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Jamie W. v. Saul

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

August 27, 2019

Jamie W., Plaintiff,
Andrew Marshall Saul, Commissioner of Social Security, Defendant.


          Lisa A. Jensen United States Magistrate Judge.

         Plaintiff Jamie W. brings this action under 42 U.S.C. § 405(g) seeking reversal or a remand of the decision denying her disability insurance benefits and supplemental security income. The parties have consented to the jurisdiction of a United States Magistrate Judge for all proceedings pursuant to 28 U.S.C. § 636(c). For the reasons set forth below, the Commissioner's decision is reversed, and this case is remanded.

         I. Background [1]

         On April 10, 2014, Plaintiff protectively filed applications for disability insurance benefits and supplemental security income. Plaintiff alleged a disability beginning on December 29, 2002, as a result of spastic colon, celiac disease, interstitial cystitis, [2] endometriosis, scar tissue, temporomandibular joint disorder, osteoarthritis, right shoulder tear, fibromyalgia syndrome, and learning disabilities. R. 282, 289. Her date last insured for disability insurance benefits was June 30, 2004.

         Plaintiff's medical records span from 2002 through 2016 and reveal treatment for numerous conditions. Plaintiff's appeal focuses on her treatment for fibromyalgia, digestive issues, and pain, so the Court will focus on the records related to those impairments. As was noted at the administrative level, there were limited medical records between Plaintiff's alleged onset date in 2002 and her date last insured in 2004.[3] Most of Plaintiff's medical records relating to the impairments at issue in this appeal do not begin until approximately 2005 when she received treatment for fibromyalgia, digestive issues, and pain. See R. 656, 864-65, 1824. Plaintiff's records, however, reference a history of digestive issues. See R. 657 (10/28/2005 medical note: “She has a history or irritable bowel syndrome.”); R. 658 (9/27/2005 medical note: “GI symptoms date back to the age of 12.”); R. 1210 (4/15/2005 medical note: “has a h/o IBS and lactose intolerance since age 12 - usually has constipation”).

         On July 18, 2016, Plaintiff, represented by an attorney, testified at a hearing before an Administrative Law Judge (“ALJ”). The ALJ also heard testimony from Dr. Ronald Semerdjian, a medical expert, and Jill Radke, a vocational expert (“VE”).

         At the time of the hearing, Plaintiff was 34 years old. Plaintiff testified that she lived alone but was dependent on her parents to help her daily. R. 50. Plaintiff testified that she was unable to work because she was “not reliable” and because her arthritis, which was throughout her body, was painful and debilitating. R. 58-59. Plaintiff's IBS related constipation also made her miss appointments or caused her to be late. R. 73, 77. However, medical marijuana provided some relief. R. 73, 79.

         Plaintiff's fibromyalgia, which she explained as her “main issue, ” also caused her to be “in bed for days.” R. 59. Plaintiff testified that Lyrica, Percocet, and medicinal marijuana helped to relieve some of her pain. R. 60. Plaintiff testified that on a good day she could walk no more than 15 minutes, but that she would need to take breaks to stretch. R. 63. She could sit for no more than 30 minutes before she needed to stretch and could lift no more than five pounds. R. 64. Plaintiff would get exhausted easily and could only complete one task for the day, such as showering or going to the grocery store or a doctor appointment. R. 61. Plaintiff also had a hard time completing tasks because her muscles would give out. R. 61. Plaintiff explained that she had a hard time showering because it was physically exhausting, and she had difficulty washing her hair because she could not hold her arms up. R. 63.

