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Gilbert Ex Rel. Edwards v. Colvin

United States District Court, Seventh Circuit

August 29, 2013

JAMIE GILBERT, o/b/o S.E., ex rel. SCOTT EDWARDS Plaintiff,
CAROLYN COLVIN Commissioner of Social Security, Defendant.


DANIEL G. MARTIN, Magistrate Judge.

Jamie Gilbert ("Plaintiff") filed this action on behalf of S.E., the minor child of Scott Edwards. Edwards himself died of unspecified causes after the Administrative Law Judge ("ALJ") issued her decision denying his disability claim. Ms. Gilbert seeks judicial review of a final decision of the Commissioner of Social Security ("Commissioner") that denied Scott Edwards' claim for Social Security Income and Disability Insurance Benefits under Title XVI of the Social Security Act. 42 U.S.C. § 1382(c). Plaintiff has filed a motion for summary judgment, and the Commissioner has filed a cross-motion. The parties have consented to have this Court conduct all proceedings in this case, including an entry of final judgment. 28 U.S.C. § 636(e); N.D.Ill. R. 73.1(c). For the reasons discussed below, Plaintiff's motion [38] is granted, and the Commissioner's motion [47] is denied.

I. Legal Standard

A. The Social Security Administration Standard

In order to qualify for disability benefits, a claimant must demonstrate that he is disabled. An individual does so by showing that he cannot "engage in 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." 42 U.S.C. § 4243(d)(1)(A). Gainful activity is defined as "the kind of work usually done for pay or profit, whether or not a profit is realized." 20 C.F.R. § 404.1572(b).

The Social Security Administration ("SSA") applies a five-step analysis to disability claims. See 20 C.F.R. § 404.1520. The SSA first considers whether the claimant has engaged in substantial gainful activity during the claimed period of disability. 20 C.F.R. § 404.1520(a)(4)(i). It then determines at Step 2 whether the claimant's physical or mental impairment is severe and meets the twelve-month durational requirement noted above. 20 C.F.R. § 404.1520(a)(4)(ii). At Step 3, the SSA compares the impairment (or combination of impairments) found at Step 2 to a list of impairments identified in the regulations ("the Listings"). The specific criteria that must be met to satisfy a Listing are described in Appendix 1 of the regulations. See 20 C.F.R. Pt. 404, Subpt. P, App. 1. If the claimant's impairments meet or "medically equal" a Listing, the individual is considered to be disabled, and the analysis concludes; if a Listing is not met, the analysis proceeds to Step 4. 20 C.F.R. § 404.1520(a)(4)(iii).

Before addressing the fourth step, the SSA must assess a claimant's residual functional capacity ("RFC"), which defines his exertional and non-exertional ability to work. The SSA then determines at the fourth step whether the claimant is able to engage in any of his past relevant work. 20 C.F.R. § 404.1520(a)(4)(iv). If the claimant can do so, he is not disabled. Id. If the claimant cannot undertake past work, the SSA proceeds to Step 5 to determine whether a substantial number of jobs exist that the claimant can perform in light of his RFC, age, education, and work experience. An individual is not disabled if he can do work that is available under this standard. 20 C.F.R. § 404.1520(a)(4)(v).

B. Standard of Review

A claimant who is found to be "not disabled" may challenge the Commissioner's final decision in federal court. Judicial review of an ALJ's decision is governed by 42 U.S.C. § 405(g), which provides that "[t]he findings of the Commissioner of Social Security as to any fact, if supported by substantial evidence, shall be conclusive." 42 U.S.C. § 405(g). Substantial evidence is "such evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401 (1971). A court reviews the entire record, but it does not displace the ALJ's judgment by reweighing the facts or by making independent credibility determinations. Elder v. Astrue, 529 F.3d 408, 413 (7th Cir. 2008). Instead, the court looks at whether the ALJ articulated an "accurate and logical bridge" from the evidence to her conclusions. Craft v. Astrue, 539 F.3d 668, 673 (7th Cir. 2008). This requirement is designed to allow a reviewing court to "assess the validity of the agency's ultimate findings and afford a claimant meaningful judicial review." Scott v. Barnhart, 297 F.3d 589, 595 (7th Cir. 2002). Thus, even if reasonable minds could differ as to whether the claimant is disabled, courts will affirm a decision if the ALJ's opinion is adequately explained and supported by substantial evidence. Elder, 529 F.3d at 413 (citation omitted).

II. Background Facts

A. Medical History

Edwards' medical records indicate a history of psychiatric treatment beginning at least in June 2004. Edwards began seeing psychiatrist Dr. Zenaida Vivar at that point for depression, though he was already on the antidepressant medication Zoloft at the time the record in this case begins. Dr. Vivar noted that his mood was appropriate and that he did not have suicidal thoughts. Numerous treatment notes throughout 2004, 2005, and 2006 contain the same assessment. (R. 283-87). The last note in the record, dated January 2008, suggests a change in Edwards' mental status. Dr. Vivar noted that he appeared depressed, though she reiterated that he did not have suicidal thoughts. (R. 267).

