgery to have plates and screws implanted to repair the bone. At the time, Mr. L. was forty-four years old and was working in construction, but he was unable to return to work during his recovery and he applied for social security disability benefits shortly thereafter. Mr. L. continued to heal after the surgery, but still experienced symptoms including pain and swelling. In December 2012, he tripped and landed with full weight on his left foot, causing additional pain.

         In June 2013, Mr. L. sought treatment from a pain management specialist. He described his pain as moderate-to-severe and reported sensitivity to touch. The doctor also noted some swelling and color changes in Mr. L.'s left knee. She diagnosed Mr. L. with complex regional pain syndrome, and recommended that he receive an injection, which he did several months later. Mr. L. continued to receive treatment over the ensuing months, and his doctor opined that he would be unable to return to his previous job in construction. At some appointments, Mr. L. was observed walking without a limp, while at others he walked with a limp and the assistance of a cane. The levels of pain Mr. L. reported fluctuated somewhat as well.

         Mr. L. later received a hearing on his claim for disability benefits. An ALJ found that while he was unable to return to his previous work, Mr. L. would be able to perform other jobs, so he denied Mr. L.'s claim. On appeal, the parties jointly agreed to remand the matter to the Commissioner for further proceedings. The claim was sent to a new ALJ with instructions to evaluate Mr. L.'s complex regional pain syndrome and to obtain expert medical evidence if warranted. This time, the ALJ found that Mr. L.'s severe impairments included complex regional pain syndrome, and he found that Mr. L.'s limitations were more extensive than those found by the first ALJ. His conclusion, though, was the same, as he found that Mr. L. retained the residual functional capacity to perform other jobs. After the Appeals Council denied review, Mr. L. filed this action seeking review of that decision.


         Because the Appeals Council denied review, the Court evaluates the ALJ's decision as the final word of the Commissioner of Social Security. Schomas v. Colvin, 732 F.3d 702, 707 (7th Cir. 2013). This Court will affirm the Commissioner's findings of fact and denial of benefits if they are supported by substantial evidence. Craft v. Astrue, 539 F.3d 668, 673 (7th Cir. 2008). Substantial evidence consists of “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401 (1971). This 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). Even if “reasonable minds could differ” about the disability status of the claimant, the Court must affirm the Commissioner's decision as long as it is adequately supported. Elder v. Astrue, 529 F.3d 408, 413 (7th Cir. 2008).

         The ALJ has the duty to weigh the evidence, resolve material conflicts, make independent findings of fact, and dispose of the case accordingly. Perales, 402 U.S. at 399-400. In evaluating the ALJ's decision, the Court considers the entire administrative record but does not reweigh evidence, resolve conflicts, decide questions of credibility, or substitute the Court's own judgment for that of the Commissioner. Lopez ex rel. Lopez v. Barnhart, 336 F.3d 535, 539 (7th Cir. 2003). Nevertheless, the Court conducts a “critical review of the evidence” before affirming the Commissioner's decision. Id. An ALJ must evaluate both the evidence favoring the claimant as well as the evidence favoring the claim's rejection and may not ignore an entire line of evidence that is contrary to his or her findings. Zurawski v. Halter, 245 F.3d 881, 887 (7th Cir. 2001). The ALJ must provide a “logical bridge” between the evidence and the conclusions. Terry v. Astrue, 580 F.3d 471, 475 (7th Cir. 2009).


         Disability benefits are available only to those individuals who can establish disability under the terms of the Social Security Act. Estok v. Apfel, 152 F.3d 636, 638 (7th Cir. 1998). Specifically, 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 Social Security regulations create a five-step process to determine whether the claimant qualifies as disabled. 20 C.F.R. § 404.1520(a)(4)(i)-(v). The steps are to be used in the following order:

1. Whether the claimant is currently engaged in substantial gainful activity;
2. Whether the claimant has a medically severe impairment;
3. Whether the claimant's impairment meets or equals one listed in ...

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