         Dr. Semerdjian, an internist, testified that Plaintiff's celiac disease was controlled. R. 87. He also believed that Plaintiff's IBS and interstitial cystitis were only an issue early on in Plaintiff's medical records. R. 87-88. In relation to Plaintiff's fibromyalgia, Dr. Semerdjian noted that throughout the record, Plaintiff's providers recommended that she exercise to relieve some of her pain. R. 91. Dr. Semerdjian concluded that Plaintiff's fibromyalgia and psychological issues were her main impairments. R. 94. When the ALJ asked if Plaintiff met or equaled a listing, Dr. Semerdjian responded that “I think the combined fibromyalgia and psychological issues probably - but I don't know what listing to assign to that because we're back into dealing with fibromyalgia again. Her testimony - I couldn't hear all of what she said, I'm sorry, but what I heard what she was saying she focused on a good degree of fatigability. I believe I heard her say if she showered she couldn't do anything else the rest of the day.” R. 94-95.

         As for Plaintiff's limitations, Dr. Semerdjian opined that Plaintiff's fibromyalgia-related pain was the only impairment that was limiting her physical functioning. R. 96. When the ALJ pressed for specific limitations, Dr. Semerdjian stated, in part, “Functionally let's say that she can - I think she can sit six of eight hours. Standing and walking my guess is it's going to be between two to four hours probably. As far as being able to lift and carry I think she could probably lift 20 pounds occasionally and 10 frequently. I don't think there's any disability that would prevent her from doing that.” R. 96.

         Dr. Semerdjian also found that Plaintiff did not meet Listing 5.08 because she did not have “any good pattern of weight loss.” R. 99. Dr. Semerdjian explained that Plaintiff's weight fluctuated over time and sometimes fell below a body mass index (“BMI”) of 17.5, but that this was merely a vacillation in her weight and not a loss where she was unable to regain the weight. R. 99-101. Dr. Semerdjian opined that Plaintiff's natural weight was low to begin with. R. 102. In response, Plaintiff explained that her weight fluctuated based on swelling and constipation. R. 101.

         Plaintiff's counsel also asked Dr. Semerdjian how often Plaintiff would miss work due to pain. Dr. Semerdjian responded that “I think that it is clear in the record that her perception of the pain - I can't - again I'm not measuring her pain, but her perception of it is such that she feels her threshold for functioning productively is low.” R. 103. Dr. Semerdjian opined that Plaintiff would likely miss work two days or more a month. R. 104.

         The ALJ ultimately denied Plaintiff's request for benefits. The ALJ found that Plaintiff had the following severe impairments: fibromyalgia, generalized anxiety disorder/depression, and intellectual disability. R. 21. The ALJ determined that Plaintiff's impairments did not meet or medically equal a listed impairment. R. 23-26. The ALJ concluded that Plaintiff had the residual functional capacity (“RFC”) to perform sedentary work with certain restrictions. R. 26.

         II. Standard of Review

         A reviewing court may enter judgment “affirming, modifying, or reversing the decision of the [Commissioner], with or without remanding the cause for a rehearing.” 42 U.S.C. § 405(g). If supported by substantial evidence, the Commissioner's factual findings are conclusive. Id. Substantial evidence exists if there is enough evidence that would allow a reasonable mind to determine that the decision's conclusion is supportable. Richardson v. Perales, 402 U.S. 389, 399-401 (1971). Accordingly, the reviewing court cannot displace the decision by reconsidering facts or evidence, or by making independent credibility determinations. Elder v. Astrue, 529 F.3d 408, 413 (7th Cir. 2008).

         However, the Seventh Circuit has emphasized that review is not merely a rubber stamp. Scott v. Barnhart, 297 F.3d 589, 593 (7th Cir. 2002) (a “mere scintilla” is not substantial evidence). A reviewing court must conduct a critical review of the evidence before affirming the Commissioner's decision. Eichstadt v. Astrue, 534 F.3d 663, 665 (7th Cir. 2008). Even when adequate record evidence exists to support the Commissioner's decision, the decision will not be affirmed if the Commissioner does not build an accurate and logical bridge from the evidence to the conclusion. Berger v. Astrue, 516 F.3d 539, 544 (7th Cir. 2008). ...

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