United States District Court, N.D. Illinois, Eastern Division
MEMORANDUM OPINION AND ORDER
D. Leinenweber, Judge
Payal Kapoor (“Plaintiff”) filed this Complaint
challenging the determination of the U.S. Social Security
Administration (the “Government”) denying her
disability benefits. Plaintiff and the Government have filed
Cross-Motions for Summary Judgment [ECF Nos. 6 and 17]. For
the reasons stated herein, the Court grants Plaintiff's
Motion in part [ECF No. 6], and denies the Government's
Motion [ECF No. 17], reversing the judgment of the
administrative law judge and remanding the matter for further
proceedings consistent with this opinion.
Kapoor (“Payal”) has a history of mental illness
and suffers from bipolar disorder or schizoaffective
disorder, bipolar type (it is unclear which). (See,
Administrative Record (hereinafter, “AR”) at 64.)
There is no question that she currently suffers from a mental
disability. This case turns on questions regarding her past.
An Administrative Law Judge (“ALJ”) denied Payal
an additional disability entitlement known as disabled
Child's Insurance Benefits (“CIB”). The
availability of CIB is governed by statute at 42 U.S.C.
§ 402(d)(1) and by federal regulation at 20 C.F.R.
404.350(a)(5). Whether a child is entitled to CIB depends
primarily on whether she had a “disability” that
began prior to reaching the age of 22. A disability means
“an inability to engage in any substantial gainful
activity by reason of any medically determinable physical or
mental impairment which . . . has lasted . . . for a
continuous period of not less than 12 months.” 42
U.S.C. § 423(d)(1)(A).
order to be granted CIB, Payal needed evidence that she
suffered from a mental impairment prior to turning 22, on
December 28, 1993. This case is complicated by the fact that,
during this time period, Payal's treatment took place
entirely in India, and the medical records she was able to
obtain are substandard. The records nevertheless paint a
picture of a potentially debilitating mental illness.
point in 1988, a doctor in India diagnosed Payal with
“psychosis.” (See, AR at 252.) Over the
course of several months that year, she was prescribed a
bewildering array of different medications. (See, AR
at 254-59.) Records indicate that doctors in India continued
to modify her drug regimen for several years, including
during the years 1989, 1990, and 1993-95. (See, AR
at 260-67.) The number of prescriptions written by her
doctors during this time totals at least 55, although some of
the same drugs appear multiple times, only in varying
hearing before the ALJ, Payal's mother (“Ms.
Kapoor”) testified about her daughter's condition
while the family lived in India, describing it as
“totally unimaginable” and
“horrific.” (See, AR at 66-67.) She
testified that her daughter was highly unpredictable; that
her behavior in public was embarrassing; and that the family
feared she might jump out a window of their 8th floor
apartment. (See, id.) Ms. Kapoor finally sought
treatment when Payal began disrobing and obliviously
wandering around the apartment. (See, AR at 67-71.)
Kapoor spoke about Payal's series of treating physicians
and about Payal's changing medications that began when
she was 16 and continued for years. (See, AR at 68.)
Although Ms. Kapoor described her daughter as completely
disconnected from reality at times, she also indicated that
Payal completed the rough equivalent in India of a
bachelor's degree and a master's degree.
(See, AR 68-69, 71-72.) Ms. Kapoor stressed,
however, that the degrees were possible only with the help of
Payal's “coach” (presumably a tutor) as well
as with the support of the entire family. (See, AR
at 68-69). The master's degree was completed entirely
through correspondence school, because Payal had difficulty
interacting with other students; according to Ms. Kapoor,
Payal “could not take . . . something as simple as how
are you doing today?” (See, AR at 70.) Ms.
Kapoor described her daughter's academic achievements as
a “miracle.” (See, AR at 69.)
moved to the United States with her family permanently in
April of 1997, and she immediately began to receive medical
treatment in Columbus, Ohio from Dr. Christopher Blank
(“Dr. Blank”). (See, AR at 63-65.) Ms.
Kapoor stated that Payal's illness has improved over
time, and that she is currently still on two medications -
lithium and tegretol - that were originally prescribed back
in India. (See, AR at 66, 72.)
the Social Security Administration (the “SSA”)
initially denied Payal's application for CIB, she
appealed (through her mother) to the SSA's Office of
Disability Adjudication and Review. The office assigned an
ALJ to the matter, and the ALJ held a hearing regarding
Payal's claim on May 16, 2013. An impartial medical
expert (“Dr. O'Brien”), an impartial
vocational expert, and Ms. Kapoor all testified. They were
questioned by the ALJ and by Payal's attorney. The ALJ
confirmed the denial of CIB, finding that Payal failed to
establish the existence of a medically determinable mental
impairment or a severe mental impairment prior to age 22 that
would entitle her to CIB payments. Payal now seeks review of
the ALJ's decision in this Court. See, 42 U.S.C.
§ 405(g) (providing jurisdiction).
Court will uphold the ALJ's decision if it correctly
applied the law and is supported by substantial evidence.
See, Jelinek v. Astrue, 662 F.3d 805, 811 (7th Cir.
2011). The ALJ is not required to discuss every piece of
evidence in the record before denying benefits, but he must
adequately support his conclusions. Id. In addition,
“a treating physician's opinion that is consistent
with the record is generally entitled to controlling
weight.” Id. (internal quotations omitted)
(citing 20 C.F.R. § 404.1527(d)(2)).
denying Payal's claim, the ALJ made several errors. First
and most important, he relied on the statements of medical
expert Dr. O'Brien, who provided conclusory and
uninformed testimony at the May 16 hearing. In questioning
Dr. O'Brien, the ALJ failed to elicit even minimally
useful information that would support his decision. Although
the ALJ states that he gave the opinion of Dr. Blank -
Kapoor's treating psychiatrist - great weight, Dr.
Blank's opinion contradicted points made by Dr.
O'Brien. The ALJ did not indicate how, if at all, he
reconciled the contradictions. Finally, the ALJ wrongly
discounted the testimony of Ms. Kapoor regarding Payal's
condition while in India. Taken together, these errors led to
a decision that is not supported by substantial evidence.