Edwards was also treated in a group setting. Notes from the group meetings, as well as Dr. Vivar's comments, reported that Edwards was not experiencing any side effects from his medication, that he was doing well, and that he had no thought disorders. The primary changes in the treatment notes throughout 2006 and 2007 involved increased dosages of Zoloft. By October 2007, Dr. Vivar had raised Edwards' medication from 100 mg. to 200 mg. each day. (R. 268).

The record does not indicate what treatment Edwards received after his January 2008 appointment with Dr. Vivar. By April 2009, however, his condition appears to have deteriorated. Edwards was admitted to the Hartgrove Hospital at that time because of suicidal thoughts that he was experiencing. Dr. Bernardo Livas stated that Edwards appeared very depressed, suspicious, and paranoid. (R. 358-61). Edwards reported that he had stopped taking his medication for several weeks. He was treated with Zoloft and other medications, and was released one week later for outpatient care with psychiatrist Dr. Piyush Buch and counselor Timothy Jenkins. Dr. Livas diagnosed Edwards on discharge as suffering from recurring major depression, alcohol abuse, and back pain. (R. 347-49).

After he was discharged, Edwards continued psychiatric treatment with Dr. Buch from January through September 2010. The nature of that treatment is not entirely clear, as Dr. Buch's short treatment notes are difficult to read. However, they contain Edwards' own self-reported feelings, as well as Dr. Buch's comments. These notes suggest that Edwards was experienced increasing levels of distress, though few details are available. He stated at each treatment session, for example, that "everything" was stressful to him and that he had felt at times like hurting himself or others. (R. 387-99). For his part, Dr. Buch checked a box on the treatment notes indicating that Edwards was not having suicidal or homicidal thoughts. Nevertheless, Dr. Buch prescribed Edwards an extensive array of antidepressants, antipsychotics, tranquilizers, and sleep medications during this period. These included sertraline (Zoloft), clonazepam (Klonopin), lithium carbonate (Eskalith), zolpidem (Ambien), bupropion (Wellbutrin), alprazolam (Xanax), risperidone (Risperdal), mirtazapine (Remeron), Lunesta, Cymbalta, trazadone (Desyrel), doxepin (Sinequan), sulfa tablets, and hydrocodone (Vicodin). (R. 385-86).

B. Medical Expert Reports

Dr. Buch issued a very brief letter concerning Edwards in November 2010. He stated that Edwards was unable to work due to his major depressive disorder and that he suffered from severe depression. (R. 384).

On December 15, 2004, state agency physician Dr. Marva Dawkins issued a Psychiatric Review Technique ("PRT") analysis of Edwards' condition. She found that Edwards suffered from depression. He was assessed with a mild restriction in his activities of daily living, and moderate restrictions in his social functioning and ability to maintain concentration, persistence, and pace. (R. 312). No episodes of decompensation were noted. Dr. Marva also issued a mental RFC that found moderate limitations in Edwards' ability to understand detailed instructions, to be punctual, to work a normal workday, and to get along with co-workers. (R. 316-17). Dr. Michael Kovar later agreed with these findings on review. (R. 338-42).

Dr. Herman Langner examined Edwards on behalf of the SSA and issued a report in January 2009. Edwards told Dr. Langner that he suffered from suicidal thoughts, that he felt like sleeping for long periods, and generally "feels horrible." Dr. Langner diagnosed Edwards with depression NOS (not otherwise specified). He assigned Edwards a Global Assessment of Functioning ("GAF") score of 40.[1] (R. 299-301).

C. Hearing Testimony

Edwards appeared before ALJ Kim Soo Nagle at a hearing held on January 21, 2011. He was 32 years old at the time of the hearing. Edwards was single and the father of one child. He had been living with his mother before they were evicted from their trailer. Edwards was currently living with a friend after having recently lived under a viaduct. Edwards described his primary difficulty as anxiety. He stated that he was ordinarily "petrified" to leave the house, despite the medications he took daily to control his anxiety and depression. His primary activity involved watching television. Edwards liked to sit alone in his room with a only a candle for light and to take deep breaths. At times, he needed to lock his bedroom door and hide under the covers of his bed. According to Edwards, "nothing could happen to me" as long as he remained alone in his room. (R. 75).

Edwards stated that his mother, friends, and his girlfriend performed the majority of his daily chores such as food preparation and routine purchases. Cash registers made him too nervous to complete most transactions for himself. Edwards feared that everyone in public looked at him "funny" and could read his thoughts. He described his limitations as emotional, rather than physical, in nature. In particular, he experienced severe anxiety around strangers and did not like working around ...

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