United States District Court, N.D. Illinois, Western Division
MEMORANDUM OPINION AND ORDER 
A. JENSEN UNITED STATES MAGISTRATE JUDGE
is seeking Social Security disability benefits based on
limitations from a stroke occurring in the fall of 2014. He
was then 49 years old. His main limitations are speech
difficulties and right-sided weakness. An administrative law
judge (“ALJ”) found that plaintiff was not
disabled largely because his condition gradually improved
over time such that he was able to do part-time work and
other activities consistent with the ALJ's findings. In
this appeal, plaintiff argues that the ALJ should have
developed the record in various ways. As explained below, the
Court is not persuaded by this argument.
medical narrative begins on November 1, 2014, when plaintiff
went to a hospital in Florida presenting with speech problems
or, in the medical parlance, expressive
dysphasia.Doctors concluded that plaintiff had a
stroke at some point. Over the next several weeks, tests and
procedures were performed. On November 13, 2014, Dr. Jacques
Morcos performed a bypass procedure to address the problems
from the stroke. On November 19, 2014, plaintiff was
discharged from the hospital. He was provided a rolling
walker and advised to participate in occupational therapy.
According to plaintiff's later testimony, this therapy
took place over the next three to four months. However, the
therapy records were not made a part of the administrative
record for reasons that are not known.
January 29, 2015, while still in Florida, plaintiff saw
neurologist Dr. Nils Mueller-Kronast as a follow-up to his
hospital treatment. This would be plaintiff's only visit
with this doctor. Dr. Mueller-Kronast observed that plaintiff
weighed 285 pounds; that he could walk independently with a
limp but he did not need a cane; that he had a 4/5 weakness
in his right shoulder with some difficulty and a possible
frozen shoulder; and that his coordination was intact with a
degree of weakness. R. 343. Dr. Mueller-Kronast told
plaintiff that he needed to lose weight, which was described
in the notes as a “drastic risk factor
modification.” Id. Dr. Mueller-Kronast
concluded as follows:
Clinically [plaintiff] is significantly improved, but still
has nonfluent speech and especially proximal right upper
extremity weakness. He is independently ambulating. In the
meantime, he has undergone smoking cessation.
following week, plaintiff filed for disability benefits under
both Title II and XVI.
March 16, 2015, Dr. Mueller-Kronast wrote a one-paragraph
letter supporting plaintiff's disability applications.
The letter states as follows:
This letter serves to certify that Mr. [C] is completely and
totally disabled. He suffered a debilitating stroke and as a
result is completely unable to obtain or participate in any
type of gainful employment. He still suffers from residual
cognitive impairment as well as non-fluent speech and upper
extremity weakness. Please feel free to contact my office
with any questions or if I can be of further assistance.
14, 2015, plaintiff was seen by consultative examiner Dr.
K.P. Ramchandani who examined plaintiff for 30 minutes and
then prepared a report. Ex. 4F. Set forth below are two
screenshots from the report, which summarize some of the key
PHYSICAL EXAMINATION: Reveals him to be alert, obese, in no
acute physical distress. Pulse: 84/min. Rhythm: regular.
Resp: 12min. BP: 110/70. Height: 69". Weight: 268
pounds. His gait is normal, unassisted. He is able to walk on
heels and toes. He is able to squat and get up without
support. He is able to get on and off the examination table
without assistance. He is able to dress and undress without
assistance. He is right-handed. Grip is 4/5 on the right and
5/5 on the left. He is able to make a fist, pick up objects,
open and close the door, oppose the thumb to fingers and flip
CNS EXAMINATION: Speech is slightly slurred and searching for
words. He is able to recall current and past presidents. He
knew the meaning of don't cry over spilled milk and the
grass is greener on the other side offence. He is able to do
serial seven's. He is alert, oriented to time, place and
person. He is well dressed and answers questions
appropriately with proper eye contact. His ability to relate
is normal. From observation claimant is capable of handling
funds in his own interest. Cranial nerves are intact. He is
able to hear and understand conversational voice without
difficulty. Motor system: Power is 5/5 in the lower
extremities and left upper extremity. Power at the right
shoulder is 3, at the right elbow 4/5 and at the right
wrist 4/5, no wasting. Tone is slightly increased in the
right upper extremity. Reflexes are brisk on the right, and
2 on the left. Plantars equivocal bilaterally. Sensory
system: No. deficit to touch and pin prick in all four
27, 2015, Dr. Lenore Gonzalez, a state agency physician, made
a residual functional capacity (“RFC”)
assessment. See Exs. 3A, 4A. Dr. Gonzalez reviewed
both Dr. Ramchandani's report, as well as Dr.
Mueller-Kronast's treatment notes and opinion letter. Dr.
Gonzalez opined that plaintiff could occasionally lift or
carry 20 pounds, could frequently lift or carry 10 pounds,
and could sit, walk, or stand six hours in an eight-hour day.
On November 30, 2015, Dr. Dimitri Teague, another agency
doctor, reached the same conclusions. Exs. 7A, 8A.
March 29, 2016, plaintiff established care with FHN Family
Healthcare Center. At the initial visit with a nurse
practitioner, plaintiff explained that he was seeking a DOT
physical and stated that most of his problems with his right
side were “gone” and that he did not have any
deficits other than a few issues with his left eye. R. 403.