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Suetkamp v. Saul

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

August 27, 2019

ANDREW M. SAUL, Commissioner of Social Security, Defendant.



         Plaintiff 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.

         I. BACKGROUND

         Ms. 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, [1] and major depressive disorder. Ms. Suetkamp has also been diagnosed with anxiety, insomnia, and dysthymic disorder.

         Most 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.

         On 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.

         On 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.

         On May 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.[2] Her specialist is considering whether Ms. Suetkamp should have a feeding tube inserted in order to relieve some of the pain.

         During 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.

         Despite 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) and 1383(c)(3).


         This 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 Cir. 2008).

         In this 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).

         III. ...

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