The opinion of the court was delivered by: Magistrate Judge Nan R. Nolan
MEMORANDUM OPINION AND ORDER
Plaintiff Bonnie Jo Lamont filed this action seeking review of the final decision of the Commissioner of Social Security ("Commissioner") denying her application for Disability Insurance Benefits ("DIB") and Supplemental Security Income ("SSI") under Titles II and XVI of the Social Security Act ("SSA"). 42 U.S.C. §§ 416, 423(d), 1381a. The parties have consented to the jurisdiction of the United States Magistrate Judge, pursuant to 28 U.S.C. § 636(c), and have filed cross-motions for summary judgment. For the reasons stated below, this case is remanded for further proceedings consistent with this opinion.
I. THE FIVE-STEP SEQUENTIAL EVALUATION PROCESS
To recover Disability Insurance Benefits ("DIB") or Supplemental
Security Income ("SSI") under Titles II and XVI of the SSA,*fn1
a claimant must establish that he
or she is disabled within the meaning of the SSA. York v. Massanari,
155 F. Supp. 2d 973, 977 (N.D. Ill. 2001); Keener v. Astrue, No. 06 C
0928, 2008 WL 687132, at *1 (S.D. Ill. 2008). A person is disabled if
he or she is unable to perform "any substantial gainful activity by
reason of any medically determinable physical or mental impairment
which can be expected to result in death or which has lasted or can be
expected to last for a continuous period of not less than 12 months."
20 C.F.R. §§ 404.1505(a), 416.905(a). In determining whether a
claimant suffers from a disability, the ALJ conducts a standard
1. Is the claimant presently unemployed?
2. Does the claimant have a severe medically determinable physical or mental impairment that interferes with basic work-related activities and is expected to last at least 12 months?
3. Does the impairment meet or equal one of a list of specific impairments enumerated in the regulations?
4. Is the claimant unable to perform his or her former occupation?
5. Is the claimant unable to perform any other work?
20 C.F.R. §§ 404.1509, 404.1520, 416.909, 416.920; see Clifford v. Apfel, 227 F.3d 863, 868 (7th Cir. 2000). "An affirmative answer leads either to the next step, or, on Steps 3 and 5, to a finding that the claimant is disabled. A negative answer at any point, other than Step 3, ends the inquiry and leads to a determination that a claimant is not disabled." Zalewski v. Heckler, 760 F.2d 160, 162 n.2 (7th Cir. 1985). "The burden of proof is on the claimant through step four; only at step five does the burden shift to the Commissioner." Clifford, 227 F.3d at 868.
Plaintiff applied for DIB and SSI on February 11, 2005, alleging she
became disabled on December 1, 1998, due to cyclothymia*fn2
and bipolar disorder. (R. at 27, 109, 111, 126.) The
application was denied initially and on reconsideration, after which
Plaintiff filed a timely request for a hearing. (Id. at 27, 75--78,
On July 10, 2007, Plaintiff, represented by counsel, testified at a hearing before an Administrative Law Judge ("ALJ"). (R. at 27, 37--74.) The ALJ also heard testimony from James Breen, a vocational expert ("VE").*fn3 (Id.)
The ALJ denied Plaintiff's request for benefits on September 21, 2007. (R. at 27-- 36.) Applying the five-step sequential evaluation process, the ALJ found, at step one, that Plaintiff has not engaged in substantial gainful activity since December 1, 1998, her alleged onset date. (Id. at 29.) At step two, the ALJ found that Plaintiff's history of a bipolar disorder and a history of substance abuse are severe impairments. (Id. at 30) At step three, the ALJ determined that Plaintiff's impairments did not meet or medically equal the severity of any of the listings enumerated in the regulations. (Id.)
The ALJ then assessed Plaintiff's residual functional capacity ("RFC")*fn4 and determined that Plaintiff has the RFC to perform a full range of work at all exertional levels but with the following non-exertional limitations: [Plaintiff], as a result of her moderate limitations related to her bipolar disorder and history of substance abuse, is limited to unskilled work and only occasional contact with the public, co-workers and supervisors.
(R. at 31.) Based on Plaintiff's RFC and the VE's testimony, the ALJ determined at step four that Plaintiff could not perform any past relevant work. (Id. at 35.) At step five, based on Plaintiff's RFC, her vocational factors and the VE's testimony, the ALJ determined that there are jobs that exist in significant numbers in the regional economy that Plaintiff can perform, including work as a warehouse worker, janitor, housekeeper, handpacker, eye glass assembler, and small products assembler. (Id. at 36.) Accordingly, the ALJ concluded that Plaintiff was not suffering from a disability as defined by the SSA. (Id.)
