United States District Court, N.D. Illinois, Eastern Division
MEMORANDUM OPINION AND ORDER
Jeffrey Cole Magistrate Judge
applied for Disability Insurance Benefits (“DIB”)
and Supplemental Security Income (“SSI”) under
Titles II and XVI of the Social Security Act
(“Act”), 42 U.S.C. §§ 416(I), 423,
1381a, 1382c, nearly four years ago. (Administrative Record
(R.) 234-45). She claimed that she became disabled as of
March 25, 2013, due to carpal tunnel surgery on her left
hand, left arm nerve and muscle damage, bilateral knee pain,
right shoulder pain, hepatitis C, and depression. (R. 283).
Over the ensuing three years, plaintiff's application was
denied at every level of administrative review: initial,
reconsideration, administrative law judge (ALJ), and appeals
council. It is the ALJ's decision that is before the
court for review. See 20 C.F.R. §§404.955; 404.981.
Plaintiff filed suit under 42 U.S.C. § 405(g), and the
parties consented to the jurisdiction of a Magistrate Judge
pursuant to 28 U.S.C. § 636(c) on August 28, 2018. [Dkt.
#6]. The case was reassigned to me on January 10, 2019. [Dkt.
# 21], and was fully briefed in April 2019. Plaintiff asks
the court to reverse and remand the Commissioner's
decision, while the Commissioner seeks an order affirming the
was born on August 30, 1964 (R. 234), and was 48 years old
when she claims she became disabled. (R. 234). She has a
ninth-grade education, and a sporadic work history, briefly
holding jobs at the night desk of hotels, in manufacturing,
and in inventory. (R. 302). Most of these were through a temp
agency. (R. 38). The only job she's had that lasted more
than a few months was in a pharmaceutical plant. (R. 302).
While she alleges an array of impairments, she seems to claim
the most of her trouble is due to her knees, and to a lesser
extent, to carpal tunnel syndrome.
about 420 pages, the medical record in this case is of
average heft as these cases go and, as is usually the case as
well, precious little of it has anything to do with whether
the plaintiff is disabled or not. Indeed, the plaintiff,
herself, indicates through citations to the record in her
brief that not even 20 pages of the record matter to her
claim that she is unable to work. [Dkt. # 16, at 3-4]. A
summary of the relevant evidence follows.
began seeing Dr. Randon Johnson for right knee pain in
December 2013. (R. 409). Plaintiff indicated she had had
right knee surgery in 1998 and 2006. (R. 409). While there
was mild swelling and mild crepitus in the knee, range of
motion was normal, there was no tenderness, no sign of tear,
and the knee was stable. (R. 409). X-rays revealed some
medial compartment narrowing. (R. 410). The doctor
administered a corticosteroid injection. (R. 410). That
worked for about four months, but in April 2014, plaintiff
returned and reported that her right knee pain was returning.
(R. 412). Again, there was no tenderness, full range of
motion, mild swelling and mild crepitus. (R. 412). Plaintiff
also reported that her left knee was now locking,
and while range of motion was nearly normal, McMurray's
test suggested a possible meniscus tear. (R. 412). X-rays of
the left knee were normal (R. 412), but an MRI of the left
knee did reveal a meniscus tear. (R. 414). Plaintiff opted
for another injection over surgery on the right knee in June
2014, but did elect surgery to repair the meniscus on the
left. (R. 414-15). Surgery was scheduled for June 26, 2014
(R. 415), but was apparently cancelled for some reason -
there are no records - and plaintiff's brief indicates
she changed her mind about it. [Dkt. # 16, at 3].
appears to have been fine with plaintiff's knees until
November 2015. [Dkt. #16, at 3]. At that time, a right knee
exam revealed mild tenderness, mild swelling, and full range
of motion. (R. 551). There was mild tenderness and swelling
in the left knee with full range of motion as well. Both
knees were stable. (R. 551). Surgery wasn't an option at
that time because plaintiff was undergoing Hepatitis C
treatment. (R. 553). Bilateral injections were administered.
(R. 551). In January 2016, examination was much the same,
although there was no longer any swelling, and plaintiff
indicated that the injections had been successful. (R. 553).
Plaintiff returned in March 2016 complaining of left knee
pain and wanted to have arthroscopic surgery, which was
scheduled for March 7th. (R. 554). By June 2016,
surgical portals were well-healed, and she had full
weight-bearing capacity, and used crutches to walk. (R. 554).
