United States District Court, N.D. Indiana, South Bend Division
OPINION AND ORDER
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.
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.
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.
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
STANDARD OF REVIEW
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).
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).
STANDARD FOR 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
1. Whether the claimant is currently engaged in substantial
2. Whether the claimant has a medically severe impairment;
3. Whether the claimant's impairment meets or equals one
listed in ...