Argued: February 24, 2014.
Appeal from the United States District Court for the Northern District of Indiana, Fort Wayne Division. No. 1:12 CV 00246 -- Roger B. Cosbey, Magistrate Judge.
For Kip Yurt, Plaintiff - Appellant: William L. Fouche Jr., Law Office of William Fouche, Dallas, TX.
For CAROLYN W. COLVIN, Acting Commissioner of Social Security, Defendant - Appellee: Jared Christian Jodrey, Attorney, Edward J. Kristof, Attorney, Social Security Administration, Office of the General Counsel, Region V, Chicago, IL.
Before FLAUM and ROVNER, Circuit Judges and KENDALL, District Judge.[*]
Rovner, Circuit Judge.
Kip Yurt suffers from a psychotic disorder which causes him to experience, among other things, auditory hallucinations and bouts of uncontrollable rage. He also struggles with obsessive compulsive disorder, moderately severe chronic obstructive pulmonary disease (" COPD" ), and chronic bifrontal tension headaches. As a result, he applied for Disability Insurance Benefits from the Social Security Administration, but an Administrative Law Judge (" ALJ" ) denied his application. After the Appeals Council declined to review the ALJ's decision, Yurt sought review in the district court pursuant to 42 U.S.C. § 405(g). A magistrate judge affirmed the decision of the ALJ, and Yurt appeals, arguing principally that the ALJ erred by failing to include many of his medical limitations in the hypothetical that she posed to the vocational expert (" VE" ). Yurt contends that the flawed hypothetical led the VE and the ALJ to erroneously conclude that he could be gainfully employed. For the reasons discussed below, we reverse the judgment of the district court and remand to the agency for further proceedings.
Yurt applied for disability in February 2011, alleging disability beginning on August 4, 2010. The Social Security Administration denied both Yurt's claim and his request for reconsideration. On his application for a hearing with an ALJ, Yurt noted that he had worked in the past in various capacities as a cook and a janitor. His final job at the " substantial gainful activity" level effectively ended in May 2010, when he had some sort of break with reality. He was taken to the emergency room and subsequently placed on medical leave for several months. Shortly after he returned to work in August 2010, he threatened a coworker with a knife, which led, unsurprisingly, to his termination.
Between the episode at the hospital in May 2010 and the date of his hearing with the ALJ on April 3, 2012, Yurt saw a number of different physicians and therapists and attempted at least one other job. The May 2010 incident occurred at Parkview Noble Hospital, where Yurt had worked in the kitchen for several years when he was found " wandering the halls" without any memory of how he had gotten there. After being taken to the emergency room, he was referred to a neurologist, Dr. Madhav Bhat, who treated him on July 1, 2010. Dr. Bhat suggested weaning Yurt off an anti-seizure medicine he had been
taking and doubling the dosage of Prozac Yurt was already taking for depression. Dr. Bhat recognized that Yurt suffered from " [r]ecurrent episodes of altered awareness of surroundings," and diagnosed Yurt's nearly daily recurring bifrontal pain in his head as a chronic tension headache. He concluded that Yurt should remain on medical leave from work for the time being.
Yurt returned to work that August, but reported that Parkview fired him shortly thereafter because " they were really afraid that he might hurt other people" and because he was accused of holding up a knife and threatening coworkers. On August 13, 2010, Yurt saw psychiatrist Dr. Frank Shao, who concluded that Yurt's frequent self-described " black outs" were difficult to diagnose precisely. Dr. Shao recommended that Yurt obtain a second opinion and prescribed Lamictal in slowly increasing dosages to help Yurt's " mood lability and violent behaviors." He recognized that Yurt may have a " certain risk of violence to himself and others" because of his urges and history of aggression, but deemed the risk not to be " acute." He assigned Yurt a Global Assessment of Functioning (" GAF" ) score of 40 to 50. This GAF score correlates with " [s]erious symptoms ... or any serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job)." Am. Psychiatric Ass'n, Diagnostic & Statistical Manual of Mental Disorders 32 (4th ed. text revision 2000).
Yurt then attempted to work part-time as a cook at St. Francis School. Although the record is short on specifics, it appears that Yurt lost this job on account of again threatening a coworker. This likely corresponds to the beginning of December 2010, when Yurt called Dr. Shao's office and reported grabbing a co-worker by the throat. He did not remember the details because he had blacked out.
Later that same month, he was admitted to the hospital for psychiatric evaluation. Dr. Shao reported that Yurt was hearing voices telling him to " kill people" and that he was afraid to go outside because the voice in his head (which he called " Alex" ) was instructing him to " randomly hurt people." Dr. Shao described Yurt as " disheveled" and assessed his GAF score to be between 25 to 30. This corresponds to behavior that is " considerably influenced by delusions or hallucinations or serious impairment in communication or judgment (e.g., sometimes incoherent, acts grossly inappropriately, suicidal preoccupation) or inability to function in almost all areas (e.g., stays in bed all day; no job, home, or friends)." Id. Dr. Shao recommended inpatient treatment for what he expected would be one to two weeks. He also increased Yurt's dosage of Celexa (an antidepressant) and continued him on Lamictal (an anticonvulsant used to treat both epilepsy and bipolar disorder) as well as Seroquel (another medication for bipolar disorder). Despite Dr. Shao's estimation ...