The Appeals Council denied Plaintiff's request for review on May 13, 2008. (R. at 12--15.) Plaintiff now seeks judicial review of the ALJ's decision, which stands as the final decision of the Commissioner. Villano v. Astrue, 556 F.3d 558, 561--62 (7th Cir. 2009).
Judicial review of the Commissioner's final decision is authorized by § 405(g) of the SSA. In reviewing this decision, the Court may not engage in its own analysis of whether the plaintiff is severely impaired as defined by the Social Security Regulations. Young v. Barnhart, 362 F.3d 995, 1001 (7th Cir. 2004). Nor may it "reweigh evidence, resolve conflicts in the record, decide questions of credibility, or, in general, substitute [its] own judgment for that of the Commissioner." Id. The Court's task is "limited to determining whether the ALJ's factual findings are supported by substantial evidence." Id. (citing 20 C.F.R. § 405(g)). Evidence is considered substantial "if a reasonable person would accept it as adequate to support a conclusion." Indoranto v. Barnhart, 374 F.3d 470, 473 (7th Cir. 2004). "Substantial 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). "In addition to relying on substantial evidence, the ALJ must also explain his analysis of the evidence with enough detail and clarity to permit meaningful appellate review." Briscoe ex rel. Taylor v. Barn-hart, 425 F.3d 345, 351 (7th Cir. 2005).
Although this Court accords great deference to the ALJ's determination, it "must do more than merely rubber stamp the ALJ's decision." Scott v. Barnhart, 297 F.3d 589, 593 (7th Cir. 2002) (citation omitted). The Court must critically review the ALJ's decision to ensure that the ALJ has built an "accurate and logical bridge from the evidence to his conclusion." Young, 362 F.3d at 1002. Where the Commissioner's decision "lacks evidentiary support or is so poorly articulated as to prevent meaningful review, the case must be remanded." Steele v. Barnhart, 290 F.3d 936, 940 (7th Cir. 2002).
A. The Relevant Medical Evidence
On December 17, 2001, Plaintiff complained of depression, stating to Jennifer McGowan, M.D. that she has been depressed for a "long time." (R. at 511.) She reported "spurts" of depression, poor concentration and anxiety. (Id.) Although Plain- tiff had been previously prescribed Zoloft and Lithium, she was not presently taking any medications for her depression. (Id.) Dr. McGowan observed "pressured"*fn5 and "quick" speech, poor concentration, and anxiety/mania. (Id.) She prescribed Paxil and recommended counseling.*fn6 (Id.)
On February 15, 2002, Plaintiff reported that she had stopped using Paxil because of fatigue and drowsiness. (R. at 513.) On examination, Dr. McGowan observed erythema and hives (id. at 511), which are serious side effects from taking Paxil, see MedlinePlus. She diagnosed depression, mild to moderate, discontinued Paxil and prescribed Zoloft. (R. at 513.)
On October 9, 2004, Plaintiff walked into the emergency room at Good Samaritan Hospital complaining of depression and polysubstance abuse. (R. at 234.) She reported being unemployed and homeless, after selling her home to pay for her alcohol and cocaine addictions. (Id.) She had been diagnosed with bipolar disorder six years prior and prescribed Lithium, but presently she did not have a prescription. (Id. at 237.) The examining doctor observed that depression and suicidal ideation was present. (Id. at 234.) On discharge, Plaintiff was diagnosed with polypharmacy abuse and depression with a history of bipolar disorder and anxiety. (Id. at 230.)
Plaintiff began treating with the DuPage County Health Department in October 2004. (R. at 410.) On October 11, 2004, Susan P. Levine, M.D., conducted a psychiatric crisis evaluation. (Id. at 226--27.) Plaintiff reported cyclical manic/depression mood changes since the age of 13 and a family history of bipolar disorder and alcoholism. (Id. at 227.) Dr. Levine found Plaintiff's mood depressed and her affect sad but appropriate. She diagnosed bipolar disorder, mixed, alcohol dependence and cocaine dependence. (Id. at 226.) Dr. Levine prescribed Depakote*fn7 and asked Plaintiff to return in two weeks. (Id.)
