United States District Court, N.D. Indiana, Fort Wayne Division
OPINION AND ORDER
P. SIMON, JUDGE UNITED STATES DISTRICT COURT.
Adams appeals the Social Security Administration's
decision to deny her application for Disability Insurance
Benefits (DIB) under Title II of the Social Security Act and
application for Supplemental Security Income (SSI) under
Title XVI. Adams alleged disability due to the following
conditions: Ehlers-Danlos syndrome, fibromyalgia,
hypothyroidism, gastro-esophageal reflux disease, asthma, bad
back and neck, morbid obesity, TMJ, migraines, and chronic
kidney stones. [Tr. 63.] An administrative law judge found that
Adams was not disabled within the meaning of the Social
Security Act and that she had the residual functional
capacity (RFC) to perform light work with some restrictions
and could perform her past relevant work as a case worker.
claims the ALJ failed to adequately explain the basis of her
decision and create a logical bridge between the medical
evidence and her conclusions. I agree with Adams, at least as
it relates to her extreme obesity. The ALJ found that Adams
had a residual functional capacity to occasionally stoop,
kneel, crouch and crawl. That seems at odds with someone who
weighs 344 pounds and has a body mass index
(“BMI”) of 57.2, as Adams does. Because I find
that the ALJ needs to make a more secure connection between
the evidence of Adams' extreme obesity and the RFC that
was assigned to her, I will REVERSE the
ALJ's decision and REMAND on this issue.
found that Adams has the following severe impairments:
asthma, obesity, Ehlers-Danlos syndrome (which involves
unstable and loose joints), degenerative disc disease at
¶ 5/S1, fibromyalgia, migraine headaches, postural
dizziness, and knee osteoarthritis with an alleged onset date
of April 18, 2013. [Tr. 10.] Adams also has several other
medical challenges that are fully accounted for in the
ALJ's opinion. [See Tr. 13.] The ALJ determined
Adams had the RFC to perform light work with several
restrictions, including that she could lift and/or carry up
to 20 pounds occasionally and up to 10 pounds frequently, she
could occasionally stoop, kneel, crouch, and crawl, and she
could stand and/or walk for two hours and sit for six hours,
however, “she would need the option to alternate
positions between sitting and standing every 30
start with some basics about my role in reviewing the work of
the ALJ. My job is not to determine from scratch whether
Adams is disabled. Rather, I only need to determine whether
the ALJ applied the correct legal standards and whether the
decision is supported by substantial evidence. See
42 U.S.C. § 405(g); Shideler v. Astrue, 688
F.3d 306, 310 (7th Cir. 2012); Castile v. Astrue,
617 F.3d 923, 926 (7th Cir. 2010); Overman v.
Astrue, 546 F.3d 456, 462 (7th Cir. 2008). The review is
deferential. This is because the “substantial
evidence” standard is not particularly demanding. In
fact, the Supreme Court announced long ago that the standard
is even less than a preponderance-of-the-evidence standard.
Richardson v. Perales, 402 U.S. 389, 401 (1971). Of
course, there has to be more than a “scintilla”
of evidence. Id. So in conducting my review, I
cannot “simply rubber-stamp the Commissioner's
decision without a critical review of the evidence.”
Clifford v. Apfel, 227 F.3d 863, 869 (7th Cir.
2000). Nonetheless, the review is a light one and the
substantial evidence standard is met “if a reasonable
person would accept it as adequate to support the
conclusion.” Young v. Barnhart, 362 F.3d 995,
1001 (7th Cir. 2004).
Adams's weight, the ALJ noted that she weighed about 344
pounds at the consultative examination, with a body mass
index of about 57.2. [Tr. 16.] The ALJ found that her obesity
contributes to limiting Adams to a reduced range of light
exertional level work that includes postural limitations
including no more than two hours of standing and/or walking
during an eight-hour workday, and the option to alternate
positions between standing and sitting every 30 minutes. [Tr.
testified at the hearing before the ALJ on April 5, 2017,
that she worked as a caseworker for approximately 14 years,
helping people apply for Medicaid and sometimes Social
Security. [Tr. 36.] Her job entailed visiting different
floors and rooms of the hospital, and helping patients with
their applications. [Tr. 36-37.] According to Adams, they let
her go because of her health. [Tr. 38.] She claims her
“joints give out on [her] too many times a day.
