United States District Court, N.D. Indiana, South Bend Division
OPINION AND ORDER
Julie Suetkamp (“Ms. Suetkamp”) appeals the
denial of her application for social security disability
insurance benefits. For the following reasons, the Court will
remand this matter to the Commissioner for further
proceedings consistent with this opinion.
Suetkamp filed an application for disability insurance
benefits on November 3, 2014, alleging disability beginning
on February 1, 2012. Ms. Suetkamp suffers from various severe
impairments including acute pancreatitis, headaches,
compression fracture of the T12 vertebrae body, chiari
malformation,  and major depressive disorder. Ms.
Suetkamp has also been diagnosed with anxiety, insomnia, and
significant, for purposes of this discussion, is the
limitations caused by Ms. Suetkamp's acute pancreatitis.
Medical records demonstrate that Ms. Suetkamp has suffered
from chronic pancreatitis since at least 2001. After
undergoing pancreatobiliary sphincterotomies and abdominal
injections/blocks, Ms. Suetkamp still required Percocet,
Vicodin, and increasing doses of Fentanyl from 2002 to 2006
to keep her pain stable. From 2006 to 2010, it was reported
that Ms. Suetkamp went to the emergency room about once every
year for four days each time due to increased abdominal pain.
In May 2010, Ms. Suetkamp began reporting intensified pain,
and by September 2011, she had a nerve stimulator inserted in
order to help control it. By June 2012, it was reported that
while Ms. Suetkamp was managing her pain with the nerve
stimulator, she could not get her nausea under control.
Medical records reveal that despite Ms. Suetkamp's desire
to “avoid hospitalization, ” she was hospitalized
at least four times in 2013, two times in 2014, and one time
in 2016 on account of her acute pancreatitis marked by severe
abdominal pain and sustained vomiting.
December 22, 2014, the examining state agent, Dr. Gupta,
documented that Ms. Suetkamp had recently lost her insurance
and was unable to afford all of her treatment. It was noted
that Ms. Suetkamp presented with headaches, abdominal pain,
nausea, and vomiting. Dr. Gupta opined that Ms. Suetkamp
suffered from a history of headaches, chiari malformation,
and chronic pancreatitis since 1999. Dr. Gupta did not assess
Ms. Suetkamp's functional limitations or ability to work.
Thereafter, reviewing state agents opined on December 31,
2014 and February 25, 2015, that Ms. Suetkamp was capable of
performing medium exertional work despite her ailments.
February 20, 2015, treating physician Dr. Glen Lehman wrote a
letter indicating that at the time he last treated Ms.
Suetkamp in 2012, she suffered from chronic pancreatitis
which required daily narcotics and nausea medication. He
noted that her pain was aggravated by most physical
activities and that she was unable to walk/stand for more
than fifteen or twenty minutes. Dr. Lehman opined that her
condition often necessitates being hospitalized for three to
ten days, missing work for five days per month, and taking
numerous daily breaks to manage the symptoms.
22, 2017, Administrative Law Judge Lovert Bassett
(“ALJ”) held a hearing during which Ms. Suetkamp,
an impartial medical expert (“ME”), and a
vocational expert (“VE”) testified. Ms. Suetkamp
testified that she stopped working as an office assistant in
2012 because she was missing too much work as a result of her
pancreatic flare-ups and chronic pain. Despite being on pain
and nausea medication, approximately every few months Ms.
Suetkamp's breakthrough pain and uncontrollable vomiting
lands her in the emergency room. In addition, at least twice
a month she suffers from pancreatic flare-ups which involve
severe stabbing pain, vomiting, and loss of focus for three
to seven days, but she avoids going to the emergency room
because she does not have insurance. Ms. Suetkamp's bad
days are unpredictable but seem to be aggravated by too much
activity and eating food that doesn't agree with her
body. Her typical day involves mostly laying down and trying
to do a little cleaning with long hourly
breaks. Her specialist is considering whether Ms.
Suetkamp should have a feeding tube inserted in order to
relieve some of the pain.
the administrative hearing, the ME indicated that based on
his review of the medical record, he believed that Ms.
Suetkamp suffered from a history of “chronic”
recurrent/relapsing pancreatitis “more prevalent and
more symptomatic in 2012 and 2013, [and] presumably more
chronic right now at this time.” R. at 44-50. By the
term “chronic, ” the ME meant that Ms.
Suetkamp's severe episodes occur from “a few to six
times a year, ” with intermittent acute processes
likely requiring hospital admissions. While the ME opined
that Ms. Suetkamp was physically capable of performing the
demands of light work, he also agreed that when Ms. Suetkamp
suffers from a flare-up it would be difficult for her to
complete tasks and focus. The ME also admitted that Ms.
Suetkamp's medical records and testimony supported her
having flare-ups every several months and suffering from
severe pain even when she doesn't go to the emergency
room. Also, during the hearing, the VE testified that if Ms.
Suetkamp missed more than ten days of work per year or was
off-task more than ten percent of the workday, then she could
not maintain competitive employment.
this evidence, the ALJ concluded that Ms. Suetkamp was
capable of performing light work (with other exertional
limitations and the ability to understand, remember, and
carry-out detailed instructions). This finding meant that Ms.
Suetkamp could perform her past work as an administrative
clerk, per the VE's testimony. Given this determination,
the ALJ denied Ms. Suetkamp's claim for disability
benefits. Once the Appeals Council denied her request for
review, the ALJ's decision became the final determination
of the Commissioner. Schomas v. Colvin, 732 F.3d
702, 707 (7th Cir. 2013). Ms. Suetkamp seeks review of the
Commissioner's decision, thereby invoking this
Court's jurisdiction under 42 U.S.C. §§ 405(g)
STANDARD OF REVIEW
Court will affirm the Commissioner's findings of fact and
denial of disability 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). Thus, 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
substantial-evidence determination, 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 the ALJ's findings. Zurawski v.
Halter, 245 F.3d 881, 888 (7th Cir. 2001). Consequently,
an ALJ's decision cannot stand if it lacks evidentiary
support or an adequate discussion of the issues.
Lopez, 336 F.3d at 539. Ultimately, while the ALJ is
not required to address every piece of evidence or testimony
presented, the ALJ must provide a “logical
bridge” between the evidence and the conclusions.
Terry v. Astrue, 580 F.3d 471, 475 (7th Cir. 2009).