On October 25, 2004, Plaintiff reported being alcohol and drug free for 19 days. (R. at 226.) However, she noticed no improvement in her mood with Depakote and had begun getting hives.*fn8 (Id.) Benadryl was prescribed to counteract the hives. (Id. at 225.) Plaintiff failed to make her November 8, 2004 appointment and did not call. (Id.) On December 13, 2004, Plaintiff reported being drug free but acknowledged drinking alcohol on one day, although it did not feel good. (Id.) She reported being anxious in general but stated that the Depakote keeps her calmer. (Id.) Plaintiff stated that she no longer had hives but was now experiencing photophobia and blurred vision.*fn9 (Id.) Dr. Levine concluded that Plaintiff's mood was better but "not entirely stable." (Id. at 224.)
On January 14, 2005, an adult clinical evaluation was performed.*fn10 (R. at 192--98.) The evaluation revealed that Plaintiff was attempting to cope with many psychosocial stressors, including custody/placement issues, homelessness, illnesses, legal problems, substance abuse, unemployment, and financial problems. (Id. at 192.) On examination, Plaintiff exhibited fair insight, depressed and anxious mood, hyperactive motor activity, spontaneous speech, circumstantial thought process, mildly impaired judgment, impaired remote memory, and good to fair problem solving. (Id. at 195.)
Plaintiff began treating with psychiatrist Todd H. Kasdan, M.D. on January 27, 2005. (R. at 219.) Plaintiff described a history of symptoms that Dr. Kasdan found were "consistent with depressive episodes consisting of sad mood, insomnia, low energy level, difficulties with concentration, increased appetite, anhedonia,*fn11 and withdrawn type behavior/feelings." (Id.) Plaintiff also described anxiety and symptoms consistent with "hypomanic to manic type episodes consisting of extremely high energy with low number of hours of sleep, extreme distractibility, increased goal directed activity, racing thoughts, talking fast, and impulsivity (in terms of money, purchasing of cars and spur of the moment vacations)." (Id.) While these symptoms are consistent with alcohol and drug dependence, Plaintiff reported that these mood and anxiety symptoms occur not only when she is intoxicated but also when she is abstinent. (Id.) On examination, Dr. Kasdan found Plaintiff's mood mildly irritable, thought process circumferential to logical and sequential,*fn12 and concentration fair. (Id. at 220). He diagnosed bipolar disorder, mixed; alcohol dependence; cocaine dependence, in early full remission; and cannabis abuse. (Id. at 221.) Dr. Kasdan assigned a Global Assessment of Functioning ("GAF") score of 51--55.*fn13 (Id.) Despite experiencing side effects like blurred vision, hair loss and weight gain, Plaintiff elected to continue on Depakote. (Id. at 219, 221.)
On February 10, 2005, Plaintiff reported an increase in outside psychosocial stress. (R. at 216.) She continued to experience side effects from the Depakote, including blurred vision, hair loss and weight gain. (Id.) On examination, Dr. Kasdan found Plaintiff's mood mildly irritable to euthymic and her thought process circumferential to logical and sequential. (Id.) Because of the side effects and the "lack of even low partial [therapeutic] response," Dr. Kasdan discontinued Depakote and prescribed Lamictal.*fn14 (Id. at 217.)
On February 24, 2005, Plaintiff reported continued psychosocial stressors- homelessness, lack of funds-and vision problems from her medication.*fn15 (R. at 213.) On examination, Dr. Kasdan noted both depressive and hypomanic/manic symptoms, as well as general anxiety. (Id.) He found Plaintiff's mood mildly irritable to dysphoric to euthymic, her thought process intact to circumstantial, and assigned a GAF score of 50--55.*fn16 (Id. at 214--15.)
On March 11, 2005, Dr. Kasdan found that Plaintiff's response to her
medication had worsened. (R. at 211.) Despite continued abstinence
from drugs and alcohol, Plaintiff's speech was normal to pressured,
mood normal to euphoric, thought process circumstantial, judgment
mildly impaired, insight fair, and problem solving fair. (Id.) Dr.
Kasdan concluded that Plaintiff's symptoms were being exacerbated by
economic, healthcare, occupational, social/environmental, support
group, and housing stressors. (Id. at 212.) He assigned a GAF score of
40--50,*fn17 and prescribed Tegretol.*fn18
On March 17, 2005, Plaintiff reported mild drowsiness from the Tegretol. (R. at 208.) Despite her improved therapeutic response to the Tegretol (id.), Dr. Kasdan concluded that her ...