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Moreno v. Berryhill

United States Court of Appeals, Seventh Circuit

February 16, 2018

Alejandro Moreno, Plaintiff-Appellant,
Nancy Berryhill, Acting Commissioner of Social Security, Defendant-Appellee.

          Argued December 12, 2017

         Appeal from the United States District Court for the Northern District of Illinois, Eastern Division. No. l:15-cv-11168 - Sidney I. Schenkier, Magistrate Judge.

          Before Bauer, Ripple, and Sykes, Circuit Judges.

          PER CURIAM.

         Alejandro Moreno appeals the order of the district court upholding the Social Security Administration's denial of his applications for Supplemental Security Income and Disability Insurance Benefits. Mr. Moreno contends that, among other shortcomings in the Administrative Law Judge's ("ALJ") determination, he improperly relied on an outdated mental-health assessment and failed to incorporate all of Mr. Moreno's limitations when posing the hypothetical to the vocational expert. We agree that the record contains new and significant evidence that could have affected Mr. Moreno's mental-health assessment. We also agree that the ALJ's hypothetical to the vocational expert failed to include Mr. Moreno's limitations with respect to concentration, persistence, and pace. Accordingly, we remand the matter to the agency for further proceedings.



         A. Mr. Moreno's Condition

         Mr. Moreno's misfortunes began in February 2006 when he fell off scaffolding and landed on his back while taping drywall. He sought treatment from an orthopedist, who found a soft tissue injury but no signs of fracture. Later testing showed improvements in Mr. Moreno's condition, but he reported that he still felt significant pain. A follow-up diagnostic test revealed acute lumbar radiculopathy-lower back pain caused by compression, inflammation and/or injury to a spinal nerve root. In addition to this condition, Mr. Moreno also is diabetic, has high blood pressure, and is obese.

         Beginning in April, Mr. Moreno sought treatment for his chronic pain from clinical psychologist Dr. Enrique Gonzalez. Dr. Gonzalez saw Mr. Moreno "on an almost weekly basis through 2009 for cognitive behavioral therapy"[1] These visits decreased in frequency to monthly between 2010 and the first half of 2011; however, for the remainder of 2011 through at least June of 2013, Mr. Moreno saw Dr. Gonzalez on a weekly basis.

         In his treatment notes, Dr. Gonzalez reported that Mr. Moreno manifested, among other symptoms, a depressed mood, irritability, memory difficulties, and an inability to concentrate. Critical to our analysis, Dr. Gonzalez documented an ongoing inability to sleep, including times when Mr. Moreno would go days without sleep.[2] Dr. Gonzalez also addressed Mr. Moreno's difficulties interacting with the public and with his family, specifically outbursts of anger precipitated by feelings that others were taking advantage of him.[3] Dr. Gonzalez observed fluctuations in Mr. Moreno's mood and behavior over time, including some periods of improvement; for instance, Dr. Gonzalez reported improved mood when Mr. Moreno had scheduled activities with his daughter and family[4]

         From March 2008 through November 2013, Mr. Moreno also saw a Dr. Walter Pedemonte on a monthly basis for psychiatric medication management. Dr. Pedemonte observed Mr. Moreno suffered from the following symptoms in March 2008: "depressed mood, anxious affect, poor immediate and recent memory, fair remote memory, poor attention, [and] poor concentration."[5] He diagnosed Mr. Moreno with major depressive disorder and, over the years, prescribed Mr. Moreno several medications, and combinations of medications, to address his condition.

         B. The Administrative Proceedings

         In March 2007, Mr. Moreno filed his applications for Supplemental Security Income and Disability Insurance Benefits. His claims were denied on initial application and upon reconsideration. A hearing was held before an ALJ in December 2009; the ALJ issued a decision denying relief in March 2010. The Appeals Council denied review, and Mr. Moreno appealed to the United States District Court for the Northern District of Illinois.

         In the district court, the parties filed an agreed motion to reverse and remand. The motion requested that, on remand, the matter "be assigned to a different ALJ, who w[ould] conduct a new hearing, and reassess inter alia Plaintiff's mental impairment(s) and the treating physician opinion(s)."[6]

         On remand, a different ALJ held a supplemental hearing. At the February 2014 hearing, Mr. Moreno testified regarding his mental health. He described a significant number of psychological concerns, including difficulty focusing, remembering, and interacting with others. He recounted that his wife administers his medication and keeps track of his physicians' appointments because he struggles to remember things. He also reported that he tried to take English classes but had trouble concentrating. Mr. Moreno also testified, as he did in the original hearing, that people "bother []" him, [7] so he avoided going to crowded church services and using public transportation.

