United States District Court, N.D. Illinois, Eastern Division
MEMORANDUM OPINION AND ORDER
SIDNEY I. SCHENKIER, Magistrate Judge.
Plaintiff Gregory Bell has filed a motion seeking reversal or remand of a determination by the Commissioner of Social Security denying him Disability Insurance Benefits ("DIB") (doc. # 13), and the Commissioner has filed a motion to affirm (doc. # 22). For the following reasons, we grant Mr. Bell's motion for remand, and deny the Commissioner's motion to affirm.
Mr. Bell filed for benefits on March 4, 2010, alleging that he became disabled on June 8, 2007, when he suffered a myocardial infarction (heart attack) days before his fifty-seventh birthday (R. 13, 141, 320). Mr. Bell also has a history of low back pain, and he was diagnosed with acute cervical disc radiculopathy in 2006 (R. 294, 339). He has not worked since his heart attack (R. 32-33). At his hearing before an administrative law judge ("ALJ") on February 7, 2012, Mr. Bell testified that, among other things, he suffers racing heart, tiredness, weakness, dizziness, shortness of breath, and pain and numbness in his hands and neck (R. 36, 40-42). This causes him to fall and drops things so he does not lift, stand, or walk much (R. 40, 44-45). Mr. Bell testified that his mother does the majority of work around the house, and he spends the majority of his time in bed (R. 17).
On March 19, 2012, the ALJ issued a written opinion finding that Mr. Bell was not disabled and denying benefits. The ALJ applied the familiar five-step sequential inquiry for determining disability (R. 13-23). See 20 C.F.R. § 404.1520(a)(4). At Step 1, the ALJ found that Mr. Bell had not engaged in substantial gainful employment since June 8, 2007 (R. 15). At Step 2, she found that Mr. Bell suffered from two severe impairments, "status post myocardial infarction" and "degenerative disc disease, " but that Mr. Bell's impairments did not meet or medically equal a listed impairment under Step 3 (R. 15-16). After discussing a portion of Mr. Bell's medical records from 2007 to 2011, the ALJ determined that Mr. Bell had an RFC to perform medium work, "except that he can frequently climb ramps and stairs, but never climb ladders, ropes, or scaffolds; can frequently balance and stoop; can occasionally kneel, crouch, and crawl; can frequently reach in all directions, including overhead with the upper extremities; and must avoid concentrated exposure to extreme cold and heat, wetness, and humidity" (R. 17).
In reaching that determination, the ALJ noted the results of some stress tests, echocardiograms, electrocardiograms and MRIs taken between 2007 and 2011, and then briefly described some of Mr. Bell's visits to his treating physician, Dr. Mahendra Patel, whom he began seeing before 2007, and continued visiting through 2011 (R. 18). After Mr. Bell suffered his heart attack, Dr. Patel initially restricted him from all work temporarily, and then repeatedly extended his work restrictions ( see, e.g., R. 521-25, 401). In 2008 and 2009, Dr. Patel opined that Mr. Bell was "totally disabled, " finding that the most he could do during that period was sit for two hours and stand for one hour ( see R. 402-06, 568). During that period and extending through 2010, Mr. Bell regularly complained of chest pain, severe (sometimes "excruciating") neck pain that radiated to his upper extremities, headaches, dizziness, weakness, numbness and fatigue (R. 442-66). Dr. Patel gave him regular injections of Depo-Medrol with Xylocaine as well as oral steroids to address his pain, which Dr. Patel described as stemming from acute and chronic cervical (neck) radiculopathy (disease of the spinal nerve roots) and peripheral neuropathy (pain, weakness, and numbness caused by nerve damage) (R. 442-66).