I'll fall just walking or standing up. I have chronic
pain. . . . migraines limit me as far as like these type of
lights, weight limit as far as lifting, the standing, the
sitting.” [Tr. at 39.] Specifically, Adams said she had
pain in her joints, back, knees, and hands. Id. Her
constant knee pain is made worse by weight bearing, standing
up, walking, moving, and bending. [Tr. 40.] Adams just got a
knee brace for her right knee, and she is supposed to wear it
every day. Id. She reported that a friend helps her
with vacuuming and sweeping. [Tr. 45.] Her joint pain
associated with the Ehlers-Danlos has gotten worse over the
past three years. [Tr. 52-53.] Although she is able to drive
to get around and prepare simple meals, when she goes to the
store she needs the assistance of a wheelchair of scooter.
[Tr. 35, 44-45, 250.]
December 2013, Adams had a lumbar spine MRI which showed disc
protrusion and bilateral L5 pars defect without
anterolisthesis or retrolisthesis of L5 on S1. [Tr. 587-88.]
In April 2014, Adams was referred to Dr. Isa S. Canavati, in
the NeuroSpine and Pain Center. [Tr. 555.] Although an MRI
showed symptoms of degenerative disc disease, Dr. Canavati
recommended conservative treatment, finding that Adams was
not an ideal candidate for surgery, and he believed her
obesity was “a big part of the problem.” [Tr.
2015, Adams was examined by a consultative examiner, Dr. H.M.
Bacchus, who opined that Adams appeared capable of performing
light duties and standing for a total of two to three hours
in a six to eight-hour day, although not continuously. [Tr.
634.] Other than stating Adams should not climb ladders, work
on uneven ground or in unprotected heights, Dr. Bacchus did
not make any other comments about any postural limitations
that Adams might have.
2015, Fernando Montoya, M.D., the state agency consultant,
completed a residual capacity assessment. Dr. Montoya opined
that Adams could perform a light range of exertional level
work. Specifically, he found Adams could lift and/or carry up
to 20 pounds occasionally and up to 10 pounds frequently.
[Tr. 86-87.] Further, he determined that Adams could stand
and/or walk for two hours and sit for about six hours during
an eight-hour work day. [Tr. 87.] Dr. Montoya agreed that
Adams should not climb ladders, ropes, or scaffolds but could
occasionally climb ramps and stairs as well as kneel, crouch,
and crawl. [Tr. 87.] In September 2015, B. Whitley, M.D.,
another consultative examiner, affirmed Dr. Montoya's
assessment at the reconsideration level. [Tr. 99, 20.]
February 2017, Adams had decreased range of motion and
swelling in both knees, but the x-ray images that were taken
showed no acute abnormalities. [Tr. 799-800.] In March 2017,
Adams was diagnosed with patellofemoral syndrome and
prescribed a knee brace, but was also advised about the
importance of weight management and knee strengthening. [Tr.
found that Adams could perform past relevant work as a
caseworker and, in the alternative, could perform other work
that exists in significant numbers in the national economy.
first argument, and the one that is dispositive for this
case, is that the ALJ failed to adequately connect the
evidence with her finding that Adams was not disabled. It is
by now well settled that when an ALJ recommends that the
Agency deny benefits, the ALJ must “provide a logical
bridge between the evidence and [her] conclusions.”
Terry v. Astrue, 580 F.3d 471, 475 (7th Cir. 2009)
(internal quotation marks and citation omitted). Although the
ALJ is not required to address every piece of evidence or
testimony presented, “as with any well-reasoned
decision, the ALJ must rest its denial of ...