United States District Court, N.D. Illinois, Western Division
Shirley J. Heitkam Plaintiff,
Nancy A. Berryhill, Acting Commissioner of Social Security,  Defendant.
MEMORANDUM OPINION AND ORDER
D. Johnston Magistrate Judge
Shirley J. Heitkam applied for Social Security disability
benefits in 2012, when she was in her mid-fifties. She
alleged that back, hip, feet, and other body pains from
fibromyalgia and arthritis, and obesity make it difficult to
walk, stand, or even sit for sustained periods. She allegedly
spends much of her day in a recliner with her feet elevated.
These conditions also cause her hands to become sore after
prolonged use. She has histoplasmosis, a fungal infection,
that led to a partial loss of vision in her right eye.
Because of this limitation, she claims to get headaches after
10 to 15 minutes of reading or looking at a computer screen.
The latter assertion is critical. Given her age and other
factors under Social Security disability regulations, the
sole issue is whether she could work as a data entry clerk, a
job requiring typing and working at a computer screen. It was
the only one of her past relevant jobs at the sedentary level
and, thus, the only one of those jobs she could possibly do
administrative law judge (“ALJ”) held two
hearings, with a different doctor and vocational expert
testifying at each. Although these experts opined about
several issues, the eye issue received the most attention.
There was much back and forth about how to describe this
particular impairment and what limitations, if any, it
imposed. In fact, it appears a second hearing was held to
address this particular issue. In addition to the hearing
testimony, plaintiff's treating ophthalmologist, Dr.
Suresh Chandra, submitted several opinion letters. In a
written decision, the ALJ found that plaintiff's eye (and
other) problems would not prevent her from working full-time
as a data entry clerk. The ALJ found (among other things)
that the two testifying doctors were more credible than
plaintiff's treating doctor. Plaintiff now seeks a
remand, raising a plethora of arguments attacking almost all
aspects of the decision. Although this Court finds that many
of these arguments would not warrant a remand on their own,
the Court concludes that a remand is required based largely
on the unresolved eye issue.
understand this issue, which will be the focus of this
opinion, it will be helpful to chronicle at some length how
it was addressed in the two hearings. The hearings provide a
peek behind the curtain of the ALJ's reasoning. These
hearings contain more detail and analysis than was included
in the ALJ's decision, which glosses over certain
questions raised in the hearings.
first hearing was held on May 5, 2014. Plaintiff testified
that she “cannot  stare at a computer screen for
hours on end” and that she gets “headaches in the
back of [her] head if [she looks] at one thing too
long.” R. 62. She described the problem as being a
strain on her left, or “good, ” eye that resulted
from her not being able to fully or properly focus with the
her right, or “bad, ” eye. R. 69. This problem
was one reason she quit her last job as a bank teller in
2007. She stated that, because of the eye problems, she had
to double and triple check deposit and cash back amounts.
called Dr. Gilberto Munoz, whose specialty is listed as
“Family Practice, ” to testify as a medical
expert. R. 147. He identified plaintiff's impairments as
follows: “Fibromyalgia, hypertension, chronic kidney
disease, right eye blindness, bilateral hip pain, and low
back pain.” R. 73. He opined that plaintiff had the
residual functional capacity (“RFC”) to do
sedentary work subject to various restrictions. Relevant to
the eye problems, plaintiff could not “drive for
defensive purposes, ” could not work in any
“safety sensitive positions, ” and could not be
around heavy machinery or work at heights. R. 74. The ALJ
then asked whether plaintiff would “be limited to
monocular vision.” Id. Dr. Munoz answered that,
“[y]es, she is, but her doctor diagnosed 20/20
vision.” Id. The ALJ asked about allegations
of headaches from “us[ing] that good eye to read the
computer” and whether that was “a
possibility.” R. 74. Dr. Munoz answered with only the
terse comment that this possibility was “[v]ery
unlikely.” Id. Like Bartleby the Scrivener,
Dr. Munoz did not offer an explanation for this conclusion,
nor did he express any doubts or qualifications.
this explanatory gap, plaintiff's counsel later in the
hearing probed further. In the following colloquy, counsel
elicited at least a partial explanation, although it is still
one that (to this Court's layperson eyes) is not entirely
Q Wouldn't you agree, Doctor, that the headaches and the
eye strain due to the use of the one eye to focus on a
computer or on reading would cause-I mean, could be caused by
A People with monocular vision with her case, they have
problem with depth perception. Some objects are not the same,
but that wouldn't be an issue because for the computer
she should be okay.
Q She'd be able to use a computer eight hours a day
without any unscheduled breaks and not have these symptoms?
Is that what you're saying?
A No, the eye on the left is perfect. It's 20/20.
Actually, it's better than average for her age.
Q I'm talking about the eye strain causing headaches, the
eye strain of using one eye to do -
A Which eye would feel strain? In order to strain your eye,
you have to have vision.
Q The right eye is the eye that has no sight at all. The left
eye is what she's using normally and then to compensate
for the lack of the right eye and she's saying that that
causes her eye strain to the point that she has to take these
frequent breaks. Wouldn't that be reasonably consistent
with her condition?
A I feel that you're asking me if I find an explanation
for that and I tell you I didn't. I know that she has
monocular vision. I am admitting to that. On her left eye,
she has perfect vision on the left eye. I don't know how
[you can] strain your good eye if it's normal.
Q You're saying you couldn't get eye strain from
using your eye, using one eye to do computer work eight hours
a day? That's impossible to get eye strain that way?
A You wouldn't have to deal with it if it is normal. You
get eye strain in your eye [that] doesn't work. That one
ALJ: I think what he's saying is he can't explain
what it is.
R. 75-76. It is worth pausing to note several points. The
precise issue plaintiff's counsel focused on initially is
whether headaches “could be” caused by the
histoplasmosis-in other words, whether they were
possible. Another point is that Dr. Munoz introduced
the concept of depth perception as being relevant to the
analysis. Another emerging question suggested by this
exchange is the relevance of a single eyechart test
(e.g. “20/20 vision” in one eye) to the
broader question of whether headaches could result from using
only that eye for eight hours or so of typing in a day.
next witness was a vocational expert, Richard Fisher. His
testimony was brief. The ALJ asked him two hypothetical
questions. The first question was based on Dr. Munoz's
RFC, and asked whether a person with plaintiff's age,
education, and work experience, who was limited to
“sedentary work, except we have occasional postural and
monocular vision” and who was limited to “safety
sensitive positions” and “no unprotected heights,
no dangerous moving machinery, ” would be able to do
her past relevant work. R. 77. Mr. Fisher stated that
plaintiff could work in her prior job as a data entry clerk.
Mr. Fisher did not discuss what the specific duties of this
job were. The second question added the qualification that
plaintiff would need to take a 5 to 10 minute break every 20
minutes, a limitation presumably designed to account for the
alleged eyestrain. Dr. Fisher opined that this qualification
would eliminate all work for which she was qualified. At this
point, plaintiff's attorney stated that he wanted
“to get a medical source statement from the
ophthalmologist.” R. 77. The following colloquy ensued:
ALJ: Okay. Make sure any significant findings I can
ALJ: I have a little trouble with ophthalmologists.  They
throw a lot of figures at me which I don't understand.
ATTY: No, I'm going to ask him about the eye strain and
how that's reasonably consistent with her problem.
4, 2014, plaintiff submitted a letter from Dr. Chandra, which