Dr. Patel reported that Mr. Bell repeatedly refused to see a cardiologist and have an angiogram done to evaluate him for coronary artery disease. However, the record shows (and the ALJ noted) that Mr. Bell visited a cardiologist, Dr. Tahir Abbasi, first in December 2007, and then several times in each of the following years through 2011 (R. 18). Dr. Abbasi opined that Mr. Bell suffered recurrent symptoms, including dizziness, shortness of breath, numbness, palpitations, fatigue and chest pain, that would prevent him from returning to his prior work as a CTA bus driver and from doing any other physical work ( see, e.g., R. 423-38, 515).
The ALJ also reviewed the results of independent examinations performed by cardiologists Roderick Childers (in September 2009) and Stuart Greenfield (in May 2011) (R. 19). As the ALJ explained, Mr. Bell told Dr. Childers that he suffered chest pain and tightness, fatigue, dizziness and shortness of breath with palpitations (R. 19, 408-09). Dr. Childers opined that Mr. Bell's continued episodes of chest pain on moderate exertion would limit him to sedentary work as long as those symptoms continued (R. 19, 412-13). By contrast, Dr. Greenfield opined that despite Mr. Bell's reports of continuing chest pain, he could return to work with no restriction from a "cardiac viewpoint" (R. 19-20, 570-72).
The ALJ next reported the results of the internal medicine consultative examination that internist M. S. Patil performed on behalf of the Bureau of Disability Determination Services in June 2010, and the opinions of two non-examining state agency physicians (R. 19-20). During Dr. Patil's forty minute examination, Mr. Bell complained of constant neck pain (rated at a six or seven out of ten) which radiated to other parts of his body, but Dr. Patil found normal range of motion and no other abnormalities (R. 304-06). On June 22, 2010, a state agency medical consultant, Virgilio Pilapil, M.D., reviewed Dr. Patil's report and the June 2007 emergency room records (Mr. Bell's "treating source statements" were not included in the file Dr. Pilapil reviewed) and determined that Mr. Bell could perform medium work (R. 20, 309-10, 314-15). State agency medical consultant Vidya Madala, M.D., affirmed Dr. Pilapil's findings (R. 318).
After reciting this record evidence, the ALJ assigned the following weight to the medical opinions: (1) "great weight" to the opinions of the State agency medical consultants; (2) "little weight" to Dr. Abbasi's opinions; (3) "little weight" to Dr. Patel's opinions; (4) "no weight" to Dr. Childers' opinion; and (5) "some weight" to Dr. Greenfield's opinion (R. 21). The ALJ also found Mr. Bell's statements concerning the intensity, persistence and limiting effects of his symptoms "not fully credible" because despite his testimony that he was severely limited, his treatment had been "routine and conservative" and he was non-compliant in that he delayed seeing a cardiologist and continued to smoke (R. 20). In light of the above, the ALJ determined that Mr. Bell was incapable of performing his past relevant work, but that he could perform other jobs existing in significant numbers in the national economy (R. 22).
"We review the ALJ's decision deferentially only to determine if it is supported by substantial evidence, which we have described as such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Yurt v. Colvin, ___ F.3d ___, No. 13 C 2964, 2014 WL 3362455, at *5 (7th Cir. July 10, 2014) (internal citations and quotations omitted). "Although we will not reweigh the evidence or substitute our own judgment for that of the ALJ, we will examine the ALJ's decision to determine whether it reflects a logical bridge from the evidence to the conclusions sufficient to allow us, as a reviewing court, to assess the validity of the agency's ultimate findings and afford [the claimant] meaningful judicial review. A decision that lacks adequate discussion of the issues will be remanded." Moore v. Colvin, 743 F.3d 1118, 1120-21 (7th Cir. 2014) (internal citations omitted).
Mr. Bell contends that the ALJ erred by improperly rejecting the opinions of his treating physicians and improperly assessing his credibility (doc. #14: Pl.'s Mem. in Supp. of Mot. for Summ. J. ("Pl.'s Mem.") at 7). Additionally, Mr. Bell moves for reversal on the grounds that the Appeals Council improperly rejected his request for review ( Id. ). For the reasons that follow, we find that the ALJ did not properly assess the opinions of Mr. Bell's ...