         In addition to the hearing testimony and the notes of Drs. Gonzalez and Pedemonte, the second ALJ also looked at Mr. Moreno's mental-health records, examinations, and assessments that predated the hearing before the first ALJ. Among these were the diagnosis and notes of Dr. Herman Langner, who examined Mr. Moreno in 2007 and diagnosed him with depression. The ALJ also considered the review of Mr. Moreno's mental-health records conducted by psychologist Margaret Wharton in 2007. In her assessment of Mr. Moreno's residual functional capacity, Dr. Wharton observed that Mr. Moreno manifested a "[disturbance of mood" evidenced by "[d]ecreased energy, " "[f]eelings of guilt or worthlessness, " and "[difficulty concentrating or thinking."[8]Under functional limitations, Dr. Wharton noted that Mr. Moreno was only mildly limited in activities of daily life and in social functioning, but he was moderately limited in maintaining concentration, persistence, and pace.[9] Her summary conclusions described Mr. Moreno as not significantly limited in "[t]he ability to carry out very short and simple instructions"; "[t]he ability to perform activities within a schedule, maintain regular attendance, and be punctual within customary tolerances"; "[t]he ability to work in coordination with or proximity to others without being distracted by them"; "[t]he ability to make simple work-related decisions"; and "[t]he ability to interact appropriately with the general public."[10]

         The ALJ then used this information to pose a hypothetical question to a vocational expert regarding Mr. Moreno's em-ployability. Specifically at the second hearing, the ALJ described a hypothetical individual with Mr. Moreno's physical limitations. In addition to physical limitations, the ALJ included in his question to the vocational expert that the hypothetical "individual can understand, remember, and carry out simple work instructions ... and exercise simple work place judgments. And further, the individual would be limited to routine work ... [with] no more than occasional changes in the work setting."[11] Finally, the ALJ required that the individual could have "no more than occasional interaction with the public."[12] Given these restrictions, the vocational expert opined that there were still a number of jobs that Mr. Moreno could perform, including that of an assembler, an inspector, a checker, and a hand packer.

         Following the hearing, the ALJ issued a written opinion in which he reviewed the evidence, applied the standard five-step analysis, see 20 C.F.R. § 404.1520(a), and concluded that Mr. Moreno was not disabled. At step one, the ALJ determined that Mr. Moreno had not engaged in substantial gainful activity since his alleged onset date in February 2006. At step two, the ALJ evaluated Mr. Moreno's physical and mental conditions, and concluded that he was suffering from severe impairments-lumbar disc disease, myofascial pain syndrome, left knee pain, obesity, and depression-within the meaning of the Act and regulations, 20 C.F.R. §§ 404.1520(c), 416.920(c). But at step three the ALJ determined that these impairments, individually or in combination, do not meet a listing for presumptive disability. Applying the "special technique, " 20 C.F.R. §§ 404.1520a, 416.920a-the method that considers "pertinent symptoms, signs, and laboratory findings" to determine whether the claimant suffers from a medically determinable mental impairment-the ALJ concluded that Mr. Moreno's mental impairments do not cause two or more "marked limitations" or one such limitation coupled with repeated episodes of decompensation. Therefore, Mr. Moreno did not satisfy the paragraph B criteria of listings 12.04 and 12.06. He found, however, that Mr. Moreno's mental impairments do cause "moderate" restrictions in social functioning and concentration, persistence, or pace, as well as "mild" restrictions in his activities of daily living.[13]

         At step four the ALJ found that Mr. Moreno could not perform his past work as a drywall taper, but at step five he concluded that Mr. Moreno could "perform light work" with some restrictions.[14] In assessing Mr. Moreno's residual functional capacity, the ALJ afforded the opinion of Dr. Wharton great weight, explaining that Dr. Wharton's analysis was "consistent with the longitudinal evidence of record."[15] The ALJ also reviewed the notes of Mr. Moreno's treating psychologist, Dr. Gonzalez, who documented fluctuating symptoms of depression, suicidal ideations, low motivation, and irritability.[16] But the evidence as a whole, in the ALJ's view, did not support a finding that Mr. Moreno's depression precluded him from engaging in work activity. The ALJ placed particular emphasis on portions of Dr. Gonzalez's treatment notes that showed improvements in Mr. Moreno's mental health during periods of increased activity.

         Mr. Moreno appealed to the Appeals Council, which declined review.

         C. District Court Proceedings

         Mr. Moreno then sought review in district court, which affirmed the agency's decision. The court first rejected Mr. Moreno's argument that the ALJ's assessment of residual functional capacity was "flawed because ... it did not account for the recommendation of Dr. Wharton that claimant is only capable of performing one-two step jobs."[17] The court concluded that the record as a whole adequately supported the ALJ's determination that Mr. Moreno could carry out "simple work instructions."[18] The district court also was unpersuaded by Mr. Moreno's argument that the ALJ's residual functional capacity assessment did not account for Mr. Moreno's limitations in concentration, persistence, and pace: "the ALJ's hypothetical to the [vocational expert] adequately addressed Mr. Moreno's specific deficiencies" even if the words concentration, persistence, and pace were not used.[19] The district court further determined that the ALJ was not required to seek an updated mental-health evaluation because the treatment notes that postdated Dr. Wharton's assessment did not show a significant change in Mr. Moreno's condition that would have caused ...

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