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Kapoor v. Colvin

United States District Court, N.D. Illinois, Eastern Division

November 2, 2016

PAYAL KAPOOR, Plaintiff,
CAROLYN COLVIN, Commissioner Of Social Security Administration, Defendant.


          Harry D. Leinenweber, Judge

         Plaintiff 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.


         Payal 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).

         So, in 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.

         At some 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 quantities.

         At a 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.)

         Ms. 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.)

         Payal 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.)

         After 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).

         II. ANALYSIS

         This 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)).

         In 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.

         A. ...

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