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Myles v. Astrue

September 9, 2009

CAROLYN MYLES, PLAINTIFF-APPELLANT,
v.
MICHAEL J. ASTRUE, COMMISSIONER OF SOCIAL SECURITY, DEFENDANT-APPELLEE.



Appeal from the United States District Court for the Northern District of Illinois, Eastern Division. No. 07 C 6122-Charles P. Kocoras, Judge.

Per curiam.

ARGUED APRIL 22, 2009

Before MANION, KANNE, and SYKES,Circuit Judges.

Carolyn Myles, who suffers from type-2 diabetes, claims that she is disabled because of symptoms of that disease, and is seeking disability insurance benefits. Her claim was rejected by an administrative law judge. Myles argues before this court that the ALJ failed to consider all of the facts in the record and made improper medical and credibility determinations. The ALJ's opinion contains multiple errors, the cumulative effect of which is to leave us without confidence that the ALJ's decision builds a "logical bridge" between the evidence and his conclusion, and so we vacate and remand for further proceedings.

Myles has had diabetes since at least 2002. Since at least July 2004, her diabetes has been uncontrolled or poorly controlled. In August 2004, Myles saw a physician, Dr. Max Goldschmidt, and at that time, she reported suffering from diarrhea, blurred vision and seeing dots in front of her eyes, frequent urination, and headaches. Myles reported to the doctor that she had not been taking one of her medications, Metformin, on a daily basis, because it gave her diarrhea. Dr. Goldschmidt instructed her not to take it if she could not do so daily, and adjusted her dosage of another medication.

Myles applied for disability insurance benefits in January 2005, claiming that she was unable to work because of her diabetes. That same month she again saw Dr. Goldschmidt. She had been out of her medication for six days and said that she was fatigued. It appears that at this time Dr. Goldschmidt re-prescribed Metformin. Dr. Goldschmidt also signed a letter saying that Myles was unable to work for an "undetermined" period, although he did not give reasons. Dr. Goldschmidt signed several similar letters in January and early February.

At another appointment that January, Myles again complained of frequent urination, and Dr. Goldschmidt discovered she had a urinary tract infection, for which he prescribed an antibiotic. Myles continued to see Dr. Goldschmidt and other doctors regularly, and in March 2005, Dr. Goldschmidt noted that he might need to consider prescribing insulin.

In 2005 a state agency physician examined Myles in relation to her application. The agency physician, Dr. Kale, noted that she had a history of poorly controlled diabetes, polyuria (passage of more than 2.5 liters of urine every 24 hours), nocturia (need to get up at night to urinate), and occasional hand and foot numbness. The examination did not reveal any neurological problems with Myles's hands or feet, and her ability to grasp and grip was not impaired.

In April 2006, Myles complained of hair loss, and Dr. Lovinger at the Lake County Health Department ordered her to stop taking Metformin and to substitute Avandia, which seems to have stopped the hair loss. At that time, Dr. Lovinger noted that Myles was not checking her blood sugar levels regularly and that her diabetes remained uncontrolled.

In August 2006, Myles reported to Dr. Lovinger that she had been suffering from fatigue and muscle weakness. Dr. Lovinger found no neurological problem. Dr. Lovinger noted that Myles may need to start insulin, but at that time he did not prescribe insulin. Instead, he left her on her prior oral medications.

In November 2006, Myles returned to Lake County, complaining of depression, for which she was prescribed Zoloft. She complained again of pain in her feet and legs that month, and, although an examination revealed no motor deficits, she was diagnosed with neuropathy. The doctor also noted that she complained of polyuria at this time. Myles complained to doctors at Lake County of tingling in her fingers the next month.

In May 2007, Dr. James Sims, a physician at Lake County, completed a Medical Assessment of Condition and Ability to Do Work Related Activities at the request of Myles's attorney. Dr. Sims, who had been treating Myles for five years, opined that Myles could stand or walk six to eight hours uninterrupted and sit six to eight hours uninterrupted on "good" days. He also opined that she could lift 25 pounds occasionally and 10 pounds frequently, and prescribed no grasping limitations. But he further opined that Myles would have trouble completing a work day and work week without interruption from her symptoms, and that she could be expected to have "good" and "bad" days.

In June 2007, an administrative law judge held a hearing on Myles's application and found that she was not disabled. Analyzing Myles's claim under the five-step analysis of 20 C.F.R. § 404.1520(a), the ALJ found Myles had not engaged in gainful employment since her onset date; that her diabetes was severe; but that it did not meet or equal any of the impairments listed in Appendix 1, Subpart P, Regulation No. 4 of the Social Security regulations. The ALJ next determined Myles's Residual Functional Capacity, and found that she had marked limitations in her capacity to work and could not continue in any of her past jobs. In assessing her RFC, the ALJ found Myles not to be credible for several reasons: Myles's claims of urinary frequency were unbelievable because, the ALJ noted, she had not complained about them to a doctor since January 2005; she had exaggerated claims of weight loss due to medication, saying she had lost 40 pounds when she really only lost 18; and the ALJ stated that Myles had not complied with her treatment, rendering her claims of severe symptoms less credible.

A vocational expert testified that based on the ALJ's hypothetical questions, Myles could still work in a bench assembly, packager, tester, clerk, or cashier position, and that there were at least 7,500 such positions available. But, the VE added, a person with occasional numbness or tingling of the hands, even as little as a sixth of the day, would not be able to perform these jobs. Further, the VE testified, a person who needed a restroom break at least once an hour would not be able to maintain employment in those jobs. The ALJ determined that Myles did not suffer from hand limitations or frequent urination, found that she could still ...


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