There was mild swelling and tenderness, and a slight
reduction of range of motion from 130 degrees to 115. (R.
554). As of December 2016, Dr. Johnson again reported that
plaintiff had full weight-bearing on both knees, but chose to
use a crutch to walk. (R. 753). By January of 2016, she had
discarded the practice. (R. 553).
January 2017, plaintiff was reporting moderate pain, but was
not taking anything for the symptoms. (R. 723). A left knee
x-ray in February 2017 showed that osteoarthritis and
narrowing of the medial compartment had progressed in the
previous three years. (R. 754). MRI showed grade IV
chondromalacia. (R. 734).
there is plaintiff's bilateral carpal tunnel syndrome. In
January 2015, plaintiff reported numbness and tingling in her
left arm. (R. 496). She had fallen in November 2014, (R.
496), and underwent left carpal tunnel surgery in July 2015.
(R. 400). Follow-up in November revealed mild swelling, but
normal range of motion without difficulty in elbow and
fingers. (R. 550). Then it was right hand numbness. In
September 2016, examination revealed plaintiff could move her
fingers without difficulty, but there was a positive
Tinel's sign and positive Durjkan's test suggesting
carpal tunnel syndrome. (R. 555). She had right carpal tunnel
release surgery in November 2016. (R. 753). At follow-up in
December, she reported some mild pain and numbness. There was
some mild swelling, but she could move her fingers without
difficulty. (R. 753).
an administrative hearing - at which plaintiff, represented
by counsel, and a vocational expert testified - the ALJ
determined plaintiff was not disabled. The ALJ found that
plaintiff had the following severe impairments: carpal tunnel
syndrome and degenerative joint disease of both knees. (R.
17). The ALJ noted that the plaintiff also suffered from
Hepatitis C and cervical spine disorder, but found these
impairments were not severe. (R. 17). He said that the
Hepatitis C was treated conservatively and studies showed
that there was only a small disc herniation in
plaintiff's neck at ¶ 6 and mild disc bulging at
¶ 4-5 and C6-7. (R. 17). The ALJ also found that
plaintiff's depression was non-severe, causing no more
than mild limitations in understanding, remembering and
applying information; interacting with others; concentrating,
persisting, or maintaining pace; and adapting or managing
herself. (R. 18). The ALJ then found that plaintiff's
impairments, either singly or in combination, did not meet or
equal a listed impairment assumed to be disabling in the
Commissioner's listings. (R. 18-19).
then stated that the plaintiff had the residual functional
capacity to perform light work - “lifting/carrying 20
pounds occasionally and 10 pounds frequently,
standing/walking about six of eight hours, sitting about six
of eight hours” - with the following list of additional
limitations: “occasional bilateral pushing/pulling with
lower extremities; never climb ladders ropes or scaffolds;
occasionally climb ramps and stairs, balance stoop crouch,
crawl, and kneel; occasional overhead reaching with the left;
occasional bilateral fingering, that is fine manipulation of
items no0 smaller than the size of a paper clip; occasional
bilateral handling of objects, that is gross manipulation;
avoid concentrated exposure to frequent vibration.” (R.
19). The ALJ then found that plaintiff's
“statements concerning the intensity, persistence and
limiting effects of [her] symptoms are not entirely
consistent with the medical evidence and other evidence in
the record.” (R. 21). Specifically, the ALJ noted that
plaintiff improved following surgery and, thereafter,
treatment was routine and conservative, and that she sat
through her hearing and did not give any signs of discomfort,
responding appropriately to questioning. (R. 21). Finally,
the ALJ felt that the plaintiff's daily activities were
inconsistent with her alleged limitations. (R. 21).
summarized the medical evidence, discussing treatment of
plaintiff's knee impairments and carpal tunnel syndrome.
Treatments in both areas moved from conservative to surgical,
with injections along the way. The ALJ noted that, in both
cases, treatment resulted in improvement, (R. 20). The ALJ
referred to a consultative examination in September 2015 with
essentially benign results. (R. 20). There were only medical
opinions on disability in the record, both from the state
agency doctors who reviewed the record during the application
process. The ALJ gave greater weight to the second - which
found plaintiff capable of light work - than the first -
which found plaintiff capable of medium work - explaining