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Gregory C. Gray v. Michael J. Astrue

January 28, 2011


The opinion of the court was delivered by: Matthew F. Kennelly, District Judge:


Plaintiff Gregory Gray seeks review of the Commissioner of Social Security's decision denying his application for Supplemental Security Income (SSI). Gray has moved for summary judgment, asking the Court to reverse and remand for further consideration. In response, the Commissioner seeks a judgment affirming the denial of benefits. For the reasons stated below, the Court grants Gray's motion and remands the case for further proceedings consistent with this decision.


Gray is a fifty-one year old man with a general equivalency diploma (GED) and some vocational training. He has not worked in any capacity since June 2007, though he received a forklift operator certificate in May 2008 after completing job training. From March 2007 until June 2007, Gray was employed on a temporary basis as an assembly line worker. Before that, he worked in the roofing and shipping industries.

Gray applied for SSI on August 21, 2006. He sought benefits based on a disability that he claimed began on August 1, 2006. The Social Security Administration (SSA) denied his claim initially on October 24, 2006 and again upon reconsideration on January 4, 2007.

Gray then filed a written request for a hearing before an administrative law judge (ALJ) on March 5, 2007. The hearing was held on January 15, 2009 in Chicago. At the hearing, Gray amended the alleged onset date of his disability to July 1, 2007 in light of his employment through June of that year. Gray was represented by counsel. He testified, as did vocational expert (VE) Richard Hammersma. On February 25, 2009, the ALJ determined that Gray was not disabled and denied his claim for benefits.

Gray retained a new attorney and sought review by the SSA's Appeals Council. He also submitted additional medical records that were not part of the record at the time of his hearing before the ALJ. The Appeals Council denied Gray's request for review on January 21, 2010.

1. Summary of medical evidence

The hearing record consists mostly of records from sporadic emergency room visits, reports from physicians who examined Gray's medical records, and occasional notes from treating physicians. This section summarizes the record chronologically.

In September 2006, Dr. Scott Kale performed an internal medicine consultative evaluation of Gray for the SSA. Dr. Kale's cardiac, abdominal, musculoskeletal, neurologic and mental examinations of Gray were normal, but a pulmonary function test revealed moderately severe obstruction with significant improvement following bronchodilator treatment. Dr. Kale's clinical impression was that Gray had a history of chronic obstructive pulmonary disease (COPD) and asthma.

In October 2006, Dr. Frank Jimenez reviewed Gray's medical records and completed a written physical residual functionality assessment of Gray for the SSA. In assessing Gray's ability to work, Dr. Jimenez concluded that Gray would have no exertional limitations but would need to avoid concentrated exposure to fumes, dusts and other respiratory irritants. In December 2006, Dr. Henry S. Bernet reviewed Gray's medical records and affirmed Dr. Jimenez's assessment.

In late 2006, Gray visited hospitals on several occasions with various medical problems. In August, he went to Provident Hospital with coughing and was diagnosed with bronchitis and exacerbation of COPD. In October, he went to Provident Hospital with a toothache and jaw swelling. He also underwent pulmonary function testing at Stroger Hospital, which showed a moderate obstructive ventilatory defect. In November, he again went to Provident Hospital, this time with back pain.

In May 2007, Gray received treatment at Provident Hospital for left shoulder pain after reportedly lifting boxes weighing thirty to forty pounds. The records from this visit contain diagnoses of tendonitis and degenerative joint disease, in addition to COPD, asthma, and emphysema. Additional records dating between August 2007 and October 2008 reflect treatment for COPD, asthma, and other complaints. These records also reveal that Gray continued abusing drugs and smoking cigarettes while receiving treatment.

Records from November 2007 show that Gray reported being hyperenergetic and hyperactive throughout his life. They also note the doctor's clinical impression of "ADHD [attention deficit hyperactivity disorder] v. BPD [bipolar disorder]." R. 276. Gray was referred for mental health treatment and prescribed Lorazepam as needed for one month. Records from May 2008 indicate that Gray had seen a psychiatrist and was taking Prozac and Trazodone but was otherwise feeling well.

In June 2008, Gray saw physicians at Provident Hospital and complained of right shoulder pain and a left wrist ganglion. He was referred to the orthopedics department and prescribed Ibuprofen. Other records show that both of these conditions persisted until at least October 2008. Finally, in October 2008 Gray's treating physician, Dr. Maryam Sanati, completed an "Illinois Department on Aging" form